Urólogo Patricio

@DoctorSotelo Siempre aplicar el “SMART” S( Start small) M( Make a plan) A( always look) R( Respect) T (Take it Easy) en la residencia y vida .

MEATIC technique (@lukha33) looks very useful. Will try instilling iodinated contrast in cystoscopy for clearer view of the ureteral orifice when there is a bloody field. sciencedirect.com/science/articl…

Our review on partial nephrectomy outcomes is now published in Current Urology Reports. What really determines outcomes in partial nephrectomy? It’s not just the robot. Key surgical factors that actually matter 👇 • Complexity • Technique • Experience • Decision-making

@RodrigoGuevaraG @Residentes_SMU @smumexico Urólogo joven rompiéndola en USA como Fellow de uno de los mejores urólogos del mundo y no le damos la visibilidad que merece. A estos urólogos es a los que deberíamos darles bastante mérito.

@FCAFigueiredo @mario_sofer @UrologyTLVMC @scoffonecesare @fgomsan My theory also involves the morcellator’s brand, model, and generation. The better the device (or the higher its speed), along with prostate density, the greater the specimen weight loss.

@mario_sofer @UrologyTLVMC @scoffonecesare @fgomsan I have always believed that immediate after morcellation, the prostatic tissue is squeezed and lose some of its water. After some time in formaldehyde, it gets back its contents and recovers part of the weight. But I agree that we all should use the same timing for comparison.

How to report prostate volume in HoLEP literature? Preoperative US, TRUS, MRI? Resected tissue weighted in the OR? Pathological report? Is the time for standardization!! ⁦@UrologyTLVMC⁩ ⁦@scoffonecesare⁩ ⁦@fgomsan⁩ ⁦@FCAFigueiredo⁩

Terminada la Fase ll, la Bioglutida revolucionará los Péptidos actuales. Será en forma de tabletas y en tres meses pierdes 15% del exceso de peso sin perder músculo y con mayores beneficios metabólicos. Nueva era en medicina.

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Tesla AI self-driving will be >10X safer than human driving

Obstructive azoospermia or recurrent seminal vesiculitis ✌️No worries any more 👍watch our semi-live session from the European Association of Urology Congress 2026. Although I couldn’t attend in person this year, I’m glad to share this work with you.

PRostate cancer guidelines 2026 update. Digital rectal exam NOW no more recommended for Asymptomatic men SO NO MORE FOR Screening Important for standing and for early diagnosis for SYMPTOMS only @Uroweb

@sbinhamrii @so_uro @PETRAurogroup Whats your opinion on using triamcinolone in these cases?

🔳 2 years post #TURP 🔳 Clear Bladder Neck Contracture 🔳 Enucleate with Low Power #Holmium @so_uro @PETRAurogroup

Delighted to share our new paper on the effects of commonly used overactive bladder medications on #erectilefunction is published in Sexual Medicine Reviews. Special thanks to @drserefoglu for the guidance and mentorship 👉🏼 bit.ly/4brxlPb @sexmedjournals @essm_tweets

Post-finasteride syndrome, PSSD, & Post-retinoid syndrome are devastating conditions. I appreciate the >1000 sufferers who responded to our survey. Robust discussion at #SUFU26. We need to advocate for patients and find solutions.@BeaumontUrology @CorewellHealth #PFS #PSSD

Exciting news! 🚀 Our study on stone management in pelvic kidneys—the largest to date—is out in the World Journal of Urology.  A huge thanks to the 11 international centers for this global collaboration! 🌍🩺  Key Findings: • Best Results: Multimodal-guided PCNL achieved the highest stone-free rate (86.7%) with fewer ancillary procedures.  • Challenges: Flexible ureteroscopy (f-URS) showed lower efficacy due to complex anatomy.  • Safety: Complication rates were low and comparable to anatomically normal kidneys.  Grateful for this team effort to improve patient care! 🙌 @smumexico @Endo_Society @CAU_URO @migokce @scoffonecesare @wjurol @VicentiniUro @2fabiosepulveda @thomastailly @emiliani_e

23 años perfeccionando enucleación prostática 🎯 Claves técnica HoLEP 'en bloque': • Liberación apical precoz • Preservación de la mucosa esfinteriana • Disminuir la tracción radial capitalizando la movilidad del adenoma y de la próstata para "llevar el campo operatorio al centro" Próximo: EAU Londres marzo - cirugía en directo. #HoLEP #CirugíaPrecisa #EAU2026

CHRONIC OBSTRUCTED URETER STONE A long-term obstructed stone is often a "silent killer" of the kidney because once the initial sharp pain (renal colic) subsides, the patient may mistakenly believe the problem has resolved, while the kidney continues to deteriorate. ➡️Effects on Renal Physiology When a stone blocks the ureter, the pressure behind it rises, triggering a "triphasic response" in the kidney: 🚩Phase 1 (Acute - First 1.5 hours): Renal blood flow increases as the body tries to "flush" the obstruction. Glomerular filtration pressure rises. 🚩Phase 2 (1.5–5 hours): Renal blood flow begins to drop while pressure in the renal pelvis stays high. 🚩Phase 3 (Chronic - After 5 hours): Renal blood flow significantly decreases. To protect the kidney from bursting, the body constricts the input of blood. 🚩Glomerular Filtration Rate (GFR) Collapse: Prolonged pressure causes the GFR to drop permanently. Even if the stone is removed later, the kidney may never return to 100\% function. 🚩Tubular Damage: The delicate tubules that concentrate urine begin to atrophy. This leads to an inability to balance electrolytes (sodium, potassium) and water. ➡️Effects on the Ureter The ureter is not just a tube; it is a living, muscular organ. Long-term obstruction causes: 🎈Stone Impaction: The stone becomes "buried" in the ureteral wall as the surrounding tissue becomes inflamed and swollen (edema). 🎈Ureteral Wall Thickness (UWT): The muscle layer thickens to try and "pump" against the blockage, but eventually, this muscle is replaced by stiff scar tissue (fibrosis). 🎈Loss of Peristalsis: The rhythmic contractions that move urine are lost. This means even after the stone is gone, urine may not flow effectively, leading to "megaureter" or permanent dilation. ➡️Long-Term Complications If the obstruction is left for more than 4–6 weeks, the damage often becomes irreversible: 🚩Hydronephrosis & Renal Atrophy: The kidney swells with trapped urine, thinning the actual functional tissue (the parenchyma) until the kidney becomes a useless "sac of fluid." 🚩Pyelonephritis & Urosepsis: Stagnant urine is a breeding ground for bacteria. This can lead to life-threatening blood infections. 🚩Secondary Hypertension: The damaged kidney releases excess renin, a hormone that spikes blood pressure, further damaging both kidneys and the heart. 🚩Chronic Kidney Disease (CKD): Permanent loss of nephrons leads to a lifelong decline in renal health. ➡️Modern Solutions (2026 Standards) The approach today is twofold: 🎈Decompress first 🎈then Clear. 🚩Emergency ➡️Ureteral Stenting or PCN  drain "pus or pressure" immediately. 🚩Definitive ➡️Laser Ureteroscopy (URS/RIRS) Using high-power lasers to "dust" the stone into sand. 🚩Complex ➡️Laparoscopic / Robotic Ureterolithotomy , For very large, old, or "impacted" stones that cannot be reached endoscopically. 🚩Reconstructive ➡️Ureteral Reimplantation / Boari Flap , If the ureter is too scarred or narrowed (stricture) from the long-term stone. 🍨Tip : "If you had a stone pain that 'went away' without the stone actually passing, your kidney might be at risk. A simple ultrasound or CT KUB can save your kidney function today." Dr Bivek Kumar

🔬 Innovation spotlight: Early apical release in HoLEP This technical modification reduced our operative time by 23 minutes average while improving continence outcomes. Sometimes the biggest advances come from small technical details and simple ideas. Key: Carefully release apex at the beggining of the operation, protect the external urinary sphincter → cleaner plane, less trauma. #HoLEP #TechnicalTip #UrologyInnovation #ProstateSurgery

@MLopezSanMartin Con su jugo Boing 🤣

Marx Arriaga sigue en su show Aferrado a su puesto en la SEP desde el viernes "Lo único que sé son rumores", dice Y mantiene el pretexto de no haber recibido ningún oficio

Post #HOLEP Incontinence from Anatomical Risk to Surgical Strategy @fgomsan @DocGauhar @trwherrmann @jfunkmd @Mohamedendourol @D_Castellani

Botox: 5 injections seems to have same efficacy as 20-30 injections @MayoUrology #MayoUroHawaii26

🔥⚔️ 200 g prostate. On aspirin. ✅No compromise. Herrmann @KARLSTORZUro electrode unleashes 👌unmatched hemostasis and 😎razor-sharp early apical release. @amy_krambeck @dr_mohannad_ksa @sbinhamrii @DrVCMohan