[Urology training in Mexico: Residents' perspective]. / Entrenamiento de urología en México: Perspectiva del residente.

OBJECTIVE: To assess and identify from the resident's perspective the current state of the urology residency training in the surgical, research, affective domain and its working future. MATERIAL AND METHODS: We performed an anonymous survey of 98 urology residents during 2014. The survey included 62 questions and assesses the surgical, the clinical research, and the affective domain, and also its working future. RESULTS: We reviewed a total of 98 surveys, average age 29 years, 92% men and 8% women. The scholarship average was 12,000-14,000 pesos. Most of them have had at least one research work in a national congress, but not in an international one. Less than 10% has published papers in PubMed, although most consider clinical research as mandatory in their urology training programs. Most residents consider their training in laparoscopy to be inadequate, but they consider the relationship between partners and teachers is adequate and most of them are satisfied with their program.

Renal Cell Carcinoma in a Pregnant Woman With Horseshoe Kidney.

To our knowledge, this is the first reported case of renal cell carcinoma in kidney horseshoe diagnosed in the second trimester of pregnancy. We performed open radical nephrectomy when the pregnancy was completed. Kidney cancer is rare during pregnancy and the symptoms can be mimic urinary infection. The diagnosis and its management can be a challenge.

The Psychological Impact of Prostate Biopsy: Anxiety and Depression Associated with a Positive Biopsy Result.

INTRODUCTION: We evaluated the psychological impact on patients caused by transrectal prostate biopsy and the emotional stress in those with a positive prostate cancer finding. METHODS: We performed a psychological evaluation of 328 men who underwent transrectal prostate biopsy using HADS (Hospital Anxiety and Depression Scale) at 3 time points. In addition we analyzed events related to the procedure, compared anxiety and depression levels in men with a negative result vs those diagnosed with prostate cancer, and evaluated anxiety and depression associated with events related to the procedure. RESULTS: Of the 328 men 99.08% completed the evaluation, including 51.2% with a biopsy positive for prostate cancer and 48.8% with a negative prostate cancer result. The group with a positive biopsy scored an average of 6.85 in the anxiety category and 3.48 for depressive symptoms with a 2.02 point difference in respect to the original evaluation (p = 0.01). Prostate cancer with prostate specific antigen greater than 20 ng/ml was associated with significant anxiety (p = 0.03). CONCLUSIONS: Biopsy positive for prostate cancer with prostate specific antigen greater than 20 ng/ml is associated with significant anxiety. However, events related to the procedure and marital status are not associated with significant anxiety.

Penile tuberculosis after intravesical bacille Calmette-Guérin immunotherapy.

Immunotherapy with bacille Calmette-Guérin (BCG) is widely used for treatment of superficial urothelial cancer. Complications associated with BCG treatment are common. The most common are minor reactions as cystitis, hematuria, fever, malaise. We report an unusual case of granulomatous balanoposthitis as a complication of intravesical BCG instillation therapy. To our knowledge, only a few reports of BCG-related penile or urethral granulomatous infection have been previously published in the literature.

Single Dose of Levofloxacin versus Three Dosages for Prophylaxis in Prostate Biopsy.

Transrectal ultrasound-guided core prostate biopsy is a key event in the diagnosis of prostate cancer, transient side events such as local pain, haematuria, haematospermia, dysuria, and rectal bleeding are reported in a large number of patients. Antimicrobial agents lower the incidence of postbiopsy infectious complications. The timing and duration of the regimen and the route of administration remain controversial. We developed a standard prophylactic regimen, in which safety and efficiency were maximized, while costs and variability were minimized. Accordingly we prospectively evaluated 425 consecutive patients, who underwent outpatient transrectal ultrasound-guided prostate biopsy after a single dose versus three doses of levofloxacin.

Abiraterone acetate and castration resistant ductal adenocarcinoma of the prostate.

Ductal adenocarcinoma of the prostate is a rare histological variant that only represents <1% of prostate tumors. This histological variant has several important clinical implications with respect to their evolution, clinical prognosis, and treatment. We report the case of a 64-year-old patient with ductal adenocarcinoma of the prostate, which progresses to castration-resistant prostate cancer, that was treated with abiraterone acetate with good clinical response, to our knowledge, the first case of ductal adenocarcinoma of the prostate in treatment with abiraterone acetate.