Camila Moreno-Bencardino, L. Zuluaga, Jaime Pérez, Camila Céspedes, Catalina Forero, N. Fernández
Introduction Although there is an increasing experience in the management of transgender individuals, this has not been thoroughly explored in children. The need to establish a comprehensive and transdisciplinary management is of critical importance. In order to solve this issue, we want to report the results of a cohort of individuals with gender dysphoria (GD) seen by our transdisciplinary group from a social and clinical and health access perspective. Methods A 10-year retrospective case series of all patients that had been seen by our transdisciplinary team was reviewed. The main demographic characteristics were described, as well as impact variables in terms of diagnosis and treatment of these individuals. A social description of each individual was described. Frequency, distribution, and central tendency measures were evaluated for data presentation. IBM SPSS Statistics for Windows, version 24.0 (IBM Corp, Armonk, NY) software was used. Results Four cases of GD were included. Three had male to female dysphoria and one female to male. The median reported age of GD awareness was 6 years old (between 4 and 8 years old), and the median time between GD awareness and the 1st medical evaluation was 7 years for all individuals. The median age at gender role expression was 12 years old (between 10 and 14 years old). All patients had already assumed their experienced gender role before the 1st evaluation by our group. The median age at the 1st evaluation by our group was 13 years old (between 10 and 16 years old); three of the patients were evaluated after initiation of puberty. In the present study, individuals with GD demonstrated having health care access barriers for their transition process. Referral times are high, and individuals with GD are cared after pubertal development, which is related to suboptimal outcomes. The spectrum of GD is broad, and management must be individualized according to expectations. Conclusion Individuals with GD face multiple access barriers that limit their possibility of being seen by a transdisciplinary team. This reflects in longer waiting times that negatively impact medical management. Gender dysphoria is a wide spectrum, and individuals should be evaluated individually by a transdisciplinary team.
介绍 尽管在管理变性人方面有越来越多的经验，但这一点尚未在儿童身上得到彻底探索。建立全面和跨学科管理的必要性至关重要。为了解决这个问题，我们想报告我们的跨学科小组从社会、临床和健康获取的角度观察到的一组患有性别焦虑症（GD）的个体的结果。方法 我们的跨学科团队对所有患者的10年回顾性病例系列进行了回顾性研究。描述了这些人的主要人口统计学特征，以及在诊断和治疗方面的影响变量。描述了每个人的社会描述。对频率、分布和中心趋势指标进行了评估，以进行数据展示。使用IBM SPSS Statistics for Windows，版本24.0（IBM Corp，Armonk，NY）软件。后果 包括4例GD。三名患者有男性对女性焦虑症，一名女性对男性焦虑症。所有个体的GD意识的中位报告年龄为6岁（4至8岁），从GD意识到第一次医学评估的中位时间为7年。性别角色表达的中位年龄为12岁（10至14岁）。在我们小组的第一次评估之前，所有患者都已经承担了他们经验丰富的性别角色。我们组第一次评估时的中位年龄为13岁（10至16岁）；其中三名患者在青春期开始后接受评估。在本研究中，GD患者在过渡过程中表现出了获得医疗保健的障碍。转诊时间很长，GD患者在青春期发育后得到护理，这与次优结果有关。GD的范围很广，必须根据预期进行个性化管理。结论 GD患者面临多重访问障碍，这限制了他们被跨学科团队看到的可能性。这反映在较长的等待时间对医疗管理产生负面影响。性别焦虑症是一个广泛的领域，个人应该由跨学科团队单独评估。
{"title":"Gender Dysphoria in the Pediatric Population: Initial Experience of a Transdisciplinary Group","authors":"Camila Moreno-Bencardino, L. Zuluaga, Jaime Pérez, Camila Céspedes, Catalina Forero, N. Fernández","doi":"10.1055/s-0041-1730327","DOIUrl":"https://doi.org/10.1055/s-0041-1730327","url":null,"abstract":"\u0000 Introduction Although there is an increasing experience in the management of transgender individuals, this has not been thoroughly explored in children. The need to establish a comprehensive and transdisciplinary management is of critical importance. In order to solve this issue, we want to report the results of a cohort of individuals with gender dysphoria (GD) seen by our transdisciplinary group from a social and clinical and health access perspective.\u0000 Methods A 10-year retrospective case series of all patients that had been seen by our transdisciplinary team was reviewed. The main demographic characteristics were described, as well as impact variables in terms of diagnosis and treatment of these individuals. A social description of each individual was described. Frequency, distribution, and central tendency measures were evaluated for data presentation. IBM SPSS Statistics for Windows, version 24.0 (IBM Corp, Armonk, NY) software was used.\u0000 Results Four cases of GD were included. Three had male to female dysphoria and one female to male. The median reported age of GD awareness was 6 years old (between 4 and 8 years old), and the median time between GD awareness and the 1st medical evaluation was 7 years for all individuals. The median age at gender role expression was 12 years old (between 10 and 14 years old). All patients had already assumed their experienced gender role before the 1st evaluation by our group. The median age at the 1st evaluation by our group was 13 years old (between 10 and 16 years old); three of the patients were evaluated after initiation of puberty. In the present study, individuals with GD demonstrated having health care access barriers for their transition process. Referral times are high, and individuals with GD are cared after pubertal development, which is related to suboptimal outcomes. The spectrum of GD is broad, and management must be individualized according to expectations.\u0000 Conclusion Individuals with GD face multiple access barriers that limit their possibility of being seen by a transdisciplinary team. This reflects in longer waiting times that negatively impact medical management. Gender dysphoria is a wide spectrum, and individuals should be evaluated individually by a transdisciplinary team.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43119344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Maltrato Laboral en Urología: “Rompiendo la Cuarta Pared”","authors":"Ximena Guzmán Robledo, H. García-Perdomo","doi":"10.1055/s-0041-1740642","DOIUrl":"https://doi.org/10.1055/s-0041-1740642","url":null,"abstract":"","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41916226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Carta al Editor en referencia al articulo “Percepción de acoso o discriminación durante la residencia de urología en Colombia”","authors":"Juan Guillermo Cataño Cataño","doi":"10.1055/s-0041-1741457","DOIUrl":"https://doi.org/10.1055/s-0041-1741457","url":null,"abstract":"","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42744010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reconocimiento a los editores RUC","authors":"Armando López López","doi":"10.1055/s-0041-1741042","DOIUrl":"https://doi.org/10.1055/s-0041-1741042","url":null,"abstract":"","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48187773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dania Carreño, A. Gómez, C. Torres, Luis Fernando Solano
Objetivo La biopsia de próstata es una ayuda esencial en el diagnóstico de cáncer, siendo el método más utilizado la biopsia transrectal guiada por ultrasonido (TRUS), con una tasa diagnóstica entre el 37% y el 45%, aunque no exenta de complicaciones como infecciones, dolor o sangrado.El enfoque alternativo y seguro a las biopsias TRUS se encuentra en la biopsia transperineal (BTP), realizada comúnmente bajo anestesia regional o general.El objetivo de este estudio fue determinar la efectividad de la BTP bajo anestesia local y guía ultrasonográfica transrectal, con el impacto sobre la sensibilidad del estudio y la tasa de readmisión hospitalaria por infección. Métodos Estudio de cohorte retrospectiva en el que se evaluaron 83 pacientes sometidos a BTP con anestesia local y guía ultrasonográfica transrectal de enero de 2017 a agosto de 2018 en una ciudad intermedia de Colombia. La muestea incluyó todos los hombres mayores de 18 años con datos de historia clínica disponibles para su análisis, así como los reportes histopatológicos de las biopsias. Se excluyeron casos de rebiopsia o con datos insuficientes.El análisis de datos nominales se realizó mediante la prueba de chi cuadrado, y el de los datos numéricos, con las prubas t de Student o de Mann-Whitney. Resultados Un total de 83 pacientes, con media de edad de 65 ± 7.9 años fueron sometidos al análisis del estudio histopatológico. Se excluyeron nueve pacientes que no tenían información disponible en el registro clínico sistematizado, ni en historia clínica de formato físico. Se encontró una proporción de positividad y diagnóstico de cáncer de prostata en el 39.7% (33) de los pacientes, distribuidos así: grado de grupo 1 (69.7%; 23); grado de grupo 2 )15.2%; 5); grados de grupos 3 y 4 (3% cada uno de ellos; 2); y grado de grupo 5 (9%; 3). En total, 60% (50) fueron negativos para malignidad y, de estos el 54% (27) tuvo hiperplasia. El antibiótico profiláctico indicado en el 96.7% (80) de los casos fue una cefalosporina de primera generación, administrada en el 15% (12) por vía parenteral preoperatoria. En esta serie de casos, no se documentaron ingresos hospitalarios asociados a infección después del procedimiento. Conclusiones La biopsia de próstata por vía transperineal es una técnica con rendimiento diagnostico similar al del abordaje transrectal: es segura, rápida, de fácil acceso, con bajo costo y, sobre todo, con un riesgo insignificante de infección y sepsis. Sus beneficios son altamente representativos en un sistema de salud como el de nuestro país, y la BTP facilita el acceso de la población vulnerable del área rural y de ciudades intermedias, en las que no se dispone de un urólogo experto.
{"title":"Biopsia de próstata, acceso transperineal bajo anestesia local","authors":"Dania Carreño, A. Gómez, C. Torres, Luis Fernando Solano","doi":"10.1055/s-0041-1740375","DOIUrl":"https://doi.org/10.1055/s-0041-1740375","url":null,"abstract":"\u0000 Objetivo La biopsia de próstata es una ayuda esencial en el diagnóstico de cáncer, siendo el método más utilizado la biopsia transrectal guiada por ultrasonido (TRUS), con una tasa diagnóstica entre el 37% y el 45%, aunque no exenta de complicaciones como infecciones, dolor o sangrado.El enfoque alternativo y seguro a las biopsias TRUS se encuentra en la biopsia transperineal (BTP), realizada comúnmente bajo anestesia regional o general.El objetivo de este estudio fue determinar la efectividad de la BTP bajo anestesia local y guía ultrasonográfica transrectal, con el impacto sobre la sensibilidad del estudio y la tasa de readmisión hospitalaria por infección.\u0000 Métodos Estudio de cohorte retrospectiva en el que se evaluaron 83 pacientes sometidos a BTP con anestesia local y guía ultrasonográfica transrectal de enero de 2017 a agosto de 2018 en una ciudad intermedia de Colombia. La muestea incluyó todos los hombres mayores de 18 años con datos de historia clínica disponibles para su análisis, así como los reportes histopatológicos de las biopsias. Se excluyeron casos de rebiopsia o con datos insuficientes.El análisis de datos nominales se realizó mediante la prueba de chi cuadrado, y el de los datos numéricos, con las prubas t de Student o de Mann-Whitney.\u0000 Resultados Un total de 83 pacientes, con media de edad de 65 ± 7.9 años fueron sometidos al análisis del estudio histopatológico. Se excluyeron nueve pacientes que no tenían información disponible en el registro clínico sistematizado, ni en historia clínica de formato físico. Se encontró una proporción de positividad y diagnóstico de cáncer de prostata en el 39.7% (33) de los pacientes, distribuidos así: grado de grupo 1 (69.7%; 23); grado de grupo 2 )15.2%; 5); grados de grupos 3 y 4 (3% cada uno de ellos; 2); y grado de grupo 5 (9%; 3). En total, 60% (50) fueron negativos para malignidad y, de estos el 54% (27) tuvo hiperplasia. El antibiótico profiláctico indicado en el 96.7% (80) de los casos fue una cefalosporina de primera generación, administrada en el 15% (12) por vía parenteral preoperatoria. En esta serie de casos, no se documentaron ingresos hospitalarios asociados a infección después del procedimiento.\u0000 Conclusiones La biopsia de próstata por vía transperineal es una técnica con rendimiento diagnostico similar al del abordaje transrectal: es segura, rápida, de fácil acceso, con bajo costo y, sobre todo, con un riesgo insignificante de infección y sepsis. Sus beneficios son altamente representativos en un sistema de salud como el de nuestro país, y la BTP facilita el acceso de la población vulnerable del área rural y de ciudades intermedias, en las que no se dispone de un urólogo experto.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49356173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Catalina Sánchez Basto, Adriana Chaves Parra, Catalina Osorio Ospino, María Paula Saenz Becerra, Johanna Vega, Daisy Ximena Roa Saavedra, Melanie López de Mesa, Irma A. Ospina-Galeano, Catalina Solano Mendoza
Introducción y Objetivo En las últimas décadas, la incidencia y prevalencia de la incontinencia urinaria han venido en aumento. Existen numerosas publicaciones sobre este tema, se han introducido nuevos dispositivos, y se han modificado las líneas de manejo de esta patología. El objetivo de este estudio es realizar un análisis bibliométrico de las publicaciones sobre incontinencia urinaria masculina en las revistas indexadas. Métodos Se realizó un análisis bibliométrico descriptivo de corte retrospectivo de la literatura médica disponible en la base de datos Web of Science (WOS) en relación con incontinencia urinaria masculina entre 2002 y 2020. Por medio de la WOS, se obtuvieron las variables a analizar, y se elaboraron tablas y gráficas en el programa Microsoft Office Excel 2017. Resultados Encontramos un total de 498 publicaciones en 88 revistas. Hubo un crecimiento exponencial de las publicaciones a partir de 2006. Las 3 revistas con mayor porcentaje de publicaciones fueron: J Urol, con 25,2% (125), Neurol Urodyn, con 16,5% (82), European Urology Journal, con 11,1% (55); sólo 5 de las 20 revistas con más publicaciones tuvieron un factor de impacto ≥ 3. El país que tuvo mayor porcentaje fue Estados Unidos con 21,2% (105), seguido por países europeos. En América Latina, el país con mayor número de publicaciones fue Brasil, con 2,6% (13). No se encontraron estudios colombianos con esta búsqueda específica. Conclusión Este es el primer estudio bibliométrico sobre incontinencia urinaria masculina. Con el tiempo, han aumentado las publicaciones acerca de este tema, y la mayoría está concentrada en revistas de Estados Unidos y Europa. No es predominante la publicación en revistas de alto factor de impacto, y es muy baja la cantidad de publicaciones que aporta Colombia y los demás países latinoamericanos.
{"title":"Análisis bibliométrico de la incontinencia urinaria masculina. Una mirada de los últimos 20 años","authors":"Catalina Sánchez Basto, Adriana Chaves Parra, Catalina Osorio Ospino, María Paula Saenz Becerra, Johanna Vega, Daisy Ximena Roa Saavedra, Melanie López de Mesa, Irma A. Ospina-Galeano, Catalina Solano Mendoza","doi":"10.1055/s-0041-1740268","DOIUrl":"https://doi.org/10.1055/s-0041-1740268","url":null,"abstract":"\u0000 Introducción y Objetivo En las últimas décadas, la incidencia y prevalencia de la incontinencia urinaria han venido en aumento. Existen numerosas publicaciones sobre este tema, se han introducido nuevos dispositivos, y se han modificado las líneas de manejo de esta patología. El objetivo de este estudio es realizar un análisis bibliométrico de las publicaciones sobre incontinencia urinaria masculina en las revistas indexadas.\u0000 Métodos Se realizó un análisis bibliométrico descriptivo de corte retrospectivo de la literatura médica disponible en la base de datos Web of Science (WOS) en relación con incontinencia urinaria masculina entre 2002 y 2020. Por medio de la WOS, se obtuvieron las variables a analizar, y se elaboraron tablas y gráficas en el programa Microsoft Office Excel 2017.\u0000 Resultados Encontramos un total de 498 publicaciones en 88 revistas. Hubo un crecimiento exponencial de las publicaciones a partir de 2006. Las 3 revistas con mayor porcentaje de publicaciones fueron: J Urol, con 25,2% (125), Neurol Urodyn, con 16,5% (82), European Urology Journal, con 11,1% (55); sólo 5 de las 20 revistas con más publicaciones tuvieron un factor de impacto ≥ 3. El país que tuvo mayor porcentaje fue Estados Unidos con 21,2% (105), seguido por países europeos. En América Latina, el país con mayor número de publicaciones fue Brasil, con 2,6% (13). No se encontraron estudios colombianos con esta búsqueda específica.\u0000 Conclusión Este es el primer estudio bibliométrico sobre incontinencia urinaria masculina. Con el tiempo, han aumentado las publicaciones acerca de este tema, y la mayoría está concentrada en revistas de Estados Unidos y Europa. No es predominante la publicación en revistas de alto factor de impacto, y es muy baja la cantidad de publicaciones que aporta Colombia y los demás países latinoamericanos.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41477599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Resumen En pacientes con estrechez uretral bulbar de una longitud mayor a 2 cm, que no sean candidatos a otras técnicas, se realiza uretroplastia con injerto. Actualmente se emplean diversas técnicas, cada una con ventajas y desventajas propias. Describir las ventajas y desventajas de las técnicas quirúrgicas empleadas actualmente en la uretroplastia con injerto, así como sus tasas de éxito. Se hizo una búsqueda en PubMed, ClinicalKey y en ScienceDirect, utilizando las palabras claves: “urethral stricture,” “urethroplasty,” “oral graft” y “flap.” Se utilizaron los estudios más relevantes, tanto originales como revisiones sistemáticas y meta-análisis, en inglés y en español. Las diferentes técnicas quirúrgicas ofrecen ventajas y desventajas teóricas frente a las otras, aunque las tasas de éxito en todas es cercana al 90%, sin ser una francamente superior frente a las demás. La elección de la técnica quirúrgica a realizar depende de las preferencias y experiencia del cirujano, dado que la tasa de éxito para todas las técnicas es similar.
{"title":"Uretroplastia bulbar con injerto: Una actualización sobre las diferentes técnicas quirúrgicas","authors":"E. S. Rodríguez, L. A. Serna, Wilmer A. Agressot","doi":"10.1055/s-0039-1696697","DOIUrl":"https://doi.org/10.1055/s-0039-1696697","url":null,"abstract":"Resumen En pacientes con estrechez uretral bulbar de una longitud mayor a 2 cm, que no sean candidatos a otras técnicas, se realiza uretroplastia con injerto. Actualmente se emplean diversas técnicas, cada una con ventajas y desventajas propias. Describir las ventajas y desventajas de las técnicas quirúrgicas empleadas actualmente en la uretroplastia con injerto, así como sus tasas de éxito. Se hizo una búsqueda en PubMed, ClinicalKey y en ScienceDirect, utilizando las palabras claves: “urethral stricture,” “urethroplasty,” “oral graft” y “flap.” Se utilizaron los estudios más relevantes, tanto originales como revisiones sistemáticas y meta-análisis, en inglés y en español. Las diferentes técnicas quirúrgicas ofrecen ventajas y desventajas teóricas frente a las otras, aunque las tasas de éxito en todas es cercana al 90%, sin ser una francamente superior frente a las demás. La elección de la técnica quirúrgica a realizar depende de las preferencias y experiencia del cirujano, dado que la tasa de éxito para todas las técnicas es similar.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48515361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julián Chavarriaga, J. Cataño, J. Villanueva, Daniel Sáenz, Daniel Suso-Palau, S. Rodríguez, Catalina Villaquirán, J. Galvis, P. Pinilla, A. Morales, German Patiño
Abstract Introduction It is known that cancer care is best approached by a multidisciplinary team (MDT). This became specifically true in the Covid-19 pandemic in which choices for urological cancer treatment are influenced by many factors. In some cases, delayed treatment may have consequences regarding the patient's oncological outcomes. The aim of the present article is to report our experience throughout the Covid-19 pandemic treating patients with urological neoplasms at a high-volume center. Methods We used a convenience sampling method. Cases were evaluated and discussed on an individual basis at the MDT meetings, and, after a consensus regarding delaying or scheduling treatment, patients were scheduled according to the risk of postponing the procedures. The Medically Necessary, Time-Sensitive (MeNTS) scoring system was measured in each patient; all patients answered the Centers for Disease Control and Prevention (CDC) Covid-19 self-screening questionnaire prior to surgery. The Covid-19-free survival rate was estimated. Results A total of 194 patients were assessed by the multidisciplinary team and finally treated, with median follow-up of 4 (interquartile range [IQR]: 2.75 to 6) months. Only two patients had Covid-19 confirmed by real-time polymerase chain reaction (RT-PCR). In total, 54 patients underwent oncological surgery, 129 were treated with radiotherapy, and 11 were treated with intravenous chemotherapy. The median age was 66 years (IQR: 59 to 94 years), and the median MeNTS score in the surgically-treated cohort was 35 points (IQR: 31 to 47 points). Conclusions The evaluation and treatment of urological cancer should be conducted by an MDT; this is of utmost importance, especially during the Covid-19 pandemic. The data collected in our institution showed that most patients could be safely treated by taking all necessary precautions and discussing each case individually in the MDT meetings and performing a close follow-up.
{"title":"Urological Cancer Treatment by a Multidisciplinary Team throughout the Covid-19 Pandemic: What Have We Learned?","authors":"Julián Chavarriaga, J. Cataño, J. Villanueva, Daniel Sáenz, Daniel Suso-Palau, S. Rodríguez, Catalina Villaquirán, J. Galvis, P. Pinilla, A. Morales, German Patiño","doi":"10.1055/s-0041-1731414","DOIUrl":"https://doi.org/10.1055/s-0041-1731414","url":null,"abstract":"Abstract Introduction It is known that cancer care is best approached by a multidisciplinary team (MDT). This became specifically true in the Covid-19 pandemic in which choices for urological cancer treatment are influenced by many factors. In some cases, delayed treatment may have consequences regarding the patient's oncological outcomes. The aim of the present article is to report our experience throughout the Covid-19 pandemic treating patients with urological neoplasms at a high-volume center. Methods We used a convenience sampling method. Cases were evaluated and discussed on an individual basis at the MDT meetings, and, after a consensus regarding delaying or scheduling treatment, patients were scheduled according to the risk of postponing the procedures. The Medically Necessary, Time-Sensitive (MeNTS) scoring system was measured in each patient; all patients answered the Centers for Disease Control and Prevention (CDC) Covid-19 self-screening questionnaire prior to surgery. The Covid-19-free survival rate was estimated. Results A total of 194 patients were assessed by the multidisciplinary team and finally treated, with median follow-up of 4 (interquartile range [IQR]: 2.75 to 6) months. Only two patients had Covid-19 confirmed by real-time polymerase chain reaction (RT-PCR). In total, 54 patients underwent oncological surgery, 129 were treated with radiotherapy, and 11 were treated with intravenous chemotherapy. The median age was 66 years (IQR: 59 to 94 years), and the median MeNTS score in the surgically-treated cohort was 35 points (IQR: 31 to 47 points). Conclusions The evaluation and treatment of urological cancer should be conducted by an MDT; this is of utmost importance, especially during the Covid-19 pandemic. The data collected in our institution showed that most patients could be safely treated by taking all necessary precautions and discussing each case individually in the MDT meetings and performing a close follow-up.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47681885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Ramos-Castaneda, A. Ruano-Raviña, Javier Osorio-Manrique, Jackeline Barreto-Mora, A. Segura-Cardona, Elkin V. Lemos-Luengas
Abstract Objectives To identify the effect of duration of surgical antibiotic prophylaxis (SAP) and other variables on infectious postsurgical complications in patients with asymptomatic bacteriuria (ASB) undergoing urological surgery. Methods We conducted an observational study of a cohort of patients with ASB scheduled for urologic surgery at three health service providers in Colombia. The study population comprised all patients with planned urologic surgery who had ASB prior to surgery from April 2018 to January 2019. The intervention evaluated was the duration of preoperative SAP, and the outcome variable was the development of any postoperative infectious complications for up to 30 days after the procedure. Results The present study included 184 patients with ASB scheduled for urologic surgery. The median duration of preoperative SAP (p = 0.49) or of 1 dose SAP (risk ratio [RR] = 1.24; 95% confidence interval [CI]: 0.45–3.39) were not statistically different in patients with postsurgical infectious complications. Infectious complications were more frequent among patients with benign prostatic hyperplasia (RR = 6.57; 95%CI: 1.98–21.76) and hospitalization in the preceding 3 months (RR = 8.32; 95%CI: 2.69–25.71). Conclusion One dose of antimicrobial therapy is sufficient to avoid infectious complications in patients with ASB. There were other factors associated with postsurgical infectious complications, such as benign prostatic hyperplasia and hospitalization in the preceding 3 months.
{"title":"Effect of Antibiotic Prophylaxis on Infectious Complications in Patients with Asymptomatic Bacteriuria Undergoing Urologic Surgery","authors":"J. Ramos-Castaneda, A. Ruano-Raviña, Javier Osorio-Manrique, Jackeline Barreto-Mora, A. Segura-Cardona, Elkin V. Lemos-Luengas","doi":"10.1055/s-0041-1730320","DOIUrl":"https://doi.org/10.1055/s-0041-1730320","url":null,"abstract":"Abstract Objectives To identify the effect of duration of surgical antibiotic prophylaxis (SAP) and other variables on infectious postsurgical complications in patients with asymptomatic bacteriuria (ASB) undergoing urological surgery. Methods We conducted an observational study of a cohort of patients with ASB scheduled for urologic surgery at three health service providers in Colombia. The study population comprised all patients with planned urologic surgery who had ASB prior to surgery from April 2018 to January 2019. The intervention evaluated was the duration of preoperative SAP, and the outcome variable was the development of any postoperative infectious complications for up to 30 days after the procedure. Results The present study included 184 patients with ASB scheduled for urologic surgery. The median duration of preoperative SAP (p = 0.49) or of 1 dose SAP (risk ratio [RR] = 1.24; 95% confidence interval [CI]: 0.45–3.39) were not statistically different in patients with postsurgical infectious complications. Infectious complications were more frequent among patients with benign prostatic hyperplasia (RR = 6.57; 95%CI: 1.98–21.76) and hospitalization in the preceding 3 months (RR = 8.32; 95%CI: 2.69–25.71). Conclusion One dose of antimicrobial therapy is sufficient to avoid infectious complications in patients with ASB. There were other factors associated with postsurgical infectious complications, such as benign prostatic hyperplasia and hospitalization in the preceding 3 months.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41733416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The use of robotic technology in minimally invasive surgery has expanded worldwide in the last two decades. Currently being the DaVinci system of the Intuitive Surgical company, one of the most used in many surgical specialties within them, Urology. This system has obtained more than 1500 patents in the robotics area; however, some have already expired. Thus, allowing the development of new platforms as an alternative to the monopoly achieved by this system. Some robotic platforms in actual development feature a modular design, open console, smaller instruments (<8mm), and haptic feedback (tactile sensation). These new designs of robotic surgery technology highlight cost-effective systems, single port surgery, artificial intelligence formachine learning, but it should be noted that they face a long and complex process of clinical studies and approval by regulatory entities.1 The SENHANCE surgical system, approved by the Food and Drug Administration (FDA) since 2017, and the Korean robotic system REVO-I, also approved in 2017 for local usage, have been IntuitiveSurgical’s competitors andhadset thebeginning for other robotic surgery companies to be available at the market. With both systems, multiple abdominal procedures have been performed in general surgery, urology, and gynecology. The existingmedical literature to date shows that they are reliable instruments,withgoodresults in termsof safety, in addition to oncological or functional follow-up according to the pathology; comparable results with those obtained with the DaVinci system were demonstrated.2–4 Other robotic systems worth mentioning are the “German Robot” AVATERA and the Japanese Medicaroid robot HINOTORI. This last onewith amission that enhances Asimov’s laws of robotics “to serve and help humans, not replace humans.” The HINOTORI obtained its license for usage in 2020 by that country, but it still does not have preclinical studies or clinical data in humans, still in the development stage. It must be highlighted what two medical device companies have done as they launched robotic surgery facilities at different latitudes of theworld, each in their way, globalizing their market and starting the real competition for Intuitive. Those are Versius Surgical Robotic System CMR Surgical in the UK with installations in India, Australia, and their own country. The other is Medtronic, recognized as one of the giants in medical devices in the world; its robotic surgical system, HUGO, has systems already installed in Latin America, Panama, and Chile with surgical programs that successfully took off a few months ago at lower costs.5–7 There is a great expectation with the project created with the merge of two large companies, Johnson & Johnson and Google, VERB SURGICAL, several years working on their robotic system. However, they have not yet come to light with their device; It has been an airtight organization in terms of system development details, but this system is expected to compete with hi
{"title":"New Horizons in Robotic Surgery: DaVinci Begins to Compete","authors":"R. Rodriguez, R. Noguera","doi":"10.1055/s-0041-1737013","DOIUrl":"https://doi.org/10.1055/s-0041-1737013","url":null,"abstract":"The use of robotic technology in minimally invasive surgery has expanded worldwide in the last two decades. Currently being the DaVinci system of the Intuitive Surgical company, one of the most used in many surgical specialties within them, Urology. This system has obtained more than 1500 patents in the robotics area; however, some have already expired. Thus, allowing the development of new platforms as an alternative to the monopoly achieved by this system. Some robotic platforms in actual development feature a modular design, open console, smaller instruments (<8mm), and haptic feedback (tactile sensation). These new designs of robotic surgery technology highlight cost-effective systems, single port surgery, artificial intelligence formachine learning, but it should be noted that they face a long and complex process of clinical studies and approval by regulatory entities.1 The SENHANCE surgical system, approved by the Food and Drug Administration (FDA) since 2017, and the Korean robotic system REVO-I, also approved in 2017 for local usage, have been IntuitiveSurgical’s competitors andhadset thebeginning for other robotic surgery companies to be available at the market. With both systems, multiple abdominal procedures have been performed in general surgery, urology, and gynecology. The existingmedical literature to date shows that they are reliable instruments,withgoodresults in termsof safety, in addition to oncological or functional follow-up according to the pathology; comparable results with those obtained with the DaVinci system were demonstrated.2–4 Other robotic systems worth mentioning are the “German Robot” AVATERA and the Japanese Medicaroid robot HINOTORI. This last onewith amission that enhances Asimov’s laws of robotics “to serve and help humans, not replace humans.” The HINOTORI obtained its license for usage in 2020 by that country, but it still does not have preclinical studies or clinical data in humans, still in the development stage. It must be highlighted what two medical device companies have done as they launched robotic surgery facilities at different latitudes of theworld, each in their way, globalizing their market and starting the real competition for Intuitive. Those are Versius Surgical Robotic System CMR Surgical in the UK with installations in India, Australia, and their own country. The other is Medtronic, recognized as one of the giants in medical devices in the world; its robotic surgical system, HUGO, has systems already installed in Latin America, Panama, and Chile with surgical programs that successfully took off a few months ago at lower costs.5–7 There is a great expectation with the project created with the merge of two large companies, Johnson & Johnson and Google, VERB SURGICAL, several years working on their robotic system. However, they have not yet come to light with their device; It has been an airtight organization in terms of system development details, but this system is expected to compete with hi","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41933296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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