J Bachiller Burgos

Hospital Juan Ramón Jiménez, Huelva, Huelva, Andalusia, Spain

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Publications (27)28.6 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To determine the ultrasound characteristics of the vesico-urethral anastomotic complex in patients with radical prostatectomy to separate normal prostate fossae from those affected by local recurrence or residual tumour. Material and methods Between January 1998 and June 1999 15 ultrasound guided transrectal biopsies of vesico-urethral anastomosis or prostate fossae were performed in patients with radical prostatectomy. The selection criteria to perform puncture in these patients were a negative extension study (abdominal-pelvic CT and bone scan), PSA higher than 0.4 ng/mL and/or suspicious DRE. The study was completed with 10 transrectal ultrasound (TRU) after radical prostatectomy in patients with normal PSA and DRE. TRU parameters in patients with tumour-positive biopsies were compare to those from patients with negative biopsies and those obtained from TRU in patients with both normal PSA and normal DRE. Results The ultrasound parameters that best described prostate fossa abnormalities were the presence of hypoechoic masses or nodes and the integrity or not of the retroanastomotic fat layer. When a hypoechoic mass or node was found at the anastomosis level, 80% biopsies were positive for tumour local recurrence. The percentage increases when changes are seen at the retro-anastomotic fat layer. Conclusiones In spite of a good correlation between ultrasound abnormalities and positive biopsies, ultrasound findings from the vesico- urethral anastomosis in patients with radical prostatectomy are not well defined. Nodes or ultrasound irregularities can exist in normal prostate fossae as well as normal anastomosis ultrasound in the presence of tumoral relapses. We believe TRU of vesico-urethral anastomosis to be the best method available to evaluate local recurrence or tumoral persistence after radical prostatectomy.
    Actas urologicas españolas 08/2013; 24(6):481–487. · 1.14 Impact Factor
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    ABSTRACT: 105 percutaneous nephrostomies in 73 patients. Indication for nephrostomy was obstruction in the drainage system in all cases. Nephrostomy was bilateral in 24 cases. Reasons for nephrostomy were: lithiasis in 35 cases, carcinoma of the bladder in 17, post-surgical iatrogenic stenosis in 13, prostate carcinoma in 9, cancer of the rectum in 9, infection in 5, neoplasia of the upper urinary tract in 5, retroperitoneal fibrosis in 3, glandular cystitis cystica in 3, ovarian cancer in 3, congenital in 2, lymphoma in 1. Six case were single-kidney patients. Renal puncture through the lower calyceal group was the preferred approach. Purulent urine was extracted in 10 cases. Complications of nephrostomy included haematuria in 34 cases, contrast extravasation in 8, fever in 6, 1 case of death due to septic shock, 2 perirenal haematoma (nephrectomy was required in 1 case), and catheter detachment in 5 cases. All patients showed improvement of both clinical signs and symptoms, and lab results.
    Actas urologicas españolas 07/2013; 24(7):568–572. · 1.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cystic-glandular cystitis is considered as part of the urothelial pre-neoplastic proliferative abnormalities. This group includes atypical hyperplasia, Von Brunn's nidus, and cystitis cystica. They are a consequence of the changes experienced at the urothelium level in response to inflammation, irritation or carcinogens. Diagnosis is mainly based in the pathoanatomical study of the biopsy obtained following endoscopic resection. The signs and symptoms it presents are varied and show a clear relationship to distribution and extension of cysts. Treatment is based in the removal of irritative factors. Cystectomy with urinary by-pass may be necessary if required by clinical evolution.
    Actas urologicas españolas 07/2013; 24(7):594–598. · 1.14 Impact Factor
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    ABSTRACT: The existence of a vesical diverticulum in the context of a congenital connective tissue disorder such as Ehlers-Danlos syndrome led us to consider the possibility of a relationship. Four types of diverticula can be found in the literature: congenital, acquired, iatrogenic and syndrome-associated. Within the later, Ehlers-Danlos syndromes type IV and IX, even type V, are associated to the existence of vesical diverticula. The potential spontaneous rupture of the diverticulum is a typical feature, as well as post-surgery relapse. The attitude towards such diverticula should be one of watchful waiting, and simple, plasty-free diverticulectomy on the bladder's neck is indicated when performing a surgical procedure.
    Actas urologicas españolas 07/2013; 24(8):673–676. · 1.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Within the exceptional tumoral pathology of the testis and paratesticular region are the common epithelial type tumors. Although, its histogenesis is under discussion, it has been interpreted as arising from the remnants of the müllerian duct, or from the mesothelium of the tunica vaginalis differentiating in a müllerian direction. Similarities with homologous ovarian tumors are well recognized and in generally we accept a good pronostic due to its low malignant potential or bordeline type, more experience with these uncommon lessions is necessary to evaluate their biologic potential.
    Actas urologicas españolas 07/2013; 24(3):256–259. · 1.14 Impact Factor
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    ABSTRACT: Endoscopic approach to the ureter both as a diagnostic procedure in various diseases and treatment of low ureteral lithiasis is a widely used technique.Review of case reports where this technique was used over the last four years. A total of 73 ureteroscopies were conducted, 64 as therapeutic approach (89.04%) and 9 for diagnosis (10.96%) achieving an overall 94.4% success rate.Multiple variables such as type and location of the stones, patient's age and sex, diagnostic methods, length of stay etc. All the above data were used for a descriptive analysis of the situation in our centre.In our experience, ureteroscopy is a good therapeutic option for low ureteral lithiasis, mainly when no extracorporeal lithotrity is available, and an excellent diagnostic tool in other ureteral processes when more traditional methods fail.
    Actas urologicas españolas 07/2013; 24(6):458–462. · 1.14 Impact Factor
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    ABSTRACT: Since 2007, various urological procedures have been performed with laparoendoscopic single-site surgery (LESS surgery), including nephrectomy, pyeloplasty, simple prostatectomy and, with the refinement of laparoscopic instrumentation, radical prostatectomy. This paper reports our initial experience in radical prostatectomy using the SILS Port from Covidiem and two lateral 5-mm trocars for triangulation. The SILS Port allows for accurate, simple insertion through a Hadson incision. The flexible port accommodates three 5-mm cannulas or two 5-mm cannulas and a 12-mm port for easier instrument exchange through a single incision. This approach decreases morbidity from bleeding, hernia and/or internal organ damage and improves cosmetic. One-port single-incision laparoscopy is part of the natural development of minimally invasive surgery. Future research is required to assess the intraoperative and postoperative benefits of LESS surgery as compared to standard laparoscopy.
    Actas urologicas españolas 06/2010; 34(6):495-9. · 1.14 Impact Factor
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    ABSTRACT: Since 2007, various urological procedures have been performed with laparoendoscopic single-site surgery (LESS surgery), including nephrectomy, pyeloplasty, simple prostatectomy and, with the refinement of laparoscopic instrumentation, radical prostatectomy. This paper reports our initial experience in radical prostatectomy using the SILS™ Port from Covidiem and two lateral 5-mm trocars for triangulation. The SILS™ Port allows for accurate, simple insertion through a Hadson incision. The flexible port accomodates three 5-mm cannulas or two 5-mm cannulas and a 12-mm port for easier instrument exchange through a single incision. This approach decreases morbidity from bleeding, hernia and/or internal organ damage and improves cosmetic results.One-port single-incision laparoscopy is part of the natural development of minimally invasive surgery. Future research is required to assess the intraoperative and postoperative benefits of LESS surgery as compared to standard laparoscopy.
    Revue Neurologique - REV NEUROL. 01/2010; 34(6):495-499.
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    ABSTRACT: The purpose of this study was to evaluate results and complications of TVT in a large series from different hospital centers in Spain. We retrospectively studied the results of TVT placement from 6 centers with 272 consecutive patients (median follow-up was 636 days). All types of stress urinary incontinence with a surgical indication were included and no previous conditions were established regarding the indication. No protocol was used for either the intervention or postoperative support measures. Data collection was protocolized and carried out using a common questionnaire that was completed by an urologist at each center from 3 to 6 months after the intervention and then annually. All patients who underwent intervention were asked about their satisfaction with the outcome. Multivariate studies were made to identify the factors that influenced the recovery of continence and the occurrence of complications. 92.1% of patients were continent and 2.4% have not shown any improvement. 91.6% of the patients claimed to be satisfied whereas only 2.7% were dissatisfied. After four years only 2.8% of patients showed mild incontinence with time and 0.4% had moderate incontinence. Only previous surgery for incontinence was found to be significantly unfavorable factor for achieving postoperative continence. We have reproduced a scenario closer to daily clinical reality than the results of series from a single institution or analyses using stricter selection criteria. This multicenter study verifies the viability and reproducibility of TVT with minimal complications in centers where patients are not selected and where not all urologists are specialized in urinary incontinence.
    Actas urologicas españolas 01/2005; 29(7):632-40. · 1.14 Impact Factor
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    ABSTRACT: Objective The purpose of this study was to evaluate results and complications of TVT in a large series from different hospital centers in SpainMethod We retrospectively studied the results of TVT placement from 6 centers with 272 consecutive patients (median follow-up was 636 days). All types of stress urinary incontinence with a surgical indication were included and no previous conditions were established regarding the indication. No protocol was used for either the intervention or postoperative support measures. Data collection was protocolized and carried out using a common questionnaire that was completed by an urologist at each center from 3 to 6 months after the intervention and then annually. All patients who underwent intervention were asked about their satisfaction with the outcome. Multivariate studies were made to identify the factors that influenced the recovery of continence and the occurrence of complicationsResults92.1% of patients were continent and 2.4% have not shown any improvement. 91.6% of the patients claimed to be satisfied whereas only 2.7% were dissatisfied. After four years only 2.8% of patients showed mild incontinence with time and 0.4% had moderate incontinence. Only previous surgery for incontinence was found to be significantly unfavorable factor for achieving postoperative continenceConclusion We have reproduced a scenario closer to daily clinical reality than the results of series from a single institution or analyses using stricter selection criteria. This multicenter study verifies the viability and reproducibility of TVT with minimal complications in centers where patients are not selected and where not all urologists are specialized in urinary incontinence
    Actas urologicas españolas 01/2005; 29(7). · 1.14 Impact Factor
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    ABSTRACT: The same as the exfoliative cytology is a routine method to diagnose bladder tumour, the prostatic cytology obtained after massage may become a useful procedure to diagnose prostate cancer. To obtain suitable prostatic cytologic material. To establish the role of the exfoliative cytology to diagnose cancer. We made a prospective longitudinal descriptive study with 60 patients out of 150 (all of them with possible prostate cancer) for two years. We compared cytologic discoveries (urine after massage) with histological parameters (biopsies). When the cytology fulfills a series of requirements (a high number of prostatic cells, anisokariosis and antibodies Ki-67+) and these are compared with the histological data, we obtained a specificity of 100% and a sensibility of 67% for prostatic cancer. With this information the cytology reaches a predictive value of 100% and negative of 92%. It is possible to obtain prostatic cytologic material in a simple and easy way. The prostatic cytology may become a valid and useful method to diagnose the carcinoma of the prostate. Also this material can be used for multiple diagnostic, follow-up and research procedures.
    Actas urologicas españolas 07/2002; 26(6):398-406. · 1.14 Impact Factor
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    ABSTRACT: To study the incidence of "residual/recurrence" tumor after a second bladder resection (2nd TUR). 40 patients with new or recurrent superficial bladder tumor underwent repeat transurethral resection within 3 months after the initial resection. 37 patients were staged as Ta-T1. We study the incidence of tumor after the 2nd TUR both macroscopically detected or included in the bladder scar. We also study the influence of possible factors as the time between both resections, stage, grade, number of tumor size, localization in the bladder, primary or recurrent tumor and tumor pattern. After the 2nd TUR we found tumor in 14 of 37 (37.8%) Ta-T1 bladder tumors. Among the 14 tumors, 10 (71.5%) were macroscopically visible tumors and 4 cases the tumor were found after resection of the bladder scar of the first resection. We did not find relation between the presence of tumor in the 2nd TUR and any of the variables. After a TUR of superficial bladder tumor the complete removal of tumor is not always achieved. The early 3 months cystoscopy may not find residual tumor. Although we have found tumor in 37.8% in the 2a TUR we can not recommend routine 2nd TUR in superficial bladder cancer.
    Actas urologicas españolas 10/2001; 25(8):553-8. · 1.14 Impact Factor
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    ABSTRACT: In this paper, we present a case of huge renal hydatic cyst. We review the literature with regard the clinical presentation, diagnosis methods and surgical technique of treatment.
    Actas urologicas españolas 03/2001; 25(2):129-32. · 1.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The existence of a vesical diverticulum in the context of a congenital connective tissue disorder such as Ehlers-Danlos syndrome led us to consider the possibility of a relationship. Four types of diverticula can be found in the literature: congenital, acquired, iatrogenic and syndrome-associated. Within the later, Ehlers-Danlos syndromes type IV and IX, even type V, are associated to the existence of vesical diverticula. The potential spontaneous rupture of the diverticulum is a typical feature, as well as post-surgery relapse. The attitude towards such diverticula should be one of watchful waiting, and simple, plasty-free diverticulectomy on the bladder's neck is indicated when performing a surgical procedure.
    Actas urologicas españolas 10/2000; 24(8):673-6. · 1.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine the ultrasound characteristics of the vesico-urethral anastomotic complex in patients with radical prostatectomy to separate normal prostate fossae from those affected by local recurrence or residual tumour. Between January 1998 and June 1999 15 ultrasound guided transrectal biopsies of vesico-urethral anastomosis or prostate fossae were performed in patients with radical prostatectomy. The selection criteria to perform puncture in these patients were a negative extension study (abdominal-pelvic CT and bone scan), PSA higher than 0.4 ng/mL and/or suspicious DRE. The study was completed with 10 transrectal ultrasound (TRU) after radical prostatectomy in patients with normal PSA and DRE. TRU parameters in patients with tumour-positive biopsies were compare to those from patients with negative biopsies and those obtained from TRU in patients with both normal PSA and normal DRE. The ultrasound parameters that best described prostate fossa abnormalities were the presence of hypoechoic masses or nodes and the integrity or not of the retro-anastomotic fat layer. When a hypoechoic mass or node was found at the anastomosis level, 80% biopsies were positive for tumour local recurrence. The percentage increases when changes are seen at the retro-anastomotic fat layer. In spite of a good correlation between ultrasound abnormalities and positive biopsies, ultrasound findings from the vesico-urethral anastomosis in patients with radical prostatectomy are not well defined. Nodes or ultrasound irregularities can exist in normal prostate fossae as well as normal anastomosis ultrasound in the presence of tumoral relapses. We believe TRU of vesico-urethral anastomosis to be the best method available to evaluate local recurrence or tumoral persistence after radical prostatectomy.
    Actas urologicas españolas 07/2000; 24(6):481-7. · 1.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Endoscopic approach to the ureter both as a diagnostic procedure in various diseases and treatment of low ureteral lithiasis is a widely used technique. Review of case reports where this technique was used over the last four years. A total of 73 ureteroscopies were conducted, 64 as therapeutic approach (89.04%) and 9 for diagnosis (10.96%) achieving an overall 94.4% success rate. Multiple variables such as type and location of the stones, patient's age and sex, diagnostic methods, length of stay etc. All the above data were used for a descriptive analysis of the situation in our centre. In our experience, ureteroscopy is a good therapeutic option for low ureteral lithiasis, mainly when no extracorporeal lithotrity is available, and an excellent diagnostic tool in other ureteral processes when more traditional methods fail.
    Actas urologicas españolas 07/2000; 24(6):458-62. · 1.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Within the exceptional tumoral pathology of the testis and paratesticular region are the common epithelial type tumors. Although, its histogenesis is under discussion, it has been interpreted as arising from the remnants of the müllerian duct, or from the mesothelium of the tunica vaginalis differentiating in a müllerian direction. Similarities with homologous ovarian tumors are well recognized and in generally we accept a good prognostic due to its low malignant potential or borderline type, more experience with these uncommon lesions is necessary to evaluate their biologic potential.
    Actas urologicas españolas 04/2000; 24(3):256-9. · 1.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: 105 percutaneous nephrostomies in 73 patients. Indication for nephrostomy was obstruction in the drainage system in all cases. Nephrostomy was bilateral in 24 cases. Reasons for nephrostomy were: lithiasis in 35 cases, carcinoma of the bladder in 17, post-surgical iatrogenic stenosis in 13, prostate carcinoma in 9, cancer of the rectum in 9, infection in 5, neoplasia of the upper urinary tract in 5, retroperitoneal fibrosis in 3, glandular cystitis cystica in 3, ovarian cancer in 3, congenital in 2, lymphoma in 1. Six case were single-kidney patients. Renal puncture through the lower calyceal group was the preferred approach. Purulent urine was extracted in 10 cases. Complications of nephrostomy included haematuria in 34 cases, contrast extravasation in 8, fever in 6, 1 case of death due to septic shock, 2 perirenal haematoma (nephrectomy was required in 1 case), and catheter detachment in 5 cases. All patients showed improvement of both clinical signs and symptoms, and lab results.
    Actas urologicas españolas 01/2000; 24(7):568-72. · 1.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cystic-glandular cystitis is considered as part of the urothelial pre-neoplastic proliferative abnormalities. This group includes atypical hyperplasia. Von Brunn's nidus, and cystitis cystica. They are a consequence of the changes experienced at the urothelium level in response to inflammation, irritation or carcinogens. Diagnosis is mainly based in the pathoanatomical study of the biopsy obtained following endoscopic resection. The signs and symptoms it presents are varied and show a clear relationship to distribution and extension of cysts. Treatment is based in the removal of irritative factors. Cystectomy with urinary by-pass may be necessary if required by clinical evolution.
    Actas urologicas españolas 01/2000; 24(7):594-8. · 1.14 Impact Factor
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    ABSTRACT: To report our series of testicular tumors diagnosed from June 1990 to June 1998. The diagnostic protocol, treatment and follow-up are described and data on patient survival over the 8-year period are presented. Our series comprised 21 testicular tumors; 19 germ cell and two non-germ cell tumors. There were 5 seminoma, three pure embryonary carcinoma, two mature cystic teratoma, 9 mixed germ cell tumor and two lymphoma. Treatment was by orchidectomy plus radiotherapy, chemotherapy and some cases were closely followed. All 5 patients with seminoma are currently tumor-free, for a mean survival of 38.6 months. Of the 14 non-seminomatous tumors, there were two deaths; the remaining patients are in complete remission, for a mean survival of 37.5 months. The overall survival rate was more than 95% at a mean follow-up of 48 months. Testicular tumor is one of the most common tumors in young male patients; germ cell tumors are the most frequent type. The different therapeutic regimens currently available have achieved a 5-year survival rate of more than 95%.
    Archivos españoles de urología 04/1999; 52(2):123-31; discussion 132.