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J Salvador Bayarri

Publications and source records attributed to J Salvador Bayarri.

16 recordsLinked to original sources
PubMed2006

[Transperitoneal laparoscopic partial nephrectomy in the renal tumor treatment].

Laparoscopic surgery is a surgical technique the urologist should add to his surgical armamentarium. Its performance tries to mimic the surgical phases of open surgery, and also its indications. Laparoscopic partial nephrectomy is a sophisticated technique that requires wide experience in the performance of endoscopic strategies. We are submitting our experience with 35 laparoscopic partial transperitoneal nephrectomies with a mean follow-up of 25 months. The mean surgical time was 200 minutes, the mean bleeding 190 cc, and the mean hospitalisation five days. Two postoperative bleedings were identified, there were no conversions, and positive margins were notified in two cases, where upon a conservative attitude was adopted.

Adult↗
PubMed2001

[Prostatic cysts of the midline: management and follow-up].

OBJECTIVE: To analyze the presenting features, diagnosis and management of uncommon cystic lesions located at the midline of the prostate. METHODS: From 1990 to 1999, 8 patients with medial prostatic cyst were treated in our hospital. Vesicorenal ultrasound evaluation was the first procedure that was performed and was diagnostic in most of the cases. Only those patients that underwent surgery required admission to hospital. RESULTS: The most common presenting features were irritative and obstructive voiding syndromes. Treatment achieved cure or clinical improvement. CONCLUSIONS: Vesicorenal ultrasound assessment is the first procedure that should be considered in the diagnosis of this disease. Before ascribing the symptoms to a prostate cyst, other urological conditions with more prognostic relevance should be excluded. Treatment should be instituted only in the symptomatic patients and should be individualized according to the characteristics of each case.

Adult↗
PubMed2001

[Cytoscopic follow-up of initial G3T1 bladder tumors treated with BCG].

OBJECTIVE: To evaluate the cystoscopic findings during initial follow-up, the anatomopathological correlation of tumor endoscopic features and the results of standard control multiple biopsy performed 6 months after TUR in patients with G3T1 transitional carcinoma treated with BCG. METHODS: 114 patients with G3T1 bladder tumor (52% associated with Cis) were treated with 81 mg Connaught BCG intravesical instillations weekly for 6 consecutive weeks. Follow-up was performed with cystoscopy and cytology at 3 months, and cystoscopy and standard multiple biopsy at 6 months. The endoscopic findings were described as normal bladder, macroscopically tumorous lesion or erythematous lesion. RESULTS: During the first 6 months of follow-up superficial recurrence was found in 16% and 5% showed progression to muscle invasion. Tumor recurrence or progression was found in 61% and 39% at 3 and 6 months, respectively. Most of the macroscopically tumorous lesions resulted in a tumor at 3 and 6 months in 56% and 64%, respectively, and the remaining lesions were mainly inflammatory granulomas produced by BCG therapy. Twenty biopsies of erythematous areas detected only one case of Cis (5%) and 98 standard multiple biopsies of endoscopically normal mucosa detected 10 cases of Cis (overall, 3 at 3 months and 7 at 6 months); all cases were preceded by initial Cis except in one case. CONCLUSIONS: Cystoscopy performed at 3 months is very useful since it detected 61% of the superficial recurrences and 66% of the cases with progression to muscle invasion during the first 6 months. Routine biopsy of erythematous areas detected during cystoscopy is of little value since a large number of these biopsies are unnecessary in view of its diagnostic yield (5%). Since 90% of the Cis detected during the first 6 months of follow-up were patients with Cis in the initial tumor, it would be appropriate to perform standard multiple biopsy for control only in this subgroup of patients if the sensitivity of cytology is low in high grade tumors or Cis.

Adjuvants, Immunologic↗
PubMed1999

[Encrusted cystitis. Is it always alkaline?].

OBJECTIVE: To report on our series of encrusted cystopathy. METHODS: The clinical records of 37 patients (25 males, 67%; 12 females, 33%) with a histological diagnosis of encrusted cystopathy were reviewed. RESULTS: Only 11 patients (29.7%) met the classical criteria for alkaline encrusted cystitis. They had an initial or predisposing bladder lesion, irritative symptoms, passed calcareous material, a demonstrated or suspected urinary infection from ureolytic pathogens and alkaline urine. The remaining 26 patients (70.2%) with histologically demonstrated encrustations on the bladder wall did not meet the foregoing criteria. Fifty-seven percent of the patients had a previous history of bladder tumor resection and treatment with intravesical instillations. CONCLUSIONS: Alkaline encrusted cystopathy is an uncommon condition. Encrusting cystopathy can develop in the absence of ureolytic pathogens or alkaline urine. The bladder lesion on which the encrusting cystopathy is established, is determinant in the subsequent evolution.

Acid-Base Imbalance↗
PubMed1999

[Clinical trial of the effect of urethral catheter on the etiology of urethral stenosis following transurethral resection of the prostate].

OBJECTIVE: To analyze the effect of the urethral catheter and urethral secretions in the development of urethral stricture post-transurethral resection of the prostate (TURP). METHODS: A clinical study was conduced on 109 patients treated by TURP. The patients were randomly assigned to one of the following groups: A (suprapubic catheter), B (urethral catheter), C (urethral cleansing). The incidence of urethral stricture in the different groups was compared using the chi-square test and survival was analyzed by the Kaplan Meier method. RESULTS: 5 patients were lost to follow-up (4.5%). The median number of days the catheter was indwelling was one day for group A, and 4 days for groups B and C. The overall incidence of urethral stricture was 4.3%; by groups the incidence was 3.8% for group A, 3% for B and 5.9% for group C. The differences were not statistically significant. CONCLUSION: The study showed no statistically significant differences in the incidence of post-TURP urethral stenosis in patients with a suprapubic or urethral catheter. Furthermore, urethral stenosis was not less frequent in patients in whom urethral cleansing was performed.

Aged↗
PubMed1997

[Role of percutaneous endopyelotomy in the treatment of pyeloureteral junction stenosis after failed ureteropyeloplasty].

OBJECTIVE: To determine the value of percutaneous endopyelotomy (PE) in the treatment of ureteropelvic junction (UPJ) obstruction, particularly after failed ureteropelvioplasty. METHODS: A series of 14 (PE) procedures performed at our institution were retrospectively studied. The patients were divided into two groups: group I comprised patients in whom PE was used for primary repair and group II comprised patients submitted to PE after failed ureteropelvioplasty. The patients were assessed for hydronephrosis, lithiasis, previous procedures performed, operating time, duration of hospital stay and outcome. The Fisher test and Mann-Whitney U test were used for statistical analysis. RESULTS: The success of PE did not correlate with the degree of hydronephrosis, the presence of calculus or a previous procedure. The operating times were similar for both groups and for patients with and without lithiasis. The results were better for group II than for group I (p = 0.01). CONCLUSIONS: 1. In correctly selected cases, PE appears to be a good method of treatment for recurrent UPJ obstruction after failed ureteropelvioplasty. 2. The difficulty and the operating time of PE for recurrent UPJ obstruction is not different to that of previously untreated cases. No factor was found to correlate more with the success or failure of PE.

Adult↗
PubMed1996

[Urethral condyloma in the male: experience with 48 cases].

OBJECTIVES: To review our experience in the diagnosis and treatment of urethral condylomata. METHODS: From June, 1977 to November, 1994, 64 patients with condyloma acuminatum were treated at our institution. Forty-eight cases who had received no previous treatment were analyzed. The main reason for consultation was the appearance of an exophytic lesion in the meatus. Most of the condylomata were located in the navicular fossa. Treatment was by electrocoagulation in 24 patients, photocoagulation with the Nd:YAG laser in 21 and other treatment modalities were utilized in 3 patients. To determine the incidence of recurrence and response to therapy, we analyzed the data of 34 patients with a minimum follow up of 2 months and a mean of 16 months. RESULTS: 36% had associated cutaneous condylomata. Urethroscopy detected 14.2% of the lesions that were undetectable by eversion of the meatus. Recurrence was observed in 35.2%. There were no differences for recurrence or complications between patients submitted to electrocoagulation and those who were treated by laser photocoagulation. CONCLUSIONS: Condyloma acuminatum of the urethra is uncommon. Urethroscopy is useful in making the diagnosis and for post-treatment follow up control evaluation. Electrocoagulation and Nd:YAG laser photocoagulation are useful in the treatment of this condition. Recurrence is frequently observed in patients with extensive lesions.

Adolescent↗
PubMed1996

[Endoscopic surgery of bladder diverticulum].

OBJECTIVE: To assess the endoscopic treatment of a vesical diverticulum by incision of the diverticulum opening and mucous fulguration associated to infravesical deobstructive surgery. METHOD: The procedure was performed in 30 male patients with flowmetry-documented infravesical obstruction. Results were radiologically evaluated, with patients being assigned to one of 3 groups: diverticulum disappearance; size reduction greater than 50% and persistence or size reduction lower than 50%. RESULTS: Disappearance of diverticulum was verified in 15 patients, size reduction greater than 50% in 9 patients, and persistence or size reduction lower than 50% in 6 patients. The complications rate in this series was 6.6%. CONCLUSIONS: Endoscopic treatment of a vesical diverticulum with the technique used in our series, was shown to be effective, particularly in diverticula with diameter under 50 mm, and was associated to low morbidity and short hospital stay.

Adult↗
PubMed1991

[Simplified technique of nephroureterectomy].

A simplified technique for nephroureterectomy is described. This technique consists of resection of the intramural ureter followed by lumbar nephrectomy and traction of the previously detached distal ureter. The use of this technique is advocated because it is easy to perform and radical from the oncologic viewpoint.

Humans↗
PubMedDate not supplied

[Initial superficial bladder tumors: our experience. Our criteria. Study Group of Bladder Tumors].

OBJECTIVES: Evaluation of a homogeneous series of Superficial Primary TCC of the Bladder. Utility of randomized biopsies (BMN). Study of risk factors and risk groups as a basis for determining treatment and followup patterns. MATERIALS AND METHODS: Survey of 1,529 PSBT cases that underwent TURB and BMN, with a mean followup of 4.2 years. Strict statistical treatment: multivariate analysis using Cox logistic regression according to Kaplan-Meier curves. RESULTS: Tumor features of note: single tumor (65%), smaller than 1.5 cm (45%), high grade (G3: 26%), and high stage (T1: 64%). BMN showed associated CIS in 284 cases (19%). Main risk factors for recurrence were multiplicity, size > 3 cm and association with CIS. The main risk factor for progression was grade 3 (OR 19.9). Grade 3 and association with CIS were found to increase mortality risk. On the basis of this data, we grouped tumors according to low-, middle-, and high-risk, and established our proposed treatment and followup for each group. CONCLUSIONS: This multivariate analysis of a homogeneous cohort of 1,529 primary superficial bladder tumor cases allowed vs to determine risk groups for treatment and followup.

Adolescent↗
PubMedDate not supplied

[Endoscopic lithotripsy by means of Lithoclast].

OBJECTIVES: We evaluated the efficacy of endoscopic pneumatic lithotripsy with the Lithoclast for urinary tract calculi. The use of this stone disintegration system and the possible complications are described. METHODS: We performed a retrospective analysis of the results achieved in the first 100 patients (156 stones) that had been treated with this system at different sites. The patients were evaluated radiologically early postoperatively and throughout follow up (mean 12 months). RESULTS: Stone fragmentation could not be achieved in three patients, the only failures. The early postoperative assessment showed residual stones in 13% of the patients; 5 patients spontaneously passed the stone remnants and 8% had stone remnants on radiological evaluation during follow up. The only remarkable complication was a perforated ureter which required no surgery. CONCLUSIONS: In our experience, the Lithoclast lithotripsy system is effective at any level of the urinary tract. It has a low complication rate and is simple and low-cost.

Adult↗
PubMedDate not supplied

[Endoscopic biopsy in the staging of infiltrating tumor of the bladder].

From July, 1990 to June, 1991, a prospective study was conducted on 65 patients with infiltrating bladder tumor to determine the possibility of distinguishing T2 from T3 tumors endoscopically. Sixty-six tumors were resected, including all of the bladder wall, and samples of perivesical fat were obtained from the tumor bed. The pathologist found infiltration of the bladder muscle wall in 50 cases (75.6%) and classified 12 tumors as T2 and 38 as T3. Fifty-five per cent of the T3a tumors were reclassified as T3b on the basis of the indirect signs of the pelvic scan and bimanual palpation performed under anesthesia. The clinical staging correlated with the pathological findings in 52.6% of the 19 cases of pT3b that underwent radical cystoprostatectomy; 31.7% of the pT3b tumors were clinically understaged, mainly due to prostatic infiltration. We can conclude from our findings that the differential diagnosis between pT2 and pT3 tumors is possible by endoscopic resection for most of the infiltrating bladder tumors; however, pT3a tumors cannot be distinguished from pT3b tumors with sufficient reliability.

Biopsy↗