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Objective: We evaluated the correlation between benign prostate hyperplasia (BPH) measures and diabetes mellitus in men with benign prostate hyperplasia in a prospective study. Materials and methods: Between 2008-2012, 100 diabetic and 200 non diabetic patients undergoing surgery due to benign prostate hyperplasia were enrolled in the study. The parameters evaluated for each patients included prostate volume, fasting blood glucose, HbA1c, total testosterone, total prostatic specific antigen (T-PSA), triglicerides, total cholesterol and body mass index (BMI). A questionnaire including international prostate symptom score (IPSS) was sdministered and uroflow test measuring the peak urinary flow rate was performed to appreciate the complaints of the patients objectively. Results: Diabetic patients are more likely to have larger prostate volume. The symptom score evaluated by IPSS and post micturition residual volume were also significantly higher in diabetic groups. The other statistically significant different parameter between two groups was total testosterone that diabetic patients tend to have lower levels. Diabetic counterparts were established to have higher BMI. No statistically significant differentiation was observed about trigliceryde and total cholesterol levels and uroflow rates. Conclusions: Our study suggests a positive correlation between high prostate volume and diagnosis of diabetes mellitus in patients with benign prostatic hyperplasia. We also observed a positive correlation between symptom scores and post micturion residual volumes and diagnosis of diabetes mellitus suggesting that the presence of diabetes is related to both static and dynamic components of benign prostate hyperplasia. Additionally testosterone levels were lower in diabetic patients. Further studies need to confirm these relationship in a larger population.

Objective: To evaluate the relationship among urolithiasis, metabolic syndrome (MetS) and serum testosterone (T) level in men. Material and Methods: 513 men older than 18 years were enrolled in this study: 313 of the subjects had a history of stones (group 1) and 200 had no history of stones (controls, group 2). Early morning T levels were recorded and anthropometric measurements were invastigated to evaluate MetS. Analyses were completed using chi-square tests. Result: Serum T level was lower in stone forming patients than coltrol subjects and 161 (%51.4) men in group 1 and 92 (%46) men in group 2 were diagnosed with metabolic syndrome. T level was found lower limit (< 285 ng/dl) in the MetS and urolithiasis group (p 0.002, OR 2.71). Conclusions: We found low testosterone levels in the patients with stone disease and prevalance of the MetS in men with urolithiasis was higher than in men without stone disease. Our findings show that levels of testosterone had no effect on stone formation, but the factors that cause stone formation can have an effect on the level of testosterone.

Aim of the study: We compared stone size, localization, complaint at the time of applying, comorbidity, treatment and complications between older (60 years of age and older) and younger patients with urolithiasis (59 years of age and younger). Materials and Methods: We retrospectively reviewed the records of 950 consecutive patients who presented to our clinic and underwent surgery for urolithiasis from January 2007 to March 2012. The patients were divided into two groups: patients ≥ 60 years an patients < 60 years. Results: There were 174 men and 61 women in elderly group, 528 men and 187 women in younger group. Ureteral stones were found more often in the younger group compared to elderly patients (p < 0.05). Conversely, bladder stone was more frequent in the elderly group. In the elderly group comorbidities are more frequent (diabetes mellitus, hypertension, ischemic heart disease, congestive heart disease, osteoarthritis and chronic obstructive lung). Patients ≥ 60 years significantly had larger kidney and bladder stones compared the younger, but ureteral stone sizes were not statistically different between the two groups. Older patients had a higher postoperative complication rate than younger patients (16% versus 3%, p < 0.05) although postoperative complications (e.g. urinary retention, cardiac dysrythmia, fever, constipation) were not serious and resolved with medical treatment. The average length of stay in hospital was longer in the elderly group, but the difference was not statistically significant. Conclusions: Elderly patients with urolithiasis usually have larger and more complex stone disease, more comorbidities and atypical presentation.

Aim: Transrectal ultrasound (TRUS) guided prostete biopsy is accepted as a standard procedure in the diagnosis of prostate cancer. Many different protocoles are applied to reduce the pain during the process. In this study we aimed to the comparison of two procedure with intrarectal lidocaine gel and periprostatice nerve blockade respective- ly in addition to perianal intrarectal lidocaine gel on the pain control in prostate biop- sy by TRUS. Methods: 473 patients who underwent prostate biopsy guided TRUS between 2008-2012 were included in the study. 10-point linear visual analog pain scale(VAS) was used to evaluate the pain during biopsy. The patients were divided into two groups according to anesthesia procedure. In Group 1, there were 159 patients who had perianal-intrarectal lidocaine gel, in Group 2 there were 314 patients who had periprostatic nerve blockade in addition to intrarectal lidocain gel. The pain about probe manipulation was aseesed by VAS-1 and during the biopsy needle entries was evalu- ated by VAS-2. Results were compared with Mann-Whitney U and Pearson chi-square test. Results: Mean VAS-2 scores in Group 1 and Group 2 were 4.54 ± 1.02 and 2.06 ± 0.79 respectively. The pain score was determined significantly lower in the Group 2 (p = 0.001). In both groups there was no significant difference in VAS-1 scores, patient’s age, prostate volume, complication rate and PSA level. Conclusion: The combination of periprostatic nerve blockade and intrarectal lidocain gel provides a more meaningful pain relief compared to group of patients undergoing intrarectal lidocaine gel.

Objectives: In recent years, it has been shown that there is association between metabolic syndrome and urinary stone disease. Stone disease and erectile dysfunction (ED) are considered as systemic diseases which are associated with hormonal and metabolic disorders. Therefore we investigated the relationship between ED and urinary tract calculi. Material and methods: 98 male patients with urolithiasis and 59 randomly selected male patients without stone disease were included in the study. Serum testosterone (T) levels were measured and International Index of Erectile Function (IIEF)-15 questionnaire forms were used to assess ED. Results: The prevalence of ED was found 29% (29 patients) in the urolithiasis group. Sixty-nine patients (71%) had no ED; 16 (16.3%) had mild, 5 (5.1%) had moderate and 8 (8.2%) had severe ED. None of the patients in the control group had severe or modarete ED, six patients (10.2%) had mild ED. Serum T levels were detected at the level of biochemical hypogonadism on 13 patients with stones (13.3%) and T levels were detected at the lower limit in 18 (18.3%) patients. Conclusion: In our study we have shown that ED and low T levels are significantly associated with urolithiasis. We propose that the patients with urolitiasis should be evaluated for ED and hypogonadism.

Varicocele is the most common and surgically correctible cause of male infertility in men attending to infertility clinics. Infertility affects 15% of all couples and male factor is the primary or contributing cause in 40% to 60% of cases. Varicocele has been shown to cause male infertility in about 15% of infertile couples. Molecular mechanisms responsible from varicocele induced testicular dysfunction and male infertility have not been completely unknown. Recent years have witnessed a huge amount of scientific works devoted to the mechanism of varicocele associated male infertility and rapid progress in research on its cellular and molecular mechanisms, including apoptosis and oxidative stress of germ cells. Here we evaluated internal spermatic vein and brachal vein ischemia modified albumin (IMA) level in 40 adult male patients with varicocele. IMA level was analyzed using albumin cobalt-binding test. Spermatic vein and brachial vein IMA levels were 0.381 ± 0.135 ABSU (absorbance units) and 0.385 ± 0.131 ABSU, respectively. There was no statistically significant difference between the two areas. IMA levels in the internal spermatic vein of patients with varicocele should not be used as a marker of hypoxia.