Biomedical subjects
Carlos Rioja Sanz
Publications and source records attributed to Carlos Rioja Sanz.
[Tactics in the intramural meatus-pathway].
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[Tricks in the ureter: ureteroscopy].
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[Tricks in the kidney: percutaneous surgery].
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[Tactics in laparoscopy. Retroperitoneoscopy in the kidney and adrenal glands].
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EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines).
OBJECTIVE: To provide the first update of the EAU guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO). METHODS: A systematic literature review was conducted based on the results of a MEDLINE search concentrating on the years 1999-2003. In combination with expert opinions recommendations were made on the usefulness of diagnostic tests, therapeutic options and follow-up. RESULTS: During initial assessment the following tests are recommended: medical history, physical examination including digital-rectal examination, International Prostate Symptom Score, urinalysis, serum creatinine and prostate specific antigen measurement, uroflowmetry and post-void residual volume. All other tests are optional or not recommended. Aim of treatment is to improve LUTS and quality of life and to prevent severe BPE-related complications. Development of a 5alpha-reductase type I and II inhibitor and the data of the MTOPS trial providing scientific evidence for a combination therapy were the most significant innovations since the first version. Finally a more detailed knowledge on the natural history with identification of several risk factors for progression is the basis for a risk-profile orientated (preventive) therapy. CONCLUSIONS: Updated recommendations for assessment, treatment, and follow-up of patients with LUTS due to BPO are presented.
[Laparoscopic lymphadenectomy. Current indications].
OBJECTIVES: To analyse the experience of our own group and other reference groups with laparoscopic pelvic lymphadenectomy since 1990 regarding different aspects: Technical details, results, complications, and establishment of its current indications for prostate cancer treatment. METHODS: We report a retrospective statistical analysis of a series of lymphadenectomies over a 10 year period with a total of 202 cases (69 laparoscopic and 133 open surgical) analysing different lymph node invasion risk factors. RESULTS: Elevated PSA and Gleason resulted in more lymph node infiltration being the cutting point in 40 and 7 respectively. CONCLUSIONS: Laparoscopic lymphadenectomy provides equal diagnostic reliability than the traditional technique. Currently we perform laparoscopic lymphadenectomy in prostate cancer for T3 tumours (independently of PSA or Gleason score) and in < T3 with PSA > or = 40, Gleason > or = 8, and in cases with Gleason 7 and PSA > 20.