PubMed Health⌕ Search

Biomedical subjects

Luis De la Torre Abril

Publications and source records attributed to Luis De la Torre Abril.

10 recordsLinked to original sources
PubMed2005

[The treatment of hydrocele as ambulatory surgery].

OBJECTIVES: To evaluate the results of this surgical treatment of hydrocele over the first four years of integration of the Urology Department in the Major Ambulatory Surgery Unit in our Hospital. METHODS: From January 2000 to July 2004 we have performed 167 hydrocelectomies as ambulatory surgery in 152 patients (15 cases bilateral) with ages ranging from 16-87 years (mean 52.6). All procedures were performed under local anesthesia, using between 10-15ml of 1% lidocaine. The Lord's vaginalis plication technique was employed in 92% of the cases, leaving resection techniques for the remaining 8%, which presented certain degree of enlargement of the tunica vaginalis. We evaluated inclusion and discharge criteria, results, and degree of satisfaction by means of a questionnaire. RESULTS: Results are equivalent to those of inpatient surgery. Only one patient required admission to the hospital due to a postoperative complication, which was clearly independent of the ambulatory character of the process. Satisfaction with treatment was higher than 95%. CONCLUSIONS: Almost all patients with hydrocele are candidates to ambulatory surgery, significantly improving the cost-efficacy rate, without diminishing the quality of care or patient satisfaction.

Adolescent↗
PubMed2005

[Orthotopic bladder substitution in the treatment of interstitial cystitis].

OBJECTIVES: To point out the efficacy of supra trigonal cystectomy with orthotopic substitution iliocystoplasty in the treatment of advanced interstitial cystitis (IC). METHODS: We study the results obtained in four women suffering IC nonrespondent to conservative treatment who underwent the procedure. All patients comply with classic diagnostic criteria of IC, presenting long-lasting symptoms, between 4 and 8 years (mean 5.6), and voiding frequency of near one-hour day and night. RESULTS: Mean postoperative follow-up was 32 months (18 to 56); post operative evaluation included clinical evaluation, ultrasound, urodynamic studies, and radiological tests. Suprapubic pain disappeared in all cases, as well as pre-op lower urinary tract symptoms, with good control of urinary frequency day and night being evident in the immediate postoperative period. All patients referred high satisfaction with the outcome. CONCLUSIONS: When conservative treatment fails, supratrigonal cystectomy with orthotopic neobladder substitution is a valid therapeutic option in IC patients who comply with classic diagnostic criteria.

Aged↗
PubMed2005

[Outpatient surgical treatment of female stress urinary incontinence].

OBJECTIVES: To evaluate the results of the outpatient surgical treatment of genuine female stress urinary incontinence (SUI) over a five year period since the integration of the Department of Urology in the Ambulatory Surgery Unit at our hospital "Consorcio Hospital General Universitario de Valencia" (CHGUV). METHODS: Between January 2000 and December 2004 26 patients (ages 49-78; mean age 69.8 yr) with the diagnosis of SUI underwent tension-free suburethral mesh sling (TVT) outpatient operations under local anesthesia-sedation at the ambulatory surgery unit of the CHGUV. All patients had clinical and urodynamic evaluation, excluding those presenting genital prolapse or non compliance with the social requirements for ambulatory surgery. Previous anti-incontinence surgery was not an exclusion criterion. We evaluate inclusion and discharge criteria, results and satisfaction degree measured by a questionnaire. RESULTS: 22 patients (85%) had genuine SUI and 4 (15%) had mixed UI with predominance of the stress component. 54% (14) of the patients were ASA I, 31% (8) ASA II, and 15% (4) well compensated ASA III. Operation tolerance under local anesthesia (20-30 ml 1% lidocaine) was good in all patients, having used additional sedation-analgesia (propofol-remifentanil IV perfusion) in 10 of them (38%). Mean operative time was 30 minutes (25-45) and stay at the unit discharge was 100 min. (80-140). All patients were discharged the same day. None of them required readmission or presented urinary retention after catheter removal. SUI disappeared in all of them. Three patients presented postoperative urge incontinence responsive to oral anticolinergic drugs. Our results are similar to those obtained with epidural anesthesia and hospital admission, being the degree of satisfaction with treatment higher than 95%. CONCLUSIONS: The development of new, revolutionary systems for the treatment of SUI has simplified the surgical treatment of this entity, so that we can say a high percentage of patients may be included in an ambulatory surgery program, significantly improving cost-efficacy without diminishment of health-care quality or patient satisfaction.

Aged↗
PubMed2005

[Symptomatic hydronephrosis during pregnancy].

OBJECTIVES: Hydronephrosis is common during pregnancy, affecting 90% of pregnant women. It is usually asymptomotic, but a small percentage of patients show clinical symptoms requiring treatment. We want to report our experience in the diagnosis and treatment of symptomatic obstructive uropathy in pregnant women. METHODS: We retrospectively evaluate the results obtained in 162 pregnant women suffering symptomatic hydronephrosis who received care at our department over the last 12 years. RESULTS: Conservative treatment was effective in most patients, 39 patients required more aggressive therapy. Thirty-five patients underwent insertion of a doubleJ catheter, 2 patients percutaneous nephrostomy, and another 2 ureteroscopy and extraction of ureteral lithiasis. CONCLUSIONS: The most frequent etiology of symptomatic hydronephrosis during pregnancy is external compression by the gravid uterus, followed by ureteral lithiasis. We consider conservative treatment as the treatment of choice, leaving ureteral double J cotheter insertion or percutaneous nephrostomy for the refractory cases. Ureteroscopy is a new diagnostic and therapeutic option when other less aggressive meosures fail.

Female↗
PubMed2004

[Ambulatory surgery in urology. Analysis of our experience].

OBJECTIVES: To show the results of our four-year experience since starting urologic procedures in the Ambulatory Surgery Unit in our hospital. The progressively increasing demand of surgery has showed up the limitations of sanitary resources. Ambulatory Surgery arises with the aim to optimize such resources, because it improves surgical procedures and rationalizes the increasing sanitary expenditures. METHODS: We study the results obtained after operating on 415 patients, showing inclusion criteria, relationship between surgical procedure and anesthetic drug employed, as well as discharge criteria. RESULTS: Among all patients operated on, 4 (11%) required hospital admission, and 12 presented with complications in the immediate postoperative period (3%), all of them minor. Satisfaction with treatment was around 95%. CONCLUSIONS: A great percentage of patients with urologic diseases who need surgery are candidates to be included in an ambulatory surgery program, without compromise of the quality of care or patient's satisfaction.

Adolescent↗
PubMed2004

[Spontaneous recanalization of the vas deferent after vasectomy: report of 2 new cases. Bibliographic review].

OBJECTIVES: Vasectomy is a low morbidity and high efficacy surgical method. A small percentage of cases may have paternity after surgery as a complication. METHODS: We reviewed all patients who underwent vasectomy at our department from 1995 to 1999 (n = 1492), defining technical failure as pregnancy or no disappearance of spermatozoids in the follow-up sperm analysis. RESULTS: We found 2 cases; one of them did not have a negative sperm test after three months, the other one's wife became pregnant after previous azoospermia. Both patients showed granulomas in the pathologic report after a second operation. CONCLUSIONS: Vasectomy is a surgical technique that may have a failure rate close to 2%. Paternity after the operation may appear even after several years. Several authors report the existence of granulomas in those cases in which spontaneous recanalization appears. In our series it was a constant.

Follow-Up Studies↗
PubMed2004

[Alfredo Tramoyeres Cases (1910-2002): first chairman of the Department of Urology at the Ciudad Sanitaria La Fe. Documentary-historical analysis of his works].

OBJECTIVES: Urology, having been part of general surgery for centuries, was completely consolidated as a medical speciality in the middle of the XX Century as the result of years of evolution and development, and all the studies and works of certain authors that represent today the mainstays of our speciality. Valencia in the middle of the 20th century saw the birth of new hospitals including the "Ciudad Sanitaria La Fe". Alfredo Tramoyeres Cases was the first chairman of the Department of Urology. This article reviews his long and fertile professional life. METHODS: We have reviewed all his scientific works. The articles have been obtained from Medicina Española, Revista Española de Cirugía Traumatológica y Ortopedia, and Archivos Españoles de Urología. His most important urological work is his doctoral thesis with the title "Sigmoid-procto-ureterostomy: personal modification" published in Valencia in 1976. For his biography we used the" Biographic and bibliographic history of the Spanish Urology over the XX century" and interviews with family members. RESULTS: We emphasize his thorough description of the various types of urinary diversion. He covers the topics of bladder diverticula and bladder neck disorders, in which he supports surgical treatment. Finally, he sets out the rupture of the posterior urethra and various treatments for prostate cancer at that time. CONCLUSIONS: Alfredo Tramoyeres Cases contributed to the definitive consolidation of our speciality in the area of Valencia during the second half of the XX century, through his long professional life, with his interesting scientific contributions.

History, 20th Century↗
PubMedDate not supplied

[Bladder squamous metaplasia: report of one case and bibliographic review].

OBJECTIVES: We report a new case of squamous metaplasia because of its interest and subtle differential diagnosis with other bladder pathologies. METHODS: We report the case of a male patient with history of previous neoplasia with an exophytic lesion of the bladder wall discovered on follow-up. Pathological diagnosis after TUR was bladder squamous metaplasia. RESULTS: Follow-up is performed by ultrasound, cystoscopy, and urine cytology in adherence to clinical guidelines due to the possibility of transformation into squamous cell carcinoma. CONCLUSIONS: Urothelium is able to develop non neoplastic transformations such as squamous metaplasia. The importance of such transformations depends on proper diagnosis and follow-up due to their ability to transform into a neoplastic process.

Aged↗
PubMedDate not supplied

[Biography and analysis of the urologic works of Dr. Nicasio Benlloch Giner (1888-1957) (I)].

OBJECTIVES: The practice of Urology in our country has a long tradition, as demonstrated by several treaties of surgery from the Renaissance; it was the end of the XIX century when the scientific basis of the speciality were established separate from Surgery, as some authors demonstrated, with the notorious contribution of Prof. Rafael Mollá Rodrigo. Dr. Nicasio Benlloch Giner (1888-1957) did the same at the beginning of the XX century when he came back from the professional school of George Marion, contributing to the consolidation of this speciality. METHODS: We reconstructed his biography and analyzed all his bibliography, both in regional and national journals. RESULTS: According to Nicasio Benlloch, renal lithiasis and its treatment were under controversy. Renal lithiasis might demand three indications: nephrectomy, pyelolithectomy and nephrolithectomy. In his chapter on intravenous pyelography he describes its absolute and relative indications. In his work about urinary catheterization and endoscopy he describes in detail the exploratory catheterization of urethra, bladder, and ureters, as well as the catheterization for evacuation and dilatation, and the most frequently used instruments. Finally, he talks about the benefits of endoscopic resection for bladder neck diseases and describes a resectoscope. CONCLUSIONS: Dr. Nicasio Benlloch contributes with his works to the consolidation of Urology as a speciality in Valencia, mainly in the field of lithiasis, a topic in which his works were fundamental.

History, 19th Century↗
PubMedDate not supplied

[Biography and analysis of the urologic works of Dr. Nicasio Benlloch Giner (1888-1957) (II)].

OBJECTIVES: The practice of Urology in our country has a long tradition, as demonstrated by several treaties of surgery from the Renaissance; it was the end of the XIX century when the scientific basis of the speciality were established separate from Surgery, as some authors demonstrated, with the notorious contribution of Prof. Rafael Mollá Rodrigo. Dr. Nicasio Benlloch Giner (1888-1957) did the same at the beginning of the XX century when he came back from the professional school of George Marion, contributing to the consolidation of this speciality. METHODS: We reconstructed his biography and analyzed all his bibliography, both in regional and national journals. RESULTS: According to Nicasio Benlloch, renal lithiasis and its treatment were under controversy. Renal lithiasis might demand three indications: nephrectomy, pyelolithectomy and nephrolithectomy. In his chapter on intravenous pyelography he describes its absolute and relative indications. In his work about urinary catheterization and endoscopy he describes in detail the exploratory catheterization of urethra, bladder, and ureters, as well as the catheterization for evacuation and dilatation, and the most frequently used instruments. Finally, he talks about the benefits of endoscopic resection for bladder neck diseases and describes a resectoscope. CONCLUSIONS: Dr. Nicasio Benlloch contributes with his works to the consolidation of Urology as a speciality in Valencia, mainly in the field of lithiasis, a topic in which his works were fundamental.

History, 19th Century↗