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G Ocal,
M Berberoğlu,
Z Siklar,
P Bilir,
R Uslu,
A Yağmurlu,
A Tükün,
N Akar, T Soygür,
S Gültan,
V Tonyukuk Gedik
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ABSTRACT: Disorders of sexual development (DSD) occur when the appearance of the internal and/or external genitalia is at variance with normal development for either sex. We reviewed the characteristics of patients with DSD.
Two hundred and eight children aged from newborn to 19 years with DSD from 1990 to 2008.
46,XY DSD (52.4%) was more common than 46,XX DSD (34.6%) and gonadal differentiation disorders (12.99%). Thirty-six (33.02%) patients were diagnosed with androgen resistance syndrome, 41 (37.61%) had 5alpha-reductase deficiency, 23 (21.10%) had testosterone synthesis disorders. Congenital adrenal hyperplasia was the most frequent underlying cause of 46,XX DSD.
There are many difficult aspects in the diagnosis and management of DSD. Gender assessment teams of endocrine centers need a multidisciplinary approach for the diagnosis, medical and surgical treatment, genetic counseling, and psychosocial support of these patients.
Journal of pediatric endocrinology & metabolism: JPEM 11/2010; 23(11):1123-32. · 0.88 Impact Factor
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ABSTRACT: The nutcracker phenomenon refers to compression of the left renal vein between the aorta and the superior mesenteric artery. Clinical features are hematuria, abdominal pain, left flank pain, pelvic or scrotal discomfort due to varicocele or ovarian vein syndrome. In this report, 2 patients with orthostatic proteinuria, in whom nutcracker phenomenon was detected as a cause, are presented. One of them had posterior nutcracker with also asymptomatic varicocele that was detected during ultrasonographic examination. Nutcracker phenomenon is a rare but important clinical condition that should be considered in the differential diagnosis of patients with proteinuria and hematuria.
Clinical nephrology 05/2006; 65(4):280-3. · 1.17 Impact Factor
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ABSTRACT: To retrospectively evaluate the role of video-urodynamics (VUD) in the diagnosis and management of voiding dysfunction in children.
The records of the 128 children with dysfunctional voiding symptoms were retrospectively evaluated. All patients had a noninvasive screening assessment consisting of a detailed voiding history, ultrasonography and uroflowmetry, and measurement of residual urine. All the patients had also undergone VUD with no selection criteria. The results of VUD were compared retrospectively with the noninvasive screening assessment results.
In 84 patients with urge syndrome VUD showed detrusor overactivity in 72 (86%); the bladder configuration and voiding-phase results were normal. Three (3.5%) patients had low-grade reflux. In 38 patients with voiding dysfunction VUD showed an intermittent flow pattern and/or increased electromyographic activity with a "spinning top" deformity of the bladder neck and increased detrusor pressure during voiding. Five (13%) of these children had low-grade reflux. In six infrequent voiders VUD revealed increased bladder capacity with fractionated flow patterns, with concomitantly increased abdominal pressures. There was decreased detrusor pressure during voiding with significant residual urine volume in only two patients; there was no reflux in any of the patients in this group.
We do not recommend routine VUD in children with non-neurogenic voiding dysfunction, as it does not generally change the management and treatment. A detailed voiding history and physical examination is usually sufficient for a correct diagnosis.
BJU International 05/2004; 93(6):841-3. · 2.84 Impact Factor
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Pediatrics International 11/2001; 43(5):508-10. · 0.63 Impact Factor
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ABSTRACT: In recent years, various minimally invasive alternatives to transurethral resection have become available for treatment of benign prostatic hyperplasia (BPH). Transurethral electrovaporization has become popular, with reported improvements in subjective and objectives measures, but a high rate of postoperative irritative symptoms and lack of tissue for histologic examination are the two most commonly reported disadvantages of this procedure. To decrease the postoperative irritative symptoms while minimizing intraoperative and postoperative bleeding and also to obtain tissue samples, we have combined the techniques of vaporization, which was termed "vapor-cut." The aim of this randomized study was to compare the efficacy and safety of vapor-cut with those of the gold standard, transurethral resection.
A series of 100 consecutive men (mean age 63.5 +/- 3.4 years) with moderate to severe symptoms of prostatism were randomized to receive transurethral resection of the prostate (TURP) or vapor-cut since November 1997. Adverse events during the procedure, including serial changes in both serum hematocrit and sodium and postoperative irritative symptoms, were recorded after removal of the urethral catheter. Preoperative and postoperative symptom scores and maximum flow rates (Qmax) were obtained from all patients. The volume of the prostate was measured preoperatively and postoperatively using transrectal ultrasonography. The mean follow-up of the patients was 6.7 months (range 6-10 months).
The mean operative times for the vapor-cut group and the TURP group were 48.2 minutes and 42.7 minutes, respectively (P > 0.05). In the TURP group and the vapor-cut group, the International Prostate Symptom Score (I-PSS) decreased from 21.6 to 5.0 (P < 0.01) and from 19.4 to 4.0 (P < 0.01), respectively, at 6 months. The Qmax increased from 9.2 +/- 2.6 mL/sec to 24.6 +/- 3.4 mL/sec (P < 0.01) in the TURP group and from 7.9 +/- 2.1 mL/sec to 26.7 +/- 3.7 mL/sec (P < 0.01) in the vapor-cut group. The mean reductions in the weight of the prostate were 49.8% in the TURP group (P < 0.05) and 53.6% in the vapor-cut group (P < 0.05). Both catheterization time and hospital stay were significantly shorter for the vapor-cut group (P < 0.05). The decreases in the mean serum sodium concentration were statistically insignificant in both groups. However, the decrease in the mean hematocrit was statistically significant in the TURP group but not in the vapor-cut group. No patient in either group had the transurethral resection syndrome or required blood transfusion. After removal of the urethral catheter, irritative voiding symptoms, usually associated with frequency, were greater in those patients treated with TURP than in those having vapor-cut. None of the patients demonstrated sphincteric incontinence, bladder neck contracture, or urethral stricture.
From our preliminary experience, vapor-cut seems to give results comparable to those of TURP. Because there is almost no bleeding during vapor-cut, the procedure is performed under excellent visibility, which permits more rapid and effective resection.
Journal of Endourology 05/2001; 15(3):317-21. · 1.85 Impact Factor
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ABSTRACT: Retrospective analysis of medical records on spinal cord injury (SCI) patients with neuropathic bladder.
To determine SCI patients' compliance with the method of bladder management they used on discharge from inpatient rehabilitation.
Ankara University Medical School, Department of Physical Medicine and Rehabilitation, Spinal Cord Injury Unit, which treats patients referred from throughout Turkey.
The bladder management method of 50 new SCI patients was noted at admission, discharge and follow-up. Reasons for changing the initial method were documented. For analysis, patients were grouped by gender, level and completeness of injury. Compliance with bladder management method was compared between these groups by chi-square test.
The method of bladder management at admission was indwelling catheter (IC) for 86% of the patients. Most were switched to clean intermittent catheterisation (CIC) by rehabilitation discharge. Of 38 patients (76%) on CIC at discharge, 20 (52%) discontinued this method and reverted to IC during follow-up. Compliance with CIC was lower for women, for tetraplegics, and for those with complete injury. Dependence on care givers, severe spasticity interfering with catheterisation, incontinence despite anticholinergic agents, and lack of availability of external collective devices for female patients were the main reasons for low compliance with CIC.
The bladder management method of SCI patients should be selected so as to be suitable to the patients' life style. Besides reducing morbidity, it also has to enhance the quality of life.
Spinal Cord 01/2001; 38(12):762-5. · 1.80 Impact Factor
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ABSTRACT: To report our initial experience with extraperitoneal bladder neck suspension for female stress incontinence due to urethral hypermobility.
Between September 1996 and September 1999, 35 patients (mean age 49.5 years) underwent extraperitoneal bladder neck suspension at our institution. An extraperitoneal space was created by a trocar-mounted balloon device, and suspension was created using a 5-mm endoscopic hernia stapler and polypropylene mesh.
The mean operative time was 39.5 minutes. In 2 patients, the bladder was inadvertently perforated during the bladder neck dissection. The perforation was repaired by laparoscopic suture ligation. The mean urethral catheterization and hospitalization time was 2.1 and 2.3 days, respectively. Urethral recatheterization because of temporary urinary retention was required in 11.4% of the patients. Symptoms of bladder instability were experienced by 13.5% of the patients in the early postoperative period. A total of 28 patients (80.0%) reported that they were totally dry after a mean of 23.2 months.
Extraperitoneal bladder neck suspension using hernia mesh and a stapler seems to be an effective and safe procedure, with a shorter operative time, in selected patient groups.
Urology 08/2000; 56(1):121-4. · 2.43 Impact Factor
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ABSTRACT: We retrospectively reviewed 77 patients with a tethered spinal cord syndrome to evaluate the results of neurosurgical treatment. The patients were divided into two groups: in group 1 there were 17 patients with primary tethered cord who had normal level conus medullaris (NLCM) and normal thickness filum terminale (NTFT) with urinary incontinence, and group 2 was made up of 60 patients with secondary spinal cord tethering after a previous closure of a midline fusion defect who had a low-lying conus medullaris. Neurological examination, radiography, urodynamic tests and electrophysiological findings confirmed the diagnosis. Conventionally, tethered cord syndrome has been defined as a state in which the conus medullaris is located below the L1-2 disc space. However, in a patient with urinary incontinence and a hyperreflexive type of neurogenic bladder, in whom the conus medullaris is found to be at the normal level, there may still be cord tethering that is causing the incontinence. In this study the comparison was based on evaluation of the response to treatment and general characteristics of the syndrome in both groups of patients to draw attention to the general approach to this incapacitating mal-development.
Child s Nervous System 04/2000; 16(3):150-4; discussion 155. · 1.54 Impact Factor
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ABSTRACT: To assess the prognostic value of peripheral blood lymphocyte subsets in patients with bladder cancer who were treated with neoadjuvant chemotherapy.
Thirty patients with a histological diagnosis of invasive bladder transitional cell carcinoma and 30 age-matched controls with no evidence of cancer and immunological disorders were evaluated. Peripheral blood samples were assessed in both groups using monoclonal antibodies. Patients with bladder cancer who achieved complete or partial responses and those who had progression of the disease after systemic chemotherapy with methotrexate, vinblastine, epirubicin and cisplatin were compared according to the pretreatment values of the peripheral blood lymphocyte subsets.
There were no significant differences in B lymphocyte levels between the groups. In patients with bladder cancer, the percentages of T lymphocytes (P<0.01), natural killer (NK) cells (P<0.05) and the CD4+/CD8+ ratio (P<0.05) were significantly lower than in the control group. In patients who responded to the chemotherapy regimen, the pretreatment values of T lymphocytes (P<0.001), the CD4+/CD8+ ratio (P<0.01) and NK cell levels (P<0.01) were significantly higher than in the patients who did not.
In patients with invasive bladder carcinoma, cell-mediated immunity may have a role in the resistance to this malignancy and in these patients the pretreatment levels of T lymphocyte subsets may be an indicator of the potential response to chemotherapy.
BJU International 12/1999; 84(9):1069-72. · 2.84 Impact Factor
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ABSTRACT: To analyze the relationship among non-neurogenic voiding dysfunction, vesicoureteral reflux (VUR), and renal scarring, taking into consideration whether the reflux was unilateral or bilateral. VUR is a common problem in the pediatric age group. Although unilateral reflux is usually due to primary insufficiency of the vesicoureteral junction, bilateral reflux can also be the result of underlying voiding dysfunction.
Between 1993 and 1998, 80 children, 52 girls and 28 boys, median age 5.7 years (range 3.8 to 14), were evaluated because of VUR. Eighteen patients who presented with associated anomalies and obvious neuropathic bladder dysfunction were excluded from the study. Complete urologic, neurologic, and urodynamic investigations were performed in all patients.
Of 62 patients, 25 (40.3%) had unilateral and 37 (59.6%) had bilateral reflux. Voiding dysfunction was found in 7 patients (28%) with unilateral reflux and in 27 patients (72.9%) with bilateral reflux (P <0.01 ). Two (25%) of the 8 patients with unilateral reflux and renal scarring had voiding dysfunction but no demonstrable urinary tract infection, and 10 (55.5%) of the 18 patients with bilateral reflux and renal scarring had voiding dysfunction and no demonstrable urinary tract infection (P <0.01).
If VUR is bilateral, the prevalence of existing underlying voiding dysfunction seems to be higher. The first step in management should be a detailed evaluation of bladder function to choose an appropriate treatment modality and to prevent renal deterioration.
Urology 11/1999; 54(5):905-8. · 2.43 Impact Factor
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ABSTRACT: To investigate the role of magnetic resonance imaging (MRI) in children with voiding dysfunction and a normal neuro-orthopedic assessment. The differential diagnosis of neurogenic and non-neurogenic voiding dysfunction, particularly in children with occult neurogenic pathologic findings without a clinically demonstrable neurologic defect, is a commonly encountered problem.
Eighty-one children with voiding dysfunction, including a history of diurnal incontinence, frequency, urgency, urge incontinence, incomplete bladder emptying, recurrent urinary tract infection, and persistent vesicoureteral reflux, constituted our study group. A detailed neuro-orthopedic evaluation was performed in all patients. The urologic evaluation consisted of a detailed history (including bowel function disturbances), renal sonography or excretory urography, spinal x-ray, urinalysis and culture, voiding cystourethrography, and multichannel water cystometry. In all cases, lumbosacral spinal axial and sagittal T1- and T2-weighted MRI performed with a 1.5-Tesla surface coil was reviewed by one neuroradiologist.
MRI revealed pathologic findings in 17 (38.6%) of 44 patients who had voiding dysfunction and a normal neuro-orthopedic assessment. All these patients underwent early surgical intervention in our pediatric neurosurgery department. In the postoperative period, objective and/or subjective improvement in voiding symptoms within short (6 months) and long (14 months) periods was observed in 8 (47.0%) and 5 (29.4%) patients, respectively. Ten (58.8%) of those 17 patients had a history of voiding dysfunction refractory to conservative management.
Our results revealed that MRI of the lower spinal cord is a valuable tool in the diagnosis of occult spinal cord disorders, especially in patients with voiding dysfunction refractory to conservative management strategies and normal neurologic and orthopedic assessments.
Urology 08/1999; 54(1):157-60; discussion 160-1. · 2.43 Impact Factor
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ABSTRACT: To assess the effect of transurethral electrovaporization of the prostate (TUVP) on serum prostate specific antigen (PSA) concentration.
Twenty-five men (mean age 61.7 years) with symptoms of prostatism underwent TUVP. Serum PSA levels were determined before any prostatic manipulation, and again at 1 and 24 h after TUVP. In the first 6 weeks after TUVP, serum PSA was measured every week. Prostatic size was measured by transrectal ultrasonography before and again at 6 weeks after TUVP.
The mean serum PSA concentration was significantly higher at 1 and 24 h after TUVP (P<0.001) than before. The PSA level returned to less than the value before TUVP at 2, 3 and 4 weeks afterwards in eight (32%), 13 (52%) and 20 (80%) patients, respectively; five (20%) patients reached the baseline value 6 weeks after TUVP. The mean reduction in prostatic volume 6 weeks after TUVP was 42% and the reduction in tissue volume was significantly correlated with the decrease in serum PSA concentration at 6 weeks (P<0.05).
TUVP increases serum PSA levels, the transient elevation persisting for up to 6 weeks but then declining to a stable, low PSA concentration. Therefore, it is important to wait at least 6 weeks to obtain an accurate and meaningful serum PSA level after TUVP.
BJU International 05/1999; 83(7):783-5. · 2.84 Impact Factor
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ABSTRACT: Postoperative irritative symptoms and lack of tissue samples for histologic examination are the two main disadvantages of transurethral electrovaporization of the prostate. To decrease the postoperative irritative symptoms while minimizing intraoperative and postoperative bleeding and also to obtain tissue samples, we have combined the techniques of transurethral resection and vaporization, a procedure we have termed Vapor-cut, by using the Wolf Wing gold-plated electrode.
Forty-eight patients with symptomatic benign prostatic hyperplasia (BPH) were enrolled in the study. Adverse events during the procedure, including serial changes in both serum hematocrit and sodium, and postoperative irritative symptoms were recorded after removal of the urethral catheter. Preoperative and postoperative symptom scores and maximum flow rates (Qmax) were obtained in each patient. The volume of the prostate was measured preoperatively and postoperatively using transrectal ultrasonography.
During the procedure, there was minimal bleeding, and serum sodium and hematocrit levels were not changed significantly. The mean operative time was 49.3 minutes. The catheterization time and hospital stay were 48 and 60 hours, respectively. Only five patients (10%) reported transient and intermittent postoperative hematuria lasting for 1 week. After removal of the urethral catheter, four patients (8%) had irritative voiding symptoms. No patients experienced postoperative urinary retention or required subsequent catheterization. At 3-month follow-up, the improvement in the mean Qmax was 114%, and the decrease in the symptom score was 72%. The average reduction in the weight of the prostate was 55%.
Vapor-cut of the prostate appears to be a safe, effective alternative to the standard loop resection and vaporization. It has the advantages of minimal blood loss, excellent operative visibility, decreased postoperative irritative symptoms, and availability of tissue samples with short catheterization and hospitalization times.
Journal of Endourology 05/1999; 13(3):225-8. · 1.85 Impact Factor
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ABSTRACT: This study was designed to investigate the relationship between the effects of testicular reactive oxygen species (ROS) levels and testicular histology on infertile patients with the aid of xanthine oxidase system and testicular tissue malondialdehyde levels. Forty patients with idiopathic infertility constituted our study group. Bilateral testicular biopsies were performed and spermatogenesis was assessed histopathologically. Patients were divided into 4 groups according to spermatogenic pattern (normal spermatogenesis; hypospermatogenesis; maturation arrest; Sertoli cell only syndrome). Testicular tissue xanthine oxidase and malondialdehyde (MDA) concentrations were analyzed in each sample by spectrophotometric assay and thiobarbituric acid reaction assay, respectively. Testicular tissue MDA and xanthine oxidase concentrations were not statistically different in patients having normal spermatogenesis, with respect to Sertoli cell only syndrome, maturation arrest and hypospermatogenesis, respectively. As a result of our study we think that there are still some factors other than ROS which may be important contributors to spermatogenetic injury that need to be examined.
International Urology and Nephrology 02/1999; 31(3):395-9. · 1.47 Impact Factor
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ABSTRACT: To evaluate the immune system of patients with bladder transitional cell carcinoma (TCC) by using peripheral blood lymphocyte subsets and to further compare the relationship between these subsets with respect to tumor stage and grade (superficial versus invasive and low versus high grade).
Thirty patients with superficial TCC of the bladder, 30 patients with invasive TCC of the bladder, and 30 age- and sex-matched control subjects without any malignancy or immunologic abnormality were included in this study. The peripheral blood lymphocyte subset analysis was performed in all patients before any treatment was performed.
All lymphocyte subset values of patients with invasive bladder cancer, except B cell value, were significantly lower (P < 0.01) than the values of the control group. There were no significant differences between the lymphocyte subset values of patients with superficial bladder cancer and those of control subjects. The comparison of the lymphocyte subset values of the patients with superficial versus invasive bladder carcinoma revealed that in patients with invasive bladder carcinoma, the numbers of T and natural killer (NK) cells were significantly lower (P < 0.05) than those of patients with superficial bladder carcinoma. Patients with high-grade tumors had significantly fewer (P < 0.05) T and NK cells than patients with low-grade tumors.
Our results indicate that analysis of mean NK and T cell values and the mean ratio of CD4+/CD8+ cells in peripheral blood might be a useful adjunct for the clinical evaluation of patients with bladder cancer.
Urology 01/1999; 53(1):88-91. · 2.43 Impact Factor
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ABSTRACT: The correlation between infertility and morphofunctional alterations following vasal occlusion is not clearly understood. Although a correlation has been found between the expression of a high titer of antisperm antibodies and the status of infertility, the relationship between the immunoglobulin (Ig) depositions in the testis and ultrastructural alterations of the peritubular structures has not been clearly established. The objective of this study is to explain the etiopathogenesis of diffuse and focal testicular lesions caused by vasal obstruction.
Unilateral vasectomy was performed on adult male rats. Ultrastructural changes of testicular tissues and immunostaining affinity of peritubular structures with anti-actin, anti-vimentin, anti-laminin, and anti-immunoglobulin G (anti-IgG) antibodies were analyzed.
In an ultrastructural study, vasectomized animals presented abundant collagen fibril accumulation in the peritubular area. In testis with intense IgG antibodies, staining revealed weak immunostaining of peritubular myoid cells with anti-actin antibodies, but intense immunostaining with anti-vimentin antibodies. The tubules of rats with no IgG deposition on peritubular structures revealed intense immunostaining with anti-actin antibodies but scant immunostaining with anti-vimentin antibodies. Anti-laminin deposits decreased severely in most of the tubules demonstrating intense IgG deposition.
Our findings suggest that spermatogenesis deteriorates more severely in testes with dense IgG deposition. The sclerosis of the lamina propria in cases with vasal occlusion is secondary to alterations in the peritubular myoid cells. With the progressive changes that occur in the peritubular myoid cells or differentiation of the peritubular myoid cells that acquire active cell characteristics, collagen accumulation adjacent to these cells increases markedly. The alterations of the peritubular myoid cells reported here may be caused by alterations in basement membrane structures.
Urology 07/1998; 51(6):1051-6. · 2.43 Impact Factor
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ABSTRACT: To evaluate the role of polytetrafluoroethylene (Gore-Tex) as a ureteral substitute in dogs after resection of a 5 to 8-cm-long middle segment.
Five mongrel dogs underwent resection of the middle segment of the left ureter and segmental replacement of the resected part with segments of Gore-Tex over a double-J catheter. The double-J stents were removed at 21 days and the dogs were evaluated by excretory urography and abdominal ultrasonography 12 weeks after surgery. They were then killed and the ureters and the kidneys examined both grossly and microscopically.
There was radiologic evidence of advanced hydronephrosis on the left side in all 5 dogs. Grossly, the left kidneys showed marked pelvic and proximal ureteral dilatation and atrophy of parenchyma. Severe stricture at the anastomotic sites and marked fibrous tissue around the prostheses were found. No cellular lining was found in the Gore-Tex lumen.
There is no potential for ureteral replacement by Gore-Tex tube graft.
Urology 03/1998; 51(3):400-3. · 2.43 Impact Factor
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ABSTRACT: The common goals of new surgical treatment for benign prostatic hyperplasia (BPH) are to improve subjective and objective symptoms, to decrease the risk of postoperative complications and short hospitalization. Transurethral electrovaporization of the prostate (TUVP) is a new, minimally invasive and a promising alternative to standard transurethral resection of the prostate (TURP) in the treatment of BPH. The aim of this study is to compare the efficacy and safety of these two treatment alternatives.
A prospective randomized trial of 60 patients with symptomatic BPH was performed. Preoperative and postoperative International Prostate Symptom Score (IPSS), maximum flow rates (Qmax) and complications were recorded in each patient. The volume of the prostate was measured preoperatively and postoperatively using transrectal ultrasound.
Of the 30 patients who underwent TURP, mean hospital stay was 4.5 days. The Foley catheter was removed on postoperative day 4 following surgery. IPSS decreased from 21.6 to 5.2, Qmax increased from 9.2 to 19.2 ml/s at 3 months. Mean prostatic volume at 3 months decreased from 51.7 to 26.2 g, a 49.3% reduction. Of 30 patients undergoing TUVP, mean hospital stay was 2.5 days and the catheter was removed within 2 days following surgery. Postoperative urinary retention did not occur in any patient. IPSS decreased from 19.4 to 4.1 and Qmax increased from 7.9 to 17.7 ml/s at 3 months. Mean prostatic volume decreased from 48.9 to 27.8 g, a 43.1% reduction at 3 months. In the TUVP group, none of the patients required blood transfusions or developed clinical transurethral resection syndrome. There were no major complications. Sphincteric incontinence, urethral strictures or bladder neck contractures were not recorded. At 3 months postoperatively, 13 patients in the TURP group and 7 patients in the TUVP group had retrograde ejaculation.
Our initial experience of TUVP suggests advantages over conventional TURP through reduced blood loss and shorter hospital stay. It appears to be an effective treatment for BPH; however, long-term results should be evaluated.
European Urology 02/1998; 34(1):15-8. · 8.49 Impact Factor
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ABSTRACT: To investigate the association between cigarette smoking and sex hormone concentrations in men with benign prostatic hyperplasia (BPH) and thus provide some understanding of the underlying mechanism of the effects of cigarette smoking on prostatic enlargement.
The association between cigarette smoking and prostatic volume was investigated in 68 men with BPH (mean age 59 years, range 52-74) by assessing changes in serum levels of oestradiol, testosterone, dihydroepiandrosterone (DHEA) and dihydroepiandrosterone sulphate (DHEA-S). Possible enzymatic mechanisms in the prostate gland that might be affected by cigarette smoking were assessed.
The mean prostate volume was greater in non-smokers than smokers. Current cigarette smokers had significantly higher mean serum oestradiol levels than did the non-smokers (33.8 and 26.7 pg/mL, respectively, P < 0.01). Cigarette smoking was inversely but not significantly related to testosterone level. These differences persisted after adjusting for body mass index. There was no significant difference in serum DHEA and DHEA-S levels between smokers and non-smokers. There was a weak correlation between the degree of prostatic enlargement, the presence of obstructive symptoms and urinary flow rates.
These results indicate that cigarette smoking may affect the size of the enlarging prostate, but through indirect effects of smoking on factors provoking the development of BPH.
British Journal of Urology 08/1997; 80(2):201-4.
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ABSTRACT: Objective To investigate the association between cigarette smoking and sex hormone concentrations in men with benign prostatic hyperplasia (BPH) and thus provide some understanding of the underlying mechanism of the effects of cigarette smoking on prostatic enlargement.Patients and methodsThe association between cigarette smoking and prostatic volume was investigated in 68 men with BPH (mean age 59 years, range 52–74) by assessing changes in serum levels of oestradiol, testosterone, dihydroepiandrosterone (DHEA) and dihydro-epiandrosterone sulphate (DHEA-S). Possible enzymatic mechanisms in the prostate gland that might be affected by cigarette smoking were assessed.ResultsThe mean prostate volume was greater in non-smokers than smokers. Current cigarette smokers had significantly higher mean serum oestradiol levels than did the non-smokers (33.8 and 26.7 pg/mL, respectively, P< 0.01). Cigarette smoking was inversely but not significantly related to testosterone level. These differences persisted after adjusting for body mass index. There was no significant difference in serum DHEA and DHEA-S levels between smokers and non-smokers. There was a weak correlation between the degree of prostatic enlargement, the presence of obstructive symptoms and urinary flow rates.Conclusion
These results indicate that cigarette smoking may affect the size of the enlarging prostate, but through indirect effects of smoking on factors provoking the development of BPH.
BJU International 07/1997; 80(2):201 - 204. · 2.84 Impact Factor
