PubMed Health⌕ Search

Biomedical subjects

L Perales Cabanas

Publications and source records attributed to L Perales Cabanas.

At least 19 recordsLinked to original sources
PubMed2005

[Treatment of female stress urinary incontinence with TVT system (tension-free vaginal tape): complications in our first 100 cases].

INTRODUCTION: The TVT system is the most common surgical technique of female stress urinary incontinence, because of the simplicity. good clinical results and rare complications. MATERIAL AND METHODS: From april, 1999 to march. 2004, it has been done in our department 100 TVT systems with the revision of the result over the six following months. The average follow-up rate was 10.36 months (R: 1-54 months) and looses mean the 11% of the cases. All the patients presented stress incontinence and their average age was 56.6 years old (30-80). The 12% of the cases have been previously operated of urinary incontinence. 21 patients presented previous surgery of pelvic floor. In the 17% of the cases, TVT systems was associated to another surgical technique: 15% of them was operated of cystocele, 1% of them had surgical correction of rectocele, 1% of them had a strong surgery of pelvic floor, that included TVT system, correction of pelvic floor and hysterectomy. RESULTS: We obtained 65% of successful cases, defined as objective confirmation of absence of looses from the observer and the subjective reference of the patient: 17% of clear improvement (clear decrease of looses from the patient and subjective improvement) and 7% of failure of the technique. The total percentage of appearance of novo post-surgery urgency is 9%. There were complications in the 12% of the cases: there were three cases of bladder perforation, two of them intra-operative and one of them deferred and associated to an infection of surgical wound; another three cases of residue in the immediate post-operative that were resolved with bladder catheterization: one case of acute urinary retention that was treated with bladder catheterization with suprapubic cistostomy: one case of chemical peritonitis corrected with a conservative treatment; two cases of vaginal extrusion of sling, which were resolved with the section of the outer sling; one patient presented a hipogastric hematoma resolved with conservative measures: and one patient presented pelvic discomfort with spontaneous resolution. CONCLUSIONS: We consider the TVT system as an effective surgical technique in the treatment of the female stress urinary incontinence. It is a simple technique with a short stay in the hospital and rare complications.

Adult↗
PubMed2003

[Surgical management and complications of urinary stress incontinence: our experience in 385 patients operated on during the last 25 years].

We present the results and complications found and compared in 2 large series of patients who underwent a surgical procedure to avoid Urinary Stress Incontinence in our hospital. From january of 1994 to december of 2001 we collected 195 patients with an average age of 57.9 y we compared them with a prior series of 189 patients collected between january of 1976 and december of 1993, with an average age of 53.6. The continence rate was similar in both series (70.8% pre-94 and 74.5% post 94), slight incontinence 22.7% pre-94 and 19.2% post-94 and for complete incontinence 6.3% pre-94 and 6.2% post-94. The Burch procedure was the most common and also shows the greatest effectiveness in our trial involving 113 cases and a continence rate of 74.3% in the first series and 144 cases and 77% respectively in the second series. The most common complications were very similar in both groups: tract urinary infection (5.2% and 9% first and second group), surgical wound infection (4.2% and 2.2% respectively). We conclude that in spite of the introduction of new and useful surgical procedure (TVT, periurethal substances injection...) the greatest long term success rate still corresponds to the Burch colposuspension.

Adolescent↗
PubMed2002

[Posterior sacral root neuromodulation in the treatment of chronic urinary dysfunction].

OBJECTIVES: To describe the effectiveness of sacral root neuromodulation in ameliorating symptoms of refractory voiding disfunction in our center. MATERIAL AND METHODS: During the period from december 1998 throught december 2001, 31 Percutaneous Nerve Evaluation (PNE) was performed to 20 patients with refractory voiding dysfunction; a sacral nerve stimulation device was implanted in 10 patients (8 female, 2 male). The median age was 49 years. Refractory voiding dysfunction included: mixed disorders (30%), idiopathic nonobstructive chronic urinary retention (20%), urgency/frequency (20%), faecal and urinary incontinence with absence of sphincter defect (20%) and frequency (10%). RESULTS: The 2 patients with frequency/urgency decreased their symptoms more than 50%, bladders were emptied without post-void residual urine in 2 patients with urinary retention, faecal and urinary incontinence in 2 patients and mixed disorders in other 3, reduced their symptoms more than 90% without residual urine. The frequency improved more than 50% in 1 patient. CONCLUSIONS: Sacral Root Neuromodulation is a successful treatment in some cases of idiopathic chronic micturition dysfunction which don't respond to pharmacotheraphy or bladder retraining. The effects of neuromodulation are long-lasting and associated morbidity is low.

Adolescent↗
PubMed2001

[Treatment of female stress urinary incontinence with the TVT (tension-free vaginal tape) system: our experience].

INTRODUCTION: The TVT system is a new surgical procedure for female stress urinary incontinence. The object of this study is to report our initial experience with this technique. We report our results and complications too. MATERIAL AND METHODS: From April 1999 to July 2000, 23 systems TVT was implanted in our hospital. The patients were followed for a 6 to 21 month period. All the patients had stress incontinence. The mean age was 59 years. Gynaecological surgery was associated in 4 patients. One of them was excluded because a diagnosis mistake. TVT implies the implantation of a prolene tape around mid-urethra via a minimal vaginal incision. RESULTS: 17 patients (77.27%) had a significantly improved in the post-operative evaluation. The mean post-surgical stay in the hospital was 1.7 days. A bladder base was damaged during the surgery. No urinary retention, erosion or urethral lesion were found. CONCLUSIONS: We consider the TVT operation to be a safe and effective surgical procedure for the treatment of female urinary stress incontinence. This surgery is easy to lean, fast, cheap and with a low rate of complications.

Adult↗
PubMed2000

[Epidermoid carcinoma of the scrotum].

OBJECTIVE: To analyze the therapeutic approach in epidermoid or squamous cell carcinoma of the scrotum, a rare tumor that is of interest for clinical and historical reasons. METHODS/RESULTS: A case of epidermoid carcinoma of the scrotum is described. The patient had undergone urethroplasty in 1972, using preputial free graft, according to the technique of Ben Johnson. Right scrotectomy and orchidectomy were performed and partial urethrectomy with inguinal lymphadenectomy 6 weeks later. At 24 months' follow-up, the patient has no tumor recurrence. CONCLUSION: Malignant tumors of the scrotum are rare. Squamous cell carcinoma is the most frequent tumor type. Radical surgery with inguinal lymphadenectomy is the treatment of choice. It must be distinguished from verrucous carcinoma, a tumor that requires a different therapeutic approach and for which radical surgery is not indicated.

Carcinoma, Squamous Cell↗
PubMed1996

[Usefulness of the urodynamic study of the lower urinary tract in renal transplantation].

OBJECTIVES: To analyze the indications, diagnostic cost-effectiveness and therapeutic implications of urodynamic assessment of the lower urinary tract in two groups of patients: 1) those awaiting renal transplantation and those with a functioning renal graft and voiding disturbances. METHODS: The first group comprised 22 patients who were evaluated before renal transplantation for a total of 32 urodynamic studies. The second group comprised 10 patients with a functioning renal graft for a total of 14 post-transplant urodynamic studies. The etiology of the chronic renal failure, indications for urodynamic assessment and videourodynamic findings in both groups were compared. RESULTS: Interstitial nephropathy associated with vesicoureteral reflux was the most common cause of chronic renal failure in the pre-transplant group, whereas glomerular nephropathy was the most common cause of chronic renal failure in the posttransplant group. Vesicoureteral reflux was the most frequent videourodynamic finding and was associated with other urodynamic disturbances in 75% of the cases. Lower urinary tract obstruction was the most common finding in the posttransplant group. CONCLUSIONS: The indications for urodynamic study in patients awaiting renal transplantation are: 1) interstitial nephropathy associated with vesicoureteral reflux, neurogenic bladder and congenital malformations; 2) patients aged 45 or older with a flowmetry suggesting obstruction; 3) those with urinary diversion, and 4) systemic diseases potentially associated with neurological damage.

Adult↗
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↗
PubMed1991

[Acute anuric renal failure in a patient with diabetic neurogenic bladder].

Herein we describe a patient with noninsulin dependent diabetes mellitus who developed acute anuric renal failure following eye surgery. This condition, ascribable to diabetic neurogenic bladder and probably to the use of anticholinergic agents, improved following placement of a urethral catheter. The physiopathological mechanisms and treatment are discussed.

Acute Kidney Injury↗
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↗
PubMedDate not supplied

[Sacral root neuromodulation. Experience in our site: 1998-2003, concerning 18 definite neuromodulation implants].

OBJECTIVE: Sacral root neuromodulation is an effective technique for the treatment of Chronic Micturition Dysfunction (CMD) refractory to conventional therapy. New indications such as chronic pelvic pain and interstitial cystitis are currently making their way within the urologic setting. Several groups of gastric surgeons are now choosing this technique for the management of rectal diseases (constipation, sphincter dysfunction). This paper contributes our experience in the treatment of patients with CMD and the comparative results at one year from implant in all patients. MATERIAL AND METHODS: From December 1998 through July 2003, 18 neuromodulation definite implants were performed. The main indication was CMD in 62.5% patients. Follow up of patients was done at one month and three months, and every six months thereafter. Follow up is conducted through a micturition diary and QoL questionnaire. Electrode implant in the first 16 patients was achieved by open surgery. The next 2 patients had the electrode placed by a percutaneous technique using the "Tined Lead" kit. RESULTS: Results at one year after implant were compared in all patients. The total number of neuromodulation implants placed was 18, 14 (77.7%) of which were women and 4 (22.3%) men. Mean age was 52.56 years. Implant indication was CMD in 72.2% patients, mixed incontinence (urinary and faecal) in 22.1%, and interstitial cystic disease in 5.5%. Symptoms improvement at one year from implant, as determined by a micturition diary and QoL questionnaire was 76.4%. Clinical improvement was greater in patients with urgency symptoms than in patients with predominance of voiding symptoms.

Adult↗
PubMedDate not supplied

[Instability of the detrusor. Treatment with oxybutynin chloride (Ditropan) in children].

We study the effect of oxybutynin chloride (Ditropan) in a random sample of 24 children with ages ranging from 5 to 14 years, diagnosed as having vesical instability from both the clinical and urodynamic standpoints. These effects were evaluated after a period of treatment that ranged from 10 to 36 months (x = 20). We obtained overall clinical improvement in 87.5%, and improvement of urodynamic alterations in 83.3% of the patients. We single out the beneficial effect of oxybutynin chloride with prolonged treatments, in instability of the detrusor, as well as its good tolerance.

Adolescent↗
PubMedDate not supplied

[Renal outcome in myelodysplastic patients with untreated, risky vesico-sphincter dysfunction].

Poor vesical accommodation with competent sphincter system and bladder-sphincter dyssynergy are major risk factors for renal function in patients with myelomeningocele. We present four cases with these urodynamic features and we analyse renal variation with time in relation to these, pointing out the poor evolution. We emphasize the need for urodynamic study with simultaneous radiology and early treatment when these risk factors exist.

Adolescent↗
PubMedDate not supplied

[Enuresis. Results of a new therapeutic approach].

We present the results of the pharmacological treatment of a syndromic entity particularly common in childhood with a new Oybutinine Chloride drug. We point out that we have achieved positive results in more than 75% from the standpoint of improvement or clinical cure and more than 50% from the urodynamic viewpoint, in the sense of disappearance or improvement of vesical stability. We underline the perfect tolerance of the drug with very few side effects. We conclude that this drug represents a valid alternative in the treatment of this syndrome, although it would be desirable for its effects not to call for such prolonged treatment, which would result in better compliance with the dosages on the part of the patients or heir relatives in the case of small children.

Adolescent↗