Biomedical subjects

J Martínez Bengoechea

Publications and source records attributed to J Martínez Bengoechea.

At least 19 recordsLinked to original sources

PubMed1993

[Matrix stones].

We report a case of matrix stone in a patient with a previous history of infective staghorn stone for which the patient had previously undergone surgery to reduce stone volume and ESWL. The ureteral matrix stone had caused purulent intrarenal retention. Puncture nephrostomy and antibiotics resolved the foregoing condition and the calculus was successfully removed by ureteroscopy. The features of this uncommon disorder and the possibilities of endoscopic treatment are discussed.

Adult↗

PubMed1993

[Supernumerary spleen].

The diagnosis of the accessory spleen, if unsuspected, is basically anatomopathological due to its frequency and, above all, its nonspecific clinical features. We report a case of a retroperitoneal mass that was shown to be composed of accessory splenic tissue.

Adult↗

PubMed1992

[Current validity of urethroplasty in two stages].

Review of 18 patients with complex urethral stenosis, who underwent a two-stage urethroplasty in our Unit over the last three years. Clinical results have been favourable in all patients and, from the radiological point of view, there has been only one re-stenosis. Complications rate has been low and can be superimposed to that of any urethroplasty procedure. The paper emphasizes the enormous relevance of the care taken between both surgical stages on the procedure's final result.

Adult↗

PubMed1992

[Value of CAT staging in renal adenocarcinoma. Correlation with anatomo-pathologic findings].

On a total of 128 renal adenocarcinomas diagnosed in our Unit between January 1975 and August 1990, the data provided by CATs carried out in 85 of them was compared with that from surgical and anatomo-pathological findings. The precision in both the diagnosis and the tumour staging was determined, evaluating the involvement of perirenal, nodular, venous and neighbouring structures fat. The diagnosis of renal adenocarcinoma was made correctly in 96% cases. With regard to staging, maximal precision was achieved in the involvement of adjacent structures and vena cava, followed by the renal vein, perirenal fat and lymphatic nodes, in this order. We conclude that CAT provides a high diagnostic reliability, permitting with a single study the determination of the most defining parameters of renal cancer staging.

Adenocarcinoma↗

PubMed1992

[Trigono-cervico-prostatic incision].

Trigone-cervico-prostatic incision is a surgical alternative in the treatment of urinary obstruction induced by small size prostate. Twenty-three patients were treated in our unit with this procedure, 17 because they were carriers of small size prostate and 6 because they were high risk surgical patients in which the simplicity and swiftness of this technique were essential. Good results have been obtained both clinical and in urological flow in 95.7% cases. The only complication was one stenosis of the urethra requiring internal urethrotomy but there were no cases of vesical cervix contracture or urinary incontinence. Average follow-up was 12.5 months. It is concluded that this is a valid, low morbidity alternative that can be offered to patients with small sized and symptomatic prostate.

Adult↗

PubMed1992

[Secondary ureterectomy in an ectopic ureteral opening into the seminal vesicle].

The ectopic ureter opening to the seminal vesicle is uncommon in the male and even less in a duplex kidney. It commonly presents as recurrent urinary infection with pelviperineal pain. Treatment is by heminephrectomy with total ureterectomy and removal of the seminal vesicle if it is cystic. Herein we describe a 70-year-old patient who had previously undergone a heminephrectomy and partial ureterectomy due to an ectopic ureter opening to the seminal vesicle of the ureter of the upper pelvis of the left kidney. The patient was submitted to a second ureterectomy procedure due to pyoureter in the ureteral stump. The main features of this pathological condition are described and the surgical approach is discussed.

Aged↗

PubMed1992

[Non-radical treatment and bladder conservation in infiltrating tumor of the bladder].

The fate of some infiltrant tumours of the bladder locally advanced (pT2-3NxM0) which were radically resected, with or without association to other treatments, has been similar to those in which initial radical treated was used. To carry out simultaneously a radical RTU as a local action plus systemic chemotherapy (M-VAC), for microscopic metastasis, clinically undetected, seems to us the most effective combination. In our Urology Unit, the evolution (September 88-January 91) of 9 patients presenting this tumour and preservation of the bladder is being followed-up. The primary tumour was treated with radical RTU in 7 cases and partial cystectomy in 2. There are 5 tP2, 1 pT2 + "in situ" carcinoma (Ca) and 3 pT3, 4 G1, 4 G2 and 1 G3. All tumours were single, small (2-4 cm), with varied location and nearly all with medium to low differentiation. Later all patients underwent systemic chemotherapy with M-VAC (3 cycles). Following RTU and QMT every three months, the likely local and systemic progression of the disease has been evaluated through cystoscopy and multiple biopsies including from the prostatic urethra, RTU of anterior scar, two-hand palpation, urinary cytology, blood testing, CAT, abdominal ECO, chest X-ray and laparoscopic lymphadenectomy (coinciding with its development within the Unit) in the last case. Average follow-up (at the time of the review) has been 15.77 months (6-28 months).(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Transitional Cell↗

PubMed1991

[Open adenomectomy: review of 223 cases].

A retrospective study was undertaken to determine the results achieved in 223 patients with prostatic hypertrophy who underwent open surgery during a period spanning 5 years. Good results were achieved in 88.34% of the cases, the mortality rate was 0.44%, and the post-operative morbidity rate was 31.3%. Urinary infection was the most common complication during this period (21.01%). Late post-operatively, we observed the following low incidence of urethral stenosis and lodge sclerosis, 1.79% and 2.24%, respectively. Six patients (2.69%) were permanently incontinent and one required surgery for recurrent obstruction of prostatic origin.

Humans↗

PubMed1991

[Transureteral resection of the prostate. Review of 20 consecutive operations (5 yr)].

In the present study we reviewed our results in the treatment of prostatic obstruction of adenomatous origin over a period of 5 years and with a follow-up of 1 to 6 years. Of the 210 patients considered evaluable, good results were achieved in 84.28%, with mortality and morbidity rates of 0.45% and 22.82%, respectively. Infections were the most commonly observed complications in the early post-operative period. Urethral stenosis, the most common cause for reoperation, was observed in 9.04% in the late post-operative period.

Adult↗

PubMed1991

[Ureteral iatrogenic injury of gynecologic cause. Our experience].

In recent years technical and technological advancements in the field of urology have led to the enhancement of iatrogenic lesions of gynecological origin. Herein we describe our experience of 15 years during which 76 renal units were treated with a mean follow-up of 29.3 months. In 46 renal units diversion was performed previously. The surgical technique was a therapeutic success in 89.28% of the cases. Ureterovesical reinsertion with vesical lateralization was the most commonly used technique. We underscore the importance of microsurgical transureteroureterostomy as a useful alternative as well as the use of effective less invasive endourological procedures.

Adult↗

PubMed1991

[Radical cystectomy for the treatment of infiltrating bladder carcinoma. Analysis of 15 years].

Radical cystectomy continues to be the procedure of choice in the treatment of invasive bladder cancer and it is currently an exceptional procedure as monotherapy. The development of surgical techniques for urinary diversion, with less complications, has led to a significant improvement of the overall results achieved with this procedure. We performed a retrospective study of 143 cystectomy procedures that had been performed over a period of 15 years in patients with this tumor type. We evaluated the operative mortality, the morbidity resulting from the procedure, and patient nutritional status and its relation to the appearance of complications. Similarly, we analyzed the different therapeutic strategies we utilized throughout the course of our urological evolution, clearly differentiated into three periods during which we associated radical cystectomy with radiotherapy pre- and post-surgery, neoadjuvant or adjuvant chemotherapy (monotherapy with CDDP or multiple therapy with M-VAC). The operative mortality rate was 0.94% and the incidence of early complications varied according to the different periods, 62% and 32%. Late complications were observed to be 24%. The overall 5-year survival rate was 39% for cystectomy + radiotherapy, 59% when we utilized cisplatin as adjuvant therapy, and 70% (2 years) when we utilized M-VAC neoadjuvant chemotherapy. We believe that distant metastasis was the most common cause of late failures of total cystectomy for infiltrating bladder tumor. Similarly, we believe that the reduced incidence of early complications reported in recent years can be ascribed to the enhanced surgical techniques, better nutritional status of the patient undergoing this procedure, antibiotic therapy, perioperative care, and overall better management and understanding of this disease entity; i. e., the use of a combined therapeutic approach.

Adult↗

PubMed1990

[Neoadjuvant chemotherapy (M-VAC) in invasive cancer of the bladder. Our experience].

Thirty-three patients with locally advanced T2-4NxM0 muscle infiltrating bladder carcinoma were treated with M-VAC (methotrexate, vinblastine, adriamycin and cisplatin) following TUR. Twenty-eight patients were evaluable since 4 had been receiving the foregoing treatment and 1 was being reevaluated after having undergone a partial cystectomy procedure prior to the chemotherapeutic regimen. Eighteen patients underwent radical cystectomy after neoadjuvant chemotherapy, 2 bladders could not be resected, 2 patients refused the procedure and the remaining 6 patients had a functioning bladder. Of the 28 patients, 46.42% (pCR) were pT0 (including the 6 patients with a functioning bladder, and 10.71% (pPR) were down-staged. This represents a pGR of 57.13%. Four of the 18 patients who underwent cystectomy had a higher pathologic stage evidenced by the surgical specimen than the initial finding at TUR indicating that 22.22% had been understaged. Noninvasive diagnostic methods (TUR, cytology, ultrasound, CT...) could not demonstrate the presence of tumor in those patients with preserved bladder. The cRC is similar (46.42%) and the cRP was 7.14%, giving a total cRG of 53.56%. With a mean follow-up of 13.63 months (range 5-36+), 54.54% are alive and disease-free, including the 6 patients with preserved bladder, and 21.21% are alive with locoregional recurrence or distant metastasis. Currently the mortality rate is 9.09%. The correlation of the data gleaned from the clinical response and that of the pathological condition, the possible understaging of the preserved bladders and the outcome in a series with a very short follow-up have as yet to be elucidated.

Aged↗

PubMed1989

[Obstruction of the pyelo-ureteral junction in adults. Diagnostic and therapeutic management].

The ureteropelvic junction (UPJ) is the most common site of upper urinary tract obstruction. We report on 46 adult patients (50 renal units) that had been treated for a UPJ anomaly at our department over a 10-year period. The most common clinical manifestations observed were lumbar pain and/or colic (82.6%) and infection (34.8%). Genitourinary malformations were observed in 21.8% of the patients. The following treatment modalities were performed: 8 nephrectomies, 39 repair surgery procedures, 3 renal units with mild dilatation and no obstruction did not undergo surgery and were closely followed. The Anderson-Hynes pyeloplasty procedure was performed in 37 (95%) renal units and the Foley Y-V plasty in 2 (5%). The most important complications were anastomotic stricture (4) and urinary fistula (2). Overall, the results of repair surgery were good in 69.2%, fair in 20.5% and poor in 10.3% of the cases. Better results were achieved in those cases with moderate (86% good results) than in those with severe (47% good results) dilatation. Following pyeloplasty, 95% of the patients were pain-free, 1 (2.3%) patient had episodes of symptomatic infection and deterioration of renal function was observed in only 1 patient with a single kidney and severe chronic renal failure prior to surgery. At 2 years, dilatation had improved in 64%, remained unchanged in 31%, and became worse in 5%. In the management of pyelocaliceal dilatation, we believe it is fundamental to clearly establish the presence of obstruction and predict the functional recovery of the obstructed kidney. Our diagnostic and therapeutic approach is described. For upper urinary tract dilatation, the following is performed: simple or diuresis IVP, diuresis renography, ultrasonography and CUMS (if reflux is suspected). When doubts exist or when the results are unclear, pressure flow urodynamic studies are performed. Thus, we perform repair surgery in dilatations with functional obstruction to avoid progressive renal deterioration. The literature on the diagnostic techniques for the assessment of obstruction and functional recovery is reviewed.

Adolescent↗

PubMedDate not supplied

[Incrusted cystitis after Mitomicin-C].

Incrusted cystitis is an infrequent process characterized by precipitation an incrustation of salts on the vesical mucosa. An alkanine urine is required to this precipitation. The urinary infection with urolithic activity microorganisms can also be a very important factor. We present a case of incrusted cystitis after using Mitomicine as vesical chemotherapy.

Alkylating Agents↗

PubMedDate not supplied

[Excretory azoospermia secondary to a cyst of the seminal vesicle].

A case report of malformation of the right mesonephric ductus, involving a seminal vesicle cyst and ipsilateral renal and ureteral agenesis. The infrequency of such pathology is recalled and the oddity, in our case, of its presentation in the fashion of infertility secondary to excretory azoospermia highlighted. The deferentovesiculography, ultrasound scanning, urography and CAT were highly illustrative in the diagnosis. The treatment of choice in symptomatic cases is surgical exeresis, which in our patient secured the resolution of the azoospermia.

Abnormalities, Multiple↗

PubMedDate not supplied

[Growing teratoma syndrome].

Appearance of residual masses following chemotherapy of retroperitoneal metastasis from testicle's non-seminomatous germinal cell tumour does not always imply we are facing an active tumoral disease. When exeresis of these masses discovers the presence of a mature teratoma during the histological study, what we have is the so called Growing Teratoma Syndrome. Such teratoma is unresponsive to chemotherapy but the patient can be cured by means of a full exeresis of the residual mass, thus the relevance of having into account the likelihood of this pathology. The paper presents the case of a patient with retroperitoneal non-seminomatous testicle tumour and metastasis which, following chemotherapy, presented a residual mass with normal serological markers. After the exeresis it was found out that it was made up by mature teratoma. Four months after rescue surgery, the patient remains asymptomatic, has normal markers and no signs of neoplastic recurrence.

Adult↗

PubMedDate not supplied

[Laparoscopic lymphadenectomy for lymphatic staging in prostatic cancer: preliminary experience].

The current diagnostic methods, primarily transrectal ultrasound scanning (supported with ultrasound-directed biopsy), CAT and tumoral markers, allow an earlier and more reliable diagnosis of prostatic neoplasias. The chances of diagnosing these tumours while in low stages (A, B, and C without affecting the seminal vesicle) imply a higher indication for radical surgery (prostatectomy) with an intention to cure. However, the prognosis and therefore the indication will be determined by the presence of regional nodular affectation. Imaging diagnostic methods (lymphography, CAR, NMR) have been proven incapable of providing an acceptable degree of diagnostic safety, therefore staging lymphadenectomy continues to be mandatory. Laparoscopic lymphadenectomy allows to meet requirements of surgical radicality comparable to those of traditional open surgery while showing an irrefutable decrease of morbidity and being more convenient for the patient. Our early experience with this surgical technique of staging in prostatic neoplastic pathology is illustrated.

Humans↗

PubMedDate not supplied

[Bladder adenocarcinoma of urachal origin. A rare tumor].

With the description of this new case of urachal adenocarcinoma in the vesical cupula we provide a review on the clinical, pathological and immunohistochemical aspects of this rare tumour, as well as a diagnostic and therapeutical approach. Its subepithelial infiltrant nature delays discovery and denotes both an insidious evolution and poor prognosis. Mucinoid production, nodes pattern and certain immunohistochemical substances as well as abnormalities in the cell's DNA content are attributes of this entity. Only surgery, either partial or exeresis, is effective since this is a radioresistant and dubiously chemosensitive tumour.

Adenocarcinoma↗