Effect of smoking cessation on sexual functions in men aged 30 to 60 years

ABSTRACT Purpose We aimed to evaluate the effects of smoking cessation on the sexual functions in men aged 30 to 60 years. Materials and Methods Male patients aged 30 to 60 years that presented to the smoking cessation polyclinic between July 2017 and December 2018 were prospectively included in the study. The amount of exposure to tobacco was evaluated in pack-year. The patients filled the International Index of Erectile Function (IIEF) form before the cessation and six months after cessation of smoking. Patients were subgrouped according to age, education level and packs/year of smoking and this groups were compared in terms of IIEF total and all of the IIEF domains. Results The evaluations performed by grouping the patients according to age (30-39, 40-49 and 50-60 years) and education level (primary-middle school and high school-university) revealed that the total IIEF scores obtained after smoking cessation were significantly higher compared to the baseline scores in all groups (p=0.007 for the 30-39 years group and p <0.001 for the remaining groups). According to grouping by exposure to smoking (≤25, 26-50, 51-75, 76-100 and 101≥ packs/year), the total IIEF scores significantly increased after smoking cessation in all groups except 101≥ packs/year (p=0.051 for the 101≥ group and p <0.001 for the remaining groups). Conclusions Erectile function is directly proportional to the degree of exposure to smoking, and quitting smoking improves male sexual function in all age groups between 30-60 years of age regardless of pack-year and education level.

Pure Yolk sac presenting with inferior vena cava thrombus extending from bilateral external iliac veins to hepatic vein

ABSTRACT Introduction: Vena cava thrombus is an extremely rare complication of testicular tumors. We report on an unusual case of testicular tumor presenting with inferior vena cava thrombus extending from the left spermatic and bilateral external iliac veins to the hepatic vein. Case report: A-35-year old man presented with a 6-month history of left scrotal mass and a 1-day history of bilateral lower extremity edema. Computed tomography (CT) revealed the presence of thrombus extending from the left spermatic vein and bilateral external iliac veins to the hepatic vein, and multiple lymph node and lung metastases. 3 cycles of chemotherapy were given after the left high inguinal orchiectomy. Pathological examination demonstrated a pure yolk sac carcinoma with lymphovascular invasion and direct tumor extension into the left spermatic cord. CT and positron emission tompgraphy-CT obtained no findings of metastasis or recurrence at 3 months after the chemotherapy. Conclusion: We review this seldom case and discuss the literature with regard to its diagnosis and treatment.

The long-term results of temporary urethral stent placement for the treatment of recurrent bulbar urethral stricture disease

ABSTRACT Aim: To evaluate the long term outcomes of temporary urethral stent placement for the treatment of recurrent bulbar urethral stricture. Materials and Methods: Twenty-eight patients who underwent temporary polymer coated urethral stent placement due to recurrent bulbar urethral stricture between 2010 and 2014 were enrolled in the study. The long term outcomes of the patients were analyzed. Results: The mean age of the patients was 62.3±6.4 (44–81). The overall clinical success was achieved in 18 (64.2%) of the 28 patients at a median (range) follow-up of 29 (7–46) months. No patient reported discomfort at the stent site. Stone formation was observed at the urethral stent implantation area only in one patient. Stenosis occurred in the distal end of the stents in two patients and took place in bulbar urethra in seven patients after removed the stents. The mean maximum urine flow rates were 6.24±2.81mL/sec and 19.12±4.31mL/sec before and at 3 months after the procedure, respectively. Conclusion: In this study, the success rate of temporary urethral stent placement has remained at 64.2% at a median follow-up of 29 months. Therefore, our outcomes have not achieved desired success rate for the standard treatment of recurrent bulbar urethral stricture.

Assessment of PSA-Age volume score in predicting positive prostate biopsy findings in Turkey

ABSTRACT Objectives: To evaluate PSA-age volume (AV) scores in predicting positive prostate biopsy findings in Turkey. Materials and Methods: PSA-AV was calculated by multiplying the patient's age by the prostate volume and dividing it by the PSA level. Sensitivities and specificities of the PSA-AV were assessed by retrospective analysis of findings from 4,717 prostate biopsies. Results: The population's average age was 63.71±7.63 years, the mean PSA level was 9.73±17.01ng/mL, the mean prostate volume was 44.46±23.88 cm3. Of the 4,717 prostate biopsies, 1,171 biopsy specimens (24.8%) were positive for prostate cancer. A PSA-AV score of 700 had a sensitivity and specificity of 95% and 15%, respectively. These values were similar to the sensitivity and specificity for a PSA cut-off of 4ng/mL (94% and 13%, respectively). Although the sensitivity of a PSA-AV cut-off of 700 in patients over 60 years was similar to the PSA cut-off of 4ng/mL and the age-adjusted PSA, in patients <60 years, its sensitivity was higher. While the sensitivities of a PSA-AV cut-off of 700 in patients with low prostate volume was higher than a PSA cut-off of 4ng/ mL, the sensitivities of both methods with moderate prostate volumes were similar. Conclusions: Considering all the biopsies, the sensitivity and specificity of a PSA-AV of 700 for predicting positive biopsy findings were similar to a PSA of 4ng/mL. We suggest the PSA-AV cut-off of 700 should only be used in patients younger than 60 with low prostate volumes (<20cm3).