Biomedical subjects

Carlos Pascual Mateo

Publications and source records attributed to Carlos Pascual Mateo.

18 recordsLinked to original sources

PubMed2006

[Tobacco consumption and bladder cancer mortality in Spain].

OBJECTIVES: To establish the trend of the bladder cancer adjusted mortality and its correlation with tobacco consumption in different Spanish Autonomic Communities over a 15 year period. METHODS: We evaluate the trends of mortality rates associated with bladder cancer between January 1st 1989 and December 31st 2002 in the geographic area of Spain, as well as the tendency of tobacco consumption. Demographic and mortality data were obtained from the National Institute of Statistics, and consumption data were obtained from the Commissioner for the Tobacco Market in the Spanish Economics and Finances Ministry. We calculate the average number of cigarettes (1 package = 20 cigarettes) consumed per person; we also calculate bladder cancer adjusted mortality rates, presented as number of deaths for that cause per 100.000 persons year, and the ratio between number of packages of cigarettes consumed and adjusted mortality rate. We determine the yearly percentage increase over the whole period of study for both the mortality rate and tobacco consumption, and evaluate their correlation by the Spearman's coefficient. RESULTS: Mean adjusted bladder cancer mortality rate over the period of study was 9.4 deaths per 100.000 habitants year, and mean tobacco consumption was 109.7 packages per person year. There has been a 2.05% yearly increase of bladder cancer associated mortality, mean cigarette consumption has diminished 1.3% per year. The Spearman's test did not show any correlation between both factors (p = 0.722). CONCLUSIONS: Despite preventive measures for tobacco addiction in our country, there is an important continuous consumption. The increase in the incidence of bladder cancer does not seem to be related with higher tobacco consumption currently, therefore it may be related with other genetic or environmental factors.

Humans↗

PubMed2006

[Laparoscopic pyelolithotomy].

The application of laparoscopy as a surgical technique in Urology has enabled to expand the therapeutic options for various pathologies. The treatment of urinary lithiasis localized in the renal pelvis is one of them. We report a laparoscopic pyelolithotomy, describing the operation step-by-step, from patient positioning and trochar insertion to drainage tube insertion and closure. The objective of this article is to show the technique, presenting it as an alternative option.

Humans↗

PubMed2006

[Impact of the weather on the serum levels of prostatic specific antigen (PSA)].

OBJECTIVES: To analyze the impact of season and weather parameters on serum PSA values in men without prostate cancer. METHODS: Retrospective study including medical records from the Spanish arm of the European Randomized Study of Screening for Prostate Cancer (ERSPC). EXCLUSION CRITERIA: prostate cancer diagnosis, PSA > = 10 ng/ml, or PSA > = 3 ng/ml and/or digital rectal examination abnormalities unless a negative prostate biopsy was provided. Univariate relationships between PSA value, season and several weather parameters were assessed. A multivariate logistic regression model was used to identify independent predictors of a PSA value > = 3 ng/ml. RESULTS: A total of 2,147 men entered into the study. Median age and PSA level were 57 years and 0.9 ng/ml respectively. A non-significant trend to higher PSA levels was observed during autumn and winter. Multivariate logistic regression analysis identified only maximum temperature (p < 0.001), minimum temperature (p = 0.001) and age (p < 0.001) as independent predictors of a PSA value > = 3 ng/ml. Mean age-adjusted PSA levels at maximum temperatures of < = 15 degrees C, 16-20 degrees C, 21-25 degrees C and > =26 degrees C were 1.25, 1.20, 1.17 and 1.09 ng/ml respectively. CONCLUSIONS: PSA levels are slightly higher during cold weather conditions. Because of the small magnitude of this PSA increment we do not recommend to change biopsy indication based solely on climatic parameters.

Aged↗

PubMed2006

[Post chemotherapy laparoscopic retroperitoneal lymph node dissection].

OBJECTIVES: To describe the laparoscopic excision of a postchemotherapy retroperitoneal residual mass in a patient with mixed germ cell testicular tumor. METHODS/RESULTS: We report the operative technique of laparoscopic excision of a retroperitoneal mass in a 33 year old patient with mixed germ cell testicular tumor. The patient is placed in a lateral decubitus right lumbotomy position and trocars are introduced into the abdominal cavity. Once the retroperitoneum is approached, and after a Kocher manoeuvre of the duodenum, the interaortocaval mass is identified and excised. The operation is completed with lympadenectomy down to the common iliac artery bifurcation bilaterally. CONCLUSION: The laparoscopic approach is another option for the surgical treatment of residual masses after chemotherapy in testicular tumors. Nevertheless, previous laparoscopic experience is necessary due to its difficulty.

Adult↗

PubMed2005

[Diagnostic antegrade ureteroscopy of the upper urinary tract in the orthotopic neobladder].

OBJECTIVES: To demonstrate the usefulness of antegrade endoscopical examination in the evaluation of the upper urinary tract pathology in patients with orthotopic neobladder. METHODS/RESULTS: We present the technique of percutaneous antegrade ureteroscopy and the indications for treatment of the upper urinary tract urothelial tumor (radical or conservative) depending on multiple pyelo-calyceal biopsies and tumor lesions. CONCLUSIONS: Endoscopical evaluation of the upper urinary tract in patients with orthotopic neobladder offers safer information than urine analysis, urine cytology, and the various radiological tests. The difficulty for retrograde examination is on the identification of the ureteral neomeatus, so that in case of failure, antegrade percutaneous approach allows complete ureteral and pyelocalyceal examination and biopsies thanks to the development of flexible endoscopes. The information supplied by these endoscopical examinations of upper urinary tract urothelial tumors (grade, stage, multifocality) allows the choice of radical or conservative (open surgery or endoscopical) treatment.

Female↗

PubMed2005

[Idiopathic local bladder amyloidosis].

OBJECTIVE: To report one case of primary bladder amyloidosis. METHODS: We studied a male patient with asymptomatic hematuria by means of transurethral resection. RESULTS: Pathologic features were consistent with amyloidosis of the bladder wall. We cannot prove either sites of amyloid deposits or an etiology for this disease. CONCLUSIONS: Local idiopathic bladder amyloidosis is a very rare disease and the most common presenting symptom is painless hematuria. It may be difficult to differentiate between this disease and a urothelial bladder neoplasia.

Adult↗

PubMed2005

[Subcapsular orchiectomy in the treatment of prostate cancer: results].

OBJECTIVES: To analyze the role of orchiectomy in the management of metastasic prostate cancer in our environment. METHODS: We studied 76 patients with the diagnosis of prostate cancer who underwent subcapsular orchiectomy. RESULTS: Mean age was 72 years, median Gleason score was 7, and only 17% had organ confined tumors. Mean follow-up was 2.3 yr. and hospital stay median three days. Ten of the 76 patients in the study died from cancer, being overall five-year survival 75%. Regarding cost analysis, surgical castration was cheaper in the long-term but has the disadvantage of its greater psychological impact. CONCLUSIONS: Orchiectomy is a valid hormonal blockade option when estimated patient survival is longer than one year.

Aged↗

PubMed2005

[Penile prosthesis. Quality outcomes and morbidity].

OBJECTIVES: To study patient satisfaction and complications appeared in a series of patients with erectile dysfunction undergoing implant of penile prosthesis. METHODS: Retrospective study of all patients undergoing surgical treatment for erectile dysfunction by penile prosthesis implant between 1993 and 2003. Collected data included patient age at the time of surgery, previous treatment, and significant medical history. We reviewed the models of prosthesis employed, incisions, and complications appeared. Finally, a questionnaire was elaborated to establish the level of patient satisfaction. RESULTS: 24 prostheses were implanted between 1993 and 2003. Mean patient age was 56.6 +/- 7.56 years (36-63), median 59.5 yr. Penile-scrotal incision was employed in 13 (54.16%) patients, suprapubic incision in 6 (25%) and subcoronal incision in 1 (4.16%). Type of prosthesis: semirrigid AMS 600 9 (37.5%), semirrigid AMS 650 10 (41.66%); the two component hydraulic prosthesis AMS Ambicor was used only in one case. Six (25%) patients presented complications. 16.66% were minor, cavernositis, pain, hematoma or prosthesis extrusion. Prosthesis extraction was necessary in 2 (8.33%) cases. 13 (54.16%) patients responded to the telephone survey 85% of them use their prosthesis. 54% percent refer adequate self-satisfaction and partner satisfaction (well satisfied/much satisfaction). 23% not too bad, and the remainder 23% bad or very bad. CONCLUSIONS: Despite the highest rate of postoperative complications, penile prosthesis is adequately accepted by patients with erectile dysfunction, even malleable models. Patient satisfaction is high, being higher in partners. Most patients would desire to undergo surgery again if they were in the same situation.

Humans↗

PubMed2005

[Spermatic cord rhabdomyosarcoma in an adult].

OBJECTIVES: To report one case of spermatic cord rabdomyosarcoma in an adult patient. METHODS: We report the case of a 36-year-old male presenting with a painful left inguinal scrotal mass. RESULTS: Left radical orchiectomy was performed with excision of the mass. Pathology showed a spermatic cord rabdomyosarcoma. The patient received several cycles of systemic chemotherapy. CONCLUSIONS: Spermatic cord rabdomyosarcoma is a rare tumor derived from the undifferentiated mesoderm. It rarely appears after the second decade of life. Local-regional recurrence after surgery is very frequent. There are adjuvant treatments, the indication and use of which couldn't be included in proper protocols due to the low incidence of this tumour in adults.

Adult↗

PubMed2005

[Ultrasound diagnosis of intratesticular varicocele].

OBJECTIVES: Varicocele is a relatively frequent entity; in most cases venous dilation only involves the extratesticular portion, but 2% of the cases present intratesticular dilation. We report one case of left intratesticular varicocele. METHODS/RESULTS: We report the case of a 25-year-old male patient referred for study of left testicular pain, whose work up only found left intratesticular varicocele. CONCLUSIONS: Intratesticular varicocele is an infrequent entity which can be associated with testicular pain, scrotal mass and infertility or may be asymptomatic. The diagnosis is established by Doppler ultrasound; if symptomatic, it may be treated by spermatic vein ligation.

Adult↗

PubMed2005

[Transperitoneal laparoscopic radical prostatectomy].

Summary.reaching widespread diffusion in the urological community but intensive training is necessary to achieve an optimal level of skill to perform them. We report the transperitoneal laparoscopic radical prostatectomy surgical technique step-by-step.

Humans↗

PubMed2005

[Hemospermia and Mullerian duct cyst].

OBJECTIVES: To report one case of utriculum cyst treated endoscopically. METHODS: We describe the case of a mid-age male patient consulting for long-term monosymptomatic hemospermia. Rectal digital examination revealed a non suspicious adenomatous prostate. Transrectal ultrasound showed a complicated utriculum cyst. RESULTS: Endoscopical marsupialization of the cyst was performed with complete remission of hemospermia. CONCLUSIONS: Transrectal ultrasound should be performed in all patients presenting with long-term hemospermia. Endoscopical marsupialization of the mullerion duct cyst is indicated in symptomatic patients or those with complex cysts on ultrasound, offering a high cure/improvement rate in this group of patients without secondary effects.

Cysts↗

PubMed2005

[Stone Cone: a device that prevents ureteral stone migration during intracorporeal lithotripsy].

OBJECTIVES: Proximal migration of stone fragments during ureteroscopic lithotripsy is a common problem influenced by pressure of irrigation solution, type of energy for lithotripsy, site and degree of fixation of the stone to the ureteral wall, and degree of proximal ureteral dilation. The Stone Cone (Boston Scientific & Spencer) is a device that helps to prevent proximal migration of fragments and favours a safe extraction during ureteroscopic lithotripsy. TECHNIQUE: The Stone Cone is an helical device made of stainless steel and nitinol alloy, which consists of an internal guide wire and a sheath-like radiopaque catheter with a 3 Fr. calibre. Once the cone is placed above the stone it is maintained in that position during lithotripsy to avoid fragment migration. The external catheter is used to coil and unroll the cone, and allows access to place the cone above the stone. METHODS: We describe two cases of urinary calculi in the left lumbar ureter treated by ureteroscopy and intracorporeal lithotripsy with holmium YAG laser using the Stone Cone to avoid migration of fragments. RESULTS: One month after surgery no lithiasic fragments were observed in the imaging tests. CONCLUSIONS: The Stone Cone decreases the need to perform repeated ureteral instrumentations, and is also a safer and simpler method for the extraction of stone fragments. The use of Stone Cone seems to have more advantages than Dormia's basket during ureteroscopic lithotripsy in terms of lower incidence of residual fragments and reoperation rate.

Adult↗

PubMed2005

[Renal carcinoma and ipsilateral pheochromocytoma].

OBJECTIVES: To report one case of associated renal cancer and ipsilateral pheochromocytoma treated by laparoscopic surgery METHODS: We describe the case of a 67-year-old female presenting with left lumbar pain and recurrent urinary tract infections. Ultrasound and abdominal CT scan were performed revealing renal carcinoma and ipsilateral adrenal mass, which was confirmed by MRI. With the diagnosis of left renal carcinoma and possible adrenal metastasis, laparoscopic left nephrectomy and adrenalectomy were performed. RESULTS: Pathologic study of the specimen reported a chromophobic renal cell carcinoma and adrenal pheochromocytoma. CONCLUSIONS: The association of renal carcinoma and pheochromocytoma is unfrequent, as suggested by the limited available bibliography on the topic. The presence of an adrenal mass in a patient with history of primary tumor is frequently secondary to metastasic disease, although primary adrenal neoplasia should not be discarded.

Aged↗

PubMedDate not supplied

[Cystic ectasia of the rete testis].

OBJECTIVES: The cystic ectasia of the rete testis is a benign entity with a typical ultrasound appearance as a collection of small hypoechoic structures in the confluence of the mediastinum testis. The clinical importance of these entity remains on doing an adequate differential diagnosis with testicular neoplasias with a cystic component. METHODS: We retrospectively reviewed the database of the Ultrasound Unit in the Department of Urology looking for patients with a diagnosis of cystic ectasia of the rete testis over a six-year period. RESULTS: Three cases of cystic ectasia of the rete testis were diagnosed over the six-year period, in all the indication for ultrasound was testicular pain. Mean patient age was 62 years. No patient developed testicular tumor on follow-up. CONCLUSIONS: The knowledge of the ultrasound characteristics found in the cystic ectasia of the rete testis helps to make a proper diagnosis of this benign entity without the need of indication of testicular biopsy.

Dilatation, Pathologic↗

PubMedDate not supplied

[Testicular microlithiasis].

OBJECTIVES: Testicular microlithiasis, characterized by the existence of microscopic calcifications within the seminiferous tubules, is rare, generally an incidental finding during a scrotal ultrasound. METHODS: We report the case of a 45-year-old male without risk factors for the development of a germ cell testicular tumor with the diagnosis of bilateral testicular microlithiasis. RESULTS: The patient was followed yearly with testicular ultrasound, without evidence of germ cell tumor over a four-year follow-up period. CONCLUSIONS: Although the clinical significance of testicular microlithiasis is under debate due to the various controversies found in the literature about its association or not with testicular tumors, as well as the various protocols for initial management and adequate intervals for follow-up, it seems reasonable to perform an ultrasound yearly independently of the existence or not of associated risk factors.

Calculi↗

PubMedDate not supplied

[Right transperitoneal laparoscopic nephroureterectomy].

OBJECTIVES: To describe the surgical technique of the right laparoscopic nephroureterectomy. METHODS/RESULTS: With the patient in the lithotomy position we performed an endoscopic section of the ureteral meatus. Once the patient is placed in the lumbotomy position and trocars are placed, the retroperitoneal space is accessed. The gonadal vein, and the ureter medial to it, are identified. We proceed to dissect and clip it. Posteriorly, the Kocher maneuver on the duodenum is performed, identifying the inferior vena cava. We dissect the renal artery and vein placing Hemolock clips on both. Once the vascular control is achieved, we free the upper pole with the help of the Ligasure Atlas instrument. When the kidney is free we continue with the ureter down. CONCLUSIONS: Laparoscopic nephroureterectomy is a feasible technique for groups with experience in laparoscopic surgery.

Humans↗

PubMedDate not supplied

[Descriptive analysis of adverse events associated with transrectal prostatic biopsy after 603 procedures].

OBJECTIVES: To establish the incidence of complications secondary to performance of transrectal prostatic biopsy, and to establish the hypothetical relationship between the rate of fever and the type of antibiotic prophylaxis employed. METHODS: All patients undergoing transrectal prostatic biopsy between January 1992 and December 2003 were included in this prospective nonrandomized study. Patients were given a self-administered questionnaire to obtain data about complications related to biopsy that included the following variables: fever, hematuria, rectal bleeding, hemospermia, voiding difficulties, acute urinary retention, need to visit primary care physician or an emergency department, hospital admissions and need of medication. The incidence of observed complications was calculated and the relationship between post-biopsy fever and type of antibiotic prophylaxis employed (oral ciprofloxacin vs. intramuscular tobramycin) was studied by means of the chi-square test, using the SPSS 11.5 for Windows; a p < 0.05 was considered significant. RESULTS: Overall, 705 questionnaires were received; 603 (85.5%) were considered valid for processing. Almost three quarters (73.9%) of the patients undergoing biopsy presented some complications, being hematuria the most frequent (53% of the cases). 40 patients presented fever (6.64%). Among 360 patients treated with oral ciprofloxacin for three days 16 developed fever (4.4%), in comparison to 24 patients out of 243 treated with intramuscular tobramycin (9.87%) (p = 0.009). CONCLUSIONS: Ultrasound guided transrectal prostatic biopsy is associated with frequent complications, although most of them are mild. The most frequent complication is hematuria; fever is the most severe. To prevent post-biopsy fever, antibiotic prophylaxis with ciprofloxacin for three days is more effective than single dose intramuscular tobramycin. However, prospective randomize studies are required to confirm it.

Antibiotic Prophylaxis↗