The aim of this pilot study is to evaluate sarcosine, uracil, and kynurenic acid in urine as potential biomarkers in prostate cancer detection and progression monitoring. Sarcosine, uracil, and kynurenic acid were measured in urine samples of 32 prostate cancer patients prior to radical prostatectomy, 101 patients with increased prostate-specific antigen prior to ultrasonographically-guided prostatic biopsy collected before and after prostatic massage, and 15 healthy volunteers (controls). The results were related to histopathologic data, Gleason score, and PSA (Prostate Specific Antigen). Metabolites were measured after analysis of urine samples with Ultra-High Performance Liquid Chromatography coupled to tandem mass spectrometry (UPLC-MS/MS) instrumentation. Multivariate, nonparametric statistical tests including receiver operating characteristics analyses, one-way analysis of variance (Kruskal–Wallis test), parametric statistical analysis, and Pearson correlation, were performed to evaluate diagnostic performance. Decreased median sarcosine and kynurenic acid and increased uracil concentrations were observed for patients with prostate cancer compared to participants without malignancy. Results showed that there was no correlation between the concentration of the studied metabolites and the cancer grade (Gleason score <7 vs. ≥7) and the age of the patients. Evaluation of biomarkers by ROC (Receiving Operating Characteristics) curve analysis showed that differentiation of prostate cancer patients from participants without malignancy was not enhanced by sarcosine or uracil levels in urine. In contrast to total PSA values, kynurenic acid was found a promising biomarker for the detection of prostate cancer particularly in cases where collection of urine samples was performed after prostatic massage. Sarcosine and uracil in urine samples of patients with prostate cancer were not found as significant biomarkers for the diagnosis of prostate cancer. None of the three metabolites can be used reliably for monitoring the progress of the disease.

Patients with UUC surprisingly presented at least equal quality of life than the presumably less debilitating and more recent ONB. This could be explained due to lower complication rate and to lower expectations of the UUC group. UUC is a considerable option for urinary diversion after radical cystectomy in the era of HRQoL for selected patients.

Purpose:The aim of the present study was to determine the diagnostic accuracy of conventional and ambulatory urodynamic studies (UDS) in estimating neobladder function.Methods:We evaluated 32 patients who underwent radical cystectomy and orthotopic Hautmann W neobladder with Abol-Enein-Ghoneim uretero-intestinal anastomosis for bladder cancer. The patients were initially examined by using both conventional and ambulatory UDS.Results:Conventional UDS detected a very high mean intravesical pressure at maximum capacity (53.7±17.5 cm H2O). By contrast, the mean intravesical pressure detected by using ambulatory UDS (which reflects the dominant pattern of pressure variation during filling) was significantly lower (34.4±5.2 cm H2O, P<0.001). The comparison between intravesical pressure at half of maximum capacity in conventional UDS and the mean value in ambulatory UDS did not show significant difference (P=0.152). The mean voided volume in conventional UDS was greater than both the mean voided volume (P<0.001) and the mean maximum voided volume in ambulatory UDS (P=0.001). However, this difference did not affect the postvoid residual urine volume measured in both studies (P=0.207). Moreover, incontinence episodes recorded in ambulatory UDS were more frequent but not statistically significantly different from those recorded in conventional UDS (P=0.332).Conclusions:The estimation of neobladder function by means of ambulatory UDS seems to provide interesting research data for the mode of lower urinary tract function in patients with orthotopic substitution after radical cystectomy. The great high value in ambulatory UDS, in cases in which conventional UDS had failed, is due to the exposure of daily and nocturnal incontinence episodes, confirming our patients’ complaints.

We aimed to determine the prevalence of early ejaculation disorders (EED) and to calculate the prevalence of lifelong premature ejaculation (PE) in Greek urban men. Associations with physiological and psychological conditions, treatment-seeking and treatment efficacy were defined. We surveyed 522 urban men aged 16-62 individually using an open, one-on-one questionnaire. A total of 305 (58.43%) participants reported EED. The prevalence of lifelong PE, according to the International Society for Sexual Medicine criteria, was calculated as 17.7%. Among sufferers of EED, unrelated stress was the most frequent comorbidity (42.6%) and, along with erectile dysfunction and lower urinary tract symptoms, occurred more frequently than in normal participants (P < 0.05). Half (50.3%) of the sufferers believed that their problem was psychological, while 69.5% never sought help. Most (69.2%) of those who did seek help sought it anonymously through the internet. Behavioural treatment was preferred to medical treatment. Few (13.8%) men were satisfied with their treatment. In conclusion, although the observed PE prevalence agrees with the previous findings, more patients suffer negative personal and relationship consequences and may also require treatment. Most men do not seek medical assistance, and from those who do, most are not satisfied with the results of treatment.

Σκοπός της διατριβής είναι η διερεύνηση του ρόλου της σαρκοσίνης, της ουρακίλης και του κυνουρενικού οξέος στην πρώιμη διάγνωση του προστατικού καρκίνου, αλλά και στην πρόβλεψη της επιθετικότητάς του, ώστε στο μέλλον να μπορούν να χρησιμοποιηθούν ως βιολογικοί δείκτες για τη συγκεκριμένη νόσο. Η σαρκοσίνη, η ουρακίλη και το κυνουρενικό οξύ υπολογίστηκαν σε δείγματα ορού και ούρων από 32 ασθενείς με καρκίνο προστάτη, πριν υποβληθούν σε ριζική προστατεκτομή, από 101 ασθενείς με αυξημένο PSA πριν υποβληθούν σε υπερηχοτομογραφικά κατευθυνόμενη βιοψία προστάτη, πριν και μετά από προστατική μάλαξη, και από 15 υγιείς εθελοντές. Οι μεταβολίτες προσδιο-ρίστηκαν με τη χρήση υψηλής επίδοσης υγρής χρωματογραφίας συζευγμένης με φασματομετρία μάζας. Τα αποτελέσματα συσχετίσθηκαν με ιστοπαθολογικά δεδομένα, με το Gleason score και το PSA. Μη παραμετρικά στατιστικά τεστ και καμπύλες ROC χρησιμοποιήθηκαν για την αξιολόγηση των αποτελεσμάτων. Οι συγκεντρώσεις των μεταβολιτών στον ορό δεν κατέστη δυνατό να προσδιοριστούν. Όσον αφορά τα ούρα, οι μέσες τιμές σαρκοσίνης και κυνουρενικού οξέος ήταν χαμηλότερες στους ασθενείς με προστατικό καρκίνο σε σχέση με τους υγιείς, σε αντίθεση με την ουρακίλη. Οι τιμές των μεταβολιτών δεν συσχετίζονταν με την ηλικία ή το βαθμό κακοήθειας. Η ανάλυση των καμπυλών ROC έδειξε ότι η σαρκοσίνη και η ουρακίλη δεν είχαν διαγνωστική αξία και δεν πλεονεκτούσαν έναντι του PSA, σε αντίθεση με το κυνουρενικό οξύ που φάνηκε ότι έχει διαγνωστική αξία όταν προσδιορίζεται σε ούρα μετά από προστατική μάλαξη. Η σαρκοσίνη και η ουρακίλη στα ούρα δεν μπορούν να χρησιμοποιηθούν ως βιολογικοί δείκτες για τη διάγνωση του καρκίνου του προστάτη, σε αντίθεση με το κυνουρενικό οξύ ούρων μετά από προστατική μάλαξη. Κανείς από τους τρεις μεταβολίτες δεν μπορεί να χρησιμοποιηθεί για την παρακολούθηση της εξέλιξης της νόσου.