Treatment for rectourethral fistulas after radical prostatectomy with biological material interposition through a perineal access.

Introduction: Rectal injury is a rare complication after extraperitoneal laparoscopic radical prostatectomy. The development of rectourethral fistulas (URF) from rectal injuries is one of the most feared and of more complex resolution in urology.

Material And Methods: Between 2013 and 2020 we have operated on a total of 5 patients with URF after extraperitoneal endoscopic radical prostatectomy through a perineal access using the interposition of biological material.

Magnetic double-J stent: Evaluation of tolerance and impact on quality of life compared to traditional double-J stent.

Introduction: The placement of a ureteral stent is one of the most widely performed procedures in urology. It can have a negative impact on the patients' quality of life, requiring a cystoscopy for its removal. The objective of this study is to evaluate the symptoms and impact on quality of life derived from the use of a magnetic double-J stent (Black Star®) and compare them to those presented in patients with a traditional double-J stent (OptiMed®).

[New recommendations for prostate cancer screening with PSA].

Prostate cancer is the most frequently diagnosed cancer in men and the second cause of death in those worldwide. The fact that is a tumor with a long latency period has led to a confusion in the convenience of its diagnosis and treatment in patients at an early stage. Classically, European and American societies have not recommended prostate cancer screening with PSA, allowing physicians take this decision.

Minimally invasive treatment for lower urinary tract symptoms due to benign prostatic hyperplasia. Our initial experience with Urolift® under local anaesthesia and sedation.

Introduction: The treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia with the Urolift® system has been carried out since 2005 with good results in the medium term. In this work, we present our experience performing this technique under local anaesthesia and sedation in 2 Spanish centres.

Material And Methods: A prospective study was conducted with 20 patients treated with Urolift® under local anaesthesia and sedation between April 2017 and April 2018.

High-intensity focused ultrasound therapy for the treatment of prostate cancer: Medium-term experience.

Introduction: The treatment of localised prostate cancer seeks to minimise the impact on sexual function and urinary continence. In this respect, therapy with high-intensity focused ultrasound offers important results. We present our experience with this technique in 2 Spanish centres.

Long-term follow-up for the treatment of male urinary incontinence with the Remeex system.

Objectives: To relate our experience in treating postprostatectomy stress urinary incontinence (SUI) with the male Remeex system (MRS). We also list the elements that comprise this system, the implantation technique and its proper adjustment. Similarly, we attempt to determine whether the latest changes made to this device, which constitute the MRS-II, have resulted in fewer mesh readjustments.

[Influence of learning curve in the diagnosis of prostate cancer by ultrasound guided biopsy].

Objective: To analyze if there is a learning curve to get to perform high quality ultrasound guided prostate biopsies that enable to effectively perform the diagnosis of prostate cancer, taking the pathological result of the samples into consideration.

Methods: We retrospectively reviewed data from 790 ultrasound-guided biopsies performed consecutively in our center between May 2009 and December 2012 by four surgeons. We reviewed the following data: Surgeon, date of intervention, patient age, PSA, rectal digital examination (DRE), ultrasound, prostate volume, number of cores obtained, pathology result of the biopsy.

Use of a barbed suture for the urethro-vesical anastomosis during the learning curve of the endoscopic extraperitoneal radical prostatectomy.

Objectives: The performance of the urethrovesical anastomosis is one of the most difficult steps in urologic laparoscopy. Many different techniques have been developed to improve this step and, recently, new sutures such as the V-loc (R) barbed system have been created. In the present study we analyze the usefulness of this suture for diminishing the time employed for the anastomosis suture during the learning curve of laparoscopic radical prostatectomy.

Importance of previous transurethral resection of the prostate before eerpe.short-term functional outcomes in a single surgeon series.

Objectives: Laparoscopic Radical Prostatectomy (LRP) is technically a very demanding procedure and potentially even more challenging in patients with previous transurethral resection (TURP). This study evaluates the impact of previous TURP on the short-term functional outcome of patients undergoing extraperitoneal LRP.

Methods: Retrospective analysis of a prospectively collected database, comprising a single-surgeon cohort of 155 consecutive LRP cases, 19 of which had previous history of TURP.

Our experience in the treatment of male stress urinary incontinence with the male Remeex system.

Objectives: We show our experience in the treatment of post-prostatectomy stress urinary incontinence with the male Remeex system (MRS). We also describe the elements of the system, its therapeutic indications, technical implantation and appropriate adjustment.

Methods: From March 2007 to January 2009 five male patients aged 57 to 71 years (mean age 66 years) with postprostatectomy stress urinary incontinence were operated on to insert a suburethral readjustable sling (Remeex).

[Green light laser efficacy in patients with prostatic hyperplasia treatment with 5-alpha reductase inhibitors].

Introduction: High prevalence of BPH and gradual ageing of the population, combined with the existence of effective medical treatments for this condition, has led to an increasing use of surgery in patients on long-term treatment with 5-alpha reductase inhibitors (5-ARIs). Initially, patients treated with 5-ARIs were not considered good candidates for photoselective vaporization of the prostate with green laser.

Objective: To assess, using a retrospective study based on our experience, wheter long-term treatment (longer than 6 months) with 5-alpha reductase inhibitors decreases effectiveness of photoselective vaporization of the prostate with green light laser in BPH.

[Prospective randomized study on the use of lidocaine local anesthesia in prostate biopsy].

Objectives: Transrectal ultrasonography-guided prostate biopsy is still the main technique in prostate cancer diagnosis. In spite of being a relatively well-tolerated exploration, often results in an awkward and painful procedure, especially in those cases in which the number of samples increase. We designed a prospective randomized study that compares biopsies tolerance with the use of intravenous analgesia and intrarectal gel with or without intracapsular prostatic anesthesia.

[Surgical treatment of renal tumours with venous extension].

Objectives: Renal carcinoma accounts for 3% of malignant urological tumors. The existence of tumor thrombus in the venous system is more infrequent, and, despite it was believed until recently its presence worsened the diagnosis of the disease, currently it is accepted that in the absence of metastatic or lymph node disease, surgery is the treatment of choice and potentially curative for these tumors.

Methods: Between June 2003 and November 2007 eight patients with renal disease and venous thrombus underwent surgery; two of them wereT3c and six T3b; in five of them surgery was carried out in association with the heart surgery team in our centre.

[Greenlight Laser Photoselective vaporization of the prostate (PVP). Surgical advantages in risk patients].

It is more and more common to have patients in our clinics with the diagnosis of BPH and indication for surgery who present limitations due to their medications, age, associated morbidity or psychosocial conditions. Transurethral resection of the prostate, though it is the surgical standard of reference, is not free from complications such as reabsorption syndrome, bleeding, or even blood transfusion in a percentage of cases. Laser PVP may be a valid alternative in this subgroup of patients.

[Penile cellulitis after oral sex].

Objective: Nowadays, there is the high prevalence of sexual intercourse including oral sex, which implies some peculiarities in the infections, balanitis and ceIlulitis they may produce.

Methods: We report two new cases of penile cellulitis treated in the urology department in our hospital.

Discussion: We review the indications of prophylaxis, and the medical and surgical treatment both referred in the literature and carried out in our patients.

[Rhabdomyolysis after laparoscopic nephrectomy: case report].

Objective: To show the clinical management of rhabdomyolysis secondary to laparoscopic surgery and how clinical treatment may be enough for adequate resolution.

Methods: Laparoscopic nephrectomy is a routine technique, which may have associated morbidity. We present one case of rhabdomyolysis which presented as gluteal pain and functional impotency, together with skin lesions, acute renal failure and elevated muscle enzymes.

[Urinary lithiasis secondary to medication in HIV+ patients receiving Indinavir].

Objectives: Therapy with protease inhibitors is commonly used in patients infected by human inmunodeficency virus (HIV). 20% of the administered dose is excreted by the kidney, and when alkaline urine is present, indinavir may crystallize forming stones and patients may experience renal colic due to this fact.

Methods: Between January 1998 and June 2005, 26 patients receiving antiretroviral treatment with protease inhibitors received care at our hospital because of renal colic or flank pain.

[Dorsal meatoplasty for the treatment of meatal stenosis in patients with balanitis xerotica obliterans].

Objectives: To present our experience in the treatment of meatal stenosis secondary to balanitis xerotica obliterans with the dorsal meatoplasty technique.

Methods: We have performed dorsal meatoplasty in 15 patients suffering stenosis of the penile meatus secondary to balanitis xerotica obliterans. All cases were performed under local anesthesia, using an inverted V incision plasty following the original of technique from Malone.

[Greenlight KTP-laser photovaporization. Initial experience in a public hospital].

Objectives: Despite the fact that transurethral resection of the prostate (TURP) continues being the gold standard for the surgical treatment of benign prostatic hyperplasia (BPH), the good results obtained with the use of new energy sources have led to their use in daily practice.

Methods: Between September 2005 and January 2007, we have treated 63 patients with KTP laser photoselective vaporization of the prostate (PVP) in our service. Preoperatively we asked for IPSS, performed physical exam, digital rectal exam, abdominal , renal, bladder and prostatic ultrasound measuring postvoid residual volume, as well as flowmetry and PSA determination.

[The use of renal ultrasound for adult acute pyelonephritis].

Objectives: To evaluate the need to perform renal ultrasound (US) in adult patients with acute pyelonephritis (APN).

Methods: A Review of the bibliography in the data bases PubMed and Cochrane Collaboration about the use of the ultrasonography in the evaluation and diagnosis of APN.

Results: Thirty-seven papers were found, but only 5 fulfilled the requirements for analysis.

[Use of urography by magnetic resonance for the study of the urinary apparatus versus conventional urography].

Unlabelled: Conventional urography (IVU) is an essential examination for the assessment of urinary tract but it is not free of complications, such as adverse reactions to contrast agents used (vasovagal and anaphylactic reactions), neurotoxicity, nephrotoxicity, as well as the damage due to the ionizing irradiation applied to the patient. For this reason, alternative imaging techniques such as magnetic resonance (MR) urography or uro-resonance have been developed.

Objective: We present a case study assessing the diagnostic accuracy, specificity and sensitivity of uro-resonance and IVU as a morphological and functional examination of the urinary tract: and a quality study of the urographic images obtained with MR versus IVU.