Thiol/disulphide homeostasis levels in erectile dysfunction patients.

This study explored the use of thiol/disulphide homeostasis as a novel oxidative stress marker in patients with erectile dysfunction (ED). Fifty-five patients aged 40-57 were divided into two groups: Group I (International Index of Erectile Function [IIEF-5] score between 22 and 25, n = 20) and Group II (IIEF-5 score < 22, n = 35). Blood samples were used to evaluate hormone levels, lipid profile and thiol/disulphide levels. A novel, fully automated method measured plasma native thiol, total thiol and disulphide levels. Mean age, body mass index, total testosterone, HbA1c, triglyceride, atherogenic index (AIP) and total cholesterol levels did not significantly differ between Groups I and II (p > .05). IIEF-5 correlated weakly with native thiol level. Although non-statistically significant, native thiol (431 [SD: 105] µmol/L vs. 404 [110] µmol/L) and total thiol (426 [64] µmol/L vs. 41 [78] µmol/L) levels were lower in the ED group compared to the controls, and disulphide (14 [11] µmol/L vs. 18 [9] µmol/L) levels were higher. Mean disulphide/native thiol and mean disulphide/total thiol ratios did not statistically differ between groups. There was a weak positive correlation between AIP and total cholesterol/HDL and disulphide and disulphide/total thiol ratios. Thiol/disulphide haemostasis levels are not a single factor in ED pathophysiology but may contribute.

The use and efficacy of the American Urological Association Symptom Index in assessing the outcome of urethroplasty for post-traumatic complete posterior urethral strictures.

OBJECTIVE: To determine if the American Urological Association (AUA) Symptom Index is an accurate and reliable instrument for use in assessing the outcome after urethroplasty. PATIENTS AND METHODS: The AUA Symptom Index questionnaire was answered by 33 men (mean age 31.3 years) who underwent end-to-end urethral reconstruction after complete urethral disruption; the index was completed at a mean of 6 months after surgery. The scores were then correlated with maximum flow rates (Qmax) and presence of re-stenosis on retrograde urethrography. RESULTS: The initial mean (SD) AUA score was 10.42 (9.6) and the Qmax 22.12 (9.37) mL/s. Of the 33 patients, six (18%) had re-stenosis, with a mean score of 30 and Qmax of 6 mL/s. There was a significant inverse correlation between the AUA symptom score and Qmax (r = - 0.401, P < 0.05). CONCLUSION: The AUA Symptom Index is inversely correlated with Qmax and may indicate the presence of re-stenosis after urethroplasty. The AUA score can thus be used as a cost-effective and easy method in the first-line screening of the outcome of urethroplasty.

Effect of transurethral resection on serum free/total prostate-specific antigen levels in patients with benign prostatic hyperplasia.

OBJECTIVES: Transurethral resection of the prostate (TURP) can cause elevation of total serum prostate-specific antigen (PSA). However, the effect of these procedures on free PSA and percent free PSA is still unknown. The aim of this study was to investigate the effect of TURP on serum total PSA, free PSA, and free/total (f/t) PSA ratio in patients with benign prostatic hyperplasia (BPH) and to determine the reliability of f/t PSA ratio after such interventions. METHODS: Fifty-three patients with BPH who underwent TURP because of severe bladder outlet obstruction symptoms were included in this study. All patients underwent digital rectal examination and transrectal ultrasound (TRUS), and routine hematologic (complete blood count) and serum biochemical tests, urine analysis, and a peak urinary flow test were performed. Serum total PSA and free PSA levels were determined 1 hour before and 24 hours after TURP by using enzyme immunometric assay. Preoperative and postoperative free and total PSA and f/t PSA ratio were statistically compared. RESULTS: Although postoperative total PSA and free PSA increased significantly compared with preoperative values (P <0.001 and P = 0.024, respectively), the difference between preoperative and postoperative f/t PSA ratios was not statistically significant (P = 0.103). CONCLUSIONS: Finding no significant change in f/t PSA ratio, although there is a significant increase in the serum levels of total and free PSA, suggests to us that f/t PSA ratio may be a more reliable parameter in the early period after such interventions as TURP.