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Purpose: The present study was designed to compare the efficacy of alfuzosin therapy as an alpha-blocker in metabolic syndrome (MetS) and non-MetS patients with moderate lower urinary tract symptoms (LUTS)., Material and Methods: This prospective study included male patients with obstructive voiding and had a moderate LUTS according to International Prostate Symptom Score (IPSS). Patients were divided into two groups: MetS and Non-MetS. Following the measurement of uroflowmetric parameters (maximum flow rate [Qmax], post-void residual volume [PVR], urine volume) and the determination of IPSS scores, the patients were initiated on alfuzosin 10 mg once daily for a period of 12 weeks. At the end of the therapy, treatment outcomes were determined based on uroflowmetric parameters and IPSS scores., Results: 301 patients were included in the study (MetS: 160, non-MetS: 141). Pre-treatment uroflowmetric measurements and IPSS scores were similar in both groups. After the therapy, the median Qmax level increased from 12.80 (10.62-14.82) ml/s to 14.55 (12.00-16.60) ml/s in the MetS group and from 12.60 (8.60-14.60) ml/s to 15.70 (13.20-17.20) ml/s in the non-MetS group (p<0.001 for both). Similar statistically significant changes were valid for PVR and IPSS. Post-treatment Qmax, PVR values and IPSS scores were higher in the non-MetS patients compared to MetS patients., Conclusion: Although the non-MetS patients had greater benefit from the alfuzosin therapy compared to the MetS patients, alfuzosin is an effective alpha-blocker in the treatment of MetS patients with moderate LUTS. Based on these findings, it is tempting to consider that MetS might be a negative factor for benign prostate hyperplasia treatment.

Purpose: We analyzed the role of oxidative stress in detrusor overactivity (DO) by measuring serum total antioxidant capacity (TAC), total oxidant status (TOS), binding capacity of exogenous cobalt to human albumin (IMA), serum advanced oxidation protein products (AOPP), paraoxonase (PON), and arylesterase., Materials and Methods: The study included 38 female patients diagnosed with DO and 29 healthy female subjects forming the control group. Serum total antioxidant capacity (TAC), total oxidant status (TOS), binding capacity of exogenous cobalt to human albumin (IMA), serum advanced oxidation protein products (AOPP), paraoxonase (PON), and arylesterase were analyzed. The results of serum TAC, TOS, IMA, AOPP, PON, and arylesterase of the subjects in both groups were compared., Results: There was no difference between the groups in terms of age. When compared to the control group, serum TAC and IMA levels were statisticaly lower (P  < 0,001)  and higher (P = 0,003), respectively. However, TOS, AOPP, PON, arylesterase levels were similar in both groups ( p > 0.05 )., Conclusion: There seems to be an association between DO and oxidative damage according to our results, this can be measured by analyzing TAC and IMA in this patient group.

Purpose: To assessment the safety of concurrent repair of inguinal hernia (IH) with mesh application during transperitoneal robotic-assisted radical prostatectomy(RARP)., Materials and Methods: Data of 20 patients (totally 25 procedures) who performed concurrent IH repair with mesh application during RARP were retrospectively enrolled in this study. Preoperative patient characteristics, intra and postoperative parameters (pathological Gleason grade, prostate volume at surgical specimen, operative time, herniorrhaphy time, estimated blood loss, complications, time of hospitalization, catheterization, and drainage) were evaluated. Standard PSA control and postoperative complications of mesh application such as herniarecurrence, mesh infection, seroma formation and groin pain were evaluated at every follow-up visits (every three in the first year, then every 6 months in years 2 to 5 and annually thereafter., Result: The mean age was 66 ± 8 years in our population. Fifteen (60 %) patients had a unilateral hernia and 5 (40%) patients had bilateral hernias. The mean operative time was 139 ± 21minutes and estimated mean blood loss was 108 ± 76 mL. The mean duration of IH repair in patients which was 27 ± 5 (range: 17- 40) minutes. The mean time of drainage, hospitalization, and catheterization were 2.5 ± 0.8 days (range: 2-6), 4 ± 0.9 days (range: 2-7) and 8.2 ± 1.9 days (range: 7-14), respectively. We did not observe any intra-operative complication due to RARP orIH repair. Wound evisceration at camera port site developed in only a patient on postoperative day 20. Our median follow-up time was 13 months and we did not observe mesh infection or hernia recurrence during follow-up., Conclusion: Concurrent IH repair with RARP procedure seem to be easy to perform, effective and safe procedure.

Purpose: To evaluate of the presence of a median lobe(ML) affect perioperative complications, positive surgical margins(PSM), biochemical recurrence(BCR) and urinary continence(UC) following robotic-assisted radical prostatectomy(RARP)., Materials and Methods: Data of 924 consecutive patients who underwent RARP for prostate cancer (PCa) and who have at least 1-year follow-up were evaluated retrospectively. All patients were divided into two groups: Group 1(n=252) included patients with ML and Group 2 (n=672) included patients without ML. The primary endpoint of this study was to compare complication rates between two groups. The secondary endpoints were to compare PSM, BCR and UC rates., Results: Both groups were statistically similar in terms of demographics and variables about PCa. Mean prostate volume was higher in Group 1 vs. Group 2 (69± 31 vs. 56±23 mL, p<.001). Total operative time was longer in Group 1 vs. Group 2 (144±38 vs. 136±44 min, p=.01). Biochemical recurrence, PSM, perioperative and postoperative complication rates of our population were 13.6%, 14.9%, 1.7% and 8.7%, respectively. There were no statistical differences in terms of perioperative complication, PSM and BCR rates between the groups(p>0.05). At the first month after RARP, total continence rate was statistically significant lower in Group 1 vs. Group 2 (49.2% and 56.5%, p=.03), respectively. However, there were no significant differences in terms of continence rates at 3rd month, 6th month and 1st-year follow-up., Conclusions: Due to our experience, the presence of ML does not seem to affect perioperative complication, intraoperative blood loss, PSM and BCR following RARP. However, the presence of ML seems to be a disadvantage in gaining early UC following RARP.