Effect of metabolic syndrome on sexual function in pre- and postmenopausal women.

Female sexual dysfunction is a prevalent and multidimensional disorder related to many biological, psychological, and social determinants. The authors assessed the effect of one of the many factors affect sexual function-metabolic syndrome-on female sexual function. They equally divided 400 women participants among 4 groups: (a) premenopausal with metabolic syndrome, (b) premenopausal without metabolic syndrome, (c) postmenopausal with metabolic syndrome, and (d) postmenopausal without metabolic syndrome. The authors used the Female Sexual Function Index to assess women's sexual function. Female sexual dysfunction was found more often in both pre- and postmenopausal women with metabolic syndrome (p =.001). Overall Female Sexual Function Index score and satisfaction, pain, and desire domain scores independently of the menopause status showed statistically significant differences across women with metabolic syndrome in comparison with participants with no metabolic syndrome (p <.05). The authors also evaluated the associations among 5 components of metabolic syndrome and Female Sexual Function Index scores. Higher fasting glucose levels were significantly associated with the Female Sexual Function Index score (p <.05). This study shows that sexual dysfunction is more prevalent in pre- and postmenopausal women with the metabolic syndrome.

Stress urinary incontinence and visceral adipose index: a new risk parameter.

OBJECTIVE: Visceral adipose index (VAI) is a novel parameter for the evaluation of visceral obesity. As we know that obesity is a risk factor for stress urinary incontinence (SUI), in this study we compared the VAI levels between the women with SUI and without SUI. MATERIALS AND METHODS: Two hundred and twenty-nine women were included in the study: 125 women with SUI and 104 women without SUI (control). All women were evaluated for SUI. We accessed the women for SUI at gynecologic position, and we performed cough stress test. In the calculations, continence was defined as no incontinence at all. RESULTS: Mean age was 52.1 (29-73) in women who have SUI and 50.8 (31-65) in control women. The women with SUI had higher BMI, TG levels, higher WC and lower HDL-C levels. Mean VAI level was 5.21 ± 2.61 in study group and 3.49 ± 1.78 in control group, respectively. VAI levels were statistically higher in women with SUI (p < 0.001). DISCUSSION: The simplicity of WC and BMI measurements and TG and HDL assessments make VAI an easily applicable index for the evaluation of visceral fat dysfunction. VAI can be a useful index for the evaluation and calculation of stress urinary incontinence risk.

Is the presence of varicocele associated with static and dynamic components of benign prostatic hyperplasia/lower urinary tract symptoms in elderly men?

OBJECTIVES: To evaluate the relationship between varicocele and benign prostatic hyperplasia/lower urinary tract symptoms in patients over the age of 40 years. METHODS: A total of 1040 patients with benign prostatic hyperplasia/lower urinary tract symptoms were evaluated for prostate volume, testicular volume, testicular consistency, total testosterone, total prostate-specific antigen and body mass index. A questionnaire including International Prostate Symptom Score and a uroflow test were also carried out. The presence and grade of varicocele was determined in each patient by physical examination. RESULTS: Varicocele was found bilaterally in 22.3% and unilaterally in 25.7% of the patients. There was no difference in terms of age and body mass index distribution between subgroups. When grouping patients for varicocele laterality, total testosterone (P = 0.04), prostate volume (P = 0.009) and total prostate-specific antigen (P = 0.02) level were significantly different. Similarly, these parameters were significant between patients with grade 1, 2 and 3 varicocele. Total testosterone level (P = 0.02) and prostate volume (P = 0.035) were found to be significantly different when patients were grouped according to testicular size. A positive correlation was found between testosterone level and prostate volume (P = 0.004; r(2) = 0.084). CONCLUSIONS: Bilateral and/or higher-grade varicocele is associated with lower prostate volume and testosterone levels, as well as lower prostate-specific antigen levels. However, it is not associated with dynamic components of benign prostatic hyperplasia/lower urinary tract symptoms in patients over the age of 40 years.

Are bladder neoplasms more aggresive in patients with a smoking-related second malignancy?

BACKGROUND: Relationships between smoking and bladder neoplasms, one of the common malignancies, are well-known. Different smoking-related malignancies may occur together. In this study, we evaluated the stage and grade of bladder neoplasms in patients also featuring lung or larynx cancer. MATERIALS AND METHODS: From January 2006 to February 2012, patients who underwent surgery for bladder neoplasms in our clinic were screened retrospectively. In the evaluation, 5 patients had larynx cancer and 20 patients have lung cancer in addition, all having been smoking for a long time. The bladder tumor stage and grade were investigated in these 25 cases. RESULTS: Mean age of patients was 66.8 (49-78). In the evaulation, all of 5 patients who had larnyx cancer also had high grade urothelial cancer. One had T2 urothelial, and 3 T1 urothelial cancer. In the same way, all of the 20 patients with lung cancer also have high grade urothelial cancer, three T2, and 13 T1. Bladder cancer stage and grade were determined to be significantly increased in patients with concomitant bladder and lung or larynx cancer. CONCLUSIONS: In the patients who have smoking releated second malignancy, bladder cancer prognosis appears more aggressive. We now need a larger series and multi-center studies for understanding relevant pathophysiology.

The metabolic syndrome is associated with more aggressive prostate cancer.

PURPOSE: The aim of this study was to analyze any association between the metabolic syndrome (MetS) and risk of prostate cancer (PCa) and cancer grade among men undergoing radical prostatectomy for PCa. MATERIALS AND METHODS: 50 patients with MetS and 50 patients without MetS who undervent radical prostatectomy (RP) were included in the study. Age at biopsy, height, weight, digital rectal examination (DRE), pre-biopsy PSA levels, prostate volume, histopathologic diagnosis after surgery and Gleason scores were collected data from all patients. Histologic material obtained at biopsy was given a Gleason score; tumours with a Gleason score ≥7 were considered high grade and <7 were considered low grade. RESULTS: The mean age at the time of biopsy was 63.7 ± 5.94 in patients with MetS and 61.6 ± 6.14 in patients without MetS. Men with MetS had significantly lower PSA levels (p=0.01) (7.21 ± 2.74 and 8.81 ± 2.72, respectively). Also, the men with MetS had higher RP tumor grade (p=0.04). CONCLUSIONS: Men with MetS undergoing RP have lower PSA levels and have significantly higher grade PCa. We must be careful for screening PCa in patients with MetS. Although the patients had lower PSA levels, they may have high grade disease.

Diabetes mellitus as a risk factor for high grade renal cell carcinoma.

BACKGROUND: Diabetes is a chronic disease characterized by impaired fasting blood glucose that leads to disturbances in various organs. In this study, we evaluated relationships between tumor size and grade in a population of diabetic and non-diabetic patients with renal cell carcinoma. MATERIALS AND METHODS: Between 2007-2013, in our clinic radical nephrectomy performed to 310 patients for renal tumors and pathology reported renal cell carcinoma cases were enrolled in the study. Patients with and without a history of diabetes regarding fasting glucose and HgA1c levels were evaluated during surgery for tumor size and Fuhrman grade. RESULTS: Diabetes was found in 95 patients. The mean age of the patients with and without diabetes mellitus was 64.3 (40-79) and 58.4 (31-87) years, respectively. In the diabetes group 51% of patients had a tumor size over 7 cm and 54% a tumor grade over Fuhrman 3. The respective figures in the non-diabetes group were 35% and 30% (p<0.05 in both cases). CONCLUSIONS: Renal cancer appears more aggressive in patients with diabetes. In this study lifestyle and risk factors with diabetes regulation were observed to be important for renal cancer patients. Multicenter studies are needed in larger series for more accurate results.

Diabetes mellitus and HbA1c levels associated with high grade prostate cancer.

PURPOSE: The aim of this study to analyze the association between history of diabetes mellitus (DM) with risk of prostate cancer (PCa) and cancer grade among men undergoing radical prostatectomy for PCa. MATERIALS AND METHODS: 50 patients with DM and 50 patients without DM who undervent radical prostatectomy (RP) were included in the study. Age at biopsy, height, weight, digital rectal examination (DRE), pre-biopsy PSA levels, prostate volume, histopathologic diagnosis after surgery and gleason scores were collected data from all patients. Histologic material obtained at biopsy was given a Gleason score; tumours with a Gleason score ≥ 7 were considered high grade and <7 were considered low grade. RESULTS: The mean age at the time of biopsy was 63.7 in patients with DM and 61.6 in patients without DM. Diabetic men had significantly lower PSA levels (p=0.01). Mean PSA level 7.04 ± 2.85 in patients with DM and 8.7 ± 2.86 in patients without DM, respectively. Also, diabetic men had higher RP tumor grade than men without DM (p=0.04). We found that HbA1c levels were higher in patients who have high grade prostate cancer (p<0.05). CONCLUSIONS: Diabetic men undergoing RP have lower PSA levels and have significantly higher grade PCa. We must be careful for screening PCa in patients with DM. Although the patients had lower PSA levels, they might have high grade disease.

Association between the metabolic syndrome and high tumor grade and stage of primary urothelial cell carcinoma of the bladder.

PURPOSE: To compare histopathologic findings of patients who underwent transurethral resection of a bladder tumor (TUR-B) between groups with and without the metabolic syndrome. MATERIALS AND METHODS: We retrospectively analyzed data of 535 patients who underwent TUR-B in our department between October 2005 and March 2011. All patients had primary urethelial cell carcinoma (UCB). Histologic stage, grade, the presence of hypertension, diabetes mellitus, body mass index (BMI), waist circumference, HDL and trigliseride levels were evaluated. The TNM classification was used, with Ta tumor accepted as lower stage and T1 and T2 tumors as higher stage bladder cancers. Also, the pathological grading adopted by the 2004 World Health Organization grading system were applied. Non-invasive papillary urothelial neoplasms of low malignant potential were regarded as low grade. RESULTS: Among the total of 509 patients analyzed in our study, there were 439 males (86.2%) and 70 females (13.8%). Metabolic syndrome was significantly associated with high histologic grade, and high pathologic stage (p<0.001). CONCLUSIONS: The patients with metabolic syndrome were found to have statistically significant higher T stage and grade of bladder cancer. Further studies with more patients are needed to confirm our study.

Impact of metabolic syndrome on stress urinary incontinence in pre- and postmenopausal women.

AIM: In the present study, we prospectively collected data from pre- to postmenopausal women with or without metabolic syndrome (MetS) and evaluated the impact of MetS on stress urinary incontinence (SUI) in women. MATERIAL AND METHODS: The women divided into four equal groups: premenopausal with and without MetS; postmenopausal with and without MetS. There were 100 women in each group. We assessed the women for SUI at gynecologic position and we determined cough stress test. MetS was defined according to the criteria established in 2005 by the NCEP/ATP III. RESULTS: Mean age was 48.52 ± 8.16 in women with MetS and 48.81 ± 8.31 in women without MetS. SUI was found more often in both pre- and postmenopausal women with MetS (p = 0.001 and p < 0.001). It seems that postmenopausal women have more SUI than premenopausal women with MetS. We also evaluated the association between five components of MetS and SUI. Just, higher fasting glucose levels and waist circumference were significantly associated with SUI (p < 0.05). CONCLUSION: Our study shows that SUI is more prevalent in pre- and postmenopausal women with the MetS. SUI can be prevented with lifestyle changes for MetS. Multicenter studies with larger series and molecular studies are needed to determine the impact of the MetS on SUI.

Renal cell carcinoma is more aggressive in Turkish patients with the metabolic syndrome.

BACKGROUND: Metabolic syndrome (MetS) is a multifactorial disease characterized by impaired glucose tolerance/diabetes, obesity, high triglyceride levels, low HDL levels, and hypertension. In this study we evaluate the relationship between tumor size and grade, and presence of the metabolic syndrome in patients with renal cell carcinoma. MATERIALS AND METHODS: Between 2007-2013, radical nephrectomy was performed for 310 patients with renal tumors in our clinic and those with pathology reported renal cell carcinoma were enrolled and divided into two groups, with and without metabolic syndrome diagnosed on the basis of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. The relationship between tumor size and grade of the two groups (Fuhrman nuclear degree) was evaluated statistically. RESULTS: The metabolic syndrome was found in 70 patients, with a mean age of 65.5 (40-87), as compared to 58.8 (31-84) years in the non-metabolic syndrome group. Tumor size over 7 cm was found in 54% and 33%, respectively, and tumor grade over Fuhrman 3 in 56% and 32% of patients. Patients with metabolic syndrome had significantly higher tumor size and grade (p<0.05). In the presence of hypertension, diabetes and high triglyceride levels, significant assocations were again observed (p<0.05). Tumor size and degree also increased with increasing body mass index but this was not statistically significant (p>0.05). CONCLUSIONS: Renal cancer is more aggressive in patients with metabolic syndrome. Lifestyle and risk factors were revealed to be significant influences in renal cancer patients.