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INTRODUCTION AND OBJECTIVES: There are 61 (9%) female urologist enrolled at Socie-dad Colombiana de Urología. 41 (40%) of urology res-identes in Colombia are women. The aim of this study is to demonstrate the work tendencies of female urologist, female residents and patient’s preferences regarding the gender of their urologist.MATERIALS AND METHODS: Descriptive observational sectional study with anonymous surveys carried out to practicing female urologists, female residents, and pa-tients. The questions evaluated the demographic char-acteristics of the surveyed individuals; the questions for female urologists evaluated their work tendencies; for the residents we evaluated their plans as urologists; and the patients were asked about their preferences to be evaluated in medical consultation and to have a surgery performed by either a male or female urologist.RESULTS: The survey was answered by 53 female urol-ogists. The average age was 37 years, the majority (54%) worked in Bogotá. 34% have subspecialized, the majority in andrology (16%) endourology (16%) and pediatric urology (16%). Most of them (73.6%) perform surgery between 5-20 hours weekly, and the most per-formed surgery was varicocelectomy. 34% referred to have been harassed in their work environment based on their gender.Thirty-six female residents answered the survey. The average age was 28 years. The average number of academic publications was 3. 80% wish to achieve a sub-specialization, of which 24% would do it in endou-rology. 41% referred to have been harassed.188 patients answered the survey, 96 men and 87 women; 44.1% preferred to be attended in medical consultation by a female urologist, and 49.2% preferred to be operated by a male urologist. CONCLUSIONS: The number of female urologists has exponentially increased, just as the percentage of fe-male residents. Female residents wish to subspecialize in diverse areas. Patients prefer to be attended by a fe-male urologist in medical consultation but prefer to have surgery performed by a male urologist.
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BACKGROUND AND OBJECTIVE: Ade-quate empirical treatment should be established for treat-ment urinary tract infections, considering the prevalence of the most frequent microorganisms in each geographic area and their susceptibility to different antibiotics. The objective of the study is to analyze the epidemiology of UTIs in our Health Area as well as to understand the antibiotic susceptibility of the most prevalent isolated mi-croorganisms to guide empirical treatment.The objective was to establish a reasoned system for recommending ITU empirical therapy, based on the mi-croorganisms causing episodes assisted in a Regional Hospital, knowing their antibiotic susceptibility.PATIENTS AND METHODS: A descriptive-retrospective study was carried out based on the results of 12,204 urine cultures of the year 2018. The overall empirical activity of the antibiotics tested was calculated, differen-tiating between episodes of the community and of inpa-tients, adults and children.RESULTS: Escherichia coli was the most frequently isolat-ed microorganism in all studied groups. The following microorganisms in frequency, in adults, were Enterococ-cus faecalis, Klebsiella pneumoniae and yeasts (8%). In the group of children these were Enterococcus faecalis and Proteus mirabilis. There was no difference in the activity of antibiotics against Escherichia coli, in adults or in children, of the community or inpatients, with sensi-tivity to fosfomycin and nitrofurantoin greater than 96%; at imipenem and piperacillin-tazobactam greater than 94% and third generation cephalosporins greater than 90%. However, the overall empirical activity, without dis-tinction by microorganism, was for fosfomycin 77.96-80.60% in adults and 92.73-94.50% in children; to prevent 77.70-78.74% in adults and 92.36-91.28% in children; for piperacillin-tazobactam of 77.57-80.03% in adults and 89.09-94.04% in children; and for cefo-taxime of 53.28-54.76% in adults and 68.73-74.77% in children.CONCLUSIONS: Fosfomycin, piperacillin-tazobactam or imipenem were the best option for empirical treatment without covering all episodes in adults. Each Center must establish a reasoned profile of empirical treatment of the infection, which should also take into account risk factors for a microorganism and clinical severity.
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OBJECTIVE: Penile metastasis is a very rare clinical entity. The primary origin is usually genitouri-nary followed by the gastrointestinal.MATERIAL AND METHODS: Review of the available lit-erature on a case of penile metastasis of urothelial blad-der carcinoma.RESULTS: Penile metastasis is an exceptional entity de-spite the rich vascularization of this organ. Less than 500 cases have been described. Most cases manifest as exophytic or nodular lesions. Its association with dis-seminated disease conditions its palliative management in a large part of the cases, as well as an unfavorable prognosis. In selected cases, surgical treatment can be chosen.CONCLUSIONS: Since its clinical presentation is vari-able, clinical suspicion is important in the presence of a skin lesion of torpid evolution taking into account the patient’s oncological history.
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OBJECTIVE: To evaluate the efficacy of hyperbaric oxygen therapy (HBOT) in the treatment of hemorrhagic radiation cystitis (HRC). MATERIAL AND METHOD: Retrospective study of pa-tients diagnosed with hematuria secondary to HRC after pelvic radiation from January 2005 to January 2017 who were treated with HBOT. Demographic and clin-ical variables were collected. A descriptive univariate and multivariate statistical analysis using Cox regression was carried out. The treatment was considered effective when there was a total or partial remission of the hema-turia based on the Radiation Therapy Oncology Group (RTOG) scoring schema. Partial remission was defined as the presence of hematuria grade 2 or less.RESULTS: A total of 67 patients with a mean age of 68,6 years (39-87) were included. 65,7% men and 34,3% women. The RT was administered in 64,2% of the cases by urological cause, prostate cancer. The av-erage dose of RT was 75,24 Gy (45-180). The mean from the RT to the HBOT treatment was 55,97 months (4-300) and from the beginning of the hematuria until the treatment was 11,3 months (1-48). Response was observed in 51 (76,1%) patients, total in 50,7% and partial in 25,4% of cases. Patients with a degree of he-maturia less than 3, those who were administered more than 30 sessions and those who did not require transfu-sion or hospital admission, responded significantly bet-ter to treatment with HBOT (p<0.05) according to the univariate and multivariate analysis. No adverse effects related to treatment were reported, only one patient was excluded due to claustrophobia.CONCLUSIONS: Hyperbaric oxygen therapy is an ef-fective and safe treatment for the management of hema-turia due to radiological cystitis secondary to radiother-apy. A better response was observed in patients with a lower degree of hematuria and those who could be administered a greater number of sessions.
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BACKGROUND: Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are relevant health problems worldwide, especially in men 50 years of age and older. With the increase in life expectancy, their prevalence is expected to rise in the coming years. AIM: To estimate the prevalence of LUTS and ED in adults 50 years of age and older and evaluate their relation to quality of life.MATERIALS AND METHODS: An analytic cross-sectional study was conducted through a personal interview with the participants. Erectile dysfunction (IIEF-5), prostate symptom (IPSS), and quality of life (EuroQoL) questionnaires were employed. The frequency and grade of LUTS and ED were evaluated and correlated with health-related quality of life perception in 300 men above 50 years of age. Summary measures were calculated. The association of LUTS and ED with quality of life was evaluated with prevalence odds ratios (ORs) and 95% confidence intervals (CIs), calculated using unconditional logistic regression models. RESULTS: Information on 300 subjects was analyzed. The general prevalence of LUTS and ED was 88.3% and 81.7%, respectively. Quality of life was classified as very poor – regular (≤ 60 points) in 18.3% of the subjects. In the multiple analysis, the presence of moderate LUTS (OR = 5.27, 1.08 – 9.73) or severe LUTS (OR = 7.05, 1.84-10.34) was associated with an increase in the possibility of presenting with a lower quality of life. CONCLUSION: Our findings suggest that erectile dysfunction and prostate symptoms were frequent events in the population studied, as was a low perception of quality of life. The opportune and efficacious treatment of those pathologies can potentially improve the individual and social dynamics of the persons affected.
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OBJECTIVES: Recently laparoscopic radical prostatectomy (LRP) is a minimally invasive surgical option for prostate cancer (PCa) treatment in the lack of robot. To eliminate numbers of trocars and to modify surgical technique can make the LRP procedure easier. We aimed to introduce our novel approach on LRP by using just only 3 trocars and to compare conventional extraperitoneal LRP (eLRP) with 3 trocars eLRP.METHODS: Of the 223 PCa patients undergone eLRP were divided into 2 groups as Group 1 (n=69) consisted of conventional eLRP, Group 2 (n=154) consisted of consecutive 3 trocars eLRP. Demographic, operative, postoperative, and short-term follow-up data including functional results were analysed. RESULTS: Mean follow-up was 10.9±5.1 months. Preoperative and demographic parameters were comparable between the groups. Mean operative time, intraoperative used carbon dioxide (CO2) gas, and hospital stay were significantly shorter in Group 2 (for all parameters p<0.001). Haemoglobin decrease was also less in Group 2 without statistical significance. Oncologic and functional results were similar. There was no major complication in Group 2.CONCLUSIONS: According to our results 3 trocars eLRP can be performed safely and effectively in experienced hands. Haemorrhage, operative time, CO2 usage, and hospital stay could be shortened with our novel approach.
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OBJECTIVES: The people of ancient age appealed to sanctuaries of different gods and goddesses they believed to have healing powers and consecrated anatomical votive offerings representing their sick or healed organs. Male genital organ votives were also present among these votives. In this article, male genital organ votive offerings presented to gods and goddesses were examined and the votives giving information about the diseases they indicated were revealed in contemporary medicine.METHODS: Information available in written resources on ancient medicine and diseases was reviewed. Main sanctuary healing centers in Anatolia (Asia Minor), Greece and Italy which concurrently hosted similar civilizations were investigated. Male genital organ shaped anatomical votive samples in national and foreign medical history and archaeology museums, galleries and special collections were investigated and examined.RESULTS: It was observed that most male genital organ votives had a healthy and normal structure and didn’t provide any specific information on a urogenital disease. But it was also observed that some votives among genital organ votives consecrated by sick individuals to gods demonstrated some urogenital diseases and conditions. Among this very limited number of genital votives providing disease information, votives indicating phimosis, hypospadias, varicocele, penile hemangioma or condylama, Peyronie’s disease or penile curvature, genital hidradenitis suppurativa, condition of pubic hair and erectile condition of penis were detected.CONCLUSIONS: As proofs of seeking a remedy for diseases or recovering from diseases, anatomical organ votives are very important to understand ancient sanctuary medicine. Among male genital organ votives, very limited number of samples providing specific information on diseases provided us important information so that we can understand some ancient age diseases.
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OBJECTIVES: The current nephrolithiasis guidelines have no recommendation about multiple calyceal stones treatment. We aimed to compare the results of two effective methods of RIRS and PNL operations in the treatment of multicalyx stones. METHODS: Data of patients who underwent RIRS or PNL for multicalyx stones between September 2014 and May 2019 in our clinic were evaluated retrospectively. In both groups, stone-free and complication rates, hospital stay, scopy times, and operation times were examined. In RIRS group, the number of sessions and total stone-free rates at the end of each session were evaluated separately. RESULTS: A total of 162 patients in the RIRS group, and 103 patients in the PNL group were evaluated. After the match pair 1:1, data of 95 patients were selected in each group. Stone burden, number, density, ASA scores, BMI were similar in both groups. At the end of the first session RIRS, 59 (62.1%) patients became stonefree, while in the PNL group 73 (76.8%) patients (p: 0.027). The statistical analysis showed that the stonefree rates obtained in the second sessions in the RIRS group were similar to those of the PNL group. After a total of 124 sessions of RIRS, a stone-free rate of 81.1% was achieved by 1.3 sessions on average. CONCLUSION: At least two session of RIRS is as effective as PNL on multiple calyceal stones. Stage RIRS can be an alternative to PNL at multicalyceal renal stones.
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OBJECTIVE: To evaluate the safety and efficacy of prostatic artery embolization in the management of LUTS secondary to BPH in elderly patients unfit for surgery.MATERIALS AND METHODS: 17 elderly patients with moderate to severe LUTS/BPH were included in the study and treated with prostatic artery embolization. The patients were evaluated by transrectal ultrasonography (to assess prostate size), IPSS, and PVR urine volume preoperatively and 6 months after the procedure.RESULTS: The mean age of patients was 76.67 ± 7.69. The mean prostate volume was 139.8 ± 81.83 g. The mean preoperative IPSS and PVR were 23 ± 5.4, and 94.43 ± 88.94 ml, respectively. The mean operative time was 90 minutes. Only three patients suffered from postoperative complications (two patients suffered from urinary tract infection and one patient had partial penile necrosis). At 6 months follow up, there was a significant reduction in the prostate volume (101 ± 73.65 cc), IPSS (12.5 ± 3.65), and PVR urine volume (48.64 ± 43.55).CONCLUSION: prostatic artery embolization is a safe and effective non-surgical alternative treatment of BPH/LUTS particularly in elderly patients with multiple comorbidities.
Case Report
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We present a case of a woman affected by Systemic Lupus Erythematosus (SLE) and distal renal tubular acidosis (DRTA) that during pregnancy presented an exacerbation of SLE together with a renal colic with spontaneous stone passage. Radiological exam revealed diffuse calcifications in both kidneys which suggests, in a context of DRTA, a nephrocalcinosis. With the stabilization of SLE and medical treatment directed to correct metabolic alterations we achieved radiological and clinical stability of lithiasic disease.
Case Report
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OBJECTIVE: TTo describe the case of a patient with subcutaneous inguinal recurrence of penile cancer without lymph node involvement.METHODS: Description of a clinical case and review of the literature on the subject.RESULTS: We present the case of a 72-year-old man with penile cancer and extranodal inguinal extension that affected subcutaneous cell tissue, with a history of negative sentinel lymph node and subsequently without invasion of the regional lymph nodes in lymphadenectomy after chemotherapy. The patient presented disease progression despite multimodal treatment.CONCLUSION: Extranodal inguinal involvement in penile cancer may occur despite a history of negative sentinel lymph node. The evolution of the patient we presented was disastrous despite the multimodal treatment carried out.
