Bilateral obstructive uropathy secondary to giant periureteral diverticulum.

Bladder diverticula are herniations of the mucosa through the fibers of the bladder muscle connected by necks of variable amplitude. They are often asymptomatic, although they may lead to complications that require a surgical therapeutic approach. We report the case of a patient with bilateral obstructive uropathy secondary to a giant periureteral diverticulum that was treated by diverticulectomy and reimplantation of the left ureter in the bladder.

Surgical treatment of corpora cavernosa fracture with complete urethral rupture.

Objective: To analyze in a short and concise way the diagnosis and treatment of traumatic fracture of both corpora cavernosa and urethra.

Methods: We present our experience with a rare case of traumatic fracture of both corpora cavernosa associated to complete urethral rupture.

Results/conclusions: The diagnosis of penile fractures can be done with the clinical history and physical examination only.

Key areas in the learning curve for robotic urological surgery: a Spanish multicentre survey.

Background: The number of robotic-assisted procedures offered in Spain is rapidly increasing despite a lack of consensus criteria for training and credentialling.

Objective: This national multicentre study was designed to analyze the different areas of the robotic urological surgery learning curve.

Material And Methods: A questionnaire was sent to all 13 urology units in Spain with an active robotics programme requesting information on training and problems encountered.

Surgical repair and analysis of penile fracture complications.

Background: The objective of this study is to describe and analyze the experience over a period of 10 years at our center through a retrospective study of a series of diagnosed and treated cases of penile fracture.

Material And Methods: From 2005 to 2009 the Urology Department of the Hospital Clínico San Carlos of Madrid carried out a retrospective case study of a total of 15 cases of penile fracture. The diagnosis was reached through physical exploration of the patient aided by a penile ultrasound; the immediate treatment performed on the patients was emergency surgical repair.

Long-term outcomes after robotic sacrocolpopexy in pelvic organ prolapse: prospective analysis.

Objective: To evaluate the feasibility and long-term outcomes of our initial series of robot-assisted laparoscopic sacrocolpopexy.

Methods: We conducted a prospective analysis of our series of robotic sacrocolpopexy.

Inclusion Criteria: patients with grades III and IV cystocele and or other symptomatic pelvic organ prolapse.

Progression of null or mild lower urinary tract symptoms indicative of benign prostatic hyperplasia after 2 years of follow-up in non-treated men aged 40 years or older.

Objectives: After screening men aged 40 years or older for lower urinary tract symptoms (LUTS) indicative of benign prostatic hyperplasia over the years 1999 to 2000, non-treated men with an initial International Prostate Symptoms Score (I-PSS) equal to or lower than 2 were assessed 2 years later for symptom progression.

Methods: A cross-sectional study was conducted in 1999 on 1804 men aged 40 years or older who were living in Madrid. In a telephone interview sociodemographic information was requested and LUTS assessed using the I-PSS.

[Correlation of bladder thickness on ultrasound with clinical and urodynamic data in symptomatic benign prostatic hyperplasia].

Objectives: Our objective is to verify the diagnostic usefulness of ultrasound measurement of the thickness of the bladder wall, and the correlation with clinical/ urodynamic findings in patients with symptomatic BPH.

Methods: We performed a prospective cross-sectional study (cross-sectional study '') in a series of 74 males (age chi= 72.4 S = 7.

Bladder diverticulum robotic surgery: systematic review of case reports.

Introduction: We report one case of robot-assisted transperitoneal bladder diverticulectomy and perform a systematic review of published experience.

Patient And Methods: Our patient was a 64-year-old male with a history of lower urinary tract symptoms secondary to benign prostatic enlargement for 6 years with recurrent urinary tract infection. Ultrasound and voiding cystourethrogram showed a 7-cm diverticulum in the posterior bladder wall.

[High dynamic risk cystoceles].

Objectives: To assess the bladder compliance in a series of cystoceles referred for urodynamic study.

Methods: Retrospective study of a series of patients with cystocele undergoing medical history, videurodynamic study, pelvic MRI and lower urinary tract, urological ultrasound and cystoscopy. We Excluded cases with neurogenic dysfunction and urinary infection.

[Urodynamic evaluation in prostate cancer patients with urinary incontinence].

Objectives: Update on the urodynamic evaluation in patients with prostate cancer who have incontinence.

Methods: To review the urodynamic studies in prostate cancer patients who suffer from incontinence, irrespective of the treatment carried out.

Results: The largest amount of information on urodynamic studies in patients with prostate cancer and incontinence was found in those with post-prostatectomy incontinence.

[Multidisciplinary development of robotic surgery in a University Tertiary Hospital: Organization and outcomes].

Background: Da Vinci system (Intuitive Surgical) is a surgical telemanipulator providing many technical advantages over conventional laparoscopic approach (3-D vision, ergonomics, highly precise movements, endowrist instrumentation...

[Development and validation of the first Spanish questionnaire of quality of life in patients with prostate cancer, based on the patient's perception].

Background: To ensure health related quality of life (HRQOL) during the survival of patients with prostate cancer (PCa) is a priority. The development of specific HRQOL questionnaires aids to assess the disease impact, its treatment and the patient's perception (concerns, expectations and interests) that might go unnoticed.

Objectives: To develop and validate the first Spanish HRQL questionnaire specific for patients with PCa.

[Prognostic factors for survival in patients with transitional bladder cancer treated with radical cystectomy].

Purpose: To recognize clinical and pathological variables that influence in bladder cancer specific mortality in patients with transitional bladder cancer treated with radical cystectomy.

Material And Method: Retrospective analysis of 333 patients with transitional bladder cancer treated with radical cystectomy. Variables included during pre-cystectomy, peri-cystectomy and post-cystectomy period were analyzed.

[Prevalence of lower urinary tract symptoms related with benign prostatic hyperplasia. Study of 1804 men aged 40 or older in Madrid].

Introduction: Lower urinary tract symptoms (LUTS) related with benign prostatic hyperplasia (BPH) are present nowadays in approximately 20 to 30% of the Spanish male population from the age of 50 onwards. The purpose of this study was to assess clinical and epidemiological characteristics of patients with LUTS.

Methods: A cross-sectional study was performed, between 1999 and 2000, among 1,804 men aged 40 or older who were living in Madrid.

[The usefulness of laser in the treatment of urethral stenosis].

Introduction: Optical urethrotomy was introduced by Sachse in 1973 and it has a registered long-term recurrence rate of 75-80%. This stimulated the search for new therapies with less recurrences. Several types of laser were tried: Nd:YAG, KTP, Argon, Ho:YAG, diode,.

[Da Vinci robot assisted radical prostatectomy: one year experience at the Hospital Clínico San Carlos].

Objectives: Hospital Clínico San Carlos in Madrid is the first Spanish public centre using the latest surgical technology: the Da Vinci robot. First operation was carried out in our department in October 9th 2006. Since then, numerous changes have happened which enabled us to overcome difficulties, to complete the learning curve.

[Video urodynamic update of the vesicoureteral reflux classification in children].

Objectives: To update the classification of vesicoureteral reflux in children.

Methods: Videourodynamics.

Results: We categorize the different types of vesicoureteral reflux in children.

[Prevalence of urodynamic anomalies in women with recurrent urinary tract infection].

Objectives: To check the urodynamic data in patients with recurrent urinary tract infection in order to demonstrate a cause justifying them.

Methods: We performed a transverse comparative study in a series of 114 women, with a mean age of 51.9 yr.

[Urodynamic test with self reduction of the cystocele in the diagnosis of lower urinary tract obstruction].

Objectives: The association of cystocele and urodynamic lower urinary tract obstruction is frequent, occasionally not being possible to rule out intrinsic obstruction of bladder neck and urethra. With the aim to confirm the obstructive character of the cystocele we performed at test consisting in manual reduction of the cystocele by the patient herself, to check if by this simple manoeuvre the urodynamic parameters of obstruction disappear or diminish.

Methods: 24 patients consulting for sensation of vaginal bulge, with a mean age of 66 years, participated in the study.

[Robotic assisted laparoscopic colposacropexy in the treatment of pelvic organ prolapse].

Laparoscopic colposacropexy has become a substitute for open surgery in the treatment of pelvic organ prolapse. In the same way, robotic assisted surgery is a new step in the evolution of the procedure. In this paper we intend to show our surgical technique and preliminary results.

[Nephron sparing surgery for the treatment of renal carcinoma in a functioning graft: case report].

Objective: We present nephron sparing renal surgery as a therapeutic option for the conservative treatment of renal cancer by reporting one case of de novo renal cell carcinoma (RCC) presenting in a functioning renal graft.

Methods/results: We describe one case of de novo RCC presenting in a functioning renal graft 51 months after transplantation. Tumorectomy was carried out with a margin of normal parenchyma and the base was free of tumor.

[En bloc transplantation of pediatric donor kidneys to adult receptors].

Objectives: Analysis of all pediatric donor en bloc transplants to adult receptors performed in our department.

Methods: Retrospective analysis of 73 en bloc kidney transplants and 497 adult transplants performed in our centre from 1990 to 2004. Mean follow-up was 50.

[New technique for the repair of anterior pelvic floor compartment defects using a synthetic implant with biological coverage: approach, fixation and transobturator anchoring].

Unlabelled: Transobturator systems for anterior vaginal wall prolapse repair exemplify the current trend in pelvic floor surgery. They may be considered an approach and also a mesh fixation system, in opposition to free mesh cystocele repair where they work by the creation of fibrotic tissue after mesh implant (biological or synthetic).

Objectives: To describe the elements of the Avaulta anterior system, its indications and the surgical technique to implant it and adequately adjust it.

[Suburethral readjustable sling (Remeex) for the treatment of female urinary incontinence: personal surgical technique].

Objectives: Currently there is not agreement about the adequate tension for each patient with female stress urinary incontinence treated with urethral slings. The adjustable tension sling Remeex (external mechanic regulation) allows adjustment to ideal tension trying to avoid or minimize possible reoperations. The objective of these paper is to describe the components of the Remeex system, its indications, and the surgical technique to implant and adjust it.