Introduction: The study aimed to explore clinical influence of prostatic stones on lower urinary tract symptoms (LUTS), seminal plasma cytokines, and serum biomarkers. Materials and Methods: A total of 70 men aged ≤50 years with LUTS divided into 2 groups: group with stones (GSt) and group without prostatic stones (GNoSt). All subjects completed the International Prostate Symptom Score (IPSS) questionnaire and National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scoring questionnaire. Pre- and post-prostate massage test and uroflowmetry were performed. The serum concentration of total prostate specific antigen (PSA), free PSA, and free/total PSA (f/t PSA) ratio, seminal concentration of cytokines interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12p70, and tumor necrosis factor-alpha were measured. Results: GSt subjects had significantly more severe symptoms based on IPSS answers (p = 0.0289). All domains in NIH-CPSI scores were significantly higher in the GSt group: pain (p = 0.001), urinary symptoms (p = 0.023), quality of life (p = 0.008), and with overall (p = 0.003). GSt subjects also had significantly lower maximum urinary flow (Qmax; p = 0.011), lower f/t PSA ratio (p = 0.048), and higher concentration of IL-1β (p = 0.011) and IL-8 (p = 0.001). Conclusions: Prostatic stones may influence the severity of LUTS and the symptoms of chronic prostatitis. They might reduce Qmax rate and lead to reduction of the f/t PSA ratio and produce more severe inflammation causing increased seminal concentration of IL-1β and IL-8.
Objective: We report a case that we believe to be the largest example of a testicular mixed germ cell tumor with a clearly defined histology pattern. Clinical Presentation and Interventions: A 21-year-old patient consulted a urologist concerning a giant testicular mass. At the time of presentation the tumor measured 29 × 20 × 16 cm, with a weight of 4,850 g. Serum α-fetoprotein was over 15,000 ng/ml, while β-human chorionic gonadotropin was normal. Chest X-ray and CT revealed multiple bilateral metastases. Histopathology revealed a mixed germ cell tumor containing 80% of yolk sack tumor, 10% of teratoma and 10% of embryonal carcinoma. Orchiectomy and chemotherapy were successful in the treatment of primary tumor and bilateral lung metastases. Conclusion: This tumor grew to extraordinary dimensions because of the patient’s failure, due to fear, lack of knowledge and embarrassment, to seek medical help and to health professionals’ negligence when performing regular check-ups.
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