Biomedical subjects

A Rodríguez Toves

Publications and source records attributed to A Rodríguez Toves.

11 recordsLinked to original sources

PubMed2006

[TRUS-guided biopsy: comparison of two anesthetic methods].

PURPOSE: The aim of the present study is to compare two analgesic techniques for ultrasound transrectal biopsy. Oral analgesia vs periprosthetic nerve blockade with 2% mevicaine. PATIENTS AND METHODS: A total of 200 patients were randomized prospectively into 2 groups, namely group I: 100 patients treated with metamizol, oral morphine 30 minutes before the procedure, and group II: 100 patients anesthesied with periprosthetic nerve blockade with 2% mepivacaine. Both groups were treated with bromacepán 3 mg 30 minutes before the biopsy. The first intention was to obtain 10 core TRUS-guided biopsy in all patients underwent. After the procedure, a ten visual analogue pain score (VAS) from 0 = no discomfort to 10 = severe pain was administered to the biopsied patients and a global estimation of pain associated with the procedure was obtained. Test T de Student was used for statistical analysis. RESULTS: There were no significant differences in age, PSA and prostate volume. 3 core TRUS-guided biopsy were obtain in group I (3 +/- 1.3), and 10 in group II (5 +/- 1.2) In the periprosthetic block group (II) 95% of patients referred no pain after the procedure (VAS = 0), 2% middle pain (VAS = 5-6) and 3% strong pain (VAS = 7-8); while patients in group I referred 12.5% no pain, 42.4% middle pain, 20% strong pain. The level of pain reported by this group of patients was significantly different from those reported by patients who performed prostate biopsy with periprosthetic nerve blockade. (p < or = 0.05). There were no significant differences in major complications. CONCLUSIONS: The use of bilateral periprosthetic block with mepivacaine is a very effective and useful technique, well tolerated by the patient, which almost completely abolishes the pain and discomfort associated with the prostate biopsy procedure. And also allows increase the number of cores.

Adult↗

PubMed2001

[Treatment of stenosis in uretero-intestinal anastomosis].

UNLABELLED: We report our experience in the treatment of uretero-enteric anastomotic strictures. Our incidence in this complication is 3.8% in orthotopic bladder substitution and 8.3% in ileal conduict. MATERIAL AND METHODS: We have treated this complication in 6 patients with orthotopic bladder substitution and 4 with ileal conduict. We tried to perform a dilatation with a high pressure balloon and to place a Double-J catheter. RESULTS: In 4 cases we could not introduce the guidewire through the stricture because there was a total stop. In the others 6 cases, one is doing well without Double-J, another one did not tolerate the catheter and we performed an open surgical reanastomosis, 2 kept the catheters until their death due to metastases and the other two continue alive with their catheter periodically replaced. CONCLUSIONS: The direct uretero-enteric anastomoses present less stenoses risk. Endourological techniques should be the first option in treatment of these patients.

Anastomosis, Surgical↗

PubMed2000

[Ureteral stenosis of uretero-ileal anastomosis].

Replacement plasty allows to perform oncology surgery while maintaining body image and preserving renal function. Entero-ureteral anastomosis is a significant element in this procedure where the main responsible for the loss of renal function are stenosis, infection and reflux. Our group has performed 206 orthotopical vesical replacements (November 1981-November 1998), using a direct Wallace-type uretero-ileal anastomosis. An intussusception valve system was used as antireflux mechanism. The number of obstructions, rate of stenosis at the uretero-ileal junction and incidence of valve stenosis were all analyzed as part of the complications occurred over a follow-up period of 54 months (6-183). Findings included 6 stenosis at the uretero-intestinal junction and 2 at the intussusception valve. Two (3.8%) of the uretero-ileal stenosis were earlier and associated to fistula; one was treated with open surgery and one had a double J placed through antegrade percutaneous access. Of the remaining late four, only one was treated with a double J catheter while the other three had to be re-operated. Stenoses of the valvular system (1.2%) were solved with open surgery. From our experience, we believe that direct uretero-ileal implantation with scraping of the ureter is a safe technique with little risk for stenosis at the uretero-ileal junction. Intussusception was used a antireflux system in all cases.

Anastomosis, Surgical↗

PubMed2000

[Orthotopic substitutive cystoplasty in women. Technical modifications in anterior exenteration: results in 9 cases].

OBJECTIVE: The results obtained in 9 female patients who underwent bladder substitution after a modified anterior pelvic exenteration are presented. METHODS: From 1994 to 1999, 9 women underwent bladder substitution after a modified anterior pelvic exenteration that preserved the two distal thirds of the urethra, the pubourethral ligaments and endo-pelvic fascia and limited laterovaginal dissection to preserve the innervation of the striated sphincter for continence. RESULTS: The bladder capacity was 332.9 +/- 35.6 ml and urinary flow was 17.7 +/- 2.9 ml/sec. Seven patients are completely continent and two patients have stress incontinence grade II. None of the patients had difficulty with bladder emptying. Fistula (one case) and diarrhea (one case) were the most important complications. CONCLUSIONS: Our approach is based on a better understanding of the anatomical mechanisms of female continence and the viability of the remaining urethra from the oncologic perspective. This technique achieves a high level of patient satisfaction and quality of life.

Aged↗

PubMed1999

[Primary abscess of the psoas. Report of a case].

Psoas abscess is an uncommon condition at the present time. The initial anodyne signs and symptoms make diagnosis difficult. It can be diagnosed and rated as primary when the origin is not found, or secondary when a focus for infection spreading is detected. Drainage either percutaneously or by open surgery, and antibiotic therapy are the choice treatment, achieving an important survival rate. This paper presents a new case of psoas abscess, including a revision of the diagnosis and treatment of this condition.

Adult↗

PubMed1998

[Percutaneous renal surgery].

RATIONALE: Analysis of complications resulting from the renal percutaneous approach. METHODS: Between 1990 and 1996, 175 percutaneous surgical procedures were performed by our group. In 69.2% cases, the reason was a lithiasic condition. We also carried out: 35 endopyelotomies, 12 renal cyst resections, 4 stenosis of uretero-ileal anastomosis, 2 diagnostic nephroscopies and 1 pyelic tumour resection. RESULTS: Total rate of complications was 22.2%. Mortality was 0.5% (one case). Surgery had to be terminated in 13 cases for different reasons. Blood transfusions were required in 9 cases. 3 cases of route perforation required extended maintenance of nephrostomy. Infectious problems developed in 9 cases. There were also 2 renocutaneous fistula, one renocolic fistula and one pneumothorax. No significant differences were found between the total number of complications and the type of treatment carried out. There is however a relationship between the lithiasic condition and the haemorrhagic complications and also with the failure of the approach. There are no significant differences between the number of complications and other variables such as age, sex, side, calix approached or duration of surgery. CONCLUSIONS: The percutaneous approach to the kidney can be considered as a technique with a low morbidity-mortality ratio.

Adolescent↗

PubMed1998

[Permanent endoprostatic prostheses in patient with obstruction caused by benign hyperplasia of the prostate].

Presentation of the results obtained using the intraprostatic prosthesis UroLume in 78 patients wit BPH obstruction, 69 of which presented high surgical risk (ASA IV). Mean age was 79.8 years (r: 62-93). All patients carried urethral catheters, except 4 (5.1%) who had a provisional metal coil that required replacement. Prosthesis were implanted successfully in 72 cases (93.3%). The most significant exclusion criterion was an excessive length of prostate urethra. Mean follow-up was 15.3 months (r: 3-38). Mean maximum flow at 1 year after implant was 12.7 mL/sec; mean symptoms score (I-PSS score) was 6.2 points and in most prosthesis, epithelization had taken place. Three patients required implant of another prosthesis, either during the same surgical procedure (1 case) or later due to retention or dysuria (2 cases). Due to acute urine retention (AUR) during the immediate postoperative, resection of the middle lobe was performed in one case while a second case required late resection of intraluminal hyperplastic tissue. Three patients (4.1%) had haematuria that forced hospital admission some months after the implant, and three cases (4.1%) required removal of the prosthesis; at patient's request (1 case), due to calcification (1 case) and for stress incontinence (1 case). After a follow-up of over three years, it can be concluded that the UroLume prosthesis is an effective alternative to TUR in patients at high surgical risk.

Aged↗

PubMed1992

[Ileal ureteroplasties].

When the ureter is extensively compromised, preservation of the kidney without recurring to external diversion may be attempted by a psoas bladder procedure, transureteroureterostomy, renal autotransplantation or ureteral substitution using the intestine. The first two are not always possible and transplantation is perhaps extremely disproportionate. We therefore recur to ureteral substitution using the intestine. Ureteral substitution may be partial or total, although it is recommended to preserve the upper segment of the lumbar ureter whenever possible. The procedure can be performed using the entire ileal segment with or without modelling to the appropriate thickness. Reducing the diameter of the ileal graft will enhance urine propulsion, reduce mucus secretion and improve antireflux dynamics. Nine cases of ureteral substitution are described herein. Treatment depended on the underlying pathology, extent of ureteral compromise and location. The techniques employed were ureteral substitution with or without modelling and ureteral substitution combined with a bladder repair procedure.

Follow-Up Studies↗

PubMed1992

[Treatment of urogenital tuberculosis with ofloxacin. Preliminary study].

Ofloxacin is a new fluoride quinolone which has been shown to be active both in vitro and in vivo against Mycobacterium tuberculosis. This prospective study presents the results obtained with a new protocol for the treatment of genito-urinary tuberculosis. The comparison drugs were Ofloxacin 200 mg every 12 hours for 6 months, Rifampicin 600 mg every 24 for 3 months and Isoniazid 300 mg every 24 hours for 3 months. The results, were clinically and microbiologically good. It is concluded that this new drug should be a valid alternative to the traditional therapy.

Adolescent↗

PubMedDate not supplied

[Tuberculosis and renal cancer].

The association of tuberculosis and renal adenocarcinoma is very uncommon. In general, the condition presents clinically, radiologically and biologically, as a tuberculosis while the diagnosis of renal carcinoma came as a pathoanatomical finding following nephrectomy. We contribute one case report of tuberculosis and renal adenocarcinoma in association that initially presented with tumoral signs and symptoms in a 34-year-old female patient. The patient, with no previous background, was later diagnosed TBC. A review is made on the pathogenesis, epidemiology and pathoanatomical diagnosis of tuberculosis. It is hypothesized that the tuberculosis damage may be a reactivation secondary to a renal tumour.

Adenocarcinoma, Clear Cell↗

PubMedDate not supplied

[Renal agenesis, cranial blind ureter and ureterocele. Report of a case].

OBJECTIVES: We report a case of associated malformations in a young male with recurrent epididymitis. METHODS: In our study we used the following techniques: ultrasound, intravenous urography, retrograde pyelography, computed tomography and cystoscopy. RESULTS: We observed three coexisting congenital malformations: renal agenesis, cranial blind-ending ureter and ureterocele. CONCLUSIONS: Different urologic malformations are usually found in association. In our view only symptomatic ureteroceles require treatment.

Abnormalities, Multiple↗