HALP score and albumin levels in men with prostate cancer and benign prostate hyperplasia.

AIMS: To evaluate the diagnostic significance of the novel index combining preoperative haemoglobin, albumin levels, lymphocyte and platelet counts (HALP) in prostate cancer (PCa) patients. METHODS: Between 1 January 2015 to 31 December 2018 at the Hitit University Erol Olçok Education and Research Hospital 225 patients who had undergone transrectal ultrasound guided prostate biopsy or prostate surgery were analysed retrospectively. A total of patients, 155 had benign prostate hyperplasia (group 1) and 70 had PCa (group 2). The preoperative serum levels of haemoglobin, albumin, lymphocyte counts and platelet counts were recorded. The HALP scores and the sub-parameters of this index for each of the two groups were compared. RESULTS: The total Prostate-Specific Antigen (PSA), albumin and lymphocyte differences between the groups were statistically significant (P = 0.0002, P = 0.0001, P = 0.005). The median value of HALP scores in Group 1 and 2 were 49.43 and 51.2, respectively, and this was not statistically significant between groups (P =0 .737). The HALP score had the least Area Under Curve (AUC) value compared with the others (0.514). The AUC of Albumin was larger than PSA for diagnostic efficacy in PCa patients (0.696-0.656). However, albumin levels were statistically significant compared with platelet count and the HALP score (P = 0.0033, P = 0.0068), except PSA and lymphocyte (P = 0.4580, P =0 .1717). CONCLUSION: Further prospective clinical studies that include more patients from multiple centres are needed to show the diagnostic role of the HALP score and its compounds on the patients with PCa.

C-reactive protein and procalcitonin levels in prostate cancer.

AIM: Prostate cancer (PCa) is one of the most common cancers among men in the world. Prostate-specific antigen is the most used biomarker for PCa diagnosis. In this study, we aimed to measure the procalcitonin (PCT) and C-reactive protein (CRP) levels in patients with PCa. METHODS: The patients who underwent transrectal prostate biopsy and transurethral prostate surgery in the last 4 years were included in the study. The patients were divided into two groups according to the pathology reports, group1; benign prostate hyperplasia and group2; prostate cancer. MedCalc Statistical Software version 17.6 was used for statistical analyses. RESULTS: The current study includes 149 patients. There were 118 patients in group 1 and 31 patients in group 2. The mean age of the patients was 66.85 and 69.41 years in groups respectively. Serum CRP and PCT levels were 3.33 and 0.01 in group 4.07 and 0.04 in group 2. Serum PCT levels were significantly higher in patients with PCa. CONCLUSION: We found that the elevated procalcitonin level was associated with prostate cancer. Further studies are needed to define the relationship between procalcitonin and prostate cancer.

Awareness of prostate cancer diagnosis and management among Turkish males: a cross sectional study from Çorum.

Introduction: Prostate cancer is the most common malignancy among men in the United States and the second most common cancer in Turkey. The incidence of prostate cancer is increasing in industrialized countries.Aim: The aim of the study was to assess the knowledge about prostate cancer, its diagnosis, and treatment among patients with lower urinary tract symptoms.Methods: This study was performed from January to April 2015 with the patients applied to our clinic. A questionnaire that includes 10 questions was administered to the participants.Results: One hundred fifty-nine participants were included in this study. The participants' ages were between 40 and 82 with a mean age of 61.5 ± 7.9 years. Patient awareness of prostate biopsy and prostate cancer were 21.37 and 71.06%. The main origin awareness of PSA testing is family and friends. On the other hand, if the doctor advises acout prostate biopsy, 47.16% of the patients would accept and 11.31% of them would refuse this invasive procedure.Conclusion: Prostate cancer is one of the important health-related problem among men in the world. Additional researches are needed to investigate the knowledge of prostate cancer among men and the Ministry of Health may take preventive methods to increase the cancer knowledge level of people.

Does plasma thiol and disulphide be a new marker for prostate cancer in prostate-specific antigen level between 10 and 20 ng/ml?

INTRODUCTION: We aimed to evaluate plasma thiol and disulphide levels as an additional marker to prostate specific antigen (PSA) in the diagnosis of prostate cancer (PCa). METHODS: Between March 2017 and January 2018 prospective study was conducted among patients with PSA levels of 2.5-20 ng/mL without suspicion of malignancy in rectal examination and who underwent prostate needle biopsy. Patients were divided into two groups according to PSA level as 2.5-10 ng/mL (Group 1) and 10.01-20 ng/mL (Group 2). Diagnostic efficacy of thiol, disulphide and PSA levels were measured by ROC analysis. RESULTS: A total of 76 patients were included in the study. There were 49 patients in group 1 and 27 patients in group 2. There was no significant difference between two groups in terms of PSA density and prostate size. In Group 1, area under curve (AUC) was higher in PSA than other parameters with statistically significant difference (p<.05). In group 2, AUC of native and total thiol was higher than PSA but there was no statistically significant difference for AUC in parameters. CONCLUSIONS: We think that plasma thiol test may be used in diagnosis of prostate cancer while PSA levels between 10 to 20 ng/mL. However, further studies are required.

Clinical features and outcomes of COVID-19 patients with benign prostatic hyperplasia in ageing male: A retrospective study of 18 cases.

AIM: A worldwide pandemic of coronavirus disease 2019 (COVID-19) which emerged in China in December 2019 affects the world very seriously. We aimed to evaluate the benign prostatic hyperplasia (BPH) patients who were admitted and treated to our hospital due to COVID-19. METHODS: Between March 18, 2020 and April 5, 2020, 18 patients admitted with COVID-19 who has BPH and are using medication for this were included in the study and analysed retrospectively. Diagnosis was confirmed by COVID-19 nucleic acid test by sampling sputum or nasopharyngeal swab. Standard COVID-19 treatment protocol determined by our Ministry of Health was applied to all patients according to their risk groups. Epidemiological, clinical, radiological features, additional diseases, laboratory tests, complications and outcome data of all patients were recorded. RESULTS: Mean age of patients was 59.6 (range: 56-73). As the mode of transmission, 10 (55.5%) of patients were infected in hospital, 5 (27.7%) patients had a relative with COVID-19 and three (16.6%) was unknown. During follow-up, 2 (11.1%) patients were transferred to intensive care unit (ICU). One of these patients dramatically progressed and died. Patients who survived and were not transferred to ICU had lesser comorbidities and were relatively young. Mean duration of hospitalisation was 14.2 days (range 12-19). CONCLUSION: We think that COVID-19 patients with BPH had a low mortality rate and did not have a poor prognosis in this patient group. It is crucial to take comprehensive preventive measures to control COVID-19 transmission via hospital route.

[Silk suture granuloma after high orchiectomy].

Suture granuloma is very rare complication of surgical procedures developing from the non-absorbable sutures. The development of suture granuloma is a chronic process and includes multinucleated giant cell formation. It has two step process including the initial reaction of tissue inflicted the passage of the needle and specific inflammatory reaction of the suture material. There is no pathognomonic imaging modality fort he diagnosis of suture granuloma. Surgery is used to for the diagnosis and eradication of the inflammation. A 59 year old man presented with 3*2 cm sized palpable, firm painless nodular mass in the right scrotum. The patient was treated with high orchiectomy before 3 weeks. The mass was excised and reported as silk suture granuloma.

Obesity is Associated with Upgrading in Prostate Cancers.

BACKGROUND: Prostate cancer (PCa) is the second most common cancer and sixth most common cause of cancer associated death among men in the world. Multiple studies demonstrated the relationship between obesity and PCa in the recent years. AIM: The present study aimed to investigate the impact of obesity on postoperative oncological results after radical prostatectomy. MATERIALS AND METHODS: A total of 110 patients who were treated radical prostatectomy between January 2011 and April 2016 were analyzed retrospectively. The patients who had information about age, height, weight, biopsy results, PSA level and pathological results were recorded. The patients were classified to three groups according to the BMI; normal (BMI<25 kg/m2), overweight (BMI>25 and <30 kg/m2) and obese (BMI>30 kg/m2). RESULTS: The present study included 101 patients. Of these patients; 26, 57 and 18 patients were in groups respectively. The age at the presentation and PSA level was lower and higher than the other patients. The proportion of locally advanced disease and high grade PCa were the highest in obese patients at prostatectomy specimen examination. The upgrading is significantly associated with obesity. CONCLUSION: This study demonstrated that obese men are younger and had higher PSA concentration at the diagnosis of PCa. High grade PCa, locally advanced disease and upgrading was seen much more in patients with BMI>30 kg/m2 at final pathology. The difference reached significance for upgrading between groups.

[Comparison of the International Prostate and Visual Prostate Symptom Scores in Turkish patients].

INTRODUCTION: Benign prostate hyperplasia is one of the most common disease in elderly men. The patients usually present lower urinary tract symptoms including frequency, urgency, nocturia and interittancy. The prostate symptom scores are usually used for daily urology practice. We aimed to compare the International Prostate Symptom Score and Visual Prostate Symptom Score in Turkish patients. METHOD: The study protocol was conducted from from February to August 2017. The patients presenting with lower urinary tract symptoms over the age of 45 years were included. The age, prostate specific antigen level, education level and symptom scores were recorded. The patients with history of neurological disease, prostatic surgery, radiotherapy and any malignancy were excluded. RESULTS: There were 81 patients in the current study. The mean age and PSA level was 58.86+/-7.39 years and 1,94+/-1,77 ng/ml. Most of the patients (54.32%) had primary level of education and the patients who were graduated from university (19.75%) followed. The secondary and high school level was 12.34% and 13.58% respectively. The fully complete rate of the symptom scores 37% for IPSS and 9.8% for VPSS and 81% for CSS (p<0.05). In the patients with fully complete; there was no significant difference for patients education level and age. CONCLUSIONS: The IPSS and VPSS are established symtom scores for patients with benign prostate hyperplasia. The difficulties to understand and translate problems of these questionnaires; new, mother language originated symptom score is needed for Turkish patients.

[Bladder stone secondary to prolene suture after gynecologic surgery].

Bladder stones are usually seen among patients with bladder outlet obstruction, especially in men over the age of 50 years. There are several risk factors for bladder stones, including urinary tract infections, abnormal urinary tract system anatomy, and presence of foreign bodies. In addition, migrating intrauterine contraceptive devices through the wall of the urinary bladder and foreign bodies such as surgical sutures may act as a nidus for developing stone formation. Here in, we report a case of bladder stone associated with surgical non-absorbable suture, used for gynecologic surgery 4 years ago, and treated endoscopically. The aim of this paper was to know gynecological association and the management of bladder stones. The patients who had a history of pelvic surgery previously and present with lower urinary tract symptoms such as dysuria, voiding difficulties, weak micturition and hematuria should be evaluated for the foreign body-associated disorders.

Changing the Stage, Grade and Histological Subtypes of Renal Cell Carcinomas during 10 Years Period.

Renal cell carcinomas (RCCs) account 80-85% of all primary renal neoplasms and originate from the renal cortex. The patients who underwent radical or partial nephrectomy for renal tumour in our unit between January 2005 and 2015 were evaluated retrospectively. The patients were divided into two groups; group 1 includes patients who were treated between January 2005 and December 2009, group 2 those from January 2010 to 2015. There were 103 patients in group 1. The patients were between 21 and 89 years with mean age of 61.46 year. Renal cell carcinomas account 83.4% of the patients, benign renal tumours were 8.7% and transitional cell carcinomas were 7.7% of the patients in group 1. A total of 32.5% RCCs were classified as pT1a, 24.4% as pT1b, 15.1% as pT2a, 11.6% as pT2b, 15.1% as pT3a and 1.1% as pT4. There were 202 patients in group 2 and the patients were between 27 and 81 years with mean age of 58.5 year. Renal cell carcinomas comprised the main bulk of the tumours with 182 nephrectomy specimens. According to the pathological classification of RCCs, 51 specimens were found as pT1a, 54 were pT1b, 13 were pT2a, 14 were pT2b, 48 were pT3a and 2 were pT4. Although, the incidence of small renal masses has been increasing with widespread use of imaging techniques and recent advancements, the proportion of high grade and advanced stage renal tumours increased during the study period.

Renal Medullary Carcinoma; A Rare Entity.

Renal medullary carcinoma (RMC) is an uncommon aggressive neoplasm of the kidney. RMC is biologically aggressive with a very poor prognosis, and metastasis is seen in up to 95% of the patients at diagnosis or shortly thereafter. The common sites of metastasis are respectively lymph nodes, lungs, livers, and adrenal glands in order of frequency. The presence of poorly differentiated eosinophilic cells in a characteristic fibro-inflammatory stroma is seen in histological examination. The origin and pathogenesis of RMC are unclear. The radiographical and pathological findings suggest that RMC probably originates in the calyceal epithelium in or near the renal papillae, which could be the result of chronic ischemic damage in the renal papillae epithelium by sickled erythrocytes. Positivity of VEGF and HIF-1α supports the chronic hypoxia that may be caused in the pathogenesis of RMC. Other factors such as genetic or environmental factors are important. Although hemoglobinopathy is very common, RMC is very rare. An understanding of the molecular and genetic factors of this rare disease is important for its prevention and treatment. We herein describe an adult Turkish patient, who presented with hematuria. The diagnosis was RMC after pathological examination.

Assessment of sexual functions in partners of women with complaints of urinary incontinence.

AIM: Investigation of the erectile functions in partners of women with urinary incontinence problems. MATERIALS AND METHODS: Sexually active female patients over the age of 18 years with complaints of urinary incontinence (n=30) (Group-1), and without urinary incontinence (n=30) (Group-2, controls) were included this study. Evaluation of the patients were done at Erzincan Mengücek Gazi Training and Research Hospital's urology outpatient clinic between June 2012 and January 2013. Partners of group-1 and group-2 were asked to fill in the 5-item International Index of Erectile Function (IIEF-5) questionnaire, and then the scores of the two groups were compared for statistically significant differences. RESULTS: Among the partners of the group-1 patients, 15 (50%) had mild erectile dysfunction (ED), 11 (36.6%) had moderate ED, 1 (3.4%) had severe ED, and erectile function was normal in the remaining 3 (10%). Among the partners of group-2 patients, 15 (50%) had mild ED, 7 had moderate ED, 1 (3.4%) had severe ED, and 7 (23.3%) had normal erectile function. Compared to the spouses of group-2 patients, ED was more prevalent among the spouses of group-1 patients. CONCLUSION: Erectile function in the partners of women with urinary incontinence may be adversely affected by the UI of their partners.

Adult urethral stricture: practice of Turkish urologists.

OBJECTIVES: To evaluate national practice patterns in the treatment of male anterior urethral strictures among Turkish urologists. MATERIALS AND METHODS: A survey form including 12 questions prepared to determine active Turkish urologists' approach to diagnosis and treatment of the adult urethral stricture (US) were filled out. Based on the survey results, the institutions which 218 urologists work and their years of expertise, methods they used for diagnosis and treatment, whether or not they perform open urethroplasty and timing of open urethroplasty were investigated. RESULTS: Optic internal urethrotomy and dilatation are the most commonly used minimal invasive procedures in treatment of US with the ratios of 93.5% and 63.3% respectively. On the other hand it was seen that urethroplasty was a less commonly used procedure, compared to minimal invasive techniques, with the ratio of 36.7%. Survey results showed us that the number of US cases observed and open urethroplasty procedures performed increases with increasing years of professional experience. CONCLUSIONS: As a method demanding special surgical experience and known as a time-consuming and challenging procedure, open urethroplasty will be able to take a greater part in current urological practice with the help of theoretical education and practical courses given by specific centers and experienced authors.

Vasculogenic erectile dysfunction and metabolic syndrome.

INTRODUCTION: Erectile dysfunction (ED), defined as the inability to achieve and/or maintain a penile erection sufficient for sexual intercourse, is a health problem affecting more than one-half of men between the age of 40 and 70 years. AIM: The aim of the present study was to determine the potential factors affecting penile vascular flow and predictability of vascular flow in patients with ED. METHODS: Totally 163 male patients between 29 and 82 years of age who were admitted to our outpatient clinic with complaints of ED were included. After a detailed medical history was obtained, all patients were asked to complete the International Index of Erectile Function (IIEF) questionnaire. Blood samples were obtained for measurements of serum cholesterol, triglycerides, and fasting blood glucose (FBG), and the body mass index (BMI) was calculated. MAIN OUTCOME MEASURES: Penile color Doppler ultrasonography (PDU) was performed to evaluate flow patterns, Mann-Whitney U-test and Spearman correlation analyses were used to assess the relationship of PDU findings with hypertension, obesity (BMI ≥ 25 kg/m(2) ), FBG, and cholesterol levels measurements. RESULTS: The mean age, IIEF score, and BMI of the study population was 51.3 ± 12.1 years, 11.9 ± 6.1 and 28.5 ± 4.0 kg/m(2), respectively. When the vascular pathologies detected with PDU and the presence of risk factors were compared, no significant correlation was determined between arterial insufficiency and metabolic syndrome (MS), whereas there was a significant correlation between veno-occlusive dysfunction and MS. CONCLUSION: The prevalence of ED increases with advanced age and with the presence of a systemic disease. Basic evaluations may not always be sufficient for assessment of ED. In the presence of MS, the use of penile Doppler ultrasonography should be considered for the evaluation of penile vascular structures in ED patients.

Bibliometric and Comparative Analysis of Castration Resistant and Refractory, Hormone Resistant and Refractory Prostate Cancer Publications.

INTRODUCTION: Prostate cancer is one of the most common cancer among men in the world. Radical prostatectomy is the gold standard treatment for localized prostate cancer but advanced diseases are treated with hormonal therapy. Unfortunately, this treatment is not curative and approximately after 2 years, castration resistant prostate cancer occurs. In this study we aimed to investigate the terminology of castration resistant and refractory, hormone resistant and refractory articles on Web of Science database. MATERIALS AND METHODS: We searched the articles in the title section such as castration resistant prostate cancer, castration refractory prostate cancer, hormone resistant prostate cancer and hormone refractory prostate cancer between 1975 and 2018. Categories, publication years, document types, authors, countries, funding agencies and citation reports were recorded in 4 groups. RESULTS: There were 6733 articles in the system. Most of the articles (72.16%) were published as using castration resistant title. The United States of America and Italy were in the top 5 countries in 4 titles. Oncology and urology nephrology categories consisted more than 80% of the articles. Of these articles, only 1745 (26%) articles had funding agency. DISCUSSION: Different terminology can be used in some diseases. One of these diseases is castration resistant prostate cancer which is referred to different terms such as castration refractory, hormone resistant and refractory. In this study we searched the literature and discussed the results. CONCLUSION: Castration resistant prostate cancer is a serious health problem for clinicians and patients. If international associations, journals and authors use the same terminology, the articles can be published without different titles in the literature.