Biomedical subjects

J Romero Maroto

Publications and source records attributed to J Romero Maroto.

At least 19 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

[Techniques and current practice of urodynamics. Problems and traps].

Development of urodynamics particularly during the past decade are highlighted, as well as a number of issues to be faced in the near future: research into the etiopathogenesis of different conditions, finding more sensitive and specific diagnostic procedures to overcome the current ones, establishing more comprehensive indications for urodynamics examinations and, as a result of all the above achieving greater improvement of certain surgical procedures. Both the technique and interpretation of the different urodynamic examinations, as well as the more recent innovations, implementation issues and controversies are detailed to a highly up-to-date level. Neuromodulation and ambulatory urodynamics deserve thoughtful consideration in this paper. Finally, attention is given to the controversies and future challenges such as urodynamic research providing accurate diagnosis of lower urinary tract obstruction in women, establishing the indication of urodynamic studies in women with urinary exertional incontinence, outlining the indications of neuromodulation and ambulatory urodynamics, applicability of artificial intelligence systems, improvement of artificial sphincter materials, tissue growth for bladder enlargement and actual prevention of myelodysplasia.

Adult↗

PubMed1995

[The acquired urethrorectal fistula: a rare pathology].

OBJECTIVES: Conservative management of iatrogenic urethro-rectal fistula is discussed and the literature briefly reviewed. METHODS/RESULTS: The patient's only symptom was rectal voiding, which he considered was not enough to justify an operation. At one-year follow up, patient condition remains unchanged. CONCLUSION: Patients with urethro-rectal fistula and a competent bladder neck, whose only symptom is rectal voiding, can be managed conservatively if the patient refuses an operation.

Aged↗

PubMed1994

[Retroperitoneal paraganglioma. Infrequent pathology].

Presentation of 3 cases of retroperitoneal paraganglioma non pre-operatively diagnosed: one dependent of the Zuckerkandl's organ with ultrasound examination showing a panelled cystic mass, and two located in the renal parahilar area, all accidental findings during renal surgery. Lack of appropriate pre-operative background and diagnosis produced a hypertensive crisis in one patient during removal manoeuvres which was entirely controlled. After a 4-, 2- and 1-year follow-up, respectively, patients remain asymptomatic and disease-free. An analysis of the most relevant features in these retroperitoneal tumorations was carried out from a clinical, diagnostic, therapeutic and prognostic point of view.

Adult↗

PubMed1994

[Treatment of urinary incontinence with the artificial sphincter AUS-800. Our experience].

The present study reviewed the first 25 incontinence prostheses implanted at the Urology Services of the Ramón y Cajal Hospital. The literature is briefly reviewed and the indications for the AUS-800 incontinence prosthesis are discussed.

Adolescent↗

PubMed1993

[Primary amyloidosis in the bladder: diagnostic and therapeutic update].

We describe an additional case of primary amyloidosis of the bladder whose form of presentation warranted a differential diagnosis from carcinoma of the bladder. The diagnosis was made on the histological findings and the immunohistochemical analyses revealed amyloid fibrils that reacted against the light chain lambda antiserum. The treatment of choice was TUR, which resolves the condition in most of the cases. Conservative surgery, however, does not prevent new deposits and undetected residual lesions may persist, which may warrant other complementary procedures in these patients. After the diagnosis has been made, it is important to discard systemic amyloidosis.

Aged↗

PubMed1993

[New location of aggressive angiomyxoma: the bladder].

Presentation of one case of aggressive angiomyxoma with vesical location in a 31-year-old female patient who underwent partial surgery, and who 8 years later remains disease-free. Emphasis is made on the low frequency of these tumours, of which only 26 cases are described in the international literature. All these cases have been located in soft areas of the pelvis and the perineum, with the exception of the one presented here, the first one with a vesical location. Clinical behaviour is characterized by the absence of metastasis and a great tendency to local relapse, 70% of cases reported.

Adult↗

PubMed1993

[Synchronous and bilateral inverted papilloma of the kidney pelvis. Conservative treatment].

Contribution of a new case of inverted papilloma (IP) of the upper urinary tract (UUT) with the idiosyncrasy of being bilateral and synchronic, a fact not found in the reviewed literature, treated with radical surgery on the left side and conservatively on the right one. Discussion on this pathology is addressed, emphasising its benign biological behaviour, which does not eliminate some cases of malignization. Treatment has to be conservative, and so we stress the relevance of defining a suspicion state to make pre- and peri- operative diagnosis in which endourological methods, that allow both direct visualization and the taking of a biopsy, play a preeminent role. Subsequent strict monitoring is essential due to the likelihood of relapse and malignant changes.

Aged↗

PubMed1992

[Enterocystoplasty in the treatment of myelodysplastic bladder].

Over the last five years 18 myelodisplastic patients with neurogenic bladder have undergone in our Unit a surgical operation consisting in vesical enlargement with patch-like bowels. They all had incontinence and urinary infections and there was a high percentage of pyelonephritic events. A report on the results from 13 patients whose post-operative evolution is longer than one year is included. Eleven patients were completely and two partially continent; pyelonephritic events have ceased or became more spaced; renal function, assessed by UIV is within normal values or shows improvement in 22 renal units while only one patient, out of 11 pre-operative cases, continues having vesico-renal reflux.

Adolescent↗

PubMed1990

[Urinary de-diversion, technical modification for creating a low-pressure bladder].

Urinary unidiversion permits the possibility of enhancing the quality of life and probably the survivorship of previously diverted patients. A modification of this technique is described which utilizes Brickne's loop and a segment of the sigmoid to create a low pressure bladder, thus sparing more intestine. The good result achieved with this technique is underscored. In our view, urinary undiversion must meet the following two conditions: to enhance patient quality of life and not to deteriorate renal function .

Adolescent↗

PubMed1986