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Biomedical subjects

L Rodríguez Vela

Publications and source records attributed to L Rodríguez Vela.

At least 19 recordsLinked to original sources
PubMed2006

[Tadalafil vs sildenafil patient preference in Spanish men with erectile dysfunction: results from an International Multicentric Study].

OBJECTIVE: To compare patient preference for sildenafil citrate (sildenafil) vs. tadalafil and for their respective dosing instructions in a cohort of Spanish patients with erectile dysfunction (ED). MATERIAL AND METHODS: Sixty four Spanish patients from a multicenter, two period, cross-over, double-blind study (265 patients enrolled in total) were randomized to receive on-demand sildenafil 50 mg or tadalafil 20 mg for 12 weeks and afterwards were crossed over to the alternate regimen for another 12 weeks to assess drug preference in an extension period of the study. Similarly, to evaluate preference for their respective dosing instructions, 30 patients were randomized to one of the 2 arms treated with tadalafil: one with sildenafil (S) dosing instructions and the other with tadalafil (T) dosing instructions. RESULTS: Seventy percent of 56 patients completing the study chose to receive tadalafil treatment versus sildenafil treatment (30%) in the extension period (p<0.01). Correspondingly, 73% of 13 evaluating each drug dosing instructions preferred T dosing instructions (p>0.05). Preference did not vary with age, concomitant diseases and previous use of sildenafil. CONCLUSIONS: In this study, 7 out of 10 patients preferred tadalafil and its dosing instructions to sildenafil, for the treatment of their ED.

Adult↗
PubMed2006

[Modificated plication technique of the tunica albuginea in penis curvature correction].

We present our penile curvature treatment experience in Peyronie's disease and cogenital curvature, using a modificated plication technique of the tunica albuginea with Prolene inverted sutures covered with Vicryl ones. The first suture gives security to the plication and the second one hides the first dots avoiding the nonabsorbable sutures bother.

Adolescent↗
PubMed2000

[Penile fracture: report of a case].

Traumatic rupture of the corpus cavernosum of the penis is rare, and has been reported infrequently. We present a case with this type of trauma, with immediate surgical management, with good morphologic and functional results.

Adult↗
PubMed1999

[Treatment by a modified plication of the tunica albuginea in patients with congenital penile curvature].

OBJECTIVE: To evaluate the results obtained with management by modified plication of the tunica albuginea in patients with congenital penile incurvation. MATERIAL AND METHODS: Between January 1992 and December 1996, a modified plication technique of the tunica albuginea was used to correct congenital and acquired penile incurvations; the procedure was performed in 27 cases of patients with congenital penile incurvation and 17 patients with de la Peyronie's disease. Mean age was 22.8 years (range 15-40 years), single ventral incurvation being the most frequent (51.8%) type. A modified technique of tunica albuginea plication was used. RESULTS: Complete correction of the incurvation was achieved in all patients (100%), with a low rate of complications. CONCLUSIONS: Modified plication of the tunica albuginea is a simple and effective surgical technique to achieve correction of congenital penile incurvations.

Adolescent↗
PubMed1998

[Treatment of erectile dysfunction using intracavernous pharmacotherapy].

Intracavernous injection of vasodilators has been the greatest diagnostic and therapeutical breakthrough in erectile dysfunction (E.D.). After 15 years experience, these vasodilators have demonstrated efficacy rates over 85%. This suggests that most cases of E.D. are the result of and inability of the smooth muscle to relax. This paper presents an overview of the diagnostic and therapeutic use of intracavernous vasodilating drugs. It includes an extensive review of the literature and our personal series with regard to efficacy, indications, contraindications and side-effects of these compounds. Alprostadil i.c. injection (PGE1) is an effective (> 70%) and safe treatment, and its use has been accompanied by an increased quality of life of patients, with very few side effects. Currently, PGE1 is a first choice drug in the treatment of impotence. When no response is seen, or pain develops after PGE1 administration, a number of vasoactive compounds associations can be used instead (phentolamine + PGE1, papaverine + phentolamine, and papaverine + phentolamine + PGE1). The phentolamine + VIP association has shown encouraging results. Prior to prescribe IC treatment with vasoactive drugs it is necessary to conduct a basic diagnostic study, and advise the patient. If treatment is finally accepted, the performance of adequate training and detailed medical follow-up is crucial.

Contraindications↗
PubMed1998

[Analysis of our series of kidney transplants: urologic complications and survival].

PURPOSE: To review our series of 416 renal transplants, with special reference to the surgical complications and their management. METHODS: From June, 1986 to October 1997, we are performed 416 heterotopic renal transplants, harvested from cadavers. Reconstruction of the urinary tract reconstruction was by ureteroneocystostomy in practically all the cases. RESULTS: There were some urological complications in 80 patients (19.2%). The most common urological complication was obstruction of the urinary tract arising from stenosis (3.3%), lymphocele (4.3%) and clotting (1.2%). 78.1% of these urological complications were resolved by endourological techniques. Urinary fistula was observed in 12 cases (2.8%). Vascular complications in 22 (6.9%), lithiasis in 5 (1.2%), and eventrations in 11 (2.6%). The treatment of these complications is described. The actuarial survival rates were 87.8% and 77.3% at one and five years respectively for the graft, and 92.4% and 83.5% for the patients. CONCLUSIONS: Our surgical complication rate in patients undergoing renal transplantation was 19.2%. The most common complication was urinary tract obstruction from stenosis (3.3%), lymphocele (4.3%) and clotting (1.6%); 78.1% of these obstructive complications were resolved by endourologic techniques. Percutaneous drainage and esclerotherapy of the lymphoceles resolved 66.6% of them. Renal biopsy performed with a 14G needle caused 5 severe hemorrhagic complications. There were no complications when an 18G needle was utilized.

Female↗
PubMed1997

[Unusual association of transitional cell carcinoma in the upper urinary tract, with contralateral renal metastasis and renal lithiasis of long clinical course].

Presentation of a case reporting an infrequent association of transitional cell carcinoma of the upper urinary tract (UUT) with a long-standing renal polylithiasis and multifocal metastasis in contralateral kidney. A description is made of the incidence, etiology, prognostic factors as well as diagnosis and therapeutical approach.

Carcinoma, Transitional Cell↗
PubMed1997

[The neurological status in patients with erectile dysfunction: somatosensory evoked potentials and the bulbocavernosus reflex].

OBJECTIVES: The present study investigated the somatosensory evoked potential (SSEP) from the dorsal penile nerve and the bulbocavernosus reflex (BCR) in healthy volunteers and patients with erectile dysfunction in order to establish a model of normality and investigate the abnormal neuro-urophysiological measurements in patients with erectile dysfunction and their relationship with different factors (age, neurological disease). METHODS: 30 healthy volunteers and 102 patients who had consulted for erectile dysfunction underwent neuro-urophysiological diagnostic evaluation (dorsal penile nerve SSEP and BCR). The mean age was 51.2 years (range 27 to 66). RESULTS: The group of healthy volunteers showed SSEP mean latency of 46.374 ms and a BCR mean latency of 43.721 ms. Thirty-four patients (33.33%) had at least one abnormal neuro-urophysiological measurement, the SSEP were abnormal in 7 (20.58%), the BCR in 5 (14.70%) and both in 22 (64.70%). We found an increased SSEP latency and BCR latency in the patients with erectile dysfunction and with no urological disease. Comparison of the older with the younger patients was only statistically significant for increased BCR latency in patients > 60 years old. CONCLUSIONS: The study revealed neuro-urophysiological abnormalities in 34 impotent patients (33.33%). The finding of abnormalities in both BCR and SSEP was the most frequent.

Adult↗
PubMed1997

[Analysis of a series of radical prostatectomies].

OBJECTIVE: Radical prostatectomy (RP) is an elective therapeutical procedure for localized prostate cancer. The paper describes the critical analysis of our 10-year series. MATERIAL AND METHODS: A total of 216 RP have been performed between June 1986 and December 1996 (60 of them in the last year); with the purpose of securing a minimum follow-up of 4 months, the 204 procedures performed up to October 1996 were studied. Mean age was 64.9 years and PSA median 10.8 ng/ml. Intraglandular clinical stage was found in 192 cases versus 12 cases extraglandular. Up to the end of 1993 Walsh's technique with erectors' preservation was being used although the poor results obtained with regard to potency as well as the existence of positive borders have compelled us to perform the standard extracapsular technique since beginning of 1994. RESULTS: Mean follow-up in our series has been 29.62 months. Post-operative complications reached 29.9%, anastomosis fistula (21 cases) among the early ones and anastomosis stenosis (16 cases) among the late ones. 82.04% patients have total continence or minimal incontinence, the percentage of obstruction being 3.58%. Total impotence is estimated at 92.77%. One patient (0.49%) died in the immediate post-operative. Understaging was observed in 36.7%. 84 patients had extracapsular disease. Our percentage of positive surgical borders is of around 43.13%. Progression has been seen in 47 of 204 patients (23.03%): 8 local relapses, 12 metastasis, 3 with both conditions and 24 biological progression. Progression has been related to pathological stage, pre-operative PSA and Gleason's sum of the specimen. Difference was statistically significant. Overall survival at 1 and 5 years is 99.2% and 95.5% respectively while tumour specific survival is 97.8% and 75.8% at 1 and 5 years. CONCLUSIONS: RP is a surgery with minimal mortality but noticeable morbidity (incontinence 14.35%; impotence 92.77%; other complications from surgical technique 29.9%). Our clinical understaging is of around 36.7%. Progression is related to the specimen's pathological stage, and pre-operative PSA and Gleason. Our overall survival at 1 and 5 years is 99.2% and 95.5% respectively while tumour specific survival is 97.8% and 75.8%.

Adenocarcinoma↗
PubMed1997

[Erectile dysfunction after radical prostatectomy. Etiopathology and treatment].

Erectile dysfunction is one of the most common sequela from radical prostatectomy. The authors evaluate the incidence of erectile dysfunction after radical prostatectomy, study the likely causative vascular mechanisms and assess the efficacy of the treatments employed. Two hundred and four (204) radical prostatectomies were analyzed. 163 (80%) patients referred adequate erections prior to surgery. In 82 cases, surgery was performed with the intention of preserving one or both bands. For the remaining cases, radical surgery with exeresis of both bands was performed. Due to secondary erectile dysfunction, 75 patients were studied by preparing: clinical history, laboratory tests, penile neurophysiological studies and intracavernous prostaglandin E1 injection test. Dynamic drug-cavernosmetry was performed in 36 patients. After radical prostatectomy, only 9.2% previously potent patients retained adequate erections. Of the 82 cases where preservation of one or both bands was attempted, 9 (11%) patients retained their erections. Changes in neurophysiological parameters were found in 69.2% cases and general vascular injury detected in 23 (63.8%) patients by drug-cavernosmetry, the main injuries being cavernous arteries insufficiency in 58.3% and veno-occlusive failure in 33.3%. Of the 75 patients studied, 48 accepted the treatment: 40 (81.6%) used intracavernous auto-injection, 8 had penile prosthesis inserted, and one patient uses a vacuum device. Intracavernous Pg E1 auto-injection has provided adequate stiffness in 95% patients and, at 6 months from onset of treatment, a decrease of the minimal effective dose has been seen which is more noticeable in men under 60 and patients who start treatment within 6 months.

Aged↗
PubMed1996

[Long-term results of the treatment with intracavernous injection of vasoactive drugs].

OBJECTIVES: To evaluate the long-term results of treatment of erectile dysfunction with intracavernous self-injection of vasoactive drugs. METHODS: The study comprised 144 patients treated with intracavernous self-injection. The most common etiologies were arterial (27%), corporal-veno-occlusive (22.2%) and diabetic (17.5%). The mean follow up was 15.6 months (range 12-44) and the total number of injections was 7,190. PGE1 was utilized in 135 patients and papaverine + PGE1 in 9 patients. RESULTS: Patients with psychogenic or neurogenic impotence responded to low doses of PGE1 (9.6 microgram and 8.4 microgram, respectively). Adequate rigidity was achieved in 96% for over 30 min in 90%, and coitus was satisfactory in 92%. There were 20 (13.9%) dropouts and 5 (3.5%) recovered erection. The most important local complications were intense pain (4 pts, 0.05%), prolonged erection (3 pts, 0.04%) and secondary fibrosis without penile curvature (3 pts, 2.1%). Systemic complications were observed in only 4 cases: palpitation (1 pt), headache (1 pt) and dizziness (2 pts). CONCLUSIONS: Patients with psychogenic and neurogenic impotence responded to low dose therapy, whereas those with veno-occlusive impotence required the highest doses of PGE1 or papaverine + PGE1. This pharmacological erection program achieved adequate rigidity in 96% and satisfactory coitus in 92%. There were minimal complications: prolonged erection (0.04%), intense pain (0.05%) and fibrosis (2.1%).

Alprostadil↗
PubMed1996

[Surgical complications in kidney transplantation. Analysis of our series (300 transplantations, 1986-1995)].

OBJECTIVES: To review our series of 300 renal transplants, with special reference to the surgical complications and their management. METHODS: From June, 1986 to August, 1995, we performed 300 heterotopic renal transplants harvested from cadavers. Reconstruction of the urinary tract was by ureteroneocystostomy in practically all of the cases. RESULTS: The overall surgical complication rate was 20.3%. The graft was lost in 2 cases (0.66%). The most common urological complication was obstruction of the urinary tract arising from stenosis (3.6%), lymphocele (5.3%) and clotting (1.6%); 78.1% of these obstructive complications were resolved by endourological techniques. Urinary fistula was observed in 9 cases (3%) and lymphocele in 16 (5.3%), which were resolved by percutaneous drainage and sclerotherapy in 81.2% of the cases. Vascular complications were observed in 14 cases (4.6%), lithiasis in 5 (1.66%) and eventration in 6 (2%). The treatment of these complications are described. The actuarial graft and patient survival rates were 90.9% and 84.7% at one and five years, respectively, for the graft and 93.5% and 89% for the patients. CONCLUSIONS: Our surgical complication rate in patients undergoing renal transplantation was 20.3%. The most common complication was urinary tract obstruction from stenosis (3.6%), lymphocele (5.3%) and clotting (1.6%); 78.1% of these obstructive complications were resolved by endourological techniques. Percutaneous drainage of the lymphocele combined with sclerotherapy achieved resolution in 81.2%. Renal biopsy performed with a 14 G needle caused 5 severe hemorrhagic complications. There were no complications when an 18 G needle was utilized.

Adult↗
PubMed1993

[Matrix stones].

We report a case of matrix stone in a patient with a previous history of infective staghorn stone for which the patient had previously undergone surgery to reduce stone volume and ESWL. The ureteral matrix stone had caused purulent intrarenal retention. Puncture nephrostomy and antibiotics resolved the foregoing condition and the calculus was successfully removed by ureteroscopy. The features of this uncommon disorder and the possibilities of endoscopic treatment are discussed.

Adult↗
PubMed1993

[Supernumerary spleen].

The diagnosis of the accessory spleen, if unsuspected, is basically anatomopathological due to its frequency and, above all, its nonspecific clinical features. We report a case of a retroperitoneal mass that was shown to be composed of accessory splenic tissue.

Adult↗
PubMed1992

[Surgical staplers. Urologic surgery with intestines].

Since the late 1980s, different reservoirs and bladder substitution techniques have been added to the urological surgical armamentarium. The necessary use of an intestinal segment--generally detubularized--make these surgical procedures complicated and time-consuming. Furthermore, problems are encountered postoperatively due to the important morbidity arising from these procedures. The present article describes our experience with mechanical sutures and resorbable material. Although the results have not been analyzed, our initial experience at the Miguel Servet Hospital has shown that these devices significantly facilitate the operative procedure, thereby reducing the incidence of urinary and intestinal fistulas. Although there is an evident risk of calculi formation, complicated solutions are not required and the biological tolerance to the metal sutures is excellent.

Humans↗