title: Review of the pathophysiological aspects involved in urological disease associated with metabolic syndrome.
abstract: BACKGROUND
  Metabolic syndrome is a constellation of disorders that includes insulin resistance, central obesity, arterial hypertension and hyperlipidaemia. These disorders can have implications for the genitourinary apparatus.
  
  
  OBJECTIVE
  To conduct a review on the pathophysiological aspects that explain the relationship between metabolic syndrome and sexual dysfunction, lower urinary tract syndrome, prostate cancer and stone disease.
  
  
  METHODS
  We performed a qualitative, narrative literature review through a literature search on PubMed of articles published between 1997 and 2015, using the terms pathophysiology, metabolic syndrome, endothelial dysfunction, lipotoxicity, mitochondrial dysfunction, kidney stones, hypogonadism, erectile dysfunction, lower urinary tract syndrome and prostate cancer.
  Metabolic syndrome constitutes an established complex of symptoms, defined as the presence of insulin resistance, central obesity, hypertension and hyperlipidaemia. Endothelial dysfunction secondary to lipotoxicity generates an inflammatory state, which involves renal cell metabolism, vascularisation of the pelvis and androgen production. These facts explain the relationship between metabolic syndrome, nephrolithiasis, lower urinary tract syndrome, hypogonadism and erectile dysfunction in men.
  
  
  CONCLUSIONS
  Strategies such as proper diet, regular exercise, insulin treatment, testosterone-replacement therapy, therapy with antioxidants and free-radical inhibitors and urological treatments classically used for lower urinary tract syndrome have shown promising results in this syndrome.
authors.affiliation: Servicio de Urología, Hospital Universitario Puerta de Hierro, Madrid, España; Departamento de Cirugía, Universidad Rey Juan Carlos, Madrid, España. Electronic address: javiersaenzmedina@yahoo.es.
authors.forename: J
authors.initials: J
authors.lastname: Sáenz Medina
authors.affiliation: Servicio de Urología, Hospital Universitario Puerta de Hierro, Madrid, España; Departamento de Cirugía, Universidad Autónoma de Madrid, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Carballido Rodríguez
mesh_terms: D004730:Endothelium, Vascular / Q000503:physiopathology; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications* / Q000503:physiopathology*; D014570:Urologic Diseases / Q000209:etiology* / Q000503:physiopathology*
keywords: Disfunción endotelial; Disfunción eréctil; Endothelial dysfunction; Erectile dysfunction; Hipogonadismo; Hypogonadism; Kidney stones; Litiasis renal; Metabolic syndrome; Síndrome metabólico