RESUMEN
INTRODUCTION: Arterioureteral fistulas are rare, life-threatening, and difficult to diagnose. Risk factors are medical interventions in the lesser pelvis (general, urological, gynecological, and vascular surgery), radiation therapy of the lesser pelvis, permanent double J catheters, and previous vessel malformations. MATERIALS AND METHODS: We retrospectively evaluated all cases of arterioureteral fistulas registered over the last 10 years in the clinic's documentation system. For all cases, clinical symptoms, diagnostics, therapies as well as clinical outcome were evaluated. RESULTS: Four of the 5 patients were women. The most common initial symptom was a gross hematuria (4/5). All patients had a permanent double J catheter after extensive surgery of the lesser pelvis. In one case the initial diagnosis was done by retrograde ureterography, in 2 patients by provocative angiography and in the other 2 cases with a laparotomy due to cardiovascular problems. Three patients were treated by open surgery and 2 patients were treated by stenting of the iliac artery. One patient died, 2 patients had a permanent kidney fistula, and 2 patients continued treatment with a permanent double J catheter. CONCLUSION: Based on the more aggressive therapy regimens, we expect that the number of patients presenting with arterioureteral fistulas will continue to rise. The identification of these patients based on their risk profile is essential.
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Hematuria/etiología , Arteria Ilíaca , Stents , Fístula Urinaria/terapia , Fístula Vascular/terapia , Anciano , Angiografía , Angioscopía , Catéteres , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Fístula Urinaria/complicaciones , Fístula Vascular/complicaciones , Procedimientos Quirúrgicos VascularesRESUMEN
There is a rise in the incidence of stone disease in the industrial nations. Due to this, the number of endurological procedures will also rise. Sometimes endourological instruments will be fragmented accidentally together with the destruction of the stone. A search for articles on this subject was performed. The aim of this article is to provide a review about the literature on this subject and how this subject can be managed today and in the future.
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Análisis de Falla de Equipo , Cálculos Renales/terapia , Litotripsia por Láser/instrumentación , Cálculos Ureterales/terapia , Diseño de Equipo , Humanos , Láseres de Estado Sólido/efectos adversos , Litotripsia por Láser/efectos adversos , Factores de Riesgo , Uréter/lesionesRESUMEN
Due to the high incidence and recurrence rate non-muscle invasive bladder cancer (NMIBC) has a relevant impact. Raman spectroscopy and optical coherence tomography represent innovative diagnostic tools. Urine markers still play a minor role in the diagnostics of NMIBC. New therapeutic options are thermochemotherapy and mitomycin-C electromotive drug administration (MMC-EMDA) as well as gemcitabine and apaziquone for intravesical administration.
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Antineoplásicos/uso terapéutico , Carcinoma de Células Transicionales/diagnóstico , Carcinoma de Células Transicionales/terapia , Hipertermia Inducida/tendencias , Tomografía de Coherencia Óptica/tendencias , Neoplasias de la Vejiga Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/terapia , Biomarcadores/orina , Carcinoma de Células Transicionales/orina , Predicción , Humanos , Músculo Liso/patología , Invasividad Neoplásica , Espectrometría Raman/métodos , Neoplasias de la Vejiga Urinaria/orinaRESUMEN
Patients with a so-called BCG failure (Bacillus Calmette-Guérin) constitute an inhomogeneous group of patients. Patients with BCG recurrence or BCG refractive tumors are real BCG failures. Therapeutic options are radical cystectomy and a conservative approach, depending on the individual risk of recurrence and progression. Intravesical chemotherapy with docetaxel or gemcitabine after BCG failure shows some promise whereas second line immunotherapy, the combination of BCG and interferon (INF)-α, is an effective regimen but results need to be confirmed. Device-assisted intravesical strategies, such as mitomycin-EMDA or chemohyperthermia are candidates to keep in mind for the near future. Finally, cystectomy results in the best disease-specific survival in patients with BCG failure.
Asunto(s)
Vacuna BCG/uso terapéutico , Cistectomía/estadística & datos numéricos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/mortalidad , Recurrencia Local de Neoplasia/mortalidad , Recurrencia Local de Neoplasia/prevención & control , Neoplasias de la Vejiga Urinaria/mortalidad , Neoplasias de la Vejiga Urinaria/prevención & control , Humanos , Análisis de Supervivencia , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
A prostatic stromal tumour of uncertain malignant potential (STUMP) is a non-epithelial, mesenchymal spindle-cell tumour that can be classified as a specialised stromal tumour of the prostate. Although in most cases STUMP is not of an aggressive nature, occasional cases have been documented with an extension into adjacent tissues or recurrence after resection. A minority of cases develop a sarcomatous dedifferentiation.We report the case of a 53-year-old male with symptoms of febrile prostatitis. After consolidation we performed TUR-P due to urinary retention. Finally, we made the pathological diagnosis of prostatic STUMP. The patient is being seen -frequently in our clinic to take prostate biopsies to exclude a progression into a stromal sarcoma (active surveillance). After 13 months the STUMP is still detectable, but with no signs of sarcoma.