Biomedical subjects

A Collado Serra

Publications and source records attributed to A Collado Serra.

7 recordsLinked to original sources

PubMed2004

[Treatment of post radical prostatectomy erectile dysfunction with sildenafil in a non-selected group of patients].

OBJECTIVE: To evaluate erectile disfunction (ED) after radical prostatectomy in a non selected group of patients and their response to sildenafil. METHODS: We included our patients who were operated on between 1998 and 2001. The patients filled in a modification of IIEF (mIIEF) before the RP operation. We tried sildenafil with doses of 100 mg in 3 different periods: 3-6, 12 and 18-24 months after the RP operation. In the event of a complete response they filled in the mIIEF again. RESULTS: The mean age of the patients was 62.8 years old and the mean observation period was 31.7 months. Only 111 (62%) of the total number of patients operated on wanted treatment and only 90 took sildenafil in the proposed protocol; 27 (30%), 18 (20%) and 45 (50%) patients had a complete response, a partial response or no response to the sildenafil respectively. The mIIEF showed 6.5+/-5.7 points less than the mIIEF pre-treatment. In the univariate analysis, the preservation of bundles, the presence of a previous partial response and the presence of the previous tumescence were significantly related to the complete response; however, only tumescence kept its value in the multivariate study. CONCLUSIONS: Urologists must involve themselves in the early rehabilitation of the erectile function even in those patients where preservation of the NVB was not possible. One must always try to preserve, uni or bilaterally, whenever the patient desires preservation of EF. The response to sildenafil is better after the first year and in patients who have previous tumescence.

Aged↗

PubMed2000

Current management of calculi in horseshoe kidneys.

OBJECTIVES: To assess treatment options for calculi in horseshoe kidneys and the impact of extracorporeal shockwave lithotripsy (ESWL) on the management of renal stones. MATERIAL AND METHODS: From June 1971 to January 1998, 52 patients with horseshoe kidneys and calculi received treatment at our Urologic Stone Unit. There were 40 men (77%) and 12 women (23%). Average patient age was 41 years (range: 10-70 years). Clinical onset, treatment received and outcome were evaluated retrospectively. A successful outcome was defined as a patient without residual calculi or with fragments <0.4 cm in size. RESULTS: Clinical onset was mainly low back pain in 37 patients (71%). Eighty-nine stones were treated, i.e. an average of 1.7 treatments per patient. Before the ESWL era (May 1987), we performed two heminephrectomies, 16 pyelolithotomies, 12 pyelolithotomies combined with ureteropyeloplasty and one percutaneous nephrolithotomy. Since the advent of ESWL, seven pyelolithotomies and three pyelolithotomies combined with ureteropyloplasty have been done. ESWL was used to treat 48 calculi. In three cases the patient was placed in the prone position due to difficulties in stone focusing. In 37 cases (77%) patients were either rendered stone-free or had residual fragments <0.4 cm in size. Urinary diversion for obstruction was carried out in two cases (4%). CONCLUSIONS: At present ESWL is the first-choice treatment for calculi in horseshoe kidneys. It involves no significant focusing difficulties and is associated with a low incidence of obstructive complications. Open surgery is indicated in cases of stone-related pyeloureteral stenosis and in the presence of calculi >2-2.5 cm in size.

Adolescent↗

PubMed2000

[Ileovesical fistula in Crohn's disease].

OBJECTIVE: To discuss the clinical presentation, complementary evaluation procedures and treatment of ileovesical fístula, an uncommon complication of Crohn's disease. METHODS/RESULTS: After the clinical presentation, complementary evaluation procedures were performed to confirm the diagnosis in all cases. Treatment was based on the patient's general condition; surgery was performed in two cases and one case was carefully followed. CONCLUSIONS: Ileovesical fístula is an uncommon complication of Crohn's disease. Occasionally, the urological symptoms may precede the digestive symptoms, therefore this condition should be suspected particularly if the complementary evaluation procedures are not very sensitive. Surgery is the treatment of choice.

Adolescent↗

PubMed1999

Renal hematoma as a complication of extracorporeal shock wave lithotripsy.

OBJECTIVE: To evaluate risk factors, clinical presentation, therapeutic management, and treatment of residual stones and subsequent development of renal hematoma following Extracorporeal Shock Wave Lithotripsy (ESWL). MATERIAL AND METHODS: A retrospective review was made of 31 post-ESWL renal hematoma cases diagnosed between May 1987 and June 1996. Lithotripsy treatments were outpatient procedures without anaesthesia. Our center has three electromagnetic sources, two with biplane X-ray centering and one ultrasound-guided (SIEMENS Lithostar II, SIEMENS Lithostar System C and SIEMENS Lithostar Ultra, respectively). We analysed findings from patient history, physical examination, blood analysis, and renovesical sonographs. Follow-up involved periodical checks, blood analyses and renovesical sonographs, scheduled first at three-month intervals and later at six-month intervals. RESULTS: Our center performed 21 699 lithotripsies on a total of 10 953 patients in this period. Thirty-one renal hematomas were diagnosed, giving an incidence rate of 0.28%. Twenty-four patients presented clinical onsets and the commonest symptom for consultation was low back pain (74%). Eleven patients of this group (46%) were hypertensive. All patients received conservative treatment. With a mean follow-up time of 18 months, ultrasound showed persistent hematoma in 11 patients (36%). There were residual stones in 71% of patients; further lithotripsy was performed on seven patients with no clinical or ultrasonographic signs of change in the hematoma. CONCLUSIONS: Renal hematoma post-ESWL is a rare complication. Main risk factors are hypertension, clotting disorders and previous ESWL sessions. Flank pain is the main symptom at presentation. Elective management is conservative. Presence of hematoma is not a contraindication for further treatments of residual stones.

Adult↗

PubMed1999

[Bladder malacoplakia: 14-year follow-up of a case].

OBJECTIVE: To describe the clinical findings, treatment and results of long-term follow-up of a case of malacoplakia of the bladder. METHODS/RESULTS: After diagnostic endoscopic evaluation, transurethral resection of the lesion was performed and antibiotic therapy was administered. The same treatment was repeated 4 years later. During the following 10 years, the patient had a yearly endoscopic evaluation that showed no recurrence of the lesion. CONCLUSIONS: Transurethral resection combined with antibiotic therapy is effective in the treatment of malacoplakia of the bladder. The importance of long-term follow-up of the patient is emphasized.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Urinary bacteriologic study prior to endoscopic urologic surgery].

OBJECTIVE: The objectives of this study are to know the incidence of preoperative bacteriuria in patients undergoing endoscopic urologic surgery, to analyze the most frequent microorganisms appearing in the cultures and their resistance to antibiotics in order to select the most appropriate prophylactic one for our population, and to determine the risk factors related to postoperative bacteriuria or sepsis of urologic origin. MATERIAL AND METHODS: 449 patients undergoing endoscopic urologic surgery were included in the study. Urinary samples were collected for culture prior to prophylactic antibiotic administration and again a week after bladder catheter removal once the antibiotic treatment was finished. Variables related to an increase in infectious complications were analyzed. Special attention was paid to postoperatory incidences, mainly those of infectious nature. RESULTS: Preoperative bacteriuria was found in 66 out of 428 patients (15.4%). It was found to be related to age, sex, previous infection episodes, diabetes mellitus, indwelling catheter and to the pathology for which operation was indicated. The most frequently found microorganism was Escherichia Coli. Resistance to prophylactic antibiotic was found in 37.9% of patients with preoperatory bacteriuria. Postoperatory bacteriuria, observed in 22.0% of the patients was exclusively related to preoperatory bacteriuria. 2.9% of patients showed sepsis of urinary origin criteria during hospital staying, and it was found to be exclusively related to length of surgery and neither to preoperatory bacteriuria nor to indwelling catheter time or the "inappropriate" prophylactic antibiotic use in these cases. CONCLUSIONS: A good part of patients who underwent endoscopic surgery showed preoperatory bacteriuria, responsible for postoperative bacteriuria in less than 25% of the cases. The length of surgery seemed to be the only related cause whit sepsis of urinary origin.

Aged↗

PubMedDate not supplied

[Spurious renal tumor: acute lobar nephronia].

OBJECTIVE: To report a case of acute lobar nephronia, an unusual form of localized renal infection, and review the literature with special reference to the clinical features, ultrasound and CT findings that distinguish this condition from other renal masses (abscess, infected cyst and renal carcinoma). METHODS/RESULTS: A female patient presented at the emergency services with symptoms and signs compatible with pyelonephritis. An admission abdominal ultrasound scan demonstrated a solid mass in the left inferior renal pole. CT showed a renal mass with peripheral enhancement after infusion of contrast and central striation. Blood and urine analyses were compatible with renal infection. Acute lobar nephronia was suspected and antibiotic treatment was administered. Control ultrasound and CT examinations performed one month after instituting antibiotic treatment showed the mass had disappeared. CONCLUSIONS: Acute lobar nephronia should be considered in all patients with a renal mass detected during an episode of urinary infection. Correlation of the clinical and radiological findings, and resolution of the mass with appropriate antibiotic therapy will confirm the diagnosis.

Acute Disease↗