[Nephrobronchial fistula secondary to chronic xanthogranulomatous pyelonephritis as a cause of pulmonary abscess and persistent hemoptysis].
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Bronchial Fistula↗
Biomedical subjects
A Borque Fernando
Publications and source records attributed to A Borque Fernando.
[Incidental prostatic cancer: T1a-T1b. Our experience after observation/radical surgery and literature review].
OBJECTIVES: To analyse the progress of T1a and T1b prostate cancer diagnosed in our hospital. MATERIAL AND METHODS: Retrospective study of 40 patients in T1a-T1b clinical stage diagnosed with prostate adenocarcinoma in our hospital, from 1986 to 1999. A restaging biopsy was performed on the 16 T1a patients after initial diagnosis and control. A radical prostatectomy was performed on the 24 T1b patients. They were all monitored every six months with rectal exam and PSA. We analysed biological and/or clinical progression, time to progression, mortality caused by the tumour and survival. RESULTS: None of the 16 patients with T1a clinical stage presented tumour progression, with a median follow-up of 90 months. 12,5% of the 24 T1b cases presented tumour progression, with a median follow-up of 70 months. Cancer-specific mortality was one patient (4,16 %) in the T1b group. CONCLUSIONS: Observation and follow-up with PSA and rectal exam appears to be a good option for T1a clinical stage, given the good prognosis. Our results show that patients with T1a clinical stage and good prognostic factors could be at a similar risk of suffering from a new prostate cancer as the normal population, although prospective studies are required to validate these results. T1b cases require active treatment and closer monitoring.
Adenocarcinoma↗
[Which is the most appropriate diagnostic algorithm for prostate cancer screening?].
Since the use of PSA to detect prostate cancer was generalised in the late 1980's, prostate cancer diagnosis has increased considerably. Although there is now indirect evidence pointing to the beneficial effect of screening, there are no data justifying PSA screening in the general population. There is also a controversy concerning the most appropriate algorithm, should screening be performed. Therefore, our aim was to review the literature and, based on our experience, attempt to define the best algorithm for prostate cancer screening. We have made a search on Medline using the following terms: prostate biopsy, screening, algorithms, radical prostatectomy, PSA and prostate cancer. After analysing the literature, we can confirm that there is no "definitive" algorithm, due to the rapid appearance and use of new technical and biological breakthroughs, although it appears that at this time, without ceasing to include a rectal examination, more value should be given to personal risk factors, including PSA, at ages under 50, with individual monitoring based on these factors. The algorithms applied to a population have first to be validated for the population concerned.
Algorithms↗
[Renal teratoma, case report and review of the literature].
We report a case of intrarenal teratoma in a 39-year-old female patient. The clinical course after three years of follow-up has been satisfactory, finding the patient totally asymptomatic. Extragonadal teratoma occurs predominantly along the median line of the body. Intrarenal teratoma is extremely rare; however, it should be distinguished from other cystic lesions.
Adult↗
[Penile curvature secondary to cavernous body abscess].
A case of unilateral cavernosal body abscess appears after fifteen days of 40 degrees C fever, without urological symptoms. The diagnosis started from a big scrotum aedema, related of a local septic focus in the left cavernosal body. ECO and TAC confirmed the diagnosis, and a surgical treatment was required. After a successful evolution, the patient presents a left penile incurvation with pain and difficulties during the sexual relations, but he did not accept any treatment.
Abscess↗
[Skin metastasis of long-course prostatic cancer].
OBJECTIVE: To present a case of prostate cancer of long evolution and follow up time, in the one which has been evidenced the appearance of skin metastases at hypogastrium level, inferior extremities root and inguinal zone. METHODS: Patient diagnosed of prostate cancer, treated with radical prostatectomy and followed in conferences during ten years by the neoplasica disease. RESULTS: Appearance of skin metastases of a prostate cancer, after ten years of a radical surgery, in the one which the pathological anatomy demonstrated the local infiltration at seminal bladders level. CONCLUSIONS: The skin metastases of a prostate cancer are extremely uncommon, appearing in most of the occasions in process of very long evolution and in those which the disease has not been able be controlled.
Adenocarcinoma↗
[Thrombosis of the renal artery secondary to closed abdominal trauma].
We report a case of female 24 years old who had a blunt abdominal trauma. The immediate consequence was the radiological evidence of a left kidney abolition, secondary to a renal artery thrombosis. The treatment was conservative, and there was not a surgical procedure.
Abdominal Injuries↗
[Penile fracture: report of a case].
Traumatic rupture of the corpus cavernosum of the penis is rare, and has been reported infrequently. We present a case with this type of trauma, with immediate surgical management, with good morphologic and functional results.
Adult↗
[Stage pT3 prostatic cancer after radical prostatectomy. Results in progression and survival].
PURPOSE: To analyse progression and survival after radical prostatectomy in patients with stage pT3 carcinoma of the prostate. MATERIAL AND METHODS: Between 1986 and November 1998, we performed 372 radical prostatectomies, 74 of which were pT3N0 (19.8%), 43 pT3a and 31 pT3b (TNM 97). RESULTS: In patients with pathological stage pT3, we found any progression in 24 patients (32%), 8 in pT3a, and 16 in pT3b. In 10 of 24 pT3, there was local relapse or distant metastases. About the freedom from biochemical relapse survival rate, we found statistically differences between pT3a and pT3b (p < 0.0001). In pT3a patients, we found no differences between PSA levels > 20 ng/ml, versus < 20 (p = 0.415), and statistically differences between pathological Gleason 6 or greater, versus < 6 (p = 0.048). However, we found no differences when we used both criteria (PSA and Gleason) (p = 0.195). CONCLUSIONS: We support for early adjuvant hormonal therapy in pT3b patients. In pT3a, the hormonotherapy may be used if appears biochemical failure, specially with adverse prognostic factors (PSA and Gleason).
Disease Progression↗
[Cervico-urethro-suspension by the Raz's technique in the treatment of stress urinary incontinence in women].
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.
Adult↗
[Predicting factors of tumor organ-confinement in adenocarcinoma of the prostate].
OBJECTIVE: Difficulties for a precise staging of patients with prostate cancer are huge. This article presents the initial results from a study to investigate the contribution that various clinical and analytical parameters, together with the study of prostate biopsy for staging, could have on our environment. MATERIAL AND METHODS: 70 patients undergoing curative radical prostatectomy were studied through an analysis of their PSA. PSAD, and PSAD ad pre-operative levels and, in the biopsy cylinders, the tumour unilateral or bilateral nature, Gleason grade, percentage and total number of involved cylinders, and percentage of cancer length over the cylinders' total length. This data was then correlated to the pathological stage. Gleason's grade and tumoral volume of the surgical specimen. RESULTS: 97% of patients studied showed clinical organ confinement versus only 64.28% after examination of the surgical specimen. (I Kappa = 0.1). Concordance between the biopsy's Gleason grade and the prostatectomy specimens was moderate (I Kappa = 0.34). Pre-operative PSA showed no statistically significant difference (SSD) between organ-confined and non-organ-confined tumours (p = 0.15), opposite to PSAD (p = 0.039) and PSAD ad (p = 0.038) which did. The tumour's unilateral or bilateral nature in the cylinders, and the total number or percentage of affected cylinders showed no SSD with regard to organ confinement of tumours. Neither the length percentage of the affected cylinders showed SSD in relation to the tumour's organ confinement. The specimen's tumoral volume was significantly correlated to the length percentage of cancer and positive biopsies, as well as with clinical stage, PSA, PSAD, and PSAD ad. CONCLUSIONS: Both PSAD and PSAD ad, and the sum of the biopsy's Gleason may contribute to predict the pathological stage. The percentage and total number of biopsy cylinders affected by the tumour, as well as the total length percentage of cancer affected cylinders are correlated to the tumoral volume but not to the organ confinement of the tumoral disease, not meeting the clinical stage in our patients (selected according to our group's staging algorithm). These findings must be ratified by further study of larger series.
Adenocarcinoma↗
[Positive margins. Surgical techniques and progression after radical prostatectomy].
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.
Adenocarcinoma↗
[Quality of life after radical prostatectomy].
OBJECTIVE: To evaluate the quality of life of our prostatectomized patients relative to the following factors: continence, mictional quality, sexual potency and psychological repercussion. MATERIAL AND METHODS: The study includes a series of 204 patients undergoing radical prostatectomy between June 1986 and October 1996, where a personal questionnaire was administered to 112 of them. The questionnaire consisted of 25 questions dealing with various aspects related to their quality of life. RESULTS: The overall rating on continence shows the following results: total continence 59.8%, minimal incontinence grade I 17.8%, moderate incontinence grade II 13.3% and total incontinence grade III 8%. Only 2.6% retains sexual potency after surgery. 29.3% of impotent patients consulted for their dysfunction. 91% declared to be satisfied with the results of the surgical procedure. CONCLUSIONS: In our experience, continence (total + grade I incontinence) is acceptable for 77.6%, the level of mictional satisfaction being very high. There is a high index of impotence after surgery. However, most patients appear to be impervious to this fact. Overall, quality of life of our patients has not changed significantly as a result of the intervention.
Aged↗
[Prostatic rebiopsy. Prognosis factors of the anatomopathologic result].
The indications for repeat prostate needle biopsy after a previous biopsy are not defined. We examined 107 prostate biopsies (in 98 patients) without a diagnosis of malignancy, which we repeat. Carcinoma was detected in 31 patients (31.6%). We didn't find statistic relationship between the repeat biopsy's outcome and: interval between biopsy and repeat biopsy, PSA value, PSA density (biopsy), PSAD of the transitional area (PSAD ad., on repeat biopsy). We found relationship with: prostatic weight (p = 0.002 on the biopsy, p = 0.0002 on the repeat biopsy), volume of the transitional area (p = 0.02 on the biopsy, p = 0.0001 on the repeat biopsy), PSA value (p = 0.02, on the repeat biopsy), PSAD ad. (p = 0.002, on the repeat biopsy), and with PSA velocity (p = 0.008). We only found clinic usefulness for the PSA velocity: patients with PSA velocity greater than 1 ng/ml/year are at high risk for prostate carcinoma on the repeat biopsy, specially in small prostates.
Aged↗
[Finding of thrombocytopenia in a patient with hematuria].
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Carcinoma, Renal Cell↗