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OBJECTIVE: To analyze the perioperatory and short-oncological outcomes in 5 cases with CRPC M0 developed after pRT that underwent salvage laparoscopic RP (sLRP) and review the current evidence. MATERIAL AND METHODS: Perioperatory and oncological outcomes were prospectively analyzed. Inclusion criteria were patients that had received pRT and posteriorly presented with CRPC M0 in standard imagines and positron emission tomography MRI coline. Evidence was reviewed in PUBMED database. RESULTS: No surgical complications and blood transfusion were reported. Two patients required an endoscopic urethrotomy due to bladder neck contracture (Clavien IIIb). Final pathological findings were T3 or more, multifocal with 3 positive surgical margins. Four patients reach undetectable PSA after surgery except one that continuous under ADT without disease progression. After 12 months follow-up, 4 patients persist with undetectable PSA and one with stable disease under ADT. Current evidence demonstrated that CRPC M0 treated with open, laparoscopic or robotic RP a biochemical recurrence of 68.7% as a hormone-sensitive PC; however, 17.4% were disease-free after 4 years of follow-up. CONCLUSION: Our serie, 4 cases are disease free after 12 months follow-up. Current evidence is a retrospective and multicenter experience with few cases and intermediate oncological follow-up. More cases with longer follow-up and better evidence are required to opt for this treatment as a first line.

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OBJECTIVE: To report 2 cases of an extremely rare bladder tumor such as Cystitis Glandularis (CG) that were management by different strategies and review the current evidence. MATERIAL AND METHODS: Both cases of 43 and 48 years reported the same lower urinary tract symptoms that simulated a malignant bladder tumor. Case 1 presented with an extensive tumor affecting the trigone and the left upper urinary tract; the second case presented a less extensive tumor also at the bladder trigone. RESULTS: The first patient required two bladder tumor resection and a laparoscopic uretero-vesical reimplantation with adyuvant steroids. The other patient only required one bladder tumor resection without adyuvant treatment. Finally, after 7 and 6 months, both patients do not present tumor recurrence; respectively. CONCLUSION: Cystitis Glandularis (CG) represent an extremely rare tumor. Usually presentation is in young people with predilection at the bladder trigone. Current evidence ruled out being preneoplastic without standardized treatment. Two cases were analyzed with completely different characteristics, but with satisfactory treatment.

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Objetivos: El objetivo del estudio fue evaluar nuestra experiencia inicial en cirugía intrarrenal retrógrada para el tratamiento de litiasis renales y determinar si es una cirugía eficaz y segura para realizarse en un centro ambulatorio. Materiales y métodos: Se evaluó a todos los pacientes sometidos a ureterorrenoscopia flexible con láser Holmium en la Clínica Andina de Urología luego de un año de procedimientos. Se determinaron datos demográficos, características de las litiasis operadas, porcentaje libre de litiasis y complicaciones según escala modificada de Clavien. Resultados: Un total de 63 pacientes fueron intervenidos desde marzo de 2017 a marzo de 2018. El tamaño medio de las litiasis urinarias fue de 11,6 mm. En un 93,6% de los pacientes la cirugía se pudo completar sin inconvenientes con un tiempo medio de 44 minutos. El porcentaje global libre de litiasis fue del 76,19%. Un 17,4% tuvo complicaciones generales, sin embargo, solo 2 pacientes requirieron reinternación. Conclusiones: La ureterorrenoscopia flexible es una cirugía mínimamente invasiva, eficaz y segura, con un bajo índice de complicaciones (AU)

Objectives: The aim of this study was to evaluate our initial experience in retrograde intrarenal surgery for the treatment of renal lithiasis and determinate if the surgery is effective and safe to be practice in an ambulatory center. Materials and methods: We recorded all patients who underwent flexible ureterorenoscopy and laser Holmium at Clínica Andina de Urología after one year of surgeries. Demographic information, stones characteristics, stone free rate and complication using Clavien system were gathered. Results: A total of 63 patients underwent flexible ureterorenoscopy from March 2017 to March 2018. Mean stone diameter was 11.6 mm. Surgery was complete in 93.6% of patients with a mean operative time of 44 minutes. Stone free rate was 76.19%. The overall complication rate was 17.4%, nevertheless, only 2 patients were readmitted. Conclusions: IFlexible ureterorenoscopy is a minimally invasive procedure, effective and safe, with a low rate of complications. (AU)

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Introducción: En varones, el estradiol circula en pequeñas concentraciones (8-40 pg/ml), sin estar del todo claras aún sus funciones. En este contexto, es necesario aclarar los efectos de esta hormona en el sexo masculino. Además de estudiarse el posible papel en la reproducción masculina, en los últimos años se ha tratado de encontrar la relación entre sus niveles y los componentes del síndrome metabólico. Sin embargo, la bibliografía existente no aclara si ejerce un papel protector o perjudicial con respecto a dicha patología. Objetivos: Analizar las relaciones existentes entre el estradiol y los componentes del síndrome metabólico en una muestra de varones excedidos de peso con síndrome metabólico de la provincia de Mendoza. Metodología: Se estudió a 40 varones con sobrepeso u obesidad y síndrome metabólico residentes en la ciudad de Mendoza, con edades entre 53 y 74 años, los cuales fueron evaluados a partir de una consulta médica de rutina. Se determinaron estradiol, testosterona, glucemia en ayunas, insulina en ayunas, índice HOMA, perfil lipídico y ácido úrico. Se evaluó el estado nutricional mediante antropometría: peso, talla, circunferencias, pliegues cutáneos y medidas derivadas. El análisis estadístico se realizó mediante correlación de Pearson o Spearman según la normalidad de las variables y la prueba de la t de Student para muestras independientes. Se utilizó un nivel mínimo de significación de p < 0,05. Resultados: Los niveles de estradiol se correlacionaron negativamente con los valores de triglicéridos (r = -0,401; p = 0,013) y con la glucemia en ayunas (r= -0,333; p= 0,041). Por otra parte, los individuos normotrigliceridémicos (valor de triglicéridos < 150 mg/dl) mostraron valores mayores de estradiol que los hipertrigliceridémicos (p = 0,02). Conclusiones: Los niveles de estradiol muestran relación inversa con triglicéridos y glucemia en ayunas en varones con síndrome metabólico.

Introduction: Oestradiol circulates in low concentrations (8-40 pg/ml) in males, with its functions still not being entirely clear. In this context, there is a need to determine the effects it has on males. Apart from studying the potential role oestradiol has on male reproduction in recent years, efforts have been made to determine the relationship between oestradiol levels and metabolic syndrome components. Nevertheless, the existing bibliography does not clarify whether oestradiol plays a protective or detrimental role in this condition. Objectives: The present work aimed to analyse the relationship between serum oestradiol levels and metabolic syndrome components in overweight men from Mendoza. Methodology: The sample consisted of 40 overweight or obese males, aged 53-74, with metabolic syndrome, and living in the city of Mendoza. Based on a health routine check-up, they were evaluated by determining the levels of oestradiol, testosterone, fasting blood glucose, insulin, HOMA index, lipid profile, and uric acid. Nutritional status was assessed using anthropometric measurements: weight, height, circumferences, and skinfold thickness. Statistical analysis was carried out using Pearson or Spearman correlation according to the normality of variables and the Student t test for independent samples. A minimum level of significance of P<.05 was used. Results: Oestradiol levels negatively correlated with triglyceride values (r = -0.401; P=.013) and fasting blood glucose (r= -0.333; P=.041). Furthermore, those with normal triglycerides (triglyceride values <150 mg/dl) showed higher oestradiol levels compared to those with high triglycerides (P=.02). Conclusions: Oestradiol levels show an inverse relationship as regards triglycerides and fasting blood glucose in men with metabolic syndrome.

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For six decades, it has been a part of the conventional medical wisdom that higher levels of testosterone increase the risk of prostate cancer. This belief is mostly derived from the well-documented regression of prostate cancer after surgical or pharmacological castration. However, there is an absence of scientific data supporting the concept that higher testosterone levels are associated with an increased risk of prostate cancer. Moreover, men with hypogonadism have substantial rates of prostate cancer in prostatic biopsies, suggesting that low testosterone has no protective effect against the development of prostate cancer. Moreover, prostate cancer rate is higher in elderly patients when hormonal levels are low. These results argue against an increased risk of prostate cancer with testosterone replacement therapy.

Por casi seis décadas ha sido parte de la cultura médica en general, que los niveles altos de testosterona incrementan el riesgo de padecer o agravar un cáncer de próstata. Esta creencia se ha derivado fundamentalmente de la bien documentada regresión del cáncer de próstata luego de la castración médica o quirúrgica. Sin embargo, no existe evidencia científica que apoye la idea de que niveles altos de testosterona están asociados con un incremento del riesgo de cáncer de próstata. Más aún, los hombres con hipogonadismo tienen una tasa substancialmente alta de cáncer de próstata detectado por biopsia, lo que sugiere que los niveles bajos de testosterona no tienen un efecto protector en el desarrollo de cáncer de próstata y, además, la tasa de cáncer de próstata es más alta en los pacientes de edades avanzadas cuando sus niveles hormonales son más bajos. Estos argumentos tienden a demostrar que no existiría un incremento del riesgo de padecer un cáncer de próstata asociado a la terapia de reemplazo con testosterona.

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Introducción: Estudios recientes indican que los varones obesos tienen menor concentración plasmática de antígeno prostático específico (PSA) que los que tienen peso normal, posiblemente debido a un mayor volumen plasmático (hemodilución) y/o a una menor actividad androgénica, dificultando la detección precoz del câncer de próstata. No está establecido claramente si esta relación se acompaña de menores cantidades absolutas dePSA. El objetivo del presente trabajo fue determinar la asociación entre el índice de masa corporal (IMC), la concentración de PSA y sus cantidades absolutas circulantes (“PSA masa”). Material y Métodos: Se determinó PSA total en 570 varones de 45 a 80 años, con PSA considerado no sospecho-so de patologías prostáticas (<4ng/mL). Se evaluaron el peso, la talla y el IMC, se estimó el volumen plasmático (VP) y el PSA masa fue calculado a partir de la concentración plasmática de PSA y el VP. El análisis estadístico se realizó mediante coeficiente de correlación de Pearson o Spearman según la normalidad de las variables (p<0,05). Resultados: El IMC se asoció significativamente con un mayor VP (r = 0,512; p<0,0001). Dado que las concentraciones de PSA se asociaron positivamente con la edad (r = 0,248; p<0,0001), se analizaro...

Recent studies indicate that obese men have lower plasma prostate-specific antigen (PSA) concentrations than normal weight men, which may probably be explained by higher plasma volume (hemodilution) and/or a lower androgenic activity. This may interfere with the ability to detect early-stage prostate cancer. It is not clear whether this relationship is accompanied by lower absolute amounts of PSA. The aim of this study was to determine the association between the body mass index (BMI), the PSA concentrations and the totalamount of PSA in circulation (“PSA mass”). Material and methods: The total amount of PSA was determined in 570 men aged 45-80 years, whose PSA values were not indicators of prostate disease (<4ng/mL). Weight, height and BMI were measured, plasma volume(PV) was estimated, and PSA mass was calculated taking into account plasma PSA concentrations and PV. The statistical analysis was performed using Pearson orSpearman/'s correlation coefficient according to the normality of the variables (P<0.05). Results: The BMI was significantly associated with a higher PV (r = 0.512; P<0.0001). Due to the positive correlation between PSA concentrations and age (r = 0.248;P<0.0001), partial correlations adjusted for...

Estudos recentes indicam que os homens obesos têm menor concentração plasmática de antígeno prostático específico (PSA) que os que têm peso normal, possivelmente devido a um maior volume plasmático (hemodiluição) e/ou a uma menor atividade androgênica,dificultando a detecção precoce do câncer de próstata. Não está estabelecido claramente se esta relação está acompanhada de menores quantidades absolutas de PSA. O objetivo do presente trabalho foi determinar a associação entre o índice de massa corporal (IMC), a concentração de PSA e suas quantidades absolutas circulantes (/"PSA masa/"). Material e Métodos: Determinou-se PSA total em 570 homens de 45 a 80 anos, com PSA considerado não suspeitoso de patalogias prostáticas (<4ng/mL). Foram avaliados o peso, a altura e o IMC, estimou-se o volume plasmático (VP) e o PSA massa foi calculado a partir da concentração plasmática de PSA e o VP. A análise estatística foi realizada mediante coeficiente de correlação de Pearson ou Spearman segundo a normalidade das variáveis(p<0,05). Resultados: O IMC se associou significativamente com um maior VP (r = 0,512; p<0,0001). Dado que as concentrações de PSA se associaram positivamente com a idade (r = 0,248; p<0,0001), analisaram-se as correlações parciais corrigidas para esta variável. Assim, o IMC se associou com uma menor concentração de PSA (r = -0,298;p<0,0001) e menor PSA massa...

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Los sistemas antioxidantes del cuerpo humano son capaces de remover a los radicales libres, protegiendo así al organismo del daño que estos pueden ocasionar, y pueden ser valorados en conjunto mediante la determinación del poder antioxidante total (TAS, por sus siglas en inglés). Este biomarcador es modulado por la alimentación mediante la incorporación de sustancias con propiedades antioxidantes o prooxidantes. El objetivo del presente trabajo fue estimar la ingestión de nutrientes antioxidantes y grupos específicos de alimentos y correlacionarla con el TAS. Fueron seleccionados al azar 45 sujetos de sexo masculino, entre 50 y 75 años, de una consulta médica de rutina. El trabajo consistió en una evaluación de TAS mediante técnica ABTS más una entrevista nutricional donde se evaluó la composición corporal mediante antropometría y la ingestión habitual de nutrientes y grupos específicos de alimentos mediante un recordatorio de 24 h y un cuestionario de frecuencia de consumo de alimentos validado para tal fin. El análisis estadístico se realizó mediante Coeficiente de Correlación de Pearson o Spearman según la normalidad de la muestra (p<0,05). El TAS se correlacionó positivamente con el consumo de licopeno (r=0,295; p=0,049) y negativamente con la ingestión de carnes rojas (r= -0,403; p=0,007). Los demás nutrientes o alimentos no se correlacionaron con el TAS. Por lo tanto, una ingestión elevada de licopeno y un consumo reducido de carnes rojas ayudarían a mejorar el sistema antioxidante del organismo.

High intake of lycopene together with low intake of red meat increases the total antioxidant status. The body's antioxidant systems are able to remove free radicals, thus protecting the body from the damage they may cause. They can be estimated, as a whole, through the determination of total antioxidant status (TAS). This biomarker can be modulated by dietary factors through the incorporation of substances with antioxidant or prooxidant properties. The aim of this study was to estimate the intake of antioxidant nutrients and specific food groups, and its correlation with TAS. Fortyfive male volunteers between 50 and 75 years were randomly selected from a medical consultation. The study included a TAS determination by ABTS and a nutritional interview where corporal composition was studied through anthropometry and the habitual consumption of nutrients was estimated by means of 24 hour diary and food consumption frequency questionnaire. Statistical analysis was performed by using Pearson or Spearman correlation coefficient (p <0.05). TAS was positively correlated with lycopene consumption (r=0,295; p=0,049), and negatively with red meat intake (r= -0,403; p= 0,007), while intake of other studied antioxidant nutrients did not correlate significantly with TAS. In conclusion, high intake of lycopene and reduced red meat consumption increase TAS.

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The body's antioxidant systems are able to remove free radicals, thus protecting the body from the damage they may cause. They can be estimated, as a whole, through the determination of total antioxidant status (TAS). This biomarker can be modulated by dietary factors through the incorporation of substances with antioxidant or prooxidant properties. The aim of this study was to estimate the intake of antioxidant nutrients and specific food groups, and its correlation with TAS. Forty-five male volunteers between 50 and 75 years were randomly selected from a medical consultation. The study included a TAS determination by ABTS and a nutritional interview where corporal composition was studied through anthropometry and the habitual consumption of nutrients was estimated by means of 24 hour diary and food consumption frequency questionnaire. Statistical analysis was performed by using Pearson or Spearman correlation coefficient (p < 0.05). TAS was positively correlated with lycopene consumption (r = 0.295; p = 0.049), and negatively with red meat intake (r = -0.403; p = 0.007), while intake of other studied antioxidant nutrients did not correlate significantly with TAS. In conclusion, high intake of lycopene and reduced red meat consumption increase TAS.

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OBJECTIVES: To determine whether lower serum prostate-specific antigen (PSA) concentration in obese men is caused by plasma hemodilution and/or decreased serum testosterone levels. METHODS: A sample of 413 men, from 45 to 75 years old, were randomly selected for the study among those who participated in prostate cancer screening at 2 urban urology practices in Argentina and Puerto Rico. Weight, height, serum testosterone and total PSA concentration were determined. Body mass index (BMI), body surface, plasma volume, and PSA mass were calculated. Prostate volume was estimated by transrectal ultrasound using the prolate ellipsoid formula. RESULTS: Mean age was 59 years old (range, 45 to 75) and mean BMI was 28.8 kg/m2 (range, 24 to 46). Mean serum PSA concentration was 1.43 ng/ml in normal weight patients (n=68), 1.4 ng/ml in overweight patients (n=222), 1.05 ng/ml in obese patients (n=114), and 0.85 ng/ml in morbidly obese patients (n=9). BMI was directly correlated with plasma volume (r= 0.687; p= 0.001) and inversely correlated with serum PSA concentration (r= -0.235; P= 0.001). PSA mass tended to be lower in obese and morbidly obese patients (P= 0.0063)compared to normal weight and overweight subjects. Serum testosterone concentration (P= 0.91) and prostate volume (P= 0.068) were similar among all BMI groups. CONCLUSIONS: Obese men had lower serum PSA concentrations than normal weight men mainly due to plasma hemodilution. PSA mass tended to be lower in obese patients, but it is unlikely a consequence of lower serum testosterone concentrations.

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BACKGROUND: Many studies have investigated the association between obesity, adipose tissue-derived factors (leptin and adiponectin) and prostate cancer (CaP) but the results are still inconsistent. METHODS: The aim of this study was to carry out a comprehensive review of the existing evidence about the role of leptin and adiponectin in prostate carcinogenesis and to provide an overview of it. RESULTS: Recent evidence suggests that leptin may play a rol in prostate cancer progression, while adiponectin may act as an "antiprostatic cancer" adipokine. CONCLUSIONS: Obesity may promote the progression of established prostate cancer and and adipokines may provide a molecular mechanism whereby obesity exerts its effects on prostate tumour biology.

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