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Biomedical subjects

E Trilla Herrera

Publications and source records attributed to E Trilla Herrera.

15 recordsLinked to original sources

[Current status of radical laparoscopic prostatectomy].

Laparoscopic surgery can be said to have come of age when it was first indicated for cancer conditions. Advances in this field are largely due to the French school, which has made it a standard practise in prostate cancer. It complies with the principles required for cancer as well as conventional surgery, but it remains to be verified whether its long-term results, both from tumoral and functional perspectives, are not only similar to those of classical surgery, but even better. In fact, increasing numbers of clinical groups are incorporating this technique in their daily work.

Humans↗

[Renal hydatidic cyst simulating hypernephroma].

OBJECTIVE: To present a new case of hydatid cyst of the kidney with a difficult radiographic diagnosis. MATERIAL AND METHODS: We describe the clinical, diagnosis and treatment of a complex renal mass and its histological confirmation after surgery. Review of the literature. CONCLUSIONS: kidney's hydatidose is an unusual placement of this pathology. It is important to take care in the differential diagnosis in the context of complexes renal masses. There are some diagnosis procedures which can help us to establish it. Surgery is the treatment of choice in the majority of the cases.

Aged↗

[Inflammatory pseudotumor of the urinary bladder].

OBJECTIVE: To present a new case of inflammatory pseudotumor of the urinary bladder. MATERIAL AND METHODS: We describe the clinical, diagnostic and treatment of a new case of inflammatory pseudotumor of the urinary bladder in a 22 years old man without urological history. CONCLUSIONS: The inflammatory pseudotumor of the bladder is a rare benign lesion of unknown etiology. The most important histopathological differential diagnosis to consider is the rabdomyosarcoma. The immunohistochemistry study is basic in the diagnostic, characterization and differentiation of both pathologies. His benign development force us to a conservative management always it is possible.

Adult↗

[Von Hippel-Lindau disease: atypical presentation].

OBJECTIVE: To describe an atypical presentation of von Hippel-Lindau disease. MATERIAL AND METHODS: We present the clinical, diagnostic and treatment of the urological signs of this disease, which has overcoat a neurological management, in a young man with familiar history of it. CONCLUSIONS: The basic knowledge of the von Hippel-Lindau disease is important for the urologist because the urological signs of it, are common and they make up one of the most important causes of morbility and mortality.

Adult↗

[Our experience with the implant of single component integrated prostheses (Hydroflex-Dynaflex)].

INTRODUCTION AND OBJECTIVES: To present our experience with Hydroflex and Dynaflex self-contained inflatable penile prosthesis. MATERIAL AND METHODS: Between october 1988 and december 2000 a total of 63 men underwent implantation of 8 Hydroflex and 55 Dynaflex penile prosthesis. The follow-up period ranged from 12 and 127 months (mean 54.5). RESULTS: A total of 124 cylinders were implanted (in 2 cases only 1 cylinder was implanted). During implantation 3 corpora cavernosun ruptures were present, but implantation was possible in 2. Specific complication rates after implantation were as follow: early infection, 3 patients (4.7%); late infection, 1 patient (1.6%); pain that needed readmission 2 cases (3.2%); mechanical device failure, 7 cylinders in 6 men (mean time 83.5 months). 7 men (11.1%) needed prolonged teaching time to operate the prosthesis. Only 6 men (9.5%) wer dissatisfied with the prosthesis. It was possible to change only 1 cylinder when needed. CONCLUSIONS: Self-contained inflatable prosthesis brings good results on long time use. The mechanical malfunction rate is low and it is possible to change only one cylinder if needed. An important number of patients need intensive and prolonged teaching time to obtain a successful result.

Adult↗

[Hematuria secondary to arterioureteral fistula. Endovascular treatment].

Presentation of case of patient with macroscopic anemic hematuria caused for the presence of a fistula between the external iliac artery and the ureter. After the diagnosis, a treatment with endovascular mangement was made. The arterioureteral fistulae are a very rare entie, which supposes a vital emergency. The diagnosis depend upon the clinical evidences (complementary explorations rarely provide specific findings). Classic treatment is bases on open surgery, while endovascular treatment may be an alternative with less aggressiveness.

Angioscopy↗

[Iliac pseudoaneurysm in non-functioning renal graft 10 years after embolization].

The arterial pseudoaneurysms are an infrequent complication or renal transplantation. Depending on her localization, are divided in intra and extrarenal. The first are relacionated with the practice of percutaneous needly biopsy. The seconds are associated with defects of vascular anastomose or infection onsurgical area (with relative precocious presentation). Presentation of case of a iliac pseudoaneurysm in non-functional kidney allograft embolizated ten years before. This pathology, for this clinic gravity, requires urgent surgical treatment.

Adult↗

[Current treatment of lithiasis in congenital renoureteral malformations].

OBJECTIVE: To evaluate the treatment of urinary calculi in renoureteral malformations. METHODS: From April 1988 to December 2000, we have treated 158 patients with renoureteral malformations (36 horseshoe kidneys, 32 caliceal diverticula, 2 megacaliosis, 2 crossed renal ectopy, 3 polycystosis, 7 hydrocalyx, 24 complete duplex ureter, 18 incomplete duplex ureter, 22 ureterocele, 2 segmental megaureter). RESULTS: Renoureteral malformations were diagnosed in 158 of 19,000 patients that were treated in our stone unit from April 1988 and December 2000. Horseshoe kidney: 54% of the patients treated by ESWL are stone-free; PNL was performed in 2 patients and conventional surgery in another 2 patients. Caliceal diverticulum: 42% of the patients treated by ESWL are stone-free; 3 patients underwent conventional surgery. Other renal malformations: 62% of the patients treated by ESWL are stone-free. Ureteral malformations: duplex ureter and megaureter: 82% of the patients treated by ESWL are stone-free. Ureterocele: due to the poor results achieved by ESWL, we performed endoscopic transurethral meatotomy. CONCLUSIONS: These results indicate that ESWL alone can be considered to be the treatment of choice for small calculi in patients with renal malformations, although we consider it to be mandatory to perform individual assessment of the urinary tract and stone size in these patients in order to choose the best therapeutic option. The same criteria for the normal urinary tract can be applied in ureteral malformations except ureteroceles, for which we advocate performing endoscopic surgery for stone removal.

Humans↗

[Extracorporeal shock-wave lithotripsy: anxiety and pain perception].

UNLABELLED: Three factors in extracorporeal shock-wave lithotripsy (ESWL) result in pain: shock wave pressure, size of focal area and pressure distribution at entry in the skin. Our Lithotripsy Unit has performed 21,000 outpatient treatments (Dornier HM-4 Lithotripter) with no sedation or anaesthetics. Pain requiring treatment discontinuation resulted in 10% instances. Anxiety-associated pain increases the perceived intensity of pain and influences the emotional response to pain. OBJECTIVE: To determine whether the variability in the response to the pain stimulus caused by ESWL is related to the patient's status/trait of anxiety. METHOD: Sample 20 patients; inclusion criteria: pyelic lithiasis > 2 cm, no previous SWEL and no obesity. One SWEL session (2500 pulses, 22 Kv). Anxiety was first evaluated using the status/trait of anxiety index (STAI) questionnaire; after treatment, pain was evaluated on a Numerical Analogic Scale. RESULTS: Pain scores ranged from 2 to 8, mean score 4.1 (S.D. = 1.67); mean score for trait of anxiety 21.8 (S.D. = 8.52), and status of anxiety 29 (S.D. = 5.89). A significant correlation was found between pain-anxiety trait (R = .51; p = .02), which was higher when compared to pain-anxiety status (R = .67; p = .001). CONCLUSIONS: SWEL is a painful therapy (95% of sample had mild-to-moderate pain); pain perception is increased by status of anxiety (45% of pain variance) more than by the trait of anxiety (26.3%); therefore, usage of sedation-analgesia in patients with high anxiety status would improve the lithotripter efficacy ratio.

Adult↗

[Pelvic lipomatosis: clinical review and report of 4 new cases].

First described by the end of the fifties, pelvic lipomatosis is an uncommon disease that develops as a result of an excessive proliferation of benign fat tissue within the perivesical and perirectal spaces. The compressive effect on the urinary, and to a lesser degree, the digestive and vascular structures result in the well-known symptoms. Diagnosis is reached through X-ray studies, primarily computerised tomography. Contribution of four new cases in young males diagnosed through imaging studies as well as biopsies in three of them. Evolution has been varying, with medical control of symptoms in two cases and renal function impairment due to upper obstructive uropathy in the other two.

Adult↗

[Treatment of urethral stenosis with thermo-expandable prosthesis "Memotherm". Our experience].

OBJECTIVE: To report our experience in the treatment of recurrent urethral stricture in the male with the Memotherm heat-expansible stent. METHODS: From December 1995 to March 1999, the Memotherm heat-expansible stent was utilized in 4 patients with urethral stricture that had undergone urethrotomy procedures, periodic urethral dilatation and in those cases with post-traumatic stricture, open surgery for urethroplasty and urethral reattachment. All patients had multiple recurrences of the urethral stricture that was not amenable to the treatments utilized, therefore the intraurethral stent was inserted. RESULTS: All patients had a good postoperative course with unhampered voiding and ample stream. The patients were followed in the outpatient setting by a 6-monthly assessment of micturition and a yearly endoscopic control evaluation to detect hypertrophic growth of the urethral mucosa and/or intraluminal calcification. All the stents were completely enveloped in the urethral wall 12 months after insertion. The only side effects observed was limited postvoid leaking during the first few months following insertion of the prosthesis and one case of transient hemospermia. CONCLUSIONS: The Memotherm intraurethral heat-expansible stent is a valid treatment option for selected cases of recurrent urethral stricture. Although this approach can be utilized before performing urethroplasty, which is often a complicated technique with uncertain results, currently it is a valid treatment option in case of failure.

Adult↗

[Suprarenal myelolipoma: an "incidental" disease].

With the development and improvement of imaging techniques, we are witnessing a greater number of disease diagnoses considered uncommon only a few years ago. When the diagnosis of a tumoral disease occurs "incidentally" while performing an imaging examination for other reasons, we name the condition "INCIDENTALOMA". A clear example of these in suprarenal conditions is the myelolipoma. Myelolipoma is a benign and non-functioning tumour originating in the suprarenal cortex and histologically consisting of mature fat and haemopoietic tissue. Given its benign and usually inactive nature, the current approach is a conservative attitude. Surgical exeresis is only accepted when large tumoral masses are present or in complicated cases. This paper presents a new case of a 10 cm suprarenal myelolipoma incidentally diagnosed during routine ultrasound examination in a 47-year old male patient. Subsequent exeresis of the suprarenal mass and pathohistological study confirmed the diagnosis.

Adult↗

[Primary bladder actinomycosis].

Primary actinomycosis of the bladder is an infrequent presentation of this condition. The main concern is obtaining a differential diagnosis from tumours of the bladder and the subsequent impact this has on the therapeutic choices. Contribution of one case report of a male patient with actinomycosis of the bladder, with remarks on relevant diagnostic (including differential diagnosis) and therapeutic data.

Actinomycosis↗

[Penile and urethral lesion caused by metallic ring. Reconstruction with radial free flap].

We report a case of a man with a severe penile injure caused by a metallic ring placed in the penile shaft for 48 hours, it coursed with partial urethral section and ischemia of the whole penile skin and dartos. It was solved with surgical excision of all death tissue and posterior reconstruction using a forearm free flap, the vascular supply came from epigastric vessels, we used hair-free skin from forearm for the urethroplasty. Ethetic and functional results obtained are successful.

Foreign Bodies↗