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OBJECTIVE: The aim of this study is toevaluate the efficacy of a local intraurethral anestheticon the pain perceived by the patient during flexiblecystoscopy.METHODS: An observational, prospective, nonrandomized,study was conducted on 142 malessubjected to a flexible cystoscopy. The patients weredivided into two groups: Group 1: 70 patients with intraurethral anesthetic (lidocaine 2%), and Group 2:72patients without intraurethral anesthetic. The results werescored on a visual analog scale and a pain questionnaireand analyzed. The statistical analysis was performedusing SPSS 17.0 and with a statistical significance ofp≤0.05.RESULTS: The mean age of Group 1 was 64.7±10.3years compared to 66.7±10.8 years in Group 2,with no significant differences. The score on the visualanalog scale in Group 1 was 2.23±2.20 versus1.69±1.74 in Group 2 (p=0.1). The overall andcurrent pain intensity in the pain questionnaire was1.81±0.87 and 1.66±1.65, respectively, in Group1, and 1.72±0.72 and 1.21±1.45, respectively, inGroup 2 (no significant differences). After dividing thepatients into groups according to a visual analog scalescore ≤2, it was observed that the cause that led tocystoscopy was an independent factor associated withthe perception of pain, increasing the risk of perceivingmore pain by 1.89.CONCLUSION: The use of local anesthetic as alubricant prior to flexible cystoscopy does not appear toreduce pain, and we consider that its routine use is notindicated.
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Summary.- OBJECTIVE: To present a retrospective, descriptive and observational study performed on a group of patients diagnosed with palpable undescended testicle (PUT) and surgically treated by pre-scrotal access, the “Bianchi technique”.METHODS. The sample consists of a group of patients from 6 to 168 months old, diagnosed with palpable undescended testicle and treated by orchidopexy through pre-scrotal access Bianchi type (4), from January 2008 to June 2015 by the Pediatric Urology Equipment of Malaga, where the authors belong. To be part of the sample, the patients must meet the following requirements: male, diagnosis PUT, older than 6 months old and a minimum of 6 months of postoperative follow.RESULTS: The sample is comprised of 200 testicles and 157 patients diagnosed with PUT, aged between 6 and 168 months old and treated by the same main surgeons. In a 72.62% of the patients the anomaly was unilateral. From the 200 testicles intervened, a 51.5% had PUT on the right side. Localization of the undescended testis was in the inguinal canal in a 64.5% of cases, 22.5% in the superficial inguinal canal and a 13% in the deep one. There weren´t significant complications but in 4.5% of the cases there were minor complications that did not require treatment (cutaneous scrotal hematoma, 2.5%; scrotal skin edema, 1.5%, and partial dehiscence, 0.5%). Regarding the state of the scar, in 15.5% it´s not visible, in 16% excellent, very good in 12.5% and only 1% had a bit of an hypertrophic aspect.CONCLUSIONS. This is a easy technique, which presents good surgical results, with minimum surgical complications, its short, medium and long term results are excellent and with a great aesthetic appearence.
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OBJECTIVES: To assess the association between empty bladder stress test and objective and subjective measures of stress urinary incontinence (SUI) severity. METHODS: Prospective, analytic and descriptive study of females with diagnosis of stress urinary incontinence referred for urodynamics study. Every patient underwent medical history (including number of daily pads) and physical examination, ISIQ-SF and short IIQ-7 questionnaires, and full urodynamic study, including the measurment of the abdominal leak pressure point (ALPP). Positive empty stress test was defined as stress urine leak on physical exam after uroflowmetry evacuation and in absence of significant post-void residual. To evaluate the relationship between empty bladder stress test and each one of the stress urinary incontinence severity measures, Stundent`s t test was performed, considering a <0.05 value statistically significant.RESULTS: 107 patients were studied in the final analysis; of them 49 had empty bladder stress test (+) and 58 (-). Patients with positive test wet a greater number of protectors per day (3.9 vs 2.8; p 0.013), higher ICIQSF score (15.04 vs 12.22; p 0.0007), higher IIQ-7 score (52.2 vs 37.5; p 0.0049) and lower urodynamics ALPP (73 cm H2O vs 91 cm H2O; p 0.0002).CONCLUSIONS: Patients with SUI and positive empty bladder stress test had a strong association with the objective and subjective perception of urine incontinence severity with a negative impact in patients quality of life.
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OBJECTIVES: To compare perioperative outcomes and complications of plasmakinetic bipolar and monopolar transurethral resection of bladder tumors (TURBT) in patients with non-muscle invasive bladder cancer (NMIBC).METHODS: Between March and December 2015, a total of 130 consecutive patients underwent TURBT for NMIBC. Patients were equally randomized into monopolar TURBT (M-TURBT) and bipolar TURBT (B-TURBT) groups. Primary outcome of this study was safety of the procedures including obturator jerk, bladder perforation, clot retention, febrile urinary tract infection and TUR syndrome.The secondary outcome was efficacy of both TURBT procedures, including complete tumor resection, sampling of the deep muscle tissue and sampling of the qualified tissues that without any thermal damage.RESULTS: Complete tumor resection rate was higher in B-TURBT than M-TURBT (89.2% vs 78.5%, respectively), but the difference was not significant (p=0.152). No significant differences were found between the muscle tissue sampling rates (64.6% vs 72.3%, p=0.345) and the numbers of patients with thermal tissue damage (7 patients vs 3 patients, p=0.194). Obturator jerk was detected in 21.5% of the patients in M-TURBT group and 4.6% of the patients in B-TURBT group, and this difference was statistically significant (p=0.013). Bladder perforation was significantly higher in M-TURBT group than B-TURBT (21.5 % vs 6.1%, p=0.039).CONCLUSIONS: Bipolar TURBT had significantly lower obturator jerk and bladder perforation than monopolar. B- TURBT is a reasonable treatment modality in patients with NMIBC.
Case Report
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OBJECTIVE: TTo expose the features related to the diagnosis, therapy and follow-up of paratesticular sarcomas, through the presentation of three cases with different histologies.METHODS: Description of the clinical cases, surgical management, and pathological results of the surgical specimens.RESULTS: We present three cases of paratesticular sarcomas, one case being a rhabdomyosarcoma and two liposarcomas. Two patients underwent a single successful surgery, while the third one required a second intervention after recurrence. Today all three patients are free of disease.CONCLUSIONS: Malignant paratesticular sarcomas are infrequent neoplasias in urology. It is essential that the urologist is aware of this possibility when faced with a paratesticular tumor, since radicalness of surgery will be the most decisive factor in the success of the treatment. Adjuvant therapies must be individualized in each case, and the follow-up after surgery should be close, given the poor evolution of these tumors in many cases.
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OBJECTIVE: Congenital anterior urethrocutaneous fistula, is a rare anomaly characterised by fistulisation of penile urethra to skin and presence of a concomitant normal or hypospadiac external urethral meatus. It may be seen as an isolated anomaly or may accompany genitourinary or anorectal malformations. We aim to present 3 new cases and define the common properties of patients stated in literature. METHOD: Information of 3 patients aged 2, 3 and 6 with this diagnosis were reviewed retrospectively and features of 51 patients in 25 articles with literature search. RESULTS: From the patients we operated, 2 had midpenile and 1 had subcoronal fistula. Urethral meatus was at tip of glans in all with 1 stenotic meatus. Two-layered primary repair was performed in 3 patients and deep ventral incision on urethral plate with meatotomy were added to fistula repair in one with stenotic meatus. Fistula recurred in this patient but resolved spontaneously after dilatations. In literature, most common fistula site was subcoronal in 27 (52.9%). Hypospadias was in 11.8% and associated genitourinary anomaly was detected in 21.5% of patients. Fistula recurrence ratio was 7.8% using different surgical techniques. CONCLUSION: Congenital anterior urethrocutaneous fistula is frequently located in subcoronal level and usually a normal urethra distal to it. Physical examination is important to detect additional anomalies. Success rates are high with primary repair techniques.
Case Report
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Case Report
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