恶性尿崩症的临床特征和意义

Dilibe Ekowa, Austin J. Marrah, Justin D. Murray, M. Wakefield, Yujiang Fang
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引用次数: 0

摘要

勃起功能障碍是指在没有适当性刺激的情况下,阴茎持续勃起超过 4 小时。勃起功能障碍一般分为缺血性和非缺血性两类。缺血性勃起功能障碍被认为是真正的泌尿科急症,因为这种亚型的持续时间通常与窦状内皮功能丧失、体质纤维化和坏死有关。非缺血性前列腺肥大是前列腺肥大的一种类型,通常是由于动静脉瘘的形成导致海绵体血流失调引起的。恶性肿瘤也是一种不太常见的前列腺增生病因。原发性或继发性恶性肿瘤被认为是引起尿失禁的罕见病因。在我们对恶性前列腺增生症的研究中,有几种病因被认为是恶性前列腺增生症的潜在病因。慢性髓性白血病、慢性淋巴细胞白血病和骨髓增生异常综合征等病变都与尿失禁的发生有关,这很可能是由于白细胞过多所致。肺、膀胱、前列腺等远端或区域性肿瘤的转移已被证明会产生继发性肿瘤,从而引发尿失禁。因此,将恶性肿瘤视为导致患者出现尿失禁的可能原因非常重要。不同患者的临床表现和预后差异很大,现代治疗方法的疗效也大相径庭。针对不同形式的恶性前列腺增生症进行综合研究,可使医护人员更好地了解其复杂性、病因和可用于患者的早期干预措施,从而受益匪浅。
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Clinical Features and Significance of Malignant Priapism
Priapism is a disorder defined as a persistent erection maintained without an appropriate sexual stimulus lasting for longer than 4 hours. Priapism is generally classified into two categories, ischemic and non-ischemic. Ischemic priapism is considered a true urological emergency as prolongation of this subtype is often associated with loss of sinusoidal endothelial function, corporal fibrosis, and necrosis. Non-ischemic priapism is a type of priapism often caused by the formation of arteriovenous fistulas that create dysregulation of cavernosa blood flow. One less common cause of priapism includes malignancy. Malignancy, either primary or secondary, is considered a rare cause of priapism. During our review of malignant priapism, several etiologies have been identified as potential causes of malignant priapism. Pathologies such as chronic myelogenous leukemia, chronic lymphocytic leukemia, and myelodysplastic syndromes have been implicated in the development of priapism, most likely due to hyperleukocytosis. Metastasis from distal or regional tumors such as the lung, bladder, prostate have been shown to produce secondary tumors that can initiate the development of priapism. Thus, it is important to consider malignancy as a possible cause of a patients priapism. The clinical presentation and prognosis between patients vary greatly and modern treatment modalities have been shown to differ greatly in its efficacy. A comprehensive study that addresses the different forms of malignant priapism may benefit healthcare professionals by providing a better understanding of the complexities, etiologies, and early interventions that can be used for their patients.
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