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Abstract
Venous thromboembolism (VTE) is a common complication in patients with cancer and portends a poor prognosis. Our understanding of the underlying pathophysiology of VTE in cancer has advanced since Trousseau first described hypercoagulability in patients with malignancy and Virchow described his famous triad of thrombosis formation. Malignancy itself induces a thrombophilic state by increasing the risk of venous stasis, endothelial injury and an imbalance of pro and anti-thrombotic factors leading to a hypercoaguable state. Additional insults to this thrombotic balance are introduced by patient-specific, treatment related and tumor-specific factors. The importance of understanding the factors associated with increased thrombosis in cancer is paramount in order to adequately identify patients who will benefit from thromboprophylaxis.
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The role of the extracellular matrix in primary myelofibrosis. Blood Cancer J 2017; 7:e525. [PMID: 28157219 PMCID: PMC5386340 DOI: 10.1038/bcj.2017.6] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 12/20/2016] [Indexed: 02/06/2023] Open
Abstract
Primary myelofibrosis (PMF) is a myeloproliferative neoplasm that arises from clonal proliferation of hematopoietic stem cells and leads to progressive bone marrow (BM) fibrosis. While cellular mutations involved in the development of PMF have been heavily investigated, noteworthy is the important role the extracellular matrix (ECM) plays in the progression of BM fibrosis. This review surveys ECM proteins contributors of PMF, and highlights how better understanding of the control of the ECM within the BM niche may lead to combined therapeutic options in PMF.
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Abstract
OBJECTIVE We evaluated the incidence of urological complications after simultaneous renal and pancreatic transplantation. PATIENTS AND METHODS We retrospectively reviewed urological complications following 107 simultaneous kidney-pancreas transplantations performed at our institution between March 1995 and June 2008. The 46 women and 61 men were of mean age 37.8 years (range, 25-66). The mean duration of diabetes mellitus was 23.0 years (range, 9-48) and the mean duration of dialysis was 19.9 months (range, 0-70). The exocrine pancreatic secretions were drained to bladder in 58 cases, or enterically in 49 patients. The mean length of follow-up was 51.7 months. RESULTS The most frequent urological complication was urinary tract infection, reported in 63.8% of patients: 42 bladder-drained and 25 enteric-drained (P = .011). Hematuria occurred in 13 patients (12.5%): 12 bladder-drained and 1 enteric-drained (P = .002). Five bladder-drained patients developed bladder calculi. Among 58 bladder-drained patients, reflux pancreatitis occurred in 28 patients and urine leaks related to the pancreatic graft occurred in 7 patients. Conversion of exocrine secretions from bladder to enteric diversion was required in 6 patients. One- and 3-year patient survival rates were 92.7% and 89.1%, respectively. Moreover, 1 and 3-year kidney graft survival rates were 90.6% and 84.4%, and pancreas graft survival rates were 78.1 and 70.3%, respectively. CONCLUSION Simultaneous kidney-pancreas transplantation with bladder drainage is associated with a high frequency of urological complications. Appropriate treatment can resolve most complications. In our opinion, both enteric and bladder drainage seemed to be safe and effective alternatives to manage pancreatic exocrine secretions.
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Abstract
OBJECTIVE We studied the long-term renal graft functions, survivals, and complications among patients with augmented bladders. PATIENTS AND METHODS Between 1976 and 2008, we performed 6/2600 renal transplantations in patients with augmented bladders. The mean patient age was 52 years. The cause of end-stage renal disease was chronic interstitial kidney disease in all patients, being secondary to lower urinary tract dysfunction. The etiology of bladder dysfunction was tuberculosis in 4 cases, bladder exstrophy in 1, and myelomeningocele in 1. Enterocystoplasty had been performed at a mean of 19 years prior to transplantation. The ureter was implanted into the native ureter in 5 cases and the bowel segment in 1 case. RESULTS With a mean follow-up of 56 months (range, 20-100 months), the overall graft survival was 50%. Three grafts were lost due to venous thrombosis (n = 1), and chronic allograft nephropathy (n = 2) at 37 and 100 months posttransplantation. No patient died during follow-up. Mean serum creatinine was 1.44 mg/dL with Modification of Diet in Renal Disease (MDRD) clearance of 76 mL/min/1.73 m(2). One fistula that caused obstructive uropathy and 2 cases of migration of a double J catheter were among the surgical complications. These patients showed a mean of 7 episodes of uncomplicated urinary infections. Only 1 patient was rehospitalized due to a complicated urinary tract infection. CONCLUSIONS Patients with enterocystoplasty and renal transplantation show a greater risk of urinary tract infections, albeit mostly uncomplicated. Despite this, the long-term results are acceptable.
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UP-2.158: First Year Acute Toxicity Analysis of Low Dose Brachytherapy to Treat Low Risk Prostate Cancer: A Uro-Oncologic Radiotherapeutic Multidisciplinar Unit Experience. Urology 2009. [DOI: 10.1016/j.urology.2009.07.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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UP.51: The Impact of Obesity on Laparoscopic Radical Prostatectomy. Urology 2008. [DOI: 10.1016/j.urology.2008.08.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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UP.75: Intra- and Peri-operative Outcomes Comparing Radical Retropubic and Laparoscopic Radical Prostatectomy: Our Experience. Urology 2008. [DOI: 10.1016/j.urology.2008.08.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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MP-5.20: Growth Factor Expression in Renal Cell Carcinoma (RCC) and Their Relationship with Classical Prognostic Factors. Urology 2008. [DOI: 10.1016/j.urology.2008.08.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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12
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MP-22.08. Urology 2006. [DOI: 10.1016/j.urology.2006.08.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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European consensus on diagnosis and treatment of germ cell cancer: a report of the European Germ Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004; 15:1377-99. [PMID: 15319245 DOI: 10.1093/annonc/mdh301] [Citation(s) in RCA: 380] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Germ cell tumour is the most frequent malignant tumour type in young men with a 100% rise in the incidence every 20 years. Despite this, the high sensitivity of germ cell tumours to platinum-based chemotherapy, together with radiation and surgical measures, leads to the high cure rate of > or = 99% in early stages and 90%, 75-80% and 50% in advanced disease with 'good', 'intermediate' and 'poor' prognostic criteria (IGCCCG classification), respectively. The high cure rate in patients with limited metastatic disease allows the reduction of overall treatment load, and therefore less acute and long-term toxicity, e.g. organ sparing surgery for specific cases, reduced dose and treatment volume of irradiation or substitution of node dissection by surveillance or adjuvant chemotherapy according to the presence or absence of vascular invasion. Thus, different treatment options according to prognostic factors including histology, stage and patient factors and possibilities of the treating centre as well may be used to define the treatment strategy which is definitively chosen for an individual patient. However, this strategy of reduction of treatment load as well as the treatment itself require very high expertise of the treating physician with careful management and follow-up and thorough cooperation by the patient as well to maintain the high rate for cure. Treatment decisions must be based on the available evidence which has been the basis for this consensus guideline delivering a clear proposal for diagnostic and treatment measures in each stage of gonadal and extragonadal germ cell tumour and individual clinical situations. Since this guideline is based on the highest evidence level available today, a deviation from these proposals should be a rare and justified exception.
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Helical computed tomography angiography is the most efficient test to assess vascular calcifications in the iliac arterial sector in renal transplant candidates. Transplant Proc 2003; 35:1682-3. [PMID: 12962756 DOI: 10.1016/s0041-1345(03)00626-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
UNLABELLED The increased scope of renal transplant indications has lead to a larger number of recipients with vascular problems due to arterial calcifications in the iliac region. Compared to magnetic resonance and conventional arteriography, helical computed tomography angiography (HCTA) accurately depicts arterial diseases, including the location and extent of arterial calcification. The objective of this study was to assess the value of HCTA with maximum-intensity-projection (MIP) reconstruction to evaluate iliac arterial calcifications and stenosis among candidates for renal transplantation. MATERIAL AND METHODS From December 1997 to March 2002, 114 HCTA scans with MIP reconstruction were performed in candidates for renal transplantation. Included patients fulfilled some of the following conditions: (a) older than 55 years, (b) diabetic, (c) second transplants, and (d) obvious vascular calcifications on plain abdominal x-ray. RESULTS Among the 114 patients, 33 (29%) were excluded for transplantation due to universal calcification of the iliac arterial sector, and 81 (71%) were included on the waiting list due to the presence of calcium-free areas for the vascular anastomosis. Transplantation, which was attempted in 28 of the 81 patients, was successful in 25 using the area programmed after HCTA analysis. The transplants failed in three cases because no calcium-free area could be found upon surgical examination. CONCLUSION HCTA with MIP reconstruction makes it possible to draw an exact map of the arterial calcifications of the iliac arterial sector, allowing better recipient selection and accurate planning for the vascular anastomosis and placement of the renal graft.
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Role of immunosuppressive treatments based on mycophenolate mofetil in posttransplantation renal surgical complications. Transplant Proc 2002; 34:96. [PMID: 11959201 DOI: 10.1016/s0041-1345(01)02682-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Long-term results of renal transplantation in elderly cadaver donor recipients 65 years old or older. Transplant Proc 2002; 34:356-7. [PMID: 11959323 DOI: 10.1016/s0041-1345(01)02798-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
OBJECTIVES To establish guidelines for the diagnosis, staging, treatment and follow-up of germ cell testicular cancer. METHODS A search of published work was conducted using Medline. Highly evidence-based articles were selected and their findings analysed by the members of the Oncological Urology Working Group of the EAU. Testis cancer is rare and affects young men in their 3rd and 4th decades of life. The majority of these tumours are derived from germ cells (seminomatous and non-seminoma germ cell testicular cancer), and more than 50% of patients are diagnosed with stage I disease. Epidemiological, pathological and clinical risk factors are well established. The tumour, node, metastasis (TNM) staging system is endorsed, and for metastatic disease a recently devised prognostic-factor-based staging system has proven to be useful. Staging assessment includes pre- and post-orchiectomy marker levels, pathology of the testis, and nodal and visceral status. Following orchiectomy, treatment depends on the tumour type, pathological risk factors for stage I disease and clinical prognostic factors for advanced disease. The cure rate is excellent for disease stages I and II, irrespective of the treatment adopted. However, the pattern of relapse (rate, timing and site) is highly influenced by therapeutic policy. For metastatic disease, survival depends on clinical prognostic factors and treatment. Follow-up schedules are tailored according to stage, tumour type and post-orchiectomy treatment schedules. CONCLUSIONS Excellent cure rates are achieved for early-stage germ cell testis tumours following accurate staging at diagnosis. Satisfactory survival rate can be achieved in advanced metastatic disease using a multidisciplinary therapeutic approach. Follow-up schedules vary, depending on the pathology and stage of the primary tumour and on the treatment policy adopted following orchiectomy.
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Abstract
BACKGROUND The age limit of the cadaver kidney donors is increasing in response to the growing demand for renal transplantation. Simultaneous double kidney transplantation (SDKT) with kidneys obtained from elderly adults has been proposed to increase the transplantation number and improve its results. However, if SDKT is performed when there are no clear indications, a negative effect could be produced on the total number of transplanted patients as both kidneys would be used for only one recipient. MATERIAL AND METHODS In December 1996 we designed a transplantation protocol to be able to extend the selection of cadaver kidney donors with normal serum creatinine levels without establishing any age limit. A pregraft renal biopsy was always performed to analyze the glomerulosclerosis (GE) percentage whenever the donors were 60 years of age or older. A SDKT was performed in a single recipient when the donor age was 75 years or older or when the donors between 60 and 74 years old had a GE rate of more than 15%. On the contrary, a single kidney transplantation was performed in two different recipients for kidneys from donors between 60 and 74 years of age with a GE rate of less than 15%. Kidneys having GE rates of more than 50% were discarded for transplantation. Donor kidneys from subjects younger than 60 years of age were always used for a single kidney transplantation. RESULTS Based on the above mentioned protocol, from December 1996 to May 1998, 181 patients received a kidney transplantation in our hospital. These patients were divided into three groups: group I which included the SDKT recipients (n=21), group II or single kidney recipients from 60- to 74-year-old donors (n=40), and group III or recipients from <60-year-old donors (n=120). The mean follow-up time was 15+/-5 months (range 6-24). Mean donor age was 75+/-7 years in group I, this was significantly higher than in group II (67+/-4, P<0.001) and group III (37+/-15, P<0.001). The primary nonfunction rate was low in the three groups, there being no statistically significant differences (5, 5, and 4%, respectively). A significantly greater percentage of patients from group I (76%) presented immediate renal graft function as compared with group II (43%, P<0.01) and III (50%, P<0.05). The acute rejections rate was very low in all three groups (9.5, 7.5, and 22%, respectively) with significant differences between groups II and III (P<0.05). No significant differences between the different groups were observed for one year actuarial patient survival (100, 95, and 98%, respectively) or graft survival rates (95, 90, and 93%, respectively). The 6-month serum creatinine levels were excellent in the three groups, although there were significant differences between groups I and II (1.6+/-0.3 vs. 1.9+/-0.6 mg/dl, P<0.05), II and III (1.9+/-0.6 vs. 1.4+/-0.4 mg/dl, P<0.001), and I and III (P<0.05). CONCLUSIONS Simultaneous double kidney transplantations make it possible to use kidneys from extremely elderly donors (>75 years) or those whose GE>15%. In addition, kidneys from donor 60-74 years old in which the GE<15% can be used for single kidney transplantations in two different recipients with excellent results.
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The double or single renal graft depending on the percentage of glomerulosclerosis in the preimplant biopsy reduces the number of discarded kidneys from donors older than 60 years. Transplant Proc 1999; 31:2285-6. [PMID: 10500580 DOI: 10.1016/s0041-1345(99)00341-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Intravesical immunoprophylaxis in recurrent superficial bladder cancer (Stage T1): multicenter trial comparing bacille Calmette-Guérin and interferon-alpha. Urology 1997; 50:529-35. [PMID: 9338727 DOI: 10.1016/s0090-4295(97)00303-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To estimate and compare recurrence rates, index of recurrence, and disease-free interval in patients with superficial recurrent bladder cancer receiving bacille Calmette-Guérin (BCG) or interferon (IFN) for immunoprophylaxis. METHODS One hundred twenty-two patients with recurrent superficial Stage pT1, grade 1 to 3 tumors were enrolled in a randomized, prospective, multicenter trial with two treatment arms of endovesical immunoprophylaxis: 150 mg of BCG versus 54 MU of recombinant IFN-alpha-2a. Administration was weekly during the first month, biweekly for 2 months, and monthly for 9 months. Both groups were similar with regard to tumor stage, grade, size, and number. RESULTS Sixty-one patients were evaluable in the BCG group and 49 in the IFN group. Tumors recurred in 34 (69.4%) of 49 patients in the IFN group (890 months of follow-up) and in 24 (39.3%) of 61 in the BCG group (1272 months of follow-up). The total number of recurrences (28 for BCG, 47 for IFN), disease-free interval (mean 19.3 months for BCG, 15.3 months for IFN), and index of recurrence (2.2 for BCG, 5.5 for IFN) were statistically significant (P = 0.001) in favor of BCG. Progression to invasive carcinoma was similar in both study arms. Neither systemic nor local side effects were seen in the IFN group. However, the previously reported toxicity of BCG was confirmed. CONCLUSIONS According to our trial, BCG remains the most efficacious agent for immunoprophylaxis of recurrent superficial bladder tumors.
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[Tuberculous prostatic abscess in a patient with AIDS]. Actas Urol Esp 1995; 19:655-61. [PMID: 8669335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Despite of prostate abscesses having become an uncommon disease, a number of cases has been described lately specially in immunodepressed patients caused by infrequent agents, such as Mycobacterium tuberculosis. This paper describes the case of one HIV-positive patient, diagnosed with a prostate abscess within a tuberculous dissemination. The best diagnostic method is considered to be the transrectal ultrasound (TRU), the choice therapy being drainage by ultrasound-guided transperineal percutaneous puncture.
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[Cerebral metastasis as first manifestation++ of a bladder carcinoma]. Actas Urol Esp 1994; 18:906-10. [PMID: 7817863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The infiltrant vesical carcinoma shows a tendency to become metastatic in a high percentage of cases, so that the preferred sites are usually the retroperitoneal lymph nodes, liver and bone. CNS metastasis is an uncommon fact, but it is even less common to find CNS affectation symptoms even before the appearance of any signs and symptoms related to the vesical affectation itself. Contribution of one case of infiltrant vesical carcinoma which presented with focal neurological symptomatology as its first manifestation.
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[Volumetric correlations of prostatic adenoma by transrectal ultrasonography]. Actas Urol Esp 1994; 18 Suppl:365-8. [PMID: 7521110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Estimation of prostate volume is one of the key elements in the study and management of both prostate benign diseases and prostate cancer. Of the available techniques, transrectal ultrasound presents greater reliability in prostatic imaging due to its degree of resolution. The present study conducted in 40 patients undergoing suprapubic adenectomy piedes with the echographic dimensions and 14 different volumetric formulae obtained by the multiple combination of the three prostate axis. The two best correlations are obtained when the cross-sectional measurement is combined with the anteroposterior (r = 0.84..0.83), and the worse when the longitudinal measure is used in isolation or combined with the anteroposterior one (r = 0.64..0.43). The exact formula is the ellipsoid [formula: see text] Contrary to what could be expected, the size of the "internal gland" (cross-sectional and anteroposterior) scarcely correlates to the adenoma weight, both with regard to the main axes (cross-sectional, r = 5.25; anteroposterior, r = 0.28) and the theoretical volume (r = 0.69).
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["Actas Urológicas Españolas: figures and data]. Actas Urol Esp 1994; 18 Suppl:334-6. [PMID: 8073919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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26
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[Granulomatous prostatitis. An infrequent diagnosis. Review of our series]. Actas Urol Esp 1994; 18:77-84. [PMID: 7976705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Granulomatous prostatitis is an inflammatory condition of the prostate which presents rarely in the urological practice. It is caused by several specific and unspecific infectious agents, and can also be secondary to prostate surgery or a local reflection of a systemic granulomatous disease. With regard to clinical manifestations and treatment, it is an unspecific entity which has a characteristic histopathology. Its major interest consists on the possibility of it being mistaken for a prostate cancer during physical examination. This paper reviews a series of 7 granulomatous prostatitis, with special emphasis on their histology and ultrasound findings.
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[Complications of varicocele embolization: adhesion of the intravascular catheter during infusion of bucrylate]. Actas Urol Esp 1994; 18:141-4. [PMID: 7976699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The introduction of percutaneous occlusion techniques to manage a varicocele has made possible the control of the process with success rates similar to those obtained with conventional surgery. Its efficacy and minimal invasive nature, although not entirely risk-free, are responsible for its expansion. Contribution of one case of adhesion of the intravascular catheter to the underlying spermatic vein wall during infusion with isobutyl cyanoacrylate (bucrylate) as embolization material, an event which forced immediate surgical removal.
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Abstract
We report on 2 patients (ages 21 and 33 years) with high flow priapism secondary to arteriocavernous fistula produced by perineal injury. Both cases were satisfactorily resolved by super-selective embolization of the fistula with bucrylate. Diagnosis was based on the results of gasometry in cavernous blood, color Doppler ultrasound and arteriography. Erectile function after 24 and 30 months of treatment, respectively, was normal in both patients. Review of the literature revealed that only 13 patients have been managed with arterial embolization. To our knowledge our report represents the first in which intracavernous bucrylate embolization produced detumescence with preservation of erectile function.
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[Renal cystic carcinoma: report of five cases]. Actas Urol Esp 1993; 17:614-22. [PMID: 8165948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Of 204 renal adenocarcinomas seen in the Urology Service at the Hospital "12 de Octubre", from January 1974 to December 1992, we found five cases (2.5%) of cystic renal carcinoma in patients with an average age of 51.8 years (range 35-69), with a female vs male ratio of 3:2, and a right-sided vs left sided ratio of 4:1. The article describes the signs and symptoms, diagnostic methods used, treatment and subsequent evolution of our series, and includes a revision of the published literature.
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[Extrinsic stenosis of the ureter. Our caseload and review of the literature]. Actas Urol Esp 1992; 16:631-43. [PMID: 1462812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Obstructive uropathy is the common presentation course for various processes with an origin either intraluminar, parietal or extraluminar. A retrospective analysis of 41 cases of extrinsically originated obstructive uropathy seen in our Urology Unit from 1976 to 1991 was carried out. The cases were divided in three groups following an exclusively etiological criterion: 21.9% (9 patients) corresponded to primary retroperitoneal fibrosis; 51.2% (21 patients) to tumoral ureteral obstruction; and 26.8% (11 patients) to non-tumoral processes. For each division established, the features of clinical presentation, performance of the various diagnostic procedures used, and different therapy approaches are described also including a review on the current literature.
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[Therapeutic options in metastatic renal carcinoma]. Actas Urol Esp 1992; 16:529-39. [PMID: 1442223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Within the scope of urogenital tract tumoral diseases, renal adenocarcinoma is the third most frequent neoplasia diagnosed in the adult population. The limited clinical presentations in early analysis and their anarchical behaviour are the cause for 50% to 60% of patients having already developed distant disease at the time of diagnosis. The only curative procedure so far is radical surgery, which is possible when there is a single metastatic site and sometimes even, depending on various factors which will be analyzed, several sites. In these occasions, the traditional therapeutic choices (Hormonotherapy, Chemotherapy, Radiotherapy) have proven to have limited or no efficacy in managing the disease. This fact, together with the successful results obtained in other tumoral processes, have allowed the clinical development of different modalities of Immunotherapy for the management of metastatic renal carcinoma, with results clearly hopeful. This work is a review of the results reported for each of the mentioned therapeutic choices, basically analyzing the role currently played by surgery and immunotherapy in the management of advanced renal carcinoma.
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Alkaline-encrusted pyelitis/cystitis and urinary tract infection due to corynebacterium urealyticum: a new severe complication after renal transplantation. Transplant Proc 1992; 24:81-2. [PMID: 1539352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Combined liver-kidney transplantation. Transplant Proc 1992; 24:128-9. [PMID: 1539207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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[Vesicovaginal fistulas: correction using lyophilized dura mater]. Actas Urol Esp 1991; 15:143-7. [PMID: 1807108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Thirty three cases of surgically corrected vesicovaginal fistulae, from a total of 73 patients with iatrogenic or pathological urinary tract conditions examined and treated in our service, are presented in this paper. Both the etiology and different surgical techniques that can be used are reviewed, contributing the novelty use of freeze dried dura mater as the material to interpose for the correction of the fistulae by means of abdominal surgical techniques. The material was used in 6 patients, with recovery being obtained in all cases and achieving the fistulae closure with a single surgical procedure.
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[Penile self-injection of a papaverine-phentolamine combination, as treatment of impotence, in patients treated with radical cystoprostatectomy]. Actas Urol Esp 1991; 15:43-5. [PMID: 2058441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Four patients with impotence secondary to radical cystoprostatectomy due to infiltrant vesical urothelial carcinoma, received treatment with a mixture of papaverine-phentolanin, at dosages of 18-0, 34 mg respectively. Good results were obtained in every occasion, all four cases achieving rigid erection for over an hour which allowed penetration. Currently, patients continue peneal self-injection treatment with these drugs, with no complications or therapy failure being reported.
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[Purulent urethritis secondary to intraurethral foreign body]. Actas Urol Esp 1991; 15:69-71. [PMID: 2058446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Due to the rarity of the cases presented in this paper, the prolonged time of residence in the urethra and the limited functional repercussion produced by the foreign bodies lodged in the urethra, we consider convenient the exposition of the mentioned cases.
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[Ectopic gas as a complication of surgical kidney biopsy]. Actas Urol Esp 1990; 14:306-8. [PMID: 2264497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Since the complications herewith presented as a consequence of surgical renal biopsy are really exceptional and references found in the existing literature rare, we have considered that the contribution of these two cases which developed a pneumomediastinum-pneumoperitoneum and pneumocele prespectively during the immediate post-surgical period would be of interest. Evolution was favourable in both cases, with spontaneous resolution of the process.
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40
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[Paratesticular liposarcoma of the spermatic cord]. Actas Urol Esp 1990; 14:202-4. [PMID: 2239397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Funiculus liposarcoma is a very uncommon tumor. Most cases have a low degree of malignancy. Inguinal orchiectomy with a wide local excision is the appropriate treatment. Liposarcoma presurgical diagnosis is very infrequent and ultrasonography is the method that can provide some help to locate it. Currently, chemotherapy indication is unclear. Due to recurrence, specially of local foci, being a possibility a periodical follow-up is necessary in these patients. Nowadays, local recurrences are treated with repeated ample local excisions and radiotherapy. This work reviews the literature and presents a new case of round cells liposarcoma of the funiculus.
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41
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[Neoplasm invasion of the renal vein by transitional cell carcinoma of the kidney pelvis]. Actas Urol Esp 1990; 14:133-6. [PMID: 2378269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We present two cases of renal pelvis transitional cell carcinoma with invasion of the renal vein. We emphasize the importance of preoperative diagnosis and review the diagnostic methods available for revealing this uncommon eventuality. Owing to the prognostic importance and subsequent surgical treatment, this possibility should be evaluated in those cases of renal pelvis transitional cell carcinoma with extensive parenchymatous invasion or in those cases in which kidney function cancellation occurs in the excretory urograph.
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42
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[Emphysematous cystitis]. Actas Urol Esp 1989; 13:384-7. [PMID: 2688370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Emphysematous cystitis constitutes an uncommon clinical radiological entity. (Approximately 160 cases in the literature). We offer five cases of emphysematous cystitis, all of which occurred in women aged 60-80 (X = 74.2). All of them except one proved to be known diabetics and the glycemia figures at the time of being attended were above the limits of normality. In no case was pneumaturia observed, and the main symptoms displayed were those of the cystitis type together with pain in the hypogastrium and macroscopic hematuria. Simple abdomen radiology was the diagnosis procedure in all cases. The treatment applied permitted the favourable evolution and resolution of the process.
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43
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Urinary morbidity of vesicoureteral reflux patients without surgical correction prior to renal transplantation. Nephron Clin Pract 1989; 51:571-2. [PMID: 2662040 DOI: 10.1159/000185405] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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44
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[Should systematic correction of vesicoureteral reflux be performed before renal transplantation?]. Actas Urol Esp 1988; 12:259-62. [PMID: 3051910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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45
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Abstract
Fifteen patients with massive vesical haematuria were treated with a 1% aluminium potassium sulphate solution in sterile distilled water, using continuous intravesical lavage with a double channel catheter. The haematuria was caused by vesical tumours in 13 patients, radiation cystitis in one and transurethral resection in one. Immediate side effects were few and none were noted in the long term, as judged by randomised biopsies from vesical mucosa. A complete response was noted in 66% of the patients, partial response in 15% and failure in 20%. This treatment is recommended for intractable bleeding from radiation cystitis and bladder tumours.
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46
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[Fibroepithelial polyps of the ureter]. Actas Urol Esp 1987; 11:435-44. [PMID: 3331056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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47
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Polyorchidism discovered as testicular torsion associated with an undescended atrophic contralateral testis: a surgical solution. J Urol 1987; 137:743-4. [PMID: 2882031 DOI: 10.1016/s0022-5347(17)44199-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We report a case of polyorchidism presenting as torsion of the supernumerary testis associated with an undescended atrophic contralateral testis. Biopsies of both descended testes revealed a normal histological pattern with active spermatogenesis. After the testicular torsion was corrected, one of the supernumerary testes was placed in the contralateral empty hemiscrotum and the undescended atrophic testis was removed. The aesthetic and functional results were excellent.
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48
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[Carcinoma of the renal pelvis]. Actas Urol Esp 1987; 11:29-36. [PMID: 3577883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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49
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[Adrenal surgical pathology. 2: Non-chromaffin tumors]. Actas Urol Esp 1987; 11:61-70. [PMID: 3577888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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50
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[Congenital cysts of the prostatic utricle]. Actas Urol Esp 1986; 10:493-6. [PMID: 3825652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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