RESUMEN
INTRODUCTION: The bladder cancer is an important disease by its morbi-mortality and its multifactorialidad. At the moment, between the possible aetiology agents that they have been indicated is the infection by the virus of papilloma human (VPH). The objective study is to analyse, by meta-analysis, the relationship between bladder cancer and infection by human papillomavirus. MATERIAL AND METHODS: We made a search in the electronic data base MEDLINE of the articles published until September of the 2004 that relate the infection of the VPH to the bladder tumors. Of 414 listed articles, we selected 38 articles. RESULTS: The articles were classified in two groups, according to they use or non methods based on the detection of the DNA. In articles based on the detection of the DNA, it was that the global proportion from the cases that had contact with the virus, through the detection of the genome was of the 19.4% (95% CI 0.160 to 0.228). Of the total of studies based on the detection of the DNA 8 were selected, to show to a group defined control, in which, the OR was investigated. If we combined the ORs, we obtain an OR estimation of 3.2 (95% CI 1.19 to 8.60) and p = 0.02. CONCLUSIONS: Most of these studies showed the relation rose at the beginning of the study. Although the majority lacked a group defined control, is possible to analyze the value of the Odds global ratio due to the homogenous behaviour of the studies with defined cases and controls affluent. This demonstrated to association between VPH and the bladder cancer.
Asunto(s)
Carcinoma de Células Escamosas/virología , Carcinoma de Células Transicionales/virología , Infecciones por Papillomavirus/complicaciones , Neoplasias de la Vejiga Urinaria/virología , Humanos , Infecciones por Papillomavirus/epidemiologíaRESUMEN
The iatrogenic trauma of ureter is a complication that appears according to the different series between the 0.05-30% from the abdominal or pelvic surgeries. It the same affects to both ureters, being the rare bilateral ureteral trauma. The most frequent location is in the lower ureter. Maybe this fact must to that that is the patron of ureter more related by viacinity to the structures or organs in wich surgery is made. The most frequent causes are the gynecological ones, followed of the surgery of colon and vascular surgery. The reconstruction techniques depend on the level of the injury. The maneuvers of support and the endourology treatment can be useful for the resolution of these injuries.
Asunto(s)
Uréter/lesiones , Obstrucción Ureteral/terapia , Ureteroscopía , Adulto , Cateterismo , Femenino , Humanos , Enfermedad Iatrogénica , Obstrucción Ureteral/etiologíaRESUMEN
The retroperitoneum is one of the most complex regions of human anatomy as it contains a variety organs and structures from different systems, in particular those belonging to the urinary and digestive tracts and the vascular systems. The emergence of different diagnostic imaging techniques has made easier to study the retroperitoneum. Thanks to ultrasonography, computerised tomography and magnetic resonance the assessment of retroperitoneal conditions has taken a great leap forwards permitting the anatomical connections and characteristics of the structures in this region to be reliably established. Owing to the location in the retroperitoneal space of the different organs of the digestive tract and the vascular system, a multidisciplinary approach is required involving the different surgical specialties. The urologist performs a large proportion of his surgical activity in this region and must, therefore, have a good knowledge of the different retroperitoneal organs belonging to the urinary tract and also the connections between these and other organs and structures of the retroperitoneal region.
Asunto(s)
Fibrosis Retroperitoneal , Neoplasias Retroperitoneales , Absceso Retrofaríngeo , Adulto , Anciano , Antibacterianos/uso terapéutico , Antineoplásicos/uso terapéutico , Enfermedades Autoinmunes/complicaciones , Enfermedades Autoinmunes/tratamiento farmacológico , Quimioterapia Adyuvante , Niño , Terapia Combinada , Quistes/diagnóstico , Quistes/cirugía , Diagnóstico por Imagen/métodos , Femenino , Humanos , Inmunosupresores , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Radioterapia Adyuvante , Fibrosis Retroperitoneal/diagnóstico , Fibrosis Retroperitoneal/etiología , Fibrosis Retroperitoneal/patología , Fibrosis Retroperitoneal/terapia , Neoplasias Retroperitoneales/diagnóstico , Neoplasias Retroperitoneales/epidemiología , Neoplasias Retroperitoneales/patología , Neoplasias Retroperitoneales/secundario , Neoplasias Retroperitoneales/cirugía , Espacio Retroperitoneal/patología , Espacio Retroperitoneal/cirugía , Absceso Retrofaríngeo/diagnóstico , Absceso Retrofaríngeo/terapia , Procedimientos Quirúrgicos UrológicosRESUMEN
We report two cases of patients who went to the emergency department complaining of penile strangulation due to metallic rings (Double key ring) at the base of the penis which was resolved by cutting the metallic rings. We look trough the scientific literature about this unusual pathology and its management.
Asunto(s)
Pene/lesiones , Adulto , Humanos , MasculinoRESUMEN
A case of a adenocarcinoma renal in a patient with situs inversus complete to which was associated bronchiectasis and chronic sinusitis (kartagener's syndrome) is reported. It is the third case described in the international literature of a renal cells carcinoma in a patient with situs inversus totalis and the first in patient the one which has the triada classic of the kartagener's syndrome plus sterility. The tumor was discovered in a way incidental upon accomplishing a TAC toracoabdominal and was solved through nefrectomia for lumbotomy approach.
Asunto(s)
Carcinoma de Células Renales/complicaciones , Síndrome de Kartagener/complicaciones , Neoplasias Renales/complicaciones , Situs Inversus/complicaciones , Adulto , Humanos , MasculinoRESUMEN
Malignant paratesticular tumors are uncommon. Of these, liposarcoma of the spermatic cord constitutes a rare tumor. Only a hundred cases have been reported. They are typically presented in elderly people. The usually have a good prognosis because of their low level of malignancy and their relapses tend to be localized. It has a high rate of survival over 5 years. Preoperative diagnosis is infrequent, it is suggested by the appearance of a progressively enlarging mass in the scrotum and the ultrasonography which shows a solid mass of the spermatic cord that is independent of the testicle. The choice treatment is radical orchidectomy, while long-term follow-up of these patients is mandatory because of local relapses. When local relapses become evident, the choice treatment is extensive local excision followed by adjuvant radiotherapy. In the present study we report a new case of a recurring, well differentiated spermatic cord liposarcoma of the type sclerotic, in a 50-year-old man. An exhaustive review of the literature has been made.
Asunto(s)
Neoplasias de los Genitales Masculinos/diagnóstico , Liposarcoma/diagnóstico , Cordón Espermático , Neoplasias de los Genitales Masculinos/patología , Neoplasias de los Genitales Masculinos/cirugía , Humanos , Liposarcoma/patología , Liposarcoma/cirugía , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico , Recurrencia Local de Neoplasia/radioterapia , Recurrencia Local de Neoplasia/cirugía , Orquiectomía , Radioterapia Adyuvante , Cordón Espermático/patología , Cordón Espermático/cirugía , Factores de TiempoRESUMEN
Wide ureteral injuries are unusual but not exceptional and have few conservative therapeutic options, specially those that involve the upper ureter. Autotransplantation, ureteral substitution by intestine and combined Boari bladder flap-psoas bladder hitch are basically the only chances to avoid nephrectomy. In this paper we report five cases in which ileum was used to substitute the ureter and review the most outstanding literature about this subject.
Asunto(s)
Íleon/trasplante , Uréter/lesiones , Uréter/cirugía , Enfermedades Ureterales/cirugía , Adulto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The abnormal persistence of the patent processus vaginalis determines the appearance of four types of pathology, depending on the grade and sort of communication: communicating hydrocele, hydrocele of cord, scrotal hydrocele and intrafunicular hernia. We have revised our casuistry of children with patent processus vaginalis pathology for the two last years (1995-1996), and we have found 75 communicating hydrocele cases, 5 hydrocele of cord and 16 scrotal hydrocele cases, on children between 1 month and 13 years old. The diagnostic was done after physical exploration with transillumination and inguino-scrotal ultrasound. Initially, conservative treatment was followed, which was enough for 58 patients (60.4%). In the 38 cases (39.6%) in which there were no improvement, surgical treatment via inguinal was carried out, with good results in nearly all cases. As a conclusion, we can assert that ultrasound is an excellent diagnostical method for patent processus vaginalis pathology and conservative treatment must have priority upon surgery, since a great number of spontaneous resolutions are observed, most of all on children aged less than two years old.
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Conductos Paramesonéfricos/anomalías , Cordón Espermático , Hidrocele Testicular/terapia , Adolescente , Niño , Preescolar , Quistes/etiología , Quistes/terapia , Humanos , Lactante , Masculino , Conductos Paramesonéfricos/diagnóstico por imagen , Estudios Retrospectivos , Hidrocele Testicular/diagnóstico por imagen , Hidrocele Testicular/etiología , UltrasonografíaRESUMEN
Contribution of two new cases of vesicouterine fistula secondary to a cesarean incision. In one case, diagnosis was achieved through cystography and cystoscopy, while in the second case cystography, cystoscopy and stain testing (methylene blue) were used. In both cases management was through transperitoneal and transvesical fistulorrhaphy. The two cases showed favourable post-operative evolution with no relapse.
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Fístula/diagnóstico , Fístula de la Vejiga Urinaria/diagnóstico , Enfermedades Uterinas/diagnóstico , Adulto , Femenino , Fístula/diagnóstico por imagen , Fístula/cirugía , Humanos , Radiografía , Fístula de la Vejiga Urinaria/diagnóstico por imagen , Fístula de la Vejiga Urinaria/cirugía , Enfermedades Uterinas/diagnóstico por imagen , Enfermedades Uterinas/cirugíaRESUMEN
Tumours derived from sex cords and primitive gonadal stroma account for 4% of total testicular tumours. The low frequency of Sertoli's cells tumour (SCT) and the uneven study and follow-up of patients makes analysis of this tumoral entity difficult. This paper contributes one case report of a Sertoli's giant cell tumour calcified in a 13-year old patient, and reviews the clinical aspects, clinico-pathological varieties believed to require assessment in patients with this type of disease. This type of tumour is considered benign in its biological behaviour, although some malignant forms have also been described. SCT is actually an heterogeneous tumoral pathogenic entity with regard to pathogenic and prognostic aspects. Our final conclusions show that the clinico-pathological variety, age, size and associated clinical manifestations appear to be related to the prognosis.
Asunto(s)
Tumor de Células de Sertoli/patología , Neoplasias Testiculares/patología , Adolescente , Humanos , Masculino , Pronóstico , Tumor de Células de Sertoli/clasificación , Neoplasias Testiculares/clasificaciónRESUMEN
Shock-wave extracorporeal lithotripsy (SWEL) is admittedly the choice method for most ureteral calculi (UC). Treatment of 1.674 UC was carried out with a Lithostar (Siemens). Endourologic support manoeuvres (ESM) were used in 11.7% patients. To determine their statistical influence on treatment's result variables such as site, size, calculus density, obstruction and functionality of the renal unit, as well as presence of ureteral malformation, were analyzed. With an average of 1.3 sessions (9100 waves) success rate was 91.8% cases. Only the variables of size, obstruction and function showed statistical significance, thus identifying through a multistep logistic regression test the subgroup of calculi less likely to succeed (calculi > 1 cm2, with severe uropathy and functional annulment or delay). Complication were rare (7.5%) and minimally relevant. We conclude than SWEL is the first choice treatment for UC regardless the location. Ureteroscopy (UR) should be considered as the first option particularly in distal (iliopelvic ureter), obstructive calculi and those of difficult radiological study.
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Litotricia , Cálculos Ureterales/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Litotricia/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Uréter/anomalías , Cálculos Ureterales/diagnósticoRESUMEN
Presentation of a review of vesico-vaginal fistulae diagnosed and treated in our Hospital between 1978-1992. There has been 20 cases. Etiology is varied, with predominance of cases due to gynaecological surgery. Considerations on diagnostic tests used in each case and the various therapeutical approaches applied, as well as on the results obtained. A revision is made of literature available on this condition.
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Fístula Vesicovaginal , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Fístula Vesicovaginal/diagnóstico , Fístula Vesicovaginal/etiología , Fístula Vesicovaginal/terapiaRESUMEN
Presentation of our experience and results in the treatment of localized renal adenocarcinoma with radiotherapy supplementary to surgery. The influence of post-operative radiotherapy in the subsequent occurrence of relapse and survival is analyzed. Also, the predictive value in our series of pre-surgery VSG, FA and LDH determinations is analyzed.
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Adenocarcinoma/mortalidad , Adenocarcinoma/radioterapia , Neoplasias Renales/mortalidad , Neoplasias Renales/radioterapia , Adenocarcinoma/sangre , Adenocarcinoma/cirugía , Adolescente , Adulto , Anciano , Biomarcadores de Tumor/sangre , Terapia Combinada , Femenino , Humanos , Neoplasias Renales/sangre , Neoplasias Renales/cirugía , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Pronóstico , Tasa de SupervivenciaRESUMEN
Renal Acquired Cystic Disease (RACD) is a frequent entity in patients with a long standing renal failure under hemodialysis treatment. Incidence of a tumor pathology is higher in those patients than in the general population. A new case is presented and some possible etiopathologenical factors of RACD and neoplasias on such pathology are established.
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Enfermedades Renales Quísticas/etiología , Fallo Renal Crónico/terapia , Trasplante de Riñón , Rechazo de Injerto , Humanos , Enfermedades Renales Quísticas/cirugía , Masculino , Persona de Mediana Edad , Nefrectomía , Diálisis RenalRESUMEN
We have had occasion to treat 8 patients suffering from tuberculous microbladder on whom we carried out augmentation plasty with a segment of ileum according to Ring-plasty technique in 6 cases, and with U-morphology in the other two, all displayed as the main symptom increase in mictional frequency. Six patients were subjected to prior tuberculostatic treatment. Mictional frequency improved in all patients. We observed morphological improvement in seven patients and functional improvement in four, there was one death, in a patients who had only been having prior tubculostatic treatment for one month. Daytime continence was achieved in al cases and there was nocturnal incontinence in five patients. U or ring ileocystoplasties are simple fast techniques displaying good capacity with low pressures and residua of less than 80 cc. No vesicourethral reflux was observed when we carried out the reimplantation.
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Íleon/cirugía , Tuberculosis Urogenital/cirugía , Enfermedades de la Vejiga Urinaria/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Métodos , Persona de Mediana Edad , Tuberculosis Urogenital/patología , Enfermedades de la Vejiga Urinaria/patologíaRESUMEN
We analyse a total of 804 kidney stones in 225 patients aged between 10 and 71 years, with an average age of around 45, by means of the following techniques: optico-differential analysis (immersion method, PRIEN and FRONDEL, 1947), fine plate, X-ray diffraction, infrared-ray spectroscopy and qualitative chemical analysis. In all the stones, we identify the composition of the nucleus and periphery separately. Our results give 51.32% of patients forming essentially oxalic stones, 28.31% uric ones, 19.46% phosphatic and 0.44% cystine stones. These statistics coincide quite closely with those obtained by Cifuentes (quot. in Dalet, F.; Pinto, B., 1976) in Madrid and differ a little more from those obtained by the Puigvert Foundation (quot. in Dalet, F.; Pinto, B., 1976) in Barcelona. They are also similar to those obtained by Sutor (1974) for non Anglo-Saxon, industrialized countries, such as Czechoslovakia and Kuwait. We identify the following components in this collection of stones: anhydrous uric acid, dihydrate uric acid, amorphous urates (sodic, ammonic), whewellite, wedellite, hydroxyapatite, carbo-apatite, struvite, newberyte, whitlockite, brushite and cystine. We found no xanthine stone.