Archivos españoles de urología
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Review Comparative Study
[Critical comparative analysis between open, laparoscopic and robotic radical prostatectomy: perioperative morbidity and oncological results (Part I)].
With regard to oncological outcomes and perioperative morbidity, surgical treatment of localized prostate cancer has proved to be an excellent treatment option. At present, there are three different approaches, open, laparoscopic and robotic. Open radical prostatectomy remains the "gold Standard" due to accumulated experience and long follow up of series. But, without a doubt, laparoscopic and robotic groups are contributing with a far from negligible experience. Looking carefully at outcomes we will have to elucidate amongst advantages and disadvantages of each one of them. In this study we have performed a review of the literature trying to compare the three techniques, focusing in available surgical morbidity and oncological outcomes. ⋯ The open surgery has become a reference for all comparisons. The laparoscopic surgery is being replaced (specially in North America) by robotic surgery which is constantly expanding. It is necessary the publication of randomized and prospective studies to be able to objectively compare the three techniques.
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To evaluate the need to perform renal ultrasound (US) in adult patients with acute pyelonephritis (APN). ⋯ The low incidence of ultrasonographic findings does not justify the practice of renal US to every patient with APN. In patients with persistent fever longer than 72 hours, antecedents of anomalies of the urinary tract, antecedents of renal lithiasis, pregnancy, atypical clinic or diabetes mellitus, there is a higher incidence of pathological US findings that justify a change in the therapeutic approach. Further prospective clinical studies are needed to confirm these conclusions.
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Analysis of all pediatric donor en bloc transplants to adult receptors performed in our department. ⋯ Pediatric donor en bloc transplants have an excellent survival and function in the middle and long-term. Vascular complications are the main cause of pediatric donor graft loss. The adoption of a pediatric donor en bloc transplant program increases the transplant activity.
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To demonstrate that strangulation of the prepuce needs immediate specialist care. ⋯ Immediate care, individualization of each case, as well as the experience of the treating physician will dictate the approach to follow in each patient. Medical personnel in adult as well as pediatric emergency departments must be aware that it is a problem that requires immediate care and avoid doing empirical and/or heroic treatments.