Biomedical subjects

J J Pacheco Bru

Publications and source records attributed to J J Pacheco Bru.

6 recordsLinked to original sources

PubMed2006

[TVA and TOA. New adjustable mesh for the treatment of female stress incontinence. Preliminaries results].

OBJECTIVES: Evaluation of a new mesh for incontinence (TVA/TOA) which enables the degree of tension applied during surgery to be readjusted at the post-operative stage. PATIENTS AND METHOD: 62 patients treated with the TVA mesh and monitored over a 14-month period (SD 7.8, range 6-38). In 33 patients (53%) some other pelvic prolapse was corrected. Evaluation was carried out by clinical report, examination of bladder full of 250 saline solution, flowmetry and urinary residue. 40 patients filled in 4 quality of life questionnaires (QoL; ICIQ-SF; PGI-S; PGI-I). RESULTS: 42 patients were found to be objectively continent in the post-operative evaluation. Of these, it was necessary to reduce tension in 7 cases (11%) due to urinary obstruction (flow < 10 ml/sec and/or residue). The tension of the mesh was tightened in 20 patients (32%) due to continue with a certain degree of incontinence. All patients were discharged as continent and with no residue. In the last revision, 58 patients (93%) proved to be objectively continent and 4 (6.5%) showed a notable improvement in their incontinence. The Q(MAX) is 19.8 ml/sec (SD 9.8). The mictional urgency had disappeared or improved in 32 of the patients who had this prior to operation (76%) and had appeared in 3 of the patients who didn't (15%). The clinical report showed a high level of consensus with the ICIQ-SF survey (Kappa = 0.89) regarding stress incontinence, diminishing clearly (Kappa= 0.13) when urge incontinence was taken into account. 34 (85%) patients scored over 95 out of 110 in the QoL. 30 (75%) scored less than 6 in ICIQ-SF. 32 (80%) showed a perception of normality and 4 (10%) slight illness in the PGI-S. In the PGI-I 29 (72.5%) were much better and 11 (27.5%) quite a lot better. A relation exists between urgency and dismissed quality of life. CONCLUSION: With the TVA (trans-vaginal adjustable) mesh it is possible to adjust the tension originally applied during surgery at the post-operative stage, so that any defects or excesses can be corrected.

Adult↗

PubMed2003

[Necrosis of the skin of the penis as a complication of the use of a urine collector].

We illustrate a case of penile skin necrosis in a patient suffering from urinary incontinence caused by a secondary neurogenic bladder that, in turn, results from a spinal cord injury. The skin necrosis developed out of continuous pressure from the condom catheter. We report the case bearing into consideration that these complications are extremely rare and that references in the literature to the topic are likewise scarce. However, due to the high frequency of patients suffering from incontinence who use these devices, we believe it necessary to account for the possible consequences which might derive from an incorrect use of them.

Accidents, Traffic↗

PubMed2003

[Renal transplantation in patients with enterocystoplasty].

OBJECTIVES: To asses the impact of augmentation enterocystoplasty on the success of cadaveric renal transplantation in patients with dysfunctional bladders. PATIENTS AND METHODS: Between 1980 and 2001, 3 men and a woman with severe dysfunctional lower urinary tract underwent a total of 4 cadaveric renal transplantations. The etiologies of the bladder dysfunction were bladder contraction secondary to urinary tuberculosis in all cases. In 3 patients were performed an enterocystoplasty with ileocecal segment and one with ileon. RESULTS: The overall allograft survival was 58.7 months. Two patients have functioning grafts 27 and 74 months after transplant, 1 has died due to an intestinal disease and other had chronic rejection after follow-up of 98 months. Technical complications occurred in 3 patients. All patients remain continent without catheterization after the transplantation. CONCLUSIONS: Enterocystoplasty is a safe and effective method of restoring lower urinary tract function in the patient with end stage renal disease and a small non compliant bladder.

Adult↗

PubMed2003

[Vesicouterine fistula. Our experience of 25 years].

OBJECTIVE: To determine the current state of vesicouterine fistulae in our hospital, the factors associated with their development and the findings obtained from the treatments used. MATERIAL AND METHODS: We carry out a retrospective study on a group of patients suffering from vesicouterine fistulae who were treated in our service for the last 25 years with a 2 year minimum follow-up. RESULTS: 6 cases of vesicouterine fistulae were evaluated. In 83.3% (5/6) of the cases occurred following caesarean section. The average age of the patients was 36.5 years old. In 50% of the cases, urinary incontinence immediately after surgery determined an early diagnosis. In 5 patients deferred abdominal surgical approach was carried out. All of the patients remained asymptomatic during the follow-up years. Two pregnancies were recorded 24 months after repair with a full term delivery. CONCLUSIONS: The vesicouterine fistula, despite being infrequent, is no longer an exceptional diagnosis. Currently, the low segmentarian caesareans constitute the major isolated risk factor for fistula development. We recommend a deferred surgical repair without discarding a conservative approach for those cases of small and early fistula.

Adult↗

PubMedDate not supplied

[Retrorbital metastasis an initial manifestation of prostatic cancer].

Orbital metastasis is an unusual localization within tumoral dissemination of prostatic cancer. Similarly, it is rare that orbital metastasis might be responsible for the clinic manifestations that determine the initial diagnosis of neoplasia. We illustrate the case of a patient suffering from prostatic adernocarcinoma that displayed alterations of facial sensitivity and right eye exophthalmos. We describe how the final diagnosis was reached and the patient's response to the suppressive hormonal treatment. The patient's rate of survival has proved to be longer than the rest of cases documented, with over 30-month follow-up.

Adenocarcinoma↗

PubMedDate not supplied

[Brucellar orchiepididymitis].

Brucellosis is a cause of human disease, especially in regions whose brucellosis in animals is enzootic. Brucella orchitis is a rare complication of systemic brucellosis (2-14%). Necrotizing orchitis is posible and it must be distinguished from necrotizing involvement arising from other pathogens (TB or Salmonella). Treatment with specific antimicrobial medication helps to avoid unnecessary orchiectomy and prevent infectious disease in the contralateral testis as well as systemic manifestations. We report a case of brucellar epididymo-orchitis presenting as an acute scrotal mass in a 19 years old male who lived in a city. The anamnesis was crucial in the diagnosis of this rare testicular infection. We review the diagnosis and management of this patology.

Adult↗