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Instituto Urología Málaga

Urological Tumors

Bladder cancer

Bladder cancer is one of the most frequent tumors in man and carries great morbidity and mortality. In the Western world it is the fourth malignant tumor in order of frequency, behind those of lung, prostate and colon.

In Europe it supposes the 5-10% of the tumors in the man. In Spain, it estimates about 8,000 new cases per year and is the second most frequent tumor of the urinary system after the prostate. The most frequent clinical presentation occurs with the appearance of blood in the urine or hematuria.

At the time of diagnosis, 85% of bladder tumors are superficial and their treatment is based on endoscopic techniques (transurethral resection of the bladder) and posterior intravesical chemotherapy, which allows to conserve the bladder in most cases.

The remainder are considered infiltrating tumors, because they affect the bladder muscle, and in most cases the indicated treatment and with higher rates of local control and healing is based on performing radical cystectomy with extended lymphadenectomy and urinary diversion, which Can be external to the abdominal wall with cutaneous or internal stoma by creating orthotopic neobladder with intestine, patient retaining urethral urination in these cases.

These complex techniques of reconstructive surgery of the urinary tract are extensively developed in our Unit, reason why whenever it is feasible are offered to our patients with this serious pathology.

Cancer of the Upper Urinary Tract

In the case of tumors affecting the upper urinary tract (ureter and renal pelvis) the treatment may be conservative or radical depending on the extent of the disease.

In these latter cases, laparoscopic radical nephroureterectomy has acquired the standard treatment condition for patients with urothelial tumor requiring complete excision of one of their upper urinary tracts.

The oncological and survival results are superimposable to those of open nephroureterectomy. The indication would be, in general, tumor of localized, non-metastatic pathways, as for open surgery.

Kidney Cancer

Renal carcinoma accounts for 2% to 3% of all cancers, with the highest incidence in the most developed countries. The annual increase in incidence across Europe is 2%, except in Denmark and Sweden.

The use of imaging techniques such as ultrasound and computed tomography (CT) have increased the number of incidental diagnoses of renal cancer. But despite this increase in the rate of fortuitous detection, the mortality from renal cancer remains unaltered to date and parallel to the transient incidence. The peak incidence is between 60 and 70 years, with predominance in men over women (1.5: 1).

The etiological factors include lifestyle, such as smoking, obesity and treatment against hypertension. The most effective prophylaxis is not smoking cigarettes and avoiding obesity.

The preferred treatment in curative therapy for patients with kidney cancer remains radical nephrectomy. Only surgery remains curative after complete removal of the cancer. Conservative surgery of the organ is recommended for smaller tumors.

In our Unit we offer patients with localized kidney cancer the treatment through minimally invasive techniques, such as laparoscopic radical nephrectomy and partial laparoscopic nephrectomy (in tumors less than 5 cm), with high rates of oncological cure and minimal aggression on the Abdominal wall, which leads to an earlier postoperative recovery.

Testicular Cancer

Testicular cancer is relatively uncommon, accounting for approximately 1-1.5% of all male cancers. However, it is the cancer that most affects young men between the ages of 30 and 40.

Most of these tumors originate from germ cells and more than 70% of patients are diagnosed in the early stages of the disease.

They currently have high cure rates with existing treatments based on surgery, chemotherapy and radiotherapy. In the surgical treatment must be performed in all cases inguinal radical orchiectomy and in cases indicated removal of the affected nodes using a surgical technique known as retroperitoneal lymphadenectomy with techniques to preserve ejaculation.

Cancer of the penis

Penile carcinoma is a rare malignant cancer with an incidence range of 0.1 to 7.9 per 100,000 men.

Social and cultural habits seem to be important factors associated with penile cancer. An example of this is that from 44% to 90% of patients suffer from previous phimosis; And there are documented data that associate human papillomavirus with penile cancer.

The treatment of these tumors is always surgical and there are different techniques that must be applied depending on the tumor stage at the time of diagnosis.

These techniques are Partial Penectomy, Radical Penectomy and Perineal Urethrostomy, Inguinal Lymphadenectomy and Emmasculation.

Prostate cancer

Currently prostate cancer is considered one of the major medical problems facing the male population. This disease accounts for 9% of cancer deaths in men.

As men's life expectancy increases, prostate cancer incidence and mortality are higher. Apart from age, the main risk factor is hereditary. In addition, the clinic seems to support the idea that exogenous factors, such as race, diets rich in animal fat, exposure to heavy metals, etc. They can have an important effect on the development of prostate cancer.

The appearance of a reliable parameter in blood, prostate-specific antigen (PSA), has allowed a greater number of men to be diagnosed at an earlier stage of the disease when they can be offered curative treatments.

In our Unit we offer to the patients diagnosed of adenocarcinoma of prostate with indication of surgical treatment the most novel and minimally invasive surgical technique such as laparoscopic radical prostatectomy with bilateral neurovascular preservation and ilio-obturator lymphadenectomy.