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M J García-Matres

Publications and source records attributed to M J García-Matres.

15 recordsLinked to original sources
PubMed1995

[Urethroplasty with lyophilized human dura mater].

OBJECTIVE: This article reports our experience with lyophilized human dura in the treatment of complex urethral stenosis. METHOD: Seven patients with iatrogenic/inflammatory urethral stricture underwent a 13 cms long x 1.5 cms wide medial urethral augmentation. RESULTS: During a mean follow-up of 23 months, good results accounted for 85.7%. CONCLUSION: Lyophilized dura patches constitute a suitable choice in selected patients who, for local or systemic reasons, are not good candidates for other urethroplasty procedures.

Aged↗
PubMed1992

[Nephrogenic adenoma of the upper and lower urinary tract. Apropos of 22 cases].

Nephrogenic adenoma (NA) is a lesion that can present in the urothelium--from the renal pelvis to the urethra-, and is considered to be immature metaplasia arising from chronic aggression. We report 22 cases of NA in 21 patients that had been diagnosed and treated in our service from 1975 to 1990. The lesion was found at all levels of the urinary tract: renal pelvis (1 case), ureter (1 case), bladder (16 cases) and urethra (4 cases). The present series was comprised of 15 males (one with bladder NA and recurrence in urethra) and 6 females, with ages ranging from 24 to 79 years (mean 55). The diagnosis was made on the histological findings in all cases and the etiology of the lesion was multiple: previous surgery (11 cases), previous or coexisting urothelial carcinoma (8 cases), intracavitary chemotherapy and/or pelvic radiotherapy (3 cases), previous history of tuberculosis (5 cases), interstitial cystopathy (4 cases), lithiasis (2 cases), permanent catheter (3 cases) and urethral stenosis (1 case). Treatment and prognosis was influenced by the underlying urological disease. NA per se does not carry an unfavourable prognosis.

Adenoma↗
PubMed1992

[A Foley-type catheter with a steerable tip].

Permanent bladder catheterization for medical or social reasons increases the risk of complications, especially urinary infection. We evaluated the usefulness of the balloon catheter with a steerable intravesical tip in reducing the volume of residual urine between the bladder neck and the balloon of the conventional Foley catheter. The results show that this new catheter affords no additional advantage over the conventional catheter.

Catheters, Indwelling↗
PubMed1992

[The imaging diagnosis of adrenal tumors].

From 1967 to 1991 we have diagnosed and treated 73 adrenal tumors in 63 patients: 12 pheochromocytomas, 24 adrenal cortical adenomas, 15 hyperplasias, 16 carcinomas, 3 myelolipomas, 2 cysts and 1 neuroblastoma. We conducted a retrospective study to analyze the preoperative images obtained by different diagnostic techniques and attempted to correlate tumor size and site with the results of the histological analysis of the surgical specimen. Nephrotomography with pneumoretroperitoneum and IV Nephrotomography were useful in detecting the increase of the size of the gland in 10 of 25 cases submitted to these procedures (40%). Arteriography as second or third technique of choice confirmed the presence of an adrenal tumor in 15 of the 21 cases evaluated by this procedure (70%). US and CT detected 94% (31/33) and 100% (33/33) of the cases, respectively. Fourteen cases were incidentally discovered by CT (7) and US (7). A direct relationship between tumor size and degree of malignancy could be established since the carcinomas had a mean diameter of 7 cm (range 5 to 12 cm). Concerning the histologic nature of the disease, specific images were found in 3 cases of adrenal myelolipoma (hyperechoic on US and of low density similar to fat on CT) and 2 cysts (anechoic with posterior band evidenced on us and liquid on CT). Radioisotopes were also utilized for tumor localization and there was positive uptake of I-131-IMBG in 2 cases of adrenal pheochromocytoma; 1 extra-adrenal (left lateral aortic paraganglioma) and 1 case of malignant adrenal pheochromocytoma with metastasis to the lungs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Gland Neoplasms↗
PubMed1992

[Giant lithiasis in left ureterocele. Its endoscopic resolution].

Herein we describe a case of giant calculus in an orthotopic ureterocele in a female patient who had consulted for recurrent left-sided nephritic colic. A plain film of the urinary tract prompted us to suspect a giant calculus, which was confirmed by IVP. Treatment was by endoscopic surgery. The patient has remained asymptomatic one year postoperatively.

Cystoscopy↗
PubMed1991

[Controversies over regional lymphadenectomy in carcinoma of the penis].

Epidermoid carcinoma of the penis, although rare, is a very aggressive tumor type. The presence or absence of inguinal metastasis is an essential prognostic factor. Treatment of these metastases is one of the current controversies in urological practice; i.e., when and to what extent lymphadenectomy should be performed. Of 24 patients with penile carcinoma, 10 had undergone regional lymphadenectomy over the past 8 years at our institution. Following treatment of the primary penile tumor, 6 patients had palpable inguinal nodes that persisted after treatment with antibiotic and antiinflammatory agents for 6 weeks. Of these, 3 had a positive node biopsy. They were submitted to regional lymphadenectomy which revealed node metastasis in 5 cases (2 pN3, 2 pN2 and 1 pN1). The patients with no palpable nodes were closely followed and were submitted to lymphadenectomy when these appeared (3 cases). The fatal outcome of 2 cases (both pN3) prompted us to perform lymphadenectomy prophylactically in the last case, a 40-year-old male with pT2G2 N0 penile cancer. This approach is advocated in patients under 65 with invasive penile carcinoma (pT greater than 1) or a high histological grade of malignancy (G2 and G3).

Adult↗
PubMed1991

[Our experience with the diagnosis and treatment of 429 renal traumatisms].

We studied 429 cases (3 bilateral) of renal injuries in 426 patients diagnosed and treated at our service from 1965 to 1990. Four-hundred twenty (98.59%) were blunt and 6 (1.41%) were penetrating injuries. In 313 the renal lesions were grade I (72.96%), 69 grade II (16.08%), 27 grade III (6.29%) and 20 were traumatic injuries to pathologic kidney (4.66%). Surgery was performed immediately in 67 cases (15.61%) (35 grade II, 21 grade III, and 11 previously pathological kidneys). Surgery was delayed in 34 cases (7.92%) (1 grade I, 23 grade II, 5 grade III and 5 pathological kidneys). Three-hundred twenty-eight cases (76.45%) were managed conservatively (312 grade I, 11 grade II, 1 grade III and 4 cases of traumatic injury to previously pathological kidney). Preservation of the renal unit was achieved in 100% of those with grade I lesions and in 91.17% of those with grade II that had been treated conservatively or submitted to delayed surgery. Of the grade II lesions that were immediately treated, 22.58% required a nephrectomy procedure. Of the grade III lesions and the cases of traumatic injury to previously pathological kidney, nephrectomy was required in 72% and 65%, respectively, although delayed surgery permitted more precise indication in a hemodynamically stable patient. The mortality rate in our series was 1.87 (8/426).

Female↗
PubMed1990

[Endo-urologic treatment of the uretero-intestinal stenoses in patients subjected to diversion].

Surgical repair of uretero-enteric strictures in patients with enteric conduit urinary diversion (incidence rate 4-8%) is difficult and has a high morbidity. With the development of endo-urologic techniques and ureteral catheters, long-term insertion of stents in the treatment of strictures has become possible and safe. We have performed long-term uretero-enteric stenting with 7-8 Fr double-J catheters in 5 patients with 6 strictures: 3 ureteroileal and 3 uretero-colic. In three cases (2 colonic conduits, 1 ileal conduit) the stent was inserted anterogradely following intercostal renal percutaneous punctures and dilatation of the stricture with teflon dilators (1 case), balloon catheter (1 case), or following the incision of the stricture (1 case). In one patient with a double uretero-enteric stricture of the ileal conduit, guide-wires were successfully inserted retrogradely which permitted subsequent high pressure dilatation of the uretero-ileal strictures with a 15 Fr balloon catheter. We used the same approach in another patient with a right uretero-colic stricture. The catheters were left indwelling for 7 to 35 months and were changed every 3 months with no remarkable observations other than 3 episodes of fever which quickly resolved with antibiotic treatment. Although is has been reported that uretero-enteric strictures are particularly refractory to endo-urologic treatment and a significant morbidity rate has been associated with long-term ureteral stenting, our results show that the approach was well-tolerated by all of the patients.

Aged↗
PubMedDate not supplied

[Management of injury of the solitary kidney].

Two cases of renal trauma are described herein. The diagnostic work up revealed the patients had solitary kidney. Trauma was classified as grade 1 and 2 and a conservative approach was adopted. The patient with grade 2 trauma was submitted to surgery one month following treatment. Preservation of the renal unit was achieved in both patients. Patient follow up at 16 years revealed no complications or sequelae from the injury. The diagnostic and therapeutic aspects of renal trauma in patients with solitary kidney are discussed.

Accidents↗
PubMedDate not supplied

[Complications in kidney transplant: our experience in 107 cases].

We introduce our case material on urological complications occurred in 107 renal transplants, 102 of which were from corpse donors and 5 form live donors. The techniques used for the reconstruction of the urinary tract were: extravesical ureterocystoneostomy (91 = 85%), pyelo-pyelic anastomosis (15 = 14%) and uretero-ureteral anastomosis (1 = 0.9%). Sixteen cases presented urinary fistula (15%), emphasizing the high percentage of extravasations occurred in the pyelo-pyelic anastomosis (5/15). The resolution of the problem with graft preservation was achieved in 11 cases (68.75%). We encountered 6 ureteral obstructions that resolved favourably in 100% if the cases. Other important complications were: appearance of lymphocele in 8 cases, detection of post-grafting ureteral stenosis in 5 patients, finding asymptomatic vesicoureteral reflux in 16 grafts, and presence of urinary lithiasis in 2 cases. Similarly, we analyzed our series of 16 vascular complications, emphasizing that 15 out of 107 grafts had arterial or venous vascular abnormalities (14.1%), that forced to perform bench surgery in two occasions. Our statistical analysis showed that arterial thrombosis was more frequent than stenosis (8.49% versus 4.71%), and in nearly 80% of the cases (7/9) it happened in grafts concerning more than one arterial vessel, including in this series thrombosis of any of the ramus. The largest loss of grafting were due to this complication, since in 5 out of 9 cases of arterial thrombosis (55.5%) a transplantectomy had to be performed. With regard to venous complications thrombosis is a relatively rare complication, representing in our series less than 1%, usually associated to uncontrollable vascular acute rejection.

Adolescent↗
PubMedDate not supplied

[Non-functioning renal graft: indications for transplant excision].

Of 107 renal transplants, 25 patients who were restarted on dialysis due to graft failure were studied. Of these, 20 underwent renal transplant nephrectomy. Graft failure was due to a progressive functional loss in 18 (16.8%) and 4 other grafts were non-functioning from the outset. Of these 22 cases, 17 (77.2%) underwent transplant removal. Three (15%) viable grafts were removed, 2 due to urologic complications and 1 due to hemorrhage following percutaneous renal biopsy. A non-functioning renal graft was left in situ in 5 patients. Rejection was the most frequent cause of transplant nephrectomy (45%), followed by arterial thrombosis (25%) and infection (15%). Eighty-five percent of these procedures were performed before one year post-transplantation, usually 1-4 weeks after diagnosis. Only 3 (13.6%) of the 22 non-functioning grafts removed were viable for more than 12 months after transplantation. The surgical technique was subcapsular in 60% and classical in the remaining cases. This was the surgical approach in all emergency cases. Except for one postoperative death directly related with surgery, complications were observed in 10% of the cases. These did not present as being especially uncommonly severe. The estimated 10-year posttransplantation survival rates for patients and grafts were 87.4% and 62.9%, respectively. The clinical evidence for transplant nephrectomy correlated well with the histologic evidence from the surgical specimens relative to the diagnosis of acute rejection and vascular thrombosis, despite its clinical under-utilization, and were discordant for urinary fistula, chronic rejection and sepsis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Value of ultrasound in the diagnosis of acute rejection of a kidney transplant].

To determine the usefulness of ultrasound in the diagnosis of acute renal graft failure, 48 renal transplants were retrospectively studied. The characteristic morphologic signs of acute rejection (AR) were compared with the histologic analysis of the graft using material obtained from percutaneous renal biopsy and/or transplantectomy. From the ultrasound scanning performed at the time the histologic specimens were taken, the following four easily identifiable signs were used for the assessment: 1) increased size, 2) increased volume and echo negativity of pyramids, 3) sinus compression, and 4) patchy cortex/sinus destructuring. Correlation of each sign with the anatomopathological data revealed a high sensitivity and predictive value but low specificity for ultrasound in the diagnosis of AR. Its true predictive value will depend on the demonstration of various signs simultaneously, with the advantage that, unlike other techniques, it is noninvasive and can be performed serially.

Evaluation Studies as Topic↗
PubMedDate not supplied

[Ultrasonic diagnosis of the complications of renal transplantation].

To evaluate the usefulness of ultrasound in the diagnosis of urologic complications in renal transplants, we reviewed the ultrasonographic studies performed in 107 renal transplants. Ultrasound disclosed 13 perirenal collection of fluid without hydronephrosis, 4 hydronephrosis without perirenal mass, 2 hydronephrosis from a perirenal fluid mass, 2 urinomas from polar infarction, 1 subcapsular hematoma, and 1 graft vascular atrophy. Ultrasound proved to be the most efficient technique in the diagnosis of hydronephrosis and perirenal fluid collection. Although it does not distinguish the nature of the latter, it permits control of diagnostic or therapeutic (75%) puncture. Moreover, it is useful in controlling percutaneous nephrostomy in transplant obstruction and permits its noninvasive follow-up.

Humans↗