["Back table" in descapsulated kidney for transplant].
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Adult↗
Biomedical subjects
E León Dueñas
Publications and source records attributed to E León Dueñas.
Peripheral afferent nerve stimulation for treatment of lower urinary tract irritative symptoms.
OBJECTIVES: To assess the efficacy of posterior tibial nerve stimulation for treatment of lower urinary tract irritative symptoms (urgency, frequency, urge incontinence and pelvic pain). PATIENTS AND METHODS: 51 female patients with a mean age of 55 years were enrolled in the study. The patients presented with the following symptoms: Frequency/urgency 26 patients (50.98%), urge incontinence 22 (43.13%) and interstitial cystitis 3 patients (5.88%). The technique consists in administering low voltage electric stimulation via a 3-5cm needle placed above the tibial malleolus. Patients received weekly stimulations of 30 minutes for a 10-week period. Quality of life questionnaires and voiding diaries before and after treatment were completed. Moreover, the results were evaluated by patients. The variables analysed include: daytime and nighttime voiding frequency, daytime and nighttime voiding volume, daytime and nighttime leakage episodes and hypogastric pain. RESULTS: A statistically significant improvement was seen in all variables, especially remarkable in relation to frequency/urgency, impact on women quality of life and hypogastric pain, being less marked in relation to leakage episodes and voiding volume. CONCLUSIONS: Afferent nerve stimulation offers an alternative treatment for managing lower urinary tract irritative symptoms. However, it would be advisable to confirm the results obtained by means of long-term randomized, follow-up studies.
Adolescent↗
[Urinary lithiasis secondary to indinavir in an HIV-positive patient].
OBJECTIVE: Indinavir is a protease inhibitor used in the treatment of HIV with a lithogenic capacity as a urological side effect. The pathogenesis, diagnosis and treatment of indinavir urolithiasis are briefly reviewed. METHODS: A 37-year-old male, seropositive for HIV on treatment with indinavir, lamiduvine and zidovudine, consulted for colicky left lumbar pain, nausea, vomiting and dark urine for the past three days. RESULTS: Patient evaluation showed a nonfunctioning left kidney and ureterohydronephrosis of unknown origin. URS showed a yellowish, friable material with a mucinous appearance that occupied the entire lumen of the ureter. Fragmentation was achieved with the lithotriptor probe. Six months later the patient had fully recovered and was asymptomatic. CONCLUSIONS: The incidence of protease inhibitor-induced urolithiasis is increasing. This condition should be distinguished from uric acid calculi whose treatment will aggravate the indinavir urolithiasis.
Adult↗
[Bladder carcinosarcoma. A clinical case].
Presentation of a new case of vesical carcinosarcoma in a 49 year-old male patient. The tumour's pathoanatomical study showed an epithelial pattern of transitional and squamous cells and a sarcomatous pattern composed of rabdomiosarcoma, osteochondrosarcoma and pleomorphous indifferentiated sarcoma with giant multinuclear cells. Histogenesis, signs and symptoms, and treatment, as well as the need of performing an immunohistochemical study for its diagnosis are discussed.
Biopsy↗
[Giant müllerian cyst. An infrequent cause of palpable hypogastric mass].
Due to its remarkable rarity, large volume and good post-operative evolution, the authors present one case of a cyst from Müller's duct debris, 18 x 16 cm in size, in a 22-year old male who presented with tangible mass in the hypogastrium and occasional nycturia. The size conditions the clinical symptomatology, although the are times such as this, when they can acquire a considerable volume and grow with practically no symptoms. Clinical history and diagnostic methodology are explained, pointing out the most relevant clinical criteria for proper differentiation from other entities, the complexity of differential diagnosis and the therapeutical procedure used.
Adult↗
[Ureteral revascularization in kidney transplantation. Report of a case].
We present uretero-pyeloplasty as a new surgical approach to stricture of the pyelo-ureteric junction in the transplant recipient. The foregoing is more frequently found in kidneys that are placed in the inverted anatomic position. The surgical procedure is performed without difficulty and at the same time permits us to evidence the presence of a new ureteral revascularization from the recipient after the interruption of vascular supply of the donor kidney.
Adult↗
[Oncocytic cell tumor. Problems, diagnosis, therapy].
Renal oncocytoma is an uncommon tumor. At least 203 such cases have been reported. This urologic condition represents a diagnostic difficulty and because its natural history has not been elucidated, its treatment remains a controversy. Two recent cases of renal oncocytoma seen at our Urology Service prompted us to review the literature and analyze the diagnostic methods, therapeutic approach and its prognosis.
Adenoma↗
[Angiomyolipoma of the kidney. Comments on 3 recent cases].
We report another three cases of renal angiomyolipoma with different modes of presentation and treatment. Two cases are considered to be of particular interest; one patient presented chyluria in the course of the disease and Wunderlich's syndrome posteriorly, and in the other patient the presenting features were extrarenal. The diagnostic and therapeutic possibilities are discussed and attention is focussed on the conservative approach whenever possible.
Adult↗
[Echographic studies in renal transplant. Our experience].
The present study briefly reports our experience in the evaluation of renal transplantation by conventional and pulsed Doppler ultrasound. We advocate the use of both imaging techniques in these patients because these are safe, reliable, easy-to-use, reproducible noninvasive imaging techniques that afford a high diagnostic yield.
Humans↗
[Angiodysplasia of the terminal ileum].
Angiodysplasia, a recently discovered disease, is a pathology of scant incidence in our environment and difficult to find because of the inconclusiveness of diagnostic proofs. The disease, generally related to adults and the elderly, and preferentially located in the large intestine, does not always manifest this way. The case we present is one of the youngest in the world literature and of ectopic localization in the terminal ileum. This confirms the enigmatic aspect of this pathology, which still has characteristics to be delimited. Its etiology, incidence and prevalence are unknown and there are no unanimous criteria for its classification or possible association with other pathologies.
Arteriovenous Malformations↗
[Echography and cytology versus cystoscopy in the follow-up of patients with superficial tumors of the bladder].
We present a prospective study on 100 consecutive patients diagnosed with superficial vesical tumour who have had a transurethral resection done on them. For the detection of relapses we use the echography-cytology association and confirm the findings observed by performing a cystoscopy. In view of the high rate of concordancy obtained we conclude by backing this association as a possible alternative to be applied in the control of specific patients with superficial vesical tumours.
Cystoscopy↗
[Unstable detrusor: usefulness of biofeedback].
Presentation of results of treatment using Biofeedback in two conditions which quite frequently associate vesical instability and incontinence: 65 cases of enuresis and 39 of urinary stress incontinence in females. The method was effective and achieved disappearance of detrusor instability in 78.2% of enuretic cases and 58.9% of urinary stress female incontinence. Outcome for incontinence was less favourable since disappearance was only achieved in 70.5% of enuretics and 20.5% cases of female incontinence. A brief description of the method and instrumentation used is done, which can be easily conveyed to any electromiographic device with real time output. The paper substantiates the authors' views relative to the likely pathogeny of the instability in both processes and the mechanism of action of Biofeedback techniques.
Adolescent↗
[Biofeedback as a therapeutic alternative in uncoordinated miction].
The Hinman Syndrome is known as an involuntary unsconscions contraction of the periurethral sphincter during micturition once neurologic disease and anatpmical obstruction are rejected. We report a case of a 23 years old man who was diagnosed of suffering from this syndrome. After the proper studies and left nephroureterectomy for ureterohydronephrosis secondary to long term massive vesicoureteral reflux, we proceeded to treat him with biofeedback and autocatheterisms. Six months after, the patient was asymptomatic with normal micturitions without residue.
Adult↗