Biomedical subjects
Publications and source records attributed to J Palou Redorta.
Two patients who had undergone resection of a transitional cell bladder tumor presented with nephrogenic adenoma of the bladder during treatment with BCG. Nephrogenic adenoma presenting in the course of intravesical chemotherapy has been previously reported in 5 cases and can mimic tumor recurrence. Thus, we consider the present case to be of special interest.
We present of one patient with isolated pharmacological fever probably caused by Isoniazid given prophylactically 24 hours prior to each vesical instillation with BCG as maintenance therapy for in situ vesical carcinoma. The fever appeared in two occasions before the instillation and did not returned once the drug was discontinued. We Review this adverse effect which may lead to diagnostic error.
A simplified technique for nephroureterectomy is described. This technique consists of resection of the intramural ureter followed by lumbar nephrectomy and traction of the previously detached distal ureter. The use of this technique is advocated because it is easy to perform and radical from the oncologic viewpoint.
We present here a 42-year-old female who developed a renopleural fistula after a percutaneous nephrolithotomy through the 11th intercostal space of a calculus of the upper calyces of the right kidney. The fistula was resolved with a chest tube and a double-J ureteral catheter.
In 1967, Bolande coined the term, congenital mesoblastic nephroma, in relation to a rare benign kidney tumor which is mainly found in infancy and that can be misdiagnosed clinically as a Wilm's tumor. It has been called renal fetal hamartoma, leiomyomatous hamartoma and renal leiomyoma. Four cases have been described in adults previously and here we report a new case.
We assayed prostatic specific antigen and prostatic acid phosphatase serum levels in 1,383 patients using a double antibody radioimmunoassay (RIA) 125I. Establishing the upper normal limit in 10 ng/ml for prostatic specific antigen and 2.5 ng/ml for prostatic acid phosphatase, the false positive results were only 1.9 and 5.1% in men with nonprostatic benign or malignant pathology and 0 and 2.2% in women, respectively. We detected false positive levels in 3.5 and 4.7% of the patients with noncomplicated benign prostatic hypertrophy, 64.8 and 19.2% in complicated benign prostatic hypertrophy, 24 and 16% in acute prostatitis and 3.3% in chronic prostatitis for both tumoral markers. The sensibility in patients with prostate cancer was 87.2 and 64.1%, respectively, and there was better correlation with prostatic specific antigen than prostatic acid phosphatase levels on tumoral spread and histologic grading. Finally, the clinical efficacy was higher with prostatic specific antigen and it did not increase with the quantification of both tumoral markers.
Of 288 patients with superficial transitional cell carcinoma of the bladder vesicorenal reflux developed after transurethral resection in 26 per cent. This proportion was higher (77 per cent) when we considered only those tumors located near the ureteral orifices. There was a statistically significant relationship (p less than 0.001) between the development of upper urinary tract tumors and vesicorenal reflux (20 per cent of the patients with reflux and 0.9 per cent without reflux had a tumor), which corresponds to a 22-fold greater risk in the former group. Close followup is advised, since 1 of 5 patients with reflux after transurethral resection may have upper urinary tract transitional cell carcinoma.
We present herewith our surgical procedure for the management of bilateral hydronephrosis and renal failure due to distal ureter infiltration by cancer of the prostate: transurethral resection of the ureteral meatus and intramural ureter or even extravesical ureter invaded by the carcinoma and placement of a double J catheter. We have performed this technique in 3 patients with good results.
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Review of 31 cases of enterovesical fistulas treated at the Departments of Urology and General Surgery during the period 1970-1982. In 20 cases (64.5%) the underlying cause was a carcinoma (overall colorectal neoplasm) and in 7 cases (23%) it was an inflammatory disease. Gouverneur's syndrome (suprapubic pain, frequency, dysuria, urinary pain and tenesmus) was present in 17 patients (54.8%). Pneumaturia and fecaluria were present in 18 and rectal micturition in only 5. The diagnosis was based on cystograms in 66.6% of the patients. Other explorations oriented us towards the location of the fistula but only confirmed it in a low percentage (10-30%). The treatment undertaken varied in each case depending on the etiology and the patient's condition: medical (3%), derivative and palliative surgery (23%) and radical surgery (68%).
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There is only rare and scanty literature explaining the different surgical techniques and results for rectourethral fistulas. Here we present a review of 18 patients with rectourethral fistula. In half of the cases Bevan-Mason repair was undertaken with success.
We present 9 cases (0.57%) of vesicoprostatic perforation during transurethral resection of 1,562 consecutive operations done during the last 3 years in our urology department. We review the symptomatology, medical and surgical treatment from the point of view of the physiopathology of the intra-abdominal extravasated fluid. A new technique for the evacuation of the extravasate is presented ( multiperforated intraperitoneal catheter) because of its speed and ease of performance.
OBJECTIVES: Evaluation of a homogeneous series of Superficial Primary TCC of the Bladder. Utility of randomized biopsies (BMN). Study of risk factors and risk groups as a basis for determining treatment and followup patterns. MATERIALS AND METHODS: Survey of 1,529 PSBT cases that underwent TURB and BMN, with a mean followup of 4.2 years. Strict statistical treatment: multivariate analysis using Cox logistic regression according to Kaplan-Meier curves. RESULTS: Tumor features of note: single tumor (65%), smaller than 1.5 cm (45%), high grade (G3: 26%), and high stage (T1: 64%). BMN showed associated CIS in 284 cases (19%). Main risk factors for recurrence were multiplicity, size > 3 cm and association with CIS. The main risk factor for progression was grade 3 (OR 19.9). Grade 3 and association with CIS were found to increase mortality risk. On the basis of this data, we grouped tumors according to low-, middle-, and high-risk, and established our proposed treatment and followup for each group. CONCLUSIONS: This multivariate analysis of a homogeneous cohort of 1,529 primary superficial bladder tumor cases allowed vs to determine risk groups for treatment and followup.