Retroperitoneal schwannoma. A complex surgical treatment of a tumor with uncertain behavior.

BACKGROUND: Retroperitoneal schwannoma is a rare nerve sheath tumor; the surgical removal of this tumor is sometimes compromised by its location. The aim of this study is to analyze our experience with the diagnosis and treatment of this type of tumor. METHOD: We present our experience between 1999 and 2011 in the diagnosis and treatment of retroperitoneal schwannoma. During that time, we diagnosed and treated five female patients (four adults and one infant) with the condition. The tumors appeared sporadically and were not associated with neurofibromatosis or other syndromes. Diagnosis was performed by computed tomography (CT) imaging in four cases and by magnetic resonance imaging (MRI) in one case. RESULTS: All patients underwent surgical treatment and complete resection of the lesion. An open resection was performed in four cases, and in the most recent case, the excision was conducted laparoscopically. In all of the cases, the histological diagnosis was retroperitoneal schwannoma, and in one case, there was a melanocytic variant that was not associated with Carney syndrome. At the time of this report, there has been no evidence of recurrence. CONCLUSION: Retroperitoneal schwannoma is a tumor that is difficult to diagnose with imaging techniques, and because of its localization, the tumor is difficult to remove surgically.

[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.

Complicación derivada del uso de Hem-O-Lok en la prostatectomía radical laparoscópica / Complications arising from the use of Hem-O-Lok in laparoscopic radical prostatectomy

Se presenta una rara complicación pos operatoria, la formación de pseu dodivertículo uretral, que se produce después de una prostatectomía radical laparoscópica con preservación de nervios, procedimiento llevado a cabo con la colocación de Hem-o-lok sobre los pedículos látero-prostáticos, en un paciente con cáncer de próstata clínicamente localizado. Por tanto, estos dispositivos deben utilizarse con precaución en la región de la anastomosis vesicouretral...

We present a rare postoperative complication, pseudodiverticulum urethral formation, occurring after a laparoscopic radical prostatectomy with nerve-sparing procedure carried out with the placement of Hem-o-lok c in the latero-prostatic pedicles, in a patient with clinically localized prostate cancer. As such, these devices should be used with caution in the region of the vesicourethral anastomosis...

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)