The relationship between anogenital distance and benign prostate hyperplasia-related lower urinary tract symptoms.

Anogenital distance (AGD) is the length between the genitals and anus which shows an androgenic activity in the evolution of the reproductive system in the uterine life. For prostatic evolution and development during the embryological stage, androgen exposure is required. In this study, we aimed to investigate the relationship between AGD and benign prostate hyperplasia (BPH)-related lower urinary tract symptoms (LUTS). A total of 70 patients who were admitted to our urology clinics with LUTS due to BPH (LUTS group) and 70 patients without LUTS (control group) were included. All patients were administered an International Prostate Symptom Score form. Data including height, weight, body mass index, total prostate-specific antigen, prostate volume and uroflowmetry Qmax values of all patients were evaluated. The AGD of the LUTS and control groups was measured. The mean AGDAS values of the LUTS group were significantly lower than the control group (p = .013). There was no statistically significant difference between the two groups in terms of the mean adjusted AGDAP values (p = .241). However, the mean adjusted AGDAS values were significantly lower in the LUTS group than the control group (p = .002). Our study results suggest that AGD may be a useful marker in BPH-related LUTS.

Can second to fourth finger ratio play a role in determining the risk of benign prostatic enlargement.

Benign prostatic enlargement (BPE) is a disease that testosterone plays a role in its aetiology. Second to fourth finger ratio is a marker of prenatal androgenic exposure and may be a risk factor for several androgen-related diseases such as BPE. In this study, we investigated the relationship between the second to fourth finger ratio and BPE. A total of 63 patients with BPE were included for study group, and age-matched 63 healthy patients were included as a control group. Finger was measured by the distance from the proximal crease to the tip by using a digital caliper. The mean age of patients with BPE and non-BPE was 62 ± 8.9 and 61.5 ± 7.1 years respectively. There was statistically significant difference between groups in terms of prostate-specific antigen levels, prostate volumes and international prostate symptom scores. The mean finger ratios for right and left hand were 0.97 ± 0.03, 0.99 ± 0.03(p = .001) and 0.93 ± 0.15, 0.98 ± 0.03(p < .001) for BPE and non-BPE groups respectively. Men with a lower second to fourth finger ratio have higher risk of developing BPE than men without BPE. Therefore, the second to fourth finger ratio, which is indicative of prenatal androgen exposure, can be used as a marker of BPE risk.

Does duration of stenting increase the risk of clinical infection?

OBJECTIVE: We investigated when an indwelling ureteral catheter should be withdrawn for infection and evaluated the importance of urinary cultures in identifying colonized microorganisms and define the bacterial flora encountered in the study. Moreover, this study tried to determine the clinical role of stent culture in clinical practice. MATERIALS AND METHODS: The study was conducted between June 2018 and February 2019. Patients with ureteral stent implantation after endoscopic ureteral stone treatment were divided into two groups and each group consisted of 45 patients. Ureteral catheter was removed 15 and 30 days after ureteral stone treatment in group 1 and 2, respectively, and transferred for microbiological examination. The urine culture was obtained before and after ureteral stent implantation. The groups were compared in terms of demographics, urine and catheter cultures results. Urine analysis and catheter culture results were also compared. RESULTS: Demographic data of patients were similar in both groups. 3 patients in group 1 and 12 patients in group 2 had positive urine culture before catheter retraction; 2 of 45 and 6 of 45 patients had positive catheter culture in group 1 and 2, respectively. Although 2 patients in group 1 and 4 patients in group 2 had urine culture sterile, they had growth in catheter culture. In Group 1, 1 of the microorganisms was E. fecalis and 1 was E. coli. In Group 2, 2 cases were E. fecalis, 3 were E. coli and 1 was MRSE. There was no significant difference between the urine analysis results of the patients before catheter retraction and catheter culture positivity. CONCLUSIONS: Pre-operative urine culture does not exclude catheter colonization, and the prolonged duration of the catheter associated with greater colonization and may be associated urinary tract infection. Ureteral catheter should be removed as early as possible.

A Simple, Non - Biological Model for Percutaneous Renal Access Training.

PURPOSE: Percutaneous renal puncture (PRP) is one of the most important and critical step of urology, especially while performing percutaneous nephrostomy and percutaneous nephrolithotomy (PCNL). In the learning period of this procedures, there is a need for validated, effective, economical models for such training. This study describes a simple non - biological model for learning PRP. The aim was to determine the effectivity of this model as a training and assessment tool, and to assess its cost relative to other models. MATERIALS AND METHODS: We designed a training box, made of foam and rubber with two open sides and performed radiopaque pelvicalyceal system maquettes to insert inside it. Experts in PCNL (i.e., > 100 cases) andnovices (i.e., pediatric surgeons and urologists without PCNL experience) performed percutaneous renal puncture. Novices performed a pre -test and a post - test (i.e., after 2 hour training). Data recorded were total procedure time, X - ray exposure time, and number of puncture attempts. Experts who performed PRP successfully were asked torate the model using a questionnaire. RESULTS: Five experts and 21 novices completed the study. Four experts rated the model as an "excellent" (score 5) training and assessment tool; one expert rated these as "very good" (score 4). Comparisons of novices' pre - and post - test median results revealed significant skill acquisition with shorter procedure time, less X - ray exposure, and fewer attempts for successful puncture (all P < .001). CONCLUSION: This new non - biological training model is an effective training tool that helps learners improve skills in PRP. The model is simple to construct, economical, and highly re-useable compared to others. It provides good visibility and imaging, is portable, and could be used widely in training centres.

The effects of cigarette smoking on prostate-specific antigen in two different age groups.

BACKGROUND: We investigate the effects of cigarette smoking on prostate-specific antigen (PSA) using 2 different age groups. METHODS: The study was carried out between January 2007 and October 2011 with men; the 2 sets of age groups were: 25 to 35 years and 50 to 70 years old. The participants were divided into 4 groups. Of the 25 to 35 age range, smokers were Group 1, and non-smokers were Group 2; of the 50 to 70 age range, smokers were Group 3 and non-smokers Group 4. In addition, for the 50 to 70 age group, the International Prostate Symptom Score was completed, digital rectal examination was performed, and transabdominal prostate volume was measured. We wanted to see whether prostate-specific antigen (PSA) levels showed a difference between the 2 age groups. RESULTS: There were 114 patients in Group 1, 82 in Group 2, 90 in Group 3, and 102 in Group 4. The mean PSA level was 0.7 ± 0.28 ng/mL for Group 1, and 0.6 ± 0.27 ng/mL for Group 2 (p = 0.27), and there was no statistically significant difference between the 2 groups. The mean PSA was 2.5 ± 1.8 ng/mL for Group 3, and 2.1 ± 2.0 ng/mL (p = 0.59) for Group 4, and there was no statistically significant difference between the these 2 age groups. INTERPRETATION: Cigarette smoking effects various hormone levels. Different from previous studies, the PSA level was higher in smokers compared to nonsmokers, although it was not statistically significant. Our study is limited by the small numbers in our study groups and the lack of PSA velocity data.

Association between severity of lower urinary tract symptoms, erectile dysfunction and metabolic syndrome.

INTRODUCTION: The purpose of this study was to investigate the association between severity of lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and metabolic syndrome. METHODS: Our study population included a consecutive series of 190 patients with LUTS (International Prostate Symptom Score-IPSS >7) with or without manifestations of the metabolic syndrome. The diagnoses of diabetes mellitus and hypertension were obtained from the patient's medical history. Data on blood pressure, waist measure, body height and weight were collected and body mass index were calculated. Patients were assessed based on the International Index of Erectile Function (IIEF) for ED and IPSS and IPSS-Quality of Life for LUTS. Blood samples were drawn from fasting patients to determine, fasting blood glucose (FBG), triglycerides, HDL-cholesterol and serum total testosterone levels. RESULTS: In severe LUTS patient group, IIEF erectile function domain scores were significantly lower than moderate LUTS patient group (p < 0.05). Multiple logistic regression analysis confirmed that presence of ED was the most predictor of severe LUTS. The prevalence of metabolic syndrome was higher in patients with severe LUTS (26%vs. 46%, p = 0.009). The severe form of the LUTS was significantly correlated with waist circumference >102 cm (p < 0.05), blood pressure > or =130/85 mmHg (p < 0.05) and FBG >110 mg/dl (p < 0.01). CONCLUSION: Obesity, high plasma level of FBG and hypertension constitute risk factors for the development of severe LUTS. Metabolic syndrome may play a key role in the pathogenesis in both ED and LUTS. Presence of ED is the most predictor of severe LUTS.