Efficiency of the estimation of physiologic ability and surgical stress (E-PASS) score in predicting postoperative complications after robot-assisted radical prostatectomy.

BACKGROUND: Robot-Assisted Radical Prostatectomy (RARP) is increasingly becoming the standard surgical treatment for prostate cancer. While some risk factors for postoperative complications of RARP have been identified, no scoring model that incorporates both preoperative physical status of the patient and intraoperative risk factors has been developed. The Estimation of Physiologic Ability and Surgical Stress (E-PASS) score was initially described to predict postoperative complications after gastrointestinal surgical procedures. This study aims to assess the effectiveness of the E-PASS score in predicting postoperative complications of RARP. METHODS: A retrospective evaluation was conducted on 204 patients who underwent RARP between 2019 and 2022. Demographic data, parameters indicating patients' preoperative physical condition, and intraoperative risk factors were analyzed. The E-PASS score and subscores were calculated for each patient. RESULTS: Of the patients, 164 (80.4%) were discharged without any postoperative complications (Group 1), and 40 (19.6%) experienced various degrees of complications (Group 2). Patients in Group 2 had higher rates of previous abdominal surgery, elevated Eastern Cooperative Oncology Group (ECOG) performance scores, longer surgical durations, and higher E-PASS scores. To assess the effectiveness of the Comprehensive Risk Score (CRS) as a predictive factor for postoperative complications, a receiver operating characteristic (ROC) curve was constructed with a 95% confidence interval (CI), and a cut-off value was established. The cut-off value for CRS was determined to be -0.0345 (area under the curve [AUC]=0.783, CI: 0.713-0.853; p<0.001). Patients with a CRS higher than the cut-off value had a 16.4 times higher rate of postoperative complications after RARP (95% CI: 5.58-48.5). CONCLUSION: The E-PASS scoring model successfully predicts postoperative complications in patients undergoing RARP by using preoperative data about the physical status of the patient and surgical risk factors. The E-PASS score and its subscores could be utilized as objective criteria to determine the risk of postoperative complications before and immediately after surgery.

Comparing the effects of akimbo and bent-in-front arm positions on jump metrics: Validity and reliability of a modified 10/5 repeated jump test.

The purpose of this study was to compare the effects of two arm positions, akimbo and the newly introduced bent-in-front, on jump metrics in the ten-to-five repeated jump test (10/5 RJT) and to evaluate the reliability and validity of new modified bent-in-front variation. In contrast to akimbo, bent-in-front arm variation allows participants to use their arms freely by holding them with free hands, with parallel arms bent in front of chest and elbows pointing downward without swinging. This new arm position was designed to alleviate postural control difficulties and ensure smooth movement during repeated jumps on the force plate. However, the 10/5 RJT was designed to measure lower-body stretch-shortening cycle (SSC) performance, and it is unknown whether the bent-in-front arm variation would affect jump performance, such as arm swing. If the arms can be freed without interfering with jump performance, it would be possible to determine lower-body SSC performance without the contribution of the arms and have the advantage of postural control assistance. Fifty-five healthy sports science students who regularly participated in intercollegiate or recreational sports performed 10/5 RJT with arms akimbo and bent-in-front during two sessions. Four jump metrics, including the reactive strength index, and four reliability and validity statistics, including intraclass-correlation-coefficients, were estimated. The results indicated no significant differences in the jump metrics between two arm variations. Bent-in-front arm variation can be deemed as a valid and reliable test. Therefore, the newly introduced 10/5 RJT with arms bent-in-front can be used to evaluate SSC performance in this cohort.

YouTube™ as a source of information on prostatitis: a quality and reliability analysis.

It was aimed to analyze the YouTube™ videos on prostatitis regarding their source, content, and information included. The term "prostatitis" was searched by relevance and the first 200 video links and features were recorded. Using the 5-point modified DISCERN tool, Global Quality Score (GQS), and Journal of American Medical Association (JAMA) score, the quality and reliability of the information were assessed by two urologists. Inter-rater agreement for DISCERN, JAMA, and GQS had Cohen's kappa coefficients of 0.883, 0.887, and 0.885, respectively. The most common source of upload was doctors/medical institutions (33.0%), and the majority of the content was about general information (27.0%). The mean modified DISCERN, GQS and JAMA scores were 3.24 ± 1.23 (1.00-5.00), 3.25 ± 1.26 (1.00-5.00) and 2.17 ± 1.36 (0.00-4.00), respectively. These scores were correlated with each other (r = 0.914, p < 0.001 between JAMA and GQS; r = 0.954, p < 0.001 between JAMA and modified DISCERN; and r = 0.885, p < 0.001 between GQS and modified DISCERN, Spearman test) and were the highest in the videos uploaded by doctors/medical institutions (p < 0.001, Kruskal-Wallis test). Of the videos, 25.5% were poor, 30.5% were moderate and 44.0% were high quality. The high quality videos were significantly shorter than those with poor quality (p = 0.039, Kruskal-Wallis test). The poor quality videos had the highest view ratio (50.49 ± 127.74 (0.03-618.91), p = 0.036, Kruskal-Wallis test). Most YouTube™ videos on prostatitis are short and high quality videos uploaded by doctors/medical institutions. However, these videos have less view ratios than those with poor quality.

Evaluation of factors associated with the detection of incidental prostate cancer after open prostatectomy for benign prostatic hyperplasia.

We aimed to evaluate the incidental prostate cancer (PCa) rate and predictive factors in patients who underwent open prostatectomy (OP) with a pre-diagnosis of benign prostatic hyperplasia (BPH). This study included patients with a pre-diagnosis of BPH, who underwent OP due to symptomatic prostate enlargement. Our database included age, medications, prostate-specific antigen (PSA), free/total PSA ratio, PSA density, digital rectal examination (DRE), prostate volume, serum neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, aspartate aminotransferase/alanine aminotransferase ratio, presence of metabolic syndrome (MetS) and histopathological results after OP. Of the 430 patients that underwent OP, 406 (94.4%) with a benign pathological diagnosis were evaluated as the benign group and 24 (5.6%) detected to have PCa constituted the incidental PCa group. The rate of incidental PCa was much higher in the elderly patients. The cut-off value of age was 71.5 years in the PCa group according to the receiver operating characteristic curve analysis. According to the multivariate analysis, DRE and the presence of MetS were effective in predicting PCa (p < .001 and p = .031, respectively). DRE was found 16 times more effective and MetS was 2.8 times more effective than the other parameters. Our results showed that DRE and the presence of MetS could be useful predictive factors of incidental PCa in OP.

Analysis of clinical factors associated with intraoperative and postoperative complications of retrograde intrarenal surgery.

The aim of this study was to evaluate the factors affecting intraoperative and postoperative complications in retrograde intrarenal surgery. In this retrospective cohort study, 706 retrograde intrarenal surgery procedures administered to 617 patients were reviewed. Intraoperative and postoperative complications were classified according to the modified Satava and modified Clavien classification systems. The stone-free rate was 407 (57.6%) and the success rate was 528 (74.8%). Intraoperative complications were observed in 215 (30.5%) patients. The most common intraoperative complication was mild bleeding 60(8.5%), while the only independent risk factor associated with intraoperative complications was the presence of residual stones. Postoperative complications were observed in 190 (26.9%) patients. The most common postoperative complication was fever requiring antipyretic drugs 60(8.6%), while independent risk factors associated with postoperative complications were the presence of residual stones and solitary kidney.

Evaluating the anxiety and depression status of prostate cancer patients whose operations were postponed because of the COVID-19 pandemic.

AIM: In this study, we aimed to evaluate the anxiety and depression status of prostate cancer (PCa) patients whose planned operations in the urology clinic of our hospital, which is serving as a pandemic hospital in Turkey have been postponed because of the coronavirus disease 2019 pandemic. METHODS: This survey study was conducted at urology clinic of Ankara City Hospital between March 1 and June 1, 2020, and included 24 male patients who agreed to answer the questionnaires (State-Trait Anxiety Inventory [STAI] I and II and Beck Depression Inventory [BDI]). Demographical and clinical data (age, time since diagnosis, total serum prostate-specific antigen (PSA) levels, risk groups according to the D'Amico classification system, smoking, alcohol habitus, major surgical history and comorbidities) of the patients were collected from hospital software. RESULTS: The mean STAI-I score of the patients (46.7 ± 1.4 [44-49]) was significantly higher than their STAI-II score (41.7 ± 2.4 [39-47]) (P < .001). The negative correlation between the decrease in age and STAI-I score was found to be statistically significant (r = 0.439, P < .05). The mean BDI score of the patients was 4.3 ± 3.2 (0-13), which was compatible with mild depression. There was no statistically significant difference among the time elapsed from diagnosis, PSA levels, smoking and alcohol habitus, major surgical history and comorbidity status and STAI-I, STAI-II and BDI scores (P > .05). CONCLUSION: Prostate cancer patients with postponed operations should be guided properly in order to manage their anxiety status especially young patients.

Six high-intensity interval training sessions over 5 days increases maximal oxygen uptake, endurance capacity, and sub-maximal exercise fat oxidation as much as 6 high-intensity interval training sessions over 2 weeks.

BACKGROUND: High-intensity interval training (HIIT) induces similar or even superior adaptations compared to continuous endurance training. Indeed, just 6 HIIT sessions over 2 weeks significantly improves maximal oxygen uptake (VO2max), submaximal exercise fat oxidation, and endurance performance. Whether even faster adaptations can be achieved with HIIT is not known. Thus, we aimed to determine whether 2 sessions of HIIT per day, separated by 3 h, every other day for 5 days (double HIIT (HIIT-D), n = 15) could increase VO2max, submaximal exercise fat oxidation, and endurance capacity as effectively as 6 sessions of HIIT over 2 weeks (single HIIT (HIIT-S), n = 13). METHODS: Each training session consisted of 10 × 60 s of cycling at 100% of VO2max interspersed with 75 s of low-intensity cycling at 60 watt (W). Pre- and post-training assessments included VO2max, time to exhaustion at ∼80% of VO2max, and 60-min cycling trials at ∼67% of VO2max. RESULTS: Similar increases (p < 0.05) in VO2max (HIIT-D: 7.7% vs. HIIT-S: 6.0%, p > 0.05) and endurance capacity (HIIT-D: 80.1% vs. HIIT-S: 79.2%, p > 0.05) were observed. Submaximal exercise carbohydrate oxidation was reduced in the 2 groups after exercise training (HIIT-D: 9.2%, p = 0.014 vs. HIIT-S: 18.8%, p = 0.012) while submaximal exercise fat oxidation was significantly increased in HIIT-D (15.5%, p = 0.048) but not in HIIT-S (9.3%, p = 0.290). CONCLUSION: Six HIIT sessions over 5 days was as effective in increasing VO2max and endurance capacity and was more effective in improving submaximal exercise fat oxidation than 6 HIIT sessions over 2 weeks.

The Effects of Transobturator Tape Surgery on Sexual Functions in Women With Stress Urinary Incontinence.

INTRODUCTION: Stress urinary incontinence (SUI) can adversely affect the patient's sexual function. AIM: To evaluate the sexual functions in women who underwent transobturator tape (TOT) surgery because of stress urinary incontinence and factors affecting the treatment results. METHODS: The study was conducted in 2 tertiary level clinics between 2013 and 2019 and included sexually active patients with a diagnosis of SUI who underwent TOT operation. The preoperative and postoperative (6 months after surgery) Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) scores of the patients were evaluated. The patients were evaluated according to the score changes of an increased score (benefited) and the same or lower score (did not benefit). The PISQ-12 questionnaire has 3 subdomains of behavioral-emotive (Q: 1-4), physical (Q: 5-9), and partner-related (Q: 10-12). Each question is scored from 0 to 4, giving a total ranging from 0 to 48. A higher PISQ-12 score indicates better sexual function. MAIN OUTCOME MEASURE: PISQ-12. RESULTS: The study included 117 patients with a median age of 52 years (range, 32-67 years), and 51.3% of the patients were postmenopausal. When the preoperative and postoperative PISQ-12 scores were evaluated in the whole group, there was a statistically significant improvement (from 24.66 to 26.52, P = .001). In the analysis of domains, there was a statistically significant improvement in physical score (from 11.68 to 13.53, P < .001), whereas behavioral-emotive and partner-related scores did not significantly change. In the multivariate analysis of menopausal status, parity and presence of diabetes mellitus were all independently and significantly associated with poor PISQ-12 outcome (OR: 2.60, 95% CI: 1.41-4.81, P = .002; OR: 1.59, 95% CI: 1.03-2.47, P = .034; and OR: 2.42, 95% CI: 1.28-4.58, P = .007, respectively). CONCLUSION: Both physical and psychological statuses should be taken into consideration when planning treatment in patients with urinary incontinence, and it should be noted that postsurgical sexual function status may not be positively affected in postmenopausal, multiparous, and diabetic patients. Kizilkan Y, Tohma YA, Senel S, et al. The Effects of Transobturator Tape Surgery on Sexual Functions in Women With Stress Urinary Incontinence. Sex Med 2020;8:777-782.

Effect of age on biochemical recurrence after radical prostatectomy.

The aim of the study was to evaluate the relationship between patient's age and biochemical recurrence (BCR) after radical retropubic prostatectomy (RRP). Data from RRP applied to 305 patients with clinically localized prostate cancer were included in the study. Patients were divided into the three age groups, < 60 years, 60-70 years, and > 70 years. The groups were compared regarding adverse pathological findings on RRP specimen, BCR, and biochemical recurrence-free survival (bRFS) rates. The rates of positive surgical margin, seminal vesicle invasion, lymph node involvement, RRP specimens' Gleason score, and BCR were not significantly different among the three age groups. bRFS rates were not different either. Nonorgan-confined disease and extracapsular extension (ECE) rates were significantly higher in the group of 60-70 years group than in the other two age groups. Factors associated with BCR in multivariate Cox regression analysis were ECE, seminal vesicle invasion, positive surgical margin, and RRP specimens' Gleason score of ≥ 4+3. Patient age and preoperative prostate specific antigen levels were not identified to be associated with BCR. Post-RRP nonorgan-confined disease and ECE are more frequently seen in patients of 60-70 years of age group than in other age groups. However, patient age is not an independent prognostic factor associated with bRFS.

Mouth Rinsing with Maltodextrin Solutions Fails to Improve Time Trial Endurance Cycling Performance in Recreational Athletes.

The carbohydrate (CHO) concentration of a mouth rinsing solution might influence the CHO sensing receptors in the mouth, with consequent activation of brain regions involved in reward, motivation and regulation of motor activity. The purpose of the present study was to examine the effects of maltodextrin mouth rinsing with different concentrations (3%, 6% and 12%) after an overnight fast on a 20 km cycling time trial performance. Nine recreationally active, healthy males (age: 24 ± 2 years; V ˙ O 2 m a x : 47 ± 5 mL·kg(-1)·min(-1)) participated in this study. A double-blind, placebo-controlled randomized study was conducted. Participants mouth-rinsed every 2.5 km for 5 s. Maltodextrin mouth rinse with concentrations of 3%, 6% or 12% did not change time to complete the time trial and power output compared to placebo (p > 0.05). Time trial completion times were 40.2 ± 4.0, 40.1 ± 3.9, 40.1 ± 4.4, and 39.3 ± 4.2 min and power output 205 ± 22, 206 ± 25, 210 ± 24, and 205 ± 23 W for placebo, 3%, 6%, and 12% maltodextrin conditions, respectively. Heart rate, lactate, glucose, and rating of perceived exertion did not differ between trials (p > 0.05). In conclusion, mouth rinsing with different maltodextrin concentrations after an overnight fast did not affect the physiological responses and performance during a 20 km cycling time trial in recreationally active males.

Association between pre-biopsy white blood cell count and prostate biopsy - related sepsis.

INTRODUCTION: Despite all preventive measures and improved biopsy techniques, serious, life-threatening complications of prostate biopsy, including sepsis, still exist. In the present study, in order to identify the risk factors that may be associated with sepsis development after prostate-biopsy, we aimed to analyze retrospectively the data of our patients who underwent transrectal ultrasound-guided prostate biopsy. MATERIAL AND METHODS: We retrospectively reviewed the data of 889 patients who underwent prostate biopsy at our clinic. We compared pre-biopsy parameters (age, prostate volume, white blood cell (WBC) count, fasting blood glucose, free and total prostate specific antigen levels) between patients who developed sepsis and those who were sepsis-free following prostate biopsy. RESULTS: 28 patients (3.1%) developed sepsis. Among the risk factors evaluated, only pre-biopsy WBC count was found to be a significant risk factor for biopsy-related sepsis. A 5.1 fold increase was detected in the risk for sepsis development, when the cut-off value of WBC was accepted as 11.165/µL, OR: 5.1 (95% CI: 2.3-11.5). The post-biopsy sepsis development rate in patients with pre-biopsy WBC count greater and less than 11.165/µL was 13.7% (n = 10) and 3% (n = 18) respectively. CONCLUSIONS: Patients with a pre-biopsy WBC count greater than 11.165/µL should be informed of the increased risk of developing post-biopsy sepsis.

Flurbiprofen alone and in combination with alfuzosin for the management of lower urinary tract symptoms.

INTRODUCTION: We aimed to investigate the effectiveness and safety of flurbiprofen, a non-steroidal anti-inflammatory drug with dual cyclooxygenase inhibition, and α-blocker alfuzosin, both alone and in combination with each other for lower urinary tract symptoms suggestive of benign prostatic obstruction (LUTS/BPO). MATERIAL AND METHODS: Ninety patients complaining of moderate-to-severe LUTS/BPO were randomly assigned into 3 groups (30 patients each) to receive alfuzosin XL 10 mg, or flurbiprofen SR 200 mg, or combination of alfuzosin XL 10 mg and flurbiprofen SR 200 mg, once daily for 4 weeks. Patients were evaluated using the international prostate symptom score (IPSS) (total and IPSSstorage, IPSSempty subscores), uroflow-metry (maximum (Qmax) and average (Qave) flow rates) and postvoid residual urine (PVR) both at baseline and following the drug therapy course. RESULTS: There was no difference among the 3 groups regarding age and baseline values of prostate volume, IPSS, IPSSstorage, IPSSempty, Qmax, Qave and PVR (P >0.05). IPSS, IPSSstorage, IPSSempty, and PVR decreased significantly in all the 3 groups after drug therapies (P <0.01). However, Qmax and Qave significantly improved only in the combination group (P <0.01). CONCLUSIONS: Addition of flurbiprofen increased the therapeutic effectiveness of alfuzosin by further improving symptoms in patients with LUTS/BPO. Combination therapy also improved urine flow compared to baseline. Monotherapy with flurbiprofen was not superior to alfuzosin.

Evaluation of biochemical recurrence-free survival after radical prostatectomy by cancer of the prostate risk assessment post-surgical (CAPRA-S) score.

BACKGROUND: The cancer of the prostate risk assessment (CAPRA) score has been defined to predict prostate cancer recurrence based on the pre-clinical data, then pathological data have also been incorporated. Thus, CAPRA post-surgical (CAPRA-S) score has been developed based on six criteria (prostate specific antigen (PSA) at diagnosis, pathological Gleason score, and information on surgical margin, seminal vesicle invasion, extracapsular extension and lymph node involvement) for the prediction of post-surgical recurrences. In the present study, biochemical recurrence (BCR)-free probabilities after open retropubic radical prostatectomy (RP) were evaluated by the CAPRA-S scoring system and its three-risk level model. MATERIALS AND METHODS: CAPRA-S scores (0-12) of our 240 radical prostatectomies performed between January 2000-May 2011 were calculated. Patients were distributed into CAPRA-S score groups and also into three-risk groups as low, intermediate and high. BCR-free probabilities were assessed and compared using Kaplan-Meier analysis and Cox proportional hazards regression. Ability of CAPRA-S in BCR detection was evaluated by concordance index (c-index). RESULTS: BCR was present in 41 of total 240 patients (17.1%) and the mean follow-up time was 51.7±33.0 months. Mean BCR-free survival time was 98.3 months (95% CI: 92.3-104.2). Of the patients in low, intermediate and high risk groups, 5.4%, 22.0% and 58.8% had BCR, respectively and the difference among the three groups was significant (P=0.0001). C-indices of CAPRA-S score and three-risk groups for detecting BCR-free probabilities in 5-yr were 0.87 and 0.81, respectively. CONCLUSIONS: Both CAPRA-S score and its three-risk level model well predicted BCR after RP with high c-index levels in our center. Therefore, it is a clinically reliable post-operative risk stratifier and disease recurrence predictor for prostate cancer.

Association between prostatic resistive index and cardiovascular risk factors in patients with benign prostatic hyperplasia.

We evaluated the relationship between prostatic resistive index (RI) and cardiovascular system (CVS) risk factors in patients with benign prostatic hyperplasia. The study included 120 patients who were attending our outpatient clinic with lower urinary tract symptoms related to benign prostatic hyperplasia. The clinical, laboratory, anthropometric data, and CVS risk factors (hypertension, diabetes mellitus, metabolic syndrome, history of CVS events, and smoking) of the patients were evaluated regarding the association between prostate RI level by regression analyses. The prostatic RI levels of the patients were measured using power Doppler imaging. In univariate regression analysis, there were statistically significant relationships between prostatic RI levels and the patients' age, International Prostate Symptom Score, hip circumference, fasting blood glucose, prostate specific antigen, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total prostate volume, uroflowmetric maximal flow rate, and all investigated CVS risk factors (p < 0.05). The prostatic RI levels were found to be associated with fasting blood glucose and total prostate volume, and also with CVS risk factors including only metabolic syndrome and cigarette smoking in the multivariate regression analysis. Our results showed that prostatic RI level is significantly related to metabolic syndrome and smoking among the investigated CVS risk factors.

Effects of medical therapy or surgery on prostatic and bladder resistive indices in patients with benign prostatic hyperplasia.

INTRODUCTION: The effects of medical therapy or surgery on bladder and prostatic resistive indices (RIs) in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) were evaluated in the present study. PATIENTS AND METHODS: A total of 124 consecutive LUTS/BPH patients who were candidates for medical therapy (alfuzosin 10 mg once daily, n=66) or surgery (transurethral prostatectomy (TUR-P), n=58) were prospectively included. Baseline assessment of patients was performed with the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), and prostatic and bladder RIs measured using power Doppler imaging (PDI). All patients were re-evaluated 3 months after treatment measuring the same parameters. RESULTS: Following medical therapy, mean IPSS (17.2±5.1 vs. 8.3±5.3, p=0.0001), postvoiding residual (PVR) urine (80.0±80.5 vs. 40.3±38.6, p=0.0001), and prostatic RI (0.73±0.1 vs. 0.70±0.1, p=0.0001) were decreased, Qmax (13.7±4.2 vs. 16.9±5.9, p=0.0001) was increased, and bladder RI remained unchanged (0.70±0.1 vs. 0.70±0.1, p=0.68). Mean IPSS (25.3±5.6 vs. 6.0±4.5, p=0.0001), PVR urine volume (134.5±115.5 vs. 35.7±25.9, p=0.0001), and prostatic (0.78±0.1 vs. 0.67±0.04, p=0.0001) and bladder RIs (0.72±0.1 vs. 0.64±0.04, p=0.005) were decreased, and Qmax (8.0±4.5 vs. 17.2±8.2, p=0.0001) was increased after TUR-P. CONCLUSIONS: Our results demonstrated that TUR-P decreased both prostatic and bladder RIs, while α-blocker therapy did not change bladder RI in the early posttreatment period in LUTS/BPH patients.

Metabolic syndrome prevalence in renal cell cancer patients.

PURPOSE: Renal cell carcinoma (RCC) is increasingly being recognized as a metabolic disease in recent studies. The aim of the present study was to identify the prevalence of metabolic syndrome (MetS) and its association with RCC among urologic patients. MATERIALS AND METHODS: The study included a total of 355 participants (117 adult RCC patients and 238 age matched controls) divided into groups, with and without MetS diagnosed using the criteria of the American Heart Association/The National Heart Lung and Blood Institute. Groups were compared statistically and logistic regression analysis was performed to investigate the impact of MetS criteria on RCC risk. RESULTS: Of the 117 RCC patients, 52 (44.4%) and of the 238 controls, 37 (15.5%) had MetS. A significant association (p<0.001) was found between the presence of MetS and RCC (OR: 4.35; 95% CI=2.62- 7.21). As the number of MetS components accumulated from 3 to 5, RCC risk increased likewise from 4 to 6 times. CONCLUSIONS: MetS is more prevalent in RCC patients in Turkey compared to controls. Risk increases with the number of coexisting MetS components.

Association of prostate volume with voiding impairment and deterioration in quality of life after prostate biopsy.

OBJECTIVE: To evaluate how voiding function and quality of life (QoL) were affected by transrectal ultrasound-guided prostate biopsy with respect to prostatic size and to determine whether there is a size-bothersomeness relationship. METHODS: Ninety-two patients who were candidates for prostate biopsy were included. Ten-core prostate biopsies were taken, and patients were followed up for 7 days. The international prostate symptom score, QoL, maximum urine flow rate (Q-max) and average urine flow rate, postvoid residual urine, and prostate volume (Vp) of the patients were recorded at baseline and on postbiopsy day 7. On receiver operating characteristics curve analysis, a Vp of 38.8 mL was found to be the best cutoff point for deterioration in QoL after biopsy. Then, patients were divided into 2 groups according to baseline Vp, as <38.8 mL and ≥38.8 mL, group 1 and 2, respectively. Baseline and postbiopsy values were compared. RESULTS: One patient in group 1 and 5 in group 2 developed acute urinary retention after biopsy, but the difference was not significant (P >.05). Only Vp and Q-max of group 1 (P <.001 and P = .035, respectively), but QoL (P = .002), international prostate symptom score, Q-max, Vp (P <.001 in all 3), and average urine flow rate (P = .006) of group 2 were significantly changed on postbiopsy day 7 compared with baseline. CONCLUSION: Patients with a Vp >38.8 mL were more prone to voiding difficulty and deterioration in QoL after biopsy. They should be informed about the likelihood of these complications.

Effects of conjugated linoleic acid supplementation and exercise on post-heparin lipoprotein lipase, butyrylcholinesterase, blood lipid profile and glucose metabolism in young men.

This study was designed to investigate the effects of conjugated linoleic acid (CLA) supplementation and endurance exercise training-induced changes on post-heparin lipoprotein lipase (PH-LPL) and butyrylcholinesterase (BChE) activities along with leptin, insulin and lipid levels in plasma by a randomized double blind experiment. Eighteen sedentary male volunteers were randomly divided into CLA and Placebo (PLC) supplementation groups. Both groups underwent daily supplementation of either 3g CLA or 3g placebo for 30 days, respectively, and performed exercise on a bicycle ergometer 3 times per week for 30-40 min at 50% VO2 peak workload. For plasma glucose, insulin and leptin levels and BChE activity fasting blood was used. For PH-LPL measurements, blood was collected 15 min after 50 IU/kg iv heparin injection. In all groups, there is a statistically significant decrease in BChE (p = 0.03, p = 0.02) and leptin (p = 0.002), insulin and HOMA-IR levels (p = 0.02). Exercise with or without CLA supplementation decreased insulin levels and increased insulin sensitivity. PH-LPL activity was increased significantly in both groups, displaying increased fatty acid mobilization. We conclude that though CLA supplementation and exercise can affect these parameters, CLA is not more effective than exercise alone. Hence, a prolonged supplementation regime may be more effective. Taken together in our small study group, our findings display that BChE is a potential marker for synthetic function of liver, fat metabolism, an obesity marker, a function long overlooked.

Impact of asymptomatic prostatitis on re-operations due to urethral stricture or bladder neck contracture developed after TUR-P.

PURPOSE: To evaluate the relationship between pathologically proven prostatic inflammation (PI) and re-operation rates due to urethral stricture (US) or bladder neck contracture (BNC) after transurethral resection of prostate (TUR-P). MATERIALS AND METHODS: We have retrospectively reviewed the data of 917 consecutive TUR-P cases. Eligible patients (n = 276) were grouped with respect to presence of PI on TUR-P pathology; Group1: PI (+) (n = 67, 24.3%), and Group2: PI (-) (n = 209, 75.7%). The "re-operation" was defined as internal urethrotomy or bladder neck resection performed for BNC or US. Groups were compared with respect to descriptive data and need for re-operation. Logistic regression analysis was performed to estimate the independent risk factors for the development of BNC and US. P values under 0.05 were considered significant. RESULTS: Of the patients, 38 (13.8%) needed re-operation while 238 (86.2%) did not. The re-operation rate in Group1 was significantly higher than Group2 (29.8 vs. 8.6%, P < 0.001). In logistic regression analysis, duration of initial TUR-P and PI were found to be independent risk factors for development of BNC or US after TUR-P. CONCLUSIONS: Prostatic inflammation on TUR-P pathology is an independent variable affecting the development of US or BNC. Our results should be supported by prospective studies including higher number of patients.

Impact of metabolic syndrome on erectile dysfunction and lower urinary tract symptoms in benign prostatic hyperplasia patients.

INTRODUCTION: The aim of this study was to investigate the relationship among metabolic syndrome (MetS), erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH). METHODS: Our study included 106 patients with BPH, 33 (31.1%) of whom had MetS. Blood pressures, waist circumferences, serum levels of fasting blood glucose, high density lipoprotein and triglyceride of patients were recorded. Erectile functions of the patients were evaluated by International Index of Erectile Function (IIEF). Patients were divided into two groups according to IIEF scores, namely 'mild/no ED' and 'moderate/severe ED'. IIEF scores of ED groups were between 17 and 30 and 6-16 in turn. LUTS severities were assessed by International Prostate Symptom Score (IPSS) and classified as mild (IPSS 0-7), moderate (IPSS 8-19) and severe (IPSS 20-35). RESULTS: There was a significant difference between ED groups concerning MetS presence (p=0.032). MetS presence was not found to be associated with the severity of LUTS (p=0.144). There was no correlation between ED groups regarding LUTS severity (p=0.303). CONCLUSION: Results of the present study showed a correlation between MetS presence and ED. In the light of our results, MetS seems to play an important role in the etiopathogenesis of ED in patients with BPH.