Impact of stress urinary incontinence on female sexual activity.

OBJECTIVE: The study aimed to investigate the impact of SUI (Stress Urinary Incontinence) on the sexual activity of women, to assess their sexual functioning, and to show the extent of the problem that SUI poses to the quality of life of women. PATIENTS AND METHODS: The study involved 70 women aged 20-48 years. The inclusion criteria included the presence of stress urinary incontinence, the sexual activity of the women, and the history of no urogynecological intervention. The authorial questionnaire and the Polish version of the Female Sexual Function Index (FSFI) were used. RESULTS: SUI contributes to reducing the frequency of intercourse and even complete resignation from sexual intercourse. There is a correlation between the occurrence of urinary leakage during intercourse and the occurrence of sexual dysfunction (p=0.023). The most common factors limiting sexual activity are decreased libido, fatigue, lack of desire, and lack of body acceptance. However, age (p=0.070), marital status (p=0.091), Body Mass Index (BMI) (p=0.436), as well as the duration of stress urinary incontinence (p=0.36) have no effect on women's sexual activity. The most common ways of dealing with the loss of urine during intercourse include micturition before intercourse, intercourse only in safe places, restriction of physical activity during intercourse, and reduction of intercourse frequency and duration. CONCLUSIONS: SUI in women has a significant effect on their sexual activity. The cause of this state of affairs is multifactorial. Some women try to cope with the problem and have developed a number of strategies that allow them to be sexually active without unpleasant surprises.

Evaluation of the prognostic value of LMR, PLR, NLR, and dNLR in urothelial bladder cancer patients treated with radical cystectomy.

OBJECTIVE: Our aim was to evaluate the association between preoperative LMR, PLR, NLR, dNLR, and survival of urothelial bladder cancer (UBC) patients treated with radical cystectomy (RC). We also analyzed the relationship between preoperative blood-based inflammatory biomarkers' levels and postoperative in-hospital complications. PATIENTS AND METHODS: This retrospective study included 144 UBC patients, who underwent RC between 2003 and 2015. The study endpoints were cancer-specific survival (CSS) and overall survival (OS). RESULTS: Univariable analysis revealed that continuous LMR, PLR, NLR and dNLR were significantly associated with CSS and OS. On multivariable regression model analysis, continuous LMR, NLR, and dNLR independently predicted both endpoints. Furthermore, the group of patients with lower LMR values had a greater chance of developing postoperative in-hospital complications. CONCLUSIONS: Our findings indicate that the cheap and simple blood-based biomarkers may be valuable in identifying UBC patients treated with RC, who are at higher risk of all-cause and cancer-related mortality.

The comparison of laparoscopic and microsurgical varicocoelectomy in infertile men with varicocoele on paternity rate 12 months after surgery: a prospective randomized controlled trial.

The best surgical approach for varicocoelectomy is still unknown, however more and more physicians favour subinguinal microsurgery. The aim of this study was to find whether microsurgical approach is superior to laparoscopic varicocoelectomy in terms of pregnancy rate, fertility potential, endocrinological function of the testis, erectile dysfunction and testicle volume increase. It was a prospective, non-masked, parallel-group randomized controlled trial with one to one allocation. It was conducted at authors' institution and designed as per protocol study. From 2012 till 2015 84 patients were randomly allocated to two groups. First group consisted of 42 patients who underwent laparoscopic varicocoelectomy, whereas patients from the second group underwent microsurgical varicocoelectomy. The indications for varicocoelectomy consisted of infertility >1 year, palpable left-sided varicocoele and at least one impaired semen parameter (sperm concentration <15 mln/mL; total motility<40%; progressive motility <32%, vitality <58% or normal morphology <4%). The primary goal was to show superiority of microsurgical varicocoelectomy over laparoscopic varicocoelectomy in terms of pregnancy rate. The secondary endpoints comprised assessment of sperm parameters in three-month intervals after intervention until one year. Other points included, LH, FSH and testosterone levels as well as testicle volume and International Index of Erectile Function. From each group five patients were lost during the follow-up period. The primary endpoint was not achieved - pregnancy rate in first and second group was 29.7% and 40.5% respectively (p = 0.34). Analysis of the sperm parameters after surgery revealed significant statistical difference in total motility, progressive motility and morphology in favour of microsurgical approach. Both methods showed improvement in all sperm parameters. There were no differences in hormonal levels as well as in erectile function and testicle volume between groups. Small number of patients in both groups are the main limitation of our study.

An inherited NBN mutation is associated with poor prognosis prostate cancer.

BACKGROUND: To establish the contribution of eight founder alleles in three DNA damage repair genes (BRCA1, CHEK2 and NBS1) to prostate cancer in Poland, and to measure the impact of these variants on survival among patients. METHODS: Three thousand seven hundred fifty men with prostate cancer and 3956 cancer-free controls were genotyped for three founder alleles in BRCA1 (5382insC, 4153delA, C61G), four alleles in CHEK2 (1100delC, IVS2+1G>A, del5395, I157T), and one allele in NBS1 (657del5). RESULTS: The NBS1 mutation was detected in 53 of 3750 unselected cases compared with 23 of 3956 (0.6%) controls (odds ratio (OR)=2.5; P=0.0003). A CHEK2 mutation was seen in 383 (10.2%) unselected cases and in 228 (5.8%) controls (OR=1.9; P<0.0001). Mutation of BRCA1 (three mutations combined) was not associated with the risk of prostate cancer (OR=0.9; P=0.8). In a subgroup analysis, the 4153delA mutation was associated with early-onset (age ≤ 60 years) prostate cancer (OR=20.3, P=0.004). The mean follow-up was 54 months. Mortality was significantly worse for carriers of a NBS1 mutation than for non-carriers (HR=1.85; P=0.008). The 5-year survival for men with an NBS1 mutation was 49%, compared with 72% for mutation-negative cases. CONCLUSION: A mutation in NBS1 predisposes to aggressive prostate cancer. These data are relevant to the prospect of adapting personalised medicine to prostate cancer prevention and treatment.