[Clinician and researcher at the time. Is it possible?].

Research in clinical practice arises as a constant need for improvement to provide better care to patients, train better human resources and make a daily reflection on the amount of scientific information we receive every day. We want to reflect on how the Centro de Adiestramiento en Investigación Clínica (CAIC) from our healthcare activity changed our practice.

[Lower urinary tract symptoms in medical residents as reflection of a stressful work environment.].

Objective: To determine if the presence of moderate to severe lower urinary tract symptoms in medical resident are associated with workplace bullying.

Material And Methods: Cross-sectional study conducted in medical residents. Moderate to severe lower urinary tract symptoms were defined as greater than 8 points on the International Prostate Symptom Score.

[Stone free rate assesment after percutaneous nephrolithotomy using nephrolitometric nomogram].

Background: Percutaneous nephrolithotomy remains the standard of care for kidney stones larger than 2cm. Therefore, setting a prognosis for complete stone resolution through this method is essential. The prognostic tools available have limited prediction.

[Prognostic factors of morbimortality in patients with emphysematous pyelonephritis].

Background: Emphysematous pyelonephritis (EPN) is a severe infection of the urinary tract, caused by gas accumulation within the collecting system, the renal parenchyma, and/or the perirenal tissue. The cause of this infection is not known at all; however, it has been suggested that it is produced by the glucose fermentation provoked by enterobacteriaceae or anaerobic organisms. Our objective was to evaluate the predictors of morbidity and mortality in patients diagnosed with EPN.

[Prevalence of urinary tract symptoms in women with diabetes mellitus].

Background: The objective was to evaluate the prevalence of urinary tract symptoms and the impact in the quality of life in women with diabetes, the association with DM and neuropathy evolution time and glycemic control.

Methods: A cohort of women from the DiabetIMSS program was evaluated from January 2011 to 2013. The personal history, time of DM diagnosis, neuropathy, urinary symptoms, glycemic control and quality of life impact were noted.

[The use of S.T.O.N.E. scale in patients undergoing percutaneous nephrolithotomy].

Objectives: The aim of this study was to apply the S.T.O.

[Intrarectal povidone-iodine to reduce the risk of genitourinary infections after transrectal prostate biopsy].

Background: The aim of this study is to compare two different preparations in patients undergoing transrectal prostate biopsies samples (TPBS) and assess the prevalence of genitourinary infections (GUI).

Methods: A historical cohort of patients undergoing TBPS for suspected prostate cancer. Two groups were compared: one with endorectal lubricant jelly and another with the addition of a povidone-iodine lubricating jelly.

[Evaluation of 2 inanimate models to improve percutaneous fluoroscopy-guided renal access time].

Background: Training devices for percutaneous renal access are expensive, have hazardous biological materials, or radiation. Two devices were designed that eliminate some or all of these characteristics (ManiPERC and iPERC).

Objective: To compare the improvement in access time to the posterior lower calix with 2 inanimate models in a group of Urology residents.

Prognostic factors of morbidity in patients undergoing percutaneous nephrolithotomy.

Objective: To determine the preoperative and perioperative predictive factors of morbidity/mortality in patients undergoing percutaneous nephrolithotomy (PCNL), using the Clavien's classification.

Materials And Methods: We performed a retrospective chart review of patients who underwent PCNL between January 2005 and January 2012. Preoperative and postoperative factors, such as age, obesity, surgical risk, Charlson comorbidity index, stone complexity, access calix, type of dilator used, and surgery time, were evaluated as predictors of complications.

[VVF: laparoscopic versus open surgical abdominal].

Background: Vesico vaginal fistula is the most common acquired fistula of the urinary tract that originates from an abnormal communication between the bladder and vagina, its main manifestation is transvaginal urine output and significantly affects the quality of life of women suffer.

Objective: To compare the success and complications of open abdominal versus laparoscopic surgical treatment of patients with vesicovaginal fistula (VVF).

Material And Methods: A retrospective, observational, comparative study of patients with a diagnosis of VVF.

[Clinical practice guideline. Traumatic urethral stenosis in males].

The incidence of urethral stenosis in Mexico had not been documented. At the Centro Médico Nacional La Raza, during the year 2010, 629 patients with urethral stenosis were attended as outpatient consultation: 85 % with previous urethral stenosis and 15 % with urethral treatment complication. Urethral stenosis is a chronic illness, with multiple etiological origins and the handling is controversial.

Percutaneous nephrolithotomy in crossed fused renal ectopia: superior calyceal access under fluoroscopic control.

Objective: To present a case report of crossed fused renal ectopia treated with percutaneous nephrolithotomy at our hospital and to perform a literature review.

Methods/results: We present the case of a male with renal calculi in a crossed ectopic and fused kidney, treated satisfactorily with percutaneous nephrolithotomy in a one-stage surgery through an upper pole access

Conclusions: Percutaneous nephrolithotomy is a minimally invasive procedure with good results and low morbidity in this kind of patients. It is technically demanding and requires surgeon's ability and experience.

Outcomes and complications of sphincterotomy with bladder neck incision in neurologically healthy male patients with voiding dysfunction.

Objectives: To evaluate the efficacy, complications and outcomes of sphincterotomy with bladder neck incision in patients with voiding dysfunction (VD).

Methods: We evaluated our prospectively established urologic urodynamic database and identified the records of 30 male patients with VD that underwent sphincterotomy between Octuber 1993 and December 2008. The IPSS and urodynamics were analyzed before and after surgery, we recorded the outcomes and complications.

Laparoscopic management of retrocaval ureter: case report and literature review.

Background: Retrocaval ureter is a rare congenital anomaly with an incidence of approx. 1/1000 live births. Recently, the laparoscopic approach has become the gold standard for treatment, relegating open surgery as a second option.

[Subtrigonal sling with abdominal fascia for treatment of complex stress urinary incontinence].

Background: The aim of this study was to describe the technique of subtrigonal sling with abdominal fascia and demonstrate its usefulness in resolving complex stress urinary incontinence (SUI).

Methods: We performed a cohort, longitudinal, observational study in adult females who attended the Urodynamics Department of the Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Mexico City, with recurrent SUI or with risk factors for recurrence, whether or not associated with urge urinary incontinence (UUI).

Results: Between 1995 and 2006, 40 patients were included.

[Lumboscopic adrenalectomy for pheochromocytoma in a patient with multiple endocrine neoplasia type 2B].

Multiple endocrine neoplasia type 2B (MEN 2B) is an autosomal dominant syndrome characterized by medullary thyroid carcinoma, pheochromocytoma, a marfanoid habitus and mucosal ganglioneuromatosis. We present a case of a 35-year-old male with MEN 2B with right adrenal pheochromocytoma diagnosed biochemically and radiologically and treated by laparoscopic adrenalectomy. Diagnosis of pheochromocytoma includes detection of catecholamines in urine and plasma and radiological tests such as computed axial tomography, nuclear magnetic resonance imaging and metaiodobenzylguanidine scintigraphy.

[Urachus cystopexy: new technique for bladder suspension associated to the Burch's technique in the treatment of cystocele and stress urinary incontinence. Long-term follow-up].

Objectives: To compare long term efficacy and morbidity in patients with stress urinary incontinence treated using Burch's colpopexy versus Burch's colpopexy plus urachus-cystopexy.

Methods: Retrospective, longitudinal comparative, observational study in 129 patients with stress urinary incontinence (SUI) or mixed urinary incontinence (MUI). Fifty four patients underwent Burch's colpopexy (group B) and 75 patients underwent Burch's colpopexy and urachus-cystopexy (group B U).

[Ejaculatory duct obstruction].

Background: Prostatic cysts are rare lesions with a reported incidence from 1 to 7.9%. They have been associated with primary infertility.

[Two methods for transrectal ultrasound-guided biopsy of the prostate: systematic vs. guided for suspect echogenic lesion].

Objective: We undertook this study to determine the efficiency of ultrasound-guided transrectal prostate biopsy applying two techniques: systematic extended vs. suspicious sonographic areas.

Methods: Medical files and histopathological reports were reviewed of patients who were treated at the Specialties Hospital of the 21st Century Medical National Center in Mexico City with suspicion of prostate cancer (T1, T2 and PSA <10 ng/ml).

[Perinephric abscess: associated factors and mortality].

Objectives: To determine predisposing factors in perinephric abscesses and to find events associated with unfavourable outcome.

Methods: We carried out a clinical, descriptive, retrospective and cross-sectional study, including 23 patients diagnosed of perinephric abscess admitted to our hospital.

Results: In patients with perinephric abscess, clinical charts included diabetes mellitus in 65.

[Fournier's gangrene. Experience of the CMN SXXI Hospital].

Objectives: To evaluate and review the Fournier's gangrene clinical presentation, initial APACHE II score and integral treatment of patients affected in HECMNSXXI.

Methods: Retrospective, descriptive and cross-sectional study in 40 patients with Fournier's gangrene diagnosis, accepted for treatment in HECMNSXXI who gather inclusion criteria, from February 1996 to February 2006.

Results: Patients were between 21 and 93 yr old.

[Penile necrosis: a review of 18 cases at the Hospital de Especialidades Centro Médico nacional Siglo XXI].

Objectives: To report the experience in the management of penile necrosis at our hospital.

Methods: We performed a review of the medical records with the diagnosis of penile necrosis at the Department of the Urology of the Hospital de Especialidades Centro Médico nacional Siglo XXI from January 1995 to March 2005.

Results: 18 cases of penile necrosis were found, with ages from 28 to 78 years (mean age 58.

[Use of UroLume as an alternative to the treatment of recurrent stenosis of bulbar urethra and obstructive prostatic hyperplasia in patients with high surgical risk].

This device consists of a woven in a form of a tubular mesh, made up for the use in the urethra. We report the clinical and uroflujometric results in 10 patients with urethral stricture and 4 with obstructive prostatic hyperplasia. The study includes a 7 year period since October of 1993 up until June 2000.