26 results on '"Manuel Esteban Fuertes"'
Search Results
2. Relationship between Mental Disorders, Smoking or Alcoholism and Benign Prostate Disease
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Paloma Chantada-Tirado, Venancio Chantada-Abal, José-David Cózar-Ortiz, Cristina Chantada-Tirado, José-Manuel Cózar-Olmo, Manuel Esteban-Fuertes, Andrea Alvarez-Ossorio-Rodal, Javier Flores-Fraile, Magaly-Teresa Márquez-Sánchez, Bárbara-Yolanda Padilla-Fernández, and María-Fernanda Lorenzo-Gómez more...
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mental disorders ,smoking ,alcoholism ,prostatitis ,Medicine (General) ,R5-920 - Abstract
Introduction: Mental disorders, smoking, or alcoholism and benign prostate disease are highly prevalent in men. Aims: To identify the relationship between mental disorders, smoking, or alcoholism and benign prostate disease. Methodology: A prospective multicenter study that evaluated prostate health status in 558 men from the community. Groups: GP—men who request a prostate health examination and whose medical history includes a mental disorder, smoking, or alcoholism prior to a diagnosis of benign prostate disease; GU—men who request a prostate health examination and whose medical history includes a benign prostate disease prior to a diagnosis of mental disorder, smoking, or alcoholism. Variables: age, body mass index (BMI), prostate specific antigen (PSA), follow-up of the mental disorder, smoking or alcoholism, time elapsed between urological diagnosis and the mental disorder, smoking or alcoholism diagnosis, status of the urological disease (cured or not cured), concomitant diseases, surgical history, and concomitant treatments. Descriptive statistics, Student’s t-test, Chi2, multivariate analysis. Results: There were no mental disorders, smoking, or alcoholism in 51.97% of men. Anxiety, smoking, major depressive disorder, pathological insomnia, psychosis, and alcoholism were identified in 19.71%, 13.26%, 5.73%, 4.30%, 2.87%, and 2.15% of individuals, respectively. Nonbacterial prostatitis (31.54%), urinary tract infection (other than prostatitis, 24.37%), prostatic intraepithelial neoplasia (13.98%), and prostatodynia (1.43%) were prostate diseases. Unresolved symptomatic benign prostate disease was associated with anxiety, depression, and psychosis (p = 0.002). Smoking was the disorder that men managed to eliminate most frequently. The dominant disorder in patients with symptomatic benign prostatic disease was alcoholism (p = 0.006). Conclusions: Unresolved symptomatic benign prostatic disease is associated with anxiety, depression, and psychosis. Alcoholism is associated with a worse prognosis in the follow-up of symptomatic benign prostatic disease. more...
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- 2024
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3. Efficacy and tolerability of the hexanic extract of Serenoa repens compared to tamsulosin in moderate-severe LUTS-BPH patients
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Antonio Alcaraz, Alfredo Rodríguez-Antolín, Joaquín Carballido-Rodríguez, David Castro-Díaz, José Medina-Polo, Jesús M. Fernández-Gómez, Vincenzo Ficarra, Joan Palou, Javier Ponce de León Roca, Javier C. Angulo, Manuel Esteban-Fuertes, José M. Cózar-Olmo, Noemí Pérez-León, José M. Molero-García, Antonio Fernández-Pro Ledesma, Francisco J. Brenes-Bermúdez, and José Manasanch more...
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Medicine ,Science - Abstract
Abstract In a subset analysis of data from a 6-month, multicenter, non-interventional study, we compared change in symptoms and quality of life (QoL), and treatment tolerability, in men with moderate to severe lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) receiving tamsulosin (TAM, 0.4 mg/day) or the hexanic extract of Serenoa repens (HESr, 320 mg/day) as monotherapy. Symptoms and QoL were assessed using the IPSS and BII questionnaires, respectively. Patients in the treatment groups were matched using two statistical approaches (iterative and propensity score matching). Within the iterative matching approach, data was available from a total of 737 patients (353 TAM, 384 HESr). After 6 months, IPSS scores improved by a mean (SD) of 5.0 (4.3) points in the TAM group and 4.5 (4.7) points in the HESr group (p = 0.117, not significant). Improvements in QoL were equivalent in the two groups. TAM patients reported significantly more adverse effects than HESr patients (14.7% vs 2.1%; p more...
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- 2021
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4. IMAGINE-IMpact Assessment of Guidelines Implementation and Education: The Next Frontier for Harmonising Urological Practice Across Europe by Improving Adherence to Guidelines
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Philip Cornford, Emma Jane Smith, Steven MacLennan, Nuno Pereira-Azevedo, Monique J. Roobol, Nicolaas Lumen, Louise Fullwood, Eilidh Duncan, Jennifer Dunsmore, Karin Plass, Maria J. Ribal, Thomas Knoll, Anders Bjartell, Hendrick Van Poppel, James N’Dow, Alberto Briganti, Karl Dorfinger, Irene Resch, Mischinger Johannes, Isabel Heidegger, Christophe Assenmacher, Thierry Roumeguère, Karel Decaestecker, Lieven Goeman, Thomas Adams, Marincho Georgiev, Krassimir Yanev, Aleksandar Timev, Igor Tomašković, Tomislav Kuliš, Stavros Charalampous, Dimitris Kontaxis, Marko Babjuk, Roman Zachoval, Tomáš Pitra, Vojtěch Novák, Lars Lund, Martin Kivi, Peep Baum, Toomas Tamm, Pritt Veskimae, Rauno Okas, Kanerva Lahdensuo, Kimmo Taari, Heikki Seikkula, Pyry Jämsä, Xavier Gamé, George Fournier, Alexandre Ingels, Gaelle Fiard, Guillaume Ploussard, Jens Rassweiler, Stefanie Schmidt, Jennifer Kranz, Susanne Krege, Ioannis Gkialas, Anthanasios Dellis, Nikolaos Ferakis, Dionysios Mitropoulos, Peter Ryan, John Paul Sweeney, Eamonn Rogers, Derek Hennessy, Niall. F. Davis, Walter Artibani, Francesco Porpiglia, Salvatore Giuseppe Voce, Maurizio Brausi, Maria A. Cerruto, Francesco Esperto, Matteo Manfredi, Mindaugas Jievaltas, Aušvydas Patašius, Albertas Čekauskas, Stasys Auškalnis, Peter Mulders, Frank Martens, Kathleen W.M. D'Hauwers, Piotr Chlosta, Anna Katarzyna Czech, Katarzyna Gronostaj, Mikołaj Przydacz, Pedro Coelho Nunes, Luís Abranches-Monteiro, Ricardo Pereira e Silva, Frederica Furriel, Pedro Gomes Monteiro, Ioanel Sinescu, Cristian Surcel, Catalin Baston, Robert Ionut Stoica, Vlad Olaru, Boris Kollárik, Ivan Mincik, Ľuboš Rybár, Viktor Kováčik, Ivan Perečinský, Boris Kosuta, Marko Zupancic, Milena Taskovska, Uros Kacjan, Andraz Miklavzina, Manuel Esteban Fuertes, Mario Alvarez-Maestro, Antoni Vilaseca, Rodrigo García-Baquero, Lotta Renström Koskela, Johan Styrke, Gezim Galiqi, Bilbil Hoxha, Evisa Zhapa, Rezart Xhani, Sergey Fanarjyan, Ruben Hovhannisyan, Avoyan E. Armen, Rafael Badalyan, Mustafa Hiroš, Davor Tomić, Damir Aganović, Archil Chkhotua, David Nikoleishvili, Zara Tchanturaia, Sigurdur Gudjónsson, Eirikur Orri Gudmundsson, Rafn Hilmarsson, Emil Ceban, Vitalii Ghicavii, Adrian Tanase, Vladislav Vasiliev, Dragoljub Perovic, Marko Vukovic, Stanisavljevic Rade, Nenad Radovic, Emil Nasufovic, Yuri Alyaev, Igor Korneyev, Sergei Kotov, Vigen Malkhasyan, Dragoslav Basic, Miodrag Aćimović, Saša Vojinov, Aleksandar Vuksanovic, Uroš Bumbaširević, Bojan Čegar, Branko Stanković, Hansjörg Danuser, Tullio Sulser, Valentin Zumstein, Ates Kadioglu, Hakan Kilicarslan, Nusret Can Cilesiz, Erhan Demirelli, Bülent Önal, Aydin Mungan, Serdar Tekgül, Levent Türkeri, Adil Esen, Oleksandr Shulyak, Sergiy Vozianov, Alexandr Shulyak, Serhii Volkov, Andrii Nesterchuk, Urology, Cornford, P., Smith, E. J., Maclennan, S., Pereira-Azevedo, N., Roobol, M. J., Lumen, N., Fullwood, L., Duncan, E., Dunsmore, J., Plass, K., Ribal, M. J., Knoll, T., Bjartell, A., Van Poppel, H., N'Dow, J., and Briganti, A. more...
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Supplementary data ,Physicians' ,Impact assessment ,business.industry ,Urology ,030232 urology & nephrology ,MEDLINE ,Guideline ,Practice Patterns ,Clinical Practice ,Europe ,Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] ,03 medical and health sciences ,Frontier ,0302 clinical medicine ,Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10] ,Nursing ,030220 oncology & carcinogenesis ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,Medicine ,Humans ,Guideline Adherence ,Practice Patterns, Physicians' ,Baseline (configuration management) ,business - Abstract
Contains fulltext : 237261.pdf (Publisher’s version ) (Closed access) Adherence to national and international clinical practice guidelines is suboptimal throughout Europe. The European Association of Urology Guidelines Office project "IMAGINE" (IMpact Assessment of Guidelines Implementation and Education) has been developed to measure baseline adherence to urological guideline recommendations across Europe and to identify issues that drive nonadherence. more...
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- 2021
5. Clinical Benefit of Tamsulosin and the Hexanic Extract of Serenoa Repens, in Combination or as Monotherapy, in Patients with Moderate/Severe LUTS-BPH: A Subset Analysis of the QUALIPROST Study
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Antonio Alcaraz, Alfredo Rodríguez-Antolín, Joaquín Carballido-Rodríguez, David Castro-Díaz, Manuel Esteban-Fuertes, José Cózar-Olmo, Vincenzo Ficarra, Rafael Medina-López, Jesús Fernández-Gómez, Javier Angulo, José Medina-Polo, Francisco Brenes-Bermúdez, José Molero-García, Antonio Fernández-Pro-Ledesma, José Manasanch, on behalf of The QUALIPROST Study Group, and Pierre Fabre more...
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Subset Analysis ,Tamsulosin ,Quality of life ,medicine.medical_specialty ,Combination therapy ,030232 urology & nephrology ,Urology ,lcsh:Medicine ,Therapeutics ,Article ,03 medical and health sciences ,0302 clinical medicine ,hexanic extract of Serenoa repens ,Lower urinary tract symptoms ,Aparell urinari ,medicine ,tolerability ,Adverse effect ,Storage symptoms ,BII ,BII, BPH, combination treatment, hexanic extract of Serenoa repens, moderate-severe LUTS, quality of life, storage symptoms, tamsulosin, tolerability ,Moderate-severe LUTS ,Intention-to-treat analysis ,Hiperplàsia suprarenal congènita ,business.industry ,lcsh:R ,Congenital adrenal hyperplasia ,General Medicine ,medicine.disease ,Tolerability ,Terapèutica ,Urinary organs ,quality of life ,moderate-severe LUTS ,030220 oncology & carcinogenesis ,Combination treatment ,BPH ,tamsulosin ,combination treatment ,International Prostate Symptom Score ,storage symptoms ,Hexanic extract of Serenoa repens ,business ,medicine.drug - Abstract
To investigate whether tamsulosin (TAM) and the hexanic extract of Serenoa repens (HESr) are more effective in combination than as monotherapy in men with moderate-to-severe lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). Subset analysis of data from a 6-month, multicenter observational study. Patients received either tamsulosin (0.4 mg/day) or HESr (320 mg/day) alone or in combination. Primary endpoints were change in symptoms and quality of life. Tolerability was also assessed. Seven hundred and nine patients were available for intention to treat (ITT) analysis, 263 treated with tamsulosin, 262 with HESr, and 184 with TAM + HESr. After 6 months, International Prostate Symptom Score (IPSS) scores improved by a mean (standard deviation) of 7.2 (5.0) points in the TAM + HESr group compared to 5.7 (4.3) points with TAM alone and 5.4 (4.6) points with HESr (p <, 0.001). Quality of life showed greatest improvement with combination therapy (p <, 0.02). Adverse effects were reported by 1.9% of patients receiving HESr, 13.3% receiving TAM, and 12.0% receiving TAM + HESr (p <, 0.001). In men with moderate/severe LUTS/BPH, combination treatment with TAM + HESr produced more effective symptom relief and greater improvement in quality of life than with either treatment alone, with acceptable tolerability. more...
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- 2020
6. The American Society of Anesthesiologists Physical Status (ASA-PS) Risk Group Classification Can Be Used to Anticipate Functional Recovery Outcomes after the Surgical Treatment of Female Urinary Incontinence with Transobturator Suburethral Tape
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Lauro-Sebastian Valverde-Martínez, María Fernanda Lorenzo-Gómez, Mario Martin-Hernandez, Javier Flores-Fraile, María-Begoña García-Cenador, Manuel Esteban-Fuertes, Juan Cisneros-Pérez, Sara Prieto Nogal, Barbara-Yolanda Padilla-Fernandez, Gemma Yusta-Martín, and Maria-Pilar Sanchez-Conde more...
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medicine.medical_treatment ,030232 urology & nephrology ,lcsh:Medicine ,Urinary incontinence ,Type 2 diabetes ,recovery of function ,Article ,03 medical and health sciences ,0302 clinical medicine ,postoperative complications ,Medicine ,suburethral sling ,030212 general & internal medicine ,stress urinary incontinence (SUI) ,Urinary continence ,business.industry ,Mortality rate ,Incidence (epidemiology) ,lcsh:R ,General Medicine ,medicine.disease ,Curettage ,Anesthesia ,Concomitant ,medicine.symptom ,business ,Body mass index - Abstract
Introduction: Stress urinary incontinence (SUI) has an incidence of 15&ndash, 80% in women. One of the most widely used surgical techniques for treatment is the placement of a suburethral transobturator tape (TOT). Although this technique has a relatively low morbidity rate, it is not exempt from intraoperative or postoperative complications, which can have an impact on functional recovery, understood as the return to routine life prior to the intervention. Aims: To assess the time for functional recovery in women operated on for SUI by TOT, to identify complications and related factors, according to anaesthetic risk, which condition the time to functional recovery, and proposals for improvements in the prevention of possible complications and in reducing functional recovery time. Materials and methods: A non-concurrent prospective observational multicenter study of 891 women undergoing TOT for stress urinary incontinence since 1 April 2003, who were successful in achieving urinary continence (completely dry). Study groups: GA (n = 443): patients with ASA I risk. GB (n = 306): patients with ASA II risk. GC (n = 142): patients with anaesthetic risk ASA III. Investigated variables: age, body mass index, follow-up time, secondary diagnoses, surgical history, obstetric-gynecological history, toxic habits, and complications derived from surgery: bleeding, pain, infection. Descriptive statistics, Student&rsquo, s t test, Chi2, Fisher, ANOVA, multivariate analysis, significance for p <, 0.05. Results: Mean age was 60.10 years (SD13.38), with no difference between groups. Mean body mass index (BMI) was 26.55 kg/m2 (SD 4.51), lowest in GA. GB had more HT (38.6%) than GC (23.23%), more type 2 diabetes (19.83% versus 10.56%), and more respiratory disorders (6.97% versus 2.11%). There were more women with anxiety in GB (19.3%) than in GC (6.33%) (p = 0.0221) and GA (10.51%) (p = 0.0004). There was more hypothyroidism in GB (16.08%) compared to GC (2.11%) and GA (9.07%). There was more history of curettage in GC (11.97%) versus GB (5.63%), and more pelvic surgery in GB (71.31%) and GC (66.9%) compared to GA (32.57%). There were more concomitant treatments with benzodiazepines in GC (27.46%) and GB (28.41%) than in GA (8.86%), and more parapharmacy treatments in GB (17.96%) than in GC (6.33%). Following the operation, 113 patients had some sign or symptom that required medical attention: in GA 48 (10.83%), in GB 49 (16.06%), in GC 16 (13.22%). Mean days until functional recovery in patients with complications: in GA 5.72 (SD2.05), bleeding 3 (SD1), pain 6.40 (SD1.34), and infection 7.33 (SD0.57), with fewer days for bleeding than for pain or infection. GB: 27.96 (SD 28.42), bleeding 3 (SD0), pain 46.69 (SD31.36), infection 10.83 (SD3.90), lowest for patients with bleeding. GC: 9.44 (SD 2.50), for bleeding 7.66 (SD2. 08), pain 10.66 (SD1.15), infection 10 (SD3.46), no differences. Overall, for women with bleeding, the time was 4.16 days (SD1.94), less in GA and GB than in GC. Pain, at 31.33 days (SD 30.70), was the factor that most delayed functional recovery, in GB women, it took longer to return to work due to pain (45.96, SD31.36) compared to GA (6.4, SD 1.34) and GC (10.66, SD1.15). In women with infection, overall mean time was 10.11 days (SD 3.61) with no difference between groups. Conclusions: Mean time for the return to normal activity in patients who underwent TOT for SUI is 5 days if there are no complications, and 16.91 days if there are any. The ASA-SP risk group classification can be used to anticipate functional outcomes. An ASA-PS risk-based functional recovery forecasting protocol should be adapted, especially ASA II patients who may present with long-term disabling postoperative pain. Preventive management measures are proposed that favour functional recovery. more...
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- 2020
7. Large study (283 women) on the effectiveness of Manosar®: 2 g of d-mannose + 140 mg of proanthocyanidins (PAC), of prolonged release
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Jesús, Salinas-Casado, Santiago, Méndez-Rubio, Manuel, Esteban-Fuertes, Antonio, Gómez-Rodríguez, Miguel, Vírseda-Chamorro, Marcos, Luján-Galán, Carlos, Iglesias-García, and Grupo, Rituman
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Vaccinium macrocarpon ,Plant Extracts ,Urinary Tract Infections ,Humans ,Female ,Proanthocyanidins ,Middle Aged ,Mannose - Abstract
To compare the efficacy and safety in the prophylasis of urinary tract infections (UTIs) with a food supplement that contains D-mannose like active ingredient (Manosar®), in comparison to another preparation in which the active ingredient are the proanthocyanidins (PAC), both of them, in prolonged released, after, they was administered for 24 weeks.A multicenter, randomized and double blind experimental study was carried out. 283 women with a history of recurrent UTIs without evidence of complication were included. They were randomized 1: 1 in two groups. In one group, 1 oral sachet of Manosar® a day was administered, and in the other group 1 oral sachet of a compound of 240 mg of continuous-release PAC. Prior to inclusion in the study, the episode of UTI was confirmed at least by the clinical symptoms and positivity of the Combur test.Valid data were obtained from 184 patients with an average age of 49.5 years: 90 received Manosar® and 94 isolated PAC. A total of 72 patients suffered an UTI due to E.coli: 25 patients in the arm with Manosar® versus 47 patients in the isolated PAC group, this difference being statistically significant (p=0.002). The free time of new UTI recurrences was 98.6 days in the group treated with Manosar® and 84.6 days in the group with isolated PAC.The oral taking of a daily sachet of Manosar® is effective and safe in preventing recurrent UTIs in women, being superior to the oral taking of isolated PAC.Comparar la eficacia y seguridad de la profilaxis de las infecciones del tracto urinario (ITUs) con un complemento alimenticio que contiene D-manosa como principio activo principal (Manosar®), en comparación con otro preparado cuyo principio activo único son las proantocianidinas (PAC), ambos de liberación continuada, tras su administración durante24 semanas.MÉTODOS: Estudio experimental multicéntrico, aleatorizado y doble ciego. Se incluyeron 283 mujeres con historia de ITUs recurrentes sin evidencias de complicación. Se randomizaron 1:1 en dos grupos. En un grupo se administró 1 sobre diario oral de Manosar®, y en el otro 1 sobre diario oral de un compuesto de 240 mg de PAC de liberación continuada. Previo a la inclusión en el estudio se confirmó el episodio de ITU al menos por la sintomatología clínica y positividad del test de Combur.Se obtuvieron datos válidos de 184 pacientes con edad media de 49,5 años: 90 recibieron Manosar® y 94 PAC aislado. Un total de 72 pacientes padecieron una ITU por E.coli: 25 pacientes en el brazo con Manosar® frente a 47 pacientes en el grupo de PAC aislado, siendo esta diferencia estadísticamente significativa (p=0,002). El tiempo libre de nuevas recurrencias de ITU fue de 98,6 días en el grupo tratado con Manosar® y de 84,6 días en el grupo con PAC aislado.CONCLUSIÓN: La toma oral de un sobre al día de Manosar® es eficaz y segura en la prevención de las ITUs recurrentes en la mujer, siendo superior a la toma oral de PAC aislado. more...
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- 2020
8. Efficacy and safety of urinary catheters with silver alloy coating in patients with spinal cord injury: a multicentric pragmatic randomized controlled trial. The ESCALE trial
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Xavier Bonfill, David Rigau, Manuel Esteban-Fuertes, Juana M. Barrera-Chacón, María L. Jáuregui-Abrisqueta, Sebastian Salvador, Carolina M. Alemán-Sánchez, Albert Borau, Manuel Bea-Muñoz, Begoña Hidalgo, Maria J. Andrade, Juan R. Espinosa, María José Martínez-Zapata, Esther Cánovas, Nuria Zazo, Ignasi Gich, Ma José Martínez-Zapata, Manuel Bea, Mónica Garran, María Paz Herrero, Montse Morcillo, Carolina M. Alemán, Enrique Bárbara, María L. Jáuregui, Montserrat Cuadrado, Nora Cívicos Sánchez, Ines Lodeiro Mendieta, Sebastián Salvador, Antonio Montoto, ME Ferreiro, Susana Moraleda, Bosco Méndez, María José Zarco, Inmaculada García, Manuel Esteban, Manuel Florencio, Juan Ignacio de Miguel, Crocifissa Maria Lanzillotti, Jorge Navarro, Maria João Andrade, Diogo Soares, Yesim Akkoc, Ozlem Senocak, Nelson Núñez Vásquez, Viviana Orrego, Marcia Courbis, and Maritza Seguel more...
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Male ,medicine.medical_specialty ,Urinary system ,medicine.medical_treatment ,Urinary Catheters ,Urinary catheterization ,law.invention ,03 medical and health sciences ,Catheters, Indwelling ,0302 clinical medicine ,Randomized controlled trial ,law ,Alloys ,medicine ,Humans ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Adverse effect ,Spinal cord injury ,Spinal Cord Injuries ,business.industry ,Silver Compounds ,Odds ratio ,Middle Aged ,medicine.disease ,Surgery ,Catheter ,Catheter-Related Infections ,Bacteremia ,Urinary Tract Infections ,Female ,Neurology (clinical) ,Urinary Catheterization ,business ,030217 neurology & neurosurgery - Abstract
Background Patients with spinal cord injury (SCI) who carry indwelling urinary catheters have an increased risk of urinary tract infection (UTI). Antiseptic silver alloy-coated (SAC) silicone urinary catheters prove to be a promising intervention to reduce UTIs; however, current evidence cannot be extrapolated to patients with SCI. Purpose This study aimed to assess the efficacy of SAC urinary catheters for preventing catheter-associated urinary tract infections. Design/Setting This is an open-label, multicenter (developed in Spain, Portugal, Chile, Turkey, and Italy), randomized clinical trial conducted in 14 hospitals from November 2012 to December 2015. Patient Sample Eligible patients were men or women with traumatic or medical SCI, aged ≥18 years, requiring an indwelling urinary catheter for at least 7 days. Outcome Measures The primary outcome was the incidence of symptomatic UTIs. The secondary outcome included bacteremia in the urinary tract and adverse events. Materials and Methods Patients were randomized to receive a SAC urinary catheter (experimental group) or a standard catheter (control group) for at least 7 days. Data were compared using chi-squared test and also calculating the absolute risk difference with a 95% confidence interval. An adjusted analysis including different risk factors of UTI was performed. This study was mainly funded by La Marato de TV3 Foundation (grant number # 112210) and the European Clinical Research Infrastructures Network organization. The funders had no role in the interpretation or reporting of results. Results A total of 489 patients were included in the study, aged 55 years in the experimental group and aged 57 in the control group (p=.870); 72% were men; 43% were hospitalized patients, and 57% were outpatients (p=1.0). The most frequent cause of SCI was traumatic (73.75%), and the localization was mainly the cervical spine (42.74%). Most of the patients had an A score (complete spinal injury and no motor and sensory is preserved) on the ASIA scale (62.37%). The median time of urethral catheterization was 27 days in the experimental group and 28 days in the control group (p=.202). Eighteen patients (7.41%) in the experimental group and 19 in the control (7.72%) group had a symptomatic UTI (odds ratio [OR] 0.96 [0.49–1.87]). The adjusted analysis revealed no change in the results. Only three patients in the experimental group had bacteremia within the urinary tract. The experimental group presented more adverse events related to the use of a catheter than the control group (OR 0.03 [0.00–0.06]). Conclusions The results of this study do not support the routine use of indwelling antiseptic SAC silicone urinary catheters in patients with SCI. However, UTIs associated to long-term urinary catheter use remain a challenge and further investigations are still needed. more...
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- 2017
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9. [Clinical and urodynamic risk factors of recurrent urinary tract infections in patients with multiple sclerosis.]
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Jesús, Salinas-Casado, Miguel, Vírseda-Chamorro, Santiago, Méndez-Rubio, Eduardo, López-Pérez, Manuel, Esteban-Fuertes, Jesús, Moreno-Sierra, Matías, Guiu-Antem, Vanesa, Pytel, Paloma, Montero-Escribano, and Jorge, Matías-Guiu Guía more...
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Male ,Urodynamics ,Multiple Sclerosis ,Risk Factors ,Urinary Tract Infections ,Humans ,Female ,Middle Aged ,Retrospective Studies - Abstract
To determine the risk factors of recurrent urinary infections (rUTIs) in patients with Multiple Sclerosis (MS).A retrospective cohort study was conducted including 114 patients with MS, 84 women (74%) and 30 men (26%), with a mean age of 49. They underwent videourodynamic study and selective sphincter electromyography due to urinary symptoms (LUTS). Clinical data (both neurological and urological) and videourodynamic data (including free flowmetry, cystomanometry and pressure flow study) were collected. In 37 patients (32%), the presence of rTUIs was demonstrated.Statistically significant differences were demonstrated between the patients with and without rUTIs with respect to the following clinical variables: the time of evolution of the symptoms (greater in the case of rUTIs), time from the diagnosis of MS (higher in the case of rUTIs), EDSS score (Expanded Disability Staus Scale) (higher in the case of rUTIs) and the EM type [higher frequency of rUTIs in the progressive types (primary and secondary)]. Urodynamic variables with significant differences were: maximum flow in free flowmetry (lower in patients with rUTIs), voiding volume in free flowmetry (lower in patients with rUTIs), micturition efficiency (higher percentage of residual urine in patients with rUTIs), stress urinary incontinence (SUI) (higher frequency of rUTIs in patients with SUI), detrusor pressure at maximum flow (lower in patients with rUTIs) and bladder contractility index (lower in patients with rUTI). No significant difference was demonstrated in relation to the presence and type of neurogenic lower urinary tract dysfunction (NLUTD).The severity and duration of MS is a risk factor for rUTIs. Urodynamic risk factors are compatible with a lower contractile capacity in patients with rUTIs, while the existence of NLUTD would not imply any specific risk factor.Determinar los factores de riesgo de infecciones urinarias recurrentes (rUTIs) en pacientes con Esclerosis Múltiple (EM).MÉTODOS: Se realizó un estudio de cohortes retrospectivo en 114 pacientes, 84 mujeres (74%) y 30 varones (26%), de edad media 49 años con EM sometidos a estudio videourodinámico y electromiografía selectiva esfinteriana por presentar síntomas urinarios (LUTS). Se recogieron los datos clínicos (tanto neurológicos como urológicos) y videourodinámicos (incluyendo flujometría libre, cistomanometría y estudio presión flujo). En 37 pacientes (32%) se demostró la presencia de rTUIs.Se demostraron diferencias estadísticamente significativas entre los pacientes con y sin rUTIs respecto de las siguientes variables clínicas: el tiempo de evolución de los síntomas (mayor en el caso de rUTIs), antigüedad de la EM (mayor en el caso de rUTIs), la puntuación EDSS (Expanded Disability Staus Scale) (mayor en el caso de rUTIs) y el tipo EM [mayor frecuencia de rUTIs en los tipos progresivos (primario y secundario)]. Las variables urodinámicas con diferencias significativas fueron: el flujo máximo en la flujometría libre (menor en pacientes con rUTIs), el volumen miccional en la flujometría libre (menor en pacientes con rUTIs), la eficiencia miccional (mayor porcentaje de residuo en pacientes con rUTIs), la incontinencia urinaria de esfuerzo (SUI) (mayor frecuencia de rUTIs en pacientes con SUI), la presión del detrusor a flujo máximo (menor en pacientes con rUTIs) y el índice de contractilidad vesical (menor en pacientes con rUTI). No se demostró ninguna diferencia significativa en relación con la presencia y tipo de disfunción neurógena del tracto urinario inferior (NLUTD).La gravedad y duración de la EM constituye un factor de riesgo para las rUTIs. Los factores de riesgo urodinámicos son compatibles con una menor capacidad contráctil en los pacientes con rUTIs, mientras que la existencia NLUTD no supondría ningún factor de riesgo específico. more...
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- 2019
10. [Functional changes during the voiding phase in males with non-neurogenic detrusor underactivity undergoing bladder catheterization.]
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Miguel, Vírseda-Chamorro, Jesús, Salinas-Casado, Santiago, Méndez-Rubio, Álvaro, Barroso Manso, and Manuel, Esteban-Fuertes
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Male ,Urinary Bladder Neck Obstruction ,Urodynamics ,Urinary Bladder, Underactive ,Humans ,Urinary Catheterization ,Aged ,Follow-Up Studies - Abstract
To investigate urodynamic changes during the voiding phase in males with detrusor underactivity (DU) undergoing bladder catheterization for urinary retention.From a total of 64 patients with urinary retention, a follow-up study was performed in 17 males with a mean age of 77 years. Patients received a urodynamic diagnosis of DU based on a Bladder Contractility Index (BCI) score of 100 and underwent permanent bladder catheterization (16 cases) or clean intermittent catheterization (1 case) for acute urinary retention (14 cases), or post void residual urine (3 cases). Patients underwent a second urodynamic study after a mean 13 months of follow-up. Fisher's exact test was used with categorical variables and Student's t test with parametric variables. The level of significance was set at p 0.05 for a two-sided test.The second urodynamic study showed a significant increase in maximal detrusor pressure, pressure at maximum flow rate, BCI score, Bladder Outlet Obstruction Index (BOOI) score, and number of patients who urinated during the pressure-flow study.Bladder catheterization in men with DU significantly improves bladder contractility and revealed obstructions of the lower urinary tract that were masked by insufficient detrusor pressure in relation to the DU of these patients. These findings could have diagnostic as well as prognostic and therapeutic applications.Determinar los cambios urodinámicos de la fase miccional en varones con hipocontractilidad del detrusor (DU) sometidos a cateterismo vesical por retención urinaria. MÉTODOS: De un total de 64 pacientes con retención urinaria, se realizó un estudio de seguimiento en 17 varones de edad media 77 años, diagnosticados urodinámicamente de DU por presentar un Índice de Contractilidad Vesical (BCI) menor de 100, sometidos a sonda vesical a permanencia (16 casos) o cateterismo vesical limpio intermitente (1 caso) por retención aguda de orina (14 casos), o residuo postmiccional patológico (3 casos). Los pacientes fueron sometidos a un segundo estudio urodinámico a los 13 meses de seguimiento de media. Las pruebas estadísticas utilizadas fueron el test exacto de Fisher para variables cualitativas y el test de comparación de media de la t de Student para variables paramétricas. El nivel de significación se fijó en p 0,05 bilateral. RESULTADOS: En el segundo estudio urodinámico, se observó un aumento significativo de la presión máxima del detrusor, la presión a flujo máximo, el BCI y el Índice de Obstrucción de Salida Vesical (BOOI) y del número de pacientes que orinaron durante el estudio presión/ flujo. CONCLUSIONES: El cateterismo vesical en varones con DU mejora significativamente la contractilidad vesical y permiten desenmascarar obstrucciones del tracto urinario inferior que estaban ocultas por una insuficiente presión del detrusor en relación a la DU de estos pacientes. Esto podría tener no sólo aplicaciones diagnósticas, sino pronósticas y terapéuticas. more...
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- 2019
11. Spanish consensus document for the diagnosis, treatment and management of neurogenic bladder
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Joan, Vidal Samsó, Manuel, Esteban Fuertes, María Ángeles, Alcaraz Rousselet, Carolina María, Alemán Sánchez, Cruz, Almuiña Díaz, Juan Carlos, Ariza Lahuerta, Aníbal, Blanco Vivo, Francisca, Carrión Pérez, Juan, Casar García, Montserrat, Cuadrado Rebollares, Manuel F, De la Marta García, Ana, Del Pino Santana León, Mónica, Garrán Díaz, Ángel Manuel, Gil Agudo, Manuel, Giner Pascual, Carmen, Grao Castellote, Ricardo, Jariod Gaudes, María Luisa, Jáuregui Abrisqueta, Natacha, León Álvarez, María Luisa, López Llano, Antonio, Montoto Marqués, Montserrat, Moreno Linares, Ariadna, Navés Prujá, María Isabel, Núñez Angulo, Carmen, Ocaña Fernández, Karla Patricia, Rojas Cuotto, Pilar, Sánchez Pérez, Fátima, Torralba Collados, Rocío, Veras Cosmo, and Inmaculada, García Obrero more...
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Neurologic event ,Consensus ,Neurogenic bladder ,Spain ,Epidemiology ,Quality of Life ,Humans ,Therapeutics ,Urinary Bladder, Neurogenic ,Lower urinary tract ,Clinical practice guidelines - Abstract
The purpose of this document is to establish practical recommendations on neurogenic bladder (NB) management based on scientific evidence and medical and nursing perspective in Spinal Cord Injury (SCI) Units as a first multidisciplinary consensual approach in Spain. METHODS: This paper reports results from the first modified Delphi consensus building exercise on this procedure. A committee of recognised opinion-leaders in rehabilitation and urology with special interest in NB was constituted. A working group formed by rehabilitation doctors, urologists and nursing staff of SCI and Neurorehabilitation Units of a number of Spanish hospitals and specialised centres associated with the panel of NB experts have prepared this document. RESULTS: This review provided an overview of the main aspects described by the different clinical guidelines already available and highlighted the need to focus on recommendations in special priority situations in which there was no consensus. In view of the considerable impact this condition has on quality of life, patients should be offered help to better understand the disorder and they should be taught how to use the treatment techniques to obtain satisfactory results and promote their autonomy. CONCLUSIONS: This article presents a version of guidelines for patients with NB. The guidelines define the clinical profile of patients to provide the best evidence- based care and also an overview of the current drug and surgical treatments of NB.El objetivo de este documento es establecer recomendaciones prácticas sobre el manejo de la vejiga neurógena (VN) en función de la evidencia científica y las perspectivas médicas y de enfermería en Unidades de Lesionados Medulares (ULM) como un primer enfoque de consenso multidisciplinar en España.MÉTODOS: En este artículo se presentan los resultados del primer ejercicio de consenso basado en metodología Delphi modificada sobre este procedimiento. Se constituyó un comité del que formaron parte reconocidos expertos en rehabilitación y urología, especializados en el manejo de VN. Este documento ha sido elaborado por un grupo de trabajo formado por médicos especialistas en rehabilitación, urólogos y personal de enfermería de ULM y unidades de Neurorrehabilitación de varios hospitales y centros especializados españoles asociados con el panel de expertos sobre VN. RESULTADOS: Esta revisión ofrece un resumen de los principales aspectos descritos en diversas guías clínicas ya disponibles y destaca la necesidad de centrarse en recomendaciones sobre situaciones especialmente prioritarias sobre las que actualmente no existe consenso. En vista del considerable impacto de esta enfermedad sobre la calidad de vida, los pacientes deben recibir ayuda para que comprendan mejor su enfermedad y también deben recibir formación sobre el uso de técnicas de tratamiento para conseguir resultados satisfactorios y fomentar su autonomía. CONCLUSIONES: En este artículo se presenta una versión de la guía para el manejo de pacientes con VN. Las guías definen el perfil clínico de los pacientes para ofrecer la mejor asistencia basada en la evidencia y también un resumen de los tratamientos farmacológicos y quirúrgicos actuales para la VN. more...
- Published
- 2019
12. [Efficacy and safety of D-mannose (2 g), 24h prolonged release, associated with Proanthocyanidin (PAC), versus isolate PAC, in the management of a series of women with recurrent urinary infections.]
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Jesus, Salinas-Casado, Santiago, Méndez-Rubio, Manuel, Esteban-Fuertes, Antonio, Gómez-Rodríguez, Miguel, Vírseda-Chamorro, Marcos, Luján-Galán, and Grupo, Rituman
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Treatment Outcome ,Double-Blind Method ,Recurrence ,Delayed-Action Preparations ,Urinary Tract Infections ,Humans ,Drug Therapy, Combination ,Female ,Proanthocyanidins ,Middle Aged ,Mannose - Abstract
To compare the efficacy and safety of dietary supplement "Manosar®" composed of D-mannose (2 g), 24 h prolonged release, associated with Proanthocyanidin (PAC) (140 mg), ursolic acid (7.98 mg), A, C, and D vitamins and the oligoelement zinc, versus 240 mg of PAC in recurrent urinary tract infections (UTI), for a designed follow-up of 24 weeks, in women.A multicenter randomized experimental double-blind study was carried out. The study was approved by review board of "Complejo Hospitalario de Toledo" (Spain), and all patients gave informed consent. A total of 150 women with non complicated UTI were screened for participation. Valid data was obtained from 93, with mean age of 48 years. Fortyfour patients were assigned to the Manosar® group and 51 patients to the PAC group. Patients were followed during six months. A previous UTI was defined based on a combination of symptoms and a positive reactive urine trip. Confirmation of a new UTI was based on symptoms, reactive urine strip and urine culture.Thirty-three patients (35%) had an UTI during the six months follow-up. The percentage of UTI of the Manosar® group during this period was 24%, while the percentage of the PAC group was 45% (p〈0.05). The disease-free time for the Manosar® group was 95 days, while this time was 79 days for the PAC group. The incidence of side effects was low. Diarrhea was the most frequent side-effect in both groups.Manosar® (oral once a day) is more effective than single dose PAC (240 mg daily orally) to prevent recurrent UTI in women. more...
- Published
- 2018
13. Risk factors to develop autonomic dysreflexia during urodynamic examinations in patients with spinal cord injury
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Pablo Gutiérrez-Martín, Antonio López-García-Moreno, Miguel Vírseda-Chamorro, Jesús Salinas-Casado, Manuel Esteban Fuertes, and Manuel de la Marta-García
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030506 rehabilitation ,Univariate analysis ,medicine.medical_specialty ,Cross-sectional study ,business.industry ,Urology ,urologic and male genital diseases ,medicine.disease ,Surgery ,Dyssynergia ,03 medical and health sciences ,Bladder outlet obstruction ,0302 clinical medicine ,Blood pressure ,Anesthesia ,medicine ,Chills ,Autonomic dysreflexia ,Neurology (clinical) ,medicine.symptom ,0305 other medical science ,business ,Spinal cord injury ,030217 neurology & neurosurgery - Abstract
Aims The risk factors for developing autonomic dysreflexia (AD) during urodynamic (UD) examination in patients with spinal cord injury (SCI) above Th6 still remain unclear. The main goal of our study is to investigate the risk factors that could be associated with AD in these particular patients. Design Cross sectional survey. Subject and methods The study was carried out in 83 patients with SCI above Th6 who were submitted to our center for a UD examination. AD was defined as a rise in systolic blood pressure above 15 mm Hg with a pulse rate below 60 beats per minute. Results The prevalence rate of AD among our patients was 54%. Univariate analysis of our study showed the following risk factors: patient's age, SCI completeness, traumatic etiology, indwelling catheter, presence of chills or sweating, anticholinergic treatment, maximum detrusor voiding pressure, detrusor pressure at maximum flow rate, detrusor external sphincter dyssynergia, and bladder outlet obstruction. Using multivariate logistic regression, we found that there are only two independent risk factors: patient's age equal to or above 45 years of age (OR = 10.995) and maximum detrusor voiding pressure equal to or above 31 cm H2O (OR = 3.879). Conclusions According to our results, the patient's age and maximum detrusor voiding pressure should be considered at the time of performing a UD examination in order to prevent the sudden onset of AD in patients with SCI above Th6. Neurourol. Urodynam. © 2015 Wiley Periodicals, Inc. more...
- Published
- 2015
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14. [Training program in oncologic urology. Future prospectives.]
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Mario, Alvarez-Maestro, Juan, Gómez Rivas, Alfredo, Aguilera Bazán, Luis, Martínez-Piñeiro, Alvaro, Juarez Soto, Jose Manuel, Cozar Olmo, and Manuel, Esteban Fuertes
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Education, Medical, Graduate ,Urology ,Fellowships and Scholarships ,Medical Oncology ,Forecasting - Abstract
Urology is a medical-surgical specialty that deals with the study, diagnosis and treatment of the medical and surgical diseases of the urinary apparatus and retroperitoneum in both sexes and the male genital apparatus without age limit, due to congenital, traumatic, septic, metabolic, obstructive and oncological conditions. Urologic oncology is the broadest urological part, where research and new advances make continuous learning essential. In this chapter we treat all academic features related with training in the field of Urooncology. more...
- Published
- 2018
15. In memoriam: Óscar Leiva Galvis
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Manuel Esteban Fuertes and Alfredo Rodríguez Antolín
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business.industry ,Urology ,Medicine ,business ,Humanities - Published
- 2018
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16. Contents Vol. 90, 2013
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Raja B. Khauli, Ken McElreavey, Gonzalo García-Fadrique, Tolga Akman, Yutian Dai, Lei Yin, Gaetano Ciancio, Cevper Ersoz, Bingkun Li, Mesrur Selcuk Silay, Muzaffer Akcay, Jinxian Pu, Shaobo Zheng, Aixia Zhang, M.A. Mirjalili, Dongxu Zhang, Yingbo Dai, Akbar Nouralizadeh, John R. Haaga, Daniel Turudić, Serkan Keskin, Shivam Joshi, Amr Kadah, Manuel Esteban Fuertes, Druck Reinhardt Druck Basel, Wei-Jie Zhu, Ahmet Yaser Muslumanoglu, Dalila Satta, Mohammad Masoud Nikkar, Jianming Guo, Chongrui Jin, Kamran Ahmed, Fenglei Zhang, Berkan Resorlu, Hamane Douadi, Ivan Povo-Martin, Cem Kezer, X. Wang, Jin Tang, Omer Faruk Bozkurt, Akif Erbin, J. Lassmann, A. Miernik, Zhibing Xu, Deirdre Anderson, Manuel Salvador-Marin, Matthew J. Maurice, Nashaat Nabil, Li Lu, Seyed Amir Mohsen Ziaee, Mohammad Hossein Soltani, G. Tosev, Sina Kardas, Noureddine Abadi, M. Kardoust Parizi, J. Liu, Yuemin Xu, Juan Carlos Gallego-Gómez, M. Oezsoy, Ekrem Ozyuvali, Huan Jiang, Danko Batinić, Declan Cahill, Murat Binbay, Hossam Hosny, Michael A. Gorin, Seyed Hossein Hosseini Sharifi, Jonathan Watkiss, Naouel Kherouatou, Nuzhath Khan, Danica Batinić, Jingfei Teng, Yongkang Zhang, M. Schoenthaler, Prokar Dasgupta, Daniel Gallego-Vilar, Zhaowei Zhu, Xu Li, Ali Unsal, Yuanfeng Yang, Sezai Vatansever, P. Weibl, Djalila Chellat, Yong Liu, Guomin Wang, Jose Florensa, Yanjun Zhu, C.L. Zhang, F.E. Kuehhas, Benlatrèche Cherifa, Yinglong Sa, Qilai Long, Tianyuan Xu, N.A. Moosa Nejad, Ljiljana Nizic, Xiang Wang, Yong Lu, Marija Topalović-Grković, Feng Pan, Yuxin Tang, Ali Ahanian, I. Schauer, Rany Shamloul, J.Y. Li, Nazih Khater, Chunxiao Liu, Faruk Tas, Ardalan Ojand, José Escribano, Emilio Rubio, Dean A. Nakamoto, Zhoujun Shen, Hang Wang, Abdullah Armagan, Miguel Vírseda Chamorro, S. Sevcenco, Alireza Lashay, Danfeng Xu, Abdulkadir Tepeler, Xiaohua Zhang, Satz Mengensatzproduktion, Xianzhen Jiang, C.M. Sun, Antonio López García-Moreno, Danko Milosevic, Lee Ponsky, Mohamed Larbi Rezgoune, Sebti Benbouhadja, Lianjun Pan, Jesús Salinas Casado, Emrah Yuruk, Liping Li, Mohammed Shamim Khan, Ben Challacombe, Hulin Li, Kristina Vrljicak, and A. Basiri more...
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Traditional medicine ,business.industry ,Urology ,Medicine ,business - Published
- 2013
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17. [Prognostic factors for the efficacy of Silodosin in the treatment of symptomatic Benign Prostatic Hyperplasia. Subanalysis of the URAL study.]
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Jesús, Salinas-Casado, Miguel, Vírseda-Chamorro, Santiago, Méndez-Rubio, Marcos, Luján-Galán, Manuel, Esteban-Fuertes, and Jesús, Moreno-Sierra
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Male ,Indoles ,Treatment Outcome ,Adrenergic alpha-1 Receptor Antagonists ,Prostatic Hyperplasia ,Humans ,Prognosis ,Aged ,Retrospective Studies - Abstract
To identify the prognostic factors influencing the clinical and urodynamics results on symptomatic benign prostatic hypertrophy (BHP) treatment in a series of patients with silodosin therapy from the URAL study.A retrospective study was performed in a cohort of 318 patients with BPH which underwent silodosine treatment, during at least 12 weeks.Univariate analysis demonstrated that the variables in relationship with a decrease of urinary symptoms` punctuation postreatment (measured with the IPSS Questionnaire), a maximum peak flow (Q max) postreatment equal or superior to 15 ml/s, a postreatment postvoid residual lower to 100 ml, and a postreatment obstruction index ( Bladder Outlet Obstruction Index: BOOI) equal or lower to 20 cm H2O, presented such both as a clinical and urodynamic character. The multivariate analysis demonstrated that a decreased punctuation of IPSS Questionnaire postreatment was in relationship to: a pretreatment cystometry bladder capacity (direct relationship), pretreatment Qmax (direct relationship), pretreatment postvoid residual (inverse relationship), and pretreatment BOOI (inverse relationship).The urodynamic study was very useful in the assessment of the prognostic factors in these patients. more...
- Published
- 2016
18. [Usefulness of urodynamics in the treatment of mixed urinary incontinence in women with suburethral slings]
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Jesús, Salinas-Casado, Santiago, Méndez-Rubio, Laura, Pesquera-Ortega, Miguel, Vírseda-Chamorro, Pablo, Gutiérrez-Martín, Luis, Resel-Folkersma, Manuel, Esteban-Fuertes, and Jesús, Moreno-Sierra
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Cohort Studies ,Suburethral Slings ,Urodynamics ,Urinary Incontinence, Stress ,Humans ,Urologic Surgical Procedures ,Female ,Middle Aged - Abstract
The urodynamic results in suburethral slings (SS), are contradictory. We evaluate a series on patients with stress urinary incontinence (associated or not with bladder hyperactivity) that underwent suburethral slings (SS) operations.42 women (age 62±12 years) with urinary incontinence underwent suburethral slings (86% TOT, 12% TVT, 2% others), 36% of them with simultaneous pelvic organ prolapse correction. Medical history and a pre and postsurgery urodynamic studies (according to ICS instructions, except when specified) were performed.After surgery, the improvement of urinary incontinence was lower in patients with previous detrusor hyperactivity (DH) than without DH (60% vs 81 %), and the bladder capacity (BC) was lower (123±36 ml) in patients with previous mixed urinary incontinence (MUI) versus no MUI (241±83 ml) (p=0.004). The decrease of BC was higher with previous MUI (184±92 ml vs 123±36 ml) versus no MUI (240±91 ml vs 237±78 ml), and the DH was more frequent in previous MUI and DH. There was a significant decrease of maximum flow rate (Qmax) (p=0.000) (although without clinical manifestation), and post void residual urine (p=0.007). We demonstrated a significant increase (p=0.001) of mean urethral resistance (URA): 12±9 cm H2O versus 15±12 cm H2O (without reaching obstruction range), and an improvement of detrusor contractility (W80-20): (3±4 W/m2; vs 6±17 W/m2;).We demonstrated worst results in MUI in patients with urinary incontinence undergoing SS. The urodynamic study gives a better prognosis reliability in the treatment of female urinary incontinence with SS. more...
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- 2016
19. Post Pelvic Radiotherapy Affectation of the Lower Urinary Tract Peripheral Innervation in Men
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Santiago Méndez-Rubio, Manuel Esteban Fuertes, Jesús Salinas Casado, Jesús Moreno Sierra, Miguel Vírseda Chamorro, and Pablo Gutiérrez Martín
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Urinary system ,030232 urology & nephrology ,Electromyography ,Pelvis ,03 medical and health sciences ,0302 clinical medicine ,Urethra ,Peripheral Nervous System ,medicine ,Humans ,Radiation Injuries ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,Radiotherapy ,business.industry ,Rectal Neoplasms ,Prostatic Neoplasms ,Retrospective cohort study ,Peripheral ,Surgery ,body regions ,Radiation therapy ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Peripheral nervous system ,Colonic Neoplasms ,business - Abstract
Introduction: The periurethral electromyography (EMGs) alterations in men who underwent pelvic radiotherapy (RT), either isolated or combined with surgery, have not been frequently described in the literature. Objective: The study aimed to compare the EMG's data in men undergoing RT versus the non-irradiated control group. Material and Methods: The study included 61 consecutive males, who had undergone RT (27 of them had been operated) and 99 control consecutive patients who underwent a retrospective assessment. The EMGs were performed using a concentric electrode needle perineally, localizing the sphincter by visual and auditory signal (electromyograph MMS Solar Active). Results: 14.8% denervation, 62.9% reinnervation, 14.9% denervation + reinnervation and 7.4% EMG normal. The age (p < 0.001) and neurogenic bladder data (p < 0.001) are risk factors. The smaller the prostate size (obtained by rectal examination) post-RT, the more the chance for an abnormal EMG (p < 0.001). The fact of having had received RT (p < 0.001) is the only risk factor. Conclusion: RT produces lesions over the pudendal nerve, showing denervation even in late periods. The surgery did not behave as a risk factor. more...
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- 2016
20. [Long-term adverse effects on bladder filling phase in males submitted to the pelvic radiotherapy]
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Santiago, Méndez-Rubio, Jesús, Salinas-Casado, Miguel, Vírseda-Chamorro, Manuel, Esteban-Fuertes, Pablo, Menéndez-Sánchez, and Jesús, Moreno-Sierra
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Male ,Urodynamics ,Time Factors ,Radiotherapy ,Rectal Neoplasms ,Colonic Neoplasms ,Urinary Bladder ,Humans ,Prostatic Neoplasms ,Aged ,Retrospective Studies - Abstract
To describe and quantify the long-term adverse effects on filling phase of lower urinary tract function in males submitted to radiotherapy.We performed a retrospective comparative study on a cohort of 99 men undergoing EBRT a mean of 4.7 years before for clinically localized prostate, rectum or colon neoplasia, and another cohort formed by 97 men over 50 years who did not undergo radiotherapy.Cystometric bladder capacity and bladder capacity at first voiding desire were significantly lower in the radiotherapy group. Univariate analysis showed that the radiotherapy group evinced a risk to present a diminished compliance of 3.5 times more and 9.3 times more to find stress urinary incontinence, but we did not found increased risk for detrusor overactivity. In multivariate analysis the history of radical surgery acted as a confounding factor in the risk of stress urinary incontinence, but not to suffer diminished bladder compliance.The main long-term adverse effect of pelvic radiotherapy on male bladder function during filling is the increased risk of low bladder compliance. more...
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- 2015
21. Risk factors to develop autonomic dysreflexia during urodynamic examinations in patients with spinal cord injury
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Miguel, Vírseda-Chamorro, Jesus, Salinas-Casado, Pablo, Gutiérrez-Martín, Manuel, de la Marta-García, Antonio, López-García-Moreno, and Manuel, Esteban Fuertes
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Adult ,Male ,Urinary Bladder ,Age Factors ,Blood Pressure ,Middle Aged ,Urodynamics ,Cross-Sectional Studies ,Urinary Incontinence ,Heart Rate ,Risk Factors ,Prevalence ,Autonomic Dysreflexia ,Humans ,Female ,Physical Examination ,Spinal Cord Injuries ,Aged - Abstract
The risk factors for developing autonomic dysreflexia (AD) during urodynamic (UD) examination in patients with spinal cord injury (SCI) above Th6 still remain unclear. The main goal of our study is to investigate the risk factors that could be associated with AD in these particular patients.Cross sectional survey.The study was carried out in 83 patients with SCI above Th6 who were submitted to our center for a UD examination. AD was defined as a rise in systolic blood pressure above 15 mm Hg with a pulse rate below 60 beats per minute.The prevalence rate of AD among our patients was 54%. Univariate analysis of our study showed the following risk factors: patient's age, SCI completeness, traumatic etiology, indwelling catheter, presence of chills or sweating, anticholinergic treatment, maximum detrusor voiding pressure, detrusor pressure at maximum flow rate, detrusor external sphincter dyssynergia, and bladder outlet obstruction. Using multivariate logistic regression, we found that there are only two independent risk factors: patient's age equal to or above 45 years of age (OR = 10.995) and maximum detrusor voiding pressure equal to or above 31 cm HAccording to our results, the patient's age and maximum detrusor voiding pressure should be considered at the time of performing a UD examination in order to prevent the sudden onset of AD in patients with SCI above Th6. Neurourol. Urodynam. 36:171-175, 2017. © 2015 Wiley Periodicals, Inc. more...
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- 2015
22. The 3-Day Bladder Diary Is a Feasible, Reliable and Valid Tool to Evaluate the Lower Urinary Tract Symptoms in Women
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Miguel A, Jimenez-Cidre, Luis, Lopez-Fando, Manuel, Esteban-Fuertes, Luis, Prieto-Chaparro, Francisco J, Llorens-Martinez, Jesus, Salinas-Casado, David, Castro-Diaz, Carlos, Müller-Arteaga, Jose M, Adot-Zurbano, Fernando, Rodriguez-Escobar, Cristina, Gutierrez, Salvador, Arlandis-Guzman, Miguel A, Bonillo-Garcia, Blanca, Madurga-Patuel, Manuel, Leva-Vallejo, Agustin, Franco de Castro, Lluis, Peri-Cusi, Joan, Conejero-Sugrañes, Jesus, Jimenez-Calvo, Pablo, Rebollo, and Ana, Mora more...
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Adult ,Observer Variation ,Incidence ,Reproducibility of Results ,Urination ,bladder diary ,Middle Aged ,patient reported outcome measures-PROM ,Medical Records ,Urodynamics ,Cross-Sectional Studies ,Urinary Incontinence ,Lower Urinary Tract Symptoms ,Surveys and Questionnaires ,Feasibility Studies ,Humans ,Female ,lower urinary tract symptoms-LUTS ,Prospective Studies ,women ,Aged - Abstract
AimsTo evaluate the feasibility (% of completion), reliability (test-retest and inter-observer) and validity (convergent vs. questionnaires and vs. urodynamic study-UDS) of the 3-day bladder diary (3dBD) in women with lower urinary tract symptoms (LUTS). MethodsEpidemiological, descriptive, cross-sectional and prospective study. Fourteen Functional Urology and Urodynamic Units participated. One hundred thirty-six women with mean age (SD) 55.2 (13.8) years with LUTS, without bladder catheterization and who were able to fill in the 3dBD were included. An UDS was performed. They filled in the 3dBD in two times separated by 15 days (test and retest), the International Consultation on IncontinenceShort Form (ICIQ-UI SF) and the Bladder Control Self-Assessment Questionnaire (BSAQ). ResultsOne hundred ten women completed 3dBD for test and retest. Feasibility: each 3dBD has 42 variables, 77.2% women completed 80%. Test-retest reliability: there were not differences in the proportion of patients classified as positive for each symptom (urgency: P=0.3173; incontinence: P=1; nocturia: P=0.0522; frequency: P=0.4386). The Intraclass Correlation Coefficient (ICC) ranged from 0.67 to 0.92, except for night time VVmax which was lower (0.54). Inter-observer reliability: ICC ranged from 0.64 to 0.99, except for day time VVmax (0.29) and the number of urgency episodes (0.45). Validity: Spearman correlation coefficients for ICIQ-UI SF and BSAQ ranged from 0.4 to 0.6 (P more...
- Published
- 2015
23. A randomized controlled trial to assess the efficacy and cost-effectiveness of urinary catheters with silver alloy coating in spinal cord injured patients: trial protocol
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Juana María Barrera Chacón, Xavier Bonfill, Sebastián Salvador de la Barrera, Ignacio Araya, Carolina María Alemán-Sánchez, María Luisa Jáuregui-Abrisqueta, Albert Borau Duran, Juan Ramón Espinosa Quirós, Manuel Esteban Fuertes, Ma José Martínez-Zapata, Manuel Bea-Muñoz, Luís Ledesma Romano, David Rigau, and Susana Moraleda Pérez more...
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Male ,Cost effectiveness ,Cost-Benefit Analysis ,Comorbidity ,law.invention ,Study Protocol ,Randomized controlled trial ,Antiseptic ,Coated Materials, Biocompatible ,law ,Risk Factors ,Protocol ,Medicine ,Single-Blind Method ,Spinal cord injury ,Aged, 80 and over ,Urinary tract infection ,Incidence ,General Medicine ,Bacterial Infections ,Equipment Design ,Middle Aged ,Anti-Bacterial Agents ,medicine.anatomical_structure ,Treatment Outcome ,Research Design ,Female ,Randomized clinical trial ,Alloy coating ,Adult ,medicine.medical_specialty ,Silver ,Adolescent ,medicine.drug_class ,Urology ,Urinary system ,Trial protocol ,Urinary Catheters ,Young Adult ,Alloys ,Spinal cord injuries ,Humans ,Aged ,business.industry ,Spinal cord ,medicine.disease ,Surgery ,Equipment Failure Analysis ,Urinary Incontinence ,Reproductive Medicine ,Spain ,Catheter-Related Infections ,business - Abstract
BackgroundPatients with non-acute spinal cord injury that carry indwelling urinary catheters have an increased risk of urinary tract infection (UTIs). Antiseptic Silver Alloy-Coated Silicone Urinary Catheters seems to be a promising intervention to reduce UTIs; however, actual evidence cannot be extrapolated to spinal cord injured patients. The aim of this trial is to make a comparison between the use of antiseptic silver alloy-coated silicone urinary catheters and the use of standard urinary catheters in spinal cord injured patients to prevent UTIs.Methods/DesignThe study will consist in an open, randomized, multicentre, and parallel clinical trial with blinded assessment. The study will include 742 spinal cord injured patients who require at least seven days of urethral catheterization as a method of bladder voiding. Participants will be online centrally randomized and allocated to one of the two study arms (silver alloy-coated or standard catheters). Catheters will be used for a maximum period of 30 days or removed earlier if the clinician considers it necessary. The main outcome will be the incidence of UTIs by the time of catheter removal or at day 30 after catheterization, the event that occurs first. Intention-to-treat analysis will be performed, as well as a primary analysis of all patients.DiscussionThe aim of this study is to assess whether silver alloy-coated silicone urinary catheters improve ITUs in spinal cord injured patients. ESCALE is intended to be the first study to evaluate the efficacy of the silver alloy-coated catheters in spinal cord injured patients.Trial registrationNCT01803919 more...
- Published
- 2013
24. Study of the prevalence and interobserver reproducibility of radiologic images suggestive of urethral diverticula in men with spinal cord injury
- Author
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Manuel Esteban Fuertes, Jose Florensa, Miguel Vírseda Chamorro, Jesús Salinas Casado, José Escribano, Emilio Rubio, and Antonio López García-Moreno
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Male ,medicine.medical_specialty ,Urology ,Interobserver reproducibility ,Kappa index ,Cystourethrography ,Prostatic urethra ,Predictive Value of Tests ,Urethral Diseases ,medicine ,Prevalence ,Humans ,Spinal cord injury ,Spinal Cord Injuries ,Observer Variation ,Chi-Square Distribution ,business.industry ,Reproducibility of Results ,medicine.disease ,Male urethra ,Surgery ,Radiography ,Diverticulum ,Urethra ,medicine.anatomical_structure ,Cross-Sectional Studies ,Logistic Models ,Spain ,Radiology ,business - Abstract
Objectives: To determine the prevalence of radiologic images suggestive of urethral diverticula (UD) in men with spinal cord injury (SCI) and to study the interobserver diagnostic reproducibility. Methods: Radiological studies (i.e. voiding cystourethrography and retrograde urethrography) performed over 1 year on men with SCI were independently reviewed by 3 researchers (1 urologist and 2 radiologists). Results: The prevalence of UD was found to be between 4.2 and 9.8% of the patients, the higher figure obtained when including also the doubtful images. The kappa index of agreement between the researchers was low (between 0.15 and 0.40). The factors that significantly influenced agreement were localization in the prostatic urethra (p = 0.021), localization in the penile urethra (p = 0.000) and fusiform morphology (p = 0.004). Logistic regression analysis showed that the variables that independently influenced diagnostic agreement were the following: localization in the penile urethra (in favor of agreement) and fusiform morphology (against agreement). Conclusions: Radiologic images suggestive of UD constitute a frequent finding in men with SCI and raise important diagnostic problems. more...
- Published
- 2012
25. [Quality of life of males with spinal cord injury and sexual dysfunction]
- Author
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Ana Isabel, Cobo-Cuenca, Juan Pedro, Serrano-Selva, Manuel, de la Marta-Florencio, Manuel, Esteban-Fuertes, Miguel, Vírseda-Chamorro, Noelia Ma, Martín-Espinosa, and Antonio, Sampietro-Crespo
- Subjects
Adult ,Male ,Young Adult ,Cross-Sectional Studies ,Erectile Dysfunction ,Quality of Life ,Humans ,Middle Aged ,Spinal Cord Injuries - Abstract
the aims of this study are to assess the quality of life (QOL) of males with spinal cord injury (SCI) and to know their sexual health. We also analyze the links among clinic and sociodemographic variables, the sexual health of males with SCI and their QOL.This is a transversal cross-sectional study that was made in the hospital of Paraplegics of Toledo. The sample included 45 men presenting SCI and sexual dysfunction. Life Satisfaction Checklist and Sexual Health Measurement Scale were used to gather data.The 97, 8% of all participants are interested in having sexual relationships; the 70% of all participants have a steady sexual couple while the 51% often maintain sexual relations. The 86% of the sample admit to suffer from erectile dysfunction and the 71% can't ejaculate. The score of the group which has erectile dysfunction are significantly low in sexual QOL (p t-Student 0.000) and in general QOL (p t-Student 0.001). The sample had an average in general QOL of 34,27 (standard deviation: 2,8), in social QOL 20,16 (SD:2,7), in sexual QOL 7,62 (SD:2,7) and in economic QOL 7,71 (SD:2,6). There isn't a significant relationship among the QOL and the etiology, the degree and the time of evolution of the SCI.The individuals who have participated in this study generally experienced a good general QOL, but their sexual life is the aspect which causes them a greater dissatisfaction. In fact, those who suffer from erectile dysfunction show less satisfaction with their general and sexual QOL. more...
- Published
- 2011
26. [Prospective study of the therapeutic usefulness and safety of a new disposable intraurethral occlusive device (Uriabsorber) for female stress urinary incontinence]
- Author
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Miguel, Vírseda Chamorro, Jesus, Salinas Casado, Manuel, Esteban Fuertes, Antonio, Mañas Pelillo, and Fernando, Teba del Pino
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Adult ,Treatment Outcome ,Patient Satisfaction ,Urinary Incontinence, Stress ,Urology ,Humans ,Female ,Prospective Studies ,Prostheses and Implants ,Safety ,Disposable Equipment - Abstract
To determine the therapeutic usefulness and side effects of a new disposable intraurethral device (Uriabsorber) for female stress urinary incontinence.A prospective study was performed in a cohort of 48 women (mean age 42.7 yr.) consulting because of urinary incontinence with coughing. Lack of manual ability or difficulty to understand, pregnancy, puerperium, vaginitis, urinary tract infection and current administration of active treatment for urinary incontinence were all exclusion criteria. Patients were instructed about the use of the device. Two visits were performed: one after two weeks and the other at the end of the month. Clinical results were collected and urine analysis was performed. A multivariate statistical analysis was performed to determine what variables influenced the final result.Treatment withdrawal rate was 42% after one month, being most withdrawals before 14 days (19 cases, 40%). The causes of withdrawal were local discomfort (11 cases, 23%) and difficult insertion (3 cases, 6%). There were only five cases (10%) of urinary tract infection, and two cases (4%) of macroscopic hematuria. The presence of cystocele was associated with higher frequency of complications (80%). 79% of the patients completing the month of treatment had positive results (50% resolution of incontinence and 29% improvement). Multivariate statistical analysis showed that variables independently influencing the results were: incontinence intensity (the lower the intensity, the better the results), presence of urinary tract symptoms (the lower the intensity of the symptoms, the better the results), and absence of past history of pathology.The intraurethral disposable device significantly reduces the rate of urinary tract infections. Tolerance depends on the ability and motivation of the patients. It is indicated in the control of non intense urinary incontinence in motivated patients, without evident cystocele. more...
- Published
- 2004
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