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P Navalón Verdejo

Publications and source records attributed to P Navalón Verdejo.

17 recordsLinked to original sources

[Endoscopic treatment of the benign prostatic hyperplasia with local anesthesia and sedation in patients with high surgical or anaesthesical risk].

INTRODUCTION AND OBJECTIVE: [corrected] The aging of the population causes an increase of the number of men affected by benign prostatic hyperplasia (BPH) with a large number of pathology associated that may limit its surgical treatment. In this study we try to show the effectiveness and security of local anaesthesia and sedation in the endoscopic treatment of the BPH in patients with high surgical-anaesthetic risk. METHODS: During the last 4 years, 38 patients underwent surgical treatment of BPH with ages between 78 and 86 years (average 81,4 +/- 3,2) with severe obstructive prostatic syndrome and high surgical-anaesthetic risk. 15 patients underwent, transurethral incision of prostate (TUIP) and in 23 patients, transurethral resection (TURP) was performed. The blockade anesthetic was made by transrectal periprostatic infiltration finger-guided with 10-15 millilitres of lidocaine 2%. During the procedure an intravenous perfusion of propofol and remifentanil was administered. The obtained results as well as the patient's satisfaction degree was evaluated by means of the elaboration of a questionnaire. RESULTS: The average length of the surgical treatment was of 12 +/- 5 minutes (rank 8 - 25), having itself not stated complications derived from the anesthetic technique. They referred a slight annoyance 4 patients (11%) that was treated increasing the rate of the sedative perfusión. The satisfaction's degree with the received treatment has been good in the 95% of patients. CONCLUSIONS: We considered that the TUIP as much as TURP made under local anesthesia with sedation are safe, effective methods and well tolerated, that fundamentally are indicated in aged patients and when the surgical-anesthetic risk is elevated.

Aged↗

[Diagnosis and management of cystic dysplasia of the seminal vesicle].

INTRODUCTION AND OBJECTIVES: Cystic dysplasia of the seminal vesicle represents a rare congenital urologic anomaly of which elective treatment is controversial. We present our experience in the diagnosis and management of this uncommon pathology. PATIENTS AND METHOD: During the last twelve years we have managed eight patients affected by this pathology. The diagnosis was incidental in the three asymptomatic patients, while the other five consulted because of low urinary tract sympthoms. Ectopic drainage of the ureter in the pathological seminal vesicle was found in three of the patients. Two of these patients presented large pelvic and ureteral ectasy. Other five patients presented renal agenesis. RESULTS: In asymptomatic patients we adopted an expectant attitude, while the other five patients underwent surgical treatment. We performed open surgery in the two cases presenting ureterohydronephrosis, whereas in the other three we performed transurethral incision of the seminal vesicle. We obtained excellent results in all of them, with no evidence of symptomatic pseudodiverticulum. CONCLUSIONS: Transurethral incision of the seminal vesicle cyst is a minimal invasive procedure with low morbidity. We have proved in all of our cases that the retraction of the cyst was practically complete, this has led us into believing that transurethral incision is the elective treatment. Therefore, open surgery would only be indicated in cases of failure of the procedure due to existence of symptomatic pseudodiverticulum, or in patients presenting renoureteral ectasy associated.

Aged↗

[Correction of the penile curvature in ambulatory surgery].

OBJECTIVE: To evaluate the results obtained in the correction of the curved penis by means of Nesbit's technique during the four first years of integration of our Service in the Major Ambulatory Surgery Unit (CMA) of our Hospital. PATIENTS AND METHOD: From January of 2000 to April of 2004 we intervened in ambulatory regime 21 patient suffering from curved penis (12 congenital and 9 with Peyronie's disease) by means of Nesbit's technique. The surgical-anesthetic performed procedure is described and also the criteria of inclusion and discharge are evaluated, as well as the results obtained and the degree of satisfaction by means of the elaboration of a questionnaire. RESULTS: None of the patients needed entrance for intrasurgery nor postsurgery complications. Thus, we obtained a null incidence of complications with the exception of the inevitable shortening of the penis, clearly independent from the regime of out-patient's process. The degree of satisfaction with the received treatment has been superior to 95%. CONCLUSIONS: The practical totality of the susceptible patients for surgical correction of penile curvature are candidates to be included in a CMA program, improving obviously the relation cost-efficacy, not diminishing for that reason the welfare quality nor the degree of patient's satisfaction.

Adolescent↗

[Adrenal gland myelolipoma: review of the bibliography regarding a case].

OBJECTIVE: To describe an additional case of this rare disease entity, with special reference to its diagnosis and treatment, and to briefly review the literature. METHODS: We report on an 82-year-old male with adrenal myelolipoma that had been incidentally discovered during evaluation for another condition. A left adrenalectomy was performed due to the large size of the tumor and in order to determine its benign or malignant nature. RESULTS: The histopathological findings disclosed an andrenal myelolipoma. CONCLUSIONS: Adrenal myelolipoma is an uncommon tumor type. CT is the most effective diagnostic method. Surgery is advocated in symptomatic cases and in asymptomatic cases with a large tumor mass.

Adrenal Gland Neoplasms↗

[Burned out testicular tumor].

OBJECTIVE: Extragonadal germ cell tumor is a rare condition. The present study reports an additional case of this uncommon disease. METHODS/RESULTS: A 24-year-old male with retroperitoneal disease and a testicular lesion detected by ultrasonography is described. Histopathological analysis of the orchiectomy specimen disclosed a 'burned out' tumor. The anatomopathological features of this tumor type are discussed. CONCLUSION: Extragonadal germ cell tumor is a rare condition. It derives from the germ cells that exist in the gonad and is located in every anatomical region but the gonad itself. Ultrasonography must be performed if an extragonadal germ cell tumor is suspected.

Adult↗

[Urologic impact of Crohn disease].

Presentation of two cases of Crohn's disease seen in our Service in which the urological symptoms were of special relevance. One patient presented clinically with a picture of anaemic gross haematuria. The other one, was a patient already diagnosed with Crohn's disease who developed an enterovesical fistula in spite of receiving medical treatment. Both cases were resolved surgically. The clinical aspects, natural history and treatment of this uncommon form of urinary tract involvement are discussed.

Adult↗

[Pheochromocytoma: a review of our own cases].

Presentation of 6 cases of pheochromocytoma, diagnosed and treated in our Unit over the last 5 years. Five were adrenal pheochromocytomas and 1 an abdominal paraganglioma in a 42 year-old woman. Distribution by gender was 4 male and 2 female, and mean age at presentation was 45.2 years ranging from 35 to 55 years. Clinically, all patients were hypertensive. Two of the 5 cases with adrenal location presented with catecholaminic crisis with BP > 240/140 mmHg. The paraganglioma was diagnosed while studying a case of sustained HBP in a 42 year-old female referred from another unit. With regard to diagnosis, the sensitivity of urinary tests was 100%, and gammagraphy with meta-iodine-benzyl-guanidine (MIBG) was particularly useful in the extra-adrenal location case. In all our patients, computerized tomography (CT) was the choice procedure to locate the tumour. Treatment was surgical in all cases, access being transperitoneal in 3 cases, thoracoabdominal in 2 and classic lumbotomy in 1. All our patients received prior treatment with alpha-blocking agents, and intraoperative complications were 1 arrythmic crisis, 1 hypotensive picture and 1 hypertensive crisis, all of which resolved successfully. Currently, 5 patients remain disease free. Mild HBP controlled with low dose captopril still persists in one patient.

Adrenal Gland Neoplasms↗

[Endoscopic electrofulguration of intraurethral condylomata acuminata].

Cluster condyloma is currently one of the sexually transmitted diseases of higher incidence. The most common sites for condyloma in males are the balanopreputial sulcus, frenulum and the glans' mucosa. Associated to penis condyloma there can be urethral lesions in 5% of patients which in 80% of cases develop less than 3 cm from the meatus. This paper presents a series of 14 cases of cluster intraurethral condyloma managed by transurethral electrofulguration. The technique consists in the introduction of a coagulation probe through the urethrotome and the application of electrofulguration to the condyloma base. Results have been satisfactory although relapse has occurred in 2 cases (14%), and in one of them the procedure had to be repeated up to 3 times. There has been no complications such as stenosis in the loop resections. The authors conclude that due to the difficulties in the medical management of these lesions, the use of invasive techniques, of which transurethral electrofulguration of the condyloma base with endoscopic urethrotome is the choice because of its simplicity and effectiveness, is justified.

Condylomata Acuminata↗

[Endoscopic trigono-cervico-prostatotomy: our experience].

Presentation of our experience in treating the disease of the vesical neck through longitudinal endoscopic transurethral incisions in 24 patients following the Orandi procedure. Of the 24 patients seen in our service, 21 showed a clear clinical and urodynamic improvement. Complications were 2 cases of epididimorchitis and 1 iatrogenic stenosis of the anterior urethra. There were no major haemorrhages, urinary incontinence, or retrograde ejaculation except for an obvious decrease of ejaculate volume in 2 cases.

Adult↗

[Urothelial carcinoma after treatment with cyclophosphamide. Review of the literature and presentation of our caseload].

Cyclophosphamide has been used since 1958 in the treatment of various malignant tumours and certain systemic diseases, toxicity to the urothelium, frequently causing haemorrhagic cystitis and less often urothelial carcinomas, being one of its most notorious side effects--some 60 urothelial carcinoma cases have been published following therapy with cyclophosphamide since 1971. The present paper is a contribution of two new cases and its raises the need of paying special attention to urinary manifestations as well as narrowing the cooperation between the physicians which prescribe cyclophosphamide and the urologist, in order to make an appropriate follow-up and management of the patient.

Carcinoma, Transitional Cell↗

[Nephrogenic adenoma of the bladder].

Presentation of one case of vesical nephrogenic adenoma diagnosed as an accidental histological finding following TUR of vesical tumour. This case if considered of interest due to the rarity of the lesion (some 300 cases reported) and the limited number of quotations in the Spanish literature.

Adenoma↗

[Association of giant condyloma acuminatum of the penis with intraurethral simple condylomata. Apropos of a case].

We report on an HIV-positive male patient with a giant condyloma acuminatum at the base of penis coexisting with simple intraurethral condylomas and no crown lesions. The association of both processes indicate the likelihood of a common viral etiology. The presentation of this florid picture in a terminal patient with AIDS indicates that urologists are likely to find an increased incidence of this condition in the forthcoming years.

Adult↗