Disfunción eréctil, síndrome metabólico y arteriopatía. Relación clínico-patológica mediante ecografía carotídea / Erectile dysfunction, metabolic syndrome and arterial disease. Clinical-pathological relation by carotid ultrasonography

Introducción: Diferentes estudios ponen de manifiesto la relación entre disfunción eréctil, síndrome metabólico y enfermedad cardiovascular. El objetivo de este estudio fue evaluar la presencia de arteriopatía mediante la realización de ecografía de carótidas en pacientes con y sin disfunción eréctil. Material y métodos: Hemos realizado un estudio caso-control con 44 pacientes que consultan por disfunción eréctil y 20 controles. Todos los sujetos rellenaron el test IIEF-5 y se estudiaron los criterios de síndrome metabólico, además de una ecografía carotídea, para estudiar el grosor íntima-media y la presencia de placas de ateroma. Resultados: La media del grosor íntima-media en milímetros fue de 0,71 ± 0,21 para la derecha y de 0,71 ± 0,17 para la izquierda en los pacientes con disfunción eréctil. En el grupo control las medias fueron de 0,54 ± 0,11 y de 0,59 ± 0,15 respectivamente, existiendo diferencias estadísticamente significativas (p = 0,02 y p = 0,05 respectivamente). No se encontró placa de ateroma en ningún control, pero sí en el 25% de ambas carótidas de los pacientes con disfunción eréctil (p = 0,01). En cuanto al síndrome metabólico, según la American Heart Association, se diagnosticó a un 52,8% de los pacientes con disfunción eréctil y a un 16,7% de los controles, y según la International Diabetes Federation un 52,3% de los pacientes con disfunción eréctil y un 25% de los controles cumplen criterios diagnósticos. En ambos casos existieron diferencias significativas (p < 0,01 y p = 0,02 respectivamente). Hemos encontrado correlación lineal y positiva entre el perímetro abdominal y el grosor íntima-media en ambas carótidas (p < 0,05). Conclusiones: Los pacientes con disfunción eréctil pueden presentar mayor riesgo de enfermedad cardiovascular, determinado por la presencia de arteriopatía en las carótidas, lo cual nos indica que debería realizarse un estudio más detenido y global a los pacientes con disfunción eréctil

Introduction: Different studies have shown the relationship between erectile dysfunction, metabolic syndrome and cardiovascular disease. The objective of this study was to evaluate the presence of arteriopathy performing carotid ultrasound in patients with and without erectile dysfunction. Material and methods: We conducted a case-control study with 44 patients consulting for erectile dysfunction and 20 controls. All subjects completed the IIEF-5 test and we studied the criteria for metabolic syndrome, and a carotid ultrasound to study the intima-media thickness and the presence of atherosclerotic plaques was performed. Results: Mean intima-media thickness was 0.71 mm±0.21 for the right and of 0.71±0.17 for the left carotid in patients with erectile dysfunction. In the control group, the means were 0.54±0.11and 0.59±0.15 mm respectively, statistically significant differences (P = 0.02 and P = 0.05 respectively).No plaque was found in any control, but in 25% of both carotid arteries of patients with erectile dysfunction (P = 0.01). As metabolic syndrome, according to the American Heart Association, were diagnosed 52.8% of patients with erectile dysfunction, and 16.7% of controls, and according to the International Diabetes Federation, 52.3% of patients with erectile dysfunction and 25% of controls met diagnostic criteria. In both cases there were significant differences (P < 0.01 and P = 0.02 respectively). We found a positive linear correlation between waist circumference and the intima-media thickness in both carotid (P < 0.05). Conclusions: Patients with erectile dysfunction may be at increased risk of cardiovascular disease, as determined by the presence of arterial disease in the carotid arteries, which indicates that we should made a more thorough and comprehensive study of patients with erectile dysfunction

Erectile dysfunction, metabolic syndrome and arterial disease. Clinical-pathological relation by carotid ultrasonography.

INTRODUCTION: Different studies have shown the relationship between erectile dysfunction, metabolic syndrome and cardiovascular disease. The objective of this study was to evaluate the presence of arteriopathy performing carotid ultrasound in patients with and without erectile dysfunction. MATERIAL AND METHODS: We conducted a case-control study with 44 patients consulting for erectile dysfunction and 20 controls. All subjects completed the IIEF-5 test and we studied the criteria for metabolic syndrome, and a carotid ultrasound to study the intima-media thickness and the presence of atherosclerotic plaques was performed. RESULTS: Mean intima-media thickness was .71mm±.21 for the right and of .71±.17 for the left carotid in patients with erectile dysfunction. In the control group, the means were .54±0.11 and 0.59±0.15mm respectively, statistically significant differences (P=.02 and P=.05 respectively). No plaque was found in any control, but in 25% of both carotid arteries of patients with erectile dysfunction (P=.01). As metabolic syndrome, according to the American Heart Association, were diagnosed 52.8% of patients with erectile dysfunction, and 16.7% of controls, and according to the International Diabetes Federation, 52.3% of patients with erectile dysfunction and 25% of controls met diagnostic criteria. In both cases there were significant differences (P<.01 and P=.02 respectively). We found a positive linear correlation between waist circumference and the intima-media thickness in both carotid (P<.05). CONCLUSIONS: Patients with erectile dysfunction may be at increased risk of cardiovascular disease, as determined by the presence of arterial disease in the carotid arteries, which indicates that we should made a more thorough and comprehensive study of patients with erectile dysfunction.

Tumor renal de células yuxtaglomerulares / Renal Juxtaglomerular Cell Tumor

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Síndrome metabólico y perfil hormonal en pacientes con disfunción eréctil / Metabolic Syndrome and Hormone Profile in Patients with Erectile Dysfunction

Objetivos: Demostrar la existencia de relación entre síndrome metabólico y disfunción eréctil y analizar el perfil hormonal de estos pacientes con respecto a un grupo de población sana. Material y métodos: Se ha diseñado un estudio de casos y controles con 65 hombres divididos en dos grupos según la presencia o no de disfunción eréctil. El grupo A está formado por 37 hombres con disfunción eréctil y el grupo B por 28 hombres sanos sin disfunción eréctil. La edad estuvo comprendida entre 40 y 65 años. Se estudió la presencia de síndrome metabólico según la definición ATP III, la realización de ejercicio físico, tabaquismo, índice de masa corporal (IMC) y perfil hormonal completo incluyendo testosterona total, libre y biodisponible. Resultados: Se ha detectado mayor presencia de síndrome metabólico entre los hombres del grupo A (72,9%) con respecto a los del grupo B (17,8%) (p=0,0001). Entre los parámetros que conforman el síndrome metabólico existen diferencias entre ambos grupos en los niveles de presión arterial sistólica y diastólica, la glucemia en ayunas y el perímetro abdominal, siendo todas ellas significativas. Tras realizar análisis multivariante entre síndrome metabólico y disfunción eréctil ajustado por edad, IMC, IIEF, ejercicio físico y tabaquismo hemos observado relación significativa independiente entre síndrome metabólico y disfunción eréctil. No hemos encontrado diferencias entre ambos grupos en ningún parámetro hormonal. Conclusión: Existe relación entre síndrome metabólico y disfunción eréctil, por lo que parece recomendable llevar a cabo el estudio de perfil metabólico y riesgo cardiovascular en estos pacientes (AU)

Objectives: To demonstrate the existence of relation between metabolic syndrome and erectile dysfunction and to analyze the hormone profile of these patients regarding a healthy population group. Material and methods: A case-control study was designed with 65 men divided into 2 groups according to presence or non-presence of erectile dysfunction. Group A was made up of 37 men with erectile dysfunction and group B by 28 healthy men without erectile dysfunction. Ages ranged from 40 to 65 years. The presence of metabolic syndrome according to the ATPIII definition, performance of physical exercise, smoking habit, body mass index and complete hormone profile including testosterone -total, free and bioavailability, were studied. Results: Greater presence of metabolic syndrome was detected among men of Group A (72.9%) versus those of group B (17.8%) (p=0.0001). Among the parameters that make up the metabolic syndrome, there are differences between both groups in systolic and diastolic blood pressure, fast blood sugar and abdominal circumference, all these differences being significant. After performing multivariate analysis between the metabolic syndrome and erectile dysfunction adjusted for age, BMI, International Index for Erectile Function (IIEF), physical exercise and smoking habit, we have observed an independent significant relation between the metabolic syndrome and erectile dysfunction. We have not found differences between both groups in any hormone parameter. Conclusion: A relationship is found between metabolic syndrome and erectile dysfunction. Thus, it seems recommendable to perform the metabolic profile and cardiovascular risk study in these patients (AU)

Priapismo de bajo flujo transformado en priapismo de alto flujo por fístula arterio-lacunar secundaria a la técnica de Winter / Low-flow priapism turned into high-flow priapism due to arterial-lacunar fistula secondary to Winter's procedure

El priapismo es una afección patológica que consiste en una erección peneana persistente más allá de la estimulación sexual. Presentamos el caso de un paciente de 80 años, diagnosticado inicialmente, por la historia clínica, valores gasométricos de los cuerpos cavernosos y ultrasonografía Doppler color peneana, de priapismo de bajo flujo. Durante la realización de la técnica de Winter se produce iatrogénicamente la laceración bilateral de las arterias dorsales, originando una fístula arterio-lacunar y, en consecuencia, un priapismo de alto flujo. Se realizó una arteriografía selectiva de la pudenda al no ser concluyente la eco-Doppler color, que puso de manifiesto dicha fístula y permitió la embolización supraselectiva bilateral con microcoils (AU)

Priapism is a pathological condition which is a persistent penile erection beyond sexual stimulation. We report a patient of 80 years, initially diagnosed by medical history, blood gas values of the corpora cavernosa and penile color Doppler ultrasound of low-flow priapism. During the performance of the technique of Winter occurs iatrogenically bilateral laceration of the dorsal arteries, causing arterial-lacunar fistula and therefore a high-flow priapism. We performed selective arteriography of the pudendal, not being eco-color Doppler conclusively that showed that fistula and allowed superselective bilateral embolization microcoils (AU)

[Metabolic syndrome and hormone profile in patients with erectile dysfunction]. / Síndrome metabólico y perfil hormonal en pacientes con disfunción eréctil.

OBJECTIVES: To demonstrate the existence of relation between metabolic syndrome and erectile dysfunction and to analyze the hormone profile of these patients regarding a healthy population group. MATERIAL AND METHODS: A case-control study was designed with 65 men divided into 2 groups according to presence or non-presence of erectile dysfunction. Group A was made up of 37 men with erectile dysfunction and group B by 28 healthy men without erectile dysfunction. Ages ranged from 40 to 65 years. The presence of metabolic syndrome according to the ATPIII definition, performance of physical exercise, smoking habit, body mass index and complete hormone profile including testosterone -total, free and bioavailability, were studied. RESULTS: Greater presence of metabolic syndrome was detected among men of Group A (72.9%) versus those of group B (17.8%) (p=0.0001). Among the parameters that make up the metabolic syndrome, there are differences between both groups in systolic and diastolic blood pressure, fast blood sugar and abdominal circumference, all these differences being significant. After performing multivariate analysis between the metabolic syndrome and erectile dysfunction adjusted for age, BMI, International Index for Erectile Function (IIEF), physical exercise and smoking habit, we have observed an independent significant relation between the metabolic syndrome and erectile dysfunction. We have not found differences between both groups in any hormone parameter. CONCLUSION: A relationship is found between metabolic syndrome and erectile dysfunction. Thus, it seems recommendable to perform the metabolic profile and cardiovascular risk study in these patients.

Priapismo de bajo flujo convertido en priapismo de alto flujo por fístula arterio-lacunar secundaria a la técnica de Winter / Low-flow priapism developing to high-flow priapism by arterial-lacunar fistula secondary to the winter procedure

El priapismo es una afección patológica que consiste en una erección peneana persistente más allá de la estimulación sexual. Presentamos el caso de un paciente de 80 años, diagnosticado inicialmente, por la historia clínica, valores gasométricos de los cuerpos cavernosos y ultrasonografía doppler color peneana, de priapismo de bajo flujo que durante la realización de la técnica de Winter se produce iatrogénicamente la laceración bilateral de las arterias dorsales, originando una fístula arteriolacunar y en consecuencia un priapismo de alto flujo. Se realizó arteriografía selectiva de la pudenda, al no ser la eco-doppler color concluyente, que puso de manifiesto dicha fístula y permitió la embolización supraselectiva con microcoils...

Priapism is a pathology consisting of prolonged penile erection unrelated to sexual stimulation. We present an 80-year-old patient with relevant clinical history; corpora cavernosa blood gas analysis and penile Doppler ultrasound examination confirmed low-flow priapism. The Winter procedure was performed, which provoked iatrogenic laceration of the dorsal artery, leading to an arterio-lacunar fistula and high-flow priapism. A second Doppler ultrasound was inconclusive, and so a selective angiography was performed to observe the pudendal artery, following which selective embolization with microcoils was carried out...