Representaciones sociales construidas sobre el cuerpo femenino por mujeres adolescentes, víctimas de explotación sexual / Social representations constructed on the female body by adolescent women, victims of sexual exploitation / Representações sociais construídas sobre o corpo feminino por mulheres adolescentes, vítimas de exploração sexual

Resumen El objetivo de este artículo es explorar y revisar las representaciones sociales y los significados cognitivos y afectivos que mujeres adolescentes víctimas, han construido sobre el cuerpo femenino. La reflexión se sumergirá en "eso" que hay debajo de su piel; de ese cuerpo constituido en objeto de deseo para quién lo explota o actúa como intermediario; se indagó sobre las representaciones sociales que, sobre el cuerpo de las víctimas, tienen los diferentes actores involucrados en esta vulneración de derechos, así como una franca crítica a la connivencia Social y Estatal con este flagelo. En ese sentido se plantean asuntos que controvierten algunas conceptualizaciones expertas e institucionales de esta problemática, como la categoría comercial, con la que se trata de explicar el tipo de relación establecida entre el explotador y un adolescente. Este texto es el resultado de la interacción por más de dos años con víctimas de explotación sexual, observando y registrando en un diario de campo esta problemática en diferentes contextos, lo que faculta el planteamiento de los puntos de vista consignados aquí. En un taller experiencial realizado con mujeres adolescentes víctimas, se obtuvieron construcciones que nos llevan a comprender aquello que podríamos llamar un cuerpo cosificado, cuya representación social es básicamente que es "una cosa" para el disfrute de otro, sin ningún interés en sus derechos o el daño que se causa. El tipo de violencia que sufren las víctimas de explotación sexual, ha sido descargada sistematicamente sobre sus cuerpos, lo que justifica la pertinencia de esta discusión.

Abstract The objective of this study was to explore and review the social representations and the cognitive affective meanings that adolescent women victims have constructed on the female body. The reflection focused on "that" what is under that body's skin, that body constituted in an object of desire for who exploits it or who act as an intermediary; this study asked about social representations that different actors involved in this violation of rights have regarding victims' bodies, as well as, frank critiques regarding social and state convenience. Accordingly, the article proposes matters that contest some expert and institutional conceptualizations as social category. It was used to try to explain the type of relation established between an exploiter and an adolescent. This text is the result of an interaction of more than 2 years working with sexual exploitation victims, observing and recording in a field diary this issue in different contexts. This allowed the proposal of the two points of view presented herein. In an experiential workshop for adolescent women victims, constructions were obtained, and they enabled us to understand that which we could call a confiscated body. The poor social representation is basically that it is "a thing" for another person's enjoyment, without any interest in that person's rights or in the damage that is caused. The type of violence that sexual exploitation victims suffer has been discharged systemically on their bodies; this justifies the pertinence of this discussion.

Resumo O objetivo deste artigo foi descobrir e revisar as representações sociais e os significados cognitivos e afetivos que as mulheres adolescentes vítimas femininas construíram sobre o corpo feminino. A reflexão estava imersa em "aquilo" sob sua pele; desse corpo constituído como objeto de desejo de quem o explora ou atua como intermediário; Perguntou-se sobre as representações sociais que sobre o corpo das vítimas, há dos diferentes atores envolvidos nesta violação de direitos, bem como uma crítica franca da convivência social e estadual. Nesse sentido, são levantadas questões que controvertem algumas conceituações especializadas e institucionais, como a categoria comercial, com as quais tentam explanar o tipo de relação estabelecida entre o explorador e um adolescente. Este texto é resultado da interação há mais de dois anos com vítimas de exploração sexual, enxergando e imputando este problema num diário de campo em diferentes contextos, o que permitiu o levantamento dos pontos de vista aqui consignados. Numa oficina experiencial realizada com adolescentes vítimas femininas, obtivemos construções que nos levaram a entender o que poderíamos chamar de corpo reificado, cuja representação social é basicamente que é "uma coisa" para o gozo de outro, sem qualquer interesse em seus direitos ou no dano que é causado.

Retrospective review of serum and urinary lithogenic risk factors in patients with osteoporosis and osteopenia.

OBJECTIVE: To analyze differences in bone remodeling markers, lithogenic factors and bone densitometry among the 3 groups of patients (controls, patients with relapsing calcium renal lithiasis, and patients with loss of bone mineral density without lithiasis). MATERIAL AND METHODS: This is a cross-sectional study including 203 patients who were divided in 3 groups: group 1 (controls), group 2 (patients with relapsing calcium renal lithiasis), and group 3 (patients with osteopenia and/or osteoporosis in the lumbar spine or hip). Bone densitometry, calcium-phosphorous and bone metabolism analysis, and analysis of lithogenic risk factors in fasting urine samples and 24-hour urine samples were performed. Statistical analysis was performed with SPSS 17.0. A P ≤.05 was considered statistically significant. RESULTS: Patients in group 2 presented greater calcium excretion and a lower citrate excretion in 24-hour urine samples as compared with the other 2 groups. The proportion of hypercalciuria and hypocitraturia was higher in group 2. In addition, patients in group 2 presented a lower loss of bone mineral density as well as altered bone remodeling markers as compared with those in group 1. Patients in group 3 also presented alterations in urine calcium and citrate excretion with respect to the control group, with elevated fasting calcium and citrate levels and calcium-to-citrateratio. CONCLUSION: Lithogenic risk factors are altered in patients with osteopenia and/or osteoporosis without renal lithiasis although to a lesser extent than patients with calcium renal lithiasis.

Outcome of urethral strictures treated by endoscopic urethrotomy and urethroplasty.

INTRODUCTION: We analyze the outcomes of patients with urethral stricture who underwent surgical treatment within the past 5 years. METHODS: This is a retrospective study of male patients who underwent surgery for urethral stricture at our service from January 2008 to June 2012. We analyzed the comorbidities, type, length and location of the stricture and the surgical treatment outcome after endoscopic urethrotomy, urethroplasty or both. RESULTS: In total, 45 patients with a mean age of 53.7 ± 16.7 years underwent surgical treatment for urethral stricture. Six months after surgery, 46.7% of the patients had a maximum urinary flow greater than 15 mL/s, whereas 87.3% of the patients exhibited no stricture by urethrography after the treatment. The success rate in the patients undergoing urethrotomy was 47.8% versus 86.4% in those undergoing urethroplasty (p = 0.01). Twenty percent of the patients in whom the initial urethrotomy had failed subsequently underwent urethroplasty, thereby increasing the treatment success. CONCLUSION: In most cases, the treatment of choice for urethral stricture should be urethroplasty. Previous treatment with urethrotomy does not appear to produce adverse effects that affect the outcome of a urethroplasty if urethrotomy failed, so urethrotomy may be indicated in patients with short strictures or in patients at high surgical risk.

Urachal anomalies in children: surgical or conservative treatment?

OBJECTIVE: To shed light on the current controversy regarding the best treatment option for managing urachal anomalies in children. PATIENTS AND METHODS: A retrospective follow-up of a case series comprising 13 children who were diagnosed with urachal anomalies was performed. All cases were diagnosed between 2000 and 2011 and followed up at the Pediatric Urology Unit of San Cecilio University Hospital in Granada (Spain). Information about the baseline and follow-up variables was collected from clinical records. RESULTS: Nine of the 13 patients were symptomatic (6 patients with urachal cysts and 3 patients with urachal persistency). Conservative management was originally used in all but one case. During follow-up, reinfection appeared in two cases, and these patients were treated surgically. Spontaneous resolution was achieved in eight cases (61.5%). Two children with persistent urachal cysts are still being followed (4 and 6 years after the diagnosis), although ultrasound monitoring reveals a gradual reduction in the size of the cysts. The median time between diagnosis and resolution was 16.5 months. CONCLUSION: With the exception of cases in which there is a clear indication for surgery (i.e. reinfection), a conservative approach based on regular monitoring may be useful.

Endoscopic treatment of ureterovesical junction obstructive pathology: A description of the oblique meatotomy technique and results.

BACKGROUND: Benign obstructive pathology of the ureterovesical junction includes congenital and acquired illnesses. The objective of this study was to describe the endoscopic oblique meatotomy technique using scissors and cold cutting to treat benign obstructive pathology of the ureterovesical junction. METHODS: From 2007 to 2012, we treated 18 patients with obstructive pathology of the ureterovesical junction (5 megaureters [3 with lithiasis], 4 iatrogenic stenoses, and 9 ureteroceles with lithiasis). In all cases, oblique meatotomy was performed using endoscopic scissors through an 8.5 Ch ureteroscope. The mean follow-up for all patients was 3 years. Pain, grade of hydronephrosis, and occurrence of vesicoureteral reflux were evaluated before and after treatment. RESULTS: The mean endoscopic treatment time was 13.4 minutes. The procedure was performed on an outpatient basis with 6 hours of hospital admission, and a double J stent was inserted for 6 weeks. We achieved treatment success in 94.5% of patients after 3 years of follow-up. Only 1 patient presented with vesicoureteral reflux at 12 months after treatment; however, this condition did not require further treatment. Overall, 100% of patients remained free from lithiasis. There are 2 main limitations: the small number of patients and the lack of another group to compare the results of this technique; however, the aim of this work was to communicate a new technique to treat ureterovesical junction stricture. INTERPRETATION: Oblique ureteral meatotomy is a safe and effective treatment for benign obstructive pathology of the ureterovesical junction and has a low index of complications.

Relación de la litiasis renal cálcica recidivante con riesgo de pérdida de densidad mineral ósea y fracturas / Relation of renal lithiasis relapses at risk of bone density loss and fractures. Study of bone remodeling markers as predictors for risk of fracture

Objetivo: Establecer puntos de corte de los niveles de marcadores de remodelado óseo mediante curvas ROC que nos permita realizar un cribado de pacientes con pérdida de densidad mineral ósea y alto riesgo de fractura osteoporótica. Material y métodos: Estudio transversal con 182 pacientes de Andalucía oriental distribuidos en grupos en función de la actividad de la actividad litogénica. Aparte de las variables clínicas, se realizaron estudios densitométricos (DEXA) y determinaciones de los marcadores bioquímicos de remodelado óseo en sangre periférica a todos los pacientes: β-crosslaps, osteocalcina, β-crosslaps/ostecalcina, calciuria 24 horas y calcio/creatinina en orina de ayunas. Resultados: Se apreciaron diferencias significativas en los valores séricos de fosfatasa alcalina, PTHi, osteocalcina, β-crosslaps y β-crosslaps/osteocalcina que se encuentran más elevados en el grupo de pacientes con actividad litogénica grave, así como una mayor pérdida de densidad ósea. Discusión: A partir de marcadores de remodelado óseo puede estimarse el riesgo de un paciente de presentar actividad litogénica grave con una sensibilidad entre 75-85%. Así, podemos realizar un control clínico y analítico de los pacientes con el fin de detectar la actividad litiásica y evitar la pérdida de densidad mineral ósea que además supone un riesgo sobreañadido de fractura ósea osteoporótica (AU)

Objective: Establish the cut-off point for markers of bone remodeling marker using ROC curves that allow us to have a selection of patients with bone mineral density loss and a high risk of osteoporotic fracture Material and methods: Transversal study with 182 patients from eastern Andalusia (Spain), distributed in groups based on lithogenic activity. In addition to the clinical variables, densitometry studies were carried out (DEXA) and the assessment of biochemical markers for bone remodeling in peripheral blood for all patients: β-crosslaps, osteocalcin, β-crosslaps/osteocalcin, 24-hr calciuria and calcium/creatinine in urine after fasting. Results: Significant differences were seen in serum values for alkaline phosphatase, PTHi, osteocalcin, β-crosslaps y β-crosslaps/osteocalcin were higher in the group of patients with serious lithogenic activity, as well as a greater loss of bone density. Discussion: Based on bone remodeling markers, the risk of a patient having serious lithogenic activity can be estimated with a sensitivity of between 75-85%. Thus, we can perform clinical and analytical controls in patients to detect lithiasis activity and avoid the loss of bone mineral density which is also an added risk of osteoporotic bone fracture (AU)

Association of severe calcium lithogenic activity and bone remodeling markers.

OBJECTIVE: To establish cutoff points for markers of bone remodeling that allow for screening of patients at risk for serious lithogenic activity. MATERIALS AND METHODS: We conducted a cross-sectional study with 182 patients (aged between 25 and 60 years) divided into 3 groups: group 1, 56 patients without lithiasis; group 2, 67 patients with light calcium lithiasis; and group 3, 59 patients with severe calcium lithiasis. The criteria for inclusion in and exclusion from the study were established, and light and severe lithogenic activity were defined. Metabolic variables in blood and urine, along with bone densitometry, were studied for the groups. Statistical analysis of the results and preparation of receiver operating characteristic curves to establish optimal cutoff points were performed. RESULTS: The patients in group 3 showed the greatest bone mineral density loss and the highest values for markers of bone remodeling, together with increased 24-hour calciuria. Using the receiver operating characteristic curves developed and based on statistical significance (P = .0001), the following cutoff points for severe lithogenic activity, with a sensitivity between 75% and 85%, were established: ß-crosslaps >0.331 ng/mL; osteocalcin >13.2 ng/mL; ß-crosslaps/osteocalcin >0.024; 24-hour calciuria >306.6 mg; and fasting urine calcium/creatinine >0.105. CONCLUSION: Patients with calcium lithiasis and elevated values for osteocalcin, ß-crosslaps, ß-crosslaps/osteocalcin, 24-hour calciuria, and fasting urine calcium/creatinine may present a high risk of severe lithogenic activity.

Effects of aminobisphosphonates and thiazides in patients with osteopenia/osteoporosis, hypercalciuria, and recurring renal calcium lithiasis.

OBJECTIVE: To analyze the effects of aminobisphosphonates and thiazides on renal lithogenic activity and bone mineral density in patients with recurring renal calcium lithiasis. MATERIALS AND METHODS: A prospective cohort study with 3 years of clinical follow-up data was performed. The study included 2 groups of patients with recurring calcium lithiasis, hypercalciuria, and bone mineral density loss. Group 1 included 35 patients who underwent treatment with 70 mg/wk alendronate. Group 2 included 35 patients who underwent treatment with 50 mg/d hydrochlothiazide and 70 mg/wk alendronate. Biochemical analysis was performed at baseline, 6 months, and 2 years, bone densitometry at baseline and 2 years, and clinical follow-up during the 3 years of treatment. The biochemical variables from the blood and urine samples, recurrent lithiasis, and bone mineral density were analyzed. RESULTS: Age, sex, baseline biochemical markers, and bone density showed no differences between the 2 treatment groups at the onset of treatment. After 2 years of treatment, group 1 showed a significant decrease in bone turnover markers and calciuria and significant improvement in bone mineral density. After 2 years of treatment, group 2 showed a decrease in calciuria and bone markers. At 2 years, the decrease in calciuria and the improvement in bone mineral density were greater in group 2 than in group 1, and the difference was statistically significant. CONCLUSION: Aminobisphosphonates improve bone mineral density and slow lithogenic activity; however, administration of aminobisphosphonates in association with thiazides produced the same clinical effects and also reduced calciuria and improved bone mineral density.

Importance of citrate and the calcium : citrate ratio in patients with calcium renal lithiasis and severe lithogenesis.

UNLABELLED: Different studies have shown the importance of citrate in the formation of calcium stones. It has further been shown that the states of metabolic acidosis result in an increase in bone resorption and lower urinary citrate levels. Increasing the intake of citrate in these patients can reduce the lithogenic risk and improve bone mineral density (BMD), contributing to control of both diseases. The study shows the importance of citrate in patients with calcium stones and BMD loss. The deficit in citrate excretion is associated with a decrease in bone mineralization and increased ß-crosslaps. A calcium : citrate ratio >0.25 in patients with calcium stones and loss of mineral density may predict severe lithogenic activity. OBJECTIVE: To analyse the importance of urinary citrate and the urinary calcium : citrate ratio in patients with calcium renal lithiasis and severe lithogenesis compared with a control group of patients without lithiasis. MATERIAL AND METHODS: A cross-sectional study of 115 patients in eastern Andalusia, Spain was conducted. The patients were divided into two groups: Group A: 56 patients aged 25-60 years without calcium renal lithiasis; Group B: 59 patients aged 25-60 years, presenting with calcium renal lithiasis and severe lithogenesis. The citrate levels and the calcium : citrate ratio in the patients' urine and the relationship of these two factors to lithiasic activity were analysed and compared. RESULTS: In Group B, 32.2% of the patients presented with hypocitraturia, compared with 14.3% of the patients in Group A (P = 0.02). The urinary citrate levels were lower in Group B than in Group A (P = 0.001) and the calcium : citrate ratio was higher in Group B than in Group A (P = 0.005). The results suggest that a patient urinary calcium : citrate ratio > 0.25 indicates severe lithogenesis (with a sensitivity of 89% and a specificity of 57%). After linear regression analysis, we found that the urinary citrate level is an independent factor associated with the changes in bone densitometry T-score values of patients. CONCLUSIONS: The patients with severe lithogenesis presented with hypocitraturia, which was associated with lower bone mineral density. The calcium : citrate ratio, which is linearly related to the bone resorption marker ß-crosslaps, could be useful in evaluating the risk of severe lithogenesis when this ratio is >0.25.

Segmental testicular infarction: partial orchiectomy in a very rare pathology.

Segmental testicular infarctions are a rare disease with a low prevalence and few cases have been reported in the literature. We present a 26-year-old male without any relevant medical history who consulted at the Urology Department due to mild pain in the right testicle over the last month. He had no previous trauma or acute testicular pain. Partial orchiectomy was performed through an inguinal incision with removal of lesions and reconstruction of the testicular parenchyma. Histological examination revealed testicular infarction with no presence of neoplastic cells.

Metabolic-mineral study in patients with renal calcium lithiasis, severe lithogenic activity and loss of bone mineral density.

INTRODUCTION: This study assessed the presence of osteoporosis/osteopenia in patients with severe lithogenic activity and compared their metabolisms with those in patients without lithiasis or with mild lithogenic activity. METHODS: From a sample of 182 patients, those with osteopenia/osteoporosis at the hip and lumbar spine were studied separately in a two-pronged study. 66 patients with bone mineral densities (BMDs) < -1 standard deviation (SD) on a T-score scale at the hip were divided into three groups: group A1 without lithiasis (n = 15); group A2 with lithiasis and mild lithogenic activity (n = 22); and group A3 with lithiasis and severe lithogenic activity (n = 29). Similarly, 86 patients with BMDs < -1 SD on a T-score scale at the lumbar spine were divided into three groups: group B1 without lithiasis (n = 15); group B2 with lithiasis and mild lithogenic activity (n = 29); and group B3 with lithiasis and severe lithogenic activity (n = 42). RESULTS: Patients from group A3 exhibited significantly higher levels of bone remodelling markers as compared to groups A1 and A2. Urinalysis also revealed higher excretion of calcium in 24-hour assessments in this group. Patients from group B3 differed from groups B1 and B2 mainly in bone remodelling markers and 24-hour urinary calcium excretion, which were significantly elevated in patients from group B3. CONCLUSION: Patients with calcium lithiasis and severe lithogenic activity in addition to osteopenia/osteoporosis present with higher levels of hypercalciuria and negative osseous balance, which possibly perpetuate and favour lithiasic activity.

Vesicoureteral refulx in overactive bladder: medical resolution through botulin toxin injection.

OBJECTIVE: Overactive bladder may have a neurogenic or non neurogenic origin. Sometimes, as a result of detrusor overactivity, disorders of the upper urinary tract function may appear. One of these alterations may be the appearance of associated vesicoureteral reflux. The treatment of overactive bladder may be done with anticholinergic drugs and if there is not response the use of botulin toxin type A is approved. The aim of this case report is to demonstrate the effect of botulin toxin type A in the treatment of overactive bladder and vesicoureteral reflux secondary to the overactive bladder. METHOD: We present the case of a 10-year-old patient without significant past medical history. When he was one year old he had a urinary infection and voiding cystourethrogram showed grade 1 right vesicoureteral reflux. When he was 4 year old he presented several episodes of pyelonephritis and then he was diagnosed of severe bilateral vesicoureteral reflux, which did not respond to treatment with Macroplastic ® or Deflux ®. Urodynamic study was performed showing overactive bladder with decreased bladder compliance. RESULTS: We performed intravesical injection of 200 U of botulin toxin type A and vesicoureteral reflux disappeared and urodynamic study improved. One year later we re-injected botulin toxin type A (300 U) and we repeated the injection after one year (300 U). The patient is currently well, without changes in the urodynamic study and without vesicoureteral reflux. CONCLUSION: Repeated injections of botulin toxin type A has shown great efficacy in the treatment of overactive bladder in children with vesicoureteral reflux improved secondary.

Reflujo vesicoureteral en vejiga hiperactiva: resolución con inyección de toxina botulínica / Vesicoureteral refulx in overactive bladder: medical resolution through botulin toxin injection

OBJETIVO: La vejiga hiperactiva puede tener un origen neurogénico o no neurogénico. En ocasiones, como consecuencia de dicha hiperactividad del detrusor pueden producirse alteraciones en la funcionalidad del tracto urinario superior. Una de esas alteraciones puede ser la aparición de reflujo vesicoureteral asociado. El tratamiento de dicha vejiga hiperactiva puede hacerse con anticolinérgicos y en caso de no presentar respuestas, está aprobado el uso de toxina botulínica tipo A. El objetivo es demostrar el efecto de la toxina botulínica tipo A en el tratamiento de la vejiga hiperactiva y del reflujo vesicoureteral secundario a la misma. MÉTODO: Presentamos el caso de un paciente de 10 años sin antecedentes personales de interés que al año de vida presentó infección urinaria y en cistouretrografía miccional seriada tenía reflujo vesicoureteral derecho grado 1. A los 4 años de edad presentó varios episodios de pielonefritis diagnosticándose de reflujo vesicoureteral severo bilateral no respondiendo a tratamiento con macroplastic® ni deflux®. Se realizó estudio urodinámico observando vejiga hiperactiva con disminución de la acomodación vesical. RESULTADOS: Se realizó inyección intravesical de 200 U de toxina botulínica tipo A observando remisión del reflujo vesicoureteral y mejoría en el estudio urodinámico. Al año se vuelve a inyectar toxina botulínica tipo A (300 U) y se repite un año después la inyección de 300 U, estando actualmente el paciente bien, sin alteraciones en el estudio urodinámico y sin reflujo vesicoureteral. CONCLUSIÓN: La inyección repetida de toxina botulínica tipo A ha demostrado gran eficacia en el tratamiento de la vejiga hiperactiva en niños con mejoría del reflujo vesicoureteral secundario(AU)

OBJECTIVE: Overactive bladder may have a neurogenic or non neurogenic origin. Sometimes, as a result of detrusor overactivity, disorders of the upper urinary tract function may appear. One of these alterations may be the appearance of associated vesicoureteral reflux. The treatment of overactive bladder may be done with anticholinergic drugs and if there is not response the use of botulin toxin type A is approved.The aim of this case report is to demonstrate the effect of botulin toxin type A in the treatment of overactive bladder and vesicoureteral reflux secondary to the overactive bladder. METHOD: We present the case of a 10-year-old patient without significant past medical history. When he was one year old he had a urinary infection and voiding cystourethrogram showed grade 1 right vesicoureteral reflux. When he was 4 year old he presented several episodes of pyelonephritis and then he was diagnosed of severe bilateral vesicoureteral reflux, which did not respond to treatment with Macroplastic ® or Deflux ®. Urodynamic study was performed showing overactive bladder with decreased bladder compliance. RESULTS: We performed intravesical injection of 200 U of botulin toxin type A and vesicoureteral reflux disappeared and urodynamic study improved. One year later we reinjected botulin toxin type A (300 U) and we repeated the injection after one year (300 U). The patient is currently well, without changes in the urodynamic study and without vesicoureteral reflux. CONCLUSION: Repeated injections of botulin toxin type A has shown great efficacy in the treatment of overactive bladder in children with vesicoureteral reflux improved secondary(AU)

Metabolic syndrome, hormone levels, and inflammation in patients with erectile dysfunction.

BACKGROUND: The end point of this study was to investigate the prevalence of MS in patients with ED in comparison with control subjects and to analyse the association with acute phase reactants (CRP, ESR) and hormone levels. METHODS: This case-control study included 65 patients, 37 with erectile dysfunction, according to the International Index of Erectile Function (IIEF) from the Urology Department of San Cecilio University Hospital, Granada (Spain) and 28 healthy controls. The prevalence of metabolic syndrome was calculated according to ATP-III criteria. Hormone levels and acute phase parameters were studied in samples drawn. RESULTS: The ATP-III criteria for MS were met by 64.9% of the patients with ED and only 9.5% of the controls (P < 0.0001, OR = 17.53, 95% CI: 3.52-87.37). Binary logistic regression analysis showed a strong association between patients with ED and MS, even after additional adjustment for confounding factors (OR = 20.05, 95% CI: 1.24-32.82, P < 0.034). Patients with hypogonadism presented a significantly higher prevalence of metabolic syndrome. Multiple linear regression analysis showed that systolic BP and CRP predicted 0.46 (model R²) of IIEF changes. CONCLUSION: Chronic inflammation found in patients with ED might explain the association between ED and metabolic syndrome.

Osteopenia/osteoporosis in patients with calcium nephrolithiasis.

The objective of this study is to analyze the alterations in bone mineral density and bone and calcium-phosphorus metabolism in patients with calcium nephrolithiasis. We designed a study with 182 patients who were distributed among three groups: group O, 56 patients without nephrolithiasis; group A, 67 patients with calcium nephrolithiasis and mild lithogenic activity; and group B, 59 patients with calcium nephrolithiasis and severe lithogenic activity. Metabolic parameters of blood and urine that were related to calcium-phosphorous and bone metabolism and bone densitometry were assessed in all patients. A comparative study was performed on the variables of bone and calcium-phosphorus metabolism and bone densitometry as well as the presence or absence of osteopenia/osteoporosis. The patients in group B had a greater loss of bone mineral density, measured by the T-score, than the patients in groups O and A. Moreover, the proportion of patients in group B with osteopenia/osteoporosis was statistically significantly higher than the proportion of patients in groups O and A. We observed higher values of calciuria, fasting calcium/creatinine ratio, and 24-h calcium/creatinine among the patients in group B compared to the other two groups. Calciuria, citraturia, and fasting calcium/creatinine were independent factors that showed a relationship with severe lithogenic activity compared to the control group, and ß-crosslaps is an independent factor that has a relationship with severe lithogenic activity as compared to mild lithogenic activity. Patients with calcium lithiasis and severe lithogenic activity have a greater loss in bone mineral density and therefore a greater risk of osteopenia/osteoporosis.

Clinical efficacy in the treatment of overactive bladder refractory to anticholinergics by posterior tibial nerve stimulation.

PURPOSE: Overactive bladder (OAB) is a clinical syndrome that is currently treated initially with anticholinergics, although some other therapeutic alternatives exist, such as neuromodulation, botulinum toxin, and posterior tibial nerve stimulation (PTNS). The purpose of this study was to assess the efficacy of PTNS in patients with OAB refractory to anticholinergics. MATERIALS AND METHODS: We present a cohort study of 14 women with OAB to whom we applied PTNS. We assessed (before and after the treatment) the diurnal micturitional frequency, the nocturnal micturitional frequency, urgency episodes, and urge incontinence episodes. Results were analyzed by using the Wilcoxon test for nonparametric samples. RESULTS: We observed statistically significant improvement in the diurnal micturitional frequency (p=0.05), in episodes of micturitional urgency (p=0.03), and in episodes of urge incontinence (p=0.004). A total of 50% of the patients felt subjective improvement from their pathology. CONCLUSIONS: PTNS is a valid, minimally invasive treatment option with minimum morbidity for patients with OAB refractory to treatment with anticholinergics.

Complications from the placement of a tension-free suburethral sling using the transobturator and retropubic methods for treatment of female urinary incontinence.

OBJECTIVE: The aim of our study was to retrospectively analyze surgical complications arising from the collocation of suburethral mesh in the lower urinary tract, using both the transobturator and retropubic methods. PATIENTS AND METHODS: During the period between November 2002 and June 2011, we retrospectively studied 190 patients that were treated for stress urinary incontinence using a tension-free suburethral sling. 50 patients were treated using the retropubic route (SPARC®), and 140 patients were treated using a transobturator (MONARC®). RESULTS: In total, 16.57% of the patients presented with intraoperative, immediate postoperative or later postoperative complications. We observed a higher rate of complications with patients who were operated on retropubically (26%) than with patients who were operated on using the transobturator method (12%). CONCLUSIONS: The rate of complications for our study was low, and was even lower in the case of transobturator tape. Thus, we usually used transobturator tape in the treatment of stress incontinence.