Luis Garcia-Aparicio

Hospital Sant Joan de Déu · Servicio de Cirugía

We describe the efficacy of dilation of the ureterovesical junction to treat primary obstructive megaureter. A total of 13 patients with primary obstructive megaureter were treated from May 2008 to December 2010. Of these patients 8 were diagnosed prenatally and the others were diagnosed after a urinary tract infection. Preoperative studies include...

Purpose: The aim of our study is to compare the outcomes of open and laparoscopic pyeloplasty in children less than 12 months of age. Patients and methods: We reviewed all medical charts of patients less than 12 months old who underwent pyeloplasty from January 2007 to February 2013. We divided them in two groups: Open pyeloplasty (OP) and lapar...

To describe the incidence, predisposing factors and management of postoperative vesicoureteral reflux (VUR) after high-pressure balloon dilation to treat primary obstructive megaureter (POM). We have reviewed patients that underwent endoscopic treatment for POM from May 2008 to November 2013. All patients were evaluated with renal ultrasound, voidi...

Objective To compare the radiological and clinical outcomes of endoscopic treatment of primary VUR using polyacrylatepolyalcohol copolymer (PPC-Vantris®) or dextranomer-hyaluronic acid copolymer (Dx/HA-Defux®). Materials and methods From October 2014 to April 2017, patients with primary VUR grade III to V that needed endoscopic treatment (ET) were...

Objectives To study related factors and clinical significance of supranormal function in paediatric patients with pelvi‐ureteric junction obstruction, and to predict which factors cause renal function overestimation. Patients and Methods Patients who underwent pyeloplasty from 2012 to 2017 were prospectively collected. Variables were compared betw...

Purpose High-pressure balloon dilatation (HPBD) of the ureterovesical junction with double-J stenting is a minimally invasive alternative to ureteral reimplantation or cutaneous ureterostomy for first-line surgical treatment of primary obstructive megaureter (POM). The aim of our study was to identify the risk factors associated with the need for s...

Objective: To determine whether sacral transcutaneous electrical nerve stimulation (S-TENS) is an effective treatment in patients refractory to anticholinergic drugs (Achs). Materials and methods: A prospective multi-center study of patients with overactive bladder (OB) refractory to Achs treated with S-TENS from 2018 to 2021 was carried out. S-...

Objective The aim of our study is to compare long-term outcome of endoscopic treatment of VUR using PPC or Dx/HA. Patients and methods From October 2014 to April 2017 patients with VUR grades from 3 to 5 that needed endoscopic treatment were eligible for this RCT. Patients were randomized in two groups: PPC and Dx/HA. A VCUG was performed at 6 mon...

Introduction Anderson–Hynes pyeloplasty is the technique of choice for the treatment of pyeloureteral junction obstruction (PUJO) with an excellent success rate. Minimally invasive surgery has become the standard of care for the management of PUJO in children. Although it has been comparable to the open approach at all levels, its diffusion or empl...

Purpose The Anderson-Hynes technique has been the treatment of choice for primary ureteropelvic junction obstruction in children. Laparoscopic approach has shown similar outcomes to open, with advantages of shorter hospital stay and less pain. We reviewed the experience of 11 geographically diverse, tertiary pediatric urology institutions focusing...

Objetivo: Presentar dos casos con duplicación uretral, los cuales se resolvieron mediante cirugía. Descripción de los casos: Fueron dos varones de tres y cuatro años de edad, con duplicación uretral tipo IA de acuerdo con clasificación de Effmann. Ambos se trataron con cirugía mediante exéresis de la uretra accesoria. Conclusión: La duplicación u...

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the s...

Introduction: The aim of the study was to compare 3 mm mini-laparoscopy (mini LP), standard 5 mm laparoscopy (LP) and open surgery for pediatric pyeloplasty in a single center. Methods: Patients who underwent pyeloplasty from 1997 to 2017 at Hospital Sant Joan de Déu were prospectively collected. Demographic data, clinical, surgical and radiolog...

Introduction: Since the first case of dextranomer/hyaluronic acid (Dx/HA) implant calcification in 2008, concern about the long-term sequelae of Dx/HA injection has been growing. According to previous reports, the incidence of Dx/HA calcification 4 years after injection would be around 2%. Aim: The primary aim was to estimate the incidence of Dx/HA...

Introducción El término «criptorquidia» se refiere a la ausencia del testículo en la bolsa escrotal. Es la anomalía genital más frecuente en el varón y afecta aproximadamente al 1% de los niños de 1 año nacidos a término. La incidencia depende de la edad, ya que el descenso testicular desde el abdomen hasta el escroto se completa en el tercer trime...

Objective. To analyze whether the application of laparoscopic surgery in the treatment of pyeloureteral junction obstruction (PUJO) has been beneficial for pediatric patients. Materials and methods. Medical records of all patients undergoing PUJO surgery from January 1997 to December 2017 were retrospectively reviewed. Patients with <6-month follow...

Material y métodos: Estudio descriptivo de las pacientes operadas de prolapso uretral desde 1992 a 2018 de los últimos seis años. Resultados: Se intervinieron cinco pacientes de prolapso uretral. La edad estuvo entre los dos y ocho años. El motivo de consulta fue sangrado. Dos de las cinco presentaron como antecedente reciente infección de vías re...

Hipospadias proximales reparados en un único tiempo. Lecciones aprendidas tras 196 intervenciones primarias VoL. 32 nº 4, 2019 Resumen Introducción y objetivo. Los hipospadias peneanos proximales, escrotales y perineales son un reto para el cirujano. Tras toda una carrera dedicada a los hipospadias, la autora principal del trabajo resume su experie...

Purpose: Proximal, scrotal and perineal hypospadias challenge the surgeon. After 40 years devoted to hypospadias surgery, the senior author summarizes her experience, share her tricks and shows that almost any hypospadias can be fully repaired in one surgery. Methods: Retrospective review and discussions of a large series of consecutive proximal...

Introduction: Congenital anomalies are the 5th leading cause of death in children under 5-years of age globally, contributing an estimated half a million deaths per year. Very limited literature exists from low- and middle-income countries (LMICs) where most of these deaths occur. The Global PaedSurg Research Collaboration aims to undertake the fir...

Introduction Congenital anomalies are the fifth leading cause of death in children <5 years of age globally, contributing an estimated half a million deaths per year. Very limited literature exists from low and middle income countries (LMICs) where most of these deaths occur. The Global PaedSurg Research Collaboration aims to undertake the first mu...

Background: Proximal hypospadias, especially those associated with penoscrotal transposition, are the most complex to repair. Despite the popularity of two-staged procedures, the authors believe that almost any hypospadias can be repaired in one surgery, mastering a few techniques and concepts.

Introduction Some guidelines recommend an early voiding cystourethrography (VCUG) after endoscopic treatment of vesicoureteral reflux (VUR), but there is no consensus if it is necessary a long-term follow-up in these patients. The aim of our study is analyze if it is necessary a delayed VCUG after initial successful treatment with Dx/HA. Material...

Renal ischemia-reperfusion injury is a major cause of acute renal failure, causing renal cell death, a permanent decrease of renal blood flow, organ dysfunction and chronic kidney disease. Platelet-rich plasma (PRP) is an autologous product rich in growth factors, and therefore able to promote tissue regeneration and angiogenesis. This product has...

Introduction: Some guidelines recommend an early voiding cystourethrography (VCUG) after endoscopic treatment of vesicoureteral reflux (VUR), but there's no consensus if it's necessary a long-term follow-up in these patients. The aim of our study is analyze if it's necessary a delayed VCUG after initial successful treatment with Dx/HA. Material a...

Rubinstein–Taybi syndrome (RTS) is a chromosomopathy associated to molecular mutations or microdeletions of chromosome 16. It has an incidence of 1:125,000–700,000 live births. RTS patients present craniofacial and thoracic anomalies that lead to a probable difficult-to-manage airway and ventilation. They also present mental retardation and comorbi...

We report the successful use of fetoscopy to treat a case of prolapsed ureterocele in a female fetus. A diagnosis of a double renal system with an intravesical ureterocele was performed at 21 weeks' gestation. Follow-up exams showed that the ureterocele was obstructing the bladder outlet causing severe megacystis, bilateral hydronephrosis and progr...

Objective To determine the incidence of urinary tract infection in those patients that we have used an ureteral double-J stent as internal diversion after urological procedures. Material and methods We reviewed all the medical records of patients who had a ureteral double-J stent after a urological procedure from August 2007 to May 2013. We have a...

Objective: To determine the incidence of urinary tract infection in those patients that we have used an ureteral double-J stent as internal diversion after urological procedures. Material and methods: We reviewed all the medical records of patients who had a ureteral double-J stent after a urological procedure from August 2007 to May 2013. We ha...

We report the successful use of fetoscopy to treat a case of severe low urinary tract obstruction (LUTO) secondary to a congenital megalourethra. A second trimester male fetus presented at 21 weeks of gestation with massive dilatation of the penile urethra. In addition, bilateral hydronephrosis, an enlarged and hypertrophic bladder, with progressiv...

Dystrophic epidermolysis bullosa (DEB) is a rare inherited disorder characterized by blistering after minimal trauma. These blisters tend to form dystrophic scars, leading to limiting and life-threatening sequelae.

Dystrophic epidermolysis bullosa (DEB) is a rare inherited disorder characterized by blistering after minimal trauma. These blisters tend to form dystrophic scars, leading to limiting and life-threatening sequelae. The anaesthetic management of patients with DEB is a challenge, even for the most experienced anaesthesiologists, but basic principles...

To evaluate the outcome of kidney transplantation in children with low weight. Retrospective review of the medical records of patients weighing 11 kg or less that received kidney transplantation between 2001 and 2013 were retrospectively reviewed. Fifty-nine kidney transplantations were performed in pediatric patients in our center, 12 of them were...

Background: Our aim is to evaluate the tolerance to pneumoperitoneum of pediatric patients during laparoscopic renal surgery and to determine the risk factors of perioperative complications. Methods: From January to November 2013, we collected ventilatory, hemodynamic and temperature data, before and during insuf flation, of all patients undergoing...

Objective: To compare the outcomes between high-pressure balloon dilatation (HPBD) of the ureterovesical junction and the ureteral reimplantation with ureteral tapering to treat primary obstructive megaureter. Patients and methods: Retrospective review of clinical data from patients who underwent surgical treatment of POM from 2005 to 2010. Patient...

To compare outcomes between high-pressure balloon dilatation of the ureterovesical junction (UVJ) and ureteral reimplantation with ureteral tapering to treat primary obstructive megaureter (POM). Retrospective review of clinical data from patients who underwent surgical treatment of POM from 2005 to 2010. Patients were divided into two groups: endo...

Purpose: To compare efficacy of Cohen's ureteral reimplantation and endoscopic treatment with Dx/HA in patients with primary VUR grades II, III and IV. Methods: From April 2002 to June 2004, patients over 1 year old with VUR grade I, II, III or IV were included. Patients were randomized into two groups: endoscopic treatment (ET) or ureteral reim...

Objective: To present our cases of ureteral obstruction after endoscopic treatment of vesicoureteral reflux (VUR) with dextranomer/hyaluronic acid (Dx/HA). Patients and methods: We collected data from patients who had suffered ureteral obstruction after endoscopic treatment of VUR with Dx/HA in our institution. Results: From April 2002 to Apri...

To analyze if the laparoscopic pyeloplasty is as effective as the open procedure in the ureteropelvic junction obstruction in patients under 2 years of age. Pyeloplasties performed in children under 2 years of age between 2007 and 2010. Weight, pre and postoperative renal pelvis and calices diameter, operating time, hospital stay and complications...

Purpose: Endoscopic treatment has become the treatment of choice in vesicoureteral reflux (VUR), but there are not randomized trials comparing efficacy of endoscopic treatment and Cohen’s procedure. This is the first randomized clinical trial that answer the question of long-term outcome of endoscopic treatment of VUR. Methods: From April 2002 to...

Lower urinary tract tumours are uncommon in paediatrics. Transitional cell carcinoma of the bladder (TCCB) is rarely found in the first two decades of life and is exceptional under 10 years of age. The present series aimed to expand the number of reported cases in the literature. In 1984-2007, six patients (four male, two female), aged 6, 9, 12, 13...

Objective To analyze the initial experience in our first patients with ureteropelvic junction obstruction (UPJO) treated by laparoscopic surgery.Patients and methodsAll laparoscopic Anderson-Hynes pyeloplasties performed from July 2007 to April 2009 were analyzed. Before surgery, patients underwent a renal ultrasound and isotope renogram. A double...

To analyze the initial experience in our first patients with ureteropelvic junction obstruction (UPJO) treated by laparoscopic surgery. All laparoscopic Anderson-Hynes pyeloplasties performed from July 2007 to April 2009 were analyzed. Before surgery, patients underwent a renal ultrasound and isotope renogram. A double J catheter was left in place...

This study aimed to establish a comparison between the data obtained in the renal functional study through magnetic resonance using gadolinium with diuretic (furosemide) charge (MR-Gd/F), on the one hand, and the parameters obtained with the classical diuretic renogram (DR) (differential renal function -DRF- and renographic curve -RC-), on the othe...

To report our experience of laparoscopic heminephroureterectomy (Hnu) in pediatric patients with duplex anomalies, in comparison to open surgery. Retrospective review of data from patients who underwent Hnu from 2005 to 2008 was performed. The patients were divided into two groups: laparoscopic (LHnu) and open surgery (OHnu). Laparoscopic surgery w...

Malakoplakia is a rare chronic inflammatory disease that was originally described in the urinary bladder but can involve many other organs and soft tissues. It is believed to be caused by an alteration in the bacterial phagocytic system. Clinically, it is described as single or multiple tumors that can appear in any part of the body. Histologically...

Median raphe cysts of the perineum are uncommon congenital lesions of the male genitalia. They can be found all the way from the distal penis and scrotum toward the perineum in a midline position. They are considered as congenital alterations in embryologic development. A case of a 6 year-old boy is presented. Review of the literature relevant to c...

The aim of this paper is to analyze our experience in different surgical techniques to perform a nephrectomy for benign renal diseases in children. From 1993 to 2005 we have performed 98 nephrectomies. We have three groups of patients depending on the surgical technique: open nephrectomy (ON), transperitoneal laparoscopic nephrectomy (TLN) and retr...

Intestinal perforations in the neonatal period are usually related to necrotizing enterocolitis (NEC) or intestinal occlusion. Intestinal perforation in the absence of these conditions is called isolated perforation (IP). Several risk factors and pathogenic mechanisms have been suggested, and most of them are common to those classically attributed...

Continent urinary diversion (based on Mitrofanoff's principle), despite its complexity, is the gold standard in the treatment of those vesicourethral disfunctions that need clean intermittent catheterization (CIC) to achieve complete vesical voiding, in patients with non easily catheterizable native urethra. To analize our experience in continent u...

The aim this study was to demonstrate the utility and suitability of octyl-2-cianocrylate in cutaneus repair of different conditions in the pediatric population. Octyl-2-cianocrylate is a topical tissular adhesive which can be used on skin and which has been tested in surgical practice as a wound sealant, avoiding the use of conventional sutures. W...

Objective The aim this study was to demonstrate the utility and suitability of octyl-2-cianocrylate in cutaneus repair of different conditions in the pediatric population. Octyl-2-cianocrylate is a topical tissular adhesive which can be used on skin and which has been tested in surgical practice as a wound sealant, avoiding the use of conventional...

Retroperitoneal laparoscopy is well known as a surgical technique in adult patients. Its use in pediatric surgery is still-recent but, because of the good results, retroperitoncoscopy indications are getting more acceptance and widening indications. The aim of this work is to analyze our initial experience in retroperitoneal laparoscopy procedures...

Laparoscopic is performed in adults for the treatment of benign renal diseases. It is widely accepted that laparoscopic surgery has more advantages than open surgery in many procedures such as nephrectomy, but there is no further experience in this technique. In pediatric urology laparoscopy has become an accepted approach for varicocele, non palpa...

Iatrogenic bronchial complications in intubated premature infants are rare. The authors present one case of rupture of a closed-tube endotracheal suction catheter. Clinical presentation was a persistent pneumothorax that required chest tube placement in several days. A foreign body was confirmed in x-ray and computed tomography (CT) scan. Flexible...

Prepubic sinuses are rare congenital anomalies of the urinary tract. There have been few case reports in the literature. The authors describe 2 clinical cases of this entity. A review of the 20 cases previously reported, to clarify the anatomic features and the embryology of this infrequent congenital anomaly, also is reported. Furthermore, the aut...

Laparoscopic approach to surgical procedures in children is used in different diseases, but there are some controversies for using this technique in the splenectomy. Laparoscopic surgery decreased pain, postoperative ileus and the hospital stay; and improve cosmetics, the most important disadvantage is the longer operating time. Splenectomy is indi...