Sexual Healing by Dr. Margarita Kressin

Just to share some recent headlines I receive from urology literature and e-mail notices.

From Urolgoy Times August 2008:
Obesity in men may lead to drop in sperm count.
In an online edition of Fertility and Sterility (1/2008), University of Utah research shows that as men’s waistline increase, their chances of fathering children decreases. Presumably this is due to the conversion of testosterone to estradiol by an enzyme (aromatase) found in fatty tissue. In fact, a 2006 federal study found that for every extra 20 pounds, there may be a 10 percent increase in male infertility.

Lifestyle changes in PCa patients change gene expression.
In men with prostate cancer, strict diet changes (plant-based diet with less than 10 percent of calories from fat), increased exercise (walking 30 minutes a day, 6 times a week) and stress reduction (daily stress management for 60 minutes) could change gene expression according to a report in the Proceedings of the National Academy of Sciences (2008;105:8369). The study found changes in more than 500 genes in men with early prostate cancer who underwent these interventions after three months.

From AUA (American Urologic Association) Daily Scope:
Studies find prostate cancer screening may be inaccurate for obese men, surgery more difficult.
HealthDay (8/8, Edelson) reported that the "standard screening test for prostate cancer may not be accurate for obese men, leaving them more vulnerable to the disease, and surgery is less likely to be effective for them," according to two studies from Duke University published in the journal BJU International. The author of one of the studies, Dr. Stephen Freedland, an associate professor of urology and pathology at the Duke University Prostate Center, said, "Obese men are more likely to be diagnosed with an aggressive form of the disease," because the "blood test that looks for elevated levels of the protein prostate-specific antigen (PSA), indicating a heightened cancer risk, doesn't seem as reliable for obese men." The second study "found that excess weight influenced the outcome of surgery for prostate cancer." The study of 1,434 men found that those "with a BMI of 35 or higher were nearly 60 percent more likely to have a recurrence of the cancer than thinner men." Researchers found that one reason is "the difficulty of operating on obese men in general," so "not all the cancer may be removed, which means a recurrence after time."

Study suggests pregnant patients with diabetes may be more likely to have offspring with birth defects.
The AP (7/31, Stobbe) reports that women with diabetes "who get pregnant are three to four times more likely to have a child with birth defects than other women," according to researchers at the Centers for Disease Control and Prevention (CDC). The study, "the largest of its kind," appears in the American Journal of Obstetrics and Gynecology, and "provides the most detailed information to date on types of birth defects that befall the infants of diabetic mothers, including heart defects, missing kidneys, and spine deformities."

According to lead investigator Adolfo Correa, MD, MPH, PhD, of the CDC's National Center on Birth Defects, the findings highlight "the importance of increasing the number of women who receive the best possible preconception care," notes Bloomberg (7/31,Cortez).

Dr. Correa added that intercepting or treating the condition early "is critical in helping to not only prevent birth defects, but also to reduce the risk for other health complications for them and their children," reported HealthDay (7/30, Preidt). For the study, the research team "analyzed data on more than 30,000 people seen at nine birth defects centers across the country" between 1997 and 2003.

The team found that, generally, "women who got gestational diabetes tended to have children with birth defects only if their pre-pregnancy BMI had been 25 or higher," added WebMD (7/30, Doheny). Yet, "diabetes diagnosed before pregnancy was linked with about 50 percent of the birth defect categories analyzed," which included heart problems, brain and spinal defects, oral clefts, kidney and gastrointestinal tract defects, and limb deficiencies.