[Severe renal traumatism with conservative treatment].
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Abdominal Injuries↗
Biomedical subjects
J A Millán Serrano
Publications and source records attributed to J A Millán Serrano.
[Cavernous hemangioma of the penis].
We report one case of cavernous hemangioma of penis shaft appeared in a 35 years old man like a painful mass. The blood analysis and radiologics examinations hadn't any important contribution to the diagnostic that, finally, was confirmed during the surgical extirpation and the posterior histological study. We make a brief description about the mentioned pathology.
Adult↗
[Retroperitoneal bronchogenic cyst mimicking adrenal gland tumor].
OBJECTIVE: To report a case of retroperitoneal bronchogenic cyst, an anomaly during the development of the primitive anterior intestine from which the bronchi and lungs are developed. METHODS/RESULTS: A 38-year-old male presented with left lumbar pain. Patient evaluation disclosed a left adrenal polycystic mass which was removed by surgery. Pathological analysis of the surgical specimen demonstrated a bronchogenic cyst. This case is compared with some of the few cases reported in the literature. CONCLUSIONS: Retroperitoneal bronchogenic cyst is a cause of retroperitoneal tumors in the splenic or hepato-renal region. Although it is uncommon, it should be taken into account when making the differential diagnosis.
Adrenal Gland Neoplasms↗
[Colonic perforation in percutaneous surgery of the kidney. Report of two cases].
We show our experience about iatrogenic damage of colon secondarily to percutaneous surgery of the kidney. One of them treated by means of open surgery, the other by conservative procedures. Making discussion on risk factors, as well as the diagnostic therapeutical aspects.
Adult↗
[Nephrogenic adenoma: study of 9 cases, including one of the urethra in a 14-year-old male].
OBJECTIVES: To review our series of nephrogenic adenoma and compare our results with those reported in the literature. METHOD: The records of our Department of Pathology were reviewed to determine the cases of nephrogenic adenoma diagnosed at our center. The clinical features, diagnostic aspects, pathological findings, treatment and outcome are presented. RESULTS/CONCLUSIONS: Nephrogenic adenoma is a rare lesion, probably arising from nephrogenic metaplasia caused by injury to the urothelial mucosa. The site of presentation is frequently the bladder, followed by the urethra. The diagnosis is based on the histopathological findings, which can be occasionally equivocal. The cases described in the present series were benign. To date there is no established therapeutic approach. We performed TUR in two patients, antibiotic therapy was administered in one patient and 4 patients were managed conservatively. Two of our patients had no control evaluation following biopsy of the lesion. In 2 of the 4 patients that were managed conservatively, the lesion remitted spontaneously.
Adenoma↗
[Ureterocervicopexy with bone anchors by the abdominal approach: medium-term results].
OBJECTIVE: To analyze the short- and medium-term results of the Burch-like urethropexy with bone anchors in the treatment of genuine stress urinary incontinence. METHODS: We performed the conventional Burch technique which was modified with the use of 4 bone anchors for bony fixation. Forty-four female patients with genuine stress urinary incontinence were operated on from November, 1995 to November, 1997. RESULTS: The patients had a bladder catheter indwelling for 4 to 9 days and only 3 of them required intermittent catheterization during two months. All patients recovered spontaneous micturition. The postoperative urinary continence was 93% at a mean follow-up of 11 months. CONCLUSIONS: Although our initial results seem encouraging, a continuous and objective follow-up is warranted to assess the long-term efficacy of this technique.
Abdomen↗
[Laparoscopic extraperitoneal suspension of the neck of the bladder in stress incontinence: midterm results].
OBJECTIVE: There are few reports on the medium- and long-term outcomes of laparoscopic suspension of the bladder neck. METHODS: Our medium-term results in 24 patients with genuine stress urinary incontinence who underwent surgery from March, 1994 to July, 1996 are presented. The patients had a mean follow-up of 18 months. RESULTS: Although the initial results were encouraging, some failures appeared in the medium-term and incontinence recurred in 20%. CONCLUSIONS: The overall outcomes of laparoscopic suspension of the bladder neck did not differ from those achieved with the original technique of Pereyra-Stamey and the mean operating time was longer. The mean length of stay did not decrease and the rate of postoperative complications was similar. All the foregoing reasons have led us to abandon this procedure in the treatment of genuine stress urinary incontinence.
Abdominal Muscles↗
[Ambulatory treatment of urinary lithiasis with extracorporeal lithotripsy (Dornier MFL-5000): comparative study of its use with low and high kilovoltages].
The present study compared the results achieved with ESWL using the Dornier MFL 5000 lithotriptor in 133 patients who received analgesics alone during treatment versus 141 patients who received analgesics plus sedation with midazolam. Both patient groups received the maximum tolerated energy and shock waves necessary to fragment the calculi. The patients who received analgesics plus midazolam tolerated the maximum energy of the lithotriptor (30 Kv), which permitted reducing the total number of shock waves required for fragmentation by 49%. Furthermore, the number of retreatments dropped by 38% (1.15 versus 1.53 sessions per renal unit) and the time required for treatment was reduced by 40% (p < 0.01).
Adolescent↗
[Injection of autologous fatty tissue in the bladder submucosa: experimental study in swine].
The results achieved by the use of inert materials via endoscopic injection for the treatment of urological pathologies have been disappointing. Furthermore, these materials are costly, carry the risk of migration and may not be tolerated locally. Autologous fatty tissue, however, is not costly and is tolerated better. The authors have conducted an experiment in the pig to evaluate the degree of resorption and persistence of autologous fat injected into the bladder submucosa. The results show that submucosal injection of autologous fat acts like an autograft and persists as mature fatty tissue. The degree of resorption and/or steatonecrosis is directly related to the amount injected; the smaller the amount used the better the results.
Adipose Tissue↗
[Percutaneous endo-retro-pyelotomy: an elective treatment method in stenosis of the uretero-pelvic junction].
Fifteen adult patients diagnosed as having congenital stricture of the ureteropelvic junction were treated by percutaneous endoureteropyelotomy. Our results were clinically satisfactory in 85.7% (excellent acured 57.1%, good/with occasional mild discomfort 28.5%). Radiologically, 64.2% were normal and 14.2% had mild ectasia but good renal function. No clinical improvement was observed in 14.2% and 21.4% had persistent hydronephrosis indicating the procedure had failed. The most important complication was intraoperative hemorrhage from effraction of an inferior polar artery which required a conventional lumbotomy procedure and Anderson-Hynes pyeloplasty. The foregoing results, with the limitations inherent in data from a small series, indicate that endoureteropyelotomy is the procedure of choice in the treatment of congenital UPJ strictures in the adult patient.
Adult↗
[Urethrocystopexy with bone anchors: technical modification].
OBJECTIVE: To communicate a technical modification of urethrocystopexy which consist in the suspension of the urethropelvic ligaments to the posterior pubic bone with using bone fixations inserted with the In-Fast system. MATERIAL AND METHODS: Between August 2000 and January 2001, thirteen patients with an mean age of 56.1 years were operated with this technic. Using a transvaginal approach and after great opening of the endopelvic fascia we insert one fixation screw in each side of the symphisis pubic bone, later we give two or three stitches to the urethropelvic ligament with the polypropylene no. 1 suture that each screw have joined to their end. RESULTS: The mean stay has been 5.1 days. The cystostomy has been remained for a mean of the 10.1 days. We didn't observe any complication neither intra nor postoperatives. With a mean follow-up of 5.3 months all the patients present a disappearance of their stress incontinence. CONCLUSIONS: Lack of confirm with a larger following and more cases, the suspension of the urethropelvisc ligaments with screw fixations directly situated into the pubic bone per vaginal approach, has been a simple method, safe and highly comfortable for the patients.
Female↗
[Giant hydronephrosis: conservative treatment by endopyelotomy].
A case of giant hydronephrosis in the right kidney and inferior pelvis of the left kidney in a 60-years-old female patient with nonspecific abdominal symptoms and signs is reported. Because involvement was bilateral and the patient insisted on conservative treatment, we performed a bilateral percutaneous endopyelotomy. The excellent results achieved were demonstrated by ultrasound. This however was not true for the functional results due to the irreversible renal lesion.
Female↗
[Bilateral renal angiomyolipoma associated with tuberous sclerosis: conservative surgical treatment].
OBJECTIVES: To evaluate the efficacy of surgical treatment of angiomyolipoma. METHODS: We present a case of multiple, bilateral renal angiomyolipoma in a patient with tuberous sclerosis, who was treated by conservative surgery. RESULTS: The patient is clinically asymptomatic one year after surgery and both kidneys are functioning correctly as shown by pyelography. CONCLUSIONS: We recommend conservative surgical treatment of symptomatic or developing angiomyolipomas.
Adolescent↗
[Endopyelotomy: 6 years of experience].
From January, 1988 to December, 1993, we have performed 35 percutaneous endopyelotomy procedures; 100 had acquired and 25 had congenital stricture. The UPJ was cut posterolaterally with an electric device in 34 cases. The mean follow up was 45.6 months. There were 6 failures (17.1%) that were resolved with the Anderson-Hynes technique (5 cases) and nephrectomy (1 case). There was 1 intraoperative complication (2.86%), a lesion to the accessory inferior pole artery that required open surgery. However, 80% of the cases were successfully treated by endourological techniques.
Adolescent↗
[Adrenal gland myelolipoma. Report of a new case].
OBJECTIVE: We report a new case of symptomatic myelolipoma of the adrenal gland. We analyse clinical, diagnostic, histopathologic and therapeutic aspects. METHOD AND RESULTS: Surgical excision was performed by lumbotomy. The patient was asymptomatic after surgery. DISCUSSION: Adrenal myelolipoma is norfunctioning benign tumour constituted by fat tissue and small islands of haemathopoyetic in a variable rate. The patients are usually asymptomatic. In symptomatic patients the most common symptoms are nonspecific abdominal pain, haematuria and hypertension. The diagnosis is achieved by ultrasound, CT and PAFF. The management is controversial: Surgical treatment or watching are options depending on the size and/or symptoms.
Adrenal Gland Neoplasms↗