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1.
Arch Esp Urol ; 74(2): 215-223, 2021 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-33650536

RESUMO

OBJECTIVE: To evaluate the efficacy of hyperbaric oxygen therapy (HBOT) in the treatment of hemorrhagic radiation cystitis (HRC). MATERIAL AND METHOD: Retrospective study of patients diagnosed with hematuria secondary to HRC after pelvic radiation from January 2005 to January 2017 who were treated with HBOT. Demographic and clinical variables were collected. A descriptive univariate and multivariate statistical analysis using Cox regression was carried out. The treatment was considered effective when there was a total or partial remission of the hematuria based on the Radiation Therapy Oncology Group (RTOG) scoring schema. Partial remission was defined as the presence of hematuria grade 2 or less. RESULTS: A total of 67 patients with a mean age of 68,6 years (39-87) were included. 65,7% men and 34,3% women. The RT was administered in 64,2% of the cases by urological cause, prostate cancer. The av-erage dose of RT was 75,24 Gy (45-180). The mean from the RT to the HBOT treatment was 55,97 months (4-300) and from the beginning of the hematuria until the treatment was 11,3 months (1-48). Response was observed in 51 (76,1%) patients, total in 50,7% and partial in 25,4% of cases. Patients with a degree of hematuria less than 3, those who were administered more than 30 sessions and those who did not require transfusion or hospital admission, responded significantly bet-ter to treatment with HBOT (p<0.05) according to the univariate and multivariate analysis. No adverse effects related to treatment were reported, only one patient was excluded due to claustrophobia. CONCLUSIONS: Hyperbaric oxygen therapy is an effective and safe treatment for the management of hematuria due to radiological cystitis secondary to radiotherapy. A better response was observed in patients with a lower degree of hematuria and those who could be administered a greater number of sessions.


OBJETIVO: Evaluación la eficacia de la oxigenoterapia hiperbárica (OHB) en el tratamiento de la cistitis rádica hemorrágica (CRH) postradioterapia.MATERIAL Y MÉTODO: Estudio retrospectivo que incluyó a los pacientes diagnosticados de hematuria secundaria a CRH postradioterapia pélvica desde enero de 2005 hasta enero del 2017 tratados con OHB. Se recogieron variables demográficas y clínicas. Se efec-tuó un análisis estadístico descriptivo, univariante y multivariante mediante regresión de Cox. El tratamiento se consideró eficaz cuando se produjo una remisión total o parcial de la hematuria en base a la escala del Grupo Oncológico de Radioterapia (RTOG). La respuesta parcial se definió como la presencia de hematuria grado 2 o menor tras el tratamiento. RESULTADOS: Se recogieron un total de 67 pacientes con una edad media de 68,6 años (39-87). Un 65,7% hombres y 34,3% mujeres. La RT fue administrada en el 64,2% de los casos por causa urológica, la más frecuente fue el cáncer de próstata. La dosis media de RT fue 75,24 Gy (45- 180). La media desde la RT hasta el tratamiento con OHB fue de 55,97 meses (4-300) y desde el inicio de la hematuria hasta el tratamiento de 11,3 meses (1-48). Se observó algún tipo de respuesta en 51 (76,1%) pacientes, siendo una respuesta total en el 50,7% y parcial en el 25,4% de los casos. Los pacientes con un grado de hematuria menor a 3, aquellos que recibieron más de 30 sesiones, y aquellos que no precisaron transfusión ni ingreso hospitalario, respondieron significativamente mejor al tratamiento (p<0,05), según el análisis univariante y multivariante. No fueron reportados efectos adversos relacionados con el tratamiento, solo un paciente fue excluido por claustrofobia. CONCLUSIONES: La terapia con OHB es una tratamiento efectivo y seguro para el manejo de la hematuria por CRH secundaria a radioterapia. Se observó una mejor respuesta en los pacientes con un menor grado de hematuria, en aquellos que recibieron mayor número de sesiones y que no precisaron transfusión ni ingreso hospitalario.


Assuntos
Cistite , Oxigenoterapia Hiperbárica , Lesões por Radiação , Adulto , Idoso , Idoso de 80 Anos ou mais , Cistite/etiologia , Cistite/terapia , Feminino , Hematúria/etiologia , Hematúria/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Lesões por Radiação/complicações , Lesões por Radiação/terapia , Estudos Retrospectivos
2.
Arch. esp. urol. (Ed. impr.) ; 74(2): 215-223, mar. 2021. ilu, tab
Artigo em Espanhol | IBECS | ID: ibc-202661

RESUMO

OBJETIVO: Evaluación la eficacia de la oxigenoterapia hiperbárica (OHB) en el tratamiento de la cistitis rádica hemorrágica (CRH) postradioterapia. MATERIAL Y MÉTODO: Estudio retrospectivo que incluyó a los pacientes diagnosticados de hematuria secundaria a CRH postradioterapia pélvica desde enero de 2005 hasta enero del 2017 tratados con OHB. Se recogieron variables demográficas y clínicas. Se efec-tuó un análisis estadístico descriptivo, univariante y multivariante mediante regresión de Cox. El tratamiento se consideró eficaz cuando se produjo una remisión total o parcial de la hematuria en base a la escala del Grupo Oncológico de Radioterapia (RTOG). La respuesta parcial se definió como la presencia de hematuria grado 2 o menor tras el tratamiento. RESULTADOS: Se recogieron un total de 67 pacientes con una edad media de 68,6 años (39-87). Un 65,7% hombres y 34,3% mujeres. La RT fue administrada en el 64,2% de los casos por causa urológica, la más frecuente fue el cáncer de próstata. La dosis media de RT fue 75,24 Gy (45- 180). La media desde la RT hasta el tratamiento con OHB fue de 55,97 meses (4-300) y desde el inicio de la hematuria hasta el tratamiento de 11,3 meses (1-48). Se observó algún tipo de respuesta en 51 (76,1%) pacientes, siendo una respuesta total en el 50,7% y parcial en el 25,4% de los casos. Los pacientes con un grado de hematuria menor a 3, aquellos que recibieron más de 30 sesiones, y aquellos que no precisaron transfusión ni ingreso hospitalario, respondieron significativamente mejor al tratamiento (p < 0,05), según el análisis univariante y multivariante. No fueron reportados efectos adversos relacionados con el tratamiento, solo un paciente fue excluido por claustrofobia. CONCLUSIONES: La terapia con OHB es una tratamiento efectivo y seguro para el manejo de la hematuria por CRH secundaria a radioterapia. Se observó una mejor respuesta en los pacientes con un menor grado de hematuria, en aquellos que recibieron mayor número de sesiones y que no precisaron transfusión ni ingreso hospitalario


OBJECTIVE: To evaluate the efficacy of hyperbaric oxygen therapy (HBOT) in the treatment of hemorrhagic radiation cystitis (HRC). MATERIAL AND METHOD: Retrospective study of patients diagnosed with hematuria secondary to HRC after pelvic radiation from January 2005 to January 2017 who were treated with HBOT. Demographic and clinical variables were collected. A descriptive univariate and multivariate statistical analysis using Cox regression was carried out. The treatment was considered effective when there was a total or partial remission of the hematuria based on the Radiation Therapy Oncology Group (RTOG) scoring schema. Partial remission was defined as the presence of hematuria grade 2 or less. RESULTS: A total of 67 patients with a mean age of 68,6 years (39-87) were included. 65,7% men and 34,3% women. The RT was administered in 64,2% of the cases by urological cause, prostate cancer. The average dose of RT was 75,24 Gy (45-180). The mean from the RT to the HBOT treatment was 55,97 months (4-300) and from the beginning of the hematuria until the treatment was 11,3 months (1-48). Response was observed in 51 (76,1%) patients, total in 50,7% and partial in 25,4% of cases. Patients with a degree of hematuria less than 3, those who were administered more than 30 sessions and those who did not require transfusion or hospital admission, responded significantly better to treatment with HBOT (p < 0.05) according to the univariate and multivariate analysis. No adverse effects related to treatment were reported, only one patient was excluded due to claustrophobia. CONCLUSIONS: Hyperbaric oxygen therapy is an effective and safe treatment for the management of hematuria due to radiological cystitis secondary to radiotherapy. A better response was observed in patients with a lower degree of hematuria and those who could be administered a greater number of sessions


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Oxigenoterapia Hiperbárica/métodos , Cistite/terapia , Hematúria/terapia , Lesões por Radiação/terapia , Estudos Retrospectivos , Cistite/etiologia , Gradação de Tumores , Fatores de Tempo , Resultado do Tratamento
5.
Cir Cir ; 85(4): 356-360, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-27320646

RESUMO

BACKGROUND: Intramuscular myxoma is a rare benign soft tissue tumour of mesenchymal origin, which appears as a painless mass of slow growth. Early diagnosis is important in order to differentiate it from other entities, especially soft tissue sarcoma. CLINICAL CASES: Two cases, both women with a mean age of 52.5 years (range 40-65) are presented. The first was seen due to growth of a gluteal mass, and the second by coccydynia. Computed tomography and nuclear magnetic resonance were the diagnostic tests of choice. In one case, where there was a single but large lesion, radical extirpation of the gluteal muscle was chosen. In the other case, in which the lesions were multiple, individualised excision of cysts was performed. Postoperative functional limitation was low in both types of surgery, with good oncological results being obtained. CONCLUSION: Intramuscular myxomas are benign lesions. There are no cases of malignancy or recurrence due to incomplete resection. It has to be determined whether they are single or multiple, since in the latter case, they could be due to syndromes such as Mazabraud syndrome, which is associated with bone fibrous dysplasia, or Albright syndrome that is also associated with pigmented skin spots.


Assuntos
Neoplasias Musculares/diagnóstico , Neoplasias Musculares/cirurgia , Mixoma/diagnóstico , Mixoma/cirurgia , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos
6.
Urol Int ; 90(4): 411-6, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23485788

RESUMO

INTRODUCTION: Interstitial cystitis (IC)/painful bladder syndrome (PBS) is a difficult disease to manage and creates critical limitations in patients' daily lives. Our objective was to determine the efficacy of hyperbaric oxygen (HBO) therapy in the maintenance of response after the administration of intravesical dimethyl sulfoxide (DMSO). MATERIALS AND METHODS: We conducted an open, prospective, randomized, comparative pilot study with women diagnosed with IC/PBS according to the European Society for the Study of Interstitial Cystitis criteria. In the first phase, DMSO was given to all patients. In the second phase, we used 1:1 randomization and administered HBO to 10 women. The evaluated variables were pain (through a visual analog scale), frequency and urgency of voids, nocturia, and quality of life using the O'Leary-Sant Interstitial Cystitis Score/Problem Index and the King's Health Questionnaire. In the second phase, we measured the length of time that clinical improvement was maintained. RESULTS: The mean age was 47.6 years (SD 18.4). Out of 20 patients, 14 experienced clinical improvement after DMSO in all of the evaluated symptoms (p < 0.05; 95% CI). After the second phase, all patients who received HBO had a more substantive and prolonged maintenance of the effects of DMSO. CONCLUSIONS: In this study, HBO improved the maintenance of the beneficial effects of DMSO among women with IC/PBS.


Assuntos
Cistite Intersticial/terapia , Dimetil Sulfóxido/uso terapêutico , Oxigenoterapia Hiperbárica , Administração Intravesical , Adulto , Idoso , Cistite Intersticial/diagnóstico , Cistite Intersticial/fisiopatologia , Dimetil Sulfóxido/administração & dosagem , Feminino , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Análise Multivariada , Medição da Dor , Projetos Piloto , Estudos Prospectivos , Qualidade de Vida , Fatores de Tempo , Resultado do Tratamento , Micção/efeitos dos fármacos
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