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.

Can the Stone Scoring Systems Be Used to Predict Infective Complications of Retrograde Intrarenal Surgery?

OBJECTIVE: We aimed to evaluate whether the retrograde intrarenal surgery (RIRS) scoring systems (Resorlu-Unsal Stone Score [RUSS], modified Seoul National University Renal Stone Complexity Score [modified S-ReCS], and R.I.R.S. score) can predict the infective complications after RIRS. SUBJECT AND METHODS: A total of 581 patients who underwent RIRS for kidney stones were included in the study. All patients were evaluated for demographic data, medical history, radiological imaging methods before surgery, duration of surgery, and hospitalization time after surgery. Stone laterality, stone burden, stone size, stone density, the number of stones, stone localization, the presence of congenital kidney anomaly, and solitary kidney were evaluated preoperatively by computed tomography. The RUSS and modified S-ReCS and R.I.R.S. score of all patients were determined. RESULTS: Infective complications were detected in 47 (8.1%) patients who underwent RIRS. Fever developed in 27 subjects (4.6%), urinary infection in 15 (2.5%), sepsis in 2 (0.3%), and septic shock in 3 (0.5%) patients. In multivariate logistic regression analysis, age (OR = 1.8; 95% CI = 1-3.4; p = 0.049), surgical duration of >60 min (OR = 1.9; 95% CI = 1.1-3.5; p = 0.027), and high R.I.R.S score (OR = 8.9; 95% CI = 1.9-42.4; p = 0.006) were shown to be independent risk factors for the infective complications after RIRS. A receiver operating characteristic curve analysis showed that the R.I.R.S. score can be used as a marker to predict infective complications (AUC = 0.619, CI = 0.55-0.69; p = 0.007). CONCLUSION: We suggest that the R.I.R.S. score can be used to predict infective complications in RIRS.

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.

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.

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.

Visceral adiposity index is useful for evaluating obesity effect on erectile dysfunction.

Studies show that erectile dysfunction (ED) is associated with obesity, and it has been shown that the possibility of developing sexual dysfunction in obese men is 30% higher compared to those with normal weight. Obesity is measured using various methods, for example waist circumference (WC) measurement or body mass index (BMI), but recently, visceral adiposity index (VAI) has also been utilised to better assess obesity and metabolic syndrome. In our study, the potential link between VAI and ED was investigated. The data of 176 patients who presented to the urology outpatient clinic with erection complaints were retrospectively screened. A control group was also established with 122 men without complaints of erectile dysfunction. The erectile functions of all participants were determined using the International Erectile Function Index-5 (IIEF-5) scoring. In addition, their serum fasting blood glucose, total testosterone (TT), triglyceride (TG), low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol levels were measured. The physical examination comprised the measurement of WC, height and weight, and BMI. The mean age of the participants was 58.7 ± 8.4 for the ED group and 57.1 ± 7.5 for the control group. The mean VAI was statistically significantly higher in the ED group (5.32 ± 2.77) compared to the control group (4.11 ± 1.93) (p < 0.001). Since VAI contains both physical and metabolic parameters, our findings suggest that it discloses the effects of WC, BMI, HDL and TG more clearly. VAI is considered useful for the assessment of the effect of obesity on ED patients.

Impact of overactive bladder on retrograde ejaculation.

PURPOSE: To evaluate the impact of overactive bladder disorder on patients diagnosed with retrograde ejaculation. MATERIALS AND METHODS: Retrospective analysis of prospective collected database made. Questionnaires conducted in urology polyclinics in five different centers. MAIN OUTCOME MEASURE(S): International Index of Erectile Function - 5 (IIEF - 5), Overactive Bladder 8 - Question Awareness Tool (OAB - V8), urodynamics, semen analysis. The participants of the study were n = 120 patients. There was retrograde ejaculation (RE) in only n = 47 patients (non / minimal symptomatic patients), n = 73 patients had RE and overactive (OAB) complaints (symptomatic patients) and received anticholinergic treatment (trospium), n = 37 control group patients who only had OAB and received an anticholinergic. RESULTS: While no difference was observed in overactive bladder examination and urodynamic values between the non / minimal symptomatic group and the symptomatic group (p > 0.05), sperm was detected and identified as fructose positive in post - ejaculation urine in the symptomatic group. Thus, it was possible to demonstrate the differences between symptomatic patients and non - symptomatic patients. Consequently, following three - month daily treatment with trospium 30 mg 2 x 1 in the control group and the symptomatic group, it was observed that an evident increase was observed in the sperm count and ejaculate volume in the symptomatic group and that no change was observed in the control group (p < 0.05). CONCLUSION: This clinical study is the first of its kind in terms of revealing the coexistence of RE with OAB upon performing urodynamics and showing that treatment is possible in selected patients.

Low serum melatonin levels are associated with erectile dysfunction

ABSTRACT Objective: Melatonin is a hormone secreted from the pineal gland and has anti-oxidative and anti-inflammatory effects. Oxidative stress is considered as an important factor in the etiology of erectile dysfunction (ED), and in many experimental models, positive results have been obtained with melatonin treatment. This study aimed to measure serum melatonin levels in ED patients and to investigate the possible relationship between ED and melatonin levels. Materials and Methods: Sixty-two patients diagnosed with mild, moderate or severe ED according to the five-item International Erectile Function Index (IIEF-5) and 22 healthy individuals were included in the study. The serum melatonin levels, anthropometric data, and other biochemical and hormonal parameters of all the subjects were recorded. Detailed anamnesis was also obtained in terms of diabetes, hypertension, cardiovascular diseases, smoking status, and alcohol use. Results: The serum melatonin level was found 34.2±13.3 ng/dL in the mild ED group, 33.3±14.7 ng/dL in the moderate ED group, 34.8±17.2 ng/dL in the severe ED group, and 44.6±16.5 ng/dL in the control group. The serum melatonin levels were significantly lower in all ED groups compared to the control group (p=0.019). There was no significant difference in the serum melatonin levels between the three ED groups. Diabetes, hypertension, cardiovascular diseases, smoking and alcohol use were not significantly different between the ED groups (p>0.05). Conclusion: We consider that if our findings are supported by further studies with larger populations, the measurement of the serum melatonin level may have a future role in the diagnosis and treatment of ED.

Low serum melatonin levels are associated with erectile dysfunction.

OBJECTIVE: Melatonin is a hormone secreted from the pineal gland and has anti-oxidative and anti-inflammatory effects. Oxidative stress is considered as an important factor in the etiology of erectile dysfunction (ED), and in many experimental models, positive results have been obtained with melatonin treatment. This study aimed to measure serum melatonin levels in ED patients and to investigate the possible relationship between ED and melatonin levels. MATERIALS AND METHODS: Sixty-two patients diagnosed with mild, moderate or severe ED according to the five-item International Erectile Function Index (IIEF-5) and 22 healthy individuals were included in the study. The serum melatonin levels, anthropometric data, and other biochemical and hormonal parameters of all the subjects were recorded. Detailed anamnesis was also obtained in terms of diabetes, hypertension, cardiovascular diseases, smoking status, and alcohol use. RESULTS: The serum melatonin level was found 34.2±13.3 ng/dL in the mild ED group, 33.3±14.7 ng/dL in the moderate ED group, 34.8±17.2 ng/dL in the severe ED group, and 44.6±16.5 ng/dL in the control group. The serum melatonin levels were significantly lower in all ED groups compared to the control group (p=0.019). There was no significant difference in the serum melatonin levels between the three ED groups. Diabetes, hypertension, cardiovascular diseases, smoking and alcohol use were not significantly different between the ED groups (p>0.05). CONCLUSION: We consider that if our findings are supported by further studies with larger populations, the measurement of the serum melatonin level may have a future role in the diagnosis and treatment of ED.

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.

Safety and Efficacy of Bipolar Versus Monopolar Transurethral Resection of the Prostate: A Comparative Study.

PURPOSE: Transurethral resection of the prostate (TURP) is considered gold standard for surgical treatment of benign prostatic hyperplasia (BPH). In this study, we aimed to compare post-operative clinical outcomes and adverse effects between monopolar and bipolar TURPs. MATERIALS AND METHODS: The study included 590 patients who underwent TURP by a single urologist (E.H.) between June 2006 and June 2014 with a diagnosis of BPH. Patients were divided into two groups as monopolar TURP (group 1, n = 300) and bipolar TURP (group 2, n = 290). Patients receiving oral anticoagulants or aspirin and those with prostate cancer diagnosis were not included in the study. Data regarding pre-operative age, International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), post voiding residual urine volume (PVR), serum prostate specific antigen (PSA) levels and prostate volume (Vp) of the patients were gathered from medical records. Groups were compared in terms of catheterization, operation time, hemoglobin (Hb) decrease, and IPSS, Qmax, and PVR values at post-operative 12th month follow-up visit. RESULTS: From pre-operative to post-operative period, IPSS, Qmax and PVR showed significant improvements within both groups (P < .001). When groups were compared with each other, bipolar TURP group had significantly lesser catheterization time and hemoglobin decrease than monopolar TURP group, while no significant differences were detected regarding all other variables. CONCLUSION: Bipolar and monopolar TURPs are both effective and safe treatment modality for BPH. Bipolar TURP is superior to conventional monopolar TURP in terms of catheterization time and Hb decrease.

Intravesical migration of intrauterine device mimicking bladder stone on radiologic imaging: a case report.

Due to its high cost-effectiveness, intrauterine device (IUD) is one of the widely used contraception methods worldwide. Intravesical migration of an IUD via perforation of the uterus and bladder is very rare. Endoscopic approach is recommended in the treatment, but open surgery may also be needed rarely. In this report, we present the case of a 37-year-old female who was misdiagnosed radiologically with bladder stone, but later on, it was understood that an IUD migrated to the bladder and resulted in stone formation. Laser lithotripsy was performed, and the migrated IUD was unearthed. Removal of the IUD with cystoscopic forceps was unsuccessful. Postoperative pelvic computed tomography revealed that a part of the IUD was outside the bladder. At the next operation session, laparoscopic removal of the IUD was applied. The patient was followed up for 5 days with a Foley catheter and discharged after performing cystography, assuring us that the bladder contours were normal.

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.