Erkek Ürogenital Hastalıkları ve Mikrobiyota
İnsan mikrobiyotası, insan vücudunda yaşayan ve insan hücresi dışındaki bakteri, mantar, virüs ve protozoa ailesinden oluşan bir topluluktur. Mikrobiyotalar vücutta kendi üreme özelliklerine uygun her yerde yaşayabilirler, en uygun ortam ise gastrointestinal sistemdir. Fakat cilt, üst solunum sistemi ve ürogenital sistemde de bulunurlar. Üriner sistem hastalıkların gelişmesinde ve progresyonunda özellikle barsak mikrobiyotasının özel bir rolü vardır. Bu Mikrobiyota insanda statik değildir, çevresel faktörlere karşı cevap oluşturur ve gelişir. Bunu hem oral alınan yiyecekler hem de ilaçlar etkiler. Kültürler arasındaki diyet ve yaşam stili farklılıkları insan barsağında hızlı ve tekrar üretilebilir değişikliklere yol açar. Benzer şekilde hem oral hem parenteral alınan antibiyotiklerin insan gastrointestinal sisteminde mikrobial ekosistem üzerinde anlamlı etkileri vardır. Son yıllarda intestinal mikrobiyotanın idrarın kompozisyonunu etkilediği bunun da taş oluşumu insidansını arttırdığı düşünülmektedir. Oxalobacter formigenes oxalatı barsakta parçalayan gram (-) bir bakteridir. Bu mikroorganizmanın yokluğunda hiperoxalüri ve oxalat taşı oluşumu arasında direkt ilişki olduğunu klinik bulgular göstermektedir. Oxalatı parçalyan mikroorganizmalrın probiyotik formülasyonunda insan ve hayvanlarında oral olarak verilmesinin geçici olarak idrar oxalat miktarında azalmaya neden olduğu gösterilmiştir. Bu formülasyonda Lactobasillus, bifi dobakterium ve enterokoklar en çok kullanılmıştır. Peniste preputial dokunun çıkartılması olarak tanımlanan sünnet genital bakteriyel toplulukları değiştirebilir. Yapılan çalışmalar erkek sünnetinin HIV, HSV tip 2 ve HPV enfeksiyonlarını azalttığı gösterilmiştir. Ayrıca sünnetli erkeklerin bayan partnerlerinde de trichomoniasis ve bakteriyel vajinosis riskinin azaldığı görülmüştür. Probiyotikler intestinal ve vajen fl orasının dengesini sağlayarak patojen mikroorganizmaların çoğalmasını engeller, immün sistemi şekillendirir, barsak endotel hücresini düzenler, mineral ve vitaminlerin biyoyararlanımını artırır ve barsak haraketlerini modifi ye eder. Sonuç olarak İntestinal mikrobiyotanın kötü regülasyonunun kanser, alerjik durumlar, metabolik ve infl amatuvar barsak hastalıklarının gelişiminde rolü olabileceği artık bilinmektedir.
Male Urogenital Diseases and Microbiota
Human microbiota is a community of bacteria, fungi, viruses, and protozoa living in the human body outside the human cell. Microbiota can live anywhere in the body in accordance with their reproductive traits, the most suitable medium is the gastrointestinal system. Bowel microbiota has a special role in the development and progression of urinary system diseases. This microbiota is not static in human, responds to environmental factors and develops. It affects both oral food and medicines. Dietary and lifestyle differences among cultures lead to rapid and reproducible changes in the human gut. Similarly, oral and parenteral antibiotics have signifi cant effects on the microbial ecosystem in the human gastrointestinal tract. In recent years, intestinal microbiota has affected the composition of urine, which is thought to increase the incidence of stone formation. Oxalobacter formigenes is a gram (-) bacterium that breaks down in the intestine. Clinical fi ndings indicate that there is a direct relationship between hyperoxaluria and oxalate stone formation in the absence of this microorganism. It has been shown that orally administration of probiotic formulation of oxidizing microorganisms in humans and animals causes a temporary decrease in the amount of urinary oxalate. Clinical fi ndings indicate that there is a direct relationship between hyperoxaluria and oxalate stone formation in the absence of this microorganism. Lactobacillus, bifi dobacterium and enterococci are the most commonly have been used in this formulation. The circumcision described as removal of the preputial tissue of the penis may alter genital bacterial communities. Studies have shown that male circumcision reduces HIV, HSV type 2 and HPV infections. It also reduces trichomoniasis and bacterial vaginosis risk in partners of circumcised men. Probiotics prevent the multiplication of pathogenic microorganisms by providing intestinal and vaginal fl ora stabilization and probiotics shape the immune system, regulate intestinal endothelial cell, increase the bioavailability of minerals and vitamins and modify bowel movements. As a result it is now known that the impaired regulation of intestinal microbiota may play a role in the development of cancer, allergic conditions, metabolic and infl ammatory bowel diseases.
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