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Biomedical subjects

M Ruibal Moldes

Publications and source records attributed to M Ruibal Moldes.

11 recordsLinked to original sources

[Clinicopathological study of incidental cancer prostate in patients undergoing surgery for symptomatic diagnosis of BPH].

UNLABELLED: OBJECTIVES-INTRODUCTION: Retrospective study of a series of patients with prostate surgery (suprapubic prostate adenomectomy -APS-, and prostate transurethral resection -RTU-P-) for presumed BPH symptomatic non-respondent to the conservative medical treatment. Analysis of prevalence, incidence, clinical-pathological, treatment, tumor progression and evolution of the patients with incidental prostate cancer (CPI) detected. MATERIAL AND METHODS: 1593 patients with prostate surgery (APS and RTU-P) during 6 years (1996-2001) were revised. APS 35%, RTU-P 65%. Revision of all pathological anatomy of surgical specimens and the evolutions of the patients with CPI. RESULTS: 78 CPI; Prevalence 4,89%; Incidence 13 cases/year. Mean age 73.6 years. Digital rectal examination was normal in 100%, mean PSA 6 ng/ml (0.5-30). Group APS: 25 CPI (32%); prevalence 4.55%; incidence 4 cases/year; mean PSA 7.7 ng/ml (2.8-30); mean weight resection 65 gs. Group RTU-P: 53 CPI (68%); prevalence 5,07%; incidence 9 cases/year; mean PSA 5.2 ng/ml (0,5-29); mean weight resection 20 gs. 22% biopsy previously by high PSA, mean PSA 14 ng/ml (4,8-30). Gleason average 5 (mean 4.8), rank 3-8. pTla 66%, pTlb 33%. TREATMENT: 57% follow-up watched without treatment (wait and see); 18% hormonal treatment; 3% finasteride; 9% Radical Prostatectomy; 9% radiotherapy. Follow Lost 4%. Mean follow-up 47.19 months (12-96). Tumor progression 13.3% (10 patients). Specific CPI mortality 2.6% (2 patients). CONCLUSIONS: We didn't observe significant differences between the prevalence of CPI in both groups (APS and RTU-P). The detected tumours were mainly well differentiated and in stage pTla. In more than half of the cases an expectant attitude without treatment was decided. 13,3% of tumor progression after 47.19 months of follow mean and specific CPI mortality 2.6%.

Aged↗

[High flow arterial priapism secondary to post-traumatic bilateral arterio-cavernous fistula. Highly selective embolization with autologous blood clot].

High flow arterial priapism is rare and characterized to a prolonged non-painful partial erection. Arteriocavernous fistula, rarely bilateral, is associated with penile or perineal trauma (genitoperineal area). Review of the literature, in only eleven cases this fistula is bilateral. Different treatments with non common norm has been used. We report a case of a 27 years old male who presented high flow priapism secondary to bilateral postraumatic arterio-cavernous fistula. Autologous blood clot was used for fistulas embolization to minimize the risk of impotence in this young patient. No complications was registered. Eight months later the patient had normal erectile function and no fistula was detected on ultrasonography doppler. We consider arteriography with highly selective embolization using re-absorbable agents obtains the best results, the least risks and complications in this process.

Adult↗

[Traumatic urethral disruption in women. A rare entity. Report of two cases].

We present two cases of urethral disruption in women, a very uncommon situation because of the anatomical features. Yet it must be always suspected in all women under a pelvic politraumatism, for eviting important problems. Both cases are traffic politraumatized young girls presenting with pelvic fracture, among others. The surgery performed was combined suprapubic-transvaginal approach, even in one a previous endoscopic realinement was done, who also needed endoscopic complementary treatment: electrofulguration of a fistulous bridge. Outcome of both is fine, achieving good continence. We also make a literature review.

Adolescent↗

[Iatrogenic prostatorectal fistula. Use of gracilis muscle pedicled flap for its reparation. Presentation of two cases].

We present two cases in which during retropubic prostatectomy for benign prostatic disease a prostatorectal fistula ocurred. We describe its reparation using a pedicled flap of gracilis muscle. We also present cystographic and opaque enema images which shows the before and after of this surgery. Patients had good outcome without incontinence nor problems related to muscle desinsertion surgery.

Aged↗

[Metastasis of prostatic carcinoma to the urethra: report of a case].

Penile metastases from prostate carcinoma are uncommon events, much more in urethra and corpus spongiosum, we add a case to the preexisting literature. A patient with hormone resistant prostate cancer consults for haematuria and voiding difficulties. During TURP we observe tumors at the penile urethra which are resected and result to be prostate cancer metastases. Patient is fine and without voiding disturbance after 7 months of following. We think is an interesant case because there is few reports in literature.

Adenocarcinoma↗

[Late pancreatic metastasis from renal carcinoma].

The appearance of solitary late metastases of renal cell carcinoma has seldom been documented. A male patient, who 5 years ago underwent left radical nefrectomy for renal cell carcinoma, presented with a solitary pancreatic metastasis (an uncommon site of metastasis for renal cell carcinoma), which was successfully treated with partial pancreatectomy. The diagnostic, treatment and prognostic implications of solitary late metastases are discussed.

Adenocarcinoma, Clear Cell↗

[Follicular cystitis. Presentation as a bladder pseudotumor].

Presentation of a case report of follicular cystitis in a 48-year old male patient who referred gross haematuria and repeat urinary infections. Ultrasonographic and endoscopic examinations show the presence of a vesical pseudoneoplasm. Definite diagnosis was achieved through histologic study after TUR-biopsy.

Cystitis↗

[Primary bladder amyloidosis].

Primary amyloidosis of the bladder is a rare disease entity manifested as extracellular deposits of a fibril protein in an amyloid substance form. Clinical presentation resembles a bladder tumor, as hematuria is the most common clinical manifestation. Single organ affectation is most frequent in the bladder, however, we have found less than 100 cases. We present the case of a woman with primary amyloidosis of the urinary bladder with symtoms of hematuria. Endoscopic examination suggested a bladder tumor.

Aged↗

[Surgical management of renal cell carcinoma with vena cava-right atrium thrombus].

Historically the presence of a thrombus in vena cava was associated with worse prognosis in patients with renal cell carcinoma, and the effective of surgery limited. However a extensive tumor thrombi can be present without evidence of lymph node and distant metastasis, an aggressive surgical approach with curative intent is justified. We retrospectively reviewed 25 patients with renal cell carcinoma and thrombus in vena cava and they underwent radical nephrectomy and thrombectomy. The IRM allowed to know the level of the thrombus into vena cava in all patients: 56% level I, 8% level II, 26% level III. There were 14 pT3b, 8 pT3c, 3 pT4, and 48% N+. The rate of complications was 36% and there were 4 perioperative death (16%). Patients without lymph node and no distant metastasis had a mean survival of 64% 46%, 37% to 2, 3, 4 years respectively. Patients with lymph node invasive an distant metastasis the prognosis was poor. We no noted correlation between level thrombus and prognosis.

Adult↗