Biomedical subjects

J C Ruiz de la Roja

Publications and source records attributed to J C Ruiz de la Roja.

10 recordsLinked to original sources

PubMed1997

[Antimicrobial prophylaxis in urology].

UNLABELLED: Antimicrobial prophylaxis in surgery has proven to be effective in controlled randomized trials. Usage in Urology is known at least since the '30s although its effectiveness has only become known since 1979. METHODS: Review of literature related to surgical antibiotic prophylaxis, more specifically urological surgery, basically from 1991 to 1995, but without overlooking those papers that have become classics due to their impact. RESULTS AND CONCLUSIONS: Efficacy of antimicrobial prophylaxis in urological surgery is nowadays beyond all doubt. Usage is indicated in the presence of sterile urine and dosage must be short, in single dosis in the immediate pre-operative or within 24 hours after the procedure. However, there is a number of issues that deserve to be treated in more detail for better understanding. Those are the establishment of adequate prophylactic regimes in renal transplantation and the use of antimicrobials based on their pharmacokinetic characteristics to optimize the prophylactic purpose.

Anti-Bacterial Agents↗

PubMed1997

[Echographic diagnosis of female urethral diverticulum].

OBJECTIVE: To describe the utility of transrectal ultrasound as an alternative imaging technique in the diagnosis of diverticulum of the female urethra. METHODS/RESULTS: A 35-year-old female that had been initially diagnosed as having a benign tumor of the vagina is described. The voiding cystogram, positive pressure urethrography with a double balloon catheter and urethroscopy were falsely negative for urethral diverticulum of the female urethra. Subsequent evaluation by transrectal ultrasound disclosed on oval-shaped, anechoic lesion located posteriorly to base of the bladder. CONCLUSIONS: Transrectal ultrasound could be the diagnostic imaging technique of choice in patients suspected as having diverticulum of the female urethra.

Adult↗

PubMed1997

[Bladder pheochromocytoma: a rare cause of ureterohydronephrosis].

OBJECTIVE: To describe a case of bladder paraganglioma with an uncommon form of presentation. The clinical features and diagnostic aspects of this condition are briefly reviewed. METHODS/RESULTS: Herein we describe the clinical history of a young male patient that had been misdiagnosed as having a ureterocele causing ureterohydronephrosis and hypertension, and had undergone nephrectomy. Pathological analysis of the surgical specimen revealed the underlying cause of the patients's condition. CONCLUSIONS: Pheochromocytoma is a rare disease entity whose most common form of presentation is hematuria or that which results from catecholamine produced by the tumor. Lesions located close to the ureteral meatus may cause obstruction. If this condition is not suspected and the findings of diagnostic imaging are inadequately interpreted, its diagnosis and treatment may be delayed, thereby increasing the surgical risk due to its secretory nature.

Adult↗

PubMed1997

[Value of transrectal ultrasonography in the assessment of failures of stress urinary incontinence surgery in women].

OBJECTIVES: To describe the role of transrectal ultrasonography as an alternative imaging technique in the evaluation of women who continue to be incontinent following surgical management of female stress urinary incontinence. METHODS: The means of independent samples of transrectal ultrasound parameters of two groups of patients (group I, patients who were continent after surgery; group II, patients who remained incontinent after surgery) were compared. RESULTS: Patients who were continent after surgery showed scanty caudal and dorsal mobility of the bladder neck and proximal urethra during the periods of increased intraabdominal pressure. The US finding in this group of patients is characterized by a funnel surrounding the bladder neck and the proximal urethra. The existence of an intrinsically incompetent sphincter can also be determined with this technique. CONCLUSIONS: Transrectal ultrasonography constitutes an alternative imaging technique in the evaluation of women who continue to be incontinent following surgical management of female stress urinary incontinence. It permitis determining whether incontinence is due to a failed procedure, the existence of an intrinsically incompetent sphincter, or whether other causes of incontinence should be investigated.

Aged↗

PubMed1996

[Usefulness of cystomanometry in the assessment of urinary irritative symptoms].

OBJECTIVES: To analyze the value of cystometry in evaluating patients with irritative voiding symptoms with no remarkable previous medical history. METHODS: 79 patients (24 males, 55 females; mean age 49.6 years) with irritative voiding symptoms and no remarkable previous medical history comprised the study. The patients underwent physical and neurourological examination. The urodynamic assessment included uroflowmetry, filling cystometry, pressure/flow study (and urethral pressure in some cases). Uninhibited detrusor contractions were registered. RESULTS: Cystometry failed to detect involuntary detrusor contractions in 68 of the 79 patients (86.1%) with no relevant medical history. Detrusor instability was not found in 41 of 52 women (78.9%) with irritative voiding symptoms and stress incontinence without neurological disease. Involuntary contractions were not observed in 14 of 16 patients (87.5%) with irritative symptoms with a diagnosis of infravesical obstruction. On the other hand, 33 of 68 patients (48.5%) with irritative complaints and a history of neurologic disease showed no hyperreflexia. A statistically significant difference was found between this latter group of patients and those with no remarkable previous medical history (p < 0.001). CONCLUSIONS: Our results indicate that filling cystometry is of little value in the assessment of patients with irritative voiding symptoms and no remarkable previous medical history, but is more useful in patients with irritative symptoms and neurological disease. Careful history-taking and physical examination should detect the underlying problem in the majority of patients.

Adult↗

PubMed1996

[Obstructive nature of the "double-J" ureteral catheter in idiopathic retroperitoneal fibrosis].

INTRODUCTION AND OBJECTIVES: "Double-J" ureteral stents are commonly used for ureteral diversion, Obstruction of these devices is rare in the absence of certain circumstances. The objective of this article is to discuss the origin of stent obstruction in the Idiopathic Retroperitoneal Fibrosis (IRF) context, and to suggest the most suitable type of urinary diversion. METHODS AND RESULTS: We presented three cases of extrinsic ureteral compression due to IRF who were inserted soft polyurethance "double-J" stents (Urosoft, Angiomed brand), 7 Fr. with multiple side holes. These stents finally turned out as obstructive ones, and needed to be changed for other types of diversion. CONCLUSIONS: Steroid treatment constitutes the first option for these patients, but if ureteral obstruction occurs, diversion should be carried out. We prefer internal ureteral diversion with spiral-reinforced ureteral stents, being also valid options percutaneous nephrostomy or external ureteral stents made of a more rigid type of polyurethane, according to the case. When a soft polyurethane stent is used in a patient with FRI, we should perform a very strict follow-up with appropriate image studies, since the possibility of being not effective always exists.

Equipment Design↗

PubMed1995

[Is it possible to do without bone gammagraphy in the staging of prostatic cancer?].

Since the discovery of the prostate specific antigen, and its use as tumoral marker, not only this has been shown to have a significant application for the diagnosis and evaluation of prostate cancer management, but also to be an eventual help to predict occurrence of bone metastasis. A retrospective study was conducted in 50 patient with prostate cancer, with mean age of 74 years (range 56-90), where PSA levels were analyzed and then correlated with the results obtained with bone scintigraphy. Our work results were that, given a 40% prevalence of the metastatic disease, no patient had PSA values under 10 ng/ml and, at the same time, bone dissemination, i.e., a 100% negative predictive value. Thus, we can state that in our group, we could have given a PSA cut-off value over 10 ng/ml to perform bone scintigraphy, without making any staging mistake.

Aged↗

PubMed1995

[Expectant treatment of superficial bladder tumors: preliminary results].

A group of patients presenting with superficial bladder tumors (Ta-T1, G1-G3) was entered in a surveillance program following TUR. A standard univariative analysis was used to study tumor and patient prognostic factors to recurrence and progression. To define further the importance of each variable, a multivariative analysis was performed. Regardless of stage, grade and sex, patients with multiple tumors and/or size > or = 2 cm were particularly exposed to frequent recurrences. Early recurrences (before month 9) were associated with high recurrence rates. Considering the results of topical chemotherapy and toxicity of BCG immunotherapy, surveillance could be and option for superficial bladder tumors, reserving adjuvant therapy for large, multiple or early recurrence.

Adult↗

PubMedDate not supplied

[Complete urethral duplication in a girl].

Urethral duplication is a very rare malformation which occurs almost exclusively in males. Associated genital and urinary malformations are frequent, and the approach in symptomatic cases in surgical management. This paper presents one case of a full double urethra in a 9-year old girl with repeat urinary infections and incontinence. The accessory urethra was surgically removed using perianal and abdominal access. Evolution has been favourable with disappearance of symptomatology.

Child↗

PubMedDate not supplied

[Clinical course of prostatic abscess treated with transperineal drainage].

It is true that appearance of prostate abscesses is currently not so frequent due to the antibiotic therapy available to stop any kind of infectious process which may trigger abscess formation. Even so, it is important to channel right from the beginning the correct diagnosis and treatment in order to avoid, as far as possible, any complications that may derive from the process. This paper deals with the case of a young patient diagnosed in our service with a prostate abscess, and faced with that suspicion we advocated the use of transrectal ultrasound (TRU) as the method for diagnostic imaging. Also, TRU offers great help as guidance in the transperineal puncture, so as to drain the purulent content. It should not be forgotten the valuable information provided by ultrasound to confirm that the treatment used was effective.

Abdominal Abscess↗