bluuebunny/crossref_metadata_2025 huggingface dataset:
El poder de las redes sociales en urología. Panorama actual del gremio de residentes de la Sociedad Mexicana de Urología (SMU)
Authors: Sánchez-Núñez Juan Eduardo , Cabrera-Mora Norma Alejandra , Magaña-González Jorge Esteban , Rosas-Nava Jesús Emmanuel , Jaspersen-Gastélum Jorge , Acevedo-García Christian
Published: February 2022

Introduction: Social networks enable their users to create, share, comment on, and transfer multimedia among millions of internet users in real time. The urology social media hashtag, #UroSoMe, provides an excellent opportunity to find and exchange health information.

Objective: To evaluate the current situation in relation to #UroSoMe among the community of urologists in training associated with the Sociedad Mexicana de Urología (SMU), a highly relevant Mexican professional organism.

Materials and methods: : A descriptive, cross-sectional study was conducted by means of an online survey on the sociodemographic characteristics of social media users and their associated perceptions and use of social media. Fifty-two questionnaires were completed.

Results: A total of 80.8% (n=42) of those surveyed were men and 19.2% (n=10) were women. Facebook ® (78.8%) and Instagram ® (51.9%) were the favored social networks utilized for social communication among residents and 78.8% (n=41) used them personally (for leisure) and professionally.

Discussion: #UroSoMe is useful in urologic activity, especially from the perspective of communication and connectivity among professionals.

Conclusions: Social networks have become a tool for healthcare professionals to communicate with one another. Urology residents associated with the SMU find them useful for keeping updated and establishing professional connections. Safeguarding the quality, security, and correct use of information shared on social media is a great challenge.
Incidencia y características clínicas de pacientes con tuberculosis genitourinaria durante el período 2003 a 2019 en un centro hospitalario de tercer nivel.
Authors: Gallegos-Sánchez Gustavo , Rosales-Velázquez César Eduardo , Ruvalcaba-Oceguera Guillermo Enrique , Aragón-Castro Marco Antonio , Gutiérrez-Rosales Rubén , Ordoñez-Jurado Aldo Uriel
Published: February 2022

Objective: To evaluate the incidence, clinical characteristics, and treatment of genitourinary tuberculosis (GUTB) in adult patients at our hospital, within the time frame of 2003-2019.

Design and methodology: A retrospective study was conducted on 18 patients (11 men and 7 women). The inclusion criteria were patients >18 years of age with GUTB (ICD-10-CM Diagnosis Code A18.1) that were hospitalized and treated at the Centro Médico ISSEMyM Toluca, within the period of January 2003 to December 2019.

Results: Renal tuberculosis was found in 7 patients and bladder tuberculosis in 3. Testicular, prostate, and ovarian tuberculosis were each found in 2 patients, one case presented with ureteral tuberculosis, and one case with adrenal gland tuberculosis. Mean patient age was 44.1 years (range: 23-79 years). Men accounted for 61.1% of the patients and women, 38.9%. Mean time from symptom onset to clinical diagnosis was ≥12 months (50%). Signs and symptoms: fever (61.1%), hematuria (55.6%), weakness (44.4%), lumbar pain (38.9%), weight loss (38.9%), and irritative symptoms of the urinary tract (33.3%). Diagnoses were confirmed through bacteriologic (55%), histopathologic (83%), and molecular (11%) methods. Urologic or gynecologic intervention was required in 100% of the patients. The standard 4-drug treatment was the preferred regimen (88.9%) and mean treatment duration was 11 ± 2 months. There were no posttreatment-related deaths.

Limitations: A retrospective study with a small number of patients.

Originality or value: To know the epidemiology of GUTB at our hospital center to improve the evaluation approach to patients and make opportune diagnoses, in an effort to reduce morbidity and mortality.

Conclusions: The early approach to GUTB is extremely important for ruling it out, treating it opportunely, and reducing permanent damage and death as much as possible.
Fístula arteriovenosa como complicación de nefrolitotomía percutánea en paciente con riñón en herradura
Authors: Pulido-Contreras Enrique , Medrano-Sánchez Javier , González Villegas Hedler Olaf , Bautista López German
Published: February 2022

Clinical case description: A 48-year-old man had a history of giant platelet disorder and diagnosis of horseshoe kidney with kidney stones. Standard 24 Fr percutaneous nephrolithotomy was performed. Ten days after surgery, the patient presented with clot-forming gross hematuria, resulting in anemia. Arteriovenous fistula was suspected and evaluation at the interventional cardiology service was ordered. Arteriovenous fistula diagnosis was confirmed and superselective embolization was performed in the anterior and posterior segmental artery, with complete resolution of the hematuria.    

Relevance: To present the uncommon, post-percutaneous nephrolithotomy complication of hematuria secondary to arteriovenous fistula that was resolved through a minimally invasive technique in a patient with a kidney fusion anomaly.

Clinical implications: To take measures in that patient group to reduce what can be a life-threatening complication, managing it through superselective embolization to prevent kidney function deterioration.

Conclusions: Color Doppler ultrasound-guided percutaneous access aids in the prevention of injury to the renal vasculature during puncture and the use of miniaturized tracts can reduce the development of segmental artery lesion that could later condition fistula formation. Embolization is safe and effective in that group of patients.
Confounding bias in the association between marijuana use and testicular germ cell tumors
Authors: García-Perdomo Herney Andrés , Davila-Raigoza Angelica Maria
Published: February 2022

Regarding the manuscript written by Ghasemiesfe et al. "Association Between Marijuana Use and Risk of Cancer: A systematic review and meta-analysis" and published in the JAMA Network Open journal, we would like to make some comments.
Antimicrobial resistance and extended spectrum beta-lactamases in urinary tract infections: A serious problem in Northern Mexico
Authors: Robles-Torres José Iván , Ocaña-Munguía Marco Alberto , Madero-Morales Pedro Antonio , Ruíz-Galindo Efraín , Garza-González Elvira , Gómez-Guerra Lauro Salvador
Published: February 2022

Objective: To describe the causal agents, prevalence of antimicrobial resistance, and risk factors associated with extended spectrum beta-lactamase (ESBL)-producing agents in urinary tract infections (UTIs).

Materials and methods: A retrospective study was conducted at a tertiary care hospital in Monterrey, Mexico. Inclusion criteria were patients that clinically presented with a UTI and had a positive urine culture, within the time frame of March to October 2017. The association with ESBL-producing agents was determined through the Χ2 test for categorical variables. Statistical significance was set at a p <0.05, utilizing SPSS version 20.0 software.

Results: A total of 353 positive urine cultures were confirmed. ESBL production was found in 21.5% of the strains. There was a high level of resistance (>50%) to amoxicillin-clavulanate, ciprofloxacin, levofloxacin, fosfomycin, and trimethoprim-sulfamethoxazole and moderate resistance (10-50%) to gentamicin and ceftriaxone. Amikacin, ertapenem, nitrofurantoin, and colistin had the lowest resistance rates (<10%). The ESBL-producing agents were associated with complicated UTI (p≤0.0001). The comorbidities associated with ESBL-positive UTIs were diabetes mellitus (p=0.02) and immunodeficiency (p=0.008), as was having undergone radiotherapy (p=0.025) and previous antibiotic use (p≤0.001).

Limitations: The clonal relationship of isolates, especially of E. coli, was not analyzed. We could not establish whether there was a high level of genetic diversity between the isolates or whether independent acquisition or cross-transmission occurred.

Value: We evaluated the epidemiologic characteristics of the ESBL-producing agents in UTIs at a Mexican tertiary care hospital.

Conclusions: One out of every five UTIs was caused by ESBLs in our study population. There was a high level of resistance to the antibiotics used as first-line empiric therapy in the patients studied.
Acute bacterial nephritis. A descriptive study of an underdiagnosed entity
Authors: Madero-Morales Pedro Antonio , Pallares-Méndez Rigoberto , Romero-Mata Rodrigo , Vizcarra-Mata Guillermo , Guillén-Lozoya Andrés
Published: February 2022

Background: Acute bacterial nephritis is an infectious process diagnosed through imaging studies. The clinical course of the disease has been shown to be more aggressive than acute pyelonephritis. It continues to be underdiagnosed, thus there are few studies on the entity in the literature.

Objective: To describe the clinical characteristics and imaging features of acute bacterial nephritis, as well as its clinical course.

Design: A descriptive, retrospective case series was conducted.

Materials and methods: Thirty-two cases of acute bacterial nephritis in patients admitted to the hospital within the time frame of 2009 to 2016 were reviewed. The patients’ clinical characteristics upon admission were registered, as well as inpatient clinical progression, culture results, and antibiotic therapy response. The imaging studies were re-evaluated and the diagnostic consistency with either the focal or multifocal disease presentation was confirmed.

Results: Cases predominated in women (n=29, 90.62%) and the most frequently associated comorbidities were diabetes (n=16, 50%) and obesity (n=9, 28.25%). The most important clinical findings upon admission were fever (n=15, 46.87%) and leukocytosis (n=27, 84.38%). Escherichia coli was the most commonly isolated bacterium (63.63%). Both acute focal bacterial nephritis and acute multifocal bacterial nephritis were observed in 46.87% (n=15) and 53.13% (n=17) of the patients, respectively. Imaging studies were required for all diagnoses.

Conclusion: Fever and leukocytosis are the main findings in acute bacterial nephritis. Imaging studies are necessary for making the diagnosis, given that acute pyelonephritis and acute bacterial nephritis cannot be clinically differentiated.
Nefrectomía parcial laparoscópica y asistida por robot en pacientes con tumor renal
Authors: Soto-Vázquez Teresita , Almeida-Magaña Ricardo , Villeda-Sandoval Christian Isaac
Published: February 2022

Background: Kidney cancer accounts for 2% of cancer deaths in Mexico. Partial nephrectomy has become the treatment of choice for renal tumors <4cm and can be carried out utilizing minimally invasive techniques.

Aim: To describe the perioperative, oncologic, and follow-up characteristics of patients that underwent partial laparoscopy with the robotic-assisted or laparoscopic approach at our hospital center.

Methods: A descriptive, retrospective cases series was conducted on patients that underwent minimally invasive partial nephrectomy at the Centro Médico Naval, within the time frame of February 2016 to February 2019.

Results: Sixteen patients had a BMI >25 kg/m2, initial creatinine was 0.97mg/dl, surgery duration was 202 minutes, blood loss was 300 ml, and 13 patients underwent warm ischemia, for a median of 24 minutes. Hospital stay was 3 days, 2 patients presented with complications, and serum creatinine at day 30 was 1.05 mg/dl. The 17 patients that presented with cancer all had clear cell renal cell carcinoma. Thirteen of those patients had nuclear grade 2 and 3 had positive margins.

Conclusions: Our good short-term oncologic and functional results were similar to those reported in the international literature. Comparison with the national literature is difficult, given the lack of studies employing the robotic approach.
Recurrencia de estenosis ureteropiélica posterior a tratamiento primario: prevalencia, factores asociados y tratamiento laparoscópico
Authors: Gonzalez-Cuenca Eduardo , Medrano-Urtecho Harvey Mauricio , Corona-Montes Víctor Enrique , Maldonado-Ávila Miguel , Rosas-Nava Jesús Emmanuel
Published: February 2022

Aim: Our primary aim was to report the prevalence of recurrent stricture following primary pyeloplasty and the secondary treatment performed. The secondary aim was to identify the clinical or surgical factors related to recurrent ureteropelvic junction obstruction (UPJO). 
Materials and methods: A retrospective study was conducted on patients diagnosed with UPJO at the Hospital General de México “Dr. Eduardo Liceaga”, between 2011-2019. Patients that underwent primary pyeloplasty, and developed recurrent UPJO, underwent secondary treatment, and had follow-up ³6 months were included in the study. A descriptive analysis was carried out.
Results: A total of 52 patients underwent open or laparoscopic pyeloplasty as primary treatment and 6 of them (11.5%) presented with recurrent UPJO at 44 months (median). Two of those patients presented with a non-functioning kidney and underwent simple laparoscopic nephrectomy and the remaining 4 patients underwent transperitoneal laparoscopic redo pyeloplasty as secondary treatment. The mean age of the patients with recurrence was 46 years, their mean BMI was 32.57±5 kg/m2, and two of them had urinary diversion prior to the primary pyeloplasty. Surgery duration was longer for laparoscopic redo pyeloplasty versus primary pyeloplasty (192 minutes versus 113 minutes) and intraoperative bleeding was similar (52cc versus 52.9cc). The surgical and histologic finding in laparoscopic redo pyeloplasty was peri-ureteral fibrosis. No aberrant vessels were found. Stricture was longer than 15 mm in the patients that underwent laparoscopic redo pyeloplasty (n=4). Obesity, lithiasis, and stricture length >15mm were more frequent in the patients with recurrence. 
Conclusions: The prevalence of UPJO in our study population was 11.5%, which concurs with international parameters. Laparoscopic redo pyeloplasty is a useful tool in cases of UPJO.
COVID-19 (SARS-CoV-2): el legado de la enfermedad a la urología
Authors: Sánchez-Núñez Juan Eduardo , Reyes-Vallejo Luis Antonio , Rosas-Nava Jesús Emmanuel
Published: February 2022

Will we have the individual and collective capacity to restore “normality” in Urology? History dictates that we will overcome, and despite the great negative impact the disease will have, not only will medicine prevail, but there will also be an excellent opportunity for reinvention and evolution.
Urología en tiempos de COVID-19: aprender a adaptarnos
Authors: Reyes-Vallejo Luis Antonio
Published: February 2022

La medicina moderna es una celebración de la curiosidad y el ingenio humano. El descubrimiento de agentes patógenos y la investigación genética cambiaron profundamente nuestra comprensión de las enfermedades y el desarrollo de sus tratamientos.
Radium 223 en tiempos de COVID-19
Authors: Barreiro Diego , Mena-Cortes Danny Roberto
Published: February 2022

Contexto clínico

Para el tratamiento del cáncer de próstata resistente a la castración (CPRC) metastásico se deben utilizar tratamientos que proporcionen beneficio en sobrevida global.

Los pacientes metastásicos sensibles a castración recibirirán tratamientos hormonales de segunda generación o taxanos.  Aproximadamente el 80% de estos pacientes son tratados con hormonas de última generación.
Etiology of testicular pain 2019: Classification into ten logical subgroups
Authors: Uribe-Arcila Juan Fernando , Delgado-Montoya Andrés , Gaviria-Gil Federico
Published: February 2022

Background: Testicular pain encompasses a vast medical diagnostic field, with numerous organ and system convergence. Acute testicular pain is a medical emergency that requires accurate evaluation and immediate resolution, whereas chronic testicular pain is enigmatic and requires sound knowledge of the mechanisms of testicular pain and the differential diagnosis.
Objective: To review the causes of testicular pain and propose a new etiologic classification consisting of 10 subgroups.  
Methods: A bibliographic search was carried out utilizing Google and the National Library of Medicine’s PubMed databases to identify original articles and review articles (hard copy or electronic) published on testicular pain, up to March 2020. The search included: MeSH terms: testicular disease (classification, complications, etiology, trauma, microbiology, pathology, pathophysiology, secondary, surgery, treatment) and vasectomy; Non-MeSH terms:  acute and chronic orchialgia, scrotalgia, orchidynia, groin pain, epididymalgia, testalgia, chronic testicular pain, chronic scrotal pain syndrome, testicular pain syndrome, epididymal pain syndrome, and post-vasectomy pain syndrome. The initial search produced 625 articles, of which 143 were included in the present review.
Results: To better understand testicular pain etiology, 100 possible diagnoses were divided into ten subgroups: infectious, neoplastic, traumatic, torsional, vascular, immunologic, neurologic, pharmacologic, obstructive, and miscellaneous causes.  Likewise, treatment can be divided into two main groups, according to therapeutic options: pharmacologic and non-pharmacologic, with the latter subdivided into: noninvasive and the increasingly performed invasive (surgical) alternatives.
Conclusions: Testicular pain should be understood as a complex pain syndrome of enigmatic origin. Treatment success depends on the correct identification, from hundreds of possibilities, of the cause of pain. Logical grouping of those possibilities could aid in making the accurate etiologic identification.
Virus del papiloma humano (VPH): microbiología, relación con el cáncer de pene y características de la vacuna
Authors: Rengifo-Rodríguez Javier Eduardo , Osorio Julio César , García-Perdomo Herney Andrés
Published: February 2022

Over the past two decades, human papillomavirus (HPV) has been an important object of study due to its causal relation to cervical cancer and its association as a risk factor for anogenital neoplasias, especially penile cancer (PC). 

The molecular study of HPV and the identification of essential proteins led to the development of the vaccine, and a clear epidemiologic relation between HPV and PC has also been identified.  With respect to the molecular aspect of that association, the alteration of the P16 cellular pathway by the oncoproteins of the virus is evident, but it is not thought to be the only pathogenic mechanism. The vaccine appears to be effective in preventing HPV infection but there is not sufficient evidence that it protects against PC.

Therefore, more research is needed, both in the clinical area, to determine whether the vaccine is definitively effective/efficacious in the prevention of PC, and in molecular biology, studying the molecular mechanisms involved in the pathogeny of that neoplasia.
Efectos de la toxina botulínica sobre la porción glandular de la próstata: fundamentos fisiopatológicos, mecanismo de acción y evidencias
Authors: Piamo Morales Alberto , Ferrer Marrero Daisy
Published: February 2022

Botulinum toxin is a potent neurotoxin that inhibits neuromuscular junctions by blocking the release of acetylcholine and desensitizes sensory nerves. In the prostate, it effects are not limited to the neuromuscular junction, but also affect the neuroglandular junction, placing the intraprostatic injection of botulinum toxin among the new treatment options for benign prostatic hyperplasia. Considering its potential as an effective therapy in prostate conditions, while at the same time its mechanisms of action are not clear, the aim of the present review was to organize the current evidence and describe the currently known pathophysiologic bases and mechanism of action involved to encourage new research. After conducting the review of the evidence, it was concluded that botulinum toxin could induce involution of the prostate in rats, dogs, and humans, without causing local inflammation or significant systemic side effects, suggesting the possibility of its use in benign or malignant prostate lesions.
Angiomiolipoma hemorrágico espontáneo asociado a esclerosis tuberosa que conduce a nefrectomía urgente – Reporte de un caso y revisión de la literatura
Authors: Gallegos Sánchez Gustavo , Rosales-Velázquez César Eduardo , Ruvalcaba-Oceguera Guillermo Enrique , Aragón Castro Marco Antonio , Gutiérrez Rosales Rubén , Velázquez Morales Igor Octavio , Ochoa Gutiérrez Hugo Enrique , Ordoñez Jurado Aldo Uriel , Montaño Roca Benjamín Enrique
Published: February 2022

Description: A 34-year-old woman came to the emergency department presenting with moderate abdominal pain in the right hypochondrium (of 3-hour duration), accompanied by hematuria and progressive and painful abdominal distention. A tomography scan revealed a 14 cm heterogenous solid tumor in the right kidney, with intratumoral bleeding. She was given a blood product transfusion due to low hemodynamic output and kept under surveillance. Hemoglobin levels continued to descend, reaching 7.2 g/dl, and so the patient underwent emergency selective angioembolization, and the bleeding temporarily stopped. The hematuria reappeared and the patient went into hypovolemic shock, leading to the definitive surgical treatment of total nephrectomy. Her recovery was uneventful. The histopathologic study reported renal angiomyolipoma with extensive bleeding.

Relevance: Wunderlich syndrome (angiomyolipoma with spontaneous bleeding) is a rare entity whose most severe and undesirable complication is refractory bleeding, which can be fatal.

Clinical implications: Early intervention in patients with hemorrhagic angiomyolipoma is important for preventing potentially life-threatening complications, such as massive bleeding.

Conclusions: In cases of angiomyolipoma with intratumoral bleeding and symptoms of Wunderlich syndrome, total nephrectomy is the best option, after conservative management and/or selective angioembolization, for saving the life of the patient.
Bruceloma Renal: A propósito de un caso
Authors: Muñiz-Suárez Laura , Hijazo-Gascón Daniel , Asensio-Matas Agustín , Gayarre-Abril Paula , Montero-Martorán Aida , Subirá-Ríos Jorge , Elizalde-Benito Francisco Xavier
Published: February 2022

Clinical case description: A patient in regular contact with cattle and sheep presented with asthenia, anemia, and fever of unknown origin. Among the complementary studies carried out, an abdominal CT scan revealed a calcified renal mass. Brucellosis was suspected, and after a positive Bengal Rose test, antibiotic therapy was begun. Right nephrectomy was performed through lumbotomy and the diagnosis was confirmed by the surgical specimen, with a PCR test positive for Brucella melitensis.

Relevance: There are very few cases of renal brucelloma reported in the literature, thus the description of cases that arise is important to broaden the knowledge of the pathology and its treatment.

Clinical implications: Noninvasive tests are often not sufficient for making the diagnosis. The surgical approach, together with antibiotic therapy, is the treatment of choice in the majority of the cases reported in the literature.

Conclusions: Brucellosis is an uncommon disease, but endemic in certain areas. Diagnosis tends to be made in the context of evaluating cases of fever of unknown origin.  The combination of antibiotic therapy and surgery is the usual treatment for renal brucelloma.
Tratamiento de la litiasis coraliforme con Litroticia extracorpórea por ondas de choque. Análisis de nuestra serie en 20 años
Authors: Hernández-Alcaraz David , Molina-Díaz Patricia , Caballero-Cobos Rocío
Published: February 2022

Objective: To evaluate the effectiveness and complications of treatment with extracorporeal shock wave lithotripsy (ESWL) for staghorn stones.

Design: A retrospective observational study on staghorn stones treated with ESWL at the Hospital Regional Universitario de Málaga, between 1990 and 2010.

Results: The study included 157 patients (136 women and 21 men) that underwent ESWL for staghorn stones. Mean number of sessions for fragmentation was 3.39± 1.94, mean number of waves was 10,066.67±6,182.96, mean intensity was 16.24±12.37, mean accumulated energy was 402.69±182.07, and mean resolution time was 7.59±7.97 months. Of the patients analyzed, 106 were stone-free and 51 had small residual fragments. Only 12 patients had stone recurrence. The mortality rate was 0%. Ten percent of the patients had type IIIb Clavien-Dindo complications, 18% had type IIIa, and 3.31% had type II. The effectiveness quotient (Clayman et al.) was 0.49, if needing more than one session was considered retreatment, and 0.71, if all sessions were considered a single treatment.

Study limitations: Given the retrospective, observational study design, the conclusions were relative, due to the heterogeneity between patients regarding urinary tract morphology, stone size, and stone composition.

Originality or value: ESWL in patients with multiple comorbidities is an alternative to surgery.

Conclusions: Even though ESWL is not the treatment of choice for staghorn stones, it is a valid option in selected cases, depending on availability at the center and/or experience of the urologist.
Manejo conservador en trauma renal contuso. Algunas recomendaciones para recordar
Authors: Franco-Buenaventura Daniela , Uribe-Bayona Antonio José , García-Perdomo Herney Andrés
Published: February 2022

Summary description of the topic: Management in blunt renal trauma is based on clinical and paraclinical surveillance during the first 24 hours. The image of choice is 3-phase computed tomography (CT). It should be taken in all patients with clinical suspicion of renal trauma and repeat only in case of clinical deterioration. In patients with risk factors for thrombosis, prophylaxis should be used or pneumatic compression socks in case of contraindication to the use of heparins. No definitive consensus has been reached on the use of antibiotic therapy, however, it is recommended in patients with signs of acute infection.

Relevance: Renal trauma is a disease with an important prevalence worldwide and in our environment, present in 5% of trauma patients. Given the recommendations based on scant evidence, conservative management is preferred, even in patients with high-grade trauma.

Conclusions: Conservative management of grade I-IV blunt renal trauma is recommended. There is still controversy about grade V renal trauma. Antibiotic prophylaxis is avoided given the low rate of infection and antibiotic use is indicated in the presence of clinical signs of infection.
Características clínico-patológicas del cáncer de pene: experiencia actual de un centro hospitalario de tercer nivel en México
Authors: Cabrera-Mora Norma Alejandra , Sánchez-Núñez Juan Eduardo , Hernández-Hernández Raymundo Armando , Rodríguez-Valle Edson David , De los Santos-González Juan Antonio , Rosas-Nava Jesús Emmanuel , Jaspersen-Gastélum Jorge
Published: February 2022

Background: Squamous cell carcinoma of the penis is considered a rare disease in developed countries, accounting for 0.4-0.6% of the malignant tumors in men, but the figure increases to 10-20% in developing countries. Ninety-five percent of penile cancers correspond to squamous cell carcinoma and the outstanding risk factors are phimosis, smoking, and human papillomavirus infection.

Objective: To describe the clinical and pathologic characteristics of patients diagnosed with penile cancer.

Materials and methods: A retrospective, retrolective, and descriptive study was carried out utilizing the physical and electronic case records of patients treated at the Urology and Oncology Service of the Hospital General de México over the 5-year period of January 2015 to January 2020.

Results: Data on 93 patients were included. Mean age of the patients was 57.87 years (23-86), 55.9% were smokers, and 50% had comorbidities. A total of 65.6% of the patients had a primary school education, 20.4% had a secondary school education, and 7.5% were illiterate.  Phimosis was identified in 74.2% and the most frequent penile cancer sites were the glans penis (40.9%), the glans penis-prepuce (33.5%), or the penile body (23.7%). Koilocytosis was present in 17.2%, lymphovascular invasion in 18.3%, and perineural invasion in 19.4%.

Conclusions: Cases of penile cancer are frequent at our hospital and the disease is one of the 20 principal diagnoses made annually. The majority of cases are ulcerous, moderately differentiated, stage T3, clinical stage N0, squamous cell carcinoma.
Pedagogía de la Ciencia
Authors: Ceballos-González Sergio
Published: February 2022

El transitar de la ciencia a través del tiempo, se ha caracterizado por ser un camino sinuoso, lastimero, frustrante. Pero también perseverante, glorioso, esperanzador. Han sido personajes aislados quienes, rompiendo paradigmas y enfrentados a toda clase de poder social, económico o religioso, se sobrepusieron a la ignominia colectiva, a la afectación de la salud propia y hasta la muerte para dejar un legado a la humanidad. Ejemplos abundan, sólo nombraré unos cuantos: Newton, Darwin, Galileo, Miguel Servet, Marie Curie.
Quiste Renal Infectado: Reporte de Caso
Authors: Incontri-Abraham Diego , Juárez-Vignon-Whaley Juan José , Magaña-González Jorge Esteban
Published: February 2022

Clinical case description: We present herein an atypical case of a patient diagnosed with an infected renal cyst.

Relevance: Although the presence of solitary renal cysts is more common than expected, they rarely become infected, especially when not associated with a cystic disease.

Clinical implications: Renal cyst diagnosis is mainly made through imaging studies. Infection is rare and normally associated with polycystic kidney disease. Patients do not usually respond well to conventional antibiotic therapy and end up needing drainage and high doses of antibiotics.

Conclusions: There are few case reports of infected renal cyst and they tend to be associated with an underlying pathology, which is important to establish. Even though patients do not usually have a good initial response to antibiotic therapy, they generally have a favorable outcome, with no complications, after drainage and long-term antibiotic administration.
Reconstrucción de las secuelas de la gangrena de Fournier, reporte de dos casos
Authors: Bravo-Gálvez Víctor Manuel , González-Villegas Hedler Olaf
Published: February 2022

Clinical case description: Two men, 47 and 39 years of age, with a history of type 2 diabetes mellitus, developed Fournier’s gangrene. They underwent emergency debridement, requiring 2 or more surgical toilets, and received antibiotic therapy. One patient underwent vacuum-assisted closure. Once the patients recovered, reconstructive surgery with advancement flaps and full-thickness autologous skin grafts taken from the thigh were carried out, respectively.

Relevance: Fournier’s gangrene is an infection that has a high mortality rate. It involves the soft tissues of the perineal and genital regions of immunocompromised patients, requiring aggressive surgical management that leaves important anatomic and functional sequelae. When our patients recovered, there was little evidence of the monitoring and treatment of Fournier’s gangrene sequelae.

Clinical implications: The goal of reconstructive therapy is the reincorporation of the patient into his everyday life, attempting to maintain the anatomy as normal and functional as possible.  There are still no guidelines on the best reconstruction method for Fournier’s gangrene sequelae but at present the use of grafts are considered the best measure.  

Conclusion: The use of full-thickness autologous skin grafts was beneficial in our patients. However, a review of the literature should be carried out to standardize the use of grafts and reconstructive techniques, according to the sequelae.
Inmunoterapia en Cáncer Vesical. Presente y Futuro
Authors: Poza del Val Marina , Martínez-Rodríguez Roberto Hugo , Amón-Sesmero José Heriberto
Published: February 2022

Bladder cancer (BC) continues to be a challenge in current urologic clinical practice. It is the seventh most frequently diagnosed tumor in men worldwide, and the eleventh, if we include both men and women.

The treatment of non-muscle-invasive bladder cancer has limitations, starting with the approach: transurethral resection is not always complete, there can be failures or early recurrence after bacillus Calmette-Guérin (BCG) therapy, and side effects of treatment with BCG can force its suspension.

In cases of muscle-invasive bladder cancer (MIBC), radical cystectomy is not always a treatment option due to important perioperative comorbidity. In patients with metastatic bladder tumors, the side effects of conventional chemotherapy, as well as tumor progression, have resulted in the need for developing new therapies. 

Advances in the knowledge of oncologic molecular biology have provided us with new therapeutic targets (such as cell cycle inhibitors), and specific drugs directed at them have been developed, through the use of monoclonal antibodies. At present, five drugs have been approved by the Food and Drug Administration and the European Medicines Agency for the treatment of metastatic MIBC: atezolizumab, nivolumab, and pembrolizumab stand out for their wider use in clinical practice.

The good results obtained in metastatic bladder cancer have led to the development of new lines of research for the use of those molecules at earlier disease stages and in neoadjuvant protocols. Likewise, numerous studies are being conducted on the combination of those new agents with conventional chemotherapy and radiotherapy to determine more adequate treatment regimens.

The present review article concisely describes the current state of immunotherapy in relation to bladder cancer.
Duración del catéter urinario pos-RTUP como factor de riesgo para estenosis de uretra
Authors: Cerda-Guerrero Enrique , Hernández-Manzo David , Ramírez-García-Luna Sofía , Gutiérrez-Aguilera Elizabeth , Zubieta-Huerta Antonio , Cabeza-Bucio Eduardo , Rodríguez-Rivera Arturo
Published: February 2022

Background: Urinary stricture is a relatively frequent urologic entity and is a common cause of lower urinary tract symptoms, with a prevalence of 0.6%.

The energy modality utilized in transurethral resection of the prostate (TURP), as a risk factor for the development of urethral stricture, is currently a subject of debate. Different authors have published conflicting data on post-TURP stricture.  

Materials and methods: The case records of patient that underwent bipolar and monopolar TURP at the Hospital General de Occidente, within the time frame of January 1, 2018 and December 31, 2018, were reviewed. The number of patients that presented with post-TURP urinary symptomatology, determined by the presence of moderate symptoms (>8 points) on the International Prostate Symptom Score (IPSS), were evaluated. Urethral stricture was determined through retrograde urethrogram or a record of having undergone internal urethrotomy after TURP. 

The primary aim was to determine the incidence of urethral stricture in patients that underwent TURP at the Hospital General de Occidente within the abovementioned time frame.

Results: The case records of 113 patients were reviewed. They were assigned to 2 groups, according to the energy modality utilized: Group A, monopolar energy, 59 patients (52.2%) and Group B, bipolar energy, 54 patients (47.8%). Sixteen variables (8 categorical and 8 continuous) were analyzed. 

The incidence of urethral stricture was 6.7% in the monopolar energy group and 5.5% in the bipolar energy group. No statistically significant increase in the incidence of stricture was found in relation to the bipolar energy group.

Conclusions: Upon comparing each of the variables separately, only catheter duration had a statistically significant association with the appearance of urethral stricture (p <0.05). We found a 0.7% risk for stricture with 2-day catheter use, a 3% risk with 5-day use, and a risk reaching 46% with 12-day catheter use.

The prolonged use of a urethral catheter after TURP was shown to be the most important risk factor for the appearance of urethral stricture.
Rendimiento diagnóstico de los métodos radiológicos en prolapsos genitales: Revisión sistemática/metaanálisis
Authors: Aguirre-Martínez Maria Alejandra , García-Perdomo Herney Andrés
Published: February 2022

Objective: To determine the diagnostic yield of radiologic studies (dynamic magnetic resonance imaging, and 2D/3D ultrasound), compared with the pelvic organ prolapse quantification (POP-Q) classification system, for identifying genital prolapse.

Methods: Clinical experiments, cross-sectional studies, case-control studies, and cohort studies were included to evaluate dynamic magnetic resonance imaging and 2D/3D ultrasound as the diagnostic tests, and the POP-Q classification system as the reference standard. A search strategy was carried out, up to the present date, in each of the following databases: Ovid MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and LILACS, as well as in the grey literature. The data were then extracted and the risk for bias was evaluated through the QUADAS-2 tool, resulting in the present meta-analysis.

Results: Once the information from the 2,227 studies evaluated was filtered, four articles were selected that met the inclusion criteria, two of which were included in the meta-analysis. From the data reported, we found a moderate-to-high correlation between magnetic resonance imaging and the POP-Q, for quantifying genital prolapse, in relation to the anterior and middle compartment measurements, with the following effect sizes: 0.60 (95% CI 0.18 to 1.03) for the pubococcygeal line; 0.63 (95% CI 0.28 to 0.98) for the H line; and 0.70 (95% CI 0.52 to 0.88) for the midpubic line.

Conclusions: Dynamic magnetic resonance imaging and transperineal 2D/3D ultrasound can be used as diagnostic methods for genital organ prolapse, especially anterior compartment prolapse.
Nefrectomía parcial vs enucleación tumoral
Authors: Gayarre-Abril Paula , López-Lorenzo Jesús , Subirá-Ríos Jorge , Hijazo-Gascón Daniel , Hijazo-Conejos José Ignacio , García-Magariño Jesús , Medrano-Llorente Pilar , Elizalde-Benito Francisco Xavier , Rioja-Zuazu Jorge , Murillo-Pérez Carlos , Ramírez-Fabián Manuel , Blasco-Beltrán Benjamín , Carrera-Lasfuentes Patricia
Published: February 2022

Background and aims: Nephron-sparing surgery has become the standard surgical technique for small renal masses, taking the place of traditional radical nephrectomy. The aim of the present study was to compare partial nephrectomy and tumor enucleation, with respect to morbidity and oncologic results.

Materials and methods: A retrospective cohort study was conducted on patients that underwent partial nephrectomy or enucleation at the Hospital Clínico Universitario Lozano Blesa de Zaragoza, between August 2011 and October 2019. Demographics, clinical and surgical characteristics, and oncologic results were the variables analyzed.

Results: Forty-eight patients were followed for 36,1±28,0 months. Compared with the partial nephrectomy group, the patients that underwent tumor enucleation presented with lower values of mean blood loss (117,7±95.1 ml and 221±293.1 ml, p=0,488), ischemia (46% and 95%, p<0,001), mean ischemia time (24,6±7,2 min and 25,1±10,4 min, p=0,844), and complications (11,5% and 22,7%, p=0,442), respectively. No local recurrence was observed. 

Conclusions: Both groups were comparable in relation to tumor stage. The enucleation group presented with less blood loss, less need for vascular clamping, and similar ischemia time, compared with the partial nephrectomy group. Both techniques were oncologically safe, with a low rate of compromised surgical margins. Postoperative morbidity with the two techniques was low.
Necesitamos un enfoque renovado en los mensajes de salud pública con respecto a la salud sexual y reproductiva
Authors: Del Rosario-Santiago Marcos
Published: February 2022

El embate de la pandemia del covid-19 ha presentado a los Estados Unidos y a otros gobiernos una rara oportunidad para detener una epidemia silenciosa de una década: el aumento continuo de las infecciones de transmisión sexual.
Adenocarcinoma de células claras en divertículo de uretra femenina. Reporte de un caso y revisión de literatura
Authors: Halún Treviño Antonio Nassim , González Bonilla Eduardo Alberto , Barrera Juárez Eduardo , González Oyervides Roberto
Published: February 2022

Clinical case description: A 64-year-old woman with an unremarkable past medical history was evaluated due to lower urinary tract symptoms and hematuria of 1-month progression. A magnetic resonance imaging scan revealed a lesion consistent with urethral tumor. During urethrocystoscopy, a tumor was found inside a urethral diverticulum. Transurethral resection was carried out, followed by the later performance of anterior pelvic exenteration. The histopathologic result was clear cell adenocarcinoma inside a proximal urethral diverticulum.  The patient did not undergo adjuvant therapy, remaining in follow-up and surveillance, and is presently recurrence-free.

Relevance: Urethral carcinoma is an uncommon tumor and its appearance in a diverticulum is rare. Those types of tumor are highly invasive and require aggressive treatment to offer the possibility of cure.

Clinical implications: No standardized treatment is in place. Surgical treatment through radical urethrectomy or anterior pelvic exenteration, with or without adjuvant therapy, is the most widely accepted therapeutic option.

Conclusions: Clear cell adenocarcinoma arising in a urethral diverticulum is uncommon and usually has a locally advanced presentation. There is no standardized treatment or follow-up for the disease.
Uretroplastia en el tratamiento de la estrechez y la estenosis uretrales
Authors: Serna-Hurtado Juan José , Castillo-Cobaleda Diego Fernando , García-Perdomo Herney Andrés
Published: February 2022

Summary of the topic: Urethral lumen pathology develops due to a process of scarring and fibrosis in the urethral mucosa and/or adjacent tissues. It functionally triggers lower urinary tract obstruction, causing alterations in micturition, and gradually deteriorates the urinary tract, directly impacting quality of life. 

Relevance: Urethral stricture and stenosis importantly affect patient quality of life. With an adequate diagnostic and therapeutic approach, they are surgically curable. Therapeutic planning depends on multiple factors related to the age of the patient, comorbidities, etiology, and level and extension of the disease.

Therapeutic options are divided into palliative and curative treatments that include minimally invasive procedures and reconstructive surgery, such as end-to-end urethroplasty, with genital or extragenital graft/flap techniques.

Conclusion: Each surgical technique of urethral reconstruction is precisely indicated, providing acceptable results. However, low levels of evidence are found in the currently available literature, with a predominance of case series and expert opinions.
Nefrectomía parcial robot asistida experiencia inicial con impresión 3D
Authors: Corona-Montes Víctor Enrique , Hermida-Ochoa Juan Carlos , González-Bonilla Eduardo Alberto , Doria-Lozano Mario Iván , Rosas-Nava Jesús Emmanuel , Almazán-Treviño Luis
Published: February 2022

Introduction: The creation of 3D printed silicone models has several purposes, one of which is to provide augmented reality (AR), thanks to the imaging and visualization methods that serve as aids in “surgical planning”. They enable precise analysis of the anatomy at the site to be treated and can influence surgical strategy change or decision-making. 
Materials and methods: The present case report describes the surgical planning carried out with a 3D printed model, in a 40-year-old patient incidentally diagnosed with a T2aN0M0 CS I left kidney tumor, measuring 20 mm, that was slightly exophytic, with a RENAL Score of 4a.
Results: Total surgery duration was 180 min, with a console time of 120 min, blood loss of 50cc, and warm ischemia time of 12 min. No drain was placed, hospital stay was 2 days, and there were no complications.
Discussion: Visualizing the anatomic characteristics on the model enabled surgical programming to be carried out, along with guided dissection and selective clamping that did not involve the entire renal hilum. Three-dimensional models are based on multi-slice digital tomography images that are converted to real scale and then printed with different materials, achieving an anatomic representation of the organ to be treated.   
Conclusions: That type of planning favors better understanding of the surgical anatomy of the tumor and improved decision-making. Case series on different anatomic variations, as well as other organs, should be carried out.
Microlitiasis testicular una patología rara y poco conocida. Reporte de casos y revisión de literatura
Authors: Galván-Montaño Alfonso , Cruces-Velázquez Michelle , García-Moreno Silvia , Espinosa de los Monteros-Pérez Luz Elena , Suárez-Roa María de Lourdes , Guzmán-Martínez Sonia
Published: February 2022

Objective: The aim of the present work was to review the cases of testicular microlithiasis revealed by ultrasound and carry out a review of the literature.

Design: Testicular ultrasounds that identified testicular microlithiasis in patients seen at the Hospital “Dr. Manuel Gea González”, within the time frame of 2011 and 2018, were reviewed. Age, study indication, and laterality were among the variables analyzed.

Results: Twenty-one ultrasounds revealed testicular microlithiasis in patients ranging from 6 to 24 years of age, with a mean of 16 years. Both testes were affected in 81% of the patients, and the left testis was affected in 29%. The indication for ultrasound was testicular pain in 33% (7 cases), testicular tumor in 14% (3 cases), and testicular torsion in 10% (2 cases). Other causes were varicocele, testicular abscess, and testicular trauma.

Study limitations: The conclusions were relative, given the study’s retrospective, observational design. 

Originality: Microlithiasis has a reported prevalence of 2.4% to 3.8% in children. It is associated with testicular tumors and can cause infertility. A possible cause is nanobacteria that induce testicular calcifications. The study of the disease could modify its treatment and prevent its appearance. 

Conclusions: Testicular microlithiasis is a rare and little-known disease that can be associated with cancer and infertility. Its etiology appears to be nanobacterial infection. More research on the disease should be carried out.
Reconstrucción testicular con toma y aplicación de injerto autólogo de túnica albugínea contralateral por trauma penetrante de testículo por proyectil de arma de fuego. Reporte de caso y revisión de la literatura
Authors: Ávalos-Jiménez Julio César
Published: February 2022

Background:

Testicular and scrotal trauma occurs mainly in young people between 15 and 40 years old.

50% of gunshot wounds end in orchiectomy.

The clinical presentation is with pain, edema, ecchymosis and hematoma, skin laceration or tissue exposure. The diagnosis is clinical. Evidence or suspicion of a testicular rupture is an emergency and requires urgent surgical exploration. The recommended surgical management is with primary closure of the tunica albuginea when possible and orchiectomy when it is not possible.

 

Clinical case:

We present the case of a 20-year-old man with gunshot testicular trauma, conditioning left trauma grade V and grade IV right. Simple left orchiectomy and right partial orchiectomy were performed with contralateral tunica albuginea graft. The patient had a satisfactory evolution with control Doppler ultrasound with preserved vascularity and increasing testosterone levels.

 

Discussion:

The goal in the treatment of testicular trauma is to preserve viable tissue and repair the testicle. The primary closure is described for a laceration of the tunica albuginea with easily identifiable edges, which was not possible in this case. Within the repairs described there are grafts of tunica vaginalis, absorbable material and biological meshes with contradictory results.

The use of tunica albuginea as repair and protection of the contralateral testicle, allowed an optimal reconstruction, avoiding the pressure increase that occurs when using the ipsilateral tunic and allowing the preservation of the parenchyma and testicular physiology.