History of gonorrhea and prostate cancer in a population-based case-control study in Mexico.

UNLABELLED: We evaluated the association between a history of sexually transmitted diseases (STDs) and the risk for prostate cancer (PC) among Mexican males. METHODS: PC incident cases (n=402) that were identified at six public hospitals in Mexico City were matched by age (±5 years) with 805 population controls with no history of PC. By face-to-face interview, we obtained information about sexual history, previous STDs, sociodemographic characteristics, and familial history of PC. An unconditional logistic regression model was used to estimate the risk for PC. RESULTS: A total of 16.6% of men reported having had at least one previous STD, and the most frequently reported STD was gonorrhea (10.5%). After adjusting by PC familial history, the history of STD was associated with a two-fold greater risk of PC: odds ratio (OR)=2.67; 95% confidence interval (95% CI=1.91-3.73). When each STD was evaluated separately, only gonorrhea was associated with a significant increase in PC risk (OR=3.04; 95% CI=1.99-4.64). These associations were similar when we stratified by low-risk PC (Gleason <7) and high-risk PC (Gleason ≥7). CONCLUSION: These results confirm that STDs, and particularly gonorrhea, may play an etiological role in PC among Mexican males, which is consistent with a previous report from a multiethnic cohort.

[Clinical practice guideline. Traumatic urethral stenosis in males]. / Guía de práctica clínica. La estenosis de uretra postraumática en el hombre.

The incidence of urethral stenosis in Mexico had not been documented. At the Centro Médico Nacional La Raza, during the year 2010, 629 patients with urethral stenosis were attended as outpatient consultation: 85 % with previous urethral stenosis and 15 % with urethral treatment complication. Urethral stenosis is a chronic illness, with multiple etiological origins and the handling is controversial. It has a great negative impact for the patients and the recurrence reaches 85 %. The treatment consisted of an invasive approach (urethral dilations, endoscopy procedure) and open surgery (urethroplasty). The World Health Organization and World Alliance take the world challenge about the urinary tract infections associated with the attention of patients, focused on urethral stenosis. The objective of the following clinical guide is to offer to the health professional a clinical tool for making decisions in the handling of the hardship or masculine urethral stenosis, based on the best available evidence, carrying out in systematized form with bibliographical research using validated terms of the MeSH: urethral structures, in the databases Trip database, PubMed, Guideline Clearinghouse, Cochrane Library and Ovid.

En México no está documentada la incidencia de la estenosis de uretra en forma consistente. En 2010, en el Centro Médico Nacional La Raza se reportaron 629 pacientes en consulta externa, 85 % de uretra anterior y 15 % de uretra posterior. La estenosis uretral es una enfermedad crónica, de etiología variada y manejo controvertido, con gran impacto negativo para los pacientes y recurrencia hasta de 85 %. El tratamiento puede ser instrumentado (dilataciones, cirugía endoscópica) y por cirugía abierta (uretroplastia). La Organización Mundial de la Salud y Alianza Mundial la consideran un reto de la atención de la salud. El objetivo de la siguiente guía es ofrecer al profesional de la salud, una herramienta clínica para la toma de decisiones en la atención de la estenosis uretral masculina, basada en la mejor evidencia identificada mediante la búsqueda bibliográfica sistematizada en las bases de datos Tripdatabase, PubMed, Guideline Clearinghouse, Cochrane Library y Ovid.

No-scalpel vasectomy: review of the first 1,000 cases in a family medicine unit

In Mexico, the Mexican Institute of Social Security (IMSS) had adopted the no-scalpel vasectomy technique by the end of 1989. The technique was described by dr. Li Shunquiang in 1974, and more than 60 million no-scalpel vasectomies have been performed in 26 countries. Among the advantages with no-scalpel vasectomy is that it has fewer complications (0.4 percent) compared to the traditional technique (3.1 percent). We studied 1,00o clinical chart of the subjects operated on between January, 1990 and January, 1993, with the objective of reporting our experiences as well as analyzing whether there existed a correlation between the subject's social and demographic characteristics and the number of control spermatic counts he attended postoperatively. In 97.9 percent of the cases, subjects has no postoperative hemorrhage or hematoma. None of the subjects had a surgical woun infection. In addition, 54.4 percent of the subjects came to the first control spermatic count, 39.7 percent came to the second, and only 18.4 percent came to all three controls. In an attempt to find a characteristic which defined the subject who attends his postoperative control spermatic count, we found an association using X² between the attendance at two controls with the subjects who had been married from 6 - 10 years (p=0.059), and with the subjects who had an income of three minimun wages. Regarding the attendance at all three controls, we found an association with subjects who had an income of two minimun wages (p=0.037). We also found a weak correlation between the attendance at all three controls and the reason reported for not having more children (the couple did not want more children) (r=0.07; p=0.025) and with the manner in which the subjects were referred to the clinic (came on their own initiative) (r=0.09; p=0.006). Finally, we consider that no-scalpel vasectomy can be implemented as an adequate family planning mehtod in Mexico's primary care centers. The lack of adequate attendance at postoperative control spermatic counts does not seem to have an important association with the subjects demographic characteristics, so it appears warranted that this issue be studied from a psychological point of view