Biomedical subjects
Publications and source records attributed to A Bono Ariño.
We report a case of signet ring-cell adenocarcinoma in augmentation colocystoplasty. We review the current literature about tumours developing in augmentation bladder.
We report a case of bladder leiomyosarcoma treated at our department. We review the published papers about this entity. We emphasize the low incidence of that pathology and the lack of consensus about treatment.
OBJECTIVES: To assess the urinary continence after radical prostatectomy and its evolution over time. To analyse possible prognosis factors. MATERIAL AND METHODS: We have reviewed 101 patients that have undergone radical prostatectomy. We define "continent patient" as that one who doesn't require any type of urinary protection. By means of Kaplan-Meier method, we evaluate the recovery of continence along time. We analyze potential conditional factors (age, stage, surgery technique, surgery experience,...). The statistical tools used are: chi-square, Fisher, Cox regression, T-test and Kaplan-Meier. RESULTS: Median monitoring time: 27.33 months. 80% are continent patients, 48.7% of which reach maximum continence before the 3rd, month is due and 17.5% after the 6 months (2.5% between 9-12 months). Their probability of becoming "continents" during the first 4 months es 0.4692. patients under 70 years old recover continence before those who are over 70 years old (medians: 3.51 months and 5.67 months respectively, p = 0.0211). CONCLUSIONS: The recovery of continence takes place progressively and a 17.5% of patients reach plain recovery in the 6-12 months period after surgery. The evaluation of the surgery treatment to correct incontinence should consider the possibility of "spontaneous" recovery in a 2.5% of patients in the 9-12 months period after surgery. Age affects negatively the recovery time; it is significantly less for patients under 70.
We present a case of pure prostatic leiomyoma, benign and rare entity, diagnosed in a patient with prostatism. We review the published papers about this disease and the different subjects about etiology, clinic, histopathology, diagnosis and treatment.
To del with a case of Intrascrotal epidermal inclusion cysts, clinical manifest like three scrotal masses. The patient was operated by transcrotally excision and he remains still asymptomatic. About this case and the terminology difficulties, we propose a differential diagnosis between different cystic lesion showed in the scrotum. The bibliography revision was performed by the Medline since 1966 until 1999.
OBJECTIVE: To report a case of leiomyoma of the bladder, a benign tumor that accounts for 0.43% of bladder tumors. The literature is briefly reviewed. METHODS/RESULTS: A 64-year-old male with prostatic syndrome is described. The preoperative evaluation showed bladder lithiasis and signs compatible with prostatic hypertrophy, but no evidence of a bladder tumor. Endoscopic evaluation, however, revealed a tumor in the bladder neck. Transurethral resection of the tumor, prostate and endoscopic lithotripsy of the bladder were performed. The anatomopathological findings showed leiomyoma of the bladder. The postoperative course was unremarkable. CONCLUSION: Leiomyoma of the bladder does not present specific symptoms and is frequently an incidental finding. The diagnosis is based on the results of the anatomopathological analysis of the specimen.
Bladder hernia is not a rare pathological condition, with a frequency between 0.3% and 3%, reaching the 10% between patients older than 50 years. Massive bladder hernia is less frequent and very rarely ureterohydronephrosis is associated with this pathology, given that the trigone is the only portion remaining fixed after herniation. Five cases have been described in the literature reviewed affecting ureters. The present paper represents the fourth case of bilateral ureterohydronephrosis in the literature. The treatment is surgical correction of the inguinoscrotal hernia.
Genitourinary involvement by the Echinococcus granulosus larvae (urinary hydatidosis) ranks third in order of frequency after liver and lung involvement. The finding of a primary hydatidic cyst with retroperitoneal location is an uncommon fact. This paper presents once case of this infrequent disease. A revision of the different etiopathogenic mechanisms, as well as diagnostic and therapeutic approaches is made.
Presentation of our results in the treatment of urinary exertional incontinence in women using Raz's cervicourethral suspension. From January 1991 through December 1995, 87 patients were operated (mean age: 55.64 years; range 36-74). Mean follow-up was 29.4 months. Recovery from incontinence or permanence of minimal occasional leaks due to major exertion were rated as good results and were achieved in 75 cases (86.20%). Percentage of success in patients with mild incontinence was 93.33%; 88.88% in moderate incontinence; and 58.33% in severe incontinence, differences being statistically significant (p < 0.01). No statistical significance was found relative to age, prior incontinence corrective surgery, hysterectomy or association with urgency incontinence. Prior to surgery, 21 patients also had a component of urgency incontinence which disappeared post-surgery in 18 (85.71%) cases. De novo urgency incontinence appeared in 4 (6.06%) cases. Complications seen were 3 vesical perforations (3.44%). 1 urethrovaginal perforation (1.15%), 2 enterocele (3.44%) and 24 patients with transient urinary retention (27.58%). We believe this technique offers long-term successful results with a moderate morbidity rate.
Presentation of an unusual case of pre-operatively non-striated retroperitoneal cystic mass confirmed to be a gastric leiomyosarcoma after pathoanatomical study. Considering the rarity of the case, we reviewed the literature as well as the epidemiological, clinical, pathoanatomical and surgical characteristics of gastric leiomyosarcomas which, as in the present case, can appear as retroperitoneal mass.
OBJECTIVES: The present study investigated the somatosensory evoked potential (SSEP) from the dorsal penile nerve and the bulbocavernosus reflex (BCR) in healthy volunteers and patients with erectile dysfunction in order to establish a model of normality and investigate the abnormal neuro-urophysiological measurements in patients with erectile dysfunction and their relationship with different factors (age, neurological disease). METHODS: 30 healthy volunteers and 102 patients who had consulted for erectile dysfunction underwent neuro-urophysiological diagnostic evaluation (dorsal penile nerve SSEP and BCR). The mean age was 51.2 years (range 27 to 66). RESULTS: The group of healthy volunteers showed SSEP mean latency of 46.374 ms and a BCR mean latency of 43.721 ms. Thirty-four patients (33.33%) had at least one abnormal neuro-urophysiological measurement, the SSEP were abnormal in 7 (20.58%), the BCR in 5 (14.70%) and both in 22 (64.70%). We found an increased SSEP latency and BCR latency in the patients with erectile dysfunction and with no urological disease. Comparison of the older with the younger patients was only statistically significant for increased BCR latency in patients > 60 years old. CONCLUSIONS: The study revealed neuro-urophysiological abnormalities in 34 impotent patients (33.33%). The finding of abnormalities in both BCR and SSEP was the most frequent.
OBJECTIVE: Repercussion of positive surgical borders (SB+) after radical prostatectomy (RP) in the oncological management of this condition is not yet well defined. The article analyzes their incidence and relevance for tumoral progression. MATERIAL AND METHODS: A review of 204 RPs is made. The erectors' preservation technique has been preferentially used until 1994, while the extracapsular standard technique was used afterwards. SB+ have been correlated to pre-operative PSA, Gleason grade, pathological stage and surgical technique. Also, status of borders has been correlated to progression. RESULTS: SB+ have been detected in 88 patients (43.13%) and were significantly correlated to the pathological stage and Gleason, but not to pre-operative PSA. Although no relation has been ascribed to the surgical technique used in terms of incidence, a decrease of posterolateral borders from 51.8% to 26.2% has been noticed using the extracapular standard technique. Progression is greater in SB+ patients (27.2% vs. 19.2%) but the difference is not statistically significant. SB+ patients who have progressed had all extracapsular tumour, 66% poorly differentiated. CONCLUSIONS: There is a decrease of posterolateral SB+ when the extracapsular standard technique is used. A correlation between presence of SB+ and progression has not been established. No patients with intracapsular tumour and SB+ has progressed. Therefore, it can be inferred his factor has little influence on the evolution of these patients.
Erectile dysfunction is one of the most common sequela from radical prostatectomy. The authors evaluate the incidence of erectile dysfunction after radical prostatectomy, study the likely causative vascular mechanisms and assess the efficacy of the treatments employed. Two hundred and four (204) radical prostatectomies were analyzed. 163 (80%) patients referred adequate erections prior to surgery. In 82 cases, surgery was performed with the intention of preserving one or both bands. For the remaining cases, radical surgery with exeresis of both bands was performed. Due to secondary erectile dysfunction, 75 patients were studied by preparing: clinical history, laboratory tests, penile neurophysiological studies and intracavernous prostaglandin E1 injection test. Dynamic drug-cavernosmetry was performed in 36 patients. After radical prostatectomy, only 9.2% previously potent patients retained adequate erections. Of the 82 cases where preservation of one or both bands was attempted, 9 (11%) patients retained their erections. Changes in neurophysiological parameters were found in 69.2% cases and general vascular injury detected in 23 (63.8%) patients by drug-cavernosmetry, the main injuries being cavernous arteries insufficiency in 58.3% and veno-occlusive failure in 33.3%. Of the 75 patients studied, 48 accepted the treatment: 40 (81.6%) used intracavernous auto-injection, 8 had penile prosthesis inserted, and one patient uses a vacuum device. Intracavernous Pg E1 auto-injection has provided adequate stiffness in 95% patients and, at 6 months from onset of treatment, a decrease of the minimal effective dose has been seen which is more noticeable in men under 60 and patients who start treatment within 6 months.
We report a case of retroperitoneal leiomyosarcoma recurrence. This entity is rare, < 0.2% of all tumours in humans and 25-30% of retroperitoneal sarcomas. The diagnosis is usually delayed in relationship with scarce clinical signs which favorite the development of great tumour volume before diagnosis. The treatment is surgical, with wide margins excision. Radiotherapy and chemotherapy are not adequates for treatment of this pathological entity.
OBJECTIVE: To describe a case of right retroiliac ectopic ureter opening into the seminal vesicle, an uncommon congenital malformation. METHODS/RESULTS: This anomaly was diagnosed in a 24-year-old male with recurrent acute right epididymitis based on the clinical, ultrasound and CT findings. Cystoscopy and IVP provided no additional information. Surgical exploration showed right renal agenesis and a retroiliac ectopic ureter opening into a dilated right seminal vesicle. These structures were resected. Patient evolution was satisfactory with no recurrence of the infective episodes. CONCLUSIONS: Diagnosis of this anomaly is based on clinical suspicion and the findings of the diagnostic imaging techniques. Surgical exploration, which is only required in symptomatic patients, will establish the correct diagnosis and treatment.