Consecuencias de la fractura de pene: complicaciones y resultados funcionales a largo plazo / Consequences of penile fracture: Complications and long-term functional outcomes

Introducción La fractura de pene (FP) es una urgencia urológica con baja incidencia, por lo que existe poca evidencia de los resultados a largo plazo. Este estudio se centra en las complicaciones postoperatorias y los resultados funcionales a largo plazo en pacientes que han sufrido una FP reparada quirúrgicamente en nuestro centro.Materiales y métodos Los registros clínicos de pacientes sometidos a cirugía urgente por FP en un hospital de tercer nivel entre 2006 y 2020 se revisaron retrospectivamente. Los resultados funcionales se evaluaron con visitas telefónicas voluntarias desde junio del 2020 a febrero del 2021. Se realizó un cribado de sintomatología del tracto urinario inferior mediante el cuestionario IPSS, de función sexual mediante el EHS y el IIEF-5, y de alteraciones morfológicas mediante pregunta directa a los pacientes.ResultadosCuarenta y un pacientes fueron sometidos a cirugía por FP; 11 de ellos además asociaron lesión uretral (mayor incidencia si había lesión de ambos cuerpos cavernosos, 19,4 vs. 80%, p<0,05). Solo un paciente presentó una complicación Clavien-Dindo tipo 3a por dehiscencia de la herida, 4 (13%) tipo 2 y 9 (29%) tipo 1. Realizaron seguimiento a largo plazo 24 pacientes, de los cuales 20 (83,3%) presentaban una función sexual normal. Doce (50%) presentaban un nódulo palpable en la zona de la fractura, 8 (33,3%) curvatura peneana de nueva aparición y un paciente con lesión uretral previa presentó estenosis de uretra.Conclusión En la fractura de pene, hay más incidencia de lesión uretral si se afectan ambos cuerpos cavernosos. Las secuelas funcionales a largo plazo tras la reparación quirúrgica de una FP son poco frecuentes (AU)

Introduction Penile fracture (PF) is a urological emergency with low incidence, and evidence of its long-term outcomes is scarce. This study focuses on postoperative complications and long-term functional outcomes in patients with PF and surgical repair at our center.Materials and method Clinical records of patients undergoing urgent surgery for PF at a third level hospital between 2006 and 2020 were retrospectively reviewed. Functional outcomes were assessed with voluntary telephone interviews from June 2020 to February 2021. Lower urinary tract symptoms were screened by IPSS questionnaire, sexual function by EHS and IIEF-5, and morphological alterations by direct questions to patients.ResultsA total of 41 patients underwent surgery for PF. Eleven of them also had urethral injury (higher incidence if there was bilateral corpora cavernosa injury, 19.4 vs. 80%, P<.05). Only one patient presented a Clavien-Dindo type 3a complication due to wound dehiscence, 4 (13%) type 2 and 9 (29%) type 1. Twenty-four patients underwent long-term follow-up, of whom 20 (83.3%) presented normal sexual function. Twelve patients (50%) had a palpable nodule at the fracture site, 8 (33.3%) had new onset penile curvature and one patient with previous urethral injury presented urethral stricture.Conclusion In cases of penile fracture, there is a higher incidence of urethral injury if both corpora cavernosa are affected. Long-term functional sequelae after surgical repair of a PF are rare (AU)

Consequences of penile fracture: Complications and long-term functional outcomes.

INTRODUCTION: Penile fracture (PF) is a urological emergency with low incidence, and evidence of its long-term outcomes is scarce. This study focuses on postoperative complications and long-term functional outcomes in patients with PF and surgical repair at our center. MATERIALS AND METHOD: Clinical records of patients undergoing urgent surgery for PF at a third level hospital between 2006 and 2020 were retrospectively reviewed. Functional outcomes were assessed with voluntary telephone interviews from June 2020 to February 2021. Lower urinary tract symptoms were screened by IPSS questionnaire, sexual function by EHS and IIEF-5 and morphological alterations by direct questions to patients. RESULTS: A total of 41 patients underwent surgery for PF. Eleven of them also had urethral injury (higher incidence if there was bilateral corpora cavernosa injury, 19.4% vs. 80%, p < 0.05). Only 1 patient presented a Clavien-Dindo type 3a complication due to wound dehiscence, 4 (13%) type 2 and 9 (29%) type 1. Twenty-four patients underwent long-term follow-up, of whom 20 (83.3%) presented normal sexual function. Twelve patients (50%) had a palpable nodule at the fracture site, 8 (33.3%) had new onset penile curvature and 1 patient with previous urethral injury presented urethral stricture. CONCLUSION: In cases of penile fracture, there is a higher incidence of urethral injury if both corpora cavernosa are affected. Long-term functional sequelae after surgical repair of a PF are rare.

[Laparoscopic placement of peritoneal dialysis catheter: description and results of a two-port technique]. / Colocación de catéter de diálisis peritoneal por laparoscopia: descripción y resultados de una técnica propia de dos puertos.

AIM: To test the feasibility, efficacy and safety of a new two port laparoscopic technique for dialysis catheter placement. MATERIAL AND METHODS: From January 2006 to July 2009 51 patients underwent dialysis catheter placing using an original technique. All procedures were finished laparoscopically using two 12 mm-sized ports. Our technique bases on placing Oreopoulos-Zellerman catheter along a straight Guyon s guide with atraumatic tip, visually guaranting optimal placement. Catheter can be repositioned if desired by reentering the guide. Median follow-up was 25 months. RESULTS: Mean operating time was 32 minutes (range 15-55 minutes). One patient suffered an immediate postoperative catheter obstruction that required surgical repositioning. No other technical intra or early postoperative complications related to technique were reported. Mean time to discharge 1.02 +/- 2.2 days. Catheter outflow failure rate was 7.6%. Conversion to haemodialysis due to peritonitis 13%. Peritonitis per patient/year was 0.27. Catheter 6 mo, 1 year and 2 year survival rate was 94%, 87% and 72%. Catheter migration rate was 4%. There was no peritoneal dialysis liquid leakage. CONCLUSIONS: The two ports technique described is an easy and rapid procedure, with few complications and early discharge. Due to its reliability, offers good catheter function outcome.

Colocación de catéter de diálisis peritoneal por la paroscopia: descripción y resultados de una técnica propia de dos puertos / Laparoscopic placement of peritoneal dialysis catheter: description and results of a two-port technique

Objetivo: Estudiar la viabilidad, la eficacia y la seguridad de nuestra técnica de dos puertos de colocación de catéter de diálisis peritoneal por laparoscopia. Material y métodos: Desde enero de 2006 a julio de 2009, 51 pacientes fueron sometidos a colocación de catéter de diálisis peritone alusando una nueva técnica. Todos los procedimientos se completaron laparoscópicamente usando dos puertos de12 mm. Nuestra técnica se basa en la colocación de un catéter de tipo Oreopoulos-Zellerman sobre una guía de Guyon recta con punta a traumática, y garantiza la óptima colocación del catéter. En caso necesario, éste se puede poner de nuevo mediante la recolocación de la guía. El seguimiento medio ha sido de 25 meses. Resultados: Tiempo quirúrgico medio: 32 minutos (rango 15-55 minutos). Un paciente presentó una obstrucción del catéter en el postoperatorio inmediato, que requirió recolocación quirúrgica. No se han producido otras complicaciones técnicas durante la cirugía o el postoperatorio inmediato. Media de tiempo al alta: 1,02 ± 2,2 días. Tasa de obstrucción del catéter: 7,6%. Tasa de conversión ahemodiálisis secundaria a peritonitis: 13%. Episodios de peritonitis por paciente-año: 0,27. Supervivencia del catéter a los 6 meses, un año y 5 años: 94, 87 y 72%,respectivamente. Tasa de migración de catéter: 4%. No se han comentado casos de fístula de líquido peritoneal. Conclusiones: La técnica de dos puertos descrita es un procedimiento sencillo y rápido, con pocas complicaciones y alta hospitalaria inmediata. Debido a su fiabilidad, ofrece buenos resultados en la función del catéter (AU)

Aim: To test the feasibility, efficacy and safety of a new two port laparoscopic technique for dialysis catheter placement. Material and methods: From January 2006to July 2009 51 patients underwent dialysis catheter placing using an original technique. Al l procedures were finished laparoscopically using two 12 mm-sized ports . Our technique bases on placing Oreopoulos -Zel lerman catheter along a straight Guyon´ s guide with atraumatic tip, visually guaranting optimal placement. Catheter can be repositioned if desired by reentering the guide. Median follow-up was 25 months . Results : Mean operating time was 32 minutes ( range15-55 minutes ) . One patient suffered an immediate post operative catheter obstruction that required surgical repositioning. No other technical intra or early postoperative complications related to technique were reported. Mean time to discharge 1.02 ± 2.2 days .Catheter outflow failure rate was 7.6%. Conversion to haemodialysis due to perionitis 13%. Peritonitis per patient/year was 0.27. Catheter 6 mo, 1 year and 2 year survival rate was 94%, 87% and 72%. Catheter migration rate was 4%. There was no peritoneal dialysis liquid leakage. Conclusions : The two ports technique des cribed is an easy and rapid procedure, with few complications and early discharge. Due to its reliability, offers good catheter function outcome (AU)

[Living donor kidney transplantation in pediatric recipients]. / Generalidades del trasplante renal pediátrico.

Currently, kidney transplantation is the treatment of choice in children with end stage renal disease, showing higher survivals than dialysis and proper weight-height, social and psychological-intellectual development. The indications for transplantation have been extended with time, so that today the indication for kidney transplantation is set for end stage renal disease with symptoms that cannot be eliminated by conservative treatment. In the pediatric age, mainly in children under two years, living donor kidney transplantation is specially indicated because it has longer survival than cadaver donor kidneys. Complications may appear: rejection, high blood pressure, infections, neoplasias, adverse events related to immunosuppressive drugs, and primary renal disease recurrences, besides surgical complications. Five-year results have improved over the last 5 decades, being mortality lower than 5%. Graft survival may reach 90% for living donor kidneys and 17% for cadaver donor. Factors related to graft survival include age (worse in receptors under 2 yr.), pretransplant dialysis, acute rejection, and race (better in caucasians).

[Bilobular benign retroperitoneal schwannoma]. / Schwannoma retroperitoneal benigno bilobulado.

OBJECTIVE: To describe an additional case of retroperitoneal schwannoma. METHODS: A case of retroperitoneal neoplasm in a 29-year-old woman is presented. The clinical and therapeutic aspects are discussed. RESULTS: The anatomopathological study showed a benign schwannoma. CONCLUSIONS: Retroperitoneal schwannoma is an uncommon lesion that is difficult to diagnose preoperatively. Treatment is by surgical resection.

[High incidence of chromosome 8 monosomy and chromosome 7 trisomy in prostatic primary tumor and its related lymphatic metastasis. Preliminary results]. / Alta incidencia de la monosomia del cromosoma 8 y la trisomia del cromosoma 7 en el tumor primario prostático y su metástasis ganglionar asociada. Resultados preliminares.

INTRODUCTION: The research on tumoral aggressivity parameters in prostate cancer, such DNA ploidy detected by fluorescence in situ hybridization, has significant relevance to refine prognostic on an individualized patient. OBJECTIVES: To identify chromosome numeric alterations by FISH in primary prostate cancer focus and its corresponding lymph node metastases. b) To describe a cytogenetic tumoral progression pathway. METHODS: So far, we have retrospectively studies eight patients with prostate cancer and lymph node metastases performing FISH analysis on the primary prostate cancer focus and its metastatic lymph node. DNA probes for chromosomes 7, 8, 10 and 12 have been used for FISH analysis. RESULTS: a) Seven out of eight tumours (85%) were aneuploid when studied by FISH and the most frequent chromosome alterations found were monosomy 8 (100%) and trisomy 7 (85.7%). All the lymph nodes were aneuploid being monosomy 8 (87.5%) and trisomy 7 (62.5%) the most common chromosome alterations. b) Monosomy 8 and trisomy 7 appeared to be in the same cytogenetic tumoral progression pathway. CONCLUSION: Although we report about a preliminary study, monosomy of chromosome 8 and trisomy 7 are related with poor evolution, probably because of the loss of a suppressor gene or a proto-oncogen overexpression. The presence of any of them in a prostate cancer focus is related with poor prognosis.