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PURPOSE: “Omics” techniques have been used to understand and to identify biomarkers of male infertility. We report on the first metabonomics models created to diagnose varicocele and infertility among men with varicocele. METHODS: We recruited 35 infertile men with varicocele (VI group), 21 fertile men with varicocele (VF group) and 24 fertile men without varicocele (C group). All men underwent standard semen analysis, scrotal duplex ultrasonography, and sexual hormone level measurement. Hydrogen-1 nuclear magnetic resonance ((1)H NMR) spectra of seminal plasma were used to create metabonomics models to discriminate between men with and without varicocele, and between fertile and infertile men with varicocele. RESULTS: Using the statistical formalisms partial least square discriminants analysis and genetic algorithm–based linear discriminant analysis (GA-LDA), we created two models that discriminated the three groups from each other with accuracy of 92.17%. We also created metabonomics models using orthogonal partial least square discriminants analysis and GA-LDA that discriminated VF group from VI group, with an accuracy of 94.64% and 100% respectively. We identified 19 metabolites that were important in group segregation: caprate, 2-hydroxy-3-methylvalerate, leucine, valine, 3-hydroxybutyrate, lactate, alanine, 4-aminobutyrate, isoleucine, citrate, methanol, glucose, glycosides, glycerol-3-phosphocoline, n-acetyltyrosine, glutamine, tyrosine, arginine, and uridine. CONCLUSIONS: (1)HNMR-based metabonomics of seminal plasma can be used to create metabonomics models to discriminate between men with varicocele from those without varicocele, and between fertile men with varicocele from those infertile with varicocele. Furthermore, the most important metabolites for group segregation are involved in the oxidative stress caused by varicocele.

Aim: To determine whether bladder functions deteriorate with age. Methods: Data contained in electronic medical record (INFOMED?) were used in this institutional retrospective review. Analysis was done on the urodynamic studies in women over 18 years old conducted between May 2011 and November 2015. Patients with previous history of pelvic surgery or radiotherapy, neurological disease, vaginal prolapse greater than grade I, congenital urogenital malformations, urinary obstructive disease, diabetes, or the use of any medication that could interfere with bladder function were excluded from the analysis. The urodynamic parameters analyzed were the Maximum Cystometric Capacity (MCC), Voiding Volume (VV), Maximum Flow (Qmax), Bladder Compliance (BC), Detrusor Pressure at Maximum Flow (PdetQmax), Bladder Contractility Index (BCI), Bladder Voiding Efficiency (BVE) and Post-Void Residual Urine Volume (PVR). Patients were further stratified in five groups according to age (A—18 to 40; B—41 to 50; C—51 to 60; D—61 to 70; E—over 70 years old). Results: Out of 3103 urodynamic studies analyzed, 719 were eligible for the study. The average age of patients was 49.3 (+13.2) years old and in all evaluated parameters, statistically significant correlation between age and decline of bladder function was obtained (p < 0.05). Moreover, mathematical equations were presented to estimate the parameters values in relation to age. Conclusions: This study showed a decline in bladder storage function (reduction in MCC and BC) and in bladder emptying function (reduction in Qmax, PdetQmax, VV, BCI and BVE with an increase in PVR) with age.

Introduction: Smoking is an important risky factor to many diseases, affecting arterial system, skin and urogenital system, including bladder neck stenosis. Its effect on bladder neck has not been described. Objective: Evaluate possible morphological changes caused by nicotine in the bladder neck. Material and Method: Fragments of bladder neck of 16 patients were submitted to stereological analysis, and those patients are divided into two groups, one of smokers and the other of non-smokers with 7 and 9 patients, respectively. After 90 days of surgery, they were submitted to free uroflowmetry and data analyzed by T test, having statistical significance with P 0.05. Results: An increase of 63.26% in the amount of fibers in the elastic system of the smokers group was observed, a reduction of 35.96% in the thickness of arteries, as well as an increase of IPSS and decrease of maximum flow in uroflowmetry, all with statistical significance. Discussion: Laboratorial changes are similar to those found in other studies with different tissues, such as skin, in which those findings are related to premature ageing. Clinical results, though statistically significant, do not have clinical consistence because the study was meant to morphological analysis. Conclusion: Smoking increases the amount of fibers in the elastic system and decreases the thickness of bladder neck arteries.