Effect of Bariatric Sleeve Gastrectomy Technique on Women’s Lower Urinary Tract Symptoms and Quality of Life: A Prospective Study

Objective Obesity triggers lower urinary tract symptoms (LUTS) secondary to accumulation of excess fat which may lead to increase in intra-abdominal/intravesical pressures and subsequent impairment in pelvic floor muscles. However, it is considered that weight loss resolve these symptoms. In this study, we aimed to investigate the effects of bariatric surgery and especially Sleeve gastrectomy (SG) on women’s LUTS, and quality of life. Materials and Methods A total of 53 patients who have undergone laparoscopic SG in our clinics between April 2014 and March 2015 were included in this prospective study. Age, body weight and body mass index (BMI) of the participants were preoperatively and postoperatively recorded. The patients have pre/post-operatively filled the Beck depression inventory (BDI), International prostate symptom score (IPSS), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and the 36-Item Short Form health survey (SF-36) scores were recorded. Additionally, post-operative decrease in body weight and BMI of the patients was recorded. Results There was a statistically significant decrease in mean BDI, IPSS and ICIQ-SF scores and SF-36 (prominent increment in physical and mental component summary (PCS and MCS) scores), when compared with pre-operative values. A positive correlation was found between BMI and parameters including age, BDI and IPSS. However, no significant correlation was present between BMI and the parameters including ICIQ-SF, PCS and MCS. Conclusion Negative effect of obesity on LUTS and quality of life cannot be ignored. We assume that bariatric surgery can induce dramatic weight loss, amelioration in symptoms of urinary dysfunction and increase in quality of life of women

Radical perineal prostatectomy: Our initial experience

OBJECTIVE: Radical prostatectomy is the standard treatment modality for localized prostate cancer. Minimally invasive surgery, especially robotic surgery, has attracted interest in the last 10 years, and open surgery has been less preferred. Among the open surgical procedures, the perineal approach is the least preferred by urologists, which may be related to their perception of its overall difficulty. In this study, we aimed to present our initial experience with learning and performing radical perineal prostatectomy (RPP) and to draw attention to this method. MATERIAL AND METHODS: After a short training period between November 2011 and May 2013, RPP was performed on 9 patients with localized prostate cancer. The patients were evaluated as for medical, and perioperative and major postoperative complications. RESULTS: The mean age of the patients was 60.4±5.3 (50–68) years, the mean preoperative prostate-specific antigen (PSA) value was 5.8±1.3 (4.0–7.6) ng/mL and the mean prostate volume was 38.8±7.7 (28–54) cc. The biopsy Gleason score ranged from 5 to 7. The median follow-up period was 14 (3–30) months. Anastomotic stricture did not occur in any of the patients. Of the 9 patients, 4 (44%) were immediately continent after catheter removal, while the remaining patients were continent at the end of three months. Of the 7 patients who underwent nerve-sparing surgery, 2 had postoperative spontaneous erections. Erectile function was maintained with phosphodiesterase 5 (PDE-5) inhibitor treatment in 3, and with intracavernosal injection in 1 patient. Penile prosthesis implantation was performed in 1 patient. CONCLUSION: RPP has been a promising procedure at the start with its favorable oncologic and functional outcomes. This method should be considered by urologists, although it has been previously perceived as a challenging surgical procedure to perform

The relationships between metabolic syndrome, erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia

WOS: 000360378600002PubMed ID: 26328190Amaç: Benign prostat hiperplazisi (BPH) nedeni ile alt üriner sistem semptomları (AÜSS) olan hastalarda, erektil disfonksiyon (ED) ve metabolik sendrom (MetS) arasındaki ilişkinin belirlenmesi amaçlanmıştır. Gereç ve yöntemler: Polikliniğimize BPH’ya bağlı AÜSS nedeniyle başvuran 40 yaş üstü 78 hasta çalışmaya kabul edildi. Hastalara AÜSS ve ED değerlendirilmesi için sırası ile uluslararası prostat semptom skoru (IPSS), Uluslararası erektil fonksiyon indeksi (IIEF-5) formları dolduruldu. MetS tanısı için the National Cholesterol Education Program Adult Treatment Panel III kriteri kullanıldı. AÜSS, IPSS’a göre hafif, orta ve şiddetli olarak, ED ise IIEF-5 skoruna göre ise hafif, orta-hafif, orta, şiddetli gruplarına ayrılarak incelendi. Bu üç durumun birbirleri ile ve yaşa göre ilişkilerin değerlendirilmesinde Student’s t test, Mann-Whitney U, ANOVA, ki-kare, Fisher Exact testi ve Pearson korelasyon analizi kullanıldı. P0.05). There was a positive correlation with age and severity of LUTS but this relationship was not found to be statistically significant (p>0.05). Mean age of the patients with ED was significantly higher than those without (p<0.001). A statistically significant relationship was not observed between the mean IPSS scores and the severity of LUTS with Mets. However, we observed a weakly positive correlation between triglyceride levels and IPSS. Mean IIEF-5 scores of the patients with MetS were significantly lower than those of the patients without MetS. Severity of ED in the patients with MetS was significantly higher than patients without MetS. The percentage of ED in patients with severe LUTS was found to be statistically higher than other patients with mild, and moderate LUTS. In addition, we found a low degree of negative correlation between IPSS and IIEF-5 scores. Conclusion: In patients with LUTS as a consequence of BPH, when severity of symptoms increases, frequency of MetS increases proportionally and severe ED is observed much more frequently