<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2007-4085</journal-id>
<journal-title><![CDATA[Revista mexicana de urología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. mex. urol.]]></abbrev-journal-title>
<issn>2007-4085</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Mexicana de Urología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2007-40852018000600452</article-id>
<article-id pub-id-type="doi">10.24245/revmexurol.v78i6.2489</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Cocaína y escroto agudo ¿Existe alguna relación?]]></article-title>
<article-title xml:lang="en"><![CDATA[Cocaine and acute scrotum: Is there an association?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Campos-Márquez]]></surname>
<given-names><![CDATA[Guillermo Patricio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Espino-Galván]]></surname>
<given-names><![CDATA[Jorge Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cruz-Zamudio]]></surname>
<given-names><![CDATA[Iris Natalia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vásquez-Hernández]]></surname>
<given-names><![CDATA[Mario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General de Matamoros Dr. Alfredo Pumarejo Departamento de Urología ]]></institution>
<addr-line><![CDATA[ Tamaulipas]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital General de Matamoros Dr. Alfredo Pumarejo Departamento de Cirugía General ]]></institution>
<addr-line><![CDATA[ Tamaulipas]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<volume>78</volume>
<numero>6</numero>
<fpage>452</fpage>
<lpage>457</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2007-40852018000600452&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2007-40852018000600452&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2007-40852018000600452&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  ANTECEDENTES:  El efecto de la cocaína en los testículos provoca un proceso isquémico, debido al bloqueo de la recaptación de neurotransmisores, con subsiguiente vasoconstricción local. Es probable que la cocaína genere episodios repetidos de isquemia del cordón testicular, daño vascular crónico, incluso un cuadro de escroto agudo que resulte en afectación vascular aguda irreversible.  CASO CLINICO:  Paciente masculino de 58 años, que acudió al servicio de Urgencias por dolor súbito en la región testicular izquierda, posterior a la inhalación de cocaína. Entre sus antecedentes personales refirió dependencia de cocaína desde los 20 años de edad; antecedentes médicos: hipertensión arterial sistémica diagnosticada hace un año, sin tratamiento actual. En la exploración urológica se observó: paciente en bipedestación con eritema testicular, escroto edematizado, testículo ascendido y horizontal; doloroso a la palpación, epidídimo en posición anterior y aumentado de volumen; reflejo cremasteriano abolido, sin mancha testicular azulada. El ultrasonido evidenció: testículo izquierdo de 4 cm, ecogenicidad heterogénea, epidídimo engrosado y fibroso (3.5 cm de espesor), con múltiples adherencias en el testículo y en la pared escrotal, e hidrocele de 40 cc aproximadamente. Según los criterios de la escala de TWIST se clasificó al pacientes en riesgo alto, por lo que se decidió efectuar exploración quirúrgica inmediata, donde se observó el cordón testicular no viable. El tratamiento definitivo consistió en orquiectomía izquierda, con evolución satisfactoria.  CONCLUSIÓN:  Es importante investigar el antecedente de consumo de cocaína en pacientes con síndrome metabólico, pues representa un factor decisivo en el inicio del cuadro clínico de escroto agudo.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  BACKGROUND:  The effect of cocaine at the testicular level is indirectly due to an ischemic process resulting from the blocking of neurotransmitter reuptake, which leads to local vasoconstriction. Cocaine users may be prone to present with repeated episodes of spermatic cord ischemia, causing chronic vascular damage. Symptoms of acute scrotum can result in irreversible acute vascular damage.  CLINICAL CASE:  A 58-year-old man arrived at the emergency service due to pain of sudden onset at the left testicular region after having inhaled cocaine. He had a personal history of cocaine addiction since the age of 20 years and a medical history of high blood pressure of one-year progression, with no current treatment. Urologic examination: with the patient standing on both feet, testicular erythema, scrotum with edema, and ascended testis with a horizontal lie were observed. Palpation was painful, the epididymis was enlarged and in the anterior position, and there was no cremasteric reflex or testicular &#8220;blue dot&#8221; sign. Ultrasound study: left testis measuring 4 cm, with heterogeneous echogenicity, a fibrous thickened epididymis (thickening of 3.5 cm) with numerous testicular and scrotal wall adhesions, and hydrocele of approximately 40 cc. The patient was classified as high-risk on the TWIST scale and so immediate surgical examination was carried out, revealing a non-viable spermatic cord. Left orchiectomy was performed as definitive treatment, and postoperative progression was satisfactory.  CONCLUSION:  The evaluation of a history of cocaine use in patients with metabolic syndrome is important, given that it can be a decisive factor in the appearance of acute scrotum.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Escroto agudo]]></kwd>
<kwd lng="es"><![CDATA[consumo de cocaína]]></kwd>
<kwd lng="es"><![CDATA[síndrome metabólico]]></kwd>
<kwd lng="en"><![CDATA[Acute scrotum]]></kwd>
<kwd lng="en"><![CDATA[Cocaine use]]></kwd>
<kwd lng="en"><![CDATA[Metabolic syndrome]]></kwd>
</kwd-group>
</article-meta>
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