The effect of metabolic syndrome on prostate cancer final pathology.

AIM OF STUDY: Metabolic syndrome (MetS) is an abnormality that increases the risk of cardiovascular disease and diabetes. In the recent years, studies showed that MetS is associated with increased risk of incidence, aggressiveness, and mortality of prostate cancer (PCa). We examined the influence of MetS at final pathology in Turkish patients with PCa. MATERIALS AND METHODS: MetS was defined according to the American Heart Association, National Heart, Lung, Blood Institute, and International Diabetes Federation and requires any three of five components. The patients without and with MetS were in Group 1 and 2, respectively. Data were compared with independent sample t-test and Chi-squared test. RESULTS: There were 117 patients in the study. The patients' age was between 51 and 77 years with a median of 64.87 ± 5.65 and 62.29 ± 5.57, and prostate-specific antigen (PSA) level of the patients was 8.19 ± 5.35 and 8.68 ± 2.22 ng/ml in Group 1 and 2. Of these patients; Group 1 and 2 had 86 and 31 patients. High-grade PCa (Gleason >7) and advanced PCa (T3, T4) at final pathology were reported in 44.18-18.60% and 38.70-32.25% in Group 1 and 2. CONCLUSION: The patients with MetS are diagnosed significantly younger and had higher PSA levels than the other patients. Advanced disease of PCa is seen much more in patients with MetS.

Effect of sildenafil citrate in testosterone induced benign prostate hyperplasia rat model.

OBJECTIVE: Efficacy of treatments for benign prostate hyperplasia (BPH) is limited because the disease has complex etiopathogenesis. Recent studies have demonstrated the presence of phosphodiesterase-5 (PDE-5) receptors in prostate tissue. We investigated efficacy of sildenafil citrate in testosteron - induced BPH in rats. MATERIAL AND METHODS: The rats were divided into three groups. Each groups had 7 rats. Group 1 was control group. Testosteron propionate 3 mg/kg/day was injected subcutaneously for two weeks in Group 2. The same procedure was done for Group 3 and sildenafil citrate was added to water at daily doses of 2 mg/kg for two weeks. The rats were euthanized with intraperitoneal pentobarbital. The body weights were measured and the prostates were removed. RESULTS: The mean weights of rats were 288±31.93, 345±23.23 and 294±32.86 g in Groups 1, 2 and 3, respectively. The mean prostate weights of rats were 0.74±0.18, 1.3±0.13 and 0.72±0.24 g in Groups 1, 2, and 3, respectively. Group 2 had statistically significantly higher prostate weights than the other groups (p<0.01). Relative prostate weight is calculated with ratio of prostate weight to body weight. BPH group showed an increase in relative prostate weight compared with other groups with significant difference (p=0.036 and p=0.040). There was statistical difference for acinar area between Group 2 and the others, no significant difference of number of acini, interstitial space and epithelial thickness. Group 2 has more papillary projections per acini than the other groups. CONCLUSION: Favourable effect of sildenafil citrate on dimensions of prostate but not all on histological parameters was observed. We expect that PDE-5 inhibitors might be a treatment option for BPH patients if the studies support our findings in the future.

Assessment of sexual functions in partners of women with complaints of urinary incontinence

ABSTRACT Aim: Investigation of the erectile functions in partners of women with urinary incontinence problems. Materials and Methods: Sexually active female patients over the age of 18 years with complaints of urinary incontinence (n=30) (Group-1), and without urinary incontinence (n=30) (Group-2, controls) were included this study. Evaluation of the patients were done at Erzincan Mengücek Gazi Training and Research Hospital's urology outpatient clinic between June 2012 and January 2013. Partners of group-1 and group-2 were asked to fill in the 5-item International Index of Erectile Function (IIEF-5) questionnaire, and then the scores of the two groups were compared for statistically significant differences. Results: Among the partners of the group-1 patients, 15 (50%) had mild erectile dysfunction (ED), 11 (36.6%) had moderate ED, 1 (3.4%) had severe ED, and erectile function was normal in the remaining 3 (10%). Among the partners of group-2 patients, 15 (50%) had mild ED, 7 had moderate ED, 1 (3.4%) had severe ED, and 7 (23.3%) had normal erectile function. Compared to the spouses of group-2 patients, ED was more prevalent among the spouses of group-1 patients. Conclusion: Erectile function in the partners of women with urinary incontinence may be adversely affected by the UI of their partners.

Assessment of sexual functions in partners of women with complaints of urinary incontinence.

AIM: Investigation of the erectile functions in partners of women with urinary incontinence problems. MATERIALS AND METHODS: Sexually active female patients over the age of 18 years with complaints of urinary incontinence (n=30) (Group-1), and without urinary incontinence (n=30) (Group-2, controls) were included this study. Evaluation of the patients were done at Erzincan Mengücek Gazi Training and Research Hospital's urology outpatient clinic between June 2012 and January 2013. Partners of group-1 and group-2 were asked to fill in the 5-item International Index of Erectile Function (IIEF-5) questionnaire, and then the scores of the two groups were compared for statistically significant differences. RESULTS: Among the partners of the group-1 patients, 15 (50%) had mild erectile dysfunction (ED), 11 (36.6%) had moderate ED, 1 (3.4%) had severe ED, and erectile function was normal in the remaining 3 (10%). Among the partners of group-2 patients, 15 (50%) had mild ED, 7 had moderate ED, 1 (3.4%) had severe ED, and 7 (23.3%) had normal erectile function. Compared to the spouses of group-2 patients, ED was more prevalent among the spouses of group-1 patients. CONCLUSION: Erectile function in the partners of women with urinary incontinence may be adversely affected by the UI of their partners.

Does resectoscope size play a role in formation of urethral stricture following transurethral prostate resection?

BACKGROUND AND AIMS: To investigate the possible effect of resectoscope size on urethral stricture rate after monopolar TURP. MATERIALS AND METHODS: A retrospective study of 71 men undergoing TURP was conducted at two centers' from November 2009 to May 2013. The patients were divided into one of two groups according to the resectoscope diameter used for TURP. Resectoscope diameter was 24 F in group 1 (n=35) or 26 F in group 2 (n=36). Urethral catheter type, catheter removal time and energy type were kept constant for all patients. Urethral stricture formation in different localizations after TURP was compared between groups. RESULTS: There was no significant difference between the two groups in terms of age, pre-operative prostate gland volume (PV), prostate-specific antigen (PSA), maximal urinary flow rates (Qmax), International Prostate Symptom Score (IPSS) and post-voiding residual urine volume (PVR). The resection time and weight of resected prostate tissue were similar for both groups (p>0.05). A statistically significant higher incidence of bulbar stricture was detected in group 2 compared to group 1 (p=0.018). CONCLUSIONS: The use of small-diameter resectoscope shafts may cause a reduction in the incidence of uretral strictures in relation to urethral friction and mucosal damage.

Is it possible to distinguish testicular torsion from other causes of acute scrotum in patients who underwent scrotal exploration? A multi-center clinical trial.

INTRODUCTION: To assess the clinical presentation of patients who underwent surgical exploration for acute scrotum and to investigate the potentially related factors for differential dignosis. MATERIAL AND METHODS: We retrospectively analyzed the medical records of 97 patients who underwent surgical exploration for acute scrotum between May 2007 and July 2013. The patients were divided into two groups as follows: Group1 included patients with testicular torsion (TT) and Group 2 contained patients with acute scrotal pathologies other than TT, including torsion of the testicular appendage, epididymo-orchitis, trauma and Henoch-Schönlein purpura. The physical examination findings, colour Doppler ultrasound (CDUS) and laboratory findings for the groups were compared. RESULTS: In total, 97 scrotal explorations were carried out for acute scrotum. Group 1 included 72 patients (74.2%) and Group 2 included 25 patients (25.8%). Group 2 was comprised of patients with torsion of the testicular appendage (n = 13), epididymo-orchitis (n = 8), testicular trauma (n = 2) and Henoch-Schönlein purpura (n = 2). In Group 1, 32 cases (44.4%) presented to a hospital less than 6 hours after onset of pain. More than half (64%) of Group 2's cases presented more than 24 hours after pain onset. Fever and pyuria appeared more frequently in Group 2 than in Group 1 and the results reached statistical significance (p = 0.001 and p = 0.044, respectively). Group 1 had more testicular tenderness than Group 2 (p <0.001). Our testicular salvage rate was 59.7%, and 40.3% of patients underwent orchiectomy. CONCLUSIONS: CDUS predicted the diagnosis of TT (sensitivity 98.6%). Furthermore, clinical findings may also play a substantial role in the differential diagnosis of acute scrotum.

Does resectoscope size play a role in formation of urethral stricture following transurethral prostate resection?

ABSTRACTBackground and aims:To investigate the possible effect of resectoscope size on urethral stricture rate after monopolar TURP.Materials and Methods:A retrospective study of 71 men undergoing TURP was conducted at two centers’ from November 2009 to May 2013. The patients were divided into one of two groups according to the resectoscope diameter used for TURP. Resectoscope diameter was 24 F in group 1 (n=35) or 26 F in group 2 (n=36). Urethral catheter type, catheter removal time and energy type were kept constant for all patients. Urethral stricture formation in different localizations after TURP was compared between groups.Results:There was no significant difference between the two groups in terms of age, pre-operative prostate gland volume (PV), prostate-specific antigen (PSA), maximal urinary flow rates (Qmax), International Prostate Symptom Score (IPSS) and post-voiding residual urine volume (PVR). The resection time and weight of resected prostate tissue were similar for both groups (p>0.05). A statistically significant higher incidence of bulbar stricture was detected in group 2 compared to group1 (p=0.018).Conclusions:The use of small-diameter resectoscope shafts may cause a reduction in the incidence of uretral strictures in relation to urethral friction and mucosal damage.

Plasmakinetic vaporization versus transurethral resection of the prostate: Six-year results.

OBJECTIVE: Benign prostate hyperplasia (BPH) is becoming more prevalent in parallel to the changing demographic structures of the community. Transurethral resection is still considered the most effective treatment. Due to advances in technology, different treatment modalities are being attempted. In our study, we compared the long-term results of standard transurethral resection of prostate (TURP) with plasmakinetic vaporization of prostate (PKVP, Gyrus Medical Ltd., Bucks, UK). MATERIAL AND METHODS: Of the 75 patients who were admitted to our outpatient clinic between 2001 and 2003 with lower urinary tract complaints and who were randomized into two groups (transurethral resection (TUR) and PKVP), 36 were enrolled to study and completed a follow-up period of 72 months. RESULTS: Both groups were equal in terms of age and preoperative parameters. The preoperative maximum uroflow rate (Qmax) in the PKVP group was 6 (2.3) mL/s and the rates were 21.8 (3.4) and 20.1 (3.1) during the control visits at 36 and 72 months, respectively. For the PKVP group, these rates were 6 (3.1), 14.4 (2.6), and 15.6 (2.8), respectively. In terms of the international prostate symptom score (IPSS), for the TUR group, these values were 22 (3.8), 5.7 (1.2), and 7.9 (2.6). For the PKVP group, the respective values were 21 (3.4), 7.6 (1.4), and 11 (2.4). The IPSS and Qmax values measured at the 36(th) and 72(nd) months for both groups were significantly different from each other (p<0.05). CONCLUSION: Compared to standard TURP, PKVP was found to be unsuccessful in the treatment of BPH when long-term outcomes were considered.

The impact of unilateral experimental rat varicocele model on testicular histopathology, Leydig cell counts, and intratesticular testosterone levels of both testes.

PURPOSE: Varicocele, most treatable pathologic condition in male infertility, exerts unfavorable effects on testicular ultrastructure via various mechanisms. In this study we aimed to demonstrate adverse effects of varicocele on both testes. MATERIALS AND METHODS: Twenty one adult male Albino rats were divided into 3 groups. Sham operation was performed for group 1 (control group), and this group of rats were sacrificed 4 weeks later. Experimental varicocele model was performed for group 2 (varicocele group) and these animals were sacrificed 4 weeks after the operation. In group 3 the rats were varicocelectomized 4 weeks later. This group of rats were sacrificed at 4 weeks postoperatively. The level of testicular damage was examined, and serum testosterone and intratesticular testosterone levels were measured. RESULTS: Mean (±SD) damage scores of the right testes of the sham, varicocele, and varicocelectomy groups were 0, 1.64 ± 1.3, and 1.21 ± 0.3, respectively. There was no statistically significant differences between damage scores of groups 2, and 3 (P = .320), relevant scores of both groups were determined to be significantly higher than group 1 (P = .009, and P = .001). Mean (±) damage scores of the left testes of the three groups were detected to be 0.43 ± 1.13, 2.29 ± 1.15, and 1.78 ± 0.39, respectively. The difference between varicocele, and varicocelectomy groups was not statistically significant (P = .112). CONCLUSION: Unilateral varicocele has deleterious effects on both testes. There was no statistically significant difference as for histopathologic recovery following varicocelectomy.

Acute scrotum in Henoch-Schönlein purpura: fact or fiction?

Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis of childhood. It is usually seen following upper respiratory tract infections. It rarely involves the genital system or causes scrotal edema. With this report, we wanted to bring a different perspective to this clinic of acute scrotum. Herein, we present two HSP patients admitted to our clinic with scrotal involvement, with a review of the literature.

Hormonal evaluation in premature ejaculation.

INTRODUCTION: Premature ejaculation (PE) is a frequently encountered sexual dysfunction in men. It significantly impairs quality of life of the affected male and his partner. The aim of this study is to investigate the role of hormonal factors in patients with PE. PATIENTS AND METHODS: 107 male patients aged between 26 and 64 years (mean 45.1 ± 10.36) who consulted our outpatient clinics with complaints of PE and 94 healthy males (48.1 ± 11.81 years) as a control group were included in the study. RESULTS: When mean serum hormone concentrations of both groups were compared, levels of prolactin and free T4 were found to be significantly higher in the PE group relative to the control group (p < 0.05). At least one of the hormonal parameters was abnormal in 36 cases (33.6%) with PE, compared to only 22 (23.4%) of the controls. The number of hyperprolactinemic cases was found to be significantly increased in the PE group (p < 0.05). CONCLUSION: We feel that during the evaluation of this problem, which affects great numbers of men and their partners throughout the world, consideration of potential effects of hormonal factors might be beneficial.

Increased sperm DNA damage in experimental rat varicocele model and the beneficial effect of varicocelectomy.

BACKGROUND: Varicocele, the abnormal dilatation of the veins in the pampiniform plexus is commonly seen in infertile patients. In this study, we aim to examine sperm DNA damage after the creation of experimental varicocele in rats and to observe the change of this damage after a varicocelectomy. MATERIALS AND METHODS: In this experimental study, a total of 30 adult male Wistar albino rats were divided into three groups. The 10 rats in group 1 underwent a sham operation, an experimental varicocele was created in both the10 rats in group 2 and the 10 rats in group 3 (a total of 20 rats). While the rats of group 2 were sacrificed after four weeks, the rats in group 3 underwent a varicocelectomy after four weeks and were sacrificed four weeks after the varicocelectomy to observe its effects. Sperm DNA fragmentation was assessed with a Halomax® kit. The DNA Fragmentation Index (DFI) was calculated and the groups were compared according to their DFI. Statistical analysis was performed using the Mann-Whitney U test. RESULTS: Median sperm DFI was 17.6 (range: 7.6) in the right testicle and 18.3 (range: 6.8) in the left testicle in the control group; 30.7 (range: 8.8) in the right testicle and 31.8 (range: 9.6) in the left testicle in the varicocele group; 27.1 (range: 8.1) in the right testicle and 28.6 (range: 8.9) in the left testicle in the varicocelectomy group. DNA damage in both right and left testicles was statistically significant between the three groups (p<0.05). CONCLUSION: The results of this study show that varicocele leads to increased sperm DNA damage and this damage is decreased by varicocelectomy.

International prostate symptom score: really appreciated by all patients or not?

PURPOSE: To investigate the relationship between the accuracy of the answers provided by the patients to the International Prostate Symptom Score (IPSS) questionnaire and age and level of education. MATERIALS AND METHODS: Two hundred and thirty-eight men were given self-administered IPSS questionnaires. After 48 to 96 hours, the IPSS form was completed again with the assistance of a physician. The relationship of the difference between the self-administered IPSS and forms completed with assistance with age and level of education was evaluated through Wilcoxon test. P values less than .05 were considered significant. RESULTS: There was not a significant difference between the two IPSS among the high school or university graduates (P = .480). However, the difference was significant among the primary and secondary school graduates (P = .042 and P = 0.34, respectively). Of values obtained from self-administered IPSS forms and those completed with the assistance of a physician, there was a statistically significant difference in the group ≥ 60 years of age. CONCLUSION: Age ≥ 60 years and being primary or secondary school graduate are factors lowering the comprehension of the IPSS by the patients. Older patients and those with lower education could benefit from the assistance of a physician while completing this questionnaire.