ON THE ISSUE OF NECESSITY TO PERFORM THE DR-70 IMMUNOASSAY PRIOR TO PROSTATE BIOPSY IN PATIENTS WITH HIGH PROSTATE SPECIFIC ANTIGEN LEVEL AND ITS EFFICACY IN PREDICTING THE BIOPSY RESULTS.

The aim is to discuss the contribution of the DR-70 for the patients with high PSA level and which cutofflevel of DR-70 must be consideredthe biopsy decision. 93 patients with high prostate specific antigen level were enrolled into the study. Before the prostate biopsy, total PSA (tPSA), free PSA (fPSA), free/total PSA rate (f/tPSA), PSA density (PSAD) and DR-70 levels were recorded. The patients were divided into two groups according to the pathological outcome of benign (G1) or malignant (G2). G1 and G2 were compared with Mann-Whitney U test, Spearman's rho and ROC curve for analysis. The significance level is taken as .05 for all tests. The median age of patients in G1 and G2 was 62.52 and 68.22 years, respectively. The mean PV in G1 and G2 were 52.16 and 39.6 mL, respectively. The mean tPSA, PSAD and DR-70 levels in G1 and G2 were found as 7.19 and 18.74 ng/mL, 0.14 and 0.48 ng/mL/cc and 0.44 and 0.5 µg/mL, respectively. The mean age of the patients in G2 was statistically significantly higher than G1 (p=.001).The mean PV of the patients in G2 was statistically significantly lower than G1 (p=.001).The mean PSAD of the patients in G2 was statistically significantly higher than G1 (p=.001). There was no statistically significant difference on DR-70 levelsbetween G1 and G2 (p=.38). In Spearman's rhocorrelationanalysis, there was nostatistically significant relationships between DR-70 levels and pathology results in G2 (p=.24). ROC curve of tPSA, fPSA, f/tPSA, PSAD and DR-70 levelswere evaluated. ROC curve of PSAD shows a fair discriminant power with AUC = 0.71 (95% CI: 0.607-0.828) for differentiation between PCa and benign tissue in prostate biopsy with moderate specificity and high sensitivity (62.5% and 75.7%, resp., cut-off level: 0.1377 ng/mL). Contrary to literature and guidelines, cutoff level of PSAD as 0.13ng/mL/cc should be kept in mind and accordingly, a biopsy decision should be made. We think that DR-70 is no needed for additional evaluation before prostate biopsy.

The effect of varicocoelectomy on the relationship of oxidative stress in peripheral and internal spermatic vein with semen parameters.

The aim of this prospective controlled study was to investigate the levels of reactive oxygen species (ROS), including asymmetric dimethylarginine (ADMA), oxidative stress index (OSI) and total oxidant capacity (TOC), and antioxidants with total antioxidant capacity (TAC) in peripheral and internal spermatic veins blood, the relationship of these factors with sperm parameters in the infertile varicocoele patients, and the amelioration effect of varicocoelectomy on these outcomes. Thirty-one primary infertile varicocoele patients and 31 fertile control patients evaluated for determining the levels of ADMA, TOC, OSI, superoxide dismutase (SOD), glutathione (GSH), TAC, and semen analysis. The patients' preoperative SOD, GSH and TAC levels, which were significantly lower than the controls, significantly increased postoperatively. Although SOD and GSH were significantly higher in spermatic vein compared to median cubital vein, TAC was significantly higher in median cubital vein. ADMA, TOC and OSI were significantly higher in the patient group. TOC and OSI were significantly higher in spermatic vein compared to median cubital vein. Postoperative TOC, OSI and ADMA reduced to the control levels. Total antioxidant capacity in the peripheral circulation and oxidative stress index in the internal spermatic vein could give an idea about the possible improvement in sperm count acquired by varicocoelectomy.

Comparación de los resultados después de flouroquinolonas y terapias de combinación en prostatitis crónica tipo IIIA / Comparison of results after flouroquinolons and combination therapies in type IIIA chronic prostatitis

Propósito: Se investigaron retrospectivamente los resultados clínicos de los pacientes con prostatitis crónica inflamatoria tipo III, que fueron tratados con fluoroquinolonas con y sin un bloqueador alfa entre 2009 y 2011. Material y métodos: Se estableció el diagnóstico con la historia médica (síntomas presentados durante más de 3 meses dentro de los 6 meses previos), examen físico, examen de Meares-Stamey y el cuestionario de la NIH-CPSI. Las respuestas al tratamiento fueron evaluadas con la prueba de uroflujometría y el cuestionario de la NIH-CPSI al principio y después de 4 semanas de tratamiento. Los pacientes con datos y tratamiento incompletos y que fueron tratados con bloqueadores alfa y/o antibióticos en el período de 4 semanas antes de la terapia iniciada en nuestra clínica, y que tuvieron una cirugía del tracto urinario inferior anteriormente, fueron excluidos. Los pacientes se clasificaron en 6 grupos: grupo 1 = ciprofloxacino; grupo 2 = ofloxacino; grupo 3 = levofloxacino; grupo 4 = ciprofloxacino + tamsulosina, grupo 5 = ofloxacino + tamsulosina; y grupo 6 = levofloxacino + tamsulosina. Se utilizaron las pruebas Wilcoxon Signed Ranks y Kruskal Wallis para la comparación de los resultados. Se utilizó la prueba U de Mann Whitney con corrección de Bonferroni realizada como post hoc (p < 0,05). Resultados: Las puntuaciones medias de la NIH-CPSI disminuyeron significativamente en todos los grupos (p < 0,05). Levofloxacino redujo las puntuaciones medianas totales de NIH-CPSI más que las monoterapias con ciprofloxacino y ofloxacino. Las terapias de combinación eran mejores que las terapias con solo antibióticos y se obtuvo un mejor resultado en la combinación de levofloxacino + tamsulosina. Conclusión: Las combinaciones de tamsulosina + fluoroquinolona (en especial tamsulosina + levofloxacino) dieron mejores resultados en ambas puntuaciones NIH-CPSI y tasas de flujo máximo (AU)

Purpose: We investigated retrospectively the clinical outcomes of the patients with type III inflammatory chronic prostatitis, who were treated with fluoroquinolones with and without an α-blocker between 2009 and 2011. Material and methods: Diagnosis was established with medical history (symptoms presented longer than 3 months within previous 6 months), physical examination, Meares-Stamey test and the questionnaire of the NIH-CPSI. The responses to the treatment were assessed with uroflowmetry test and the questionnaire of NIH-CPSI at initial and after 4 weeks of the treatment. The patients with incomplete data and treatment and who treated with α-blockers and/or antibiotics in the period 4 weeks prior to the therapy started in our clinic and had any surgery of lower urinary tract previously were excluded. The patients were classified under 6 groups: group1 = ciprofloxacin, group2 = ofloxacin, group3 = levofloxacin, group4 = ciprofloxacin + tamsulosin, group5 = ofloxacin+tamsulosin, group 6 = levofloxacin + tamsulosin. Wilcoxon Signed Ranks and Kruskal Wallis test were used for comparison of results. Mann Whitney U test with Bonferroni correction made was used as post hoc (p < 0.05). Results: The median scores of NIH-CPSI decreased significantly in all groups (p < 0.05). Levofloxacin reduced the median total scores of NIH-CPSI more than ciprofloxacin and ofloxacin monotherapies. The combination therapies were better than antibiotic therapies alone and best result was obtained in levofloxacin + tamsulosin combination. Conclusion: Tamsulosin + fluoroquinolone (especially tamsulosin + levofloxacin) combinations yielded better results in both NIH-CPSI scores and peak flow rates (AU)

Comparison of results after fluoroquinolones and combination therapies in type IIIA chronic prostatitis.

PURPOSE: We investigated retrospectively the clinical outcomes of the patients with type iii inflammatory chronic prostatitis, who were treated with fluoroquinolones with and without an α-blocker between 2009-2011. MATERIAL AND METHODS: Diagnosis was established with medical history (symptoms presented longer than 3 months within previous 6 months), physical examination, Meares-Stamey test and the questionnaire of the NIH-CPSI. The responses to the treatment were assessed with uroflowmetry test and the questionnaire of NIH-CPSI at initial and after 4 weeks of the treatment. The patients with incomplete data and treatment and who treated with α-blockers and/or antibiotics in the period 4 weeks prior to the therapy started in our clinic and had any surgery of lower urinary tract previously were excluded. The patients were classified under 6 groups; group1=ciprofloxacin, group2=ofloxacin, group3=levofloxacin, group4=ciprofloxacin+tamsulosin, group5=ofloxacin+tamsulosin, group 6=levofloxacin+tamsulosin. Wilcoxon Signed Ranks and Kruskal Wallis test were used for comparison of results. Mann Whitney U test with Bonferroni correction made was used as posthoc (P<.05). RESULTS: The median scores of NIH-CPSI decreased significantly in all groups (P<.05). Levofloxacin reduced the median total scores of NIH-CPSI more than ciprofloxacin and ofloxacin monotherapies. The combination therapies were better than antibiotic therapies alone and best result was obtained in levofloxacin+tamsulosin combination. CONCLUSION: Tamsulosin+fluoroquinolone (especially tamsulosin+levofloxacin) combinations yielded better results in both NIH-CPSI scores and peak flow rates.