Is there an association between a high monocyte/high-density lipoprotein cholesterol ratio and recurrence of urethral stricture after internal urethrotomy?

INTRODUCTION: Internal urethrotomy (IU) has been the most commonly used procedure for the treatment of urethral strictures (US) since it was described by Scahse in 1974. Although simple to perform and associated with a short recovery time, the main disadvantage is the high recurrence rate of stenosis. At present, there are no markers available for the prediction of recurrence after IU. The aim of this study was to evaluate the correlation between MHR and recurrence rates. METHODS: The data of a total of 250 male patients who underwent IU for the first time for bulbar urethral stricture less than 2cm in our hospital between January 2011 and January 2019 were retrospectively analysed. The MHR was calculated as the ratio of monocytes to HDL-C. RESULTS: In all, 78 patients experienced a recurrence while the remaining 177 did not. The stricture recurrence rate was recorded as 31.2% at the 3-year follow-up. There was a statistically significant difference in stricture length and MHR (P=0.015 and 0.001 respectively). MHR was high in the recurrent group. As a result of the Chi-square test, the positive predictive values (PPV) and negative predictive values (NPV) were 65.3% and 89.7%, respectively. ROC analysis was used to determine the optimal cut-off value. The cut-off value was found to be 1.72. CONCLUSION: In our opinion, a high MHR may indicate the presence of immune inflammation and it can be used as a prognostic factor for stricture recurrence after IU.

Systemic Inflammatory Index: A Promising Non-Invasive Marker for the Prediction of Response to Neoadjuvant Chemotherapy prior to Cystectomy.

INTRODUCTION: The main challenge to the optimal use of neoadjuvant chemotherapy (NAC) is the difficulty in selecting patients who may or may not benefit from NAC. Our aim in this study was to investigate whether the Systemic Inflammatory Index (SII) predicts response to chemotherapy in patients who receive NAC prior to cystectomy. METHODS: We retrospectively analysed the data of patients who underwent NAC followed by cystectomy at our institution between January 2010 and September 2015 and whose 5-year follow-up was completed. All patients who underwent diagnostic biopsy with complete transurethral resection of bladder tumour at our hospital and whose pathology result was muscle-invasive transitional cell carcinoma were included in the study. At least 3 courses of gemcitabine/cisplatin NAC were given to all patients. A pathological response was defined as a reduction in cystectomy to a lower pathological stage after NAC. RESULTS: The SII was 320.8 ± 51 in the responders and 388.28 ± 50 in the non-responders. SII optimal cut-off of 350 was determined. The sensitivity and specificity of SII in predicting response were found to be 80% and 83%, respectively. Low SII (<350) was found to be a significant predictor of response compared with the other factors on multivariate analysis. The mean overall survival time was 55.4 months in patients with a low SII value and 40.3 months in the high SII group. CONCLUSION: SII, together with known clinicopathological factors and newer genetic and molecular markers, can be used to select patients for NAC.

Systemic Inflammatory Index: A Novel Biomarker for Predicting the Progression in Active Surveillance in Patients with Prostate Cancer.

OBJECTIVE: To investigate active surveillance (AS) for patients with prostate cancer to show the systemic inflammatory index (SII) progression and to evaluate whether SII will be an AS criterion in PCa patients. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Department of Urology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, from February 2015 to December 2021. METHODOLOGY: For active surveillance follow-up criteria, patients with prostate cancer who underwent AS with PSA <10 ng/ml, GS ≤6, clinical stage t1c-t2b, ≤2 core positive, and for each positive core had ≤50% tumour cells, were inducted and SII was determined. RESULTS: As a result of the univariate analysis, high SII values, number of cores involved, and length of the tumour in one core significantly affected progression (in order of p = 0.009, B = 1.830, Exp(B) = 6.233, CI [1.58-24.497]; p = 0.018, B = 0.682, Exp(B) = 1.978, CI [1.123-3.482]; p=0.006, B = 1.835, Exp(B) = 6.263 CI [1.692-23.181]). High SII values (>443.42) had better explanations for progression than the number of core involvement but were similar to the length of the tumour in one core. As a result of the multivariate analysis, high SII values (>443.42) and the tumour 's length in one core had similar effects on progression (in order of p = 0.011, B = 1.978, Exp(B) = 7.227, CI [1.570-33.269]; p = 0.009, B = 1.958, Exp(B) = 7.084, CI [1.642-30.555]). CONCLUSION: Th use of SII early in the course of treatment can help to identify which prostate cancer patients can be selected for active treatment instead of active surveillance, and to assess the probability of progression. KEY WORDS: Prostate cancer, Active surveillance, Systemic inflammatory index, Biomarker.

The effect of urinary tract infection on overall mortality in elderly male patients.

INTRODUCTION: Urinary tract infections are the most common bacterial infections in the older population.