[The role of obesity in the pathogenesis of benign prostatic hyperplasia].

The pathophysiological role of obesity as one of the most significant and actual metabolic non-infectious diseases and the key component of the metabolic syndrome based on results of modern epidemiological and clinical-experimental studies is discussed in the review. General information on the prevalence of obesity and its negative effect on the quality of life of men is presented. The endocrinology of adipose tissue and associated hormonal and metabolic disorders are discussed in more detail. The analysis of pathophysiological mechanisms explaining an influence of obesity on prostate metabolism, which leads to the initiation and progression of the benign prostatic hyperplasia, is carried out. Currently, there is a large body of evidence that obesity and benign prostatic hyperplasia have a lot of common interacting pathogenetic mechanisms. An opinion that, considering a global increase in the prevalence and severity of obesity in men and its negative effects on the prostate, treatment for obesity in men can be considered as an effective primary preventive measure, and in patients with benign prostatic hyperplasia as an effective secondary preventive measure.

[Vitamin D deficiency, metabolic syndrome, and prostate adenoma: current epidemiological trends and pathophysiological mechanisms of interaction].

This review, based on the results of modern epidemiological and clinical-experimental studies, highlights the important pathophysiological role of vitamin D and the disturbances of its metabolism (deficiency/insufficiency) in the pathogenesis of the metabolic syndrome (MS) in men, which according to available literature, is associated with adenoma of the prostate (AP). General information about the endocrinology of vitamin D and its role in maintaining various aspects of mens health is presented. The authors analyze currently known pathophysiological mechanisms involving vitamin D interacting with each other within the framework of the pathogenesis of MS and AP. At present, there is much evidence that MS and AP have common universal interacting mechanisms of pathogenesis (obesity, insulin resistance, dyslipidemia, systemic chronic subclinical inflammation, endothelial dysfunction) that are realized with the direct participation of vitamin D. The authors argue that taking into account a global prevalence of vitamin D deficiency in the modern population, accompanied by an increasing incidence of both MS and AP affecting younger populations, a rational management of vitamin D metabolism in men can be regarded as a promising and effective pathogenetic prevention of MS and BPH.

[Systematic approach in performing isolated and simultaneous operations in elderly patients with prostate adenoma].

AIM: To develop a scientifically based system for treating elderly patient with prostate adenoma (AP), aimed at reducing the incidence and severity of complications and mortality after isolated and simultaneous operations. MATERIALS AND METHODS: Between 1995 and 2015, 1170 elderly and older patients with prostate adenoma (PA) underwent isolated adenomectomy (AE) or transurethral resection of the prostate (TURP) or simultaneous operations (SO). Simultaneous interventions were performed in 335 (28.6%) patients. RESULTS: Immediate treatment results were significantly better in patients who underwent isolated TURP or TURP as a part of SO than that of those who had isolated AE or AE as a part of SO. SO was not associated with greater incidence of local or general postoperative complications and mortality compared with isolated AE or TURP. CONCLUSION: Continuous advancements in diagnostic and treatment methods contributed to a significant reduction in the incidence of postoperative complications and deaths in geriatric patients with PA. The study findings confirm the superiority of TURP over AE, as previously reported by other authors.