Archivos españoles de urología
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Review Meta Analysis
Molecular markers for ischemia, do we have something better then creatinine and glomerular filtration rate?
Acute kidney injury (AKI) can occur spontaneously or iatrogenically, and rates of AKI continue to rise over the last two decades despite improvements in clinical care and development of preventive strategies. Serum creatinine (sCr) is the current gold standard for measuring changes in kidney function and identifying AKI. Detection of AKI by sCr, however, is delayed and small rises connote significantly increased morbidity and mortality. ⋯ A review of the current literature regarding these biomarkers reveals that they individually have unique strengths and weaknesses that can provide different types of information about patients. Currently, NGAL is the urine biomarker with the most promise as an individual marker. However, combining multiple markers to form a 'biomarker panel' along with sCr is an improvement over current clinical risk prediction models alone, and may be able to provide more individualized detail about the type and location of renal injury.
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Case Reports
Bladder injury during trans-obturator tape surgery in a patient with previous colposuspension: is there a connection?
Bladder injuries are quite rare and complex complications of transobturator tapes in the treatment of female stress urinary incontinence, with very few published cases. The authors present a case report and discuss possible injury mechanisms and the role of cystoscopy in this setting. ⋯ In patients with previous incontinence surgical treatments, cystoscopy at the time of surgery should be considered to exclude and treat eventual injuries, in order to avoid future complications.
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Calyceal fistula is a rare complication of renal transplantation that may lead to graft loss. This article reports a case of functional recuperation of a graft that seemed condemned to failure. ⋯ Calyceal fistulas are complications of difficult resolution. However, the present case demonstrates that with an appropriate treatment it is possible to save a graft with no apparent solution at the first place.
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To report a rare case of penile paraffinoma caused by the subcutaneous or intra-urethral injection of foreign substances containing long-chain saturated hydrocarbons. These were injected in order to increase the penis size which generated a chronic granulomatous inflammatory reaction. This is a rare practice in the western world. ⋯ The injection of foreign substances to enhance penis size is currently an unjustifiable practice. However, it is still carried out, especially in Eastern Europe and Asia. In most cases surgical treatment is needed to treat the complications and the best modality seems to be radical excision together with follow-up.