Factors related to early castration resistance in metastatic prostate cancer. Results from the National Prostate Cancer Registry in Spain

Abstract Introduction The objective of the study was to determine the factors independently related with the development of castration resistance (CR) in prostate cancer (PC) in the medium term. Material and methods 155 patients diagnosed with metastatic PC with a follow-up of up to 39 months. Data taken from the National PC Registry. The evaluated variables were age, PSA, nadir PSA, Gleason, perineural invasion, TNM stages, and ADT type (intermittent / continuous). Results Mean follow-up 26,2 ± 13,4 months. 47.1% developed early CR, with mean time until onset of 12,2 ± 8,7 months. Univariate analysis: the mean PSA was correlated with CR (290 ± 905,1 ng/mL in non CR, 519,1 ± 1437,2 ng/mL in…

The influence of comorbidities on the aging males' symptoms scale in patients with erectile dysfunction.

To investigate if certain common age-related comorbidities are related with a positive aging males' symptoms (AMS) test outcome.This was a multicentric, transversal, observational study carried out in a male population with erectile dysfunction. Comorbidities and testosterone levels were registered. The relationship between comorbidities, testosterone levels, and the AMS test outcomes was studied using the global score and the sub-scale score components.The study included 1112 patients. In the multivariate analysis the global score strongly correlated with TT  12 nmol/L (odds ratio [OR] = 3.17; p  0.05), psychiatric disorders (OR = 2.73), dyslipidemia (OR = 2.07) and diabetes mellitus (OR =…

Holmium Laser Endoureterotomy With the Lovaco Technique for the Treatment of Ureterointestinal Stenosis: Step by step.

Abstract Objective To describe holmium laser endoureterotomy with the Lovaco technique for the treatment of ureterointestinal stenosis. This common problem after cystectomy represents a surgical challenge, with endourological techniques being useful in this context. We present a technique that has been described before, but which we consider useful and decisive. The key points and difficult aspects of the technique are shown, along with our experience with it. Methods We collected data on cases of ureterointestinal stenosis treated using holmium laser endoureterotomy with the Lovaco technique, in a prospective manner, between January 2017 and January 2018. Intraoperative data, postoperative…

Satisfacción y adherencia al tratamiento en disfunción eréctil a medio y largo plazo

Resumen Introduccion El objetivo ha sido mostrar la satisfaccion y adherencia al tratamiento en disfuncion erectil (DE) a medio y largo plazo. Material y metodos Estudio descriptivo y comparativo llevado a cabo en 2 centros mediante entrevistas telefonicas a pacientes que realizaron una primera visita entre 2012 y 2014 por DE. Se realizo una anamnesis completa sobre el uso y abandono del tratamiento. En caso de uso actual se cumplimentaron los cuestionarios EDITS y GAQ, y en caso de uso pasado solo el GAQ. Para el analisis estadistico se utilizaron el test exacto de Fisher para las comparaciones de porcentajes y el test de Kruskal-Wallis para comparar medias. Resultados Doscientos cincuenta…

Retrograde endoureterotomy as a treatment option for impacted calculus in the ureterointestinal junction

Introduction: In patients with a history of radical cystectomy and with intestinal diversion, urolithiasis in the upper urinary tract is a frequent event. Material and methods: We describe for the first time a case of retrograde endoureterotomy used to treat a calculus proximal to the ureterointestinal junction. Results: This technique is of interest when antegrade access is not possible. In our example, after passing the guidewire percutaneously, and externalize it through the stoma, the left meatus was reached with a resectoscope inserted through the ileal duct. After the use of a balloon to prevent migration of the calculus, a retrograde endoureterotomy was performed with a Collins knife…

Is there a relationship between varicocele and testosterone levels?

The goal of this work was to study the relationship between presence of varicocele and testosterone serum levels in adulthood.A comparative, cross-sectional study of 387 men who consulted for erectile dysfunction. Age, body mass index (BMI), diabetes (DM), and presence of varicocele were related to testosterone levels through uni- and multi-variate analysis.A total of 248 cases (70.8%) had no varicocele, 46 (13.1%) had grade I varicocele, 36 (10.3%) grade II, and 20 (5.7%) grade III. The mean total testosterone levels were 4.77 ng/mL in the non-varicocele group and 4.34 ng/mL in the varicocele group (We were not able to establish a relationship between the presence of varicocele and decreas…

Factores relacionados con la resistencia a la castración precoz en el cáncer de próstata metastásico. Resultados del Registro nacional de cáncer de próstata en España

Resumen Introduccion El objetivo del estudio fue establecer los factores que se relacionan de forma independiente con el desarrollo de resistencia a la castracion (RC) a medio plazo en el cancer de prostata (CP). Material y metodos Ciento cincuenta y cinco pacientes con CP metastasicos al diagnostico del registro nacional de CP con un seguimiento de hasta 39 meses. Las variables estudiadas fueron: edad, PSA, nadir de PSA, Gleason, invasion perineural, estadios T, N y M y tipo de bloqueo (intermitente/continuo). Resultados Media de seguimiento 26,2 ± 13,4 meses. El 47,1% desarrollo RC precoz, con una media hasta el desarrollo de RC 12,2 ± 8,7 meses. Analisis univariante: se relacionaron con …

hTERT mRNA expression in urine as a useful diagnostic tool in bladder cancer. Comparison with cytology and NMP22 BladderCheck Test®

Abstract Introduction To study the relationship between quantitative mRNA determination (hTERT) in patients with bladder tumor, history of bladder tumor, and in subjects without a history of this neoplasia. Material and methods A prospective randomized controlled study with 91 subjects included. The value of mRNA-hTERTN was determined in 63 patients with a history or suspicion of bladder tumor and in 28 controls. Urine samples were sent for evaluation of the mRNA level (hTERT), the cytological study and the NMP22 result. Results Differences were observed in mean hTERTN levels in each of the groups: tumor presence 21.33 ± 40.66, tumor history 2.16 ± 2.67, controls 0.9 ± 1.75 (p  Conclusions …

Endoscopic treatment of intraluminal ureteral suture with holmium laser

Although reconstructive surgery is the most accepted treatment for ureteral injury, there are reports of cases where endourologic treatment led to correct resolution of the problem. We present the case of a female patient aged 72-year-old who was previously underwent sacralcolpopexy because of anterior vaginal compartment prolapse. The patient underwent surgery to remove the mesh, due to the pain she had had since it was placed. A mid-line laparotomy was performed removing completely the mesh. At 48 hours after intervention, the patient started feeling an intense pain in the left renal fossa that was not relieved with anti-inflammatories and morphic drugs. In the diagnostic ureteroscopy, it…

Expresión de ARNm de hTERT en orina como herramienta diagnóstica útil en cáncer de vejiga. Comparación con citología y NMP22 BladderCheck Test®

Resumen Introduccion El objetivo fue estudiar la relacion entre la determinacion cuantitativa de ARNm (hTERT) en pacientes con tumor vesical, antecedentes de tumor vesical y en sujetos sin antecedentes de esta neoplasia. Material y metodos Se trata de un estudio prospectivo, aleatorizado y controlado con 91 sujetos incluidos. El valor de ARNm-hTERTN se determino en 63 pacientes con antecedentes o sospecha de tumor vesical y en 28 controles. Se enviaron muestras de orina para evaluar el nivel de ARNm (hTERT), el estudio citologico y el resultado de NMP22. Resultados Se observaron diferencias en los niveles medios de hTERTN en cada uno de los grupos: presencia de tumor 21,33 + /- 40,66, antec…

Renal papillary necrosis, an endoscopic vision.

Renal papillary necrosis is described as an ischemic or chemical lesion at the end of the Malpighi pyramid, which causes the necrosis, with detachment and expulsion of the papilla in the urine. It ...

Disfunción eréctil: prevalencia y su relación con los síntomas del tracto urinario inferior

Resumen Antecedentes y objetivo El objetivo fue determinar la prevalencia de disfuncion erectil en los varones mayores de 40 anos, y su relacion con enfermedades frecuentes en atencion primaria. Pacientes y metodos Se incluyeron 302 varones (40-79 anos). Se determinaron antecedentes medicos, habitos y parametros antropometricos. Se les administro el cuestionario internacional de sintomatologia prostatica (IPSS), el cuestionario de salud sexual del varon (SHIM) y el test de Goldberg para ansiedad y depresion. Se determino la prevalencia de disfuncion erectil y se estudio la relacion de las diferentes variables obtenidas mediante analisis univariante y multivariante. Resultados La prevalencia…

Endoscopic Treatment of Complete Ureterointestinal Stenosis Without Antegrade Ureteroscopy

Background: Ureterointestinal stenosis is a frequent complication after radical cystectomy, occurring in up to 10%–12% of cases. Endoscopic treatment of complete stenosis has been described through double access, with antegrade flexible ureteroscopy and simultaneous retrograde endoscopy through the intestinal diversion. We present a case of endoscopic treatment without use of antegrade ureteroscopy. Case Presentation: A 52-year-old man underwent surgery for peritoneal carcinomatosis secondary to mucinous adenocarcinoma. Ileocecal resection, omentectomy, sigmoidectomy, rectal resection, cystoprostatectomy, and ileal duct were performed. He had a complicated postoperative period because of en…

Endoureterotomy with the Lovaco technique for treatment of ureterointestinal strictures: outcomes in an experienced center and factors associated with procedural success or failure.

INTRODUCTION The study aimed to present the outcomes of an endoureterotomy series using the Lovaco technique for the treatment of ureterointestinal strictures. Factors influencing the success or failure of this technique were also determined. MATERIALS AND METHODS Data were collected from all endoureterotomies for ureterointestinal strictures performed in a single-center between 2017 and 2020. Clinical variables and characteristics of the stricture were recorded in each case, and success was defined as the complete resolution of ureterohydronephrosis. Univariate analysis was used to correlate the variables recorded with procedural success or failure. RESULTS A total of 25 patients were recr…

Dislodgement in Long-Term Patients with Nephrostomy Tube: Risk Factors and Comparative Analysis Between Two Catheter Designs

Objective: To determine possible risk factors for accidental nephrostomy tube dislodgement and compare two different tube types in this context in patients with chronic catheters. Materials and Met...

Double Hydrodistention Implantation Technique (HIT) in the endoscopic treatment of vesicoureteral reflux

Comparison of three different antibiotic protocols in transurethral resection of bladder tumour and the possible infectious risk factors: A non-randomized, prospective study

Introduction: We sought to investigate three different antibiotic protocols in transurethral resection of a bladder tumour (TURBT), and the possible infectious risk factors of this surgery.Methods: We conducted a non-randomized, prospective study, gathering cases of patients in whom TURBT had been performed. The sample was divided into three groups based on those who received antibiotics as: a single preoperative dose (Group A); a preoperative dose, plus a long protocol during the hospitalization (Group B); a preoperative dose, plus a long protocol during the hospitalization, plus five days at home (Group C). Intra- and postoperative data that could be relevant to infections was gathered.Re…

Erectile dysfunction: Prevalence and its relationship with lower urinary tract symptoms

Abstract Background and objective The objective was to determine the prevalence of erectile dysfunction in men over 40 years of age and their relationship with frequent pathologies in Primary Care. Patients and methods Three hundred two men (40–79 years) were included. Anthropometric medical history, habits and parameters were determined. They were given the international prostate symptomatology questionnaire (IPSS), the male sexual health questionnaire (SHIM) and the Goldberg test for anxiety and depression. The prevalence of erectile dysfunction was determined and the relationship of the different variables obtained by univariate and multivariate analysis was studied. Results The prevalen…

Response to "Evaluation of transverse dorsal lumbotomy in management of PUJ obstruction in patients younger than 6 months".

Ureteral realignment with combined access as a treatment of complete ureteral transection.

Ureteral realignment using a ureteral stent can be an alternative treatment in cases of complete ureteral transection and may avoid the need for reconstructive surgery. The combined access can help the passage of the guidewire through the injured area and the threading of the urinary system of the patient. We present a case of a 38-year-old man with multiples abdominal surgeries, who underwent a complete ureteral section treated with ureteral realignment with combined access. The subsequent evolution was favourable, with resolution of the ureteral injury at the acute time, and without the presence of long-term obstruction. Although we must accept that the standard treatment of the complete …