Department of Urology. Medicine Faculty of Ahi Evran University. Kirsehir. Turkey.
Objective: We aimed to identify the changes in the application rate of two surgical techniques in distal hypospadias repair in years and compare the most popular two surgical repair techniques for distal hypospadias in terms of surgical outcomes, the factors that affect the outcomes, which were performed over a 20 year period.
Methods: In this study, the records of 492 consecutive patients that had undergone an operation for distal hypospadias in the urology clinic of Ankara between May 1990 and December 2010 using either Mathieu or TIPU surgical techniques were reviewed retrospectively. The patients who had glanular, coronal, and subcoronal meatus, were accepted as distal hypospadias cases. Read More
Objetive: Primary undifferentiated pleomorphic sarcoma (UPS) of the testicular tunics is rare, and synchronism with other malignancies of the urinary tract is uncommon, and may complicate the staging and therapeutic approach. We report the case of a patient diagnosed with primary paratesticular UPS with synchronous Renal Carcinoma.
Methods: Patient presenting with intrascrotal tumor who underwent left radical orchiectomy. Read More
Objective: The purpose of this study was to determine the prevalence of different microorganisms isolated from the urogenital tract of infertile men and assess whether there are differences in semen parameters according to the presence or absence of genital infections.
Methods: 280 semen samples from infertile men were studied retrospectively. Semen parameters were analyzed according to the World Health Organization criteria (WHO 2010). Read More
Objective: To evaluate the overall survival rate and renal function in our series after radical nephrectomy (RN) and partial nephrectomy (PN) in renal tumors in an early stage.
Methods: We retrospectively reviewed the medical records of 229 patients who underwent RN or PN for renal cancer T1-T2N0M0 in our center between 1995 and 2015. We described demographic factors, first symptom, TNM, histology, post-surgery data, recurrence rate and renal function. Read More
Objectives: Lower Urinary Tract Dysfunction (LUTD) is the most common clinical problem in pediatric urology. To our knowledge non-validated instruments properly designed to screen lower urinary tract symptoms in the pediatric population has been translated and adapted to Spanish population. Pediatric Lower Urinary Tract Symptoms Score (PLUTSS) has proven to be a valid questionnaire for screening and evaluation of the response of children with LUTD to therapy. Read More
Bladder hyperactivity is described as the presence of "voiding urgency, generally associated with increased daytime frequency and nocturia, with or without urinary incontinence, in the absence of urinary tract infection or other obvious pathology". Onabotulinum toxin A (BTA) is a recommendable therapeutic option in case of failure, contraindication or refusal of the conservative therapy or other non-pharmacological therapies. The injection of BTA in the detrusor has been performed under local, regional or general anesthesia either in the conventional or major ambulatory surgery operative room or in the cystoscopy room. Read More
Objetive: To describe the adult type granulosa cell testicular tumors (classified as sex cordstromal tumor) due to their behavior, hardly known with a small number of cases reported.
Method: We report a new case of a 59-year-old man presenting an adult type granulosa cell tumor of the testis (AGCTT), painless, with a 3.3 centimeter intratesticular heterogeneous mass on ultrasound, with solid and cystic areas. Read More
Objetive: We report a case of acquired renal cystic disease associated with renal dialysis and endstage renal disease. The patient suffered the two major complications related with acquired renal cystic disease; hemorrhage and renal carcinoma.
Methods: Our case is a patient with acquired renal cystic disease, single kidney after surgery for renal clear cell carcinoma four years earlier, who developed a Wünderlich syndrome (WS). Read More
Objectives: We performed this prospective clinical study to compare the postoperative recovery profile of our patients after transperitoneal (Group T) and retroperitoneal (Group R) laparoscopic nephrectomy approaches. Our primary hypothesis was that epidural analgesic consumption in Group R would be higher at the end of the first postoperative day.
Methods: Forty-four patients scheduled for elective transperitoneal or retroperitoneal laparoscopic nephrectomies were enrolled. Read More
Director de la Escuela Internacional de Urología Pediátrica y fetal del Colegio de Médicos de Málaga. España. Director del Master Internacional de Urología Pediátrica de la Universidad Internacional de Andalucía. Málaga.España.
Bifid Spine is a multisystem malformation incurable and transmissible with a lot of important sequelae, some of them with treatment and some other avoidable. They affect and limit not only health but social-work life too. The main objective must be prevention. Read More
Departamento de Urología. Hospital Universitario Nuestra Señora de la Candelaria. Tenerife. España. Departamento de Urología. Hospital Clínico Universitario de Valladolid. España. Departamento de Cirugía Vascular. Hospital Clínico Universitario de Valladolid. España. Departamento de Anestesia. Hospital Clínico Universitario de Valladolid. España.
Objectives: To analyze surgery for renal cancer with venous thrombus at different levels, perioperative complications and prognostic factors associated to overall, cancer-specific and disease-free survival.
Material And Methods: Retrospective analysis of 42 cases of renal cancer with venous thrombus performed between 2005 and 2015. The level reached by the thrombus was established according to the Mayo Clinic classification. Read More
Objectives: To determine the tolerability, persistenceand satisfaction of patients with overactive bladder syndrome (OAB) treated with transdermal oxybutynin (OXY-TDS).
Methods: Observational, retrospective, multicenter study, in patients with OAB who had started treatment with OXY-TDS at least 12 months before their inclusion. Tolerability was evaluated by number, severity criteria, resolution type of adverse reactions, and cognitive function with Mini-Mental State Examination (MMSE), at 1 year of treatment. Read More
Objectives: Mini-PCNL is a potentially less invasive technique than standard percutaneous nephrolithotomy (PCNL). We present our experience and results comparing both approaches in large burden complex renal calculi.
Methods: Prospective non randomized study comparing PCNL (24/26F nephroscope; Group A) and Mini-PCNL (15/18F; Group B) perioperative and postoperative results, in 40 (20 each group) consecutive patients between 2013 and 2014. Read More
Objectives: To analyze the predictive factors for retreatment in RIRS to achieve complete lithiasis resolution.
Methods: Retrospective comparative study analyzing 298 cases of RIRS performed in our center over a 3 year period. The cohort was divided in two groups: Resolution in one operation or more than one, evaluating homogeneicity for age and gender. Read More
Objective: Testicular cancer (TC) is the most common cancer in men between 15 and 44 years. It has been reported that the incidence of TC is rising. The aim of this article is to determine the epidemiology of TC in Colombia. Read More
Objective: To analyze retrospectively the safety and effectiveness of percutaneous microwave ablation of solid renal tumors, and also review different approach techniques.
Methods: It is a retrospective study approved by the ethics committee of both hospitals. 14 tumors with a mean size of 37 mm (12-50 mm) were treated in a single session, under general anesthesia and with CT guidance, in 14 patients (9 men) with a mean age of 66 years, using the ablation system AMICA by different approaches (trans pulmonary, trans peritoneal and retroperitoneal). Read More
Objective: The limitations of total serum PSA values remains problematic; nomograms may improve the prediction of a positive prostate biopsy (PB). We compare in a prospective study of Chilean men with suspicion of prostate cancer due to an elevated total serum PSA and/or abnormal digital rectal examination, the use of two on-line nomograms with the detection of primary malignant circulating prostate cells (CPCs) to predict a positive PB for high risk prostate cancer.
Methods: Consecutive men with suspicion of prostate cancer underwent 12 core TRUS prostate biopsy. Read More
Objectives: To analyze the indication criteria used for conducting seminal vesicles biopsies as well as the diagnostic capacity of other variables involved.
Methods: We present the results of an observational and retrospective study (May 2006 - December 2012) using a sample of 140 patients to whom seminal vesicles biopsies was performed in a first set of prostate biopsy. They were patients eligible for curative treatment and presented any of the following criteria: PSA ≥15 ng/ml, suspicion of neoplastic seminal vesicle invasion on transrectal US, and/or suspicious node in the prostate base on DRE or transrectal US. Read More
Objective: To describe the laparoscopic approach for uretero-ileal anastomosis strictures and to analyse our long term series.
Methods: A retrospective review was performed evaluating our series of patients with benign ureteroileal anastomosis strictures treated laparoscopically from 2011 to 2017. Demographics and perioperative data were obtained and analyzed. Read More
Objective: To present in detail our surgical technique and to show our initial experience with ureteral reimplantation using the transumbilical LESS approach to treat patients with ureteral stenosis secondary to various diseases and surgical complications.
Methods: We performed 7 ureteral reimplantations from February 2012, using the multichannel Richard- Wolf (KeyPort) platform placed transumbilical by a small 2-2,5 cm transversal incision. We always use a 3. Read More
Continued progresses in the field of laparoscopy have been introduced in urological surgery. With the development of smaller instrumental minilaparoscopy was born seeking to reduce abdominal trauma and improve cosmetic scars, obtaining similar or better results than conventional laparoscopy.
Objective: The objective of this paper is to evaluate the results and reproducibility of mini-laparoscopic pyeloplasty. Read More
Objectives: Retroperitoneal fibrosis is a disease that may condition a severe involvement of various organs, mainly upper urinary tract, even causing renal insufficiency. It was first described by Albarran in 1905 and it is also known as Ormonds disease. The correct diagnosis includes, in many cases, the performance of one or more tests: CT scan, MRI, renal scan, etc. Read More
Objective: Renal transplant surgery has not undergone any major changes until a few years ago, probably due to the technical difficulty involved in performing a laparoscopic transplant. With the introduction of robotic technology, the difficulties derived from laparoscopic surgery in certain procedures have been reduced, so we can now offer a minimally invasive approach to kidney recipients.
Methods: Review of published literature on robotic kidney transplantation. Read More
Objectives: Uretero-pelvic junction (UPJ) obstruction has been classically treated by open dismembered pyeloplasty. Recently, laparoscopic (LP) and robotic pyeloplasty (RP) have become the techniques of choice for the treatment of UPJ stenosis in adult and pediatric population. Our objective in this paper is to review the results of minimally invasive surgery as the treatment of UPJ obstruction, the trend to use these approaches and the current limits of LP and RP. Read More
Objective: To perform a literature review on the use of buccal mucosa graft (BMG) in the treatment of extensive ureteral stenosis, according to the criteria of Evidence Based Medicine.
Methods: Pubmed search of published studies with the following keywords: "ureteral stricture treatment", "buccal mucosa graft ureteral treatment" and "buccal mucosa graft ureteroplasty", without time limits, in English and Spanish; 12 articles were identified with a total of 48 cases (46 patients) of BMG use in ureteral repair.
Results: The main etiologies of ureteral stenosis, where BMG has been applied, have been iatrogenic and inflammatory strictures. Read More
Objectives: The most frequent ureteral lesions are iatrogenic, mainly due to gynecologic and urologic procedures. The resolution and repair of these lesions, when they require surgery, is often the performance of ureteroneocystostomy. We describe the technique for the repair of distal ureter lesions that preserves both anatomy and function of the urinary tract (1). Read More
Objectives: Laparoscopic ureteral reconstructive surgery is routinely performed , because it demonstrated efficacy and safety profiles similar to open surgery in expert hands. The most frequent surgical complications after transplant are urological, appearing in up to 12,5% of the cases; they can compromise graft function and mortality. The most frequent ones include ureterovesical anastomosis stenosis (2,5-7,5%) and vesicoureteral reflux (0,4-2,2), which present in up to 80% of the cases. Read More
Although the laparoscopic ureteral reimplantation (LUR) has a history of over 20 years, its presence in the literature is relatively sparse, almost always in the form of small case series with low statistical power, which has prevented consistent results. It has proven to be a safe and effective technique, improving the safety profile and perioperative complications compared to open ureteral reimplantation (OUR). The few long-term results suggest a similar success rate between the open and laparoscopic approaches. Read More
Objectives: Surgical restoration of pelvic floor anatomy in pelvic organ prolapse (POP) should avoid extensive areas that may injure healthy tissues and lead to scar fibrosis producing dysfunctional rigidity. Laparoscopic sacrocolpopexy corrects POP by lifting pelvic elements with a minimally invasive procedure.Various current strategies and approaches make it a diverse procedure. Read More
Objectives: To review the role of robot- assisted laparoscopic colposacropexy (RALCS) as a treatment for pelvic organ prolapse (POP) accordingly with the available literature and our own experience.
Methods: We have analyzed the studies with the results of robot-assisted colposacropexy (RALCS) and others in which this technique is compared with the abdominal (ACS) and/or the laparoscopic approach (LCS), including our own series. The main data collected are surgical time, blood loss, complications, clinical outcomes, quality of life and the different costs of LCS versus RALCS. Read More
Introduction: In the last 15 years, the role of laparoscopic surgery has progressively increased to include reconstructive procedures such as pyeloplasty and management of ureteral stricture, in addition to being a field in continuous development, this refers to the improvement of ergonomics, new instruments and new techniques. We present a review on basic features of laparoscopic reconstructive surgery in urology.
Acquisition Of Evidence: For this review, an exhaustive literature search was performed in PUBMED, MEDILNE, BioMed central and others, with the keywords: reconstructive surgery, urology, laparoscopy. Read More
Objectives: To evaluate the results of synchronous dual implantation of penile (PP) and artificial urinary sphincter prosthesis (AUSP) in patients with severe erectile dysfunction (ED) and urinary incontinence (UI) after radical prostatectomy (RP).
Methods: Between January 2006 and March 2015, patients who underwent synchronous dual implantation of PP for severe post-RP ED and AUSP for moderate to severe post-RP UI in our clinic were screened retrospectively. The erectile function and the continence status were evaluated by the questionnaires of IIEF-5 and ICIQ-SF. Read More
Objective: We report two cases of patients diagnosed with lymphoepithelioma-like carcinomas of the urinary tract. We review the literature of this rare entity. The objective is to clarify the clinical and therapeutic characteristics. Read More
Introduction: The present study analyzes cases of urachal abnormalities treated with laparoscopic approach in our hospital.
Case Description: A retrospective descriptive study of urachal disorders with laparoscopic surgery approach performed at our hospital in the period 1999-2015. Patients' clinical data are presented (radiological findings, surgical data, pathology findings, complications and a follow-up of each patient). Read More
Differentiating between the cases of megaureter that require surgery and the ones in whom treatment can be delayed is challenging. A large number of surgical techniques for the treatment of POM been proposed aiming mainly to reduce renal damage by relieving the affected ureter. Resection of the affected ureteral segment followed by vesicoureteral reimplantation either with or without reduction ureteroplasty is the classic treatment, however posing a high rate of complications when performed in patients aged less than one year. Read More
Objective: Hypercalciuria is a common lithogenic risk factor. The aim of this study was, first, to study the characteristics of urine biochemical factors of children with hypercalciuria (HC) and compare them with those of children without hypercalciuria. Second, to analyze the differences between children with HC and lithiasis (HCL) and children with HC and no lithiasis (HCNL). Read More
Introduction: In 2006, sunitinib approval by the FDA was a real revolution for the treatment of metastatic renal cell carcinoma (mRCC). However, considerable rates of dose reductions and therapeutic suppressions with the standard regimen (4:2) have forced the search for new schedule proposals in order to optimize the balance between side effects and oncologic efficacy. Among these new proposals, the 2:1 scheme is the one that has generated more expectations. Read More
Objectives: Although prostate cancer is probably the most frequent cancer in men, little is known about its etiology. Clear evidence exists about variations in the incidence of prostate cancer between populations living in different countries. These variations could be explained by differences in lifestyle and a possible association with a set of substances that are able to intervene in the origin of the disease. Read More