The role of exogenous testosterone and social environment on the expression of sociosexuality and status-seeking behaviors in young Chilean men.

Testosterone plays an important role as a social hormone. Current evidence suggests that testosterone is positively related to sociosexuality increasing the psychological attitudes toward investing in short-term versus long-term mating and promotes status-seeking behaviors both by dominance and prestige. In addition, the social environment may play an important role in the expression of mating effort through changes in sociosexuality and status-seeking behaviors. However, the causal relationships among the mentioned variables are still debated. We employed a double-blind, placebo-controlled within-individual design, in order to test and integrate the proposed causal relationships between testosterone and social environment over short-term and long-term mating orientation and dominant and prestigious status-seeking behaviors in a sample of 95 young Chilean men. We did not find evidence that the administration of exogenous testosterone increased short-term or decreased long-term mating orientation as expected. Moreover, exogenous testosterone did not affect either aggressive or cooperative behavior failing to support the social status hypothesis. We also did not find any relationship between short or long-term mating orientation with status-seeking behaviors. Finally, we found support for the effect of social environment on sociosexual attitudes but not over status-seeking behaviors. Thus, men reported higher levels of short-term mating orientation in the presence of a woman compared to a man and no differences were found for long-term mating orientation. We argue that sociosexuality may be expressed flexibly, but contextual factors such as the presence of women seem more important than changes in testosterone levels.

Evidence of the active participation of women in the intergroup conflict based on the use of aggression and cooperation.

Intergroup conflict has been a persistent aspect of human societies since the emergence of our species. Various researchers have proposed that competition between groups has acted as a key selective force throughout human evolutionary history. Such intergroup competition for limited resources exacerbated the expression of intergroup aggression and intragroup cooperation. Furthermore, it would have a sexual dimorphism, with men demonstrating increased sensitivity to conflict threats-in order to maximize reproductive opportunities-, while women generally reject from active engagement in intergroup conflict. In the present study, we conducted behavioral experiments under controlled laboratory conditions to measure cooperation and aggression from using virtual games, specifically the Public Good Games and the Point Subtraction Aggression Paradigm, in a sample of 541 participants. We created control and experimental intergroup competition scenarios, where aggression and cooperation were necessary to increase monetary rewards. Our results shows that men modulate aggression and cooperation in the presence of intergroup conflict. In addition, our data also reveals that women cooperate more than men and display heightened levels of cooperation and aggression when confronted with intergroup conflict. These findings prompt a reevaluation of current functional theoretical models concerning the role of women in intergroup conflict and suggest that the dynamics of human aggression and cooperation may be more nuanced than previously believed.

Long-Term Mating Orientation in Men: The Role of Socioeconomic Status, Protection Skills, and Parenthood Disposition.

From an evolutionary perspective, phenotypic, social, and environmental factors help to shape the different costs and benefits of pursuing different reproductive strategies (or a mixture of them) from one individual to another. Since men's reproductive success is mainly constrained to women's availability, their mating orientations should be partially calibrated by features that women prefer in a potential partner. For long-term relationships, women prefer traits that signal access to resources, protection skills, and the willingness to share them. Using generalized linear models with laboratory data taken from a Chilean population (N = 197), this study aimed to test whether real and potential resources (measured as self-reported socioeconomic status), protection skills (measured as handgrip strength), and the willingness to provide resources and protection (measured as their disposition toward parenthood) are related to mating orientation in men. Our predictions were: (1) socioeconomic status would be positively associated with long-term and short-term mating orientation but for long-term-oriented individuals, this would be enhanced by having a more favorable parenthood disposition and (2) strength would be positively related to long-term mating orientation in men with higher socioeconomic status and a favorable disposition toward parenthood and it would have a positive and direct association with short-term mating orientation. Our results partially supported the first hypothesis, since men with higher socioeconomic status were more long-term oriented, but parenting disposition did not moderate this effect. Contrary to our expectations, socioeconomic status was not related to short-term mating orientation. Strength appeared not to be significant for long-term mating orientation, even interacting with other traits. However, strength by itself was powerfully linked with a short-term mating orientation. Our results suggest that only some individuals that are attractive for long-term relationships are indeed long-term oriented and may reflect the overall conflict of interests between mating strategies among sexes.

The Relationship between Androgen Receptor Gene Polymorphism, Aggression and Social Status in Young Men and Women.

In both sexes, aggression has been described as a critical trait to acquire social status. Still, almost uniquely in men, the link between aggressiveness and the genetic background of testosterone sensitivity measured from the polymorphism in the androgen receptor (AR) gene has been previously investigated. We assessed the relevance of the AR gene to understand aggression and how aggressiveness affects social status in a cross-sectional study of 195 participants, for the first time in both young men and women. We estimated polymorphism sequences from saliva and measured aggression and self-perceived social status. Unfortunately, the results did not support our prediction because we did not find any of the expected relationships. Therefore, the results suggest that the genetic association between aggressive mechanisms and polymorphism of the AR gene is less straightforward than expected, at least in men, and seems to indicate that aggression is not usually used to gain social status in our population.

Correction: Testing strategic pluralism: The roles of attractiveness and competitive abilities to understand conditionality in men's short-term reproductive strategies.

[This corrects the article DOI: 10.1371/journal.pone.0237315.].

Testing strategic pluralism: The roles of attractiveness and competitive abilities to understand conditionality in men's short-term reproductive strategies.

The decision to allocate time and energy to find multiple sexual partners or raise children is a fundamental reproductive trade-off. The Strategic Pluralism Hypothesis argues that human reproductive strategies are facultatively calibrated towards either investing in mating or parenting (or a mixture), according to the expression of features dependent on the individual's condition. This study seeks to test predictions derived from this hypothesis in a sample of 242 young men (M ± SD = 22.12 ± 3.08) from Chile's 5th Region (33Ö¯ south latitude). Specifically, two predictions were considered that raise questions about the relationship between traits related to physical and psychological attractiveness (fluctuating facial asymmetry and self-perception of attractiveness) and competitive skills (baseline testosterone and self-perception of fighting ability) with short-term reproductive strategies. Our results indicate that psychological features related to the self-perception of physical attractiveness are related to short-term reproductive strategies. However, no evidence was found that fluctuating facial asymmetry, basal levels of testosterone and self-perception of fighting ability were related to short-term reproductive strategies. These results support the existing evidence of the importance of physical attractiveness in calibrating men's reproductive strategies but cast doubts about the role of fluctuating facial asymmetry. They also suggest that traits related to physical attractiveness, in comparison to competitive capabilities, play a more important role in calibrating men's short-term reproductive strategies.

Men's Bodily Attractiveness: Muscles as Fitness Indicators.

Bodily attractiveness is an important component of mate value. Musculature-a crucial component of men's bodily attractiveness-provides women with probabilistic information regarding a potential mate's quality. Overall musculature is comprised of several muscle groups, each of which varies in information value; different muscles should be weighted differently by attractiveness-assessment adaptations as a result. In the current study, women and men ( N = 1,742) reported size preferences for 14 major muscle groups. Women's reported preferences provided only partial support for our hypotheses that women will prefer muscles that most reliably differentiate between potential mates to be larger; men tended to prefer larger upper-body muscles. We discuss possible interpretations of these mixed findings. Ultimately, our findings suggest that attractiveness-assessment adaptations are sensitive to the information contained within specific muscle groups and they highlight the potential for additional research on the nuances of bodily attractiveness assessment.

Testosterone-dependent facial and body traits predict men's sociosexual attitudes and behaviors.

OBJECTIVES: Strategic Pluralism Theory contends that human mating strategies are calibrated toward short-term (ST) or long-term (LT) mating according to the expression of condition-dependent traits and characteristics of the social and physical environment. Traits reflecting the effects of testosterone have been considered condition-dependent traits that provide information about the calibration of male mating strategy. We investigated the relationship of muscle mass and facial masculinity with attitudes and behaviors reflecting ST and LT mating tactics. METHODS: We measured skeletal muscle mass (SMM) through bioelectrical impedance and facial width-to-height ratio (fWHR) in a sample of Chilean men (n = 206; mean age = 22.52 ± 4.65 SD), and collected information about sociosexual attitudes and past sexual behavior. RESULTS: Our results showed an interaction effect of SMM and fWHR on unrestricted (but not restricted) sociosexual attitudes and past sexual behavior. Individuals with a consistent expression of both traits (ie, high SMM and fWHR or low SMM and fWHR) reported higher levels of unrestricted sociosexual attitudes and a greater number of lifetime and previous-year sexual partners. CONCLUSIONS: These findings suggest that the intensity and consistency of expression of body and facial masculinity is important in signaling male mating tactics and sociosexual attitudes.

Sex Affects the Relationship Between Third Party Punishment and Cooperation.

Prosocial third-party punishment (3PP) is a punitive behavior against antisocial individuals, which might explain extended cooperativeness in humans. 3PP shows sexual dimorphism, being more frequent in men than in women. We studied whether sexually dimorphic features related to sexual hormones during development (facial dimorphism and 2D:4D) influence the tendency to engage in 3PP in a sample of 511 women and 328 men. After playing a Prisoner's Dilemma, participants had to decide whether to penalize the defection of a third player who had exploited his/her counterpart's cooperation. In line with previous studies, we observe that men are more prone to engage in 3PP than women. We find that this sex difference is due to cooperative men being more likely to punish than cooperative women. In addition, men with higher facial masculinity are less likely to engage in 3PP, whereas no features influence 3PP in women. We discuss the possibility that sex differences in the motivations and fitness implications underlying 3PP might be driving the observed results.

Muscularity and Strength Affect Individual Variation in Self-Perception of Fighting Ability in Men.

Objective: There is evidence that competitive conflicts are the main form of intrasexual competition among men. The capacity to recognize visual cues of fighting ability in competitors is thought to be an important characteristic that allows men to avoid the costs of contest competition. However, for an accurate comparison to take place, individuals need to compare the fighting ability of their competitors to their own to assess this asymmetry. Methods: In order to improve our understanding of this self-assessment process, here we study the relationship between visual fighting ability cues, namely (i) muscularity, as measured with a bioimpedance device, (ii) the real capacity to inflict cost to a rival based on strength, as measured with a hand grip dynamometer (HGS), and (iii) self-perceived fighting ability, as determined with a questionnaire. The study sample was 364 men between 18 and 38 years of age (M ± SD = 22.27 ± 3.99). Results: Our results confirm the expected positive relationship between upper-body muscularity and strength, while controlling for body mass index (BMI). However, muscularity explained only around 30.2% of the variance in strength. In addition, muscularity was related to self-perception of fighting ability in our sample, its effect being partially mediated by strength. Conclusion: The more muscular men perceive their fighting ability as being greater, and not only because they are stronger (at least in the HGS task). Accordingly, it seems that men take into account the overestimation the robustness of the relationship between strength and muscularity that prevails within his peers.

Diferencias en la conducta de emparejamiento entre mujeres jóvenes universitarias de Santiago de Chile en relación con el consumo de píldoras anticonceptivas orales / Differences in mating behavior among university young women of Santiago de Chile in relation to the consumption of oral contraceptive pills

Durante los últimos años en Chile se ha detectado una masificación en el uso de anticonceptivos orales. Sin embargo, en Chile y al igual que en casi todos los países latinoamericanos prácticamente no se han investigado sus implicancias sobre la conducta humana. Específicamente, este estudio evaluó el impacto del uso de estos anticonceptivos sobre la conducta de emparejamiento en un grupo de 164 mujeres jóvenes universitarias, con una media de edad igual a 19 años y provenientes de cuatro universidades chilenas. Para ello se utilizó la adaptación chilena del Cuestionario de Componentes del Valor de Pareja que está compuesto por 22 ítems que se responden en una escala Likert de siete valores. Los resultados señalan diferencias entre las mujeres que consumen píldoras anticonceptivas (PA) y las que no lo hacen. Las consumidoras presentan los mayores valores del índice general del cuestionario sobre los componentes del valor de pareja y las subescalas de historia de relaciones de pareja, apreciación desde el sexo opuesto y apariencia. Estos resultados indican que las mujeres consumidoras de la PA se autoperciben y creen que el sexo contrario las evalúa como atractivas y muestran una vida sexual más diversificada, no mostrando diferencias en los otros aspectos relevantes para el valor de pareja no vinculados centralmente al atractivo físico. En definitiva, los resultados parecen indicar que el consumo de anticonceptivos hormonales no modifica la conducta social y parental de las mujeres, aunque su uso parece estar asociado con una mayor autopercepción de atractivo y mayor diversidad sexual.

Oral contraceptives, also known as birth control pills (PAs from now on), have been available on the world market for five decades. At present, the use of PA is massifier worldwide, being consumed by more than 100 million women on the planet. In recent years, in Latin America has been detected a dramatic increase in the use of oral contraceptives, and Chile is not the exception. In this sense, it is probable that the increase in the consumption of PAs in Chile is linked to the increase of women who decide to pursue higher studies and to develop professional careers. Concurrently, a wide field of research has been focused on the physiological and psychological effect of the consumption of oral contraceptives on human behavior, being mating behavior one of the main topics of research. However, in Chile as in most Latin American countries there is a lack of studies on the implications of the consumption of oral contraceptives on human behavior. In the present study, we investigated in a group of 164 university young women (Mean ± Standard Deviation: 19.27± 2.88 years) of Chile the impact of the use of oral contraceptives on mating behavior. Accordingly, we have applied a validated psychometric test to assessed mate value, one of the more relevant components of mating behavior i.e., the Mate Value Questionnaire. Mate value can be defined as a construct that incorporates a number of physical, psychological, and social dimensions that are related to an individual's ability to find, attract, and successfully retain a partner. This questionnaire is composed by 22 items and 7 subscales that are answered in a Likert Scale of 7 values. The Mate Value Questionnaire showed a high reliability (α = .85). According with previous studies that showed a decrease in sexual satisfaction and desire on women that consume oral contraceptives, we predicted a decrease of mating behavior and, then, a decrease on Mate Value for those women that use oral contraceptives. This effect was expected for all subscales of this questionnaire with the exception of relationship history subscale since women that consume oral contraceptives reported to have more diverse sexual partners on previous studies. The results show differences between women who use oral contraceptives (n = 87 women: 19.60 ± 2.89 years) in comparison to those who do not (n = women: 18.90 ± 2.84 years). However, the differences were, in general, opposed to our expectations being the consumers of oral contraceptives who presented the highest values of the general index of the Mate Value Questionnaire, and, concretely, for the subscales of relationship history, views of the opposite sex, and looks. In addition, we have failed into found any differences between groups in subscales that were not associated to physical appearance, such as wealth, sociality and fear of failure. The results suggest that the use of hormonal contraceptives does not modify the social and parental behavior of the women, although their use seems to be associated with a greater self-perception of attractiveness and greater diversity in sexual life. This study provides new information that will increase the understanding and discussion about the hypothetical effect that would or would not, the consumption of the PA on the pairing behavior. It is important to point out that the field of research on changes in the sexual preferences of women, derived from hormonal states, is in an important discussion process. Therefore, we believe that it is critical to carry out research in the future in order to elucidate the real robustness of this phenomenon, improving our understanding about the behavioral effects of consuming oral contraceptives.

Cross-Cultural Investigation of Male Gait Perception in Relation to Physical Strength and Speed.

Previous research documents that men and women can accurately judge male physical strength from gait, but also that the sexes differ in attractiveness judgments of strong and weak male walkers. Women's (but not men's) attractiveness assessments of strong male walkers are higher than for weak male walkers. Here, we extend this research to assessments of strong and weak male walkers in Chile, Germany, and Russia. Men and women judged videos of virtual characters, animated with the walk movements of motion-captured men, on strength and attractiveness. In two countries (Germany and Russia), these videos were additionally presented at 70% (slower) and 130% (faster) of their original speed. Stronger walkers were judged to be stronger and more attractive than weak walkers, and this effect was independent of country (but not sex). Women tended to provide higher attractiveness judgments to strong walkers, and men tended to provide higher attractiveness judgments to weak walkers. In addition, German and Russian participants rated strong walkers most attractive at slow and fast speed. Thus, across countries men and women can assess male strength from gait, although they tended to differ in attractiveness assessments of strong and weak male walkers. Attractiveness assessments of male gait may be influenced by society-specific emphasis on male physical strength.

Facial Features: What Women Perceive as Attractive and What Men Consider Attractive.

Attractiveness plays an important role in social exchange and in the ability to attract potential mates, especially for women. Several facial traits have been described as reliable indicators of attractiveness in women, but very few studies consider the influence of several measurements simultaneously. In addition, most studies consider just one of two assessments to directly measure attractiveness: either self-evaluation or men's ratings. We explored the relationship between these two estimators of attractiveness and a set of facial traits in a sample of 266 young Spanish women. These traits are: facial fluctuating asymmetry, facial averageness, facial sexual dimorphism, and facial maturity. We made use of the advantage of having recently developed methodologies that enabled us to measure these variables in real faces. We also controlled for three other widely used variables: age, body mass index and waist-to-hip ratio. The inclusion of many different variables allowed us to detect any possible interaction between the features described that could affect attractiveness perception. Our results show that facial fluctuating asymmetry is related both to self-perceived and male-rated attractiveness. Other facial traits are related only to one direct attractiveness measurement: facial averageness and facial maturity only affect men's ratings. Unmodified faces are closer to natural stimuli than are manipulated photographs, and therefore our results support the importance of employing unmodified faces to analyse the factors affecting attractiveness. We also discuss the relatively low equivalence between self-perceived and male-rated attractiveness and how various anthropometric traits are relevant to them in different ways. Finally, we highlight the need to perform integrated-variable studies to fully understand female attractiveness.

Physical strength, fighting ability, and aggressiveness in adolescents.

OBJECTIVES: Recent research suggests that evolutionary selection pressures have shaped mental mechanisms to be able to assess one's own and other's physical strength, fighting ability, and aggressiveness. According to the recalibrational theory, anger may be linked to fighting ability and serve as a bargaining mechanism to improve welfare obtained in social conflict. We hypothesized that late adolescent men (but not mid-adolescent men or women) use this mechanism, as it would be particularly adaptive for them to avoid potential costs from direct conflict in male competition. METHODS: The present study investigated the relationship between fighting ability (estimated from handgrip strength [HGS], a measure of upper body strength, and self-reported fighting ability) and aggressiveness (physical and nonphysical) in 288 Spanish adolescents aged 14-18 years. RESULTS: Our results indicated a positive relationship between self-perceived fighting ability and HGS in both sexes during adolescence. There was no association between fighting ability and aggressiveness in late adolescent women (17-18 years). For men, there was a positive relationship between fighting ability and physical aggression, but the strength of this relationship decreased with age. Additionally, for men, there was a positive relationship between fighting ability and anger but only in late adolescence, and thus arguing that for adolescent men aggression strategies shift from physical to nonphysical as they age. CONCLUSIONS: With reference to the recalibrational theory of anger, our results suggest that the sex- and age-dependent associations between fighting ability and physical and nonphysical aggression indicate divergent adaptive skills between sexes, which are driven by intrasexual competition.

Complicaciones urológicas de la radioterapia pélvica / Urologic complications in pelvic radiotherapy

Las neoplasias ginecológicas suelen tratarse mediante radioterapia y cirugía, ya sea aisladamente o en combinación. Sus resultados son buenos en cuanto al control de la enfermedad, y en la literatura internacional se informa que sus complicaciones son raras. Este estudio se realizó a causa de la elevada demanda de consultas y hospitalizaciones en el servicio en que trabajan los autores por parte de pacientes complicadas. Se revisaron los expedientes de 136 pacientes con una o varias complicaciones relacionadas con la radioterapia con el fin de identificar la incidencia de complicaciones, los tipos de tratamiento recibidos y las intervenciones quirúrgicas realizadas para resolverlas. Se encontraron diez complicaciones, las tres principales cistitis hemorrágicas, estenosis ureteral y estenosis uretral, con 118, 56 y 32 casos respectivamente, para una incidencia global de 4.8, 2.3 y 1.3 en cada variedad. Se otorgaron 1 640 consultas (12 por paciente en promedio) y la hospitalización sumó 2 382 días (17.5 por paciente). Además, se realizaron 571 intervenciones quirúrgicas mayores o menores por esta causa durante un periodo de siete años. Se presentan los resultados y las experiencias en el hospital en que trabajan los autores

Síndrome subsecuente a resección transuretral de la próstata / Post-TURP syndrome

La resección transuretral de la próstata es una de las operaciones más comunes de la cirugía urológica, y hasta hoy es la única que ha establecido su eficacia a largo plazo, su morbilidad como la hemorragia y el síndrome subsecuente a resección transuretral de la próstata (post-RTUP), tal vez tiendan a desaparecer con el advenimiento de tecnologías como la electrovaporización del tejido prostático; entre tanto, sus tasas de buen éxito objetivo y subjetivo de 85 a 90 por ciento la convierten en el estándar de oro del tratamiento de la hiperplasia benigna de la próstata, por lo que es de interés revisar las actualidades en la fisiopatología, las manifestaciones clínicas y el tratamiento del síndrome post-RTUP

Dolor por litotripsia extracorpórea: tratamiento novedoso con neuroestimulación eléctrica y nalbufina / Pain caused by extracorporeal lithotripsy: a novel treatment by means of electric neurostimulation and nalbufine

La litotripsia extracorpórea por ondas de choque fue introducida por Chaussy y col. en 1980, y revolucionó el tratamiento de la litiasis renal. Se ha informado que el sistema piezoeléctrico de litotripsia para la generación de la onda de choque es una modalidad libre de dolor. Sin embargo, la observación no confirma tal concepto. En este estudio se define el grado de dolor presentado por los pacientes que se someten a litotripsia extracorpórea con generación de ondas de choque por medio de un sistema piezoeléctrico. Se observó que 89.3 por ciento de los pacientes experimentaron dolor de un grado que requirió aplicación de analgesia para poder efectuar una sensasión adecuada de litotripsia con comodidad y eficacia para el paciente con buenos resultados. Sólo 10.7 por ciento de los pacientes manifestaron un grado de dolor que no requirió analgesia. Además, en este estudio se propone una novedosa modalidad de analgesia basada en la neuroestimulación eléctrica transcutánea combinada con nalbufina subcutánea, que eliminó el dolor en forma eficaz con una diferencia estadísticamente significativa entre el empleo de esta modalidad y su omisión (P < 0.05)

Hidronefrosis gigante con asociación de carcinoma de células transicionales de la pelvis renal. Informe de un caso y revisión de la bibliografía / Giant hydronephrosis associated with transitional cell carcinoma of renal pelvis. Report of a case and literature review

La hidronefrosis gigante es un trastorno patológico raro. Stirling emitió una definición en 1939 como la presencia de 1 000 ml de líquido en los sistemas pielocaliciales. El diagnóstico en numerosas ocasiones es erróneo, y se confunde con quiste de ovario, hemartoma retroperitoneal y quiste hepático. Se informa el caso de un paciente de 48 años con hidronefrosis gigante que contenía 4 900 ml de líquido en los sistemas pielocaliciales y, además, carcinoma de células transicionales de la pelvis renal incidentalmente asociado. El carcinoma de células transicionales de la pelvis renal y la hidronefrosis gigante son dos trastornos patológicos poco frecuentes. El primero manifiesta una incidencia de 5 por ciento de todos los cánceres renales, y la asociación de ambos trastornos es rara, por lo que son pocos los informes en la literatura mundial

Receptores androgénicos y p53 en cáncer de próstata avanzado / Androgenic receptors an p53 in advanced prostate cancer

Se estudiaron la prevalencia de receptores androgénicos y de p53 en el carcinoma de próstata avanzado y las probables relaciones entre ambos y con el sistema del Gleason. El estudio se efectuó con 30 ejemplares de cáncer de próstata, 25 hormonodependientes y 5 hormorrefractarios, obtenidos de resección transuretral, biopsia transrectal y necropsias, por métodos inmunohistoquímicos y utilizando anticuerpos policlonales y monoclonales contra p53 y receptores androgénicos. Fueron positivos a p53 80 por ciento de ejemplares de tumores hormonorefractarios, contra sólo 24 por ciento de los tumores de pacientes etapa D2. La intensidad y el porcentaje de p53 en tumores refractarios y hormonodependientes fueron estadísticamente significativos (P= 0.025). Todos los ejemplares (n= 30) fueron positivos a receptores androgénicos, y las diferencias significativas fueron sorpresivamente mayores en los tumores hormonoindependientes (P= 0.009). No se encontró ninguna relación entre receptores androgénicos, clasificación de Gleason o p53, pero sí entre la clasificación de Gleason y p53, con 8 de 10 tumores positivos a p53 localizados entre 7 y 10 (pobremente diferenciados). Este estudio mostró una diferencia en el incremento de p53 en tumores metastásicos y hormonoidependientes, pero ninguna relación con el tiempo de progreso, la puntuación de Gleason o la etapa con los receptores androgénicos.

Valoración de la eyaculación y la fecundidad posteriores al tratamiento quirúrgico del carcinoma testicular con linfadenectomía retroperitoneal / Evaluation of ejaculation and fertility after surgical treatment of testicular carcinoma with retroperitoneal lymphadenectomy

Se comunica la experiencia del Servicio de Urología del HOspital de Especialidades, Centro Médico Nacional de Occidente, IMSS, con el diagnóstico y el tratamiento quirúrgico del carcinoma testicular con linfadenectomía retroperitoneal. Esta experiencia comprende un grupo de 40 pacientes que se diagnosticaron y se trataron dentro del periodo comprendido entre julio de 1991 y diciembre de 1994. Los resultados pusieron de manifiesto una edad promedio de 29.1 años al momento del diagnóstico; más de 60 por ciento de los pacientes tenían más de 25 años. La manifestación clínica más frecuente fue la presencia de una tumoración de consistencia firme en uno de los testículos, que se observó en 60 por ciento de los pacientes estudiados. En 20 por ciento había reacción de tipo inflamatorio sin dolor, y en la proporción restante de 20 por ciento había dolor agudo. En todos los casos se realizó orquiectomía con ligadura alta del cordón afectado, seguida por linfadenectomía retroperitoneal. El carcinoma se produjo en el testículo derecho en 80 por ciento de los pacientes, y el 20 por ciento restante lo hizo en el izquierdo. El estudio histopatológico de los testículos señaló que 40 por ciento de los tumores eran teratomas y 60 por ciento carcinomas embrionarios, El informe histopatológico de los ganglios linfáticos retroperitoneales resecados señaló negatividad a metástasis en todos los pacientes. El tiempo de evolución de la sintomatología al arribo para la primera consulta médica especializada en el servicio fue de seis meses. Una proporción de 90 por ciento de los pacientes experimentaron eyaculación anterógrada después de la linfadenectomía retroperitoneal.