Impact of body mass index, age and varicocele on reproductive hormone profile from elderly men.

OBJECTIVES: To study the impact of obesity, age and varicocele on sexual hormones of adult and elderly men. MATERIALS AND METHODS: 875 men who were screened for prostate cancer were enrolled in this study. Data recorded comprised age, body mass index (BMI), serum levels of total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH) and follicular stimulating hormone (FSH). Patients were divided in groups according to their BMI in underweight, normal weight, overweight and obese grades 1, 2 or 3. First, it was studied the association between age, BMI, and hormone profile. Then, clinical varicocele was evaluated in 298 patients to assess its correlation to the others parameters. RESULTS: Obese patients had lower levels of TT, FT and SHBG (p<0.001) compared to underweight or normal weight patients. There were no differences in age (p=0.113), FSH serum levels (p=0.863) and LH serum levels (p=0.218) between obese and non-obese patients. Obese grade 3 had lower levels of TT and FT compared to obese grade 1 and 2 (p<0.05). There was no difference in the SHBG levels (p=0.120) among obese patients. There was no association between varicocele and BMI; and varicocele did not impact on testosterone or SHBG levels. CONCLUSIONS: Men with higher BMI have a lower serum level of TT, FT and SHBG. The presence of clinical varicocele as well as its grade has no impact on hormone profile in elderly men.

Impact of body mass index, age and varicocele on reproductive hormone profile from elderly men

ABSTRACT Objectives: To study the impact of obesity, age and varicocele on sexual hormones fof adult and elderly men. Materials and Methods: 875 men who were screened for prostate cancer were enrolled in this study. Data recorded comprised age, body mass index (BMI), serum levels of total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH) and follicular stimulating hormone (FSH). Patients were divided in groups according to their BMI in underweight, normal weight, overweight and obese grades 1, 2 or 3. First, it was studied the association between age, BMI, and hormone profile. Then, clinical varicocele was evaluated in 298 patients to assess its correlation to the others parameters. Results: Obese patients had lower levels of TT, FT and SHBG (p<0.001) compared to underweight or normal weight patients. There were no differences in age (p=0.113), FSH serum levels (p=0.863) and LH serum levels (p=0.218) between obese and non-obese patients. Obese grade 3 had lower levels of TT and FT compared to obese grade 1 and 2 (p<0.05). There was no difference in the SHBG levels (p=0.120) among obese patients. There was no association between varicocele and BMI; and varicocele did not impact on testosterone or SHBG levels. Conclusions: Men with higher BMI have a lower serum level of TT, FT and SHBG. The presence of clinical varicocele as well as its grade has no impact on hormone profile in elderly men.

Urodynamic pressure flow studies can predict the clinical outcome after transurethral prostatic resection.

PURPOSE: We evaluate whether urodynamic evaluation can determine preoperatively the clinical prognosis of patients treated with transurethral prostatic resection as measured by urinary symptom score and quality of life index. MATERIALS AND METHODS: A total of 253 patients who previously elected transurethral prostatic resection based on clinical symptoms completed the American Urological Association symptom score and quality of life index, and underwent urodynamic evaluation before and after operation. The patients were divided into 7 groups in accordance with detrusor pressure at maximum urinary flow rate. The preoperative and postoperative symptom score and quality of life index were analyzed in each group. RESULTS: Of the patients 42% were not obstructed and could not be distinguished from those who were obstructed preoperatively based on total urinary symptoms (p = 0.95) or subjective impression measured by the quality of life index (p = 0.96). The entire obstructed group demonstrated marked improvement compared to the nonobstructed group (p = 0.018). Analysis of severity also revealed a clear relationship with clinical outcome and subjective satisfaction with obstruction grade, that is the more severely obstructed cases had greater clinical benefit compared to those with little or no obstruction. Furthermore, the nonobstructed subjects did not show any clinical or subjective improvement after transurethral prostatic resection (p = 0.24). CONCLUSIONS: Urodynamic studies provide great predictive value of clinical improvement after prostatic relief but they also properly predict the poor clinical results in nonobstructed patients.

Sacral agenesis: why is it so frequently misdiagnosed?

Thirty-four patients with sacral agenesis were seen from 1954 to 1983, cases of meningomyelocele excluded. Five recognizable and consistent patterns of bone malformation were identified. Urodynamic examinations were done in 10 of the 34 patients. Their evaluation and response to treatment are analyzed; we tried to determine and establish the possible causes for its late diagnosis and consequences regarding the upper urinary tract.

Valvula de uretra posterior:tratamento perinatal. / Posterior urethral valve: perinatal treatment

Reportamos um caso de tratamento de valvula de uretra posterior, no qual novo acesso foi tentado com exito. O acesso proposto faculta o tratamento ja no periodo perinatal e prescinde de instrumental infantil. Foi feita uma vesicostomia como primeiro procedimento e, depois, a cauterizacao da valvula feita pelo orificio da mesma, quando a crianca estava com seis meses de vida. As vantagens do metodo sao discutidas

Transplante renal em criancas. / Renal transplantation in children

Os autores analisam experiencia com 73 transplantes renais realizados em 60 criancas com idade inferior a 15 anos, em um periodo de 16 anos. Trinta e sete estao vivos e com o aloenxerto funcionante.A sobrevida do enxerto foi de 79% no primeiro ano e 59% no decimo ano de seguimento, quando o rim era de doador vivo e 56% e 18%, quando de doador cadaver. A sobrevida do paciente foi de 94% no 1o. ano, 81% no 20, 64% no 5o. e 61% no 10o. ano, quando com rim de doador vivo, e 71% no primeiro, 33% no quinto e 25% no decimo, quando de doador cadaver. Complicacoes infecciosas foram vistas em 61% dos casos e as cirurgicas sem 23% dos pacientes. Crescimento ocorreu nas criancas transplantadas antes da idade de 10 anos. Concluem que a melhor terapeutica para a crianca uremica e o transplante renal

Tumor de testiculo em criancas: relato de tres casos. / Testicular tumor in children: report of 3 cases

Os tumores de testiculo em crianca sao uma patologia rara. Os autores apresentam 3 casos, todos tratados cirurgicamente, atraves de orquiectomia radical por via inguinal. Nao foi utilizada a radioterapia, nem a quimioterapia associada. Apos 3 anos de acompanhamento, dos 3 casos, nao se evidenciaram metastases, ou qualquer sinal de disseminacao

Nefrectomia subcapsular tardia em rim transplantado. / Late subcapsular nephrectomy of transplanted kidney

Foram estudados 17 pacientes com insuficiencia renal pos-transplante que necessitaram nefrectomia em periodo pos-operatorio tardio.Nesta condicao a nefrectomia apresenta em geral grande dificuldade devida a firmes aderencias que se desenvolvem entre o rim e as estruturas vizinhas, que aumentam sobremaneira a possibilidade de lesoes destas durante o ato operatorio. Entre as 17 nefrectomias tardias realizadas entre 1972 e 1979,cinco foram feitas pela classica via extracpsular e 12 pela via capsular descrita neste trabalho.Esta ultima mostrou-se em nossa experiencia ser mais pratica e de menor morbidade

Aspectos tecnicos da prostatectomia suprapubica. / Technical aspects of the suprapubic prostatectomy

Os autores discutem os aspectos tecnicos de cirurgia suprapubica da hipertrofia benigna da prostata, salientando as caracteristicas dos acessos transvesical e retropubico

Fistula renobronquica. / Renobronchial fistula

Os autores apresentam um caso de fistula renobronquica, secundaria a nefrolitotomia por calculo corafilorme em rim tuberculoso realizada em outro servico. Sao discutidos aspectos etiologicos, diagnostico e terapeutico, e apresentada uma revisao da literatura

Uretrotomia interna com faca fria sob visao direta. / Internal urethrotomy with cold knife under direct vision

Os autores apresentam 49 pacientes com estenose de uretra operados via transuretral atraves uretrotomia interna com faca fria. A tecnica cirurgica e descrita e os resultados apresentados (65% de bons resultados)