PubMed Health⌕ Search

Biomedical subjects

C Miguélez Lago

Publications and source records attributed to C Miguélez Lago.

At least 19 recordsLinked to original sources
PubMed2005

[Spontaneous urinary bladder perforation after pediatric cystoplasty].

OBJECTIVE: The spontaneous cystoplasty perforation is a serious and potentially fatal problem if a delay in diagnosis and treatment occurs. We pretend: 1) to look for prevention analyzing the risk factors, 2) to identify the main data of diagnostic suspicion and 3) to evaluate the result of the treatments done. MATERIAL AND METHODS: Out of 30 children with cystoplasty 5 of them have presented 8 perforations (16,6%). Several influential factors, the symptoms, the treatments and the evolution are reviewed. RESULTS: The average time between cystoplasty and the perforation was 8,2 years. A urethral resistance that allows continence, and an insufficient intermittent catheterization, have been the main risk factors. In the 8 episodes there were abdominal pain and distension. The ultrasonography showed intraperitoneal extravasation in 5 episodes, multiple peritoneal cysts in one, and suggestive image of appendicular plastron in another one. The cystography showed intraperitoneal extravasation only in 3 cases. The initial management was conservative in the 7 episodes diagnosed before surgery, and 3 had a good evolution (42,8%); the other 4 needed surgery with good evolution in all cases. Two of 5 patients (40%) presented 3 relapses in an average time of 5 years. The survival is 100%. CONCLUSIONS: 16,6% of patients with cystoplasty of this series had one or more episodes of spontaneous bladder perforation. The more significant risk factors are a high urethral resistance and an inadequate intermittent catheterization. The patients with cystoplasty, and their families, must know this complication, their risk factors and symptoms to prevent it, or to facilitate an early diagnosis.

Adolescent↗
PubMed1999

[Long-term follow-up of children with neurogenic bladder and artificial urinary sphincter].

MATERIALS AND METHODS: Since 1986 an artificial urinary sphincter was implanted in 16 children (13 males and 3 females) 4 to 12 years old (median age 9) in order to solve their urinary incontinence. Mean age at implantation was 9 years. In 10 children (63%) only the implant procedure of artificial sphincter was performed without any other procedure associated (Group A), while in 6 children an augmentation cystoplasty simultaneously was performed (Group B). The results were analysed in both groups separately: 1. Group A: 10 patients. Two are functioning excellently after 10 and 11 years of follow up. Eight developed some type of troublesome: Five developed a deterioration of urinary tract and all of five were treated by augmentation cystoplasty; one of them is in a good condition after 11 years, another presented a fail of the device after 10 years, it has been changed, and in the others three the apparatus was removed by diverse causes. Two developed a mechanical fail of device: one was removed due familiar decision and the other has received another device. One urinary fistula developed 6 months later. The device was removed. 2. Group B: 6 patients (artificial sphincter and augmentation cystoplasty simultaneously). Five are functioning without trouble some. One persistent urinary fistula. The device was removed. Actually, of 16 cases (both groups) 8 cases (50%) are good functioning, 6 devices have been removed and 2 are waiting a new implant. CONCLUSIONS: The artificial urinary sphincter is a good solution for children with urinary incontinence in selected cases, but is mandatory a correct follow up because longterm complications can be developed. Results seem better when an augmentation cystoplasty is associated.

Child↗
PubMed1997

[Laparoscopy in the non-palpable testicles. Is it always necessary?].

In order to know the role of diagnostic laparoscopy with non palpable testicles (NPT), 15 children with 16 NPT were studied. Middle age was 7 years (R: 2-12). The surgical procedure was: laparoscopy initially and open inguinal surgery (OIS) after that. Six NPT were discovered with laparoscopy (37.5%). With OIS inguinal hernia was present in 4 cases, with testicle into the inguinal sac in 3 cases; 12 cases had not inguinal hernia, and 6 of them showed spermatic vessel and vas deferent without testicle. Orquidopexy of the 6 located testicles and testicular prothesis implantation in the other 10 cases, were performed. Finding of laparoscopy and OIS were perfectly correlated. Laparoscopy made the diagnosis in 7 cases, which the OIS would have been unable to do it (43.7%). In the other 9 cases, the OIS would have been diagnostic enough (56.2%) without laparoscopy. For those results, the authors prefer to begin the surgical procedure with OIS and if the spermatic vessels are no located, then the laparoscopy is done under the same anesthesia.

Child↗
PubMed1997

[The treatment of the primary intrarenal reflux. Is the surgery always necessary?].

UNLABELLED: THE AIMS OF THIS STUDY was to evaluate the relationship between intrarenal reflux (I.R.R.) and reflux nephropathy (R.N.) in order to know the results of surgical and non surgical treatment. Fifty one children with 64 kidneys with primary I.R.R. were studied. 53% of them were less than one year of age. Initial examination were: urography, ultrasounds, cystography and DMSA scan; the follow up was done with ultrasounds, DMSA scan and cystography. When no R.N. was present, grade of reflux was < IV, and age < 12 years, a non surgical treatment was indicated. RESULTS: During first examination R.N. was demonstrated in 47% of kidneys; the main difference was the grade of reflux: 16/44 II-III (36%) and 14/20 IV-V (70%). Surgical treatment was performed in 42 (82%) children and non surgical in 9 (18%). Reflux stopped in 98% and 100%, respectively. Only one child, without R.N., developed a new renal scar, and a previous R.N. progressed in two. I.R.R. can be treated successfully without surgery in selected cases.

Child↗
PubMed1996

[The first year of life of children with myelodysplasia: a multicenter study of 393 cases].

A multicentric study about the first year of life of myelodisplastic children, was done. Family, pregnancy, delivery, newborn somatometry, and anatomical-pathological and terapeuthical aspects were review in 393 patients born before july 1992. Annual prevalence vary from 6 (1973) to 28 (1984). The families clinical history was not significant. There were 9 (2,3%) gemelar pregnancies, but both children were affected only in one case. Prenatal ultrasound was not diagnostic in 61%-84% of patients are meningomyeloceles, the anatomical level of myelodisplasia was lumbar and or sacral in 98%. There was hydrocephalus in 59%, hip dislocation in 24%, feet deformities in 50%, upper urinary tract dilatation in 12%, vesicoureteral reflux in 15%. In total 825 surgical procedures were performed (M = 2); the neurosurgery was 94% of them.

Adolescent↗
PubMed1996

[Enterocystoplasties: results in 22 children].

A study of paediatric enterocystoplasty in 22 children of 1 to 14 years of age (M = 8) during 5 years is presented. The diagnoses were: neurogenic bladder 16 (73%), extrophic bladder 3, urethral valves 1, and complex uropathies 2. The intestinal segments used were: ileum 12 cases, sigmoid 8, and ileocaecal region 2 (non myelodisplastic). During the last years sigmoid have been preferred due to its bigger size. The middle follow up is 3.5 years (R 1-6). The results have been good in: renal function 86%, and upper urinary tract 95%. Bladder capacity was 278% higher, bladder pressure was 82% less, and residual urine was 217% more, than preoperatively. Five children developed 6 complications (23%), and 4 reinterventions were performed (18%). When it is indicated, paediatric enterocystoplasty is a good alternative to urinary diversion, and it is useful to prevent the upper urinary tract deterioration; but a frequent and, all the life long follow up is necessary, due to its possible complications.

Adolescent↗
PubMed1996

[Postnatal differential diagnosis of fetal ureteropelvic dilatation].

UNLABELLED: A clinical study of 51 children with prenatal diagnosis of pielocaliceal dilatation with 65 kidney affected is done. The objective was to assess the accuracy of the postnatal diagnostic studies practiced in order to an early differentiation between obstructive and non obstructive dilatation. MATERIAL AND METHODS: There were evaluated ultrasonography (US), intravenous pielography and diuretic isotopic renogram. The data were statistically analyzed with SPSS program. A regression logistic analysis was carried out between all the significant variables in order to identify the obstruction risk factors. Also the probabilities calculated index and the sensibility and specificity were studied. RESULTS: The obstruction risk factors were: grade III dilatation or greater in the US, differential renal function less of 40%, and half time more than 21 minutes. The probabilities calculated index showed that the probabilties of obstruction are different according to the number of obstruction risk factors presented in every patient. Risk factors have a high sensibility and specificity as diagnostic test.

Diagnosis, Differential↗
PubMed1992

[Laparoscopic testicular autotransplantation].

The authors describe an experimental technique of endoscopic autotransplantation of the testis. Four trocars are utilized; one is placed at the level of the umbilicus, one in the right flank, another in the left flank, and one in the hypogastrium. Five or six cms of the epigastric vessels are dissected and sectioned. Then the spermatic vessels and released from the inguinal orifice up to their origin and sectioned. The testis is taken to the peritoneal cavity through the skin and the sustenaculum testis is sectioned. Both vascular pedicles are exteriorized through an incision at the level of the inguinal duct. Microvascular anastomosis is performed as in a routine procedure and the vessels are inserted into the abdomen again, the testis is taken to the scrotum and the inguinal duct is closed from inside.

Animals↗
PubMed1992

[Laparoscopic orchidopexy].

The authors have experimented in the pig the possibility of endoscopic treatment of cryptorchidism. Sixteen orchidopexy procedures were performed utilizing 12 Large White pigs weighing 10 to 15 kg. The procedure is described herin, including some details of anesthetic induction. The animal is placed in the Trendelenburg position and three trocars are inserted, in a position which corresponds to that of the umbilicus in humans (through which a laparoscope is passed), in the hypogastrium and in the hypochondrium of the corresponding side. The spermatic vessels are dissected all the way up to their origin and the vas deferens up to a short distance from the bladder. Then an incision is made in the inguinal canal, from the epigastric vessels up to the conjoined tendon. Pressure is applied outside until the testis is introduced into the peritoneal cavity where it is released by sectioning the sustenaculum testis. The cord is then pulled and passed in front of the epigastric vessels and taken out through the deep orifice of the inguinal canal. Once it is free in the peritoneum and after the vessels and the vas have been dissected, it is brought to the bottom of the scrotum with the grasping forceps and the aid of the hand outside. Then it is fixed with a suture through the skin. Finally, the incision in the inguinal canal is sutured with atraumatic nylon 0 suture as in the McVay technique for inguinal hernia repair. The procedure has started to be employed in the clinical setting.

Animals↗
PubMed1990

[Enuresis and urinary pathology].

The incidence of urinary pathology is studied in 71 pediatric cases of primary nocturnal enuresis. These incidences have been 18.3 per cent, but there are two different groups. After a negative urological anamnesis, incidence goes down to 5.4 for 100 (3 patients of 55). When anamnesis shows suspicious of uropathy, incidence growth to 62.5 for 100 (10 patients of 16). Urological study with ultra sound and XR is recommended in nocturnal enuretic children only when there are suspicions of uropathy after a detailed clinical exploration and anamnesis.

Adolescent↗
PubMed1987

[Clinical aspects of infantile megaureter].

84 patients with 126 megaureteres, are studied. There are some clinical differences depending on the type of megaureter and the patient's age. The number of asymptomatic cases is increasing due to ultrasonography during fetal and neonatal period. The younger the patient the more unspecific the symptomatology. Fever, anorexia, failure to gain weight and vomits are the most frequent symptoms in babies. In patients over 6 years of age a more specific symptomatology is present, such as dysuria and lumbar pain. Failure to gain weight is more frequent in cases of refluxing megaureter, especially when they are caused by obstructive uropathy, and when they are bilateral. A urological check up is recommended during fetal ultrasonography: in babies with failure to thrive; in all cases of urinary tract infection; and in micturition disorders.

Adolescent↗
PubMed1984

[Contralateral reflux after unilateral antireflux surgery].

108 unilateral antireflux surgical procedures are analysed over a period of seven years. All the cases were operated upon for essential or primary renal reflux, using ureteral advancement techniques crossing the bladder midline. There were 10 patients who developed contralateral renal reflux (CRR) in the postoperative evolution (9,2%). The CRR disappeared in all cases, but three of them needed surgical treatment because of urinary tract deterioration (Reflux nephropathy, bladder lithiasis, and shift of reflux grade from I to III). Two different surgical antireflux techniques were utilised. Using the Glenn-Anderson's technique the incidence of CRR was 9/68 (13,2%) whereas this incidence was 1/40 (2,5%) using the Cohen's technique, which does not disrupt the trigonal area. The authors do not believe that systematic bilateral antireflux surgery for unilateral reflux is necessary. When CRR occurs an initially conservative management is recommended.

Child, Preschool↗
PubMed1984

[Renal injuries in children].

16 children admitted to the hospital for blunt renal trauma were studied. Following Mandour's classification 10 cases were minor, five mayor and one was critical. No vascular or ureteral problems were seen. The treatment was initially conservative in all cases, without explorative lumbotomy or perirenal drainage. Only one patient was operated on for an arteriovenous fistula in the renal parenchyma; an exeresis of that portion was done. The follow-up (for one year) with clinical, IVP, echography and blood pressure controls was normal in all cases. The present authors prefer a conservative management, whenever possible, and surgical treatment only for complications and vascular or pyeloureteral disruption.

Child↗
PubMed1980

[Early diagnosis of G.U. tract anomalies through angiocardiography in congenital heart disease patients (author's transl)].

A study done in 100 consecutive pediatric heart catheterisations is presented. Filming reno-uretheral system after angiocardiography has selected 28 patients with possible or proven urological anomalies; in 19 of these, intravenous pyelography was abnormal. Cistogram showed 4 cases of vesicorenal reflux among these. Surgical treatment for grade IV reflux was needed in two patients. It is recommended, thus, that renoureteral system by filmed as a routine after angiocardiography, so as to screen associated uropathies.

Abnormalities, Multiple↗
PubMed1978

[Respiratory distress syndrome and pulmonary congenital malformations (author's transl)].

The present report is based on three infants with respiratory distress syndrome due to congenital lobar emphysema in two and cystic adenomatoid malformation of the lung in the third. The serious worsening of the respiratory distress in two children prompted a partial pulmonary resection within the first 24 hours of life. A brief description of the clinical, radiological and pathological characteristics of this anomalies is included. Our three patients remain asymptomatic showing a normal development, after a follow-up period of five months in one child and just over two years for the other two. Any neonate showing progressive respiratory distress should have a chest X-ray taken to rule out a lobar emphysema or a severe malformation of the lung leading to abnormal ventilation. The management in this cases should be the immediate resection of the affected pulmonary lobes.

Female↗
PubMedDate not supplied

[Spontaneous autoembolization in a child with high-flow post-traumatic priapism].

There are two sort of priapism: the venous or low flow priapism, that is usually painful, and the arterial or high flow one, painless and rare, especially in childhood. We present a case of a boy 5 years old, who 6 days after to suffer a perineal closed traumatism, had a painless and arterial priapism, with aneurism and fistula of the dorsal penile arteria, that was resolute spontaneously through self-embolization, 11 days after. We review the bibliography of 14 cases of arterial posttraumatic priapism in childhood, without find any case resolute by spontaneous self-embolization.

Blood Flow Velocity↗
PubMedDate not supplied

[Pyeloureteral stenosis secondary to Schoenlein-Henoch purpura].

We present an 8-year-old male suffering from Schönlein-Henoch purpura with multisystemic clinical manifestations, which developed as a complication a pyeloureteral stenosis secondary to vasculitis. He was operated on and a ureteropyeloanastomosis was carried out according to the Anderson-Hynes technique with good results. We discuss the etiology, diagnostic methods and therapeutic possibilities. It is the eighth case in the literature requiring surgical correction as a result of this exceptional complication.

Child↗