Factores pronósticos en cáncer renal localizado y localmente avanzado / Prognostic factors in localised and regionally advanced renal cell carcinoma

En los últimos 10 años se han identificado diversos factores que confieren efecto pronóstico en el cáncer renal. El estadio patológico, el grado nuclear e histológico, son los más frecuentemente estudiados y los más importantes en este momento. Evaluamos esos factores y agregamos otras variables, en un intento por encontrar nuevos parámetros que pudieran ser de utilidad. Se incluyeron para el presente estudio 96 casos de cáncer de células renales no metastásico. Encontramos como se menciona por otros autores que el estadio patológico y de Furhman son los factores pronósticos más fuertes, pero la presencia de tumor palpable, dolor o pérdida de peso también tuvieron significancia estadística (AU)

In the last 10 years, several factors have been identified to confer a prognostic effect on renal cancer outcome. Pathologic stage, nuclear and histologic grade are the most frecuent studied and the most important at this moment. We evaluated those factors and introduced some others, looking for new parameters that could be useful. 96 cases of non methastatic renal cell cancer were included in our study. We found that as was mentioned by other authors pathologic and Furhman stage are the stronger prognostic factors but the presence of palpable tumor, pain and weight lost had significance too (AU)

[Encrusted prostatitis: case report and literature review]. / Prostatitis incrustante: caso clínico y revisión de la bibliografía.

We report a case of encrusted prostatitis, term which is not found in MedLine search. Alkaline encrusted cystitis was described 70 years ago and few cases have been described since that time, most of them associated with Corynebacterium infection. In fact, we find these two entities very similar, except for the organ affected. Both present irritative urinary symptoms, alkaline urine and tisular necrosis below a calcification layer. Another entity described in 1993 is encrusted pyelitis, related to patients with immunodeficiency, particularly those with renal transplantation and also associated with ureolytic bacteria. The treatment of encrusted cystitis an pyelitis may include specific antibiotics, urinary acidification and endoscopic excision of the calcified lesions.

Prostatitis incrustante: caso clínico y revisión de la bibliografía / Encrusted prostatitis: case report and literature review

Presentamos un caso clínico de prostatitis incrustante, término que no se encuentra en la búsqueda hecha en MedLine. La cistitis alcalina incrustante se describió hace 70 años y son pocos los casos descritos desde entonces, la mayoría de ellos asociados a infección por Corynebacterium1 . De hecho, consideramos que estas dos entidades son muy similares, excepto en lo que se refiere al órgano afectado. Ambas presentan síntomas urinarios causantes de irritación, orina alcalina y necrosis tisular por debajo de una capa de calcificación. Otra entidad descrita en 1993 es la pielitis incrustante, relacionada con pacientes con inmunodeficiencia, especialmente los receptores de trasplante renal y también asociada a bacterias ureolíticas. El tratamiento de la cistitis y la pielitis incrustantes puede incluir antibióticos específicos, acidificación urinaria y escisión endoscópica de las lesiones calcificadas

We report a case of encrusted prostatitis, term which is not found in MedLine search. Alkaline encrusted cystitis was described 70 years ago and few cases have been described since that time, most of them associated with Corynebacterium infection1 In fact, we find these two entities very similar, except for the organ affected. Both present irritative urinary symptoms, alkaline urine and tisular necrosis below a calcification layer. Another entity described in 1993 is encrusted pyelitis, related to patients with immunodeficiency, particularly those with renal transplantation and also associated with ureolytic bacteria. The treatment of encrusted cystitis an pyelitis may include specific antibiotics, urinary acidification and endoscopic excision of the calcified lesions

[Mechanism of acute urinary retention in patients with giant bladder diverticulum. Report of 4 cases]. / Mecanismo de la retención urinaria aguda en pacientes con divertículo vesical gigante. A propósito de 4 casos.

Urinary retention due to bladder diverticulum is a rare clinical entity. We report Three males that were subjected to transurethral resection of prostate due benign hyperplasia with urinary retention, after removal of the catheter during postoperative period, requiring a new catheterization, and an adolescent woman with history of urinary infection that presented urinary retention four previous months to her first interview in the service. The later investigation demonstrated in all patients a big bladder diverticulum. The diverticulectomy reestablished the satisfactory bladder emptying in all patients. The origin of the bladder diverticula, the mechanism of the urinary retention without obstruction and its treatment is discussed.

[Assessment of effectiveness of and tolerance to oxybutynin in the treatment of unstable bladder in women]. / Evaluación de la efectividad y tolerancia de la oxibutinina en el tratamiento de la vejiga inestable en la mujer.

Unstable bladder is a frequent syndrome in women and is due in the most part because of detrusor involuntary contractions, mainly due to detrusor denervation, which produces voiding hypersensitivity and loss of cortical inhibition control, clinical manifestations are: frequency, nicturia, urgency and urge incontinence. Historically the most effective treatment has been muscular relaxing agents and anticholinergic agents. We present a prospective, double blind, cross, placebo control study to evaluate efficacy and tolerance of oxybutynin in women with unstable bladder. We included 44 adult women with unstable bladder, 22 unitially received oxybutynin 5 mg t.i.d. and 22 placebo 5 mg t.i.d. aleatory in both groups through 6 weeks, later wash-out period was performed and those women in which initially received oxybutynin were administered placebo and those women in which initially received placebo, were administered oxybutynin, for another six weeks. Five patients which initiated the study with oxybutynin abandoned the study, 2 of them for intolerance and 3 for unknown causes. Two women in which initially received placebo abandoned follow-up too. A total of 74 subjects (37 for each branch of study) had an age average of 51.7. Symptoms scoring decreased from 13 to 11 and 6 points with placebo and oxybutynin respectively (p = 0.001). The analog visual scale of symptoms decreased from 77% to 62.5% and 40% with placebo and oxybutynin respectively (p = 0.003). The overall rate of improvement evaluated through symptoms scoring was from 27% with placebo and 72.9% with oxybutynin (p = 0.000) and evaluated through analog visual scale of symptoms was from 40% with placebo and 78.3% with oxybutynin (p = 0.002). The vesical volume at first voiding sensation increased from 129 ml to 134 ml and 187 ml with placebo and oxybutynin respectively (p = 0.021) and the maximum cystometric capacity increased from 231 ml to 236 ml and 301 ml with placebo and oxybutynin respectively. The most frequent adverse effect in both groups was mouth dryness and it presented in 7 (19%) and 34 (91%) patients with placebo and oxybutynin respectively (p = 0.000). Only 5 of 44 patients (11.3%) with oxybutynin and 2 of 44 patients (4.4%) with placebo abandoned follow up (p = 0.14). We concluded that oxybutynin improve significantly the unstable bladder symptoms in women, possibly by increasing functional bladder capacity and decreasing voiding sensitivity, with good tolerance of mouth dryness in the majority of patients.