W.-J. Wu

The interaction of serum testosterone levels and androgen receptor CAG repeat polymorphism on the risk of erectile dysfunction in aging Taiwanese men.

Testosterone has been found to play important roles in mens sexual function. However, the effects of testosterone can be modulated by androgen receptor (AR) CAG repeat polymorphism. It could also contribute to the risk of erectile dysfunction (ED). The aim of this study is to evaluate the interaction of serum testosterone levels and AR CAG repeat polymorphism on the risk of ED in aging Taiwanese men. This cross‐sectional data of Taiwanese men older than 40 years were collected from a free health screening held between August 2010 and August 2011 in Kaohsiung city, Taiwan. All participants completed a health questionnaires included five‐item version of the International Index of Erectile Function (IIEF‐5) and the International Prostate Symptoms Score, received a detailed physical examination and provided 20 cm3 whole blood samples for biochemical and genetic evaluation. The IIEF‐5 was used to evaluate ED. Serum albumin, total testosterone (TT), and sex hormone‐binding globulin levels were measured. Free testosterone level was calculated. AR gene CAG repeat polymorphism was determined by direct sequencing. Finally, 478 men with the mean age of 55.7 ± 4.8 years were included. When TT levels were above 330 ng/dL, the effect of testosterone level on erectile function seemed to reach a plateau and a significantly negative correlation between AR CAG repeat length and the score of IIEF‐5 was found (r = −0.119, p = 0.034). After adjusting for other covariates, the longer AR CAG repeat length was still an independent risk factor for ED in subjects with TT above 330 ng/dL (p = 0.006), but not in TT of 330 ng/dL or below. In conclusion, both serum testosterone levels and AR CAG repeat polymorphism can influence erectile function concomitantly. In subjects with normal TT concentration, those with longer AR CAG repeat lengths have a higher risk of developing ED.

The impact of metabolic syndrome on the responsiveness to α1-blocker in men with BPH/LUTS

Aims: Increasing evidence has proposed the components of metabolic syndrome (MtS) as risk factors for the development of benign prostate hyperplasia (BPH); therefore, it is thought that MtS may play a role in lower urinary tract symptoms related to BPH (BPH/LUTS) aetiology. Considering the closed relationships between MtS and BPH/LUTS, it is possible that patients with MtS might have different drug responsiveness in men with BPH/LUTS. We prospectively investigated the impact of MtS on responsiveness to α1‐blocker in men with BPH/LUTS.

897 Translocation of nuclear factor-κB and expression of cyclooxygenase-2 is enhanced by ketamine-induced ulcerative cystitis in rat bladder

INTRODUCTION AND OBJECTIVES: Hydrogen sulfide (H2S) is a third endogenous gasotransmitter besides NO and CO, and induces smooth muscle relaxation. In this study, we investigated pharmacological profiles of exogenous H2S-induced relaxation of bladder and prostate smooth muscle and expression levels of H2S synthesis enzymes, cystathionine b-synthase (CBS) and 3-mercaptopyruvate sulftransferase (MPST), in these tissues of the rat. METHODS: Bladder dome and trigone (BL-D and BL-T), and ventral and dorsolateral prostate (PR-V and PR-D) were prepared from male Wistar rats (350e400 g). Relaxation effects of NaHS, an H2S donor, were evaluated by organ bath studies on acetylcholine (1x10 5 M)-induced contractions of bladder and on noradrenaline (1x10 5 M)induced ones of prostate. Protein levels of CBS and MPST in each part were also investigated by Western blotting. RESULTS: NaHS dose-dependently elicited relaxation on BL-D and BL-T pre-contracted by acetylcholine and on PR-V and PR-D precontracted by noradrenaline. There were no significant differences in values of EC50 and relaxation rate against the pre-contractions among these tissues. CBS was detected in PR-V and PR-D, and the expression levels in PR-D were higher than those in PR-V. In BL-D and BL-T, CBS was not detected. MPST was detected in all these tissues. Expression levels of MPST in PR-V were the highest and those in prostate were higher than those in bladder. CONCLUSIONS: H2S induces relaxation of bladder and prostate smooth muscle. H2S synthesis enzymes are expressed in both bladder and prostate. These results suggest that H2S could function as an endogenous relaxation factor in both tissues. Endogenous H2S might be a new therapeutic target for lower urinary tract dysfunction such as overactive bladder and benign prostatic hyperplasia. Source of Funding: none

Inguinoscrotal herniation of bladder: case series and literature review

SummaryBackgroundBladder hernias are relatively rare condition while only accounts for 1–4 % of inguinal hernias. It is not the surgery but the diagnosis that remain the major challenges of clinical practice.MethodsHerein, we report five cases of bladder hernias with different clinical presentation, and review of current literature.ResultsThe definite diagnosis relies on clinical suspicion and multiple urographic imaging. Sonography is a preferred image modality for its inexpensive and noninvasive nature. Abdominal computed tomography (CT) could depict the anatomic details of the hernia lesion and its relationship with the surrounding pelvic organs. Although bladder herniation is not a malignant condition, it can be fatal due to iatrogenic surgical complications.ConclusionsIn addition to current indications, refractory urinary tract infection should be viewed as another indication of partial cystectomy. Besides, repeated urography should be considered as the tool to ensure the result of surgery.