bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.