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Smoking and urological disease

Department of Chemical Pathology & Human Metabolism Royal Free Hospital & School of Medicine (University of London) Pond Street London NW3 2QG United Kingdom

E.S. Ganotakis, MD, FRSH

Department of Chemical Pathology & Human Metabolism Royal Free Hospital & School of Medicine (University of London) Pond Street London NW3 2QG United Kingdom

J.A. Papadakis, MD, FRSH

Department of Chemical Pathology & Human Metabolism Royal Free Hospital & School of Medicine (University of London) Pond Street London NW3 2QG United Kingdom

J.Y. Jeremy, MSc, PhD, FRSH

Department of Chemical Pathology & Human Metabolism Royal Free Hospital & School of Medicine (University of London) Pond Street London NW3 2QG United Kingdom

It is important to realise that virtually every part of the body, including the urological sys tem, is adversely affected by smoking. Smoking is the most important known preventable cause of urinary bladder cancer and is also associated with a risk of prostatic and renal can cer. The exact mechanism by which smoking increases the incidence of urological malig nancy is not known. One possibility is that chemicals in cigarette smoke inhibit the syn thesis of cytoprotective eicosanoids. Deficient local protection, against the hostile environ ment caused by the presence of urine, could then encourage the process of carcinogenesis. Smoking is a powerful predictor of erectile dysfunction; cessation may restore normal func tion. Cigarette smoke also exerts adverse effects on sperm motility and count. Although there is no convincing evidence of reduced fertility in male smokers, it is advisable for men to quit smoking should they have marginal semen quality and wish to start a family. Smoking causes substantial urological pathology; these facts can be used to convince patients with urological problems to quit smoking.

Key Words: Erectile dysfunction • prostatic cancer • renal cancer • smoking • sperm motility and urinary bladder cancer

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