ABSTRACT
Objetivos: Dada la escasez de artículos científicos que revisen las distintas técnicas disponibles para modificaciones estéticas en el pene y que son causa de problemas uro-andrológicos posteriores, se revisa la literatura existente tras la asistencia de una infección peneana tras inyección de ácido hialurónico subcutáneo con fines estéticos. Material y métodos: Se expone un caso de un varón de 38 años de edad sin antecedentes médicos o psiquiátricos de interés, que acude a la urgencia por presentar inflamación y abscesificación en la piel peneana tras la inyección de ácido hialurónico. Fue preciso tratamiento quirúrgico mediante denudamiento y exéresis de la piel afecta, siendo la posterior evolución satisfactoria. El análisis psicológico realizado mostró una personalidad narcisista, posiblemente secundaria a traumas en la infancia. Se ha revisado la literatura presente en bases de datos médicas, así como información disponible on-line. Resultados. El aumento del tamaño del pene es una importante preocupación cultural y social, por lo que existen en el mercado distintos dispositivos para satisfacer esta demanda, entre los que destacan la fitoterapia, los ejercicios de estiramiento, pesas, bombas de vacío o dispositivos extensores. Entre las técnicas quirúrgicas descritas están la liposucción púbica, la sección del ligamento suspensorio del pene o la inyección de material autólogo o sustancias sintéticas, entre otras. Existen otras modificaciones estéticas peneanas entre las que destacan una amplia variedad de piercings genitales, tatuajes e implantes subcutáneos también denominados pocketing o "implantes 3D". Todas estas técnicas o modificaciones se describen en este artículo junto con sus posibles complicaciones urológicas asociadas más frecuentes. Conclusiones: Cada vez son más frecuentes las manipulaciones estéticas en el pene, y tanto la terminología popular como sus implicaciones médico-quirúrgicas deben ser conocidas por los urólogos y andrólogos
Objectives: Due to the scarcity of scientific articles that review the technical alternatives available for aesthetic modifications in the penis that are the cause of subsequent uro-andrological problems, the existing literature is reviewed after the assistance of a penile infection by injection of subcutaneous hyaluronic acid with aesthetic purposes. Material and methods: A 38-year-old male patient with no medical or psychiatric remarkable reports who came to the emergency room due to inflammation and abscess in penile skin after injection of hyaluronic acid. Surgical treatment was required and degloving and excision of affected skin was performed, with subsequent satisfactory evolution. The psychological analysis showed a narcissistic personality possibly secondary to traumas in childhood. We have reviewed the literature present in medical databases as well as information available on-line. Results: Enlargement of the penis is an important cultural and social concern, so that there are different devices in the market to meet this demand, among them: herbal medicine, stretching exercises, weights, vacuum pumps or extensor devices. Among the surgical techniques, there have been described the pubic liposuction, the section of the suspensory ligament of the penis or the injection of autologous material or synthetic substances among others. As for the aesthetic modifications of the penis, there is a wide variety of genital piercings, tattoos and subcutaneous implants also called "pocketing" or "3D implants". All of these techniques or modifications are described in this article along with their possible associated more frequent urological complications. Conclusions: Aesthetic manipulations in the penis are becoming increasingly popular, and both its terminology and its medical implications should be known by urologists and andrologists. Community
Subject(s)
Humans , Male , Adult , Penile Diseases/psychology , Penile Diseases/surgery , EstheticsABSTRACT
OBJECTIVES: Due to the scarcity of scientific articles that review the technical alternatives available for aesthetic modifications in the penis that are the cause of subsequent uro-andrological problems, the existing literature is reviewed after the assistance of a penile infection by injection of subcutaneous hyaluronic acid with aesthetic purposes. MATERIAL AND METHODS: A 38-year-old male patient with no medical or psychiatric remarkable reports who came to the emergency room due to inflammation and abscess in penile skin after injection of hyaluronic acid. Surgical treatment was required and degloving and excision of affected skin was performed, with subsequent satisfactory evolution. The psychological analysis showed a narcissistic personality possibly secondary to traumas in childhood. We have reviewed the literature present in medical databases as well as information available on-line. RESULTS: Enlargement of the penis is an important cultural and social concern, so that there are different devices in the market to meet this demand, among them: herbal medicine, stretching exercises, weights, vacuum pumps or extensor devices. Among the surgical techniques, there have been described the pubic liposuction, the section of the suspensory ligament of the penis or the injection of autologous material or synthetic substances among others. As for the aesthetic modifications of the penis, there is a wide variety of genital piercings, tattoos and subcutaneous implants also called "pocketing" or "3D implants". All of these techniques or modifications are described in this article along with their possible associated more frequent urological complications. CONCLUSIONS: Aesthetic manipulations in the penis are becoming increasingly popular, and both its terminology and its medical implications should be known by urologists and andrologists. community.
Subject(s)
Body Modification, Non-Therapeutic/adverse effects , Body Modification, Non-Therapeutic/psychology , Penile Diseases/etiology , Penile Diseases/surgery , Penis/surgery , Adult , Esthetics , Humans , Male , Plastic Surgery Procedures/methods , Urologic Surgical Procedures, Male/methodsABSTRACT
La dosis de diálisis es un elemento fundamental en la diálisis adecuada y en la supervivencia del paciente. Entre los elementos que influyen en la misma destacan: tiempo, flujo sanguíneo (Qb), coeficiente de transferencia de masa de urea (KoA) y flujo del baño (Qd). El objetivo es evaluar si con Qd 800 ml/ min y tiempo programado 240 minutos conseguimos mayor eficacia que con Qd 500 ml/min y tiempo programado 240 minutos y con Qd 500 l/min y tiempo efectivo 240 minutos. Pacientes y métodos Estudio prospectivo sobre población prevalente en hemodiálisis, con criterio de inclusión pacientes mayores de edad en hemodiafiltración on-line postdilucional con flujo sanguíneo adecuado. En cada paciente se realizan 18 sesiones consecutivas variando Qd y tiempo con siguiente esquema: Fase 1: 6 sesiones con Qd 800 ml/min y tiempo programado 240 minutos. Fase 2: 6 sesiones con Qd 500 ml/min y tiempo programado 240 minutos, Fase 3: 6 sesiones con Qd 500 ml/min y tiempo efectivo 240 minutos. El análisis estadístico se realiza mediante SPSS 13.0 para Windows. Las variables cuantitativas se expresan como media, desviación estándar y rango. Las variables cualitativas, como frecuencia y porcentaje. Resultados Analizamos 432 sesiones obteniendo Kt y Volumen total de reinfusión (VTR) mayores en la fase 3 del estudio con respecto a las otras dos, no existiendo diferencias significativas entre la fase 1 y 2. Discusión y conclusiones No existen diferencias en la eficacia dialítica entre Qd 500 ml/min y Qd 800 ml/min, mientras que con el aumento de 10 minutos de media en cada sesión, se incrementa la dosis de diálisis en 2,77 litros y el VTR en un 9%, reduciendo a la mitad el número de pacientes que no logran los 20 litros de volumen de reinfusión. Y esto, con un menor coste adicional especialmente por las diferencias de envasado del bicarbonato (AU)
The dialysis dose (DD) is a key element of dialysis adequacy and affects survival of patients undergoing dialysis. Some elements standing out concerning the DD are: dialysis time, blood flow rate (Qb), transfer area coefficient (KOA) and dialysate flow rate (Qd). The aim of this study is to find out whether Qd 800 ml / min and 240 minutes prescribed time is more effective than Qd 500 ml / min and 240 minutes prescribed time and also to compare Qd 500 ml/min and 240 minutes of real dialysis time. Patients and Methods. A transversal prospective study was conducted of a population in dialysis, inclusion criteria being an adult treated with post-dilution on-line haemodiafiltration and sufficient blood flow rate. In all patients was performed 18 consecutive sessions varying Qd and time as follows: Stage 1: 6 sessions Qd 800 ml/min and prescribed time 240 minutes (F1) Stage 2: 6 sessions Qd 500 ml/min and prescribed time 240 minutes (F2) Stage 3: 6 sessions Qd 500 ml/min and real dialysis time 240 minutes (F3) Statistical analysis performed using SPSS 13.0 for Windows. Quantitative variables were expressed as mean, standard deviation and range, and qualitative variables expressed as frequency and percentage. Results 432 sessions analysed getting higher Kt and reinfusion volume (VTR) in stage 3 in relation to other stages. No significant difference between stage 1 and 2. Discussion and conclusions: No differences in dialysis efficacy Qd 500 ml / min versus Qd 800 ml / min. Nevertheless, increasing 10 minutes in each session, the dialysis dose increases 2.77 litres and VTR increases 9%, halving this way the number of patients that dont reach 20 litres reinfusion volume. All this achieved with a lower fee due to the size difference bicarbonate concentrate packaging(AU)
