Biomedical subjects

Gino Espinales Castro

Publications and source records attributed to Gino Espinales Castro.

7 recordsLinked to original sources

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

[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

[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↗

PubMed2004

[Preliminary results in a series of patients with prostate cancer who underwent radical prostatectomy].

OBJECTIVES: To analyze the preliminary results in our series of radical retropubic prostatectomies (RRP) in terms of complications; and to evaluate also its efficacy in disease control (cancer progression and survival). METHODS: We reviewed the charts of 139 patients who underwent radical prostatectomy. Preoperative data such as age at the time of diagnosis, serum PSA, presence of suspicious digital rectal examination (DRE), clinical stage, and Gleason's score on biopsy. Complications noted after RRP were studied. Survival analysis (Kaplan-Meier) was performed to study clinical and biochemical progression in relation to factors such as baseline PSA, pathologic Gleason's score, pathologic stage, affected surgical margins and capsular penetration. Univariate comparison of factors was performed using the log-rank test. Multivariate analysis (Cox model) was also carried out to identify predictive variables (or risk factors) for progression. RESULTS: 127 patients were available for progression assessment (91.4%). Overall, 19 complications were registered in the immediate postoperative period. 89 patients (91.8%) stated being continent in their last follow-up visit. Complete erectile dysfunction (ED) was noted in 74 patients (76.3%), partial ED in fifteen (15.5%), and 8 (8.2%) reported not they have not problems with their erectile function after surgery. Thirty-four patients (26.8%) presented biochemical progression, being the mean time to progression for the whole series 5.8 years (standard error 0.38). 2 and 5-year probability to remain free of biochemical progression were 71.2% and 58.8%, respectively. Only preoperative PSA (p = 0.023) and Gleason's score in the surgical specimen (p = 0.001) were identified as predictive variables for biochemical progression on the univariate analysis (log-rank). CONCLUSIONS: Radical prostatectomy offers acceptable results in terms of tolerability and short and mid-term survival. Preoperative PSA or Gleason's score in the surgical specimen may help to predict subsequent outcome of the disease.

Adult↗

PubMedDate not supplied

["Mini-percutaneous" percutaneous nephrolithotomy: technique and indications].

OBJECTIVES: Since Helal and Jackman developed the mini-percutaneous ("mini-perc") percutaneous nephrolithotomy (PCNL) for the treatment of pediatric renal lithiasis various authors have used is technique in adults with the aim to preserve renal parenchyma and diminish morbidity associated with the standard PCNL. METHODS: We describe the surgical technique of "mini-perc" PCNL in the treatment of renal lithiasis. RESULTS: We review various case series from the literature of "mini perc" PCNL for the treatment of adult renal lithiasis, its current indications, percentages of stone free patients, and associated problems, mainly the required instruments. CONCLUSIONS: Morbidity associated with "miniperc" PCNL seems to be lower than with the standard PCNL, but the use a smaller calibre tract with the only aim to preserve renal parenchyma does not offer advantages. It is a complementary technique to the standard PCNL; however, the diameter of the percutaneous access is not well defined yet and depends on the calibre of the instruments used.

Humans↗

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↗