Abstract:
OBJECTIVES:To report our experience in the diagnosis and treatment of the lower urinary tract obstruction after urinary incontinence corrective surgery, analysing the different techniques performed, retropubic or vaginal urethrolysis. METHODS:We report a series of 14 patients with the diagnosis of obstruction after incontinence corrective surgery. They were classified in 2 groups, those who underwent retropubic procedures (5 cases) and those who underwent prolene mesh sling procedures (9 cases). We detail preoperative clinical-urodynamic parameters, and postoperative bladder outlet obstruction confirmation. Retropubic urethrolysis was performed in all patients after retropubic surgery, with the association of hysterectomy if indicated. The performance of a new sling- urethropexy was individualized. In three cases of retropubic surgery repeated urethropexy was not done. Unilateral section was performed in the sling series for all except one case of double section. A new mesh sling was performed in two cases; two cases did not undergo reoperation. Urethrolysis results were evaluated both subjectively by satisfaction degree scales and objectively by clinical-urodynamic evaluation, comparing clinical data and urodynamic parameters using the proper statistical test. RESULTS:In the retropubic surgery group all patients are continent. Satisfaction degree is: very satisfied 3 patients and 2 quite satisfied. Two presented with voiding urgency not needing anticholinergic drugs, and their urodynamic data returned to normal values without post void residual. The obstructed patients in the sling group reported minimal urgency after urethrolysis in 2 cases. Two patients have stress urinary incontinence: one of them is better than before and refused to undergo a new operation; the other one, who repeated sling, developed a clinical picture of urgency-incontinence again, underwent second section and continues having stress urinary incontinence. Among 7 patients undergoing sling, 4 are very satisfied, 1 quite satisfied, 1 somewhat satisfied and 1 not at all satisfied. Voiding difficulties have disappeared in all cases; comparisons between pre and postoperative urodynamics maximum flow, detrusor pressure at maximum flow and postvoid residual show statistically significant differences. Post-urethrolysis parameters return to preoperative values. CONCLUSIONS:The immediate development of symptoms after surgical correction of urinary stress incontinence is the best diagnostic criteria for obstruction. Detrusor muscle responds to obstruction, but sometimes its response is so minimal that it is difficult to diagnose urodynamically. The knowledge of preoperative values helps to confirm the diagnosis. In any case, urodynamic parameters did not influence the success of urethrolysis. Urethrolysis is an effective operation to cure symptoms secondary to obstruction after incontinence corrective surgery. When a sling has been the procedure performed, probably it is not worth to perform a standard urethrolysis; a simple section of one of the branches seems to be enough to improve symptoms. Currently, there is not scientific evidence about the convenience or not of bladder neck-urethral re-suspension after urethrolysis. The only case-scenario in which it is clearly indicated is that when there is stress incontinence in addition to obstructive symptoms.
journal_name
Arch Esp Uroljournal_title
Archivos espanoles de urologiaauthors
Romero Maroto J,Prieto Chaparro L,López López C,Quilez Fenoll JM,Rodríguez Fernández Esubject
Has Abstractpub_date
2002-11-01 00:00:00pages
1107-14issue
9eissn
0004-0614issn
1576-8260journal_volume
55pub_type
杂志文章abstract::This study was conducted to assess the clinical reliability of the prostatic Urolume Wallstent for symptomatic BPH patients. One hundred patients were treated under intravenous sedation or local anesthesia. Pre- and postoperative patient evaluation included scoring of subjective symptoms, physical examination, laborat...
journal_title:Archivos espanoles de urologia
pub_type: 临床试验,杂志文章
doi:
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:Seminal vesicle cysts are rare diseases and frequently cause no symptoms. An acquired giant seminal vesicle cyst in a 73-year-old man is presented. Bladder outlet obstruction was the main complaint, mimicking that arising from the prostate. METHODS:Ultrasonography and computed tomography revealed a well-defi...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2002-05-01 00:00:00
abstract::We present a case of vesical extrophy complicated by an adenocarcinoma in a 35-year old patient. It is this type of neoformation which most frequently affects the extrophic bladder and which, contrary to what has happened in most of the cases published, quickly presented bone and skin metastases. ...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1981-05-01 00:00:00
abstract::Erectile dysfunction is not the only cause of impotence in the male; impotencia coeundi may result from various disorders, although cavernosal erectile function is normal. The present study reviews the congenital and acquired penile disorders, as well as the cutaneous disorders that may cause penile morphological chan...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:To describe an additional case of desmoid tumor of the penis. The incidence, etiopathogenesis, symptoms, diagnosis and treatment of this condition are discussed. METHODS:A 70-year-old male consulted at the emergency services for pain and urinary symptoms. Physical examination showed no regional lymphadenopat...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:The results of in situ dissolution of a cystine calculus is described. This approach was attempted in a female patient for whom surgery was not considered to be the best therapeutic option. METHODS:An obstructive cystine calculus was treated by in situ litholysis using N-acetylcysteine applied locally via tw...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:To assess Latzko's colpocleisis with bilateral Martius flap as a solution for vesico vaginal fistula secondary to radiotherapy. METHOD:65 year old woman with past medical history of cervix adenocarcinoma treated with hysterectomy, pelvic radiotherapy and brachytherapy. She also had terminal colostomy for re...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2011-11-01 00:00:00
abstract::A retrospective study was undertaken in 243 cases of transitional cell carcinoma of the bladder to determine the correlation of clinical parameters (sex, age, symptoms and duration of the disease) and tumor gross anatomic features (cystoscopic aspects, tumor number, size and site) with survival. The study comprised 14...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:Involvement of extralymphatic tissue in chronic lymphocytic leukemia (CLL) is uncommon and that of the epididymis and spermatic cord is rare. This paper describes an unusual case with metastasis to both epididymis and the spermatic cord as the first sign of reactivation of CLL. METHODS/RESULTS:A patient with...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:To analyze the information provided by computed tomography (CT) in Fournier's gangrene, particularly in regard to the early diagnosis of the disease, and its utility as a complementary diagnostic imaging technique. METHODS:A retrospective study identified five cases of Fournier's gangrene. These patients had...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1998-11-01 00:00:00
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journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:2020-09-01 00:00:00
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journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:2003-09-01 00:00:00
abstract::To perform the adequate treatment of upper urinary tract lesions it is very important to have an exact diagnosis. When the suspicion of an upper tract urothelial tumor is established the initial evaluation is carried out by imaging diagnostic tests (intravenous urography, pyelography, and others). The association of r...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:Indinavir is a protease inhibitor used in the treatment of HIV with a lithogenic capacity as a urological side effect. The pathogenesis, diagnosis and treatment of indinavir urolithiasis are briefly reviewed. METHODS:A 37-year-old male, seropositive for HIV on treatment with indinavir, lamiduvine and zidovud...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVES:The value of ultrasonography for the study of female urinary incontinence has been redefined over the last years. METHODS:We review the literature about the value of ultrasound in the workup of females with urinary incontinence, mainly transperineal ultrasound for the female stress urinary incontinence (SUI...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:10.4321/s0004-06142006000400012
更新日期:2006-05-01 00:00:00
abstract::To determine the usefulness of ultrasound in the diagnosis of acute renal graft failure, 48 renal transplants were retrospectively studied. The characteristic morphologic signs of acute rejection (AR) were compared with the histologic analysis of the graft using material obtained from percutaneous renal biopsy and/or ...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
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journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2015-03-01 00:00:00
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journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2020-12-01 00:00:00
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journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1998-09-01 00:00:00
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journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
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journal_title:Archivos espanoles de urologia
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doi:
更新日期:2007-01-01 00:00:00
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journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:10.4321/s0004-06142008000900028
更新日期:2008-11-01 00:00:00
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journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
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更新日期:1993-11-01 00:00:00
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journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2012-06-01 00:00:00
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journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract::La aplicación del láser en urología viene utilizándose desde hace muchos años, pero es realmente en nuestros tiempos donde está alcanzando unos niveles de popularidad excelentes. :La aplicación del láser en urología viene utilizándose desde hace muchos años, pero es realmente en nuestros tiempos donde está alcanzando...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
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更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:To show the beginning of the General Hospital of Madrid, its localization, economical problems and medical protagonists, mainly the first medical director: Dr. Perez de Herrera. Also, to show its scientific and health-care contributions to the people of Madrid and other cities, coming in the search for train...
journal_title:Archivos espanoles de urologia
pub_type: 历史文章,杂志文章
doi:10.4321/s0004-06142006000700001
更新日期:2006-09-01 00:00:00
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journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
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journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00