[Effect of body mass index on PSA in northeast Mexican patients]. / Efecto del índice de masa corporal en los niveles séricos del antígeno prostático específico en pacientes del Noreste de México.

OBJECTIVE: To evaluate the effect of body mass index (BMI) on PSA in northeast Mexican patients included in prostate cancer (Pca) early detection screening campaigns offered by our institution. MATERIAL AND METHODS: One hundred and ninety seven patients came voluntarily to our Pca early detection screening campaigns. EXCLUSION CRITERIA: PSA >10 ng/dl, patients on 5-α Reductase inhibitors or hormonal replacement. Overweight and obesity were considered when BMI was between 25-29.9 and ≥30 kg/m(2) respectively. Simple linear and multiple regression were used in the statistical analysis. Mean and standard deviation were utilized to evaluate spread and normal distribution. P values <0.05 were considered statistically significant. RESULTS: One hundred and fifty two patients were included in this study. Forty four percent (83) and 30.3%(46) presented with overweight and obesity, respectively. Mean BMI was 28.16 kg/m(2) (SD 1.77). A statistically significant negative effect of BMI on PSA was observed in the linear regression. This effect persisted when adjusted for age in the multiple regression model. A decrease of 0.085 ng/dl for every unit of BMI (p <0.001) was observed in the simple linear regression. This value was 0.07 in the multiple regression (p=0.006) CONCLUSIONS: A higher negative effect of BMI on PSA was found in comparison to published literature. A higher proportion of patients with BMI >25 kg/m(2) than the national mean was observed. A multicentric national study is needed in order to challenge these results.

[Effect of one month treatment with dutasteride on transurethral resection of the prostate]. / Efecto en el sangrado perioperatorio durante la resección transuretral de la próstata tras un mes de tratamiento con dutasteride.

OBJECTIVE: Evaluate the effect of dutasteride in perioperative bleeding during Transurethral Resection of Prostate (TURP). MATERIALS AND METHODS: Forty consecutive patients with criteria for TURP were included. Finasteride/dutasteride use, renal impairment, prostate < 30 cc, age <50 were excluded. Patients were divided in 2 groups. Group 1: 24 consecutive patients treated with dutasteride 0.5 mg/day/30-days prior TURP. Group 2: 16 without treatment. Prostatic volume, difference in hemoglobin pre/post TURP, duration and amount of resected tissue were recorded. Surgeon was blinded. STATISTICAL ANALYSIS: Multiple linear regression, Mann-Whitney and student t-tests were used. RESULTS: In group 1, 33% (8) improved their lower urinary tract symptoms and skipped TURP. Mean Hemoglobin loss difference between groups was 0.11 gr/dl (CI 95% -0.55; 0.77, p=0.88). There was no statistical difference among variables. No positive or negative predictive values in the linear regression model. CONCLUSION: Dutasteride did not significantly impact the studied variables in these non randomized and small sample size settings.

[Evaluation of male sexual satisfaction after vasectomy]. / Evaluación de la satisfacción sexual masculina posterior a la vasectomía.

OBJECTIVE: Evaluate male sexual satisfaction perception after vasectomy using the International Index of Erectile Function (IIEF-15). PATIENTS AND METHODS: Twenty nine males were scheduled for vasectomy in our hospital between November 2006 and July 2008. Mean age was 38 years (28-52) and mean offspring at surgery was 3. Before vasectomy, a Spanish version of the IIEF-15 was given at visit 1. A second visit was scheduled 12 weeks later, same questionnaire was given. Differences between general scores and specific domains were collected. Positive or negative response was defined as any change in comparison with the previous score. The Wilcoxon Test was used for statistical analysis. RESULTS: According to the total score, 38% improved and 48% remained unchanged. The mean difference in the total score of the IIEF after visit 1 and 2 was 0.76 (95%CI -0.09; 1.60, p=0.07). None of the domains by their own had significant changes, except for the orgasm domain as shown in table 1. Mean difference between visits was 0.34 (95%CI 0.12; 0.57, p=0.01). CONCLUSIONS: Vasectomy showed no significant influence in most sexual satisfaction domains. So, one could speculate that if some change is expected it might be positive, particularly in the orgasm domain, this contrasts of what reported in the literature using the IIEF scale.

Efecto en el sangrado perioperatorio durante la resección transuretral de la próstata tras un mes de tratamiento con dutasteride / Effect of one month treatment with dutasteride on transurethral resection of the prostate

Objetivo: Evaluar el efecto del dutasteride en el sangrado perioperatorio durante la resección transuretral de la próstata (RTU-P). Material y métodos: Un total de 40 pacientes fueron incluidos. Los pacientes recibiendo finasteride o dutasteride, creatinina>2mg/ml, con volumen prostático <30cc, edad <50 fueron excluidos. Los pacientes fueron divididos en 2 grupos. En el grupo 1: 24 pacientes consecutivos que aceptaron recibir dutasteride 0,5mg/día durante 30 días previo a la RTU-P. En el grupo 2, 16 pacientes consecutivos sin tratamiento adicional (control). Los valores de hemoglobina previos e inmediatamente posteriores a la RTU-P y el peso del tejido resecado en gramos fueron recolectados. El cirujano estuvo cegado. El análisis estadístico utilizado fue la prueba t de student, la prueba no paramétrica de Mann-Whitney y una regresión linear múltiple. Resultados: En el grupo 1, 33%(8) mejoró su sintomatología obstructiva urinaria baja y no evitaron la RTU-P. La media de la diferencia, entre los grupos 1 y 2, de la Hb en los valores antes y después de la RTU-P fue 0,11g/dl (IC 95% −0,55; 0,77, valor de la p 0,88). No hubo diferencias estadísticamente significativas en las variables del modelo de regresión linear múltiple. Conclusiones: El dutasteride no tuvo un impacto significativo en las variables estudiadas en este pequeño estudio no aleatorizado (AU)

Objective: Evaluate the effect of dutasteride in perioperative bleeding during Transurethral Resection of Prostate (TURP). Materials and Methods: Forty consecutive patients with criteria for TURP were included. Finasteride/dutasteride use, renal impairment, prostate <30cc, age <50 were excluded. Patients were divided in 2 groups. Group 1: 24 consecutive patients treated with dutasteride 0.5mg/day/30-days prior TURP. Group 2: 16 without treatment. Prostatic volume, difference in hemoglobin pre/post TURP, duration and amount of resected tissue were recorded. Surgeon was blinded. Statistical analysis: Multiple linear regression, Mann-Whitney and student t-tests were used. Results: In group 1, 33%(8) improved their lower urinary tract symptoms and skipped TURP. Mean Hemoglobin loss difference between groups was 0.11gr/dl (CI 95% −0.55; 0.77, p=0.88). There was no statistical difference among variables. No positive or negative predictive values in the linear regression model. Conclusion: Dutasteride did not significantly impact the studied variables in these non randomized and small sample size settings (AU)

Evaluación de la satisfacción sexual masculina posterior a la vasectomía / Evaluation of Male Sexual Satisfaction after Vasectomy

Objetivo: Evaluar la percepción de la satisfacción sexual masculina posterior a la vasectomía utilizando el Índice Internacional de la Función Eréctil (IIFE-15). Material y métodos: Veintinueve pacientes que fueron programados para vasectomía en nuestro hospital entre Noviembre del 2006 y Julio del 2008 fueron incluidos en este estudio. La mediana de edad fue 38 años (28–52) y el promedio de hijos previo al procedimiento fue de 3. Antes de la vasectomía, la versión en español del IIFE-15 les fue entregada y contestada en la visita 1. Doce semanas posteriores, una segunda visita fue programada y el cuestionario fue nuevamente contestado. Se recopilaron las diferencias entre los resultados generales y los de cada dominio de manera individual. Las respuestas negativas o positivas fueron definidas como cualquier cambio en comparación con la puntuación previa. La prueba de Wilcoxon fue usada para el análisis estadístico. Resultados: La media de la puntuación total fue 67,07±5,25 vs. 67,83±5,71 antes y después de la vasectomía respectivamente (p=0,07). El 38% mejoró, el 48% tuvo el mismo resultado y el 14% empeoró. No hubo cambios significativos en los diferentes dominios de manera individual excepto el del orgasmo 9,03±0,83 vs 9,36±0,82 en la visita 1 vs visita 2 respectivamente (p=0,01). Conclusiones: La vasectomía no mostró tener influencia en la mayoría de los dominios de la satisfacción sexual de manera individual. Podríamos especular que si algún cambio es esperado, éste debe ser positivo, particularmente en el domino del orgasmo. Estos resultados contrastan con lo reportado en la literatura utilizando el IIFE-15 (AU)

Objective: Evaluate male sexual satisfaction perception after vasectomy using the International Index of Erectile Function (IIEF-15). Patients and methods: Twenty nine males were scheduled for vasectomy in our hospital between November 2006 and July 2008. Mean age was 38 years (28–52) and mean offspring at surgery was 3. Before vasectomy, a Spanish version of the IIEF-15 was given at visit 1. A second visit was scheduled 12 weeks later, same questionnaire was given. Differences between general scores and specific domains were collected. Positive or negative response was defined as any change in comparison with the previous score. The Wilcoxon Test was used for statistical analysis. Results: According to the total score, 38% improved and 48% remained unchanged. The mean difference in the total score of the IIEF after visit 1 and 2 was 0.76 (95%CI −0.09; 1.60, p=0.07). None of the domains by their own had significant changes, except for the orgasm domain as shown in table 1. Mean difference between visits was 0.34 (95%CI 0.12; 0.57, p=0.01). Conclusions: Vasectomy showed no significant influence in most sexual satisfaction domains. So, one could speculate that if some change is expected it might be positive, particularly in the orgasm domain, this contrasts of what reported in the literature using the IIEF scale (AU)

¿Es la edad un factor predictor en el desarrollo de hipertensión en pacientes con oclusión unilateral de la arteria renal secundario a trauma abdominal contuso que fueron tratados conservadoramente? / Is age a predictor for the development of hypertension in conservatively managed unilateral renal artery occlusion secondary to blunt abdominal trauma?

Objetivo: Presentar 2 casos de oclusión de la arteria renal unilateral secundario a trauma abdominal contuso manejados conservadoramente y revisar, en la literatura, el rol de la edad como factor predictor en el desarrollo de hipertensión. Material y métodos: Masculino y femenina de 14 y 12 años, respectivamente, participaron en accidentes automovilísticos diferentes sin portar cinturón de seguridad permaneciendo en el asiento. Ambos arribaron a urgencias pediatría con signos vitales normales. Ambas tomografías revelaron riñón sin captación de contraste. El manejo fue conservador. Resultados: Posterior a 38 y 36 meses de seguimiento, respectivamente, ninguno presenta hipertensión o daño en la función renal. Encontramos solo 7 casos, en la literatura, con edad ≤16 manejados conservadoramente. En total 9, existió hipertensión en 2(22%). Conclusiones: No se puede llegar a una conclusión contundente con una muestra tan pequeña aunque existe evidencia suficiente que soporta el manejo conservador del padecimiento a cualquier edad (AU)

Objective: To present 2 cases with unilateral renal artery occlusion after blunt trauma conservatively treated and review, in the literature, the role of age as a prognostic factor for the development of hypertension. Material and methods: A 14 and 12 y/o male and female passengers, who were unrestrained in the back seat of a car, were involved in different motor vehicle accidents. Both remained in the seat and arrived at the Pediatric Emergency Department with normal vital signs. Computerized tomography scans showed unenhancing kidneys. Conservative management was advocated. Results: After 38 and 36 months follow-up, respectively, normal renal function and arterial pressure. We found only 7 cases in the literature where age ≤16 was reported and treatment was conservative. Nine in total, hypertension developed in 2(22%). Conclusions: No conclusion could be made with such a small sample. There is enough evidence in the literature supporting conservative management at all ages (AU)

[Is age a predictor for the development of hypertension in conservatively managed unilateral renal artery occlusion secondary to blunt abdominal trauma?]. / ¿Es la edad un factor predictor en el desarrollo de hipertensión en pacientes con oclusión unilateral de la arteria renal secundario a trauma abdominal contuso que fueron tratados conservadoramente?

OBJECTIVE: To present 2 cases with unilateral renal artery occlusion after blunt trauma conservatively treated and review, in the literature, the role of age as a prognostic factor for the development of hypertension. MATERIAL AND METHODS: A 14 and 12 y/o male and female passengers, who were unrestrained in the back seat of a car, were involved in different motor vehicle accidents. Both remained in the seat and arrived at the Pediatric Emergency Department with normal vital signs. Computerized tomography scans showed unenhancing kidneys. Conservative management was advocated. RESULTS: After 38 and 36 months follow-up, respectively, normal renal function and arterial pressure. We found only 7 cases in the literature where age < or =16 was reported and treatment was conservative. Nine in total, hypertension developed in 2(22%). CONCLUSIONS: No conclusion could be made with such a small sample. There is enough evidence in the literature supporting conservative management at all ages.

[Conservative treatment of Peyronie's disease: colchicine vs. colchicine plus vitamin E]. / Tratamiento conservador de la enfermedad de Peyronie: colchicina versus colchicina más vitamina E.

OBJECTIVE: To retrospectively review the response of patients with Peyronie's disease (PD) treated with colchicine as monotherapy and colchicine plus Vitamin E. MATERIAL AND METHODS: We evaluated 100 men with PD. A dose of 1.5 mg/day oral Colchicine as monotherapy (CCM) was given to 59 patients and 1.5/800 mg/day oral Colchicine/Vitamin E (CCVE) to 41. Response was categorized as follows: Good response, when at least 2 of the following conditions were achieved: Decrease/stabilization of curvature and/or plaque and/or pain relief. Partial response if one of the former conditions were observed. No response and worsening. No statistical differences between groups were found. RESULTS: Good response was observed in 39% vs 41% in the CCM and CCVE groups respectively. When looking at each variable, we observed improvement on the plaque's size in 36 vs 29%, pain relief in 46 vs 57% and curvature 32 vs 33% in the CCM and CCVE respectively. None of these differences were statistically significant. CONCLUSION: Oral conservative treatment with CCVE failed to show statistically significant differences in efficacy in pain relief, penile curvature or plaque size against CCM in this study. However, there is slight evidence of a positive prognostic effect on the conservative treatment when history of previous unsuccessful PD treatment was recorded, this was statistically significant in the CCVE group, supporting the theory of a combined treatment. A randomized double blind placebo controlled study with a sample size calculation should be performed to confirm our results.

Tratamiento conservador de la enfermedad de Peyronie: colchicina versus colchicina más vitamina E / Conservative treatment of Peyronie's disease: Colchicine vs. colchicine plus vitamin E

Objetivo: Revisar de manera retrospectiva la respuesta de pacientes con enfermedad de Peyronie (EP) tratados con colchicina como monoterapia (CM) o combinada con vitamina E (CVE). Material y métodos: Evaluamos 100 pacientes con EP. La CM por vía oral en dosis de 1,5mg/día fue recibida por 59 pacientes, y la CVE en dosis de 1,5/800mg/día fue recibida por 41 pacientes. La respuesta fue definida de la siguiente manera: respuesta buena, cuando al menos 2 de las siguientes condiciones fueron alcanzadas: disminución/estabilización de la curvatura y/o tamaño de la placa y/o alivio del dolor; respuesta parcial, cuando se alcanzó al menos una de las condiciones anteriores. Así como ausencia de respuesta o empeoramiento. No hubo diferencias significativas en los grupos. Resultados: Hubo buena respuesta en el 39 y el 41% de los pacientes del grupo CM y CVE, respectivamente. Mejora por variable: tamaño de la placa en el 36 vs. el 29%, alivio del dolor en el 45 vs. el 57%, curvatura en el 32 vs. el 33% en los grupos CM y CVE, respectivamente. Ninguna de estas diferencias fue estadísticamente significativa. Conclusiones: La CVE no demostró diferencias estadísticamente significativas en la eficacia del alivio del dolor, curvatura y tamaño/consistencia de la placa vs. el grupo control. Sin embargo, existe ligera evidencia de un efecto pronóstico positivo en el tratamiento conservador de la EP si hay antecedente de tratamiento previo fallido, que fue estadísticamente significativo en el grupo CVE, fomentando la teoría del tratamiento combinado. Un estudio aleatorizado, doble ciego controlado con placebo debe realizarse para confirmar estos resultados (AU)

Material and methods: We evaluated 100 men with PD. A dose of 1.5mg/day oral Colchicine as monotherapy (CCM) was given to 59 patients and 1.5/800mg/day oral Colchicine/Vitamin E (CCVE) to 41. Response was categorized as follows: Good response, when at least 2 of the following conditions were achieved: Decrease/stabilization of curvature and/or plaque and/or pain relief. Partial response if one of the former conditions were observed. No response and worsening. No statistical differences between groups were found. Conclusion: Oral conservative treatment with CCVE failed to show statistically significant differences in efficacy in pain relief, penile curvature or plaque size against CCM in this study. However, there is slight evidence of a positive prognostic effect on the conservative treatment when history of previous unsuccessful PD treatment was recorded, this was statistically significant in the CCVE group, supporting the theory of a combined treatment. A randomized double blind placebo controlled study with a sample size calculation should be performed to confirm our results (AU)

[Prostate adenocarcinoma metastatic to penis]. / Adenocarcinoma de próstata metastático a pene.

Prostate cancer is a disease that appears with a very high frequency. However, the presence of metastasis to the penis is rare. Only 98 cases reported in the literature up to 2003. We present one case of a patient with painless metastatic nodules on the penis secondary to a prostate cancer.

Adenocarcinoma de próstata metastático a pene / Prostate adenocarcinoma metastatic to penis

El cáncer de próstata es una enfermedad que se presenta frecuentemente. A pesar de eso, la presencia de metástasis al pene son muy raras. Sólo se han descrito en la literatura 98 casos hasta el 2003. Presentamos el caso de un paciente con nódulos metastáticos en pene indoloros secundarios a cáncer de próstata

Prostate cancer is a disease that appears with a very high frequency. However, the presence of metastasis to the penis is rare. Only 98 cases reported in the literature up to 2003. We present one case of a patient with painless metastatic nodules on the penis secondary to a prostate cancer