Biomedical subjects

Javier Cabrera Pérez

Publications and source records attributed to Javier Cabrera Pérez.

5 recordsLinked to original sources

PubMed2005

[Upper urinary tract video-urodynamics. Current indications].

OBJECTIVES: Upper urinary tract videourodynamic studies were first described in the second half of the 20th century (years 60-70). The antegrade pyelogram with constant pressure and controlled flow received the name of its author, "Vela Navarrete test" (1982), who currently refers to it as video-urodynamic study of the upper urinary tract. It is the simultaneous study of pressure, flow, and dynamic x-ray of the upper urinary tract and it keeps same indications than the original design, in spite of the appearance of new dynamic and static imaging techniques (ultrasound, CT scan, MRI, radioisotope studies). The continued practice of video urodynamic study of the upper urinary tract in the FJD prompted an update of the procedure reviewing its current indications. METHODS: Patient is positioned in the prone decubitus on an x-ray table with video. After punctioning renal cavities with fine needle, video urodynamic tests are performed: pyelomanometry, basal pyelic pressure (basic urodynamics study), pressure changes after induced diuresis, and pressure-flow studies. 10-20 ml of urine are obtained for biochemical tests (creatinine, electrolytes, osmolarity,...), which give information about the functional viability of the renal unit, cytology or microbiological tests. Finally, the study concludes with an antegrade pyelogram, a fluoroscopic study of the radiological anatomy which provides morphologic and dynamic data of the upper urinary tract. In the Urodynamics Unit of the FJD, urologists perform 30-40 studies per year. We analyzed retrospectively all studies performed over the last five years (1999-2005) for various pathological entities of kidney dilation. (Table I). RESULTS: Structural and dynamic data obtained by the studies offered conclusive information in most of them facilitating the decision for surgery or observation (Table II). CONCLUSIONS: The interpretation of the upper urinary tract video-urodynamic study is based on radiological and dynamic findings. Flow-controlled pyelogram enables determining the existence of obstruction, dilation volume, and ureteral peristaltic behaviour. Constant pressure enables quantification of obstruction. The video urodynamic study of the upper urinary tract is easy to perform, well tolerated and may be repeated as many times as required, mainly if nephrostomy tube is placed for more prolonged evaluations. It offers excellent anatomical, dynamic, and etiological information about the upper urinary tract, and furthermore conclusive, with minimal risk.

Humans↗

PubMed2004

[Benign prostatic hyperplasia: five year follow-up in patients who underwent contact laser vaporization].

OBJECTIVES: To determine the long-term efficacy and complications of contact laser prostatectomy in the treatment of the benign prostatic hyperplasia (BPH). METHODS: 32 patients in a prospective clinical trial of contact laser prostatectomy were followed for 5 years. Patients were assessed by physical examination, International Prostate Symptom Score (IPSS), uroflowmetry, post void residual urine, transrectal ultrasound and PSA. RESULTS: From the initial cohort, three patients had died from concomitant diseases. Three patients (9%) had undergone reoperation (TURP). Seven Patients (22%) received alpha blockers for irritative symptoms. IPSS and maximum flow improved significantly and remained stable at five years. There were not statistically significant differences in prostate volume or PSA level. CONCLUSIONS: Contact laser prostatectomy is a safe and effective treatment for BPH in the long-term. It has minimal morbidity and durable therapeutic effects. Nevertheless, in our experience postoperative irritative voiding symptoms (22%) are the major disadvantage.

Aged↗

PubMed2004

Experimental methods for "in vivo" study of detruso-sphincteric pharmacological response: a critical review.

OBJECTIVE: We review "in vivo" methods most commonly used for the investigation of detruso-sphincteric pharmacological response. We compare this information with the procedures used in our Institution for these purposes. METHODS: The medical databases MEDLINE, EMBASE and Pascal Biomed were searched to identify articles on this subject. The methods used have been critically analyzed and compared with the methods used in our experiments. RESULTS: The "in vivo" dynamic investigation of vesico-sphincteric function began at our Institution in the late 70s. Methods for the study of vesical or urethral dynamic behaviour have been devised to be applied independently or simultaneously. Great difficulties have been encountered, both in our experience and in the work of revised authors, in the integrated investigation of Lower Urinary Tract function. Methods to overcome these drawbacks have been proposed. CONCLUSIONS: Methods for "in vivo" studies of physiological and pharmacological detruso-sphincteric function are presented and compared with current procedures found in the literature. It is highlighted that an integrated method for the simultaneous study of vesico-sphincteric function is a difficult challenge yet to be taken up.

Animals↗

PubMed2003

[Bladder calculi. Is extracorporeal shock wave lithotripsy the first choice treatment?].

OBJECTIVES: To evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL) treatment of bladder stones using a retrospective study. METHODS: Between February 1991 and June 2002, 45 patients with bladder stones were treated (41 males and 4 females). Age ranged from 23 to 87 years. 63% had previous renal-ureteral lithiasis and 29% had undergone upper urinary tract ESWL. We used the Storz Modulith SL 10/SL 20. Treatments were performed using intravenous analgesia on an outpatient basis. RESULTS: 83 sessions of ESWL were performed on 53 stones. Complete fragmentation and elimination was achieved in 55% of the patients after a single session, 26.7% of the patients after 2 sessions, 6.7% after 3 sessions, 8.8% four, and 2.2% five. Mean number of shock waves was 3196.3 with an average 7-8 Kv. 8.5% had stone recurrence due to residual lithiasis, whereas 79% achieved total elimination. 13% required endoscopic procedures to evacuate stone fragments impacted in urethra. 6.6% required transurethral prostatic resection after ESWL. CONCLUSIONS: ESWL therapy is an effective option for the treatment of patients with bladder stones, non invasive, with low morbidity, without need for anesthesia, and outpatient. The effectiveness is high (79% of the patients stone free) and even higher when treating smaller stones.

Adult↗

PubMedDate not supplied

[Impotence and cardiovascular disease: a new perspective in the health-care compromise of the urologist].

OBJECTIVES: To review the evidence currently available to establish the pathogenic connection between erectile dysfunction (ED) and cardiovascular disease (CVD), and the effects this scientific progress has introduced in the classical impotence urology clinic. METHODS: We reviewed the most recent publications about this disease (2000-2004) and the concept of endothelial dysfunction by appropriate MEDLINE searches, with specific selection of reviews and clinical practice guidelines. RESULTS: The fact that ED and CVD share risk factors is confirmed; the pathogenic unity of both processes having endothelial dysfunction as the underlying problem; anticipation of ED over CVD in time of presentation; notable increase of research about this issue over the last two years; the change of scenario in the impotence urology clinics due to these findings. CONCLUSIONS: The number of cases in which ED is not an organ disease but an early symptom of endothelial dysfunction forces changes in the extent and depth of the diagnostic, prognostic and follow-up strategies in the urology impotence clinics of extraordinary importance from both the individual and health-care politics point of view.

Cardiovascular Diseases↗