{"title":"Economic evaluation of ceftibuten in the treatment of uncomplicated urinary tract infections in adult Mexican patients","authors":"A. Reyes-López , V. Blandón-Vijil","doi":"10.1016/j.uromx.2015.11.002","DOIUrl":"10.1016/j.uromx.2015.11.002","url":null,"abstract":"<div><h3>Background</h3><p>Urinary tract infections are a leading cause of medical consultations in Mexico and the growth of antimicrobial resistance results in increased morbidity and rising costs.</p></div><div><h3>Aim</h3><p>To make an economic evaluation of ceftibuten as treatment for uncomplicated urinary tract infections in adults, from the perspective of the Mexican private health system.</p></div><div><h3>Methods</h3><p>A cohort-based decision-making model was developed to compare ceftibuten with TMP-SMX, ciprofloxacin, and cefalexin. Effectiveness was measured using local susceptibility rates of <em>Escherichia coli</em>. Costs were obtained from official market value data and converted to 2014 USD values. Incremental analysis was employed to determine if ceftibuten was a worthwhile investment on the part of the private health system in Mexico.</p></div><div><h3>Results</h3><p>The total expected cost per patient for ciprofloxacin was $116 USD and the corresponding costs for TMP/SMX and cefalexin were $92.40 USD and $74.80 USD, respectively. Ceftibuten had a lower expected cost ($34.50 USD) and a higher percentage of therapeutic success (99.4%), compared with ciprofloxacin 21%, cefalexin 41%, and TMP/SMX 31.7%.</p></div><div><h3>Conclusions</h3><p>Even though ceftibuten has a higher market price than other antimicrobials in Mexico, it can represent possible savings by avoiding the costs associated with undesirable results due to antimicrobial resistance to <em>E. coli</em>.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121014631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J.A. Rodríguez-Robles, L. Almazan-Treviño, J.I. Monjaras-Guerra, V.I. Victoria-Mejía, A.C. Martínez-Baez, M.P. Ávila-Boza, M.A. Reyes-Gutierrez
{"title":"Sustitución de uréter con apéndice cecal en un paciente con estenosis ureteral: primer caso reportado en México y revisión de la literatura","authors":"J.A. Rodríguez-Robles, L. Almazan-Treviño, J.I. Monjaras-Guerra, V.I. Victoria-Mejía, A.C. Martínez-Baez, M.P. Ávila-Boza, M.A. Reyes-Gutierrez","doi":"10.1016/j.uromx.2015.12.005","DOIUrl":"https://doi.org/10.1016/j.uromx.2015.12.005","url":null,"abstract":"<div><p>Over a span of 20 years, urologic, gynecologic, and general surgery operations were responsible for 42%, 34%, and 24% of injuries, respectively. In 1912, Melnikoff described the first substitution of a ureter with the vermiform appendix as treatment for ureteral stricture.</p></div><div><h3>Objective</h3><p>Our aim was to present herein a case of ureter substitution with the cecal appendix to promote the feasibility of the procedure and to describe the first experience at a tertiary care hospital in Mexico.</p></div><div><h3>Material and methods</h3><p>A 35-year-old woman was diagnosed with right distal ureteral stricture secondary to injury after a total abdominal hysterectomy and right nephrostomy placement.</p></div><div><h3>Results</h3><p>Given that the course of the stricture was approximately 10<!--> <!-->cm, transposition of the appendix was decided upon. The cecal end of the appendix was previously isolated and splinted with a double-J ureteral stent and then anastomosed to the ureter with the end-to-end method and the distal end was reimplanted into the bladder with the Politano-Leadbetter technique. At 11 months after the procedure, the patient presented with adequate progression, was asymptomatic, and the control imaging studies showed satisfactory passage of urine from the kidney to the bladder, with no pyelocaliceal dilation or stricture.</p></div><div><h3>Conclusions</h3><p>There are various advantages to using the appendix as a substitute material, among which are good contractibility, availability to be moved with a blood supply, the fact that it does not absorb urine, the possibility to create a submucosal tunnel to prevent reflux, and a caliber similar to that of the ureteral lumen.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.12.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92119273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Eversión transuretral de la vejiga, reporte de caso","authors":"A. González-Serrano , M. López-Gallegos","doi":"10.1016/j.uromx.2015.10.004","DOIUrl":"10.1016/j.uromx.2015.10.004","url":null,"abstract":"<div><p>Transurethral bladder eversion is extremely rare and very few cases are described in the literature.</p><p>The aim of this report was to present the management established for this pathology and to analyze its possible predisposing factors.</p><p>The case of a 72-year-old, multiparous, postmenopausal woman is presented herein. Her past history included numerous pregnancies resulting in births, uterine prolapse, pessary use, and transurethral bladder eversion. Urethral remodeling, colporrhaphy, and cystopexy were performed.</p><p>The exact mechanisms by which bladder eversion occurs have yet to be established. Management is heterogeneous due to the lack of reported cases and results tend to be variable.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.10.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131318392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A.A. Cayetano-Alcaraz, M. Sotomayor-de-Zavaleta, R.A. Castillejos-Molina, F. Gabilondo-Navarro, G. Feria-Bernal, F.T. Rodríguez-Covarrubias
{"title":"Resultados oncológicos en enfermedad N1 posterior a la prostatectomía radical","authors":"A.A. Cayetano-Alcaraz, M. Sotomayor-de-Zavaleta, R.A. Castillejos-Molina, F. Gabilondo-Navarro, G. Feria-Bernal, F.T. Rodríguez-Covarrubias","doi":"10.1016/j.uromx.2015.11.004","DOIUrl":"https://doi.org/10.1016/j.uromx.2015.11.004","url":null,"abstract":"<div><h3>Background</h3><p>Radical prostatectomy<!--> <!-->+<!--> <!-->pelvic lymph node dissection can improve progression-free survival and cancer-specific survival in lymph node disease.</p></div><div><h3>Aim</h3><p>To analyze the characteristics of patients with lymph node disease in the histopathologic findings of the radical prostatectomy and lymph node dissection.</p></div><div><h3>Material and methods</h3><p>A retrospective study was carried out on patients that underwent radical prostatectomy with metastatic lymph node disease within the time frame of 1988 to 2015.</p></div><div><h3>Results</h3><p>The study included 25 patients with a mean 66.5 years of age (SD<!--> <!-->±<!--> <!-->6.5), a mean prostate-specific antigen of 20.17<!--> <!-->ng/dl (IQR: 18), and a median follow-up period of 63 months (IQR: 86). According to the D’Amico classification, 15 (60%) patients were high-risk, 8 (32%) were intermediate-risk, and 2 (8%) were low-risk. Positive margins were found in 15 cases (60%); 4 (16%) patients had T2 tumor stage, 3 (12%) had T3A, 17 (68%) had T3B, and one patient (4%) had T4. Fourteen (56%) patients had one positive lymph node, 3 (12%) patients had 2 positive lymph nodes, and 8 (32%) patients had more than 2 positive lymph nodes. Three (16%) patients received radiotherapy and 24 (96%) underwent hormone blockade. Progression-free survival was 105 months and cancer-specific survival was 86% at 5 years and 45% at ten years. The HR for biochemical progression was significant in positive margins (HR: 9.5, 95% CI: 0.99-91.5, <em>P</em> <!-->=<!--> <!-->.50) and when there were<!--> <!-->≥<!--> <!-->2 positive lymph nodes (HR: 8.5, 95% CI: 1.1-61.9, <em>P</em> <!-->=<!--> <!-->0.34). Involvement of<!--> <!-->≥<!--> <!-->2 lymph nodes predicted progression with an odds ratio of 7.2 (95% CI: 1.06-48.6, <em>P</em> <!-->=<!--> <!-->.043).</p></div><div><h3>Conclusions</h3><p>The average 5-year survival was above 80%. The number of positive lymph nodes could be a predictive factor for biochemical progression.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.11.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92055767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Marquina S., J.C. Ramírez R., P. Esquivel P., I. Zafra., L. Alba., A. Ruiz R., A. Hernández P.
{"title":"Reparación laparoscópica de fístula de arteria renal derecha a vena cava, posnefrectomía radical derecha","authors":"M. Marquina S., J.C. Ramírez R., P. Esquivel P., I. Zafra., L. Alba., A. Ruiz R., A. Hernández P.","doi":"10.1016/j.uromx.2015.12.004","DOIUrl":"10.1016/j.uromx.2015.12.004","url":null,"abstract":"<div><h3>Background</h3><p>Post-nephrectomy arteriovenous fistula is rare in relation to the number of nephrectomies performed worldwide and they are more frequent on the right side, as was true for the case presented herein.</p></div><div><h3>Case report</h3><p>A 66-year-old woman underwent right radical nephrectomy in January 2005. In May 2015 she came to a cardiology consultation presenting with anasarca and an abdominal murmur. An abdominal tomography scan was done and an arteriovenous fistula involving the right renal artery and the vena cava was diagnosed. The hemodynamics specialist ruled out endovascular treatment and the patient was referred to our urology service.</p><p>Through laparoscopy performed with the patient in the right lateral decubitus position, 2<!--> <!-->L of ascites were extracted and the origin of the right renal artery was dissected. Two 10<!--> <!-->mm Hem-o-Lok staples were applied. On the first postoperative day the patient had minimal abdominal pain, tolerated a liquid diet, passed gases, and had normal vital signs, but the abdominal murmur continued to be heard. At 30<!--> <!-->h after the procedure, an abdominal tomography scan was carried out that revealed no change in the arteriovenous fistula. The double Hem-o-Lok staples were observed in the superior mesenteric artery, but there was flow despite the 2 staples (partial obstruction). Emergency laparoscopy was performed, removing the staples from the superior mesenteric artery. The right renal artery was located and 2 Hem-o-Lok staples were placed. The murmur ceased. The patient had excellent postoperative progression. The control tomography scan showed there was no arteriovenous fistula and the superior mesenteric artery was normal with no staples.</p></div><div><h3>Conclusions</h3><p>This was an unusual and complex case that was resolved through laparoscopy. Perhaps an atheroma prevented complete superior mesenteric artery obstruction. The position of the patient was an important factor in locating the right renal artery.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.12.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132126653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J.E. Sedano-Basilio, V. Cornejo-Dávila, L. Trujillo-Ortiz, M. Cantellano-Orozco, G. Fernández-Noyola, C. Martínez-Arroyo, J.G. Morales-Montor, C. Pacheco-Gahbler
{"title":"Experiencia y revisión de la literatura en el manejo de gangrena de Fournier en una institución, 2008-2015","authors":"J.E. Sedano-Basilio, V. Cornejo-Dávila, L. Trujillo-Ortiz, M. Cantellano-Orozco, G. Fernández-Noyola, C. Martínez-Arroyo, J.G. Morales-Montor, C. Pacheco-Gahbler","doi":"10.1016/j.uromx.2015.12.003","DOIUrl":"10.1016/j.uromx.2015.12.003","url":null,"abstract":"<div><h3>Background</h3><p>Fournier's gangrene is characterized by necrosis and gangrene of the subcutaneous tissue, superficial and deep fascia, and muscles in the perineum and genitals. The risk factors are: alcoholism, diabetes, malnutrition, advanced age, and immunosuppression. Treatment is based on broad-spectrum antibiotics and radical surgical debridement.</p></div><div><h3>Aim</h3><p>To report our institutional experience in the treatment of Fournier's gangrene.</p></div><div><h3>Material and Methods</h3><p>A retrospective, analytic study was conducted that included 46 patients attended to within the time frame of 2008-2015.</p></div><div><h3>Results</h3><p>Low socioeconomic level was the most frequent factor (61.4%), followed by diabetes (52.3%). Multiple surgeries were required in 79.5% of the cases and the mortality rate was 6.8%. A total of 68.3% of the cases had a urologic origin, followed by soft tissue involvement (27.3%), and the most frequent microorganism was <em>Escherichia coli</em> (61.4%).</p></div><div><h3>Discussion</h3><p>Treatment included broad-spectrum antibiotics (carbapenems) and radical surgical treatment; vacuum-assisted closure was recommended. Once a negative culture was obtained, rehabilitation and reconstruction were carried out to optimize the functional capacity of the patients. In our population, economic limitations and treatment abandonment limited the described management.</p></div><div><h3>Conclusions</h3><p>Fournier's gangrene presents with a critical mortality rate. Initial aggressive antibiotic and surgical treatment improves survival and later rehabilitation and reconstruction improve functional capacity.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.12.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124892157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D.A. García-Herrera, C.L. Vázquez-Niño, R. Gutiérrez-Rosales, M.A. Aragón-Castro, G. Ruvalcaba-Oceguera
{"title":"Hipogonadismo de inicio tardío: revisión de conceptos y pautas diagnósticas","authors":"D.A. García-Herrera, C.L. Vázquez-Niño, R. Gutiérrez-Rosales, M.A. Aragón-Castro, G. Ruvalcaba-Oceguera","doi":"10.1016/j.uromx.2015.11.001","DOIUrl":"https://doi.org/10.1016/j.uromx.2015.11.001","url":null,"abstract":"<div><p>Late-onset hypogonadism is a clinical and biochemical syndrome that is increasingly more frequent in the adult male population. However, it is rarely diagnosed and therefore goes untreated in the majority of affected men. The association between age-related testosterone deficiency and late-onset hypogonadism continues to be a subject of debate and its relation to symptoms such as loss of muscle strength and volume, loss of libido, erectile dysfunction, and changes in affective and emotional statuses of the patient are insidious, given that the symptomatology is often attributed to the “normal” aging process or other comorbidities of the patient. The diagnosis of late-onset hypogonadism is based on the coexistence of low total or free testosterone serum levels and symptoms suggestive of hypogonadism. Even though screening questionnaires directed at patients with clinical suspicion of the disease have been developed for late-onset hypogonadism, their diagnostic sensitivity and specificity is limited. Accurate and opportune diagnosis is vitally important because it enables testosterone levels to be reestablished and significant clinical improvement to be made through androgen replacement therapy.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91974246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Síndrome de Shy Drager, Repercusiones Urológicas","authors":"V.M. Telich , C.C. Merayo , S.E. Cartagena , A.C. González , O.G. Zubieta , M.J. Garzón , A.A. Flores","doi":"10.1016/j.uromx.2015.10.002","DOIUrl":"https://doi.org/10.1016/j.uromx.2015.10.002","url":null,"abstract":"<div><h3>Background</h3><p>Shy-Drager syndrome, also known as multiple system atrophy, is a neurodegenerative entity of autoimmune etiology. Clinical symptoms encompass Parkinsonism and cerebellar and autonomous symptomatology, including urinary and sexual alterations and cortical dysfunction of the pyramidal pathway. There is little drug response. Incidence is similar by sex, disease onset is in adulthood, and it is a progressive pathology with a poor prognosis.</p><p>Case 1: We present herein the case of a 39-year-old woman that presented with signs of neurocardiogenic syncope and dysautonomia 5 years prior to her present hospital admission. That evaluation protocol showed data of sinus bradycardia, treated with a pacemaker, as well as gastric intolerance and urinary retention. Due to the insidious progression of her illness, the clinical data, and auxiliary diagnostic studies, the diagnosis of multiple system dysautonomia, or Shy-Drager syndrome, was made. In relation to urology, the patient presented with recurrent urinary infections and urinary retention on numerous occasions. A urodynamic study was performed, but was inconclusive due to a dysautonomic event during the study. In the filling cystomanometry, storage was 700<!--> <!-->cc, but the patient was unable to micturate. Given the above, long-term management with clean intermittent catheterization was decided upon, but it could not be achieved due to another dysautonomic event, and therefore a transurethral catheter was left in place. The patient sought an alternative, because she wanted to continue to have an active sex life and the urethral catheter caused episodes of intense dyspareunia and dysautonomia. Thus, the joint decision was made to perform cystostomy, which the patient retains today.</p></div><div><h3>Aim</h3><p>To report on the urologic implications and management in a patient with Shy-Drager syndrome.</p></div><div><h3>Material and methods</h3><p>The case record of a patient diagnosed with Shy-Drager syndrome was employed and she was treated for urologic complications at the <em>Hospital Ángeles Pedregal</em>.</p></div><div><h3>Results</h3><p>Following medical-surgical management, the patient was released to her home 3 days after her hospital admission due to clinical improvement. Currently she is being monitored as an outpatient.</p></div><div><h3>Discussion</h3><p>Shy-Drager syndrome was first described in 1960 by Milton Shy and Glenn Drager. It is classically described as the presence of orthostatic hypotension, anhidrosis, and cerebellar dysfunction and/or Parkinsonism of varying magnitude. Alterations in bladder voiding and erectile dysfunction are the predominant urologic disorders. In the case presented herein, the patient had been previously treated for cardiovascular problems and she is currently receiving satisfactory management for urologic complications.</p></div><div><h3>Conclusions</h3><p>Urologic symptoms have been observed in 60% of the patients that presen","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91974247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Delgado-Guerrero , L.M. Covarrubias-Méndez , A. González-Gómez , J. Bernal-Hernández , J. Torres-Aguilar , R. Arellano-Cuadros
{"title":"Experiencia de adenomectomía prostática laparoscópica","authors":"F. Delgado-Guerrero , L.M. Covarrubias-Méndez , A. González-Gómez , J. Bernal-Hernández , J. Torres-Aguilar , R. Arellano-Cuadros","doi":"10.1016/j.uromx.2015.11.003","DOIUrl":"10.1016/j.uromx.2015.11.003","url":null,"abstract":"<div><h3>Background</h3><p>Up to the present, transurethral resection of the prostate has been recognized as the standard surgical treatment for prostatic growth. The first report of a laparoscopic procedure for the management of prostatic growth was in 2002, when Dr. Mariano Mirandolino published an anecdotal case of laparoscopic prostatic adenomectomy (LPA) in Brazil. Since then 19 studies have been published reporting on the experience with this laparoscopic technique. The procedure was begun at our hospital in mid-2010.</p></div><div><h3>Aim</h3><p>The aim of the present study was to describe the experience with LPA at our hospital, along with the characteristics of the patients that underwent the procedure.</p></div><div><h3>Material and methods</h3><p>Patients that underwent LPA within the time frame of 2010 to December 2014 were included in the study. Preoperative characteristics, intraoperative findings, and postoperative results were documented.</p></div><div><h3>Results</h3><p>A total of 58 patients were included. The median age was 66 years (range: 46 to 85 years). Twelve patients presented with chronic degenerative diseases. Mean surgery duration was 148.6<!--> <!-->min with a range of 90 to 240<!--> <!-->min, and mean blood loss was 228.56<!--> <!-->ml, with a median of 400<!--> <!-->ml. The mean weight of the extracted adenomas was 118<!--> <!-->±<!--> <!-->34<!--> <!-->g. The postoperative means were: hospital stay, 2.7 days, time with a transurethral Foley catheter, 7.79 days, and time with a Penrose drain in the space of Retzius, 6.4 days. Follow-up was carried out in outpatient consultation for a mean 4.2 months, and IPSS questionnaires were applied one month after surgery, showing a mean improvement of 15 points (<em>P</em> <!--><<!--> <!-->.001). In relation to postoperative complications (9%), acute urinary retention due to bladder clots presented the day after the procedure.</p></div><div><h3>Conclusions</h3><p>LPA is an alternative procedure to transurethral resection of the prostate that shows good functional results and a low complication rate.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.11.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122070369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Quezada-León , C. Vázquez-Niño , A. Costilla-Moreno , J. Hernández-Alvarado
{"title":"Metástasis ureteral contralateral por tumor renal de células claras","authors":"C. Quezada-León , C. Vázquez-Niño , A. Costilla-Moreno , J. Hernández-Alvarado","doi":"10.1016/j.uromx.2015.09.005","DOIUrl":"10.1016/j.uromx.2015.09.005","url":null,"abstract":"<div><p>Renal cell carcinoma represents 2-3% of all cancers and is the most frequent solid lesion of the kidney. Incidental diagnosis is made through imaging studies in approximately 50% of the cases and the majority are asymptomatic. Radical surgical treatment is the basis of management, and follow-up through imaging techniques is a priority for detecting local or systemic recurrence.</p><p>A 60-year-old man had a past history of left radical nephrectomy due to kidney tumor 10 years prior. His current clinical manifestation was painless gross hematuria. CT-urography showed right ureteropelvic ectasia with a lesion occupying the distal third of the ureter that caused a negative filling defect. Endoscopy examination, lesion excision, and adjuvant therapy based on tyrosine kinase inhibitor (sorafenib) were carried out.</p><p>This clinical case underlines the importance of strict follow-up in patients with renal neoplasias in the absence of clear knowledge of the metastatic behavior and predictable dissemination routes in renal cell carcinoma.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.09.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115406477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}