Biomedical subjects

Milagros Fabuel Deltoro

Publications and source records attributed to Milagros Fabuel Deltoro.

3 recordsLinked to original sources

PubMed2006

[Primary bladder neck obstruction in males].

OBJECTIVES: To report our experience on the diagnosis and treatment of this rare type of infravesical functional obstruction. METHODS: Over the last ten years we diagnosed and treated 32 males with this entity. We evaluate previous treatments and time to diagnosis. Clinical, radiological, endoscopic, and urodynamic features are evaluated, as well as results obtained with the administration of alpha-adrenergic blockers and endoscopic transurethral incision of the bladder neck. RESULTS: Patient age ranged from 26 to 48 years (Mean 38.2). All patients presented significant long-lasting lower urinary tract symptoms, having received various non-specific treatments. Uroflowmetry showed a peak of mean flow of 9.8 +/- 3.2 cc/s, being the voiding detrusor pressure 98 +/- 25 cm H2O, with significant post void residual volume in 21 patients (188 +/- 62 cc). Medical treatment with alpha-adrenergic blockers only achieved significant subjective improvement in four patients. Twenty one patients underwent unilateral endoscopic bladder neck incision, obtaining objective and subjective improvements all of them. CONCLUSIONS: Endoscopic bladder neck incision is the treatment of choice of this dysfunction, being imperative to inform the patient of the risk of retrograde ejaculation as a postoperative sequel, since this entity appears in young males, for whom fertility may be a priority.

Adult↗

PubMed2006

[The usefulness of virtual endoscopy and CT urography in the diagnosis of upper urinary tract tumors].

OBJECTIVES: Upper urinary tract (UUT) tumors are a relatively low incidence pathology which often represents a diagnostic challenge for the urologist, because several imaging tests are usually necessary to achieve the final diagnosis. Over the last years CT scan has suffered a notable development and nowadays, with the arrival of new image processing hardware and software, it is possible to detect small urothelial lesions and to perform 3-D urinary tract reconstruction and virtual endoscopic navigation. METHODS: Between January 2004 and June 2005 we performed a total of 15 examinations in 15 patients for the study of asymptomatic hematuria of probable upper urinary tract origin. The technique included three phases to obtain images: basal phase, vascular phase and excretory phase. Processing and image analysis was performed by one radiologist. RESULTS: A total of 10 tumors were diagnosed, with pathological confirmation in all cases. We did not register any complication secondary to the technique, and all patients tolerated well the exam. CONCLUSIONS: The CT urography is a safe, well-tolerated, highly sensitive and efficient imaging test, very useful in the diagnosis of renal and UUT pathology. It may become the only imaging test performed in the study of asymptomatic hematuria and the test of choice for the study of urological tumoral pathology.

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↗