[Severe condylomatosis treated with CO2 laser].
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
A Escudero Barrilero
Publications and source records attributed to A Escudero Barrilero.
[Treatment of female stress urinary incontinence with TVT system (tension-free vaginal tape): complications in our first 100 cases].
INTRODUCTION: The TVT system is the most common surgical technique of female stress urinary incontinence, because of the simplicity. good clinical results and rare complications. MATERIAL AND METHODS: From april, 1999 to march. 2004, it has been done in our department 100 TVT systems with the revision of the result over the six following months. The average follow-up rate was 10.36 months (R: 1-54 months) and looses mean the 11% of the cases. All the patients presented stress incontinence and their average age was 56.6 years old (30-80). The 12% of the cases have been previously operated of urinary incontinence. 21 patients presented previous surgery of pelvic floor. In the 17% of the cases, TVT systems was associated to another surgical technique: 15% of them was operated of cystocele, 1% of them had surgical correction of rectocele, 1% of them had a strong surgery of pelvic floor, that included TVT system, correction of pelvic floor and hysterectomy. RESULTS: We obtained 65% of successful cases, defined as objective confirmation of absence of looses from the observer and the subjective reference of the patient: 17% of clear improvement (clear decrease of looses from the patient and subjective improvement) and 7% of failure of the technique. The total percentage of appearance of novo post-surgery urgency is 9%. There were complications in the 12% of the cases: there were three cases of bladder perforation, two of them intra-operative and one of them deferred and associated to an infection of surgical wound; another three cases of residue in the immediate post-operative that were resolved with bladder catheterization: one case of acute urinary retention that was treated with bladder catheterization with suprapubic cistostomy: one case of chemical peritonitis corrected with a conservative treatment; two cases of vaginal extrusion of sling, which were resolved with the section of the outer sling; one patient presented a hipogastric hematoma resolved with conservative measures: and one patient presented pelvic discomfort with spontaneous resolution. CONCLUSIONS: We consider the TVT system as an effective surgical technique in the treatment of the female stress urinary incontinence. It is a simple technique with a short stay in the hospital and rare complications.
Adult↗
[Urachal cyst presenting as acute urinary retention].
About 2% of adults have an urachal cyst. The diagnosis is usually made due to its clinical complications. We report an inusual case of acute urinary retention due to an urachal cyst, with hipogastric pain and anuria as initial syntoms.
Acute Disease↗
[Primary testicular lymphoma. Report of a new case and review of the literature].
Primary testicular lymphoma is an uncommon testicular tumour that accounts for no more than 9% of all testicular tumours in those series with higher incidence; testicular lymphoma as haematopoietic tumours are also rare accounting for just 1% of all lymphomas; but due to their highly malignant histopathology they may become highly aggressive tumours. Patient age at presentation is over 60 years old which makes it the most frequent tumour for this age group. There is no standard protocol to treat this malignancy due to lack of extensive series. We contribute one case and make a literature review discussing the current therapeutic trends for this disease.
Humans↗
[Metastasis in renal graft of primary renal adenocarcinoma].
Acquired cystic renal disease (A.C.R.D.) is a risk factor for the development of renal carcinoma in the patient's own kidney after renal transplant (R.T.), development of a primitive tumor in the renal graft is infrequent, but the presence of metastasis of an epithelial tumor is very rare. This is the second case reported in the literature of metastasis of an epithelial tumor in the renal graft and the first case described of renal cell carcinoma metastasis (R.C.C.) in the renal graft. This paper describes the case of a patient with a normally functioning renal transplant and A.C.R.D. who develops RCC in his own kidney, with metastasis in the renal graft.
Adenocarcinoma↗
[Surgical management and complications of urinary stress incontinence: our experience in 385 patients operated on during the last 25 years].
We present the results and complications found and compared in 2 large series of patients who underwent a surgical procedure to avoid Urinary Stress Incontinence in our hospital. From january of 1994 to december of 2001 we collected 195 patients with an average age of 57.9 y we compared them with a prior series of 189 patients collected between january of 1976 and december of 1993, with an average age of 53.6. The continence rate was similar in both series (70.8% pre-94 and 74.5% post 94), slight incontinence 22.7% pre-94 and 19.2% post-94 and for complete incontinence 6.3% pre-94 and 6.2% post-94. The Burch procedure was the most common and also shows the greatest effectiveness in our trial involving 113 cases and a continence rate of 74.3% in the first series and 144 cases and 77% respectively in the second series. The most common complications were very similar in both groups: tract urinary infection (5.2% and 9% first and second group), surgical wound infection (4.2% and 2.2% respectively). We conclude that in spite of the introduction of new and useful surgical procedure (TVT, periurethal substances injection...) the greatest long term success rate still corresponds to the Burch colposuspension.
Adolescent↗
[Renal metastasis of hepatocellular carcinoma].
OBJECTIVE: To report the case of a solitary renal metastasis secondary to hepatocellular carcinoma. METHODS: We report the case of a 51 year old patient who on abdominal ultrasonography was revealed a left renal tumour and a hepatic mass incidentally. A TAC showed the left renal tumor measuring 17 cm in size, possible involvement of left renal vein and a tumour mass in the right lobe of the liver. A TAC guided fine needle punction aspiration biopsy demonstrated a malignant hepatic lesion compatible with hepatocarcinoma, and malignant renal cells compatible with renal or adrenal carcinoma. Left radical nephrectomy and right hepatectomy was performed. RESULTS: Histopathologic study confirmed the diagnosis of moderately differentiated trabecular hepatocarcinoma with lymph node and left renal metastasis.
Carcinoma, Hepatocellular↗
[Testicular torsion in the geriatric patient. Review of the literature apropos of a case].
Testicular torsion in adult, is an uncommonly etiology, but we should make differencial diagnosis in every person over thirty years old, with acute scrotum. The wrong diagnosis raises the incidence orchiectomy in adults for vascular etiology. We report a male of 74 years old with acute scrotum and review of the literature.
Aged↗
[Sarcomatoid carcinoma of the kidney. Report of a new case and review of the bibliography].
We report a new case of sarcomatoid renal cell carcinoma, in a male of 67 years old, with locoregional recidive four months after first surgery, with two episodes of retroperitoneal hemorrhage after second surgery. The objective of this work is to contribute a new case and of doing one revision.
Aged↗
[Benign retroperitoneal schwannoma in patient with antecedents of Willm's tumor in the infancy].
We report a case of benign retroperitoneal schwannoma diagnosed casual in a 23 years old woman treated of a Wilm's tumour twenty years ago. A review of the on this unusual tumour is included.
Adult↗
[Posterior sacral root neuromodulation in the treatment of chronic urinary dysfunction].
OBJECTIVES: To describe the effectiveness of sacral root neuromodulation in ameliorating symptoms of refractory voiding disfunction in our center. MATERIAL AND METHODS: During the period from december 1998 throught december 2001, 31 Percutaneous Nerve Evaluation (PNE) was performed to 20 patients with refractory voiding dysfunction; a sacral nerve stimulation device was implanted in 10 patients (8 female, 2 male). The median age was 49 years. Refractory voiding dysfunction included: mixed disorders (30%), idiopathic nonobstructive chronic urinary retention (20%), urgency/frequency (20%), faecal and urinary incontinence with absence of sphincter defect (20%) and frequency (10%). RESULTS: The 2 patients with frequency/urgency decreased their symptoms more than 50%, bladders were emptied without post-void residual urine in 2 patients with urinary retention, faecal and urinary incontinence in 2 patients and mixed disorders in other 3, reduced their symptoms more than 90% without residual urine. The frequency improved more than 50% in 1 patient. CONCLUSIONS: Sacral Root Neuromodulation is a successful treatment in some cases of idiopathic chronic micturition dysfunction which don't respond to pharmacotheraphy or bladder retraining. The effects of neuromodulation are long-lasting and associated morbidity is low.
Adolescent↗
[Treatment of female stress urinary incontinence with the TVT (tension-free vaginal tape) system: our experience].
INTRODUCTION: The TVT system is a new surgical procedure for female stress urinary incontinence. The object of this study is to report our initial experience with this technique. We report our results and complications too. MATERIAL AND METHODS: From April 1999 to July 2000, 23 systems TVT was implanted in our hospital. The patients were followed for a 6 to 21 month period. All the patients had stress incontinence. The mean age was 59 years. Gynaecological surgery was associated in 4 patients. One of them was excluded because a diagnosis mistake. TVT implies the implantation of a prolene tape around mid-urethra via a minimal vaginal incision. RESULTS: 17 patients (77.27%) had a significantly improved in the post-operative evaluation. The mean post-surgical stay in the hospital was 1.7 days. A bladder base was damaged during the surgery. No urinary retention, erosion or urethral lesion were found. CONCLUSIONS: We consider the TVT operation to be a safe and effective surgical procedure for the treatment of female urinary stress incontinence. This surgery is easy to lean, fast, cheap and with a low rate of complications.
Adult↗
[Silica urolithiasis: report of a new case].
We report a new case of silica urolithiasis in a 71-year-old patient with background of medicament ingesta (antacid) which could justify the formation of these calculi with so uncommon composition. Medicament calculi amounts about 1% from total urinary calculi. Among them, silica ones (silicon dioxide or Si O2) have been relate din their etiology to chronical ingest of antacid drugs, specially those with magnesium trisilicate. Silica formation in urine is facilitated and conditioned by an acid pH of it. Diagnosis and therapeutical approach does not change in relation to other lithiasis with similar dimension or location. After its composition report, and ruling out the possibility for patient's malingering, urine alkalinization was applied, with an excellent follow-up afterwards. The antacid was substituted by other drug. We analyze the most important aspects about this case. We also make reference to the main related bibliography.
Aged↗
[Diffuse bladder hemangioma].
Contribution of a case report of diffuse bladder haemangioma developed since childhood, focusing on the diagnosis and management of these tumours and on the pathoanatomical analysis of the lesion. Literature review.
Adult↗
[Testicular embryonal carcinoma with contralateral synchronous intratubular germ cell neoplasia: analysis of a case].
We report the case of a 20-year old male with a right testicular tumor. Bilateral orchidectomy was practised considering the synchronous clinical, ultrasonographical and histological (intraoperative biopsy) findings of the left testis. The definitive pathological report showed a right embryonal carcinoma with wide intratubular germ cell neoplasia (IGCN) of the contralateral testis. IGCN (formerly carcinoma in situ) is present in about 5% of cases in the contralateral gonad of those patients with a testicular neoplasm. More than 50% will develop cancer in that testis. Clinical and physical examination findings are usually unspecific. The diagnosis of IGCN is based on biopsy, although ultrasonography could give some data too, as some authors report. We analyze the therapy options for IGCN: (orchidectomy, chemotherapy, radiotherapy, or "wait and see"). In our case, the first one was made. Chemotherapy was used due to existence of retroperitoneal lymph node metastases, with an excellent follow-up afterwards.
Carcinoma, Embryonal↗
[Solitary renal metastasis of primary esophageal cancer].
We present an unusual case of single kidney metastasis from an primary esophageal neoplasm. Its main clinical and diagnostic topics are described. They made us consider him as a good candidate for surgery. The pathological study of the nephrectomy specimen was surprising. The postoperative period was unfortunate, however.
Aged↗
[Lymphadenectomy in squamous carcinoma of the penis: review of our series].
OBJECTIVE: To analyze the series of patients who underwent inguinal lymphadenectomy in our Center due to squamous penile carcinoma, between years 1984 to 1999. MATERIAL AND METHODS: Lymphadenectomy was carried out in 19 patients, with a mean age of 61 years. Bilateral ilioinguinal (42.1%) was the most frequent type of intervention. Only four patients underwent penectomy and lymphadenectomy simultaneously. We present the clinical and pathological results, according to the 1997 TNM classification. RESULTS: Palpable inguinal nodes after antibiotherapy remained in seven out of 12 patients. The overall correlation between N and pN stages in our series was 68.42%. Pathological results according to pT and pN stages are also presented. Postoperative complications were present in 13 cases (68.42%), (lymphedema being the most frequent one). In those patients with two or less pN(+) nodes, an overall one-year and five-year survival of 90 and 80% were obtained; compared to 11.11 and 0% when there were more than two. CONCLUSIONS: The importance about control of metastatic lymph nodes in squamous carcinoma of the penis, places inguinal lymphadenectomy as an essential tool, in those suitable cases. However, its incidence of complications makes a progressive agreement about its indications be necessary.
Adult↗
[Replacement of prosthesis of the penis].
OBJECTIVE: To analyze the series of patients who underwent replacement of their penile prosthesis between years 1990 to 1999, due to any kind of complication. MATERIAL AND METHODS: 85 patients underwent implantation, 13 different prosthesis models being utilized. It was replaced (once or more) in 15 of these patients (17.64%). The mean age at the moment of the replacement was 51.5 years. The most frequent surgical approach was the infrapubic one. RESULTS: A total of 32 prosthesis-replacement interventions were carried out. The main causes were: mechanical failure (13 cases, 40.62%); infection (10 cases, 31.25%); and corpus cavernosum perforation (five cases, 15.62%). Progressive increase of complications incidence with regard to the ordinal number of the implanted prosthesis was not observed. Best overall results: Mentor Mark II and AMS 700 Ultrex Plus. At present day, only eight (53.33%) out of 15 reimplanted patients use their prosthesis with normality. CONCLUSIONS: Those patients who undergo replacement of their penile prosthesis are potential sources for later complications. Their knowledge and proper handling is important in order to a progressive improvement of the final results, (above all if--such as our case--these ones are not suitable for conformity).
Adult↗