1
|
Coronas Soucheiron M, Casal Beloy I, Villalón Ferrero FN, Martín Solé O, Capdevila Vilaró B, González Temprano N, Larreina De la Fuente L, García González M, Carbonell Pradas M, Pérez Bertólez S, Tarrado Castellarnau X, García Aparicio L, Somoza Argibay I. Efficacy of sacral transcutaneous electrical nerve stimulation in patients with overactive bladder refractory to anticholinergic treatment: a prospective multi-center study. Cir Pediatr 2023; 36:180-185. [PMID: 37818900 DOI: 10.54847/cp.2023.04.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
OBJECTIVE To determine whether sacral transcutaneous electrical nerve stimulation (S-TENS) is an effective treatment in patients refractory to anticholinergic drugs (Achs). MATERIALS AND METHODS A prospective multi-center study of patients with overactive bladder (OB) refractory to Achs treated with S-TENS from 2018 to 2021 was carried out. S-TENS was applied over 3 months. Symptom progression was assessed using the voiding calendar and the Pediatric Lower Urinary Tract Symptoms Score (PLUTSS), excluding questions 3 and 4 -referring to enuresis- so that progression of daytime symptoms only (LUTS variable) was analyzed. RESULTS 66 patients -50% of whom were female- were included, with a mean age of 9.5 years (range: 5-15). S-TENS significantly lowered PLUTSS (19.1 baseline vs. 9.5 final, p< 0.001) and LUTS (13.1 baseline vs. 4.8 final, p< 0.001). It also reduced the number of mictions (8.5 baseline vs. 6.4 final, p< 0.001), while increasing urine volume in the voiding records (214 ml baseline vs. 258 ml final, p< 0.001). Enuresis was the only variable refractory to S-TENS. Complication rate was 3% (2 patients with dermatitis in the S-TENS application area). CONCLUSIONS S-TENS is effective and safe in the short-term in patients with OB refractory to Achs. Further studies assessing long-term efficacy and potential relapses are required.
Collapse
Affiliation(s)
| | - I Casal Beloy
- Pediatric Urology Unit. Pediatric Surgery Department. Hospital Virgen del Rocío. Sevilla (Spain). Pediatric Urology Unit. Pediatric Surgery Department. Hospital Sant Joan de Déu. Barcelona (Spain)
| | - F N Villalón Ferrero
- Pediatric Urology Unit. Pediatric Surgery Department. Hospital Universitario de Donostia. Donostia (Spain)
| | - O Martín Solé
- Pediatric Urology Unit. Pediatric Surgery Department. Hospital Sant Joan de Déu. Barcelona (Spain)
| | - B Capdevila Vilaró
- Pediatric Surgery Department. Hospital Sant Joan de Déu. Barcelona (Spain)
| | - N González Temprano
- Pediatric Urology Unit. Pediatric Surgery Department. Hospital Universitario de Donostia. Donostia (Spain)
| | - L Larreina De la Fuente
- Pediatric Urology Unit. Pediatric Surgery Department. Hospital Universitario de Donostia. Donostia (Spain)
| | - M García González
- Pediatric Urology Unit. Pediatric Surgery Department. Complejo Hospitalario Universitario A Coruña. A Coruña (Spain)
| | - M Carbonell Pradas
- Pediatric Surgery Department. Hospital Sant Joan de Déu. Barcelona (Spain)
| | - S Pérez Bertólez
- Pediatric Urology Unit. Pediatric Surgery Department. Hospital Sant Joan de Déu. Barcelona (Spain)
| | | | - L García Aparicio
- Pediatric Urology Unit. Pediatric Surgery Department. Hospital Sant Joan de Déu. Barcelona (Spain)
| | - I Somoza Argibay
- Pediatric Urology Unit. Pediatric Surgery Department. Complejo Hospitalario Universitario A Coruña. A Coruña (Spain)
| |
Collapse
|
2
|
Torres Montebruno X, Martinez JM, Eixarch E, Gómez O, García Aparicio L, Castañón M, Gratacos E. Fetoscopic laser surgery to decompress distal urethral obstruction caused by prolapsed ureterocele. Ultrasound Obstet Gynecol 2015; 46:623-626. [PMID: 25865633 DOI: 10.1002/uog.14876] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 03/27/2015] [Accepted: 04/05/2015] [Indexed: 06/04/2023]
Abstract
We report on the successful use of fetoscopic surgery to treat a case of prolapsed ureterocele in a female fetus. At 21 weeks' gestation, a double renal system with an intravesical ureterocele obstructing the bladder outlet was diagnosed, causing severe megacystis, bilateral hydronephrosis and progressive oligohydramnios. Ultrasound evaluation following referral to our center confirmed severe bilateral hydronephrosis with pelvic and calyceal dilatation, but amniotic fluid volume was normal and the ureterocele was not visualized in the bladder. Instead, a cystic mass within the external genitalia was observed, suggestive of a prolapsed ureterocele, causing intermittently severe obstruction of the urethra. The parents were counseled about the uncertain prognosis and fetal surgery to decompress the urinary system was proposed. The procedure involved firing a contact diode laser until perforation of the ureterocele was achieved. Following laser surgery, resolution of megacystis, reduction of hydronephrosis and normalization of amniotic fluid volume were observed. Our report demonstrates that fetoscopic decompression of a distal urethral obstruction is feasible in the rare event of congenital prolapsed ureterocele.
Collapse
Affiliation(s)
- X Torres Montebruno
- BCNatal, Barcelona Center for Maternal-Fetal Medicine and Neonatology, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) - Maternal-Fetal Medicine and Neonatology, Barcelona, Spain
| | - J M Martinez
- BCNatal, Barcelona Center for Maternal-Fetal Medicine and Neonatology, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) - Maternal-Fetal Medicine and Neonatology, Barcelona, Spain
| | - E Eixarch
- BCNatal, Barcelona Center for Maternal-Fetal Medicine and Neonatology, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) - Maternal-Fetal Medicine and Neonatology, Barcelona, Spain
| | - O Gómez
- BCNatal, Barcelona Center for Maternal-Fetal Medicine and Neonatology, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) - Maternal-Fetal Medicine and Neonatology, Barcelona, Spain
| | - L García Aparicio
- Department of Pediatric Surgery, Hospital Sant Joan de Déu, Barcelona, Spain
| | - M Castañón
- Department of Pediatric Surgery, Hospital Sant Joan de Déu, Barcelona, Spain
| | - E Gratacos
- BCNatal, Barcelona Center for Maternal-Fetal Medicine and Neonatology, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) - Maternal-Fetal Medicine and Neonatology, Barcelona, Spain
| |
Collapse
|
3
|
Saura L, Aparicio LG, Julià V, Ribó JM, Rovira J, Rodó J, Tarrado X, Prat J, Cáceres F, Morales L. [Which surgical technique should we perform for benign renal disease in children?]. Cir Pediatr 2007; 20:49-53. [PMID: 17489494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
AIM The aim of this paper is to analyze our experience in different surgical techniques to perform a nephrectomy for benign renal diseases in children. MATERIAL AND METHODS From 1993 to 2005 we have performed 98 nephrectomies. We have three groups of patients depending on the surgical technique: open nephrectomy (ON), transperitoneal laparoscopic nephrectomy (TLN) and retroperitoneal laparoscopic nephrectomy (RLN). ON was performed in 36 patients. Mean age was 3.3 years. TLN was performed in 39 patients. Mean age was 4.7 years old. RLN was performed in 23 patients. Mean age was 3.6 years old. Criteria to nephrectomy was a renographic function under 19%. We have compared the three surgical techniques in relation with surgical time and mean hospital stay. RESULTS Mean operative time was 126.2 minutes in ON, 132.3 minutes in TLN and 134.1 minutes in RLN. Mean stay was 5.02 days in ON, 2.35 days in TLN and 1.86 days in RLN. The median hospital stay of the ON group is significantly longer than that of NLT and NR groups (p < 0.05). However, there are no differences related to surgical time between all the groups. CONCLUSIONS Nephrectomy may be performed for benign disease in children using less invasive surgical techniques. They are associated with minimal morbidity, minimal postoperative discomfort, improve cosmesis and a shorter hospital stay. However, we haven't found differences between TLN and RLN.
Collapse
Affiliation(s)
- L Saura
- Servicio de Cirugía Pediátrica, Agrupació Hospital Sant Joan de Déu-Hospital Clínic, Universidad de Barcelona.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Tarrado X, Rodó J, Sepúlveda JA, García Aparicio L, Morales L. [Continent urinary diversion: the Mitrofanoff principle]. Cir Pediatr 2005; 18:32-5. [PMID: 15901106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Continent urinary diversion (based on Mitrofanoff's principle), despite its complexity, is the gold standard in the treatment of those vesicourethral disfunctions that need clean intermittent catheterization (CIC) to achieve complete vesical voiding, in patients with non easily catheterizable native urethra. AIM To analize our experience in continent urinary diversion at our centre. PATIENTS AND METHODS We have reviewed the records of the 14 cases of continent urinary diversion in the last 8 years. They were grouped in order to the underliying condition: 1-Bladder exstrophy group (n=5): Mean age at diversion time was 5.5 years (range 3-7). In all patients the original Mitrofanoff s technique was performed (continent cutaneous appendicovesicostomy). Associated procedures were: ureterovesical reimplantation in all 5 cases; bladder neck reconstruction also in all 5 (3 of them needed vesicourethral transection); and bladder augmentation in two cases, using ileum and sigmoid respectively. 2- Myelomeningocele group (n=9, 10 procedures): Mean age was 11.5 years (range 6-16). Appendicovesicostomy was performed in 7 cases and a reconfigured ileum with the Casale technique was used in 3 cases (primarily in 2 and as an alternative in one). Associated procedures were: ureterovesical reimplantetion in 5 cases and bladder augmentation in 7 (using sigmoid in 4, ileum in 2 and urether in one case). RESULTS In all patients complete continence was achieved. Complications found were: one appendicostomy prolapse, one appendix necrosis (that was then diverted with Casale's technique), one appendicular conduit stenosis and one case with catheterization difficulties that needed a tappering of the ileum conduit. Nowadays, 13 out of 14 pacients follow the CIC program each 3-4 hours without complication. CONCLUSION Continent urinary diversion improves autonomy and life quality in those patients that need a definitive urinary diversion and have a long life expectancy. We have used these procedure with good results in patients with severe vesicourethral disfunction (of an intrinsic or neuropathic origin) in which clean intermittent catheterization was not possible through native urethra, or in patients with refractary incontinence in which vesicourethral transection was the only effective treatment.
Collapse
Affiliation(s)
- X Tarrado
- Servicio de Cirugía Pediátrica, Unidad Integrada, Hospital Sant Joan de Déu/Hospital Clínic, Barcelona, Universidad de Barcelona.
| | | | | | | | | |
Collapse
|
5
|
Castañón García-Alix M, Sancho Vendrell MA, Parri Ferrandis FJ, San Vicente Vela B, García Aparicio L, Tarrado Castellarnau X, Muñoz Fernández ME, Morales Fochs L. Utilidad del adhesivo tisular 2-octil cianoacrilato en cirugía pediátrica. An Pediatr (Barc) 2003; 59:548-51. [PMID: 14636519 DOI: 10.1016/s1695-4033(03)78778-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim this study was to demonstrate the utility and suitability of octyl-2-cianocrylate in cutaneus repair of different conditions in the pediatric population. Octyl-2-cianocrylate is a topical tissular adhesive which can be used on skin and which has been tested in surgical practice as a wound sealant, avoiding the use of conventional sutures. MATERIAL AND METHODS We applied octyl-2-cianocrylate in 100 patients with skin wounds smaller than 5 cm. The patients were distributed as follows: Emergency department: simple sharp wounds in the face and extremities (20 patients); surgical block: surgical wounds in 80 patients with the following conditions: inguinal hernia (20 patients), cryptorchidism (20 patients), umbilical hernia (10 patients), hypospadias (17 patients), post-hypospadias fistula repair (8 patients) and cleft lip (5 patients). The results were analyzed in terms of efficacy, cosmetic result, procedure time, material used, and patient comfort. CONCLUSIONS Octyl-2-cianocrylate was easier to use than conventional sutures in all its applications, requiring less time than conventional sutures and therefore lowering the cost per procedure.
Collapse
Affiliation(s)
- M Castañón García-Alix
- Servicio de Cirugía Pediátrica. Unidad Integrada Hospital Sant Joan de Déu-Clínic. Universidad de Barcelona. España
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Parri FJ, Soares-Oliveira M, García Aparicio L, Sancho MA, Sarget R, Morales L. [Bilateral cleft lip and palate: experience from a center with a multidisciplinary approach]. Cir Pediatr 2001; 14:124-6. [PMID: 11547634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The aim of this work is to analyse the global experience of a center where a pluridisciplinar approach of the child affected with a cleft lip and palate is regularly done. Since january 1980 until january 2000, a total of 36 children (8 F, 28 M) with bilateral cleft lip and palate were treated. Only 5 children were born at this hospital. The others (n = 31) were referred soon after birth (24/31) or later for treat sequels. A multidisciplinary team evaluated every case. The parameters analysed were: surgical protocol, aesthetic and speech outcome, hearing disturbance, complications and the number of secondary lip surgeries. Surgical approach consisted on a soft palate closure before 3 months follow by a bilateral cheiloplasty (6 months) and a hard palate closure before 4 years of age, in the majority of cases (24/36). The esthetical result was evaluated in 25 children and was acceptable in the great majority (22/25). 16 children were submitted to tympanic draining in order to treat their secretory otitis. Speech outcome was analysed in 27 children and was good in 23. With a follow-up of 8.4 years, 15 children (8 treated soon on this center and 7 that came for their sequels) were treated for complications. There was a media of 4.5 surgeries per children.
Collapse
Affiliation(s)
- F J Parri
- Servicio de Cirugía Pediátrica, Unidad Integrada Hospital Sant Joan de Déu-Hospital Clínic, Universidad de Barcelona, Barcelona
| | | | | | | | | | | |
Collapse
|
7
|
Ribó JM, García Aparicio L, Morales I. [Laparoscopic splenectomy in the treatment of hematologic diseases]. Cir Pediatr 2001; 14:69-72. [PMID: 11480195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Laparoscopic approach to surgical procedures in children is used in different diseases, but there are some controversies for using this technique in the splenectomy. Laparoscopic surgery decreased pain, postoperative ileus and the hospital stay; and improve cosmetics, the most important disadvantage is the longer operating time. Splenectomy is indicated more in immune thrombocytopenic purpura (PTI) and hereditary espherocytosis (HE). We review our experience in laparoscopic spelenectomy.
Collapse
Affiliation(s)
- J M Ribó
- Servicio de Cirugía Pediátrica, Unitat Integrada Hospital Sant Joan de Déu-Hospital Clínic, Universitat de Barcelona, Barcelona
| | | | | |
Collapse
|
8
|
García Aparicio L, Viedma MA, Lloveras J, Aguayo MT, Vicente R, Grinyó JM, Constante C. Evolution of the organ donor profile in Catalonia. Transplant Proc 1999; 31:2587-8. [PMID: 10500729 DOI: 10.1016/s0041-1345(99)00512-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
|
9
|
García Aparicio L, Grinyó JM, Viedma MA, Aguayo MT, Lloveras J, Constante C. Cadaver kidney transplantation in Catalonia: successful organization. Transplant Proc 1999; 31:346-50. [PMID: 10083137 DOI: 10.1016/s0041-1345(98)01656-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- L García Aparicio
- Catalan Transplant Organization (OCATT), Catalan Health Service, Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
10
|
García Aparicio L, Viedma MA, Vicente R, Félix MJ, Rius E. The Organ Interchange Coordination Unit model of extrahospital transplant coordination: activity during 3-year period (1993 to 1995). Transplant Proc 1997; 29:1500-1. [PMID: 9123399 DOI: 10.1016/s0041-1345(96)00704-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
11
|
García Aparicio L, Cabrer C, Guix M, Viedma MA. Application of American Society of Mechanical Engineers diagram in the process of extrahospital transplant coordination at the Organ Interchange Coordination Unit level. Transplant Proc 1997; 29:1498-9. [PMID: 9123398 DOI: 10.1016/s0041-1345(96)00703-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|