The Impact of Body Mass on Male Fertility in a Cohort of 127 Patients

Background: Aromatase and leptin are two adipose tissue cytokines. The former converts androgens into estrogens and stimulates adipogenesis. The latter cannot fully stimulate GnRH release as its hypothalamic receptors are reduced in obese men. Thus, obesity which is associated with an adipose tissue increment can interfere with male fertility. Objective: We aim to study the correlation between the body mass index (BMI) of an individual and the quality of semen he produces. Patients and Method: By means of the software R 4.2.1 we performed a retrospective analysis of the relationship between the BMI and the semen alterations in the patients managed at the former Military Teaching Hospital of Cotonou from October 1, 2017, to September 30, 2022: a bi-varied analysis and Fischer’s exact test (significance threshold 5%, confidence interval 95%) followed by a logistic regression when a non-significant p-value is below 0.20. Results: 127 males managed for infertility (mean age = 36.2 years) were recorded, including 11.1% obese (BMI > 30 kg/m2) and 36.5% overweighted (25 kg/m2 < BMI ≤ 30 kg/m2). The most frequent semen alterations were: oligoasthenospermia (27.8%), asthenospermia (22.2%), oligoasthenoteratospermia (14.3%), azoospermia (13.5%) and asthenoteratospermia (9.5%). Bi-varied analysis showed no correlation between the BMI and the semen alterations (p-value ranged from 0.086 to 0.9) and no difference in semen alterations between patients with BMI below and above 25 kg/m2 (p-value ranged from 0.12 to 0.9). Logistic regression demonstrated that asthenoteratospermia were correlated with BMI ≥ 25 kg/m2 [OR = 2.1, 95% CI (1.50 - 2.70), p = 0.021]. Conclusion: Male obesity and overweight can trigger asthenoteratospermia.

Prevalence of Comorbidities in the Urological Patients at the Former Military Teaching Hospital of Cotonou

Background: Comorbidities are additive diseases and care burdens in urological patients. Determining the epidemiologic profile of comorbidities in urological patients in our setting may help us to better the management of urological disease. Objective: To evaluate the prevalence of comorbidities in urological patients. Patient and Method: We collected comorbidity, urological disease and demographic data in all urological patients managed at the former Military Teaching Hospital of Cotonou from January 1, 2012, to December 31, 2020. We used the software R 4.2.2 to perform descriptive and bi-varied data analysis. Student’s t test was used to compare means. Results: The prevalence of comorbidities was 14.2%, i.e., 601 comorbidity-affected among 4242 patients. The comorbidities predominantly affected men: the sex ratio was 13:1. The presence of comorbidity was correlated with patients’ age (p < 0.001). The comorbidities observed in the 601 affected patients were hypertension (84.5%), diabetes (26.5%), asthma (2%), and heart failure (1.2%). Hypertension (p = 0.001) and asthma (p = 0.030) were correlated with age. No comorbidity was associated with gender. The comorbidities’ prevalence was highest in patients aged 40 - 80 years who presented urological diseases such as BPH (68.9%), Erectile dysfunction (ED) and ejaculatory disorders, overactive bladder (OAB) and neurogenic lower urinary tract dysfunction (LUTD), renal cyst (5%), inguinal hernia (4.2%), urinary stones (2.8%), and prostate cancer (2.3%). Conclusion: The comorbidities’ prevalence was 14.2% in the urological patients. The main comorbidities were hypertension (84.5%) and diabetes mellitus (26.5%).

Correlation of PSA Level and ISUP Grade Group with Scintigraphic Bone Metastases Detection in 36 Prostate Cancer Patients

Background: We need population-specific clinical features that can predict bone metastases as an affordable therapeutic decision-making tool in newly diagnosed prostate cancer patients as scintigraphy or positron emission tomography are not available and as no such study had ever been performed in our country. Objective: To determine biologic and pathologic criteria that can predict the scintigraphic detection of bone metastases in our prostate cancer patients. Patients and Method: We analyzed with student’s t test and logistic regression the PSA level, the ISUP grade and the scintigraphic data retrospectively collected in newly diagnosed prostate cancer patients. Results: In ten years, 36 prostate cancer patients were sent to the Korle Bu Teaching Hospital in Accra (Ghana) for bone scintigraphy (mean age = 63.9 years;55.6%, 19.4% and 25.0% ISUP grade ≤ 2, 3 or ≥4). Among 28 patients who had performed the bone scintigraphy, 6 (21.4%) presented bone metastases, 22 (78.6%) had no bone metastasis. The mean PSA level was 36.7ng/mL in the non-metastatic patients and 97.7 ng/mL in the metastatic patients. The difference in PSA level between the 2 groups was significative (p = 0.041). 63.6% of the non-metastatic cancers versus 16.7% of the metastatic cancers were ISUP grade 2 or less. Inversely, 36.4% of the non-metastatic cancers versus 83.3% of the metastatic cancers were ISUP grade 3 or more. The difference was significative in the ISUP grade 2 or less (p = 0.035), was significative in the ISUP grade group 3 or more (p = 0.035). Metastasis was more likely in prostate cancer patients with PSA equal 30 ng/mL or more and ISUP grade 3 or more (83.3%) than in prostate cancer patients with PSA less than 30 ng/mL and ISUP grade less than 3 (16.7%) [OR = 13.7;CI 95% (1.59;31.0);p = 0.035]. Conclusion: The scintigraphic detection of bone metastases is low in patients with PSA < 30 ng/mL and ISUP grade < 3. This can be helpful in curative therapy decision making for prostate cancer when nuclear medicine or other metastases detection tools are lacking.

A Panorama of the Urological Diseases at the Former Military Teaching Hospital of Cotonou

Background: Urological care has been advancing quickly over the last ten years in Benin. In order to conveniently support that trend towards better urological care standards, decision-makers need sound data on urological diseases in the country. Objective: To determine the prevalence of urological diseases in the former Military Teaching Hospital of Cotonou. Patients and Method: We retrospectively collected the urological diseases that the institution had managed from January 2012 to December 2020. We used Excel© 2010 and SPSS© to analyze the collected data. Results: 4244 patients, i.e. 3717 males (87.58%) and 527 females (12.42%) were managed during the study period. The main diseases diagnosed were benign prostatic hyperplasia (32.61%, n = 1384), erectile dysfunction (10.44%, n = 443), chronic prostatitis (5.94%, n = 252), prostate cancer (4.03%, n = 171), and ejaculatory disorders (3.44%, n = 146). In patients ≤ 15 years, predominant diseases were peritoneal vaginal canal (15.9%, n = 43), circumcision (15.6%, n = 42), testicular dystopia (10.7%, n = 29), hydrocele (7.8%, n = 21), and hypospadias (5.6%, n = 15). Wilms tumor (1.9%, n = 5) was the first cancer, testicular (0.4%, n = 1) and para-testicular (0.4%, n = 1) tumors were the next. In patients > 15 and ≤40 years, the main diseases were infertility (14.1%, n = 189), chronic prostatitis (12.9%, n = 173), erectile dysfunction (10.1%, n = 135), ejaculatory disorders (6.2%, n = 83), genital infections (6.2%, n = 83) and urinary stone (4.9%, n = 66). The first cancer was kidney cancer (0.97%, n = 13) followed by bladder cancer (0.3%, n = 4) and testicular tumor (0.3%, n = 4). In patients >40 years, the most prevalent diseases were BPH (52.0%, n = 1370), erectile dysfunction (11.7%, n = 308), prostate cancer (6.5%, n = 171), inguinal hernia (5.1%, n = 134), and urinary stone (3.9%, n = 102). Prostate cancer is the first cancer;the next were bladder (0.95%, n = 25) and kidney (0.68%, n = 18) cancers. Conclusion: Benign prostatic hyperplasia and urological cancers (prostate, bladder and kidney cancers) were the main urological diseases at the former Military Teaching Hospital of Cotonou. Urological malformations and Wilms tumor were the main diseases in the children.