Bouchikhi Ahmed-Amine, Tazi Mohammed Fadl, Mellas Soufiane, Amiroune Driss, Elammari Jalal Eddine, Khallouk Abdelhak, El Fassi Mohammed Jamal, Farih Moulay Hassan
Urology Department, University Hospital of Fez, Fez, Morocco.
J Med Case Rep. 2013 Mar 27;7:85. doi: 10.1186/1752-1947-7-85.
Polycythemia vera is a polyglobular myeloproliferative syndrome related to the mutation of multipotent hemopoietic stem cells. This case report describes a patient whose bladder tumor was associated with polycythemia vera and erectile dysfunction. The association of bladder neoplasia with polycythemia vera and erectile dysfunction has not previously been reported in the literature.
A 40-year-old Moroccan man was followed up for a bladder tumor which manifested with coagulant hematuria and a facial erythrosis with a hemoglobin level of 20.3g/L suggesting polycythemia vera. The patient also suffered from an erectile disorder. Considering the anesthesia difficulty due to polyglobulia, the patient was treated by bleeding. This treatment enabled the patient's sexual performance to be improved and adjustment of his hemoglobin to a level allowing anesthesia, and hence surgical resection of his bladder tumor.
Erectile dysfunction associated with polycythemia vera is elucidated by rheological disorders. Bleeding contributed to satisfactory sexual performance and facilitated treatment of polycythemia vera because it enabled anesthesia to be performed and hence the surgical resection of the bladder tumor.
真性红细胞增多症是一种与多能造血干细胞突变相关的多血症性骨髓增殖综合征。本病例报告描述了一名膀胱肿瘤与真性红细胞增多症及勃起功能障碍相关的患者。膀胱肿瘤与真性红细胞增多症及勃起功能障碍的关联此前在文献中尚未见报道。
一名40岁的摩洛哥男子因膀胱肿瘤接受随访，该肿瘤表现为凝血性血尿及面部红斑，血红蛋白水平为20.3g/L，提示真性红细胞增多症。该患者还患有勃起功能障碍。考虑到因红细胞增多导致的麻醉困难，对该患者进行了放血治疗。该治疗使患者的性功能得到改善，血红蛋白调整至允许进行麻醉的水平，从而得以对其膀胱肿瘤进行手术切除。
真性红细胞增多症相关的勃起功能障碍可通过血液流变学紊乱来解释。放血有助于获得满意的性功能，并促进真性红细胞增多症的治疗，因为它使麻醉得以进行，进而能够对膀胱肿瘤进行手术切除。
