Archivos españoles de urología
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Review Case Reports
Persistence of an infected urachus presenting as acute abdominal pain. Case report.
We report a case of urachal remnant disease and review the literature. ⋯ Urachal remnant diseases are rare and they usually present during the neonatal period with fever and wet navel, lower abdominal pain around the middle line, palpable mass and urination symptoms with or without urinary infections. The presentation as acute abdominal pain in an older child is less common, and its differential diagnosis must be performed with other abdominal or pelvic acute diseases. The most appropriate imaging technique is an ultrasound exam.
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Review Case Reports
[Gunshot wound with a bullet lodged in the prostate].
We describe a most unusual urological emergency: a firearm wound in which the blunt-nosed hand-gun bullet was lodged in the prostate. A bibliographic search of the literature revealed no similar case. ⋯ The velocity of a rifle or hand-gun bullet is the main determinant of the severity of this type of injury. As there was no exit wound, we knew that the entrance velocity was low, therefore tissue damage would probably be small. In these cases, a preparatory suprapubic cystostomy is essential to be able to carry out a urethral reconstruction later. Radiological control during the procedure proved extremely useful to precisely locate the bullet. Our conservative approach of simply leaving in place the catheter helped us later to avoid a difficult repair of a recto-urethral fistula.
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Review Comparative Study
[Critical comparative analysis between open, laparoscopic and robotic radical prostatectomy: perioperative morbidity and oncological results (Part I)].
With regard to oncological outcomes and perioperative morbidity, surgical treatment of localized prostate cancer has proved to be an excellent treatment option. At present, there are three different approaches, open, laparoscopic and robotic. Open radical prostatectomy remains the "gold Standard" due to accumulated experience and long follow up of series. But, without a doubt, laparoscopic and robotic groups are contributing with a far from negligible experience. Looking carefully at outcomes we will have to elucidate amongst advantages and disadvantages of each one of them. In this study we have performed a review of the literature trying to compare the three techniques, focusing in available surgical morbidity and oncological outcomes. ⋯ The open surgery has become a reference for all comparisons. The laparoscopic surgery is being replaced (specially in North America) by robotic surgery which is constantly expanding. It is necessary the publication of randomized and prospective studies to be able to objectively compare the three techniques.
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To evaluate the need to perform renal ultrasound (US) in adult patients with acute pyelonephritis (APN). ⋯ The low incidence of ultrasonographic findings does not justify the practice of renal US to every patient with APN. In patients with persistent fever longer than 72 hours, antecedents of anomalies of the urinary tract, antecedents of renal lithiasis, pregnancy, atypical clinic or diabetes mellitus, there is a higher incidence of pathological US findings that justify a change in the therapeutic approach. Further prospective clinical studies are needed to confirm these conclusions.
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Review Case Reports
[Breast metastasis as initial presentation of a renal carcinoma].
To report the case of a breast metastasis as initial presentation of renal carcinoma. ⋯ Breast metastases are exceptional as initial presentation of a renal carcinoma. We performed a bibliographic review on the topic.