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A Borrell Palanca

Publications and source records attributed to A Borrell Palanca.

12 recordsLinked to original sources
PubMed2005

[Urological attendance in the Integral Health Center "Alto Palancia": model of primary-specialized integration and unique consultation].

INTRODUCTION AND OBJECTIVE: The progressive increase in the demand of urological attendance demands to establish new welfare models that avoid the saturation of consultations and improve the quality in the attention to the user. The objective of this work is to analyze the improvement of the welfare activity developed in Integral the Sanitary Center Alto Palancia, after the restoration of new welfare models based on integration between Attention Primary and Specialized and the putting in practice of the denominated Unique Consultation. MATERIAL AND METHODS: We analyzed the characteristics of the Center, functions and activity of the specialty developed during year 2002. We described to the application of the model of Unique Consultation and the elements of integration with Primary Attention. We analyzed the improvement of the activity through indicators, that we compared with preceding years. In order to determine the degree of satisfaction of the users we made a survey of opinion of patients and/or taken care of relatives in the Center under the new welfare models. Finally we analyzed the advantages that the applied process presents for the patient and the own sanitary institution. RESULTS: 42% of patients have been taken care of by means of the model of Unique Consultation, being the predominant pathology the HBP in the man and the ITUs in the woman. The time of delay for first visit has been reduced from 49 days in single December 2001 to 3 in December 2002. Single 7.7% of patients discharged from the hospital for pursuit by Primary Attention have been sent again to the specialist. The time that the urólogo dedicates to consultations has reduced in a 29%, being this time dedicated to the accomplishment smaller surgery and final reconnaissances (echography, urodynamic studies and others). The opinion survey has shown a satisfaction of the user very elevated. CONCLUSION: The model of Integral Attention Primary-Specialized and the putting in practice of Unique Consultation applicable to the specialty of Urology, increasing the quality perceived by the user and with evident advantages for the Sanitary Organization.

Humans↗
PubMed2005

[Comparison of diferents suburethral slings for the treatment of stress urinary incontinence].

OBJECTIVES: To compare the results of the different procedures of sling suburetral used in our service (TVT, Sparc, IVS, Obtape and Monarc) for the treatment of the female urinary incontinence. MATERIAL AND METHODS: 96 patients retrospective analysis affects of female urinary incontinence and subjected to different procedures of sling suburethral without tension. The half age: 56.1 +/- 10.7 years. 75 patients were intervened by means of procedures retropubics (48 TVT, 17 Sparc, 10 IVS) and 21 with obturators (10 Obtape, 11 Monarc). The half time of pursuit: 26.3 +/- 12.7 months (29.4 months for the methods retropubics and 11.7 for the obturators). The analyzed variables were: age, obesity, grade of previous incontinence, type of used procedure, time of pursuit, and previous surgical procedures. We compare the complications and the results obtained with the different ones technical. RESULTS: the cure percentage was of 95.7%. 7 patients presented complications: one intestinal perforation, two bladders perforations, one erosion of vaginal wall, three incontinences of novo urgency. In 6 cases the stress incontinence persists. When analyzing the association between the diverse variables and the success, we appreciate that the variables with value presage were the age and the obesity (P < 0.05) not observing relationship with the technique employeed. CONCLUSIONS: The existence of multiple surgical approachs and a varied auxiliary materials allow each surgeon to choose that with the one that is more familiarized and comfortable without, seemingly, influence it in the results.

Adult↗
PubMed2005

[Treatment of males with post-prostatectomy stress urinary incontinence by a mesh anchored to the ischio-pubic bones].

We presented the results of an alternative in the treatment of the stress urinary incontinence of male radical postprostatectomy. Is a technique of renewed interest in the last years, cradle in the procedure of Stamey, consisting of placing an on guard suburetral polypropylene mesh, anchored by means of screws to the isquiopubian branches. We have applied the procedure in 4 patients and with stress urinary incontinence of long evolution. After an average pursuit of 12.5 months, two patients present total continence, one has improved significantly and in the other the incontinence persists. There have been no postoperating complications nor rejection of the mesh. From these preliminary results and the reviewed bibliography, we thought that this technique can constitute an alternative to the artificial urinary sphincter, dices its clinical results, its facility of execution, the good tolerance and his low cost.

Aged↗
PubMed2003

[Unusual bladder tumors: primary epidermoid carcinoma, adenocarcinoma, and sarcoma. Clinical behavior. Our experience].

INTRODUCTION AND OBJECTIVES: Non-transitional cell tumours of the bladder are both a diagnostic challenge for the pathologist and a therapeutic challenge for the urologist, because although uncommon (less than 5% of all malignancies of the bladder) they show different biological behaviours each requiring a unique approach. The most significant pathoanatomical types are: primary epidermoid carcinoma, primary adenocarcinoma and primary sarcoma. This paper presents an analysis of our experience in these types of tumours. MATERIAL AND METHODS: A retrospective study of unusual cases of cancer of the bladder seen in our hospital between 1988-2001. Their biological behaviour and the therapies applied are analysed. The extravesical origin of the tumour was ruled out in all cases. RESULTS: We found 21 cases of the following pathoanatomical varieties: 13 epidermoid carcinomas, 7 adenocarcinomas (3 urachal) and 1 sarcoma. Mean age was very different between epidermoid carcinomas (69.2 +/- 9.1 years) and adenocarcinomas (50.3 +/- 8.1). Tumour behaviour was very aggressive in all three histological varieties. At the time of diagnosis 19 patients had locally advanced stages (> or = T2). Although elective therapy was cystectomy, this was only feasible in 10 cases. Systemic chemotherapy (most frequently M-VAC) and/or local radiotherapy was used in 7 cases. 14 patients have died after a mean survival of 15.7 +/- 11.6 months. CONCLUSIONS: Late diagnosis of these tumours and their aggressive biological behaviour involve a gloomy prognosis. Only early diagnosis and radical therapy could improve the prognosis.

Adenocarcinoma↗
PubMed2000

[Anterograde insertion of ureteral catheter].

We report twenty-four patients with urinary obstruction, in which twenty-seven antegrade ureteral stent (double J) insertions were attempted (in six patients the obstruction was bilateral and in three other patients we failed). In all of them access to the urinary tract was through a nephrostomy catheter, in seventeen cases we proceeded to insert the antegrade catheter immediately after percutaneous nephrostomy and in ten remaining cases we achieved in a second try after carrying nephrostomy and failing a conventional retrograde approach to ureteral stent insertion. We got a 90-per cent success rate. A case of perirrenal hematoma occurred after applying a nephrostomy. It was the only relevant complication. In conclusion we consider that the antegrade ureteral stent insertion is a good alternative when, under several circumstances, the conventional retrograde insertion fails.

Female↗
PubMed2000

[Tuberous angioma of the glans penis: treatment with laser and local anesthesia].

A case of angioma tuberous of the glans penis treated with Neodymiun:Yag laser under local anesthesia in a eleven-years-old outpatient is reported. These lesions are extremely rare. Local excision of this tumor was accepted treatment, but we think that laser treatment (Neodymiun:Yag) is far superior to surgical excision and we think this treatment of choice. The particularity of the case we report, is aside the rarity, the possibility of treatment in an outpatient child, with local anesthesia and excellent tolerance.

Anesthesia, Local↗
PubMed2000

[Studer-type orthotopic urinary bladder: our experience].

OBJECTIVE: To analyze the outcome, complications and functional results in patients undergoing bladder substitution with the Studer continent urinary pouch. METHODS: The clinical records of 6 male patients who underwent radical cystectomy for invasive bladder cancer and bladder substitution with the Studer reservoir at our hospital from January 1996 to February 2000 were reviewed. Patient mean age was 54.2 years and mean follow-up was 14 months. Follow-up evaluation included abdominopelvic CT, chest x-ray, urinalysis, blood biochemistry, venous gasometry and ultrasonography with evaluation of postvoid residual urine. RESULTS: Transitional cell carcinoma was found to be the most frequent histopathological type. Distribution by grade and pathological stage showed they were all high grade infiltrating tumors localized to the bladder. Four patients are free of disease, one died from metastatic disease and one patient with tumor progression and multiple lung metastases at two months' follow-up is currently on chemotherapy. The mean operating time was significantly longer for this procedure than for the non-continent Bricker urinary diversion (mean 7.2 hours vs 3.5 hours, respectively). The immediate postoperative complications were: ileus (> 7 days) in two patients, diarrhea (> 3 days) in two, occlusive ileus due to fecaloma in one, metabolic acidosis in one, wound seroma in one, and wound infection in two patients. The early and late postoperative complications were: incontinence for up to one month after removing the urethral catheter in three patients (two of these patients are still incontinent at two months' follow-up), wound infection in two and impotence in 6 patients. CONCLUSION: Reservoir function in the medium-term is good; spontaneous urethral micturition and continence are maintained. To achieve good results, patients should be followed carefully and should be given detailed information about postoperative care and management.

Carcinoma↗
PubMed1999

[Retroperitoneal germ cell tumor].

We report a case of retroperitoneal extragonadal germ-cell tumor in an 17 years old patient who presented with aedema and pain in left inferior extremity asociated with hemopthysis caused by pulmonar metastasis, who was treated with chemotherapy and resection of residual mass and pulmonary nodes. Dyagnosis was stableshed by fine neadle aspiration biopsy of the wass. We comment on the difficult of stableshing differential dyagnosis between retroperitoneal extragonadal germ-cell tumor and metastasis of a testicular tumor. Dyagnosis is stableshed by the finding of a histologically malignant germ-cell tumor with normal testis. We considered physical examination and ecographyc exploration enough for a correct dyagnosis.

Adolescent↗
PubMed1996

[Cystic lymphangioma of the adrenal gland in adults. Review of the literature and report of a new case].

Presentation of one case of cystic lymphangioma of the suprarenal gland in a 34-year-old female patient with a background of lower urinary tract infections, presenting with continuous and aggravating pain in left lumbar area and with no other associated symptomatology, diagnosed with ultrasound, IVU and CAT. A review of the literature is made. The present study pretends to give an overall view of a rare and benign disease, commenting upon the difficulties found in its diagnosis and the different therapeutical options.

Adrenal Gland Neoplasms↗
PubMed1995

[Bladder leiomyoma. Review and report of a case].

OBJECTIVE: The present study reviews bladder leiomyoma, an uncommon pathology. The problems of differential diagnosis and the therapeutic options are discussed and the literature reviewed. METHODS/RESULTS: A 33-year-old female with anterolateral intramural leiomyoma of the bladder is described. Patient evaluation included US, cystography, CT, cystoscopy and ultrasound-guided suprapubic puncture. CONCLUSIONS: Leiomyoma is an uncommon benign tumor of the bladder. To our knowledge, only 235 cases have been reported in the literature. We advocate the use of ultrasound-guided suprapubic puncture, a simple procedure that is frequently diagnostic, in the evaluation of this tumor type.

Adult↗
PubMed1994

[Acquired enterovesical fistulas].

We report on 23 patients with acquired vesicoenteric fistula treated during the past 12 years: 48% of these were of inflammatory etiology (11 cases), 35% were caused by neoplasms (8 cases) and 17% were iatrogenic (4 cases). The most frequent symptoms were pneumaturia and fecaluria (78% of cases). Cystoscopy was the most useful diagnostic procedure in detecting fistula (13 of 18 cases). Other imaging techniques, though less effective for diagnosis, were useful in assessing the status of the GI tract and, at times, in determining the etiology of the fistulae. Treatment depends on the etiology, localization and patient general condition. The technique most frequently applied in our series was resection of the fistulous tract, together with the compromised intestinal segment, and bladder suture.

Adult↗