Análisis de efectividad y costes sanitarios de la inmunoprofilaxis con autovacuna MV140, vacuna MV140 y tratamiento antibiótico continuado en la prevención de las infecciones urinarias recurrentes / Effectiveness and health cost analysis between immunoprophylaxis with MV140 autovaccine, MV140 vaccine and continuous treatment with antibiotics to prevent recurrent urinary tract infections

Introducción El objetivo de este estudio fue comparar los resultados del tratamiento antibiótico continuado, la autovacuna MV140 y la vacuna bacteriana polivalente MV140 de cepas de colección en la prevención de ITU recurrentes no complicadas. Métodos Se analizaron prospectivamente 377 pacientes desde enero de 2017 hasta agosto de 2019 y se dividieron en 3 grupos según la profilaxis administrada. Grupo A (126): tratamiento antibiótico, Grupo B (126), autovacuna MV140; Grupo C (125), vacuna bacteriana polivalente MV140 a partir cepas seleccionadas. Las variables analizadas fueron: sexo, edad, menopausia, número de episodios de ITU al inicio y a los 3 y 6 meses de finalizar la profilaxis, costes sanitarios a lo largo del seguimiento a los 3 y 6 meses. Resultados A los 3 meses, los episodios de ITU se redujeron a 0-1 en el 65% del grupo A, en el 80,8% del grupo B y en el 81,7% del grupo C. A los 6 meses, se presentaron 0-1 episodios de ITU en el 44,4% del grupo A, en el 61,6% del grupo B y en el 74,6% del grupo C. En cuanto a los costes sanitarios a lo largo del seguimiento, a los 3 meses el grupo A registró 21.171,87 euros, el grupo B 20.763,73 euros y el grupo C 18.866,14 euros. A los 6 meses, los costes sanitarios fueron de 32.980,35 euros en el grupo A, de 28.133,42 euros en el grupo B y de 23.629,19 euros en el grupo C. Conclusiones La autovacuna MV140 y la vacuna bacteriana polivalente MV140 fueron más eficaces reduciendo el número de episodios de ITU a los 3 y 6 meses y con unos costes sanitarios menores durante el seguimiento, en comparación con la profilaxis antibiótica continuada (p < 0,05). La vacuna bacteriana polivalente MV140 de cepas seleccionadas fue más eficaz en la reducción del número de episodios de ITU con unos costes sanitarios menores que la autovacuna (AU)

Introduction The objective of this study was to compare the results on prevention of uncomplicated recurrent UTI between continuous use of antibiotics, MV140 autovaccine and MV140 polybacterial vaccine from collection strain. Methods 377 patients were prospectively analyzed from January 2017 to August 2019 and divided into 3 groups according to the prophylaxis. Group A (126): antibiotics, Group B (126): MV140 autovaccine, Group C (125): MV140 polybacterial vaccine from the collection strain. Variables analyzed were: gender, age, menopause, number of UTI at baseline and 3 and 6 months after the end of prophylaxis, health cost along follow-up at 3 and 6 months. Results At 3 months, group A had 0-1 UTI in 65%, group B had 0-1 UTI in 80.8% and group C in 81.7%. At 6 months, group A had 0-1 UTI in 44.4%, group B had 0-1 UTI in 61.6% and group C in 74.6%. Regarding health cost along follow-up, at 3 months group A had €21,171.87, group B had €20,763.73 and group C €18,866.14. At 6 months, health cost was €32,980.35 in group A, €28,133.42 in group B, and €23,629.19 in group C. Conclusions MV140 autovaccine and MV140 polybacterial vaccine were more efficient with lower number of UTI at 3 and 6 months and lower health cost along follow-up compared to continued prophylaxis with antibiotics (p < .05). Polybacterial MV140 vaccine from collection strain had higher effect to reduce the number of UTI and less health cost than autovaccine (AU)

Effectiveness and health cost analysis between immunoprophylaxis with MV140 autovaccine, MV140 vaccine and continuous treatment with antibiotics to prevent recurrent urinary tract infections.

INTRODUCTION: The objective of this study was to compare the results on prevention of uncomplicated recurrent UTI between continuous use of antibiotics, MV140 autovaccine and MV140 polybacterial vaccine from collection strain. METHODS: 377 patients were prospectively analyzed from January 2017 to August 2019 and divided into 3 groups according to the prophylaxis. Group A (126): antibiotics, Group B (126): MV140 autovaccine, Group C (125): MV140 polybacterial vaccine from the collection strain. Variables analyzed were: gender, age, menopause, number of UTI at baseline and 3 and 6 months after the end of prophylaxis, health cost along follow-up at 3 and 6 months. RESULTS: At 3 months, group A had 0-1 UTI in 65%, group B had 0-1 UTI in 80.8% and group C in 81.7%. At 6 months, group A had 0-1 UTI in 44.4%, group B had 0-1 UTI in 61.6% and group C in 74.6%. Regarding health cost along follow-up, at 3 months group A had euro21,171.87, group B had euro20,763.73 and group C euro18,866.14. At 6 months, health cost was euro32,980.35 in group A, euro28,133.42 in group B, and euro23,629.19 in group C. CONCLUSIONS: MV140 autovaccine and MV140 polybacterial vaccine were more efficient with lower number of UTI at 3 and 6 months and lower health cost along follow-up compared to continued prophylaxis with antibiotics (p < 0.05). Polybacterial MV140 vaccine from collection strain had higher effect to reduce the number of UTI and less health cost than autovaccine.

[Renal hydatidic cyst simulating hypernephroma]. / Quiste hidatídico renal simulando hipernefroma.

OBJECTIVE: To present a new case of hydatid cyst of the kidney with a difficult radiographic diagnosis. MATERIAL AND METHODS: We describe the clinical, diagnosis and treatment of a complex renal mass and its histological confirmation after surgery. Review of the literature. CONCLUSIONS: kidney's hydatidose is an unusual placement of this pathology. It is important to take care in the differential diagnosis in the context of complexes renal masses. There are some diagnosis procedures which can help us to establish it. Surgery is the treatment of choice in the majority of the cases.

Quiste hidatídico renal simulando hipernefroma / Renal hydatidic cyst simulating hypernephroma

Objetivo: Presentar un nuevo caso de quiste hidatídico renal de diagnóstico iconográfico complejo. Material Y Métodos: Se describe la clínica, diagnóstico y tratamiento de una masa renal compleja y posterior confirmación histológica tras la exéresis de la misma. Revisión de la literatura. Conclusiones: la hidatidosis renal es una localización infrecuente de esta patología. Es importante tenerla en cuenta a la hora del diagnóstico diferencial en el contexto de masas renales complejas. Existen procedimientos diagnósticos que nos pueden ayudar a confirmarla ante su sospecha. La cirugía es el tratamiento de elección en la mayoría de los casos (AU)

Objective: To present a new case of hydatid cyst of the kidney with a difficult radiographic diagnosis. Material And Methods: We describe the clinical, diagnosis and treatment of a complex renal mass and its histological confirmation after surgery. Review of the literature. Conclusions: kidney´s hydatidose is an unusual placement of this pathology. It is important to takecare in the differential diagnosis in the context of complexes renal masses. There are some diagnosis procedures which can help us to establish it. Surgery is the treatment of choice in the majority of the cases (AU)

[Von Hippel-Lindau disease: atypical presentation]. / Enfermedad de von Hippel-Lindau: una presentación atípica.

OBJECTIVE: To describe an atypical presentation of von Hippel-Lindau disease. MATERIAL AND METHODS: We present the clinical, diagnostic and treatment of the urological signs of this disease, which has overcoat a neurological management, in a young man with familiar history of it. CONCLUSIONS: The basic knowledge of the von Hippel-Lindau disease is important for the urologist because the urological signs of it, are common and they make up one of the most important causes of morbility and mortality.

[Inflammatory pseudotumor of the urinary bladder]. / Pseudotumor inflamatorio vesical.

OBJECTIVE: To present a new case of inflammatory pseudotumor of the urinary bladder. MATERIAL AND METHODS: We describe the clinical, diagnostic and treatment of a new case of inflammatory pseudotumor of the urinary bladder in a 22 years old man without urological history. CONCLUSIONS: The inflammatory pseudotumor of the bladder is a rare benign lesion of unknown etiology. The most important histopathological differential diagnosis to consider is the rabdomyosarcoma. The immunohistochemistry study is basic in the diagnostic, characterization and differentiation of both pathologies. His benign development force us to a conservative management always it is possible.

Enfermedad de Von Hippel-Lindau: una presentación atípica / Von Hippel-Lindau disease: an atypical presentation

OBJETIVO: Describir una presentación atípica de la enfermedad de von Hippel-Lindau. MATERIAL Y MÉTODO: Presentamos la clínica, diagnóstico y tratamiento de las manifestaciones urológicas de esta enfermedad, de índole mayormente neurológica, en un varón joven con antecedentes familiares de la misma. CONCLUSIONES: Es importante para el urólogo el conocimiento básico de la enfermedad de von Hippel-Lindau porque las manifestaciones genitourinarias de ella son frecuentes, y constituyen una de las causas predominantes de morbi-mortalidad (AU)

Pseudotumor inflamatorio vesical / Inflammatory pseudotumor of the urinary bladder

OBJETIVO: Presentar un nuevo caso de pseudotumor inflamatorio vesical. MATERIAL Y MÉTODOS: Se describe la clínica, diagnóstico y tratamiento de un caso de pseudotumor inflamatorio de localización vesical en un varón de 22 años sin antecedentes urológicos de interés. CONCLUSIONES: El pseudotumor inflamatorio es una lesión benigna poco frecuente y de etiología desconocida. El principal diagnóstico diferencial morfológico es el rabdomiosarcoma vesical. El estudio inmunohistoquímico es fundamental en el diagnóstico, caracterización y diferenciación de ambas patologías. Su carácter benigno obliga a un tratamiento conservador siempre que sea posible (AU)