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L Alvarez Castelo

Publications and source records attributed to L Alvarez Castelo.

At least 19 recordsLinked to original sources
PubMed2006

[Clinicopathological study of incidental cancer prostate in patients undergoing surgery for symptomatic diagnosis of BPH].

UNLABELLED: OBJECTIVES-INTRODUCTION: Retrospective study of a series of patients with prostate surgery (suprapubic prostate adenomectomy -APS-, and prostate transurethral resection -RTU-P-) for presumed BPH symptomatic non-respondent to the conservative medical treatment. Analysis of prevalence, incidence, clinical-pathological, treatment, tumor progression and evolution of the patients with incidental prostate cancer (CPI) detected. MATERIAL AND METHODS: 1593 patients with prostate surgery (APS and RTU-P) during 6 years (1996-2001) were revised. APS 35%, RTU-P 65%. Revision of all pathological anatomy of surgical specimens and the evolutions of the patients with CPI. RESULTS: 78 CPI; Prevalence 4,89%; Incidence 13 cases/year. Mean age 73.6 years. Digital rectal examination was normal in 100%, mean PSA 6 ng/ml (0.5-30). Group APS: 25 CPI (32%); prevalence 4.55%; incidence 4 cases/year; mean PSA 7.7 ng/ml (2.8-30); mean weight resection 65 gs. Group RTU-P: 53 CPI (68%); prevalence 5,07%; incidence 9 cases/year; mean PSA 5.2 ng/ml (0,5-29); mean weight resection 20 gs. 22% biopsy previously by high PSA, mean PSA 14 ng/ml (4,8-30). Gleason average 5 (mean 4.8), rank 3-8. pTla 66%, pTlb 33%. TREATMENT: 57% follow-up watched without treatment (wait and see); 18% hormonal treatment; 3% finasteride; 9% Radical Prostatectomy; 9% radiotherapy. Follow Lost 4%. Mean follow-up 47.19 months (12-96). Tumor progression 13.3% (10 patients). Specific CPI mortality 2.6% (2 patients). CONCLUSIONS: We didn't observe significant differences between the prevalence of CPI in both groups (APS and RTU-P). The detected tumours were mainly well differentiated and in stage pTla. In more than half of the cases an expectant attitude without treatment was decided. 13,3% of tumor progression after 47.19 months of follow mean and specific CPI mortality 2.6%.

Aged↗
PubMed2006

[Renal angiomyolipomatosis and pulmonary lymphangiomyomatosis. Its relationship with Bourneville syndrome].

INTRODUCTION: Renal angiomyolipomas are not very frequent in urologic activities. Pulmonary lymphangioleiomyomatosis is a rare disease that occurs mainly in women of reproductive age. Tuberous sclerosis shows lesions to different organs, including these both entities. MATERIAL AND METHOD: We retrospectively analyze patients treated in our center. Three most representatives cases are reported. An indexed literature review is done, in order to establish a clinical protocol to manage these kinds of patients. RESULTS: [corrected] Between 1990 and 2004, eight patients have been attended with an angiomyolipoma renal diagnostic. Five women (62%) and three men (38%). Medium age is 52,3y (29-69). In 3 of them (all women), it was also done a diagnostic of pulmonary lymphangioleiomyomatosis. CONCLUSIONS: Bourneville syndrome is not very frequent. Associated angiomyolipomas usually are multiple, bilateral, with tender to grow and require more interventions. Previous diagnostic let us prevent future complications with vigilance, selective arterial embolization and nephron-spare surgery. Tumour size and the presence of symptoms are more decisive to decide best therapy alternative. Young patients with pulmonary lymphangioleiomyomatosis should be advise against pregnancy and the use of preparations containing estrogens.

Abdominal Pain↗
PubMed2005

[Role of nephrectomy in metastatic renal cell carcinoma. Experience of the Department of Urology Juan Canalejo Hospital].

OBJECTIVES: We expose our experience in nephrectomy in metastatic renal cell carcinoma, and also show complications, evolution and survival of these patients. MATERIAL AND METHODS: We performe a retrospective review of renal cell carcinoma treated at our service in the period between January 1st 1991 and December 31st 2002. We only studied those which presented in a metastatic pattern (31), and divide these in two groups: the ones which were nephrectomized and those which were not. We try to showw the differences between the two groups in order of status performance (E.C.O.G.), associated morbidity and median survival. In the first group we also study complications of surgery and treatment that patients underwent. RESULTS: we performed nephrectomy in 19 cases, all of them E.C.O.G. 0-1. Median postoperative stay was 12 days, and complication rate was 11.5%. Of these patients, 45% underwent some type of systemic treatment, and median survival was 31 months. We didn't performed nephrectomy in 12 patients, of which 9 were E.C.O.G. 2-3. Associated co-morbidity was higher in this group. Only in three patients any treatment was offered always with palliative reason. Median survival was 3.8 months. CONCLUSIONS: In those patients with good performance status this approach does not represent more morbility nor mortality than in non-metastatic patients, and that is a cornerstone in their management. We also make a literature review in which we see the last pathways in the management of these patients, and that show the needing for a combined approach both quirurgical and inmunotherapical. We have review with special interest the studie's conclusions of SWOG and EORTC groups.

Adult↗
PubMed2004

[High flow arterial priapism secondary to post-traumatic bilateral arterio-cavernous fistula. Highly selective embolization with autologous blood clot].

High flow arterial priapism is rare and characterized to a prolonged non-painful partial erection. Arteriocavernous fistula, rarely bilateral, is associated with penile or perineal trauma (genitoperineal area). Review of the literature, in only eleven cases this fistula is bilateral. Different treatments with non common norm has been used. We report a case of a 27 years old male who presented high flow priapism secondary to bilateral postraumatic arterio-cavernous fistula. Autologous blood clot was used for fistulas embolization to minimize the risk of impotence in this young patient. No complications was registered. Eight months later the patient had normal erectile function and no fistula was detected on ultrasonography doppler. We consider arteriography with highly selective embolization using re-absorbable agents obtains the best results, the least risks and complications in this process.

Adult↗
PubMed2004

[Traumatic urethral disruption in women. A rare entity. Report of two cases].

We present two cases of urethral disruption in women, a very uncommon situation because of the anatomical features. Yet it must be always suspected in all women under a pelvic politraumatism, for eviting important problems. Both cases are traffic politraumatized young girls presenting with pelvic fracture, among others. The surgery performed was combined suprapubic-transvaginal approach, even in one a previous endoscopic realinement was done, who also needed endoscopic complementary treatment: electrofulguration of a fistulous bridge. Outcome of both is fine, achieving good continence. We also make a literature review.

Adolescent↗
PubMed2004

[Iatrogenic prostatorectal fistula. Use of gracilis muscle pedicled flap for its reparation. Presentation of two cases].

We present two cases in which during retropubic prostatectomy for benign prostatic disease a prostatorectal fistula ocurred. We describe its reparation using a pedicled flap of gracilis muscle. We also present cystographic and opaque enema images which shows the before and after of this surgery. Patients had good outcome without incontinence nor problems related to muscle desinsertion surgery.

Aged↗
PubMed2003

[Double-barreled wet colostomy: analysis of a urinary diversion].

We analyse our experience in performing the wet colostomy, also called urocolostomy and present seven cases treated at our hospital in which this was used. We present: a) three women, one underwent an urocolostomy as a result of a myelomeningocele with urinary and fecal incontinence, another because of a pelvic malignancy, and the third after developing a post radiotherapy cysto-proctitis; b) four men, one underwent this surgical procedure as a result of a traumatic paraplegia with multiple urinary fistulae and neurogenic bladder, the other three were secondary to pelvic malignancies (two bladder and one sigmoid malignacies). The outcome was fine in all cases with no pyelonephritis or metabolic imbalances; in all cases it represented a good option for these patients.

Adult↗
PubMed2003

[Metastasis of prostatic carcinoma to the urethra: report of a case].

Penile metastases from prostate carcinoma are uncommon events, much more in urethra and corpus spongiosum, we add a case to the preexisting literature. A patient with hormone resistant prostate cancer consults for haematuria and voiding difficulties. During TURP we observe tumors at the penile urethra which are resected and result to be prostate cancer metastases. Patient is fine and without voiding disturbance after 7 months of following. We think is an interesant case because there is few reports in literature.

Adenocarcinoma↗
PubMed2002

[Metabolic risk factors in calcium urolithiasis according to gender and age of the patients].

INTRODUCTION: Little information is available on the metabolic changes found in relation to gender and aging in patients with urolithiasis. In this study a comparison has been made of the metabolic profiles in men and women, in different groups of aging, with calcium-containing urinary stones in order to identify possibly significant differences. MATERIAL AND METHODS: In the past five years, a total of 500 patients with calcium-containing urinary stones, 226 male (45.2%) and 274 female (54.8%), have undergone comprehensive metabolic evaluation. The mean age was 47.4 years, with a range of 20 to 75 years. The patients was included in 3 groups: 151 patients aged 20-39 years, 255 patients aged 40-59 years and 94 patients aged 60-75 years. A comparison has been made of the frequency of metabolic changes, the urinary biochemical parameters and the supersaturation index (AP(CaOx)) between a group of men and a group of women and the different groups of aging. All patients carried out in an identical manner to metabolic diagnosis. The patients with morphologic and functional abnormalities were excluded. RESULTS: Hyperoxaluria, hyperuricosuria and hypocitraturia were more common in men than in women, whilst in women, hypercalciuria and a low urinary volume were more frequent with respect to men, though the differences in hypercalciuria were not statistically significant. Men excrete higher levels of calcium, phosphate, oxalate, uric acid and magnesium than women. On the other hand, women excrete higher levels of citrate than men. The AP(CaOx) index is significantly higher in men than in women. Hypercalciuria were more common in patients aged < 60 years, and low urinary volume were more frequent in patients aged < 40 years. Patients aged < 60 years excrete higher levels of calcium, phosphate and uric acid. The AP(CaOx) index is significantly higher in patients aged < 60 years. CONCLUSIONS: Differences were observed between the metabolic profiles of men and women, and in different groups of aging. Men and younger patients afford a metabolic profile of upper lithogenic risk compared with women and older patients; this is consistent with the upper reported prevalence of lithiasis and the upper tendency to recurrence in men and middle-age patients.

Adult↗
PubMed2002

[Penile adenoma: clinical case].

Penile melanoma is a very uncommon neoplasm, being reported less than 60 cases. Event yet it outlines not few doubts about its diagnosis and treatment, and in advanced stages represents a challenge for the future since it prognosis is awful at short time. In the present article, its presented a glans melanoma diagnosed and treated at our Service. We make a brief revision of the literature and some basic issues on the management of this entity when it's localized in penis, since in the cases in which it extends far from this organ is yet oncological field.

Aged↗
PubMed2002

[Bladder metastasis of a stomach carcinoma. Presentation of a case].

Metastatic tumors account for a small percentage within bladder neoplastic pathology. The presence of signs of bladder neoplasm in a patient with malignancies in other location must aware us about its metastatic origin. One of the most frequent locations of the primary tumor is the stomach. Its evolution is always bad. We present a case of a woman who previously had undergone surgery for a gastric carcinoma, and later suffered a metastatic bladder affectation. We make special attention in the clinic presentation, very similar to the typical transitional cell carcinoma, its anatomopathological diagnosis after transurethral resection (T.U.R.), and its evolution. We make a brief revision of the bladder metastatic pathology.

Adenocarcinoma↗
PubMed2002

[Typical renal metanephric adenoma. Conservative surgery].

Metanephric Adenoma is uncommon renal tumor included in the complex group of the embryologics or nefroblastics renal tumors. Generally occurs in young females and usually has excellent prognosis. It's important to differentiate of malignant variants, particularly renal cell papillary carcinoma, metanephric adenosarcoma and adult Wilms tumor. The suspicion and intraoperative analysis of the tumor can to facilitate the use of conservative renal surgery in order to avoid unnecessary radical and aggressive surgery. To exist cases of metastatic metanephric adenoma, and the totally benign characteristic of the metanephric adenoma and the malignant potential isn't totally clarify.

Adenoma↗
PubMed1998

[Follicular cystitis. Presentation as a bladder pseudotumor].

Presentation of a case report of follicular cystitis in a 48-year old male patient who referred gross haematuria and repeat urinary infections. Ultrasonographic and endoscopic examinations show the presence of a vesical pseudoneoplasm. Definite diagnosis was achieved through histologic study after TUR-biopsy.

Cystitis↗
PubMed1997

[Urinary lithiasis in transplanted kidney].

OBJECTIVE: We reviewed the records of patients submitted to renal transplantation at our institution to determine the incidence and risk factors for calculus formation in these patients. METHODS: Of 794 functioning renal grafts that had been transplanted from January, 1981 to May, 1996, 16 patients (2%), 9 males and 7 females, had upper urinary tract calculi post-transplantation. All 16 patients had received kidneys from cadaver donors. Three had donor graft lithiasis. The calculi were located predominantly in the calyces, at multiple sites in 7 patients and the mean size was 8.3 mm. The composition of the calculi was predominantly uric acid. Four patients who developed sudden obstructive anuria with elevated serum creatinine, underwent percutaneous drainage. RESULTS: All patients had one or more stone-predisposing factors, such as obstructive uropathy, recurrent urinary tract infection or metabolic abnormalities (predominantly hyperuricosuria). Five patients passed their stones spontaneously, 7 patients with uric acid stones were treated with urinary alkalinization, two patients underwent open pyelolithotomy, one underwent percutaneous nephrolithotomy and one patient with a small asymptomatic caliceal stone was managed conservatively (watchful waiting). During long-term follow-up (mean 69 months), 4 patients lost the real graft [only one case was related to urinary calculi (primary hyperoxaluria)] and 4 patients had recurrent calculi. CONCLUSION: Urinary lithiasis after renal transplantation is a relatively uncommon complication. A multifactorial etiology for calculus formation has been observed. The predisposing factors and composition of the calculi, but not frequency, are identical to those of non-transplant patients. A variety of methods are used to treat posttransplant calculi. The least invasive treatment available should be utilized according to the likelihood of recurrence and the need to preserve renal function. With adequate treatment and prophylaxis, posttransplant urolithiasis does not appear to affect graft function.

Adolescent↗
PubMed1997

[Effect of complete androgen block before radical prostatectomy for cancer of the prostate].

OBJECTIVE: To evaluate the efficacy of complete androgen deprivation in downstaging advanced localized prostate cancer prior to radical prostatectomy. The study evaluated positive margins, prostate volume, PSA and histological changes. METHODS: We evaluated 22 patients with stage T2 (13 pts, 59%) and T3 (13 pts, 59%) prostate cancer treated with complete androgen deprivation for at least 3 months prior to radical prostatectomy. RESULTS: PSA levels dropped in 97% (51.1-1.4 ng/dl) after treatment (p < 0.001); 20 (90%) had PSA < 3 ng/dl, including 3 cases (14%) with positive nodes; 2 cases (9%) with pT2 tumor had PSA > 3 ng/ml. The mean prostate volume dropped 33% from 52.6 to 35.2 cc (p < 0.001). Of the 22 cases, only one T2 (4%) was staged down; 10 (45.5%) had positive margins versus 17 (53%) of the control group (p > 0.05). The Gleason score increased in 19 (86%) and 90% had cytoplasmic vacuolization and pyknosis with moderate nuclear lysis in 50%. CONCLUSION: Neoadjuvant treatment significantly reduces PSA levels and prostate volume. The decrease in PSA levels, however, does not appear to have a direct correlation with the final pathologic stage. Tumor stage changed slightly in patients with T2 tumors and no response was observed in those with T3. Patients receiving neoadjuvant therapy had a slight advantage with respect to positive margins. The histological findings were suggestive of cellular lysis.

Adenocarcinoma↗
PubMed1997

[Disseminated carcinoma of the prostate: monotherapy or complete androgenic blockade?].

OBJECTIVES: To review the different modalities of hormonal therapy in the treatment of prostatic cancer and to analyze the results achieved by monotherapy and total androgen blockade. METHODS: The results of different studies published in the literature are reviewed, with special reference to the results of the more important randomized studies. RESULTS/CONCLUSIONS: Hormone suppression achieves a response rate of more than 75% and is therefore a valid alternative in the management of metastatic cancer of the prostate. Monotherapy and total androgen blockade have similar survival rates and disease free intervals. However, the results according to prognostic groups are significantly better for those treated with total androgen blockade and has less severe disease, suggesting early treatment.

Androgen Antagonists↗
PubMed1996

[Kidney transplantation with pediatric grafts. Technique and results].

OBJECTIVES: To demonstrate the viability of grafts from pediatric donors transplanted into adult recipients and to analyze new approaches. METHODS: The present series comprised 40 renal transplants in adults utilizing grafts from pediatric donors aged three years or less. A single renal unit was transplanted into each recipient in most of the cases in which grafts from pediatric donors over one year old (n: 26) were used. When the donor was less than one year old and in 3 cases aged over one year (n: 14), both renal units were transplanted en bloc (4 patients) or sequentially (10 patients) into each recipient. RESULTS: Graft survival rate was 58% at 29 months' mean follow-up (range 5-67) when a single unit was transplanted, 50% at 51 months' mean follow-up (range 49-53) when both renal units were transplanted en bloc and 70% at 22 months' mean follow-up (8-26) when both both renal units were transplanted sequentially. Most of the grafts that were lost were due to problems arising from vascular thrombosis; the incidence of failed grafts from immunological causes was very low. No technical problems were encountered and the urological complications were minimal. Only one case of bladder fistula was observed. CONCLUSIONS: Kidney grafts from pediatric donors of any age are viable for transplantation into adults. In the light of current technological and pharmacological developments, we believe that both renal units should be transplanted into the same recipient-preferably sequentially-if the donor is less than a year old. A single renal unit can be used if the donor is over one year old.

Adult↗