Vitamin D deficiency in infertile patients.

OBJECTIVES: According to the WorldHealth Organization (WHO) definition, infertility is "thefailure of a sexually active, non-contracepting couple toachieve pregnancy in one year" and is a complicateddisorder with its medical, psychosocial and economicaspects. There is some proof that vitamin D deficiencyhas important effects on the male reproductive system.There are numerous animal trials and a limited numberof human trials investigating this topic. In our study, thepurpose is to consider vitamin D deficiency as a causeof infertility and investigate the relationship of serum vitaminD levels and infertility primarily in our region whereexposure to sunlight is relatively low. MATERIALS AND METHODS: Between 01.10.2014and 01.05.2015, 103 patients between the ages 20-40 that applied because of infertility were included in the study as the study group, and fertile male patientsbetween the ages 20-40 that applied for reasons otherthan infertility were included as the control group.A detailed anamnesis was obtained and physical examinationswere performed in all patients participatingin the study. The ages, duration of marriage, primarydiagnoses and presence of other diseases were questioned,semen analyses were performed. The serum testosterone,vitamin D, Ca (Calcium), follicle stimulatinghormone (FSH) and luteinizing hormone (LH) levels weretested after a 12 hour fasting period between 10:00and 12:00 in the morning. RESULTS: There was no significant difference between the study group and control group in demographic features and serum testosterone levels. Vitamin D deficiency was detected in 89 (86.4%) patients of the study group and 33 (66%) of the control group. A significant difference of vitamin D deficiency rates was detected between the groups (p0.05). CONCLUSION: It has been shown that vitamin D hasimportant functions in the male reproductive system. Inpatients with vitamin D deficiency, the semen parametersare affected negatively and vitamin replacement isrequired.

OBJETIVO: De acuerdo con la definición de la OMS, la infertilidad es "la imposibilidad de conseguir un embarazo en un año de una pareja sexualmente activa que no utiliza sistemas anticonceptivos" y es un trastorno complejo con sus aspectos médicos, psicosociales y económicos. Existen algunas pruebas de que la deficiencia de vitamina D tiene importantes efectos en el sistema reproductivo del varón. Hay numerosos ensayos en animales y un número limitado en humanos que investigan este asunto. En nuestro estudio, el propósito es considerar la deficiencia de vitamina D como causa de infertilidad e investigar la relación de los niveles de vitamina D sérica e infertilidad primariamente en nuestra región donde la exposición al sol es relativamente baja.MÉTODOS: Entre el 1-10-2014 y el 1-5-2015 se incluyeron como grupo de estudio 103 pacientes con edades entre 20 y 40 años que consultaron por infertilidad, y se incluyeron en el grupo control los pacientes fértiles entre 20-40 años que consultaron otras razones diferentes de infertilidad. En todos los pacientes participantes en el estudio se obtuvo una anamnesis detallada y se realizó una exploración física. Se recogieron la edad, duración del matrimonio, diagnósticos primarios y presencia de otras enfermedades y se realizaron análisis de esperma. Se hicieron análisis de testosterona, vitamina D, Calcio (Ca), FSH y LH después de un periodo de ayuno de 12 horas entre las 22:00 y las 12:00 del mediodía. RESULTADOS: No había diferencias significativas entre el grupo de estudio y el grupo control en los datos demográficos y niveles de testosterona sérica. Se detectó deficiencia de Vitamina D en 89 pacientes (86,4%) del grupo de estudio y 33 (66%) del grupo control. Se detectó una diferencia significativa entre los grupos en la tasa de deficiencia de vitamina D (p0,05). CONCLUSIONES: Se ha visto que la vitamina D tiene importantes funciones en el sistema reproductivo masculino. En pacientes con deficiencia de vitamina D los parámetros del semen se ven afectados negativamente y es necesario la reposición de vitamina.

Endoscopic versus open approach of bladder cuff and distal ureter in the management of upper urinary tract transitional cell carcinoma.

OBJECTIVE: Nephroureterectomy with the removal of the ipsilateral ureteral orifice and bladder cuff en bloc remains the gold standard treatment for upper urinary tract urothelial cancer. The distal ureter can be removed with the open surgical technique or endoscopic approach. We compared the outcomes of the endoscopic approach with those of conventional open surgery on the distal ureter. MATERIALS AND METHODS: We collected data from the charts of 30 patients who underwent radical nephroureterectomy at our clinic from January 1997 to January 2007 for upper urinary tract urothelial carcinoma. The patients were divided into two groups according to procedure performed on the distal ureter. Group I (n:12) was comprised of patients who underwent an open surgical procedure, and group II (n:18), was comprised of patients who underwent an endoscopic approach. Both groups were compared in terms of operative time, blood loss, transurethral catheter duration and duration of hospital stay. RESULTS: Patient age and tumor location showed no significant differences between the two groups. The operative time was significantly longer in group I than group II (181 versus 128 minutes; p<0.05). On the other hand, the estimated blood loss, transurethral catheter duration and duration of hospital stay were significantly lower in group II (205 mL versus 435 mL, 5 versus 8.5 days and 5.6 versus 9.2 days, respectively; p <0.05). CONCLUSION: The results of our study show that the endoscopic approach is less invasive than open surgery on the distal ureter. This procedure can easily be performed in the management of upper urinary tract urothelial carcinoma.

PSA density and PSA transition zone density in the diagnosis of prostate cancer in PSA gray zone cases.

This study assessed the efficacy of prostate specific antigen density (PSAD) and PSA transition zone density (PSATZ) in predicting prostate cancer in men with PSA levels of 4.0-10.0 ng/ml. Between July 1996 and July 2000, PSAD and PSATZ were determined in 202 patients who underwent ultrasonography-guided systemic sextant biopsies plus 2 transitional zone biopsies. Of the 202 patients, 27 (13.4%) had prostate cancer and 175 (86.6%) had benign prostatic hyperplasia (BPH) on pathologic examination. Although there was no significant difference in mean PSA level between the prostate cancer and BPH patients (p = 0.28), the mean PSAD (p = 0.011) and PSATZ (p = 0.036) were significantly higher in prostate cancer than in BPH patients. In discriminating prostate cancer patients, the cut-off values of 0.35 ng/ml/cc for PSATZ, and 0.15 ng/ml/cc for PSAD yielded specificity levels of 69 and 56, and sensitivity levels of 63 and 81%, respectively. In conclusion, no substantial advantage of PSATZ over PSAD could be demonstrated.