RESUMO
OBJECTIVES: To study the incidence and characteristic of the bilateral tumours of testicle. MATERIAL AND METHODS: It was carried out a retrospective study on a database of testiculars tumours 98 tried in our service among the years 1979 and 2004. RESULTS: We registered 4 cases of bilateral tumours (4,1%) in the series. The interval of appearance of the second tumor oscillated between 14 months and 4 and a half years (being the medium of 47 months). In three cases the initial tumour was an embryonic Carcinoma and in one a tumour of Lydia. In two cases the second tumour was of the same type histological (embryonic Ca and tumour of Leydig), while in the other two cases of embryonic Ca, the second tumour was a seminoma and a teratocarcinoma. Regarding the histology of the first tumour, it was observed that only 3 of the 27 embryonic Ca (11%) of our series, they experienced a second neoplasia in front of 1 of the 2 tumours of Leydig (50%). CONCLUSIONS: The incidence of bilateral tumours in our series was of 4,1%. In our series the risk of the second tumour seems to be higher in patients with Leyding tumours, therefore the lesser number of tumours do not allow us to know significantly conclusions.
Assuntos
Neoplasias Testiculares/patologia , Adulto , Humanos , Masculino , Estudos RetrospectivosRESUMO
OBJECTIVES: To study the characteristics and evolution of the epidermoid penis tumours. MATERIAL AND METHODS: It was carried out a retrospective study on the epidermoid penis tumours treated in our center between 1981 and 2005. RESULTS: 16 tumours penis epidermoides were diagnosed. The average age of the patients was of 71.7 years (interval between 54 and 90 years). In 80% of the cases they are diagnosed in advanced stadiums (T3 and T4). The most habitual presentation forms are the ulcerous lesions (53%) and papilar (33%). The average diameter of the lesion was 2.3 cm, and the most frequent localization the glands (53%) and balano prepucial (33%). They were carried out 7 local scissions, 8 partial penectomies, one total penectomy, and an local scission pluslocal treatment with 5-fluoracile. With a follow-up of 24 months 5 relapses took place, mainly in patients subjected to local excision of the lesion (p = 0.06 log-rank test). CONCLUSIONS: The epidermoid carcinoma of the penis is a tumoral lesion characteristic of advanced ages that is diagnosed later and treated in not very aggressive way. Therefore it is frequent the advanced stadiums and the tumour relapses.
Assuntos
Carcinoma de Células Escamosas , Neoplasias Penianas , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Neoplasias Penianas/patologia , Neoplasias Penianas/cirurgia , Estudos RetrospectivosRESUMO
INTRODUCTION: The Bladder neck cerclage diminishes the risk of bleeding after transvesical prostatectomy, but it increases the risk of suffering postoperative bladder neck sclerosis. Our objective is to value the effectiveness and therapeutic security of the temporary bladder neck cerclage after transvesical prostatectomy. MATERIAL AND METHODS: It was carried out a prospective and longitudinal study in a cohort of 25 age patients mean age 68,5 years (standard deviation, 2,6 years), subjected to transvesical prostatectomy (Freyer) with bladder neck cerclage using polipropilene number 1 suture, that was retired at the 24 hours of the surgery. To value the hemostatic utility of bladder neck cerclage, it was measured the hematocrit and hemoglobin concentration at the 24 hours of the intervention. To evaluate the appearance of obstructive sequels, the maximum urinary flow was measured three months after the surgery. RESULTS: It was observed a mean hematocrit at the 24 hours of surgery of 7,3%, and a mean decrease of the hemoglobin at the 24 hours of the surgery of 2,7 gr/dl. In any cases the postoperative hemoglobin concentration was inferior to 8 mg/dl, therefore, it was not necessary transfusion. The uroflowmetry carried out at 3 months of surgery showed that 24 of the 25 intervened patients presented a maximum flow superior to 15 ml/sg. CONCLUSIONS: The temporary bladder neck cerclage is a good hemostatic technique. The precocious cercalge retreat avoids the late sequels (bladder neck sclerosos), that originates the permanent cerclage.
Assuntos
Prostatectomia/métodos , Bexiga Urinária/cirurgia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Cuidados Pós-Operatórios/métodos , Estudos ProspectivosRESUMO
INTRODUCTION: The Extracorporeal shock waves lithotripsy (ESWL) is fundamental in the treatment of lithiasis. However, there are evidences that it can produce renal damage. The objective of our study is to determine the degree of affectation of the glomerular and tubular function after ESWL, and the influence of the lithiasis location on the type of renal damage. MATERIAL AND METHODS: A prospective longitudinal study was carried out in 14 patients with normal renal function subjected to ESWL. We determined the basal level, and the levels at the 24 hours, at the 4th and the 10th day post ESWL of: microalbuminuria (MA) (that values the glomerular function), and N-acetyl glucosamide (NAG) and alanine aminopeptidase (AAP), (that value the tubular function). RESULTS: The basal levels of of MA, NAG and AAP didn't show significant differences in connection with the localization of the stones. A significant increase was observed of the three parameters only 24 hours post ESWL. No significant differences were observed between the variation of the microalbuminuria levels, AAP and NAG and the treatment in relation to the localization of the stones. CONCLUSIONS: It exists a glomerular and tubular damage after ESWL. This damage is not related with the pelvic or calicial location of the stones. In patient with previous normal renal function, the renal damage recovers at the 4th day post ESWL.
Assuntos
Albuminúria/etiologia , Litotripsia/efeitos adversos , Cálculos Urinários/terapia , Adulto , Idoso , Feminino , Humanos , Rim/patologia , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
OBJECTIVES: The testicular tumors are frequent in the young adult, coinciding with the incorporation to the Military Service. The objective of our work is to evaluate the tumoral characteristic, its evolution with the time and the result of the treatments used in our center for this type of tumors. MATERIAL AND METHODS: We carried out a retrospective longitudinal study in a cohort of 98 patients with an average age of 28.6 years, subjected to orchiectomy for testicular tumor in our center between 1979 to 2004. In the study, we collected data referred to the age of the patients, the tumoral characteristic, the outcome of the treatment and the evolution of the tumor. RESULTS: In 61% of the cases, the affected testicle was the right (significant differences). The most common histologyc type was the non seminomatous germ cell tumors (NSGCT) (65.3%). Followed by the pure seminomas (27.6%), and non germinal cell tumors (NGC) (7.1%). The NSGCT was diagnosed to a average age (23.2 years) significantly smaller that the other two types. The stage I was the most frequent (58%). The seminomas presented a stage I in a significantly bigger frequency (80%) that the others tumors. The data picked up during the 25 years didn't show a significant variation regarding the tumoral characteristic. The survival análisis indicated that the tumoral characteristic with better pronostic regarding the probability of tumoral recurrences were the seminomas and the tumoral stages I and II. CONCLUSIONS: The non seminomatous germ cell tumors (NSGCT) are the most frequent testicular tumors in young adults. Most of the tumors are diagnosed in initial stages, and their pronostic is better in the case of the seminomas and in the stages I and II.
Assuntos
Neoplasias Testiculares/patologia , Adulto , Hospitais Militares/estatística & dados numéricos , Humanos , Masculino , Estudos Retrospectivos , Análise de Sobrevida , Neoplasias Testiculares/mortalidade , Neoplasias Testiculares/cirurgiaRESUMO
Herein we present the case of a patient who went to the emergency department complaining of haematuria. With a conservative management, the radiologic and endoscopic studies show a bladder tumour and an incidental left renal mass. After several radical procedures, the last a cystoprostatectomy, it was shown that the patient had a new tumour inside his prostate gland. We comment the surgical procedures, the clinical evolution and the five years follow-up. We review the few cases described in the literature.
Assuntos
Carcinoma de Células de Transição/diagnóstico , Neoplasias Renais/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias da Bexiga Urinária/diagnóstico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To identify a potential relationship between two variables, risk of metastasis and use of imaging techniques, in an extension study in prostate cancer patients diagnosed in the Autonomous Community of Madrid in 2000. MATERIAL AND METHODS: 1,127 patients with available data on the tumour extension study were analysed. Performance and non performance of bone scans and CTs were correlated to risk variables for developing metastasis as described in the literature (PSA, Gleason and stage) and to therapy administered. RESULTS: The proportion of patients with risk variables for metastasis when bone scans were performed was between 7% to 14% greater than in patients with no variables. No differences were seen for CTs based on risk variables. With matching risk variables, more imaging techniques were used in patients receiving radiotherapy that in those managed with prostatectomy. CONCLUSION: Based on current recommendations imaging techniques were used in excess in the extension study in patients with no risk variables for metastasis. Conduct of a further study in the Autonomous Community seems advisable to confirm the likelihood of implementing such recommendations considering our prevalence of metastatic disease.
Assuntos
Adenocarcinoma/secundário , Neoplasias Ósseas/secundário , Neoplasias da Próstata/epidemiologia , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/epidemiologia , Adenocarcinoma/radioterapia , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico/sangue , Prostatectomia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/radioterapia , Neoplasias da Próstata/cirurgia , Cintilografia , Fatores de Risco , Espanha/epidemiologia , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To know the therapeutic options used in patients diagnosed with prostate cancer in the Autonomous Community of Madrid in 2000. MATERIAL AND METHODS: The study was conducted on 1,745 patients referred by hospitals taking part in the study. Data on treatment used was available for 1,104 (63%) patients. Treatment modality was correlated to clinical stage and patient age. RESULTS: Most frequent choice was hormone therapy (35%) followed by radical prostatectomy (34%) and radiotherapy (25%). Prostatectomy was most commonly used in patients with localised (42.3%) disease while hormone therapy was preferred for locally advanced (45.6%) or disseminated (94%) disease. There are significant differences in therapeutic indications between the various Health areas participating in the survey. Median age of patients with localised and locally advanced disease was lower in patients managed with prostatectomy (65 and 64 years, respectively) than in those managed with radiotherapy (70 and 69 years, respectively). CONCLUSION: The therapeutic modality indicated by urologists in the Madrid Autonomous Community for managing patients with prostate cancer generally meets with literature recommendations.
Assuntos
Adenocarcinoma/terapia , Neoplasias da Próstata/terapia , Adenocarcinoma/epidemiologia , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Hormonais/uso terapêutico , Terapia Combinada , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prostatectomia/estatística & dados numéricos , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/patologia , Radioterapia/estatística & dados numéricos , Estudos Retrospectivos , Espanha/epidemiologiaRESUMO
OBJECTIVE: To know the incidence in the year 2000 of prostate cancer in the Autonomous Community of Madrid and its breakdown by Health Areas. MATERIAL AND METHOD: Study of histologically confirmed prostate cancer case reports and retrospective data acquisition for 2000 in the Autonomous Community of Madrid, both from Public and Private Health Care hospitals. RESULTS: Gross incidence of prostate cancer in the Autonomous Community of Madrid was 100.4 cases per 100,000 males. The incidence adjusted for the Spanish, European and Worldwide population was 120.1, 103.5 and 68.6 cases per 100,000 males, respectively. Mean age at diagnosis was 70 +/- 7.8 (40-94) years, median of 70 years. The age group with higher incidence was 70 to 79 years. CONCLUSIONS: The incidence of prostate cancer in the Autonomous Community of Madrid is lower than that in the US but higher than in most countries or regions in the EU. The different way of using PSA testing in the Health Areas of the Autonomous Community may explain the differences seen in terms of incidence by Area.
Assuntos
Neoplasias da Próstata/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Estudos Retrospectivos , Espanha/epidemiologiaRESUMO
OBJECTIVE: To know the presentation form, diagnostic method and clinical stage at the time of diagnosis in subjects with prostate cancer (PC) in the Autonomous Community of Madrid in 2000. MATERIAL AND METHOD: Data from 1745 patients with histologically confirmed prostate cancer obtained from 15 Hospitals participating in the study was analysed. The variables studied were: associated disease, reason for visiting the hospital, digital rectal examination (DRE), PSA, diagnostic method, graded Gleason score, tests performed in the tumoral extension study and tumour staging. The qualitative variables are given in percentages of the overall number and the quantitative variables are expressed as the median, standard deviation, maximum and minimum values and 25%, 50% (median) and 75% percentiles. RESULTS: 67% cases had an associated disease. In most (75%) patients the reason for visiting the hospital was prostatic syndrome. DRE revealed that 42.7% has no tumour. At the time of diagnosis half the patients had PSA levels lower than or equal to 11 ng/ml. Transrectal ultrasound-guided biopsy was used for diagnosis in 93% subjects. The most commonly reported Gleason scores were 6 (31.3%) and 7 (28.7%). In 75% subjects the disease was considered to be clinically limited to the prostate, in 12.5% locally advanced and in 12.5% metastatic. CONCLUSIONS: Most patients came to the hospital because of symptoms not related to PC. Transrectal ultrasound-guided biopsy is confirmed as the choice technique for PC diagnosis. When a comparison is made to historical series in our Autonomous Community a pattern of earlier diagnosis can be seen.
Assuntos
Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha/métodos , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Próstata/diagnóstico por imagem , Próstata/patologia , Antígeno Prostático Específico/sangue , Estudos Retrospectivos , Espanha , UltrassonografiaRESUMO
Objetivo: Realizar una evaluación comparativa de tres tipos de sondas de lavado vesical con el fin de determinar cuál de ellas permitía un mayor flujo de entrada el líquido de lavado y de salida del líquido de la vejiga. Métodos: Se compararon tres tipos de sonda de tres vías, de un calibre 22 F, cuya principal diferencia fue el material de que estaban fabricadas: látex, silicona o polivinilo. Resultados: La sonda de polivinilo mostró una diferencia significativa tanto en el flujo de entrada como de salida del líquido de infusión respecto a los otros dos tipos de sonda (p= 0,000, ANOVA con test post hoc de Sheffe). La sonda de látex mostró además una disminución significativa del flujo de salida al inflar el balón autorretentivo. Conclusiones: La sonda de polivinilo, debido a la rigidez del material con que está fabricada, es la que un mayor flujo de lavado vesical permite (AU)
Objectives: To perform a comparative evaluation of three types of continuous bladder irrigation catheters with the aim of determining which of them allows greater irrigation solution inflow and bladder outflow. Methods: We compared three types of three-way catheters, 22F in caliber, being the material the main difference between them: latex, silicone, or polyvinyl. Results: The polyvinyl catheter showed significant differences both in inflow and outflow in comparison with the other two types of catheters (p =0,000, ANOVA test with Sheffes post hoc). Additionally, the latex catheter showed a significant outflow decrease with the insufflation of the self retentive balloon. Conclusions: The polyvinyl catheter, due to material rigidity, is the one that allows better bladder irrigation (AU)
Assuntos
Irrigação Terapêutica/instrumentação , Drenagem/instrumentação , Drenagem/métodos , Sonda de Prospecção , Análise de Variância , Materiais Biocompatíveis/uso terapêutico , Administração Intravesical , Cateteres de Demora/tendências , Cateteres de Demora , Cateterismo Urinário/métodos , Bexiga Urinária/fisiopatologia , Hematúria/complicações , Hematúria/diagnóstico , Cateterismo/instrumentação , Cateterismo Urinário/estatística & dados numéricos , Cateterismo Urinário/tendênciasRESUMO
Objetivos: Estudiar la incidencia y características de los tumores bilaterales de testículo. Material y métodos: Se realizó un estudio retrospectivo sobre una base de datos de tumores 98 testiculares tratados en nuestro servicio entre los años 1979 y 2004. Resultados. Se registraron 4 casos de tumores bilaterales (un 4,1%) en la serie. El intervalo de aparición del segundo tumor osciló entre 14 meses y 4 años y medio (siendo la mediana de 47 meses). En tres casos el tumor inicial fue un Carcinoma embrionario y en uno un tumor de Leydig. En dos casos el segundo tumor fue del mismo tipo histológico (Ca embrionario y tumor de Leydig), mientras que en los otros dos casos de Ca embrionario, el segundo tumor fue un seminoma y un teratocarcinoma. Respecto a la histología del primer tumor, se observó que sólo 3 de los 27 Ca embrionarios (11%) de nuestra serie, experimentaron una segunda neoplasia frente a 1 de los 2 tumores de Leydig (50%). Conclusiones. La incidencia de tumores bilaterales en nuestra serie fue del 4,1%, en nuestra serie el riesgo de aparición de un segundo tumor parece ser mas elevado en pacientes con tumores de Leydig aunque el pequeño número de caso no son permite extraer conclusiones significativas
Objectives: To study the incidence and characteristic of the bilateral tumours of testicle. Material and methods. It was carried out a retrospective study on a database of testiculars tumours 98 tried in our service among the years 1979 and 2004. Results. We registered 4 cases of bilateral tumours (4,1%) in the series. The interval of appearance of the second tumor oscillated between 14 months and 4 and a half years (being the medium of 47 months). In three cases the initial tumour was an embryonic Carcinoma and in one a tumour of Lydia. In two cases the second tumour was of the same type histological (embryonic Ca and tumour of Leydig), while in the other two cases of embryonic Ca, the second tumour was a seminoma and a teratocarcinoma. Regarding the histology of the first tumour, it was observed that only 3 of the 27 embryonic Ca (11%) of our series, they experienced a second neoplasia in front of 1 of the 2 tumours of Leydig (50%). Conclusions. The incidence of bilateral tumours in our series was of 4,1 %. In our series the risk of the second tumour seems to be higher in patients with Leyding tumours, therefore the lesser number of tumours do not allow us to know significantly conclusions
Assuntos
Masculino , Humanos , Germinoma/patologia , Neoplasias Testiculares/patologia , Estudos Retrospectivos , Seminoma/patologia , Teratocarcinoma/patologia , Tumor de Células de Leydig/patologia , Recidiva , Neoplasias Testiculares/epidemiologiaRESUMO
Objetivos. Estudiar las características y evolución de los tumores epidermoides de pene. Material y métodos. Se realizó un estudio retrospectivo sobre los tumores epidermoides de pene tratados en nuestro centro entre 1981 y 2005. Resultados. Se diagnosticaron 16 tumores epidermoides de pene. La edad media de los pacientes fue de 71,7 años (intervalo entre 54 y 90 años). En el 80% de los casos se diagnostican en estadios avanzados (T3 y T4). Las formas de presentación más habituales son las lesiones ulcerosas (53%) y papilares (33%), siendo el diámetro medio de la lesión de 2,3 cm, y la localización más frecuente el glande (53%) y el surco balano prepucial (33%). Se realizaron 7 escisiones locales, 8 penectomías parciales, una penectomía total, y una escisión más tratamiento local con 5-fluoracilo. Con una media de seguimiento de 24 meses se produjeron 5 recidivas, principalmente en pacientes sometidos a escisión local de la lesión (p = 0,06 test de log-rank). Conclusiones. El carcinoma epidermoide de pene es una lesión tumoral propia de edades avanzadas que se diagnostica tardíamente y se trata de manera poco agresiva, por lo que son frecuentes los estadios avanzados y las recidivas
Objetives. To study the characteristics and evolution of the epidermoid penis tumours. Material and methods. It was carried out a retrospective study on the epidermoid penis tumours treated in our center between 1981 and 2005. Results. 16 tumours penis epidermoides were diagnosed. The average age of the patients was of 71,7 years (interval between 54 and 90 years). In 80% of the cases they are diagnosed in advanced stadiums (T3 and T4). The most habitual presentation forms are the ulcerous lesions (53%) and papilar (33%). The average diameter of the lesion was 2,3 cm, and the most frequent localization the glands (53%) and balano prepucial (33%). They were carried out 7 local scissions, 8 partial penectomies, onetotal penectomy, and an local scission pluslocal treatment with 5-fluoracile. With a followup of 24 months 5 relapses took place, mainly in patients subjected to local excision of the lesion (p = 0,06 log-rank test). Conclusions. The epidermoid carcinoma of the penis is a tumoral lesion characteristic of advanced ages that is diagnosed later and treated in not very aggressive way. Therefore it is frequent the advanced stadiums and the tumour relapses
Assuntos
Masculino , Humanos , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Penianas/epidemiologia , Estudos Retrospectivos , Recidiva Local de Neoplasia/epidemiologiaRESUMO
Introducción: El cerclaje del cuello vesical disminuye el riesgo de sangrado tras adenomectomía prostática, pero aumenta el riesgo de padecer esclerosis cervical postoperatoria. Nuestro objetivo es valorar la eficacia y seguridad terapéutica del cerclaje temporal del cuello vesical tras adenomectomía prostática. Material y métodos: Se realizó un estudio longitudinal perspectivo en una cohorte de 25 pacientes de edad media 68,5 años (desviación típica, 2,6 años), sometidos adenomectomía prostática transvesical tipo Freyer con cerclaje cervical temporal utilizando polipropileno del número 1 que se retiró a las 24 horas de la cirugía. Para valorar la utilidad hemostática del cerclaje se midió el descenso del hematocrito y la concentración de hemoglobina a las 24 horas de la intervención. Para evaluar la aparición de secuelas obstructivas se midió el flujo miccional máximo a los tres meses de la cirugía. Resultados: Se observó una disminución media del valor hematocrito a las 24 horas de la cirugía del 7,3%, y una disminución media de la hemoglobina a las 24 horas de la cirugía de 2,7 gr./dl. En ninguno de los casos la concentración de hemoglobina postoperatoria fue inferior a 8 mg/dl, por lo que no se precisó transfusión. Los resultados obtenidos en la medición de la flujometría realizada a los 3 meses de esta mostró que 24 de los 25 pacientes intervenidos presentaron a los 3 meses un flujo máximo superior a 15 ml/sg. Conclusiones: El cerclaje vesical temporal es una buena técnica hemostática. La retirada precoz del cerclaje evita las secuelas tardías (esclerosis de cuello vesical) que origina el cerclaje permanente
Introduction: The Bladder neck cerclage diminishes the risk of bledding after transvesical prostatectomy, but it increases the risk of suffering postoperative bladder neck sclerosis. Our objective is to value the effectiveness and therapeutic security of the temporary bladder neck cerclage after transvesical prostaectomy. Material and methods: It was carried out a prospective and longitudinal study in a cohort of 25 age patients mean age 68,5 years (standard deviation, 2,6 years), subjected to transvesical prostatectomy (Freyer) with bladder neck cerclage using polipropilene number 1 suture, that was retired at the 24 hours of the surgery. To value the hemostatic utility of bladder neck cerclage, it was measured the hematocrit and hemoglobin concetration at the 24 hours of the intervention. To evaluate the appearance of obstructive sequels, the maximun urinary flow was measured three months after the surgery. Results: It was observed a mean hematocrit at the 24 hours of surgery of 7,3%, and a mean decrease of the hemoglobin at the 24 hours of the surgery of 2,7 gr/ dl. In any cases the postoperative hemoglobin concentration was inferior to 8 mg/dl, therefore, it was not necessary transfusion. The uroflowmetry carried out at 3 months of surgery showed that 24 of the 25 intervened patients presented a maximum flow superior to 15 ml/sg. Conclusions: The temporary bladder neck cerclage is a good hemostatic technique. The precocious cercalge retreat avoids the late sequels (bladder neck sclerosos), that originates the permanent cerclage
Assuntos
Masculino , Idoso , Humanos , Hiperplasia Prostática/cirurgia , Cerclagem Cervical/métodos , Prostatectomia/métodos , Estudos Prospectivos , Complicações Pós-Operatórias/epidemiologia , HemostasiaRESUMO
Introducción: La litroticia por ondas de choque (LEOC) es fundamental en el tratamiento de las litiasis. Sin embargo, existen evidencias de que puede producir daño renal. El objetivo de nuestro estudio es determinar el grado de afectación de la función glomerular y tubular tras LEOC, y si influye la localización litiásica en el tipo de daño renal. Material y métodos. Se realizó un estudio longitudinal prospectivo en 14 pacientes con función renal normal sometidos a LEOC. Se determinó el nivel basal, y a las 24 horas, al 4º y al 10º día post LEOC, de microalbuminuria (MA) (que valora la función glomerular), y de N-acetil glucosamida (NAG) y la alanina aminopeptidasa (AAP) (que valoran la función tubular).Resultados: Los niveles de basales de MA, NAG y AAP no mostraron diferencias significativas en relación con la localización de los cálculos. Se observó un aumento significativo de los tres parámetros sólo a las 24 horas post LEOC. No se observaron diferencias significativas en la variación de los niveles de microalbuminuria, AAP y NAG con el tratamiento en relación a la localización de los cálculos. Conclusiones: Existe un daño glomerular y tubular tras LEO. Este daño es independiente de la localización pélvica ocalicial del cálculo. En pacientes con función renal normal previa, el daño renal se recupera al 4º día post LEOC (AU)
Introduction: The Extracorporeal shock waves lithotripsy (ESWL) is fundamental in the treatment of lithiasis. However, there are evidences that it can produce renal damage. The objective of our study is to determine the degree of affectation of the glomerular and tubular function after LEOC, and the influence of the lithiasis location on the type of renal damage. Material and methods: A prospective longitudinal study was carried out in 14 patients with normal renal function subjected to ESWL. We determined the basal level, and the levels at the 24 hours, at the 4th and the 10th day post ESWL of: microalbuminuria (MA) (that values the glomerular function), and N-acetil glucosamide (NAG) and alanine aminopeptidase (AAP), (that value the tubular function). Results: The basal levels of of MA, NAG and AAP didnt show significant differences in connection with the localization of the stones. A significant increase was observed of the three parameters only 24 hours post ESWL No significant differences were observed between the variation of the microalbuminuria levels, AAP and NAG and the treatment in relation to the localization of the stones. Conclusions: It exists a glomerular and tubular damage after ESWL. This damage is not related with the pelvic or calicial location of the stones. In patient with previous normal renal function, the renal damage recovers at the 4º day post ESWL (AU)
Assuntos
Masculino , Feminino , Adulto , Idoso , Pessoa de Meia-Idade , Humanos , Litotripsia/efeitos adversos , Glomérulos Renais/lesões , Túbulos Renais/lesões , Cálculos Renais/cirurgia , Estudos Longitudinais , Estudos Prospectivos , Cálculos Renais/complicações , Testes de Função RenalRESUMO
Objetivos: Las neoplasias testiculares son frecuentes en el adulto joven, coincidiendo con la incorporación al Servicio Militar. El objetivo de nuestro trabajo es evaluar las características tumores, su evolución con el tiempo y el resultado de los tratamientos empleados en nuestro centro para este tipo de tumores. Material y métodos: Se realizó un estudio longitudinal retrospectivo en una cohorte de 98 pacientes de edad media 28,6 años, sometidos a orquiectomía por neoplasia testicular en nuestro centro entre los años 1979 a 2004. En el estudio se recogieron los datos referentes a la edad de los pacientes, las características tumorales, el tratamiento realizado y la evolución de la neoplasia. Resultados: En un 61% de los casos, el testículo afectado fue el derecho (diferencias significativas). El tipo histológico más común fueron los tumores germinales no seminomatosos (TGNS) (65,3%) de los casos seguidos de los seminomas puros (27,6%), y de tumores no germinales (TNG) (7,1%). Los TGNS se diagnosticaron a una edad media (23,2 años) significativamente menor que los otros dos tipos. El estadio I fue el más frecuente (58%). Los seminomas presentaron un estadio I con una mayor frecuencia significativamente mayor (80%) que el resto de los tumores. Los datos recogidos durante los 25 años no mostraron una variación significativa respecto a las características tumorales. El análisis de supervivencia indicó que las características tumorales con mejor pronóstico respecto a la probabilidad de recurrencias tumorales fueron los seminomas y los estadios tumorales I y II. Conclusiones: Los tumores germinales no seminomatosos (TGNS) son los más frecuentes en adultos jóvenes. La mayoría de los tumores se diagnostican en estadios iniciales, y su pronóstico es más favorable en el caso de los seminomas y los estadios I y II (AU)
Objetives: The testicular tumors are frequent in the young adult, coinciding with the incorporation to the Military Service. The objective of our work is to evaluate the tumoral characteristic, its evolution with the time and the result of the treatments used in our center for this type of tumors. Material and methods: We carried out a retrospective longitudinal study in a cohort of 98 patients with an average age of 28,6 years, subjected to orchiectomy for testicular tumor in our center between 1979 to 2004. In the study, we collected data referred to the age of the patients, the tumoral characteristic, the outcome of the treatment and the evolution of the tumor. Results: In 61% of the cases, the affected testicle was the right (significant differences). The most common histologyc type was the non seminomatous germ cell tumors (NSGCT) (65,3%). Followed by the pure seminomas (27,6%), and non germinal cell tumors (NGC) (7,1%). The NSGCT was diagnosed to a average age (23,2 years) significantly smaller that the other two types. The stage I was the most frequent (58%). The seminomas presented a stage I in a significantly bigger frequency (80%) that the others tumors. The data picked up during the 25 years didnt show a significant variation regarding the tumoral characteristic. The survival análisis indicated that the tumoral characteristic with better pronostic regarding the probability of tumoral recurrences were the seminomas and the tumoral stages I and II. Conclusions: The non seminomatous germ cell tumors (NSGCT) are the most frequent testicular tumors in young adults. Most of the tumors are diagnosed in initial stages, and their pronostic is better in the case of the seminomas and in the stages I and II (AU)
Assuntos
Masculino , Adulto , Humanos , Orquiectomia/estatística & dados numéricos , Neoplasias Testiculares/epidemiologia , Estudos Retrospectivos , Militares , Seminoma/epidemiologia , Germinoma/epidemiologia , Prognóstico , Sobrevivência , Estadiamento de NeoplasiasRESUMO
Teniendo en cuenta que la dilatación de la uretra es una de las técnicas utilizadas para resolver su estenosis , queríamos comprobarsu repercusión en pacientes con esta patología, y, además , valorar si había o no diferencias de resultados con el uso de dos diferentesmodelos de dilatadores, utilizando siempre unas técnicas cuidadosas. Llegamos a la conclusión de una tendencia ascendente enmedidas de calibración y flujos y decreciente en los residuos (AU)
Taking into account that the dilatation of the urethra is one of the techniques used to solve its stenosis, we wanted to check its repercussionon patients with this pathology, and, besides, to value if there was or not differences of results with the use of two differentmodels of expanders, always using some careful techniques. We arrive to the conclusion of an increasing trend in measurements ofcalibration and flows and decreasing in the waste (AU)
Assuntos
Humanos , Estreitamento Uretral/cirurgia , Cateterismo Urinário/métodos , Dilatação/métodos , Cuidados de Enfermagem/métodos , Cateterismo/métodos , Dilatação/instrumentaçãoRESUMO
OBJETIVO: Conocer la incidencia del cáncer de próstata en la Comunidad de Madrid y en sus distintas Áreas Sanitarias en el año 2000.MATERIAL Y MÉTODO: Estudio de casos incidentes con confirmación histológica de cáncer de próstata y con recogida de datos retrospectiva en la Comunidad de Madrid durante el año 2000, tanto en la Sanidad Pública como en la Privada. RESULTADOS: La incidencia bruta del cáncer de próstata en la Comunidad de Madrid fue de 100,4 casos por 100.000 hombres. La incidencia ajustada a la población española, europea y mundial fue de 120,1, 103,5 y 68,6 casos por 100.000 hombres respectivamente. La edad media al diagnóstico fue de 70 ñ 7,8 (40-94) años con una mediana de 70 años. El tramo etario con una incidencia más elevada se situó entre los 70 y los 79 años. CONCLUSIONES: La incidencia del cáncer de próstata en la Comunidad de Madrid es más baja que en USA, pero más elevada que en la inmensa mayoría de los países o regiones de Europa. El diferente uso del PSA en las distintas Áreas Sanitarias de la Comunidad podría justificar las diferencias observadas en la incidencia por Área (AU)
Assuntos
Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Idoso , Adulto , Masculino , Humanos , Espanha , Incidência , Distribuição por Idade , Antígeno Prostático Específico , Estudos Retrospectivos , Neoplasias da PróstataRESUMO
OBJETIVO: Conocer la forma de presentación, el método diagnóstico utilizado y el estadio clínico en el momento del diagnóstico de los sujetos diagnosticados de cáncer de próstata en la Comunidad de Madrid en el año 2000.MATERIAL Y MÉTODOS: Se analizaron los datos de los 1.745 pacientes con diagnóstico histológico de cáncer de próstata remitidos por los 15 Hospitales que colaboraron en el estudio. Las variables analizadas fueron: patología asociada, motivo de consulta, tacto rectal, PSA, método de diagnóstico, score de Gleson agrupándose en grados de diferenciación, pruebas realizadas en el estudio de extensión tumoral y clasificación tumoral. Las variables cualitativas se expresaron en porcentajes del total de las mismas. Las variables cuantitativas se expresaron mediante la media, la desviación típica, los valores máximo y mínimo y los percentiles 25 por ciento, 50 por ciento (mediana) y 75 por ciento. RESULTADOS: El 67 por ciento presentaron patología asociada. La mayoría (75 por ciento) de los pacientes consultó por síndrome prostático. El 42,7 por ciento presentaban al tacto rectal una glándula no sospechosa de tumor. La mitad de los pacientes en el momento del diagnóstico presentaron un PSA igual o menor a 11 ng/ml. El 93 por ciento de los sujetos fueron diagnosticados mediante biopsia transrectal ecodirigida. Los score más frecuentemente informados fueron el 6 (31,3 por ciento) y el 7 (28,7 por ciento). El 75 por ciento se consideraron clínicamente como enfermedad localizada a la próstata, el 12,5 por ciento como enfermedad localmente avanzada y el otro 12,5 por ciento como enfermedad metastásica. CONCLUSIONES: La mayoría de los pacientes consultaron por síntomas no relacionados con el CP. La biopsia transrectal ecodirigida se confirma como la técnica de elección para el diagnóstico del CP. Al comparar con series históricas de nuestra Comunidad se observa una anticipación diagnóstica (AU)