Risk factors of urethral diverticula in male patients with spinal cord injury.

STUDY DESIGN: A case-control study in a series of 55 males with urethral diverticula (UD) and their correspondent control, matched by age and time of radiological assessments. OBJECTIVES: To evaluate the risk factors to develop UD in males with spinal cord injury (SCI) and the place in the urethra where they are, most commonly, allocated. SETTING: Toledo, Spain. METHODS: Clinical histories and urodynamic studies, of all patients, were reviewed. The study was completed with a telephone survey according to an established protocol. RESULTS: The univariate analysis study showed the following risk factors: the age of onset of the spinal injury, the sphincterotomy procedure, personal history of lower urinary tract infections (LUTIs) and the chronic need of either indwelling catheter (IC) or the external condom drainage (ECD). Regarding the location of the UD, we have found the stress urinary incontinence as the only risk factor to develop UD in the prostatic urethra.On the other hand, we can conclude that the sphincterotomy, the ECD, the personal history of LUTIs and the detrusor external sphincter dyssynergia seem to be risk factors to develop diverticula in the bulbo-membranous urethra. Finally, we could point out the IC as the only risk factor for penile UD. Multivariate analysis showed that all of these risk factors were independent among them except the age of the onset of the injury and the ECD for UD in the bulbo-membranous urethra. CONCLUSION: According to our study, there is evidence of some specific risk factors for the development of UD in male patients with SCI, and therefore we should adopt the appropriate preventive measures to prevent them.

Mejoría de la calidad de vida en mujeres con incontinencia tras el tratamiento rehabilitador. ¿Existe relación entre el ICIQ-SF y el pad test? / improvement of quality of life in females suffering from urinary incontinence with rehabilitation treatment. The relationship between ICIQ-SF and pad-test?

Introducción. Los objetivos de este trabajo son: 1) Conocer las características en las pacientes con incontinencia urinaria (IU) derivadas a una Unidad de Suelo Pélvico; 2) Analizar si existe relación entre los datos objetivos y subjetivos de IU medidos con el pad test y el cuestionario International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) respectivamente, y 3) Valorar si existe mejoría en la calidad de vida con el tratamiento rehabilitador. Material y métodos. Se realiza un estudio retrospectivo de junio de 2008 a diciembre de 2010, recogiendo diferentes variables (demográficas, tipo de IU, antecedentes quirúrgicos y obstétricos, índice de masa corporal, objetividad de la IU (pad test), tipo de tratamiento rehabilitador pautado y calidad de vida (cuestionario ICIQ-SF) valorada en la primera consulta y al alta de tratamiento. Resultados. Se obtiene una muestra de 145 mujeres con una edad media de 51 años, de las cuales el 51% presentan IU de esfuerzo y 38,6% de IU mixta. El 86,2% tienen antecedentes de dos o más partos. El 70,3% presentan sobrepeso u obesidad. Las pacientes con mayores pérdidas de orina según el pad test, obtienen mayor puntuación en el ICIQ-SF. La puntuación global del ICIQ mejoraba tras tratamiento rehabilitador. Conclusiones. El perfil de paciente es el de una mujer de 50 años con sobrepeso, que ha tenido dos o más partos y presenta una IU de esfuerzo. Existe una relación positiva entre los datos objetivos de IU (pad test) y los subjetivos (ICIQ-SF). La calidad de vida de las pacientes mejora con el tratamiento rehabilitador (AU)

Introduction. Objectives are: 1) To determine the characteristics of women suffering from UI who have been referred to the Pelvic Floor Unit; 2) Analysis of whether a relationship exists between objective UI results measured with the pad test and subjective UI results measured with International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) test; and 3) To assess whether there is an improvement in quality of life with rehab treatment. Materials and methods. A retrospective study was conducted between june 2008 and december 2010, collecting the following variables: demography, type of UI, previous surgical and obstetrics history, body fat percentage, objectivity of the UI, type of treatment arranged and quality of life before and after treatment. Results. A total of 145 female patients, with a mean age 51 years, of whom 51% had UI due to stress, 38.6% with a mixed UI. The large majority (86.2%) had given birth on 2 or more occasions. Obesity or overweight was observed in 70.3%. Patients with more loss of urine had a higher score on ICIQ-SF, according to the pad test. The overall ICIQ-SF score improved after rehab treatment. Conclusion. The profile is an overweight 50-year-old woman, who has given birth on 2 or more occasions, presenting with a stress UI. There is a positive relationship between the objective results of UI (pad test) and the subjective results (ICIQ-SF). The patient quality of life improved after rehab treatment (AU)

[Inverted urothelial papilloma: our clinical experience]. / Papiloma invertido urotelial: nuestra experiencia clínica.

UNLABELLED: A study of inverted urothelial papilloma in our area. METHODS: A study was conducted of inverted urothelial papillomas diagnosed at our center from January 1994 to December 2007. This was a retrospective and prospective study with a descriptive statistical analysis: urological history, reason for consultation, diagnostic methods, tumor focality, follow-up method, prognosis, and recurrence. SPSS software version 13 was used for statistical analysis. RESULTS: Fourteen inverted papillomas were diagnosed in the study period in patients with a median age of 59 years. The presenting complaint was hematuria in 7 patients (50%), followed by low back pain in 2 patients (14.28%), and irritative syndrome in 1 patient (7.14%). The tumor was incidentally diagnosed in 4 patients (28.5%). A single relapse/recurrence occurred in a low-grade tumor during the follow-up period. CONCLUSIONS: Prognosis, recurrence, and malignant potential of this tumor are unclear, and controversy exists in the literature on this subject. Thus, although we think this is a benign tumor, we advise follow-up as if it were a low-grade urothelial tumor.

Papiloma invertido urotelial: nuestra experiencia clínica / Inverted urothelial papilloma: Our clinical experience

Estudio de los papilomas invertidos uroteliales en nuestra área. Material y métodos: Realizamos un estudio de los papilomas invertidos uroteliales diagnosticados en nuestro centro entre enero de 1994 y diciembre de 2007. Se realizó un estudio retrospectivo y prospectivo con análisis estadístico descriptivo: antecedentes urológicos, motivo de consulta, método diagnóstico, focalidad tumoral, método de seguimiento, pronóstico y recurrencia. Se realizó un estudio estadístico con el software SPSS versión 13. Resultados: En el período de estudio se han diagnosticado 14 papilomas invertidos, con una mediana de 59 años. El motivo de consulta fue hematuria en 7 enfermos (50%), seguido de dolor lumbar en 2 enfermos (14,28%) y de síndrome irritativo en 1 enfermo (7,14%), fue diagnosticado en 4 enfermos (28,5%) de manera incidental. Durante el período de seguimiento sólo se produjo una recidiva/recurrencia en un tumor de bajo grado. Conclusiones: El pronóstico, la recurrencia y el potencial de malignización de este tumor no están claros, existiendo controversias en la literatura médica mundial, hecho por el cual aunque desde nuestro punto de vista su naturaleza es benigna, aconsejamos un seguimiento como si se tratase de un tumor urotelial de bajo grado (AU)

A study of inverted urothelial papilloma in our area. Methods: A study was conducted of inverted urothelial papillomas diagnosed at our center from January 1994 to December 2007. This was a retrospective and prospective study with a descriptive statistical analysis: urological history, reason for consultation, diagnostic methods, tumor focality, follow-up method, prognosis, and recurrence. SPSS software version 13 was used for statistical analysis. Results: Fourteen inverted papillomas were diagnosed in the study period in patients with a median age of 59 years. The presenting complaint was hematuria in 7 patients (50%), followed by low back pain in 2 patients (14.28%), and irritative syndrome in 1 patient (7.14%). The tumor was incidentally diagnosed in 4 patients (28.5%). A single relapse/recurrence occurred in a low-grade tumor during the follow-up period. Conclusions: Prognosis, recurrence, and malignant potential of this tumor are unclear, and controversy exists in the literature on this subject. Thus, although we think this is a benign tumor, we advise follow-up as if it were a low-grade urothelial tumor (AU)

Fiebre de origen desconocido y líquen plano en pene / Unkown origien fever and lichen planus in penis

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Investigación en atención primaria: 1994-2003 / Research in primary care: 1994-2003

Objetivos. Conocer las características de los artículos originales publicados en la revista Atención Primaria en los últimos 10 años. Diseño. Estudio bibliométrico. Emplazamiento. Atención primaria de salud. Participantes. Artículos originales publicados en Atención Primaria entre 1994 y 2003. Mediciones principales. La categoría profesional de los autores, si se trataba de un estudio multidisciplinario y si era multicéntrico, la comunidad autónoma de procedencia, el tema, el tipo de estudio y si constaba alguna beca o ayuda. Resultados. Se han revisado 1.229 artículos. En el 40,0% figura la autoría de un médico de familia. El 31,4% se puede considerar multidisciplinario y el 20,5% multicéntrico. Las comunidades valenciana, madrileña, andaluza y catalana acaparan más del 60% del volumen de publicaciones. El tema más común es el relacionado con la prestación y organización de los servicios sanitarios (40,5%). Sólo un 4,3% de los diseños es experimental. En el 16,2% de los artículos consta alguna beca o ayuda. Conclusiones. Aunque la situación respecto a años anteriores no ha variado demasiado, algunos hallazgos positivos, como la emergencia de grupos de investigadores, la presencia cada vez mayor de estudios multicéntricos y multidisciplinarios, el mayor acceso a fuentes de financiación, etc., sugieren que estamos en un proceso de mejora de la calidad investigadora en atención primaria

Objectives. To analyse the characteristics of the original articles published in the journal Atención Primaria (Primary Care) during the last 10 years. Design. Literature study. Setting. Primary health care. Participants. Original articles published in Atención Primaria between 1994 and 2003. Main measurements. The professional category of the authors, whether it was a multidisciplinary or multicentred study, the autonomous community of origin, the topic, the type of study, and if it had a grant or financial assistance. Results. 1229 articles have been reviewed. In 40.0% of them a family doctor is included in the authorship. 31.4% can be considered multidisciplinary and 20.5% multicentred. The Communities of Valencia, Madrid, Andalusia, and Catalonia took up 60% of the volume of publications. The most common topic is the provision and organisation of the health services (40.5%). Only 4.3% of the designs are experimental. A grant or financial aid is stated in 16.2% of the articles. Conclusions. Although the situation as regards the previous years has not varied too much, some positive findings, such as the emergence of research groups, increasing presence of multicentre and multidisciplinary studies, better access to sources of finance, etc, suggest that we are in a process of improving the quality of research in primary care