RESUMEN
OBJECTIVE: To valorate the existence of the variability, in surgical rates on urinary tract and masculine genital organs, between the population of Health Centres (HC) adscribed to the Hospital of Ciudad Real. It so, quantify the influence of the distance (from Health Center to Hospital) or the income have in the variability of these rates. MATERIAL AND METHOD: Surgical activity of the period 1996-98. It has been analyzed for every procedure: residence, sex, age and type (coded by CIE 9th MC). The surgical rates, standardized for age and sex, (TFQ) for every HC has been compared whit the mean (t alpha/2 n-1 alpha = 0.99) of the distribution of rates by HC. The relation between the TFQ and distance or income has been analyzed by lineal regression and ANOVA test for one variable, using the Newman Keuls test to assess the difference of the rates between the HC at different distance or income. It has been considered as significative every p < 0.05. RESULTS: The population studied has a TFQ significatively different (p < 0.01). significant relationship exists between the TFQ and the distance. There were no relations between the TFQ for HC and the income. CONCLUSIONS: 42% of the variance (variability) of the distribution of TFQ for HC is due to the distance.
Asunto(s)
Enfermedades de los Genitales Masculinos/cirugía , Enfermedades Urológicas/cirugía , Procedimientos Quirúrgicos Urológicos Masculinos/estadística & datos numéricos , Adolescente , Adulto , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Renta , Masculino , Persona de Mediana Edad , EspañaRESUMEN
OBJETIVO: Valorar la existencia de variabilidad en las tasas de frecuentación quirúrgica sobre aparato urinario y órganos genitales masculinos, entre los centros de salud adscritos al Complejo Hospitalario de Ciudad Real. Y en caso afirmativo, cuantificar la influencia que la distancia (desde el centro de salud al hospital) o la renta tiene en la variabilidad de estas tasas. MATERIAL Y MÉTODO: Actividad quirúrgica del periodo 1996-1998; discriminando según residencia, edad, sexo, o tipo de intervención realizada. La comparación de Tasas de Frecuentación Quirúrgica (TFQ) para cada grupo de procedimientos (CIE 91 MC) se ha realizado, tras ajustadas por edad y sexo, con la media poblacional (t/2 n-1 = 0,99) de la distribución de tasas por centro de salud. La relación entre la TFQ con la distancia o la renta se ha analizado mediante los modelos de regresión, Anova y prueba de Newman-Keuls. Se ha considerado como significativo todo resultado p < 0,05.RESULTADOS: Las poblaciones estudiadas presentan TFQ significativamente diferentes (p < 0,01). Existe relación significativa entre la TFQ y la distancia. No se ha encontrado esta relación entre la TFQ por centro de salud y la renta. CONCLUSIONES: El 42 por ciento de la varianza (variabilidad) de la distribución de TFQ por centro de salud es debida a la limitación que, para el acceso a este tipo de prestaciones, supone la distancia desde el centro de salud al hospital. El nivel de renta de la población no parece condicionar significativamente el uso de los servicios quirúrgicos en la población estudiada (AU)
Asunto(s)
Persona de Mediana Edad , Adolescente , Adulto , Masculino , Femenino , Humanos , España , Procedimientos Quirúrgicos Urológicos Masculinos , Enfermedades Urológicas , Renta , Accesibilidad a los Servicios de Salud , Enfermedades de los Genitales MasculinosRESUMEN
OBJECTIVE: To describe the mathematical representation of a common phenomenon: the urinary flow curve. METHODS: The statistical adjustment for minimum squares was the method employed in the study. RESULTS: A mathematical expression was obtained with a goodness of fit for each flow curve and an acceptable margin of error. CONCLUSIONS: The model which considers the flow curve as a parabola is not useful since this is an expression of a statistical phenomenon that varies from case to case. We utilized the minimum squares fit to obtain a regression curve that provides the nearest possible representation of urinary flow. Furthermore, we consider the flow curve to be the result of forces that develop in the detrusor, which produces the complex phenomenon of voiding. This study is the first step toward the development of a mathematical representation of the urinary flow mechanics.
Asunto(s)
Urodinámica , Humanos , MatemáticaRESUMEN
OBJECTIVE: The results of in situ dissolution of a cystine calculus is described. This approach was attempted in a female patient for whom surgery was not considered to be the best therapeutic option. METHODS: An obstructive cystine calculus was treated by in situ litholysis using N-acetylcysteine applied locally via two percutaneous nephrostomies and adjuvant oral metaphylaxis. The patient had a long clinical history of lithiasis that had also required surgery and a family history of cystinuria. RESULTS: In situ litholysis completely dissolved the cystine calculus and avoided the need for a complex surgery. The procedure and a pharmacological analysis are presented. CONCLUSIONS: In our view, this procedure is practical, carries minimal morbidity and should be considered in the management of cystine calculus.
Asunto(s)
Acetilcisteína/administración & dosificación , Cistina/análisis , Cálculos Renales/terapia , Adulto , Enfermedad Crónica , Terapia Combinada , Cistinuria/genética , Cistinuria/terapia , Femenino , Humanos , Cálculos Renales/química , Inducción de Remisión , Soluciones , Factores de TiempoRESUMEN
Exposition of one case of fibroepithelial polyp of the ureter in a young male patient. The interest of the case lies in the rarity of this entity. Review of all likely etiologies, clinical presentations and differential diagnosis, mainly with malignant tumours whose prognosis and treatment are entirely different. Endoscopic approach and surgical removal of the polyp and its base are the therapeutical choice for this type of neoformations.
Asunto(s)
Pólipos , Neoplasias Ureterales , Adulto , Humanos , Masculino , Pólipos/diagnóstico , Pólipos/cirugía , Neoplasias Ureterales/diagnóstico , Neoplasias Ureterales/cirugíaRESUMEN
Presentation of four patients with primary plain epidermoid carcinoma of the bladder. The patients, three men and one woman, aged 50-74 years, presented clinically with gross haematuria and irritative mictional syndrome; their background was prostatism with in-dwelling vesical catheter and repeat urinary infections. Revision of the immunohistochemical pattern and the clinico-pathological differential diagnosis, as well as the pathoetiology, biological behaviour and management of this uncommon type of tumour.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Neoplasias de la Vejiga Urinaria/diagnóstico , Anciano , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Terapia Combinada , Resultado Fatal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Vejiga Urinaria/patología , Vejiga Urinaria/cirugía , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/cirugíaRESUMEN
Although this anomaly is seen more frequently, the present case is unique in that the genital anomaly (imperforate vagina with the subsequent hematocolpos and hematometra) was associated with contralateral renal agenesis, whereas the cases reported in the literature have all been ipsilateral. Like most of the cases, the presenting symptom was acute urinary retention arising from extrinsic compression of the genital mass on the lower urinary tract. The embryological aspects of the genitourinary system concerning the present case are discussed, as well as some of the hypotheses that have been put forward to explain the etiology of these anomalies, although these have been developed on the basis of the associated ipsilateral anomalies observed.
Asunto(s)
Hematocolpos/diagnóstico , Hematómetra/diagnóstico , Riñón/anomalías , Anomalías Múltiples/diagnóstico , Enfermedad Aguda , Adolescente , Femenino , Hematocolpos/etiología , Hematocolpos/cirugía , Hematómetra/etiología , Hematómetra/cirugía , Humanos , Retención Urinaria/diagnóstico , Retención Urinaria/etiología , Retención Urinaria/cirugía , Útero/anomalías , Vagina/anomalíasRESUMEN
The spiral intraurethral prosthesis is a device that maintains the urinary tract expedite and overcomes the prostatic obstacle. It is used as an alternative in patients requiring permanent bladder catheters due to prostatic obstruction syndrome that are at high risk for surgery and in those patients that are on the waiting list for surgery. We report the results of a one-year follow-up of 13 patients in whom a prosthesis had been implanted. The spiral prosthesis had to be removed in 6 cases (one due to calcification two months after placement); the remaining 7 patients are still being followed. We briefly analyze the micturition hydrodynamics and the changes of the continence mechanisms and attempt to explain the poor flowmetry results and incontinence observed in these patients with the urological spiral prosthesis. We have recently abandoned the metal prosthesis and now use the so-called "intraureteral catheter" which has become available. However, further experience is warranted in order to determine its results.
Asunto(s)
Prótesis e Implantes , Obstrucción Uretral/terapia , Calcinosis/etiología , Estudios de Evaluación como Asunto , Estudios de Seguimiento , Hematuria/etiología , Humanos , Masculino , Hiperplasia Prostática/complicaciones , Prótesis e Implantes/efectos adversos , Obstrucción Uretral/etiología , Cateterismo Urinario , UrodinámicaRESUMEN
Endorectal sonography (ES) + fine needle aspiration biopsy (FNAB) constitute a considerable advancement in the diagnosis of prostate cancer (PC). With ES we can detect lesions less than 0.5 cm, and FNAB permits us to know its histologic nature. Both techniques complement each other and together permit accuracy and early diagnosis while other available methods do not. Cure of this tumor type, the second most frequent in men, is based on early diagnosis. Since early tumor staging is mandatory for adequate treatment, this can only be achieved if the tumor is diagnosed in the asymptomatic phase. The present study reviews the scant epidemiologic studies available reporting a prevalence of up to 30% in males over 50 years old. In our own study, our statistical data reveal a prevalence of 9.97/1000 which is no doubt lower than the true prevalence of this disease. We discuss the ultrasound features of prostate disease with a special focus on prostate cancer. Hypothetically, we compare the cost of screening or not screening for early diagnosis and conclude that this method is of the highest diagnostic value in early, correct treatment of this disease entity.
Asunto(s)
Tamizaje Masivo , Neoplasias de la Próstata/diagnóstico , Adulto , Anciano , Biopsia con Aguja , Estudios Transversales , Humanos , Masculino , Tamizaje Masivo/economía , Persona de Mediana Edad , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/epidemiología , Neoplasias de la Próstata/patología , España/epidemiología , UltrasonografíaRESUMEN
Alkaline incrusting cystitis is an uncommon clinical condition that usually presents in the course of bladder disease. It has characteristic presenting features and is difficult to treat despite currently available therapeutic measures. Three such cases that had been diagnosed and treated at our department is described herein. The literature is reviewed and the pathologic mechanisms of this condition are analyzed.