Relationship between serum sex hormones levels and degree of benign prostate hyperplasia in Chinese aging men

Benign prostatic hyperplasia （BPH） is one of the most common medical conditions in middle aged and older men. This study investigated the relationship between serum levels of sex hormones and measures of BPH in the aging male population of China. Prostate symptoms were assessed as part of a free health screening program for men ~40 years of age. The examination included digital rectal examination, determination of serum prostate-specific antigen levels, International Prostate Symptom Score （IPSS） and transrectal ultrasonography. Serum levels of total testosterone （TT）, sex hormone binding globulin （SHBG）, free testosterone （FT）, luteinizing hormone （LH）, follicle-stimulating hormone （FSH）, prolactin （PRL） and estradiol （E2） were evaluated. The men also completed a health and demographics questionnaire and received a detailed physical examination. The final study population consisted of 949 men with a mean age of 58.9 years. Pearson correlation analysis indicated that there were significant correlations between age and levels of all sex hormones except TT, and between age and prostate volume （PV; r=0.243; P〈0.01） or IPSS （r=0.263; P〈0.01）. Additional significant correlations were found between IPSS and serum levels of LH （r=0. 112; P〈0.01） and FSH （r=0.074; P〈0.05）, but there were no significant correlations between sex hormone levels and PV. Multivariate linear regression analysis showed significant correlations between age and body mass index （BMI） with PV （P〈0.0001）. In addition, there was a significant correlation between age and PV with IPSS （P〈0.0001）. Serum sex hormone levels did not correlate with PV or IPSS. The effects of endocrine changes on measures of BPH in aging men require further investigation in longitudinal and multicenter studies that include oatients with all severities of BPH.

Successful robot-assisted partial nephrectomy for giant renal hilum angiomyolipoma through the retroperitoneal approach: A case report

BACKGROUND Giant renal angiomyolipomas(AMLs)may lead to complications including flank pain,hematuria,hypertension,retroperitoneal hemorrhage and even death.Giant AMLs which grow around renal hilar vessels and the ureter are rare.Most previous reports on the treatment of giant renal AMLs have focused on open surgery or a transperitoneal approach,with few studies on the retroperitoneal approach for large AMLs.We here report a case of giant renal hilum AML successfully treated with robot-assisted laparoscopic nephron sparing surgery the retroperitoneal approach,with a one-year follow-up.CASE SUMMARY A 34-year-old female patient was diagnosed with renal AML 11 years ago and showed no discomfort.The tumor gradually increased in size to a giant AML over the years,which measured 63 mm×47 mm×90 mm and was wrapped around the right hilum.Therefore,a robotic laparoscopic partial nephrectomy(LPN)via the retroperitoneal approach was performed.The patient had no serious postoperative complications and was discharged soon after the operation.At the one-year follow-up,the patient's right kidney had recovered well.CONCLUSION Despite insufficient operating space via the retroperitoneal approach,LPN for giant central renal AMLs can be completed using a well-designed procedure with the assistance of a robotic system.

Identification of late-onset hypogonadism in middle-aged and elderly men from a community of China

In this study, we investigated the essential criteria for late-onset hypogonadism （LOH） syndrome based on the presence of symptoms associated with low testosterone levels in Han Chinese men. Blood tests for total testosterone （TT） and sex hormone-binding globulin （SHBG） were performed, and the aging male symptoms （AMS） questionnaire was conducted in a randomly selected cohort composed of 944 Chinese men aged 40 to 79 years from nine urban communities. Three sexual symptoms （decreased ability/frequency of sexual activity, decreased number of morning erections, and decreased libido） were confirmed to be related to the total and free testosterone levels. The thresholds for TT were approximately 12.55 nmol l^-1 for a decreased ability/frequency to perform sex, 12.55 nmol l^-1 for decreased frequency of morning erections, and 14.35 nmol l^-1 for decreased sexual desire. The calculated free testosterone （CFT） thresholds for these three sexual symptoms were 281.14, 264.90, and 287.21 pmol l^-1, respectively. TT 〈13.21 nmol l^-1 （OR =1.4, 95%Ch 1.0-1.9, P= 0.037） or CFT 〈268.89 pmol l^-1 （OR - 1.5, 95%Ch 1.1-20, P=0.020） was associated with an increase in the aforementioned three sexual symptoms. The prevalence of LOH was 9.1% under the criteria, including all three sexual symptoms with TT levels 〈13.21 nmol l^-1 and CFT levels 〈268.89 pmol l^-1. Our results may improve the diagnostic accuracy of LOH in older men.

Vlinimally invasive simple prostatectomy for a case ）f giant benign prostatic hyperplasia

Dear Editor, We would like to present a rare case of giant prostatic hyperplasia （GPH）, which is defined as a prostate weight over 200g for Easterners or 500 g for Westerns.： Only 14 cases of GPH exceeding 500 g had been reported in the English literature by 2015 （Supplementary Table 1）. To the best of our knowledge, this is the first report of removing a GPH exceeding 500 g by using minimally invasive laparoscopic technique.