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M A López Costea

Publications and source records attributed to M A López Costea.

17 recordsLinked to original sources
PubMed1998

[Ambulatory treatment of ureteral lithiasis using shock wave extracorporeal lithotripsy].

Presentation of the results obtained with extracorporeal shock wave lithotripsy (ESWL) applied to 3173 ureteral lithiasis with a Dornier HM-4 equipment. Location of lithiasis was pyeloureteral junction (329), lumbar ureter (1068), sacral ureter (238), iliopelvic ureter (1474) and "lithiasic path" (64). All lithiasis were treated in situ. Treatments were carried out ambulatory with no anaesthesia. Treatment/lithiasis rate was 1.3. Percentage of stone-free patients with ESWL alone was 79.2% after the first session, and reached 86.14% with retreatment. Percentage of success for lithiasis in pyeloureteral junction was 81.8%, 79.7% for lumbar ureter lithiasis, 80.09% sacral lithiasis, 90.10% iliopelvic ureter lithiasis and 79.9% for those in the "lithiasic path". 12.6% lithiasis required post-ESWL auxiliary manoeuvres. Post-ESWL minor complications (pain, vegetations) occurred in 5.6% cases and major complications (obstruction, fever, sepsis) in 2.9%. The factors influencing lithiasis fragmentation were the number of shock waves and the lithiasis duration. Size of lithiasis and presence or absence of ureteral catheter had no influence. These results suggest that ESWL is an effective method for managing ureteral lithiasis.

Ambulatory Care↗
PubMed1993

[Transplantectomy today: indications and complications].

Analysis of the indications for transplantectomy and its complications over a 12-year period. Over a total of 159 failure grafts, we performed 53 transplantectomies (33.3%). The percentage of complications was 16.9%. Three patients died (5.6%) during the more or less immediate post-operative period. In our experience, consistent and prolonged maintenance of immunosuppression should avoid the need for transplantectomy in a high percentage of grafts. Only 15 transplantectomies were made on 104 failure grafts after 6 months (14.4%). Our short but successful experience with embolization of 2 rejected grafts confirms the validity of this conservative alternative versus conventional surgical transplantectomy in selected cases.

Humans↗
PubMed1993

[Ureteral obstruction secondary to endometriosis. Report of a case].

The urinary tract is rarely affected by endometriosis, urinary bladder being the most common location. This paper presents one case of advanced extrinsic endometriosis which initially presented as obstructive pyelonephritis. The diagnostic methodology, including uro-tomographic imaging, is evaluated. Although good results have been reported with hormone-therapy, we support the surgical approach sanctioned by the patho-anatomical findings.

Adult↗
PubMed1993

[Renal angiomyolipoma. Our case histories].

We reviewed the cases of angiomyolipoma that had been diagnosed and treated in our urology services from 1978 to 1991. The study showed a higher incidence in the females; it frequently presented as a solitary tumor; a high specificity was found for the US (hyperechoic mass) and CT (areas of low attenuation ratio) findings. Owing to these diagnostic techniques, conventional surgery is no longer the only treatment. Embolization is considered to be the first therapeutic approach.

Adult↗
PubMed1992

[Acquired cystic renal disease associated with renal carcinoma: report of 3 cases].

Presentation of three cases of haemodialysis patients with acquired cystic renal disease (ACRD) who, over the course of their illness, developed clear cells renal carcinoma. The paper emphasizes the common association of these two entities and the need to consider ACRD cases as patients at high risk of developing renal neoplasia.

Adenocarcinoma↗
PubMed1992

[Urinary sepsis as manifestation of a renal angiomyolipoma].

Renal angiolipomas are the most frequent benign renal tumours. Since ultrasound techniques have been in use to study algetic lumbar syndromes, their symptomatic appearance has decreased. Most authors agree that CAT has a 100% specificity. The paper contributes one case of renal angiomyolipoma isolated in a 39-year old woman, its primary interest being the clinical presentation, within an extensive septic milieu of urinary origin, the intra-operative diagnosis, considering the previous false-negative echography and dubious tomographic diagnoses, and the findings of regional node invasion, all exceptional states in the reviewed literature.

Adult↗
PubMed1992

[Renal transplantation in patients over 50 years old: our experience with 58 cases].

Retrospective analysis of the results from corpse renal transplantation, under immunosuppressive therapy with cyclosporin in a group of 58 elderly receptors (greater than or equal to 50 yr). The results are compared with those obtained in 152 receptors under 50 year of age transplanted during the same period of time (1984-1988). No statistical differences were seen between both groups regarding immunosuppressive therapy, number of transfusions, HLA histocompatibility, number of transplantations and percentage of hypersensitive patients. Incidence of rejection is significantly higher in the younger patients group, as well as graft loss due to immunological reasons. Mortality was significantly higher in the elderly group. Actuarial survival of the graft after two years is similar in both groups. It is concluded that in the era of cyclosporin, the receptor's age should still be considered a risk factor and, therefore, that maximum precautions should be taken in order to detect any additional risk factor within this group in a strategy to improve their survival.

Adolescent↗
PubMedDate not supplied

[Primary bladder actinomycosis].

Primary actinomycosis of the bladder is an infrequent presentation of this condition. The main concern is obtaining a differential diagnosis from tumours of the bladder and the subsequent impact this has on the therapeutic choices. Contribution of one case report of a male patient with actinomycosis of the bladder, with remarks on relevant diagnostic (including differential diagnosis) and therapeutic data.

Actinomycosis↗
PubMedDate not supplied

[Urinary diversions: our experience and selection approach].

Retrospective review of 126 urinary by-passes performed in our service over the last 15 years where efficacy and complications arisen from the ureteroileal by-passes, ureterosigmoidostomy and skin ureterostomy are analyzed. Patients were found to be pre-operatively homogeneous with no statistically significant differences with regard to age, renal function or previous radiotherapy, except in the case of ureterostomies which are always initiated from a poorer renal function and general condition. It was concluded that there was no difference between the various Bricker types according to the anastomosis, which allows joint a comparison with other groups. After three months, Bricker's showed better radiologic evolution than Goodwin's (p less than 0.08) and a statistically lower number of complication (p less than 0.05) therefore establishing they should be the choice procedure versus any other type of by-pass. Literature review with regard to results and conditions of container reservoirs and vesical substitutions, evaluating their contraindications within the neoplastic scope and/or psychosocial range, as well as comparing the reflux, stenosis and infection rates with our series, make the ureteroileal by-pass a technique entirely legitimate at present.

Adolescent↗
PubMedDate not supplied

[Kidney preservation].

Extensive literature review on the current state of organs preservation; solutions and methodology. Major advances in immunosuppression methods and the ongoing increase in the number of renal transplants encourage the search and investigation of better preservation techniques. Continuous pulsatile perfusion and perfusion plus hypothermal storage represent the two most frequently used techniques nowadays. In spite of the advantages shown by the former in the case of prolonged cold ischemia, hypothermal storage remains as a practical technique widely used in our environment.

Cryopreservation↗
PubMedDate not supplied

[Germinal tumors of the testis. A caseload and review of the literature].

Between 1974 and 1988, 35 testicle germinal tumours, 16 seminomas and 19 non seminomas, were studied. Mean age in seminoma cases was 34 years and 26 in non seminoma cases; the former were mainly presented as located stages at the time of diagnosis (75%) while the latter were, on the contrary, mostly stages II and III. Following orchiectomy, all histologically pure seminomas received radiotherapy with the exception of two cases. All of them are presently free from the disease with an average follow-up of 2.8 years (range 0.5-5 Yr.) Radiotherapy continues to be proposed as first choice therapeutic action for siminomas in located stages, although we do not disagree with other more conservative possibilities. In the non seminoma group, all three patients diagnosed in stage I were clinically controlled without supplementary therapy, two of them having a recurrence during the first year of follow-up, but currently free of the disease after chemotherapy and surgery of residual masses. Of the three non seminoma patients in stage II, with negative post-orchiectomy markers, two underwent lymphadenectomy and the other one only chemotherapy. In the remaining group of non seminoma patients, and always after an orchiectomy, chemotherapy was performed as first choice therapy, although rescue lymphadenectomy was required in eight cases. Chemotherapy schemes with cisplatin have relegated to a second level any other therapy for the non seminoma patients. The excellent response and reduction of side effects allow the adoption of more conservative attitudes. This paper explains our retrospective study and, following a wide review of exiting literature, discussed any conflictive prognostic and therapeutic items.

Adolescent↗
PubMedDate not supplied

[Rigid ureteroscopy: results and complications].

We make an evaluation of 66 ureteroscopies (URS) carried out in our Service over a period of 18 months. In 55 cases it was done for therapeutic purposes in ureteral lithiasis, and in 11 cases it was for diagnostic purposes. In the treatment of lithiasis resolutive effectivity at the first attempt was 68%, in 9% ureterolithotomy had to be performed due to the impossibility of approaching the calculus, and in 23% supplementary treatment was carried out by means of external litrotripsy. In the diagnostic field, effectivity was 72%. Notable complications arose in 6 cases (9%), 6 ureteral perforations, in three of which a urinoma was formed, all settled with a double J catheter. Open surgery was not resorted to in any case. No sequelae were observed and this technique therefore showed itself to be safe and effective.

Adult↗
PubMedDate not supplied

[Adrenal masses discovered incidentally].

The introduction of new diagnosis techniques has made the study of the suprarenal gland much more accessible. In particular, ultrasonography, CAT and MRI have contributed to the increased detection of suprarenal masses by chance, and this raises problems when it comes to deciding the attitude to take to the diagnosis of these masses. We present nine suprarenal tumours, most of which appeared in the course of follow-up of patients suffering from carcinoma of the bladder. On detecting a suprarenal mass, we carry out a morphological study with CAT as well as determination of hormonal activity and puncture with cytology of the mass, according to the schema proposed by Copeland. We comment on the most significant clinical aspects and on the criteria of action proposed by various authors.

Adenoma↗
PubMedDate not supplied

[Conservative treatment in major kidney trauma].

The kidney is frequently involved in penetrating abdominal injuries, and less so in closed abdominal traumatism. This paper presents one case of major renal trauma with total renal fracture and development of urinoma that separated both segments that, after a minimally invasive manoeuvre (percutaneous drainage), evolved favourably thus avoiding a surgical procedure which, quite reasonably, would have led to nephrectomy.

Adult↗