Ischaemic priapism as a presentation of chronic myeloid leukaemia.

OBJECTIVE: To describe ischemic priapism as an atypical presentation of chronic myeloid leukaemia. METHODS / RESULTS: We discuss two patients diagnosed with chronic myeloid leukaemia presenting an episode of priapism, adequately resolved after applying the treatment protocol established in our center. CONCLUSION: Priapism is defined as a persistent erection that persists despite not having sexual stimulus, without involvement of the spongy tissue of the penis. Its debut appearance as a hematologic dyscrasia is a rare event. It is a urological emergency, requiring early multidisciplinary (Urology and Hematology) management, since the speed in treatment will result in good functional results and the preservation of a good quality of life.

PSA levels in patients on hemodialysis treatment.

OBJECTIVES: Standardized prostate-specific antigen (PSA) levels are based upon the general population levels and, although a higher incidence of prostate cancer in patients on hemodialysis (HD)has not been demonstrated, some studies point at the possibility of observing higher PSA levels in this type of patients than in males with preserved renal function. The objective of the present study is to compare PSA levels in males on hemodialysis with those of the population with normal renal function. METHODS: Comparative, transversal study of the variables age, total PSA, free PSA and PSA index in 190 patients with chronic renal disease on hemodialysis treatment (group 1) and 237 subjects without renal disease ( group 2). We carried out a descriptive analysis and a comparative study of the above mentioned variables using the SPSS software. RESULTS: Median age of patients on HD was 55 in cases (47-61)and 59 in controls (54-63.5). Mean total PSA was 1.49 ng/mL [1.24-1.73] in cases and 1.62 ng/mL [1.29-1.95] in controls; mean free PSA was 1.40 ng/mL [0.89-1.91] in group 1 and 2.31 ng/mL [-0.83-5.45] in group 2; mean PSA index was 27.67% [19.91-35.63] in cases and 14.82%[12.79-16.85]] in controls. The comparative study showed differences between the two groups in free PSA (p ≤ 0.007), PSA index (p ≤ 0.000) and total PSA (p ≤ 0.000) in patients under 50 after an age-specific analysis. CONCLUSIONS: Total PSA is higher in patients on HD within the subgroup of patients under 50 with statistically significant but not clinically relevant difference. PSA index is remarkably higher in the group of patients on HD. These data could have clinical implications as far as indications for biopsy is concerned.

Priapismo isquémico como presentación de leucemia mieloide crónica / Ischaemic priapism as a presentation of chronic myeloid leukaemia

OBJETIVO: Describir el priapismo isquémico como forma de presentación atípica de la leucemia mieloide crónica. MÉTODO/RESULTADO: Comentamos 2 pacientes diagnosticados de leucemia mieloide crónica a partir de un episodio de priapismo, resueltos adecuadamente tras la aplicación del protocolo de tratamiento establecido en nuestro centro. CONCLUSIÓN: El priapismo se define como una erección persistente, que se mantiene a pesar de no haber estimulo sexual, sin participación del tejido esponjoso del pene. Su aparición como debut de una discrasia hematológica es un suceso poco frecuente, constituyendo una urgencia urológica que requiere un manejo precoz y multidisciplinar por parte de los servicios de Urología y Hematología, ya que la rapidez en el tratamiento derivará en una función eréctil conservada, y con ello preservar la calidad de vida

OBJECTIVE: To describe ischemic priapism as an atypical presentation of chronic myeloid leukaemia. METHODS / RESULTS: We discuss two patients diagnosed with chronic myeloid leukaemia presenting an episode of priapism, adequately resolved after applying the treatment protocol established in our center. CONCLUSION: Priapism is defined as a persistent erection that persists despite not having sexual stimulus, without involvement of the spongy tissue of the penis. Its debut appearance as a hematologic dyscrasia is a rare event. It is a urological emergency, requiring early multidisciplinary (Urology and Hematology) management, since the speed in treatment will result in good functional results and the preservation of a good quality of life

Niveles de PSA de los pacientes en hemodiálisis / PSA levels in patients on hemodialysis treatment

OBJETIVO: Los niveles de PSA por los que nos regimos actualmente están basados en la población general, y aunque no se ha demostrado una mayor incidencia de cáncer de próstata en los pacientes en hemodiálisis (HD), algunos estudios señalan la posibilidad de encontrar niveles de PSA más elevados en estos pacientes que en los varones con función renal conservada. El objetivo de este estudio es medir y comparar los niveles de PSA de los varones en diálisis con los de la población con función renal normal. MÉTODO: Estudio transversal comparativo de las variables edad, PSA total, PSA libre e índice de PSA en 190 pacientes con enfermedad renal crónica en tratamiento sustitutivo en hemodiálisis (grupo 1) frente a 237 pacientes sanos desde el punto de vista renal (grupo 2). Realizamos análisis descriptivo y estudio comparativo de las variables referidas con el paquete informático SPSS. RESULTADOS: La mediana de edad de los pacientes en HD fue 55 años en los casos (47-61) y de 59 años (54-63,5) en los controles. El PSA total medio fue de 1,49 ng/ml [1,24-1,73] en los casos y 1,62 ng/ml [1,29-1,95] en los controles; el PSA libre medio 1,40ng/ml [0,89- 1,91] en grupo 1 y 2,31ng/ml [-0,83- 5,45] en grupo 2; el índice de PSA medio 27,67 % [19,91-35,63] en los casos y 14,82 % [12,79-16,85] en los controles. En el estudio comparativo encontramos diferencias entre los 2 grupos con respecto al PSA libre (p ≤0,007) y el índice (p ≤0,000) así como en el PSA total (p ≤0,000) en menores de 50 años tras un análisis por rangos de edad. CONCLUSIONES: El PSA total es más elevado en pacientes en HD en el subgrupo de edad de menos de 50 años con diferencia estadísticamente significativa aunque no clínicamente relevante. El índice de PSA es significativamente más alto en el grupo de pacientes en HD. Estos datos podrían tener implicación clínica en cuanto a la indicación de biopsia (AU)

OBJECTIVES: Standardized prostate-specific antigen (PSA) levels are based upon the general population levels and, although a higher incidence of prostate cancer in patients on hemodialysis (HD) has not been demonstrated, some studies point at the possibility of observing higher PSA levels in this type of patients than in males with preserved renal function. The objective of the present study is to compare PSA levels in males on hemodialysis with those of the population with normal renal function. METHODS: Comparative, transversal study of the variables age, total PSA, free PSA and PSA index in 190 patients with chronic renal disease on hemodialysis treatment (group 1) and 237 subjects without renal disease (group 2). We carried out a descriptive analysis and a comparative study of the above mentioned variables using the SPSS software. RESULTS: Median age of patients on HD was 55 in cases (47-61) and 59 in controls (54-63.5). Mean total PSA was 1.49ng/mL [1.24-1.73] in cases and 1.62 ng/mL [1.29-1.95] in controls; mean free PSA was 1.40ng/mL [0.89-1.91] in group 1 and 2.31ng/mL [-0.83- 5.45] in group 2; mean PSA index was 27.67% [19.91-35.63] in cases and 14.82% [12.79-16.85] in controls. The comparative study showed differences between the two groups in free PSA (p ≤ 0.007), PSA index (p ≤ 0.000) and total PSA (p ≤ 0.000) in patients under 50 after an age-specific analysis. CONCLUSIONS: Total PSA is higher in patients on HD within the subgroup of patients under 50 with statistically significant but not clinically relevant difference. PSA index is remarkably higher in the group of patients on HD. These data could have clinical implications as far as indications for biopsy is concerned (AU)