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Biomedical subjects

R Burgos Rodríguez

Publications and source records attributed to R Burgos Rodríguez.

At least 19 recordsLinked to original sources
PubMed2002

[Clinical and urologic management].

The concept of clinical management try to incorporate to the physicians the importance of their decessions regarding the dinamical and complex process of efficiency and health expenses. In this article the authors carry out a reflexive analysis of the reliable repercussion of this process into the healthy people, governmental authorities and assistencial setting of patients. It establish the involvement of the doctor in management, clinical management and it concludes the regulatory function to achieve the true clinical efficiency which harmonizes the relationship between the assistencial process and the corresponding resources consumption.

Disease Management↗
PubMed1998

[Analysis of the clinical decision in the initial management of BPH].

RATIONALE: Diagnostic management of prostate benign hyperplasia remains a controversial issue subject to variations as made evident in surveys conducted in our country showing that 47.9% urologists regularly perform intravenous urography. The aim of this paper was to determine the preferred strategy from the standpoint of a more accurate diagnosis for evaluation of patients with prostate benign hyperplasia and no absolute indication for surgery. MATERIAL AND METHODS: The methodology used was an analysis of the decision taken by elucidation of the problem using a decision tree with three major choices: (a) to perform IPSS, flowmetry and ultrasound: (b) to perform IPSS and flowmetry, or (c) to perform IPSS alone. Basic analysis by estimation of the expected value and three sensitivity analysis, one-tailed and two-tailed, were used to see whether the dominant choice changed. RESULTS: The choice of performing IPSS alone, resulted in accurate diagnosis adjustment in 80.5% cases. When flowmetry was added from the beginning, this percentage declined to 66.2%; if ultrasound was also done, the decline reached down to 11.2%. The Odds Ratio (OR) for diagnosis imbalance was 15.52 and 33, in choice (a) versus choices (b) and (c), respectively. The OR for the IPSS and flowmetry choice to cause imbalance versus IPSS alone was 2, 12. Also, the choice with greater expected value was IPSS, and this result did not change with the sensitivity analysis. CONCLUSIONS: The choice that considers the possibility of symptom quantification in the IPSS scale and, based on the results, continuation of the diagnostic sequence is the one that should be followed, since it provides higher effectiveness from the standpoint of diagnosis adjustment.

Decision Trees↗
PubMed1996

[Partial transplantectomy combined with substitution of the urinary tract, in the treatment of segmental renal infarction after transplantation].

OBJECTIVES: To present our experience with post-transplantation necrotic infarction involving large areas of the renal parenchyma, causing caliceal fistula, and the therapeutic possibilities aimed at achieving graft survival. METHODS: 690 kidney transplants were reviewed: of these 6 had post-transplantation segmental renal infarction with subsequent parenchymal necrosis involving 25 to 40% of the organ and associated with urinary tract necrosis in two cases. The patients were treated conservatively by partial graft resection, the calyces were closed separately and the lining repaired with vascularized parietal peritoneal flaps or lyophilized patches of human dura mater sealed with fibrin glue and substitution of the necrotic urinary tract in two cases. RESULTS: One patient died a few minutes after the operation from cardiorespiratory causes. In the remaining 5 patients, the fistula was resolved definitively. Five years postoperatively, the salvaged parenchyma is functioning well and dialysis has not been required. CONCLUSIONS: Partial graft resection, followed by separate closure of the calyces, lining repair with parietal peritoneum or lyophilized human dura and fibrin glue and substitution of the urinary tract, if compromised by necrosis can salvage renal grafts with wide areas of necrosis.

Graft Survival↗
PubMed1994

[Penile prosthesis. Implantation under local anesthesia].

UNLABELLED: We report our motivation, technique, results and the current status of penile prosthesis implantation under local anesthesia at our institution. The lack of anesthetists to cope with the surgical demands and the conflicting views on the priority assigned to the different pathologies prompted us to seek an alternative approach. TECHNIQUE: Anesthetic blockade with mepivacaine (2%) for the pudendal nerve branches (dorsal and perineal, in some cases; cavernous, in the first one) responsible for penile innervation, and anesthetic blockade of the genitofemoral and ilioinguinal nerves that innervate the scrotum and its contents. Of the five patients, 80% had excellent and 20% had good tolerance of the procedure. The definition of the foregoing categories are discussed herein. Currently, we have no waiting list or conflicts relative to treatment priorities. We reserve the technique for patients with anesthetic contraindications, as case number five.

Adult↗
PubMed1994

[Acute focal bacterial nephritis. Pathology mimicking renal masses].

Focal acute bacterial nephritis is an uncommon form of renal acute infection with a clinical presentation that, although similar to other acute infections of the renal parenchyma, must be taken into account in order to reach a correct differential diagnosis with other processes which have very similar radiological images but highly different management approaches, such as the renal carcinoma. This paper present one case in which the sings and symptoms were crucial to establish the diagnosis.

Acute Disease↗
PubMed1994

[Unilateral ureteral hernia. Report of a case].

Hernia of the ureter is an uncommon condition and may classified into two types in relation to the peritoneum: extraperitoneal (without hernial sac) and paraperitoneal (with permeable peritoneum and redundant sac). This condition is generally asymptomatic and may be detected incidentally during urography or herniorrhaphy. We report on a case that had been detected during radiologic control evaluation of a left percutaneous nephrostomy prior to treatment with ESWL of a calculus in the ipsilateral lumbar ureter.

Aged↗
PubMed1993

[An arteriovenous fistula as a complication of percutaneous nephrostomy].

Percutaneous nephrostomy has emerged as a substitute for surgical nephrostomy. The complication rate is low, hematuria being one of the most common. Treatment should be conservative while possible since the clot plays an important role in the tamponade of hemorrhage. Arteriovenous fistulas following percutaneous nephrostomy are rare. Diagnosis is by arteriography and treatment is by selective embolization.

Arteriovenous Fistula↗
PubMed1993

[Lymphatic staging by laparoscopic surgery].

Lymphadenectomy is mandatory in vesical and prostatic tumours for a precise staging of candidates to radical surgery. Presentation of our series of 18 ilioobturative lymphadenectomies between May 1992 and February 1993, performed in 14 prostate carcinoma and 4 vesical tumours. As most interesting results, the average number of nodes removed, which was 8, and the discovery of nodular affectation in 5 cases, understaged by the non-invasive procedures, are highlighted; likewise, the reduction in surgery duration up to the current frame of 80 to 120 minutes must be emphasized. Mortality due to the procedure was null. We believe that laparoscopic lymphadenectomy should be the choice technique in the staging of tumoral dissemination in the ilioobturative domain.

Humans↗
PubMed1993

[Laparoscopic exeresis of a completely duplicated kidney].

During the '80s, laparoscopy in general has undergone an enormous boom as representative of minimally invasive surgery, urology standing out in that progression as the specialty leading the endoscopic approach both for the tradition and profusion of techniques developed. In Spain, major scope laparoscopic surgery started with lymphadenectomy in which we are the second Spanish and first Andalusian group to perform it. The experience accumulated by our group has allowed us to perform and present one case of laparoscopic nephrectomy, this being the first time in Andalusia and second in Spain that an Urology Unit develops this technique, the distinct feature being the presence of complete duplicity of the kidney. The procedure had no peri or post-operative complications and the patient was discharged four days later. We conclude that although presently the indications of renal exeresis for this procedure are limited, these will soon be expanded thanks to the urologists' concern, the accumulation of experience and the improvement of the instrumentarium.

Adult↗
PubMed1993

[Metastatic disease of the penis. Report of 3 cases].

Metastatic lesions of the penis are uncommon, only some 200 cases having been reported in the literature. Priapism is the most frequent symptom, although increased penis size, ulceration and nodes formation have also been described; metastasis happens simultaneously in 20% cases while in 50% of cases they appear 2 years after initial diagnosis. Survival of untreated patients has not exceed 24 weeks, whereas treated patients have survived 47 weeks.

Aged↗
PubMed1993

[Local anesthesia in the surgical management of hydrocele and cysts of the spermatic cord].

Traditional management of vaginal fluid collections has always been surgery. The benignancy of this disease does not correspond with the morbidity caused by the anaesthetic techniques used. Over the last few years, sclerotherapy has become increasingly attractive as an alternative to hydrocelectomy. Indications are, nonetheless, restricted, presenting a relapse rate which varies according to the substance used and the operating team. The study proposes the use of local anaesthetics for the surgery of vaginal fluid collections so as to minimize the immediate postoperative period and thus the hospital stay. Between May and October 1991, 55 patients, 49 with hydrocele (4 bilateral) and 6 with sperm cord cyst, were treated in our Unit. Patients were monitored in the theatre (EKG, blood pressure and oximeter) to supervise their life constants, and 2% Mepivacaine (10-20 cc) was infiltrated into the sperm cord and the area of scrotal wall to be cut. Surgical techniques range from dissection to scission of the bag until partial eversion, requiring the use of reabsorbable suture and a careful haemostasis to avoid drainage. Anaesthetics tolerance has been highly satisfactory in 52 patients (94%), good in one patient (2%) and unsatisfactory in two cases (4%). Recorded complications include: severe bradycardia and hypotension in one case (2%), persistent right renoureteral pain in one case (2%), scrotal haematoma in 5 cases (9%) and suture dehiscence in another patient (2%). It is concluded that surgical management of vaginal collection with local anaesthetics is feasible, and reduces the immediate postoperative period also avoiding morbidity derived from a more aggressive anaesthetic technique.

Adolescent↗
PubMed1992

[Laparoscopic testicular autotransplantation].

The authors describe an experimental technique of endoscopic autotransplantation of the testis. Four trocars are utilized; one is placed at the level of the umbilicus, one in the right flank, another in the left flank, and one in the hypogastrium. Five or six cms of the epigastric vessels are dissected and sectioned. Then the spermatic vessels and released from the inguinal orifice up to their origin and sectioned. The testis is taken to the peritoneal cavity through the skin and the sustenaculum testis is sectioned. Both vascular pedicles are exteriorized through an incision at the level of the inguinal duct. Microvascular anastomosis is performed as in a routine procedure and the vessels are inserted into the abdomen again, the testis is taken to the scrotum and the inguinal duct is closed from inside.

Animals↗
PubMed1992

[Laparoscopic orchidopexy].

The authors have experimented in the pig the possibility of endoscopic treatment of cryptorchidism. Sixteen orchidopexy procedures were performed utilizing 12 Large White pigs weighing 10 to 15 kg. The procedure is described herin, including some details of anesthetic induction. The animal is placed in the Trendelenburg position and three trocars are inserted, in a position which corresponds to that of the umbilicus in humans (through which a laparoscope is passed), in the hypogastrium and in the hypochondrium of the corresponding side. The spermatic vessels are dissected all the way up to their origin and the vas deferens up to a short distance from the bladder. Then an incision is made in the inguinal canal, from the epigastric vessels up to the conjoined tendon. Pressure is applied outside until the testis is introduced into the peritoneal cavity where it is released by sectioning the sustenaculum testis. The cord is then pulled and passed in front of the epigastric vessels and taken out through the deep orifice of the inguinal canal. Once it is free in the peritoneum and after the vessels and the vas have been dissected, it is brought to the bottom of the scrotum with the grasping forceps and the aid of the hand outside. Then it is fixed with a suture through the skin. Finally, the incision in the inguinal canal is sutured with atraumatic nylon 0 suture as in the McVay technique for inguinal hernia repair. The procedure has started to be employed in the clinical setting.

Animals↗
PubMed1992

[Dermatomyositis as paraneoplastic syndrome of bladder tumor].

The dermatomyositis is a connective tissue disease characterized by changes affecting both the skin and the muscle, appearing most frequently around the fifth and sixth decades and which association to a vesical tumour is very rare. This paper contributes one case of paraneoplastic dermatomyositis associated to infiltrant vesical tumour, presenting erythematous damage in face, nape of the neck and upper thorax, as well as periorbital heliotrope erythema and fingernails base and sides telangiectasia, all of which are typical signs of dermatomyositis.

Aged↗
PubMed1992

[Laparoscopic ileal conduit].

The authors describe an experimental model for performing the Bricker procedure endoscopically. After placing the operating table in the Trendelenburg position, the trocars are inserted through the incisions at the level of the umbilicus, the right and left flanks and the hypogastrium. Both ureters are dissected free from the inferior pole of the kidney up to a short distance from the bladder, clamped and cut. The right flank incision is extended a few cms longitudinally and the right ureter and ileal loop are brought out through the incision. Once exteriorized, a segment of the ileum is separated and intestinal continuity reestablished. The right ureter is then attached to the distal end of the ileal segment. The other end of the loop is brought to the left flank and exteriorized together with the left ureter, as described above. Once the ureter has been attached, they are passed inside. The incisions are sutured and a stoma is created in the right flank. The authors recommend the application of this simple technique in the clinical setting.

Animals↗