BJU International

Cover image for Vol. 116 Issue 1

Edited By: Prokar Dasgupta

Impact Factor: 3.533

ISI Journal Citation Reports © Ranking: 2014: 13/76 (Urology & Nephrology)

Online ISSN: 1464-410X

Diabetes, Obesity and Metabolic Syndrome in Urology

BJUI presents a FREE Virtual Issue bringing together the best recent papers on Diabetes, Obesity and Metabolic Syndrome in Urology, selected by our Editor-in-Chief, Prokar Dasgupta

BJUI Virtual Theme Issue: Diabetes, Obesity & Metabolic Syndrome

Introduction: Dr Jonathan Rees, GP, Backwell & Nailsea Medical Group with interest in Men’s Health & Urology May 2014

The concept of ‘men’s health’ was for many years taken to consist of the male-specific urological conditions such as prostate disease and erectile dysfunction. However, despite the importance of these conditions, particularly in terms of quality of life, it is cardiovascular disease and the components of the metabolic syndrome (hypertension, type 2 diabetes, dyslipidaemia) which have the biggest impact on the shorter life expectancy (and healthy life expectancy) seen in men. This collection of articles reflects the increased interest and awareness of these issues amongst Urologists, and demonstrates a number of important themes that have been seen in the wider urological literature over recent years:

1. Obesity and other components of the metabolic syndrome are seen to significantly increase the risk of developing a number of urological conditions. Insulin resistance, the driving force behind many components of metabolic syndrome also appears to be implicated in the pathogenesis of erectile dysfunction, benign prostatic hyperplasia, prostate cancer, hypogonadism, nephrolithiasis and overactive bladder.

2. The presence of visceral obesity and the metabolic syndrome may influence biological outcomes in many conditions with, for instance, men with high waist circumference (a fundamental component of metabolic syndrome) seen to have more severe lower urinary tract symptoms, whilst those with prostate cancer shown to have more aggressive disease at diagnosis and worse outcomes after radical prostatectomy.

3. Central obesity in particular, and high body mass index in general, increases surgical complexity (with consequent risks to patient safety) and operating times, and is therefore an important factor in predicting surgical outcomes. As understanding of these associations grows within the specialty of Urology, it allows Urologists to act as true advocates for overall men’s health. Just as we have become familiar with looking for undiagnosed diabetes and future cardiovascular risk in men with erectile dysfunction, the evidence increasingly points to the importance of consideration of these issues in many other urological disease processes. Identification of central obesity, hypertension, dyslipidaemia, diabetes or ‘pre-diabetes’ and other components of the metabolic syndrome offers the potential for lifestyle intervention and primary prevention strategies. Urologists may wish to arrange these tests themselves or more likely, liaise with colleagues in primary care with more expertise in the management of these conditions.

Central obesity as measured by waist circumference is predictive of severity of lower urinary tract symptoms
Lee, Richard K.; Chung, Doreen; Chughtai, Bilal; Te, Alexis E.; Kaplan, Steven A.

Obesity is associated with castration-resistant disease and metastasis in men treated with androgen deprivation therapy after radical prostatectomy: results from the SEARCH database
Keto, Christopher J.; Aronson, William J.; Terris, Martha K.; Presti, Joseph C.; Kane, Christopher J.; Amling, Christopher L.; Freedland, Stephen J.

Association between obesity and alteration of sperm DNA integrity and mitochondrial activity
Fariello, Roberta M.; Pariz, Juliana R.; Spaine, Deborah M.; Cedenho, Agnaldo P.; Bertolla, Ricardo P.; Fraietta, Renato

Visceral obesity is a strong predictor of perioperative outcome in patients undergoing laparoscopic radical nephrectomy
Hagiwara, Masayuki; Miyajima, Akira; Hasegawa, Masanori; Jinzaki, Masahiro; Kikuchi, Eiji; Nakagawa, Ken; Oya, Mototsugu

Amelioration of diabetes-induced cavernosal fibrosis by antioxidant and anti-transforming growth factor-beta 1 therapies in inducible nitric oxide synthase-deficient mice
Ferrini, Monica G.; Moon, Joanne; Rivera, Steve; Rajfer, Jacob; Gonzalez-Cadavid, Nestor F.

Safety and efficacy of ureteroscopic lithotripsy for stone disease in obese patients: a systematic review of the literature
Aboumarzouk, Omar M.; Somani, Bhaskar; Monga, Manoj

Obesity is associated with worse oncological outcomes in patients treated with radical cystectomy
Chromecki, Thomas F.; Cha, Eugene K.; Fajkovic, Harun; Rink, Michael; Ehdaie, Behfar; Svatek, Robert S.; Karakiewicz, Pierre I.; Lotan, Yair; Tilki, Derya; Bastian, Patrick J.; Daneshmand, Siamak; Kassouf, Wassim; Durand, Matthieu; Novara, Giacomo; Fritsche, Hans-Martin; Burger, Maximilian; Izawa, Jonathan I.; Brisuda, Antonin; Babjuk, Marek; Pummer, Karl; Shariat, Shahrokh F

Metabolic syndrome increases the risk of aggressive prostate cancer detection
Morote, Juan; Ropero, Jordi; Planas, Jacques; Bastaros, Juan M.; Delgado, Gueisy; Placer, Jose; Celma, Anna; de Torres, Ines M.; Carles, Joan; Reventos, Jaume; Doll, Andreas