Sex with animals (SWA): behavioral characteristics and possible association with penile cancer. A multicenter study.

INTRODUCTION: Zoophilia has been known for a long time but, underreported in the medical literature, is likely a risk factor for human urological diseases. AIM: To investigate the behavioral characteristics of sex with animals (SWA) and its associations with penile cancer (PC) in a case-control study. METHODS: A questionnaire about personal and sexual habits was completed in interviews of 118 PC patients and 374 controls (healthy men) recruited between 2009 and 2010 from 16 urology and oncology centers. MAIN OUTCOME MEASURES: SWA rates, geographic distribution, duration, frequency, animals involved, and behavioral habits were investigated and used to estimate the odds of SWA as a PC risk factor. RESULTS: SWA was reported by 171 (34.8%) subjects, 44.9% of PC patients and 31.6% of controls (P < 0.008). The mean ages at first and last SWA episode were 13.5 years (standard deviation [SD] 4.4 years) and 17.1 years (SD 5.3 years), respectively. Subjects who reported SWA also reported more venereal diseases (P < 0.001) and sex with prostitutes (P < 0.001), and were more likely to have had more than 10 lifetime sexual partners (P < 0.001) than those who did not report SWA. SWA with a group of men was reported by 29.8% of subjects and SWA alone was reported by 70.2%. Several animals were used by 62% of subjects, and 38% always used the same animal. The frequency of SWA included single (14%), weekly or more (39.5%), and monthly episodes (15%). Univariate analysis identified phimosis, penile premalignancies, smoking, nonwhite race, sex with prostitutes, and SWA as PC risk factors. Phimosis, premalignant lesions, smoking, and SWA remained as risk factors in multivariate analysis. However, SWA did not impact the clinicopathological outcomes of PC. CONCLUSION: SWA is a risk factor for PC and may be associated with venereal diseases. New studies are required in other populations to test other possible nosological links with SWA.

Formas de presentación de las lesiones ano-recto-perineales en los pacientes ingresados por guardia al Hospital Periférico / Presentation forms of the anus-rectum-perineal injuries in patients admitted by emergency room at Peripheral Hospital

Antecedentes: Las heridas ano-recto-perineales se presentan con frecuencia en las guardias del Hospital periférico. Objetivo: Presentar nuestra experiencia y alertar sobre la necesidad de incluir estas lesiones en los diagnósticos diferenciales del abdomen agudo, proctorragia y otras. Lugar: Hospital Zonal General de Agudos "Dr. Lucio A. Meléndez" de Adrogué, Pcia. de Bs. As. Diseño: Estudio retrospectivo. Presentación de casos. Población: de 2140 pacientes ingresados en el período comprendido entre enero de 1992 y enero de 1997 con Heridas de Arma Blanca (HAB), Heridas de Arma de Fuego (HAF) y Prácticas sexuales aberrantes (PSA), 8 fueron heridas Anorrectoperineales. Métodos: Observación, clínica y quirúrgica. Resultados: Se observa que en el 0.37 por ciento de los pacientes ingresados a la guardia del Hospital periférico en cuestión, por HAF, HAB y PSA son traumatismos ano-recto-perineales. Conclusiones: Debe plantearse siempre la posibilidad de una lesión ano-recto-perineal en los pacientes que ingresan por abdomen agudo, también en las proctorragias y otras patologías traumáticas. Por lo tanto recomendamos incluirlas en el diagnóstico diferencial ya que a pesar de no ser patologías muy frecuentes tienen elevada mortalidad (12,5 por ciento). (AU)