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    Association between benign prostate enlargement-related storage and voiding symptoms and systolic blood pressure: a single-center cross-sectional study
    (Associacao Paulista Medicina, 2019) Guven, Esref Oguz; Selvi, Ismail; Karaismailoglu, Eda
    BACKGROUND: Lower urinary tract symptoms significantly worsen quality of life. The hypothesis that they might lead to serious systolic blood pressure alterations through inducing sympathetic nervous activity has not been studied so far. OBJECTIVES: To investigate the relationship between benign prostate enlargement-related storage and voiding symptoms and systolic blood pressure. DESIGN AND SETTING: Cross-sectional single-center study on data from a hospital patient record system. METHODS: We evaluated the medical records of all consecutive patients with benign prostate enlargement-related lower urinary tract symptoms admitted between January 2012 and December 2017. Storage and voiding symptoms were assessed separately. International Prostate Symptom Score, uroflowmetry, postvoiding residual urine volume and systolic blood pressure were recorded. Pearson correlation and linear regression analysis were used. RESULTS: Positive correlations were found between systolic blood pressure and all of the storage symptoms. Among these, urgency had the most significant effect. There were 166 patients (41.4%) with urgency for urination, which increased mean systolic blood pressure from 124.88 mmHg (average value in elevated blood pressure group) to 132.28 mmHg (average value in stage-1 hypertension group). Hesitancy in urinating and feeling of incomplete bladder emptying had weak positive correlations with systolic blood pressure. There was a negative correlation between systolic blood pressure and intermittency of urination. CONCLUSIONS: With increasing numbers of urine storage symptoms, systolic blood pressure also increases, while the opposite occurs for voiding symptoms in patients with benign prostate enlargement. We conjecture that storage symptoms may lead to this increase through inducing sympathetic hyperactivity. Further prospective studies with larger groups are needed to confirm these findings.
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    Clinical and Histopathological Features of Genitourinary Sarcomas: Our Experiences and Case Series at a Single Center
    (Galenos Yayincilik, 2019) Selvi, Ismail; Guven, Esref Oguz
    Objective: The incidence of genitourinary sarcomas is very low, so the published reports in the literature are very limited. We aimed to present our experiences of eight cases originating from various genitourinary organs treated in our clinic. Materials and Methods: We retrospectively reviewed the data and postoperative follow-up findings of eight cases aged 3-72 years who were diagnosed as genitourinary sarcoma and treated between January 2013 and February 2017. Results: All eight cases were male and the mean age at diagnosis was 47.87 (range = 3-72) years. The most common site was paratesticular area (five cases, 62.5%) followed by kidney (two cases, 25%) and prostate (one case, 12.5%). Histological types of tumors were rhabdomyosarcoma (RMS) (two cases, 25%), liposarcoma (LPS) (two cases, 25%), leiomyosarcoma (LMS) (two cases, 25%), synovial sarcoma (one case, 12.5%) and malignant fibrous histiostoma (MFH) (one case, 12.5%). At a median follow-up of 23.5 (range = 4-62) months, the recurrence-free and progression-free survival rate was 50%, while the overall survival rate was 50%. Among the five paratesticular sarcomas, the worst prognosis was seen in LMS (local recurrence at the 4th, overall survival was 28 months) and MFH (local recurrence at the 8th, overall survival was 33 months). Among all sarcoma cases, LMS and synovial sarcoma were the histologic types with the worst prognosis. The histological types with the best prognosis were LPS and RMS with no recurrence or progression during follow-up. In all cases with a median tumor size of 52.5 mm (range = 11-210), LPS was found to have a better prognosis, although the largest tumor size was in renal LPS. According to FNCLCC classifications, local recurrence-free survival was significantly higher in grade II sarcomas than in grade III (p=0.042). Conclusion: Histopathological features and oncologic outcomes of genitourinary sarcomas differ. The prognosis of paratesticular sarcomas is better than other genitourinary organ sarcomas. LPS has higher cure rates after treatment in histological subtypes. The prognosis of histopathologically poorly differentiated subtypes and high-grade tumors is poor. If adjuvant treatments are not added, they may be fatal with local recurrence or distant metastasis in a short time.