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.

Estrangulación de la base peneana por aros metálicos / Penile strangulation by metallic rings

Presentamos dos casos clínicos recientes de pacientes que acuden al Servicio de Urgencias por presentar lesión en base de pene por estrangulación de aro metálico (Doble anilla de llavero) que se resolvieron mediante sección del cuerpo metálico. Revisamos la literatura sobre esta patología excepcional y su manejo terapéutico. (AU)

[Strangulation of penile base by metallic rings]. / Estrangulación de la base peneana por aros metálicos.

We report two cases of patients who went to the emergency department complaining of penile strangulation due to metallic rings (Double key ring) at the base of the penis which was resolved by cutting the metallic rings. We look trough the scientific literature about this unusual pathology and its management.

[Treatment of lithiasis in patients with one kidney by extracorporeal shock wave lithotripsy]. / Tratamiento de la litiasis en pacientes monorrenos con litotricia extracorpórea de ondas de choque.

OBJECTIVE: To describe the efficacy of extracorporeal shock wave lithotripsy in the treatment of lithiasis in patients with solitary functioning kidney. METHODS: The study comprised 56 patients with solitary kidney that had been treated by extracorporeal shock wave lithotripsy. These patients had a solitary kidney for the following reasons: 30 had undergone nephrectomy due to lithiasis, 11 had lost renal function arising from lithiasis, 9 had undergone nephrectomy for other pathologies and 6 had renal agenesis. Nine stone variables and treatment were analyzed. The same variables were analyzed and compared for statistical significance in a representative sample of 125 lithiasic patients with two kidneys who were treated by ESWL. RESULTS: Patients with solitary kidney frequently had a single calculus of < or = 1 cm located in calyces, unobstructive and did not require complementary endourological procedures. The mean number of shock waves was 8535. The psot-lithotripsy success rate was 82.1%; 98.2% had no complications. Comparison of these variables in both groups of patients showed statistically significant differences for stone location, indication for complementary endourological procedures and the number of shock waves utilized. CONCLUSIONS: In our view, ESWL is the treatment of choice in patients with lithiasis in a solitary kidney due to its high success rate and low morbidity. Stringent criteria must be employed before indicating prior endourological procedures to preserve the patency of the excretory tract and to minimize the risk of ureteral obstruction.