Antonio Nacchia

Metabolic Syndrome Does Not Increase the Risk of Ejaculatory Dysfunction in Patients With Lower Urinary Tract Symptoms and Benign Prostatic Enlargement: An Italian Single-center Cohort Study

OBJECTIVE To evaluate the relationship between metabolic syndrome (MetS) and ejaculatory dysfunction (EjD) in patients with lower urinary tract symptoms and benign prostatic enlargement. MATERIALS AND METHODS From 2012 to 2016, a consecutive series of men with lower urinary tract symptoms and benign prostatic enlargement who were attending our prostate clinic were evaluated using the International Prostate Symptom Score (IPSS) and were subsequently enrolled into a prospective database. All patients were assessed using the short form of the International Index of Erectile Function (IIEF-SF) and the Male Sexual Health Questionnaire ejaculatory dysfunction short form (MSHQ-EjD-SF) that evaluates the ability to ejaculate, the ejaculation force, the ejaculation volume, and subjective bother associated with EjD. MetS was defined according to the Adult Treatment Panel III criteria. RESULTS A total of 220 patients were enrolled; 48 of 220 patients (22%) presented a MetS. Mean age was 70 ± 8 years, mean IPSS was 8.3 ± 6.2, mean IIEF score was 17.3 ± 7.9, and mean MSHQ-EjD-SF was 9.9 ± 4.7. Overall, 109 of 220 patients (50%) were affected by a moderate or severe EjD. On multivariate analysis, age (odds ratio [OR]: 1.058, 95% confidence interval [CI]: 1.016-1.123; P = .007), IIEF score (OR: 0.899, 95% CI: 0.856-0.943; P = .000), and IPSS (OR: 1.065, 95% CI: 1.011-1.123; P = .018) were found to be predictors of EjD. In our series MetS was not found to be predictive of EjD. CONCLUSION In our single-center study, MetS has no influence on the EjD evaluated with the MSHQ-EjD-SF.

Repeat prostate‐specific antigen (PSA) test before prostate biopsy: a 20% decrease in PSA values is associated with a reduced risk of cancer and particularly of high‐grade cancer

To analyse the impact of repeating a prostate‐specific antigen (PSA) level assessment on prostate biopsy decision in a cohort of men undergoing prostate biopsy.

Analysis of the relationship between benign prostatic hyperplasia/lower urinary tract symptoms and total serum testosterone level

Study design, materials and methods From 2009 onwards, a consecutive series of patients with LUTS related to BPE were prospectively enrolled. Patients were evaluated using the International prostatic symptom score (IPSS), ultrasound prostate volume assessment. Body mass index (BMI) as well as waist circumferences were measured. Blood samples were collected and tested for: PSA levels, testosterone, Sex Hormone Binding Globuline (SHBG), 17-Beta estradiol. We evaluated the association between hormone serum levels and LUTS/BPE using logistic regression analyses and Spearman correlation test.