Compliance to therapy with Dapoxetine in comparison to a conventional selective serotonin reuptake inhibitor (Citalopram) in 118 patients with premature ejaculation.

Premature Ejaculation (PE) is a sexual dysfunction that concern 20-30% of the male population. Dapoxetine is a new serotonine re-uptake inhibitor (SSRI)specific for PE treatment.Aim of the study is to assess compliance and effectiveness of the treatment with dapoxetine compared to the treatment with citalopram (a classic SSRI used to treat PE).

Coronary endarterectomy to facilitate bypass surgery for patients with extensive stenting of the left anterior descending artery

A 52-year-old male. Admitted for acute coronary syndrome because of three-vessel disease with a FMJ–LAD

Leptin plasma levels in patients undergoing prostate biopsy. a preliminary study in 50 patients

Introduction/Aim: To reduce the number of negative prostate biopsies and to detect clinical significant prostate tumors in patients with elevated serum PSA represent major challenges in urological oncology. Prostate tumors diagnosed in patients with elevated Body Mass Index (BMI) show higher Gleason score and more aggressive biological behavior than those diagnosed in normal population (1). Elevated plasma levels of leptin and other adipose tissue derived factors (adipokines), are evident in obese men (2). Many studies have investigated the role of leptin as a putative molecular mediator between obesity and prostate cancer with contradictory results. Also in normal or overweight (BMI <30) m…

Does Exist A Correlation Between BMI and Gleason Patterns 4 and 5 At Prostate Biopsy?

Background: Obesity has been related with higher Gleason grade and worse prognosis. Increasing proportion of Gleason pattern 4 or 5 is a critical factor for biochemical recurrence, progression and mortality. The endocrine activity of visceral fat could be responsible of the differentation of the prostatic malignant cell towards a more aggressive fenotype. The aim of our study was to correlate Body Mass Index with the presence of Gleason pattern 4 or higher at biopsy. Materials and Methods: Consecutive patients with positive prostate biopsy were included. A transrectal prostate biopsy procedure with 12 cores, was performed. All tissue samples were reviewed. Results: Out of 135 patients diagn…

The clinical value of PSA increase during intravesical adjuvant therapy for nonmuscle-invasive bladder cancer.

Introduction Prostatic Specific Antigen (PSA), Bacillus Calmette-Guerin (BCG) increase after intravesical BCG has been reported. The need of prostate biopsy in these patients is object of debate. The aim of our study was to evaluate the effect of intravesical therapy on PSA after transurethral resection (TUR) of nonmuscle-invasive bladder cancer (NMIBC). Materials and methods Patients undergoing intravesical chemotherapy or immunotherapy for NMIBC were entered. PSA was measured before TUR, before the first and after the sixth instillation, 30 and 90 days after the last instillation. Patients with PSA ≥4 ng/ml or palpable prostate nodule were excluded. Results Out of 130 patients, 105 were e…

CT imaging findings of abdominopelvic vascular compression syndromes: what the radiologist needs to know.

AbstractAbdominopelvic vascular compression syndromes include a variety of uncommon conditions characterized by either extrinsic compression of blood vessels by adjacent anatomical structures (i.e., median arcuate ligament syndrome, nutcracker syndrome, May-Thurner syndrome) or compression of hollow viscera by adjacent vessels (i.e., superior mesenteric artery syndrome, ureteropelvic junction obstruction, ureteral vascular compression syndromes, portal biliopathy). These syndromes can be unexpectedly diagnosed even in asymptomatic patients and the predisposing anatomic conditions can be incidentally discovered on imaging examinations performed for other indications, or they can manifest wit…

Evidence of intimal tear in type A intramural hematoma of the aorta: A case series

Highlights • We report two cases of type A intramural hematoma of the aorta. • We found radiological and intraoperative evidence of an intimal tear. • This finding supports the hypotesis that IMH belong to “aortic dissection” disease.

Radiologic and Intraoperative Finding of Intimal Tear in Type A Intramural Hematoma of the Aorta

AbstractAortic intramural hematoma (IMH) is described as “dissection without intimal tear” due to rhexis of vasa vasorum, which results in bleeding within the tunica media in the absence of intimal disruption or blood flow communication. The aim of our study is to validate perioperative evidence of intimal entry tear in IMH patients and to suggest that this entity may represent a part of a disease and not a separate disease.

Compliance to therapy with Dapoxetine in patients affected by Premature Ejaculation

Introduction Premature ejaculation (PE) is a sexual dysfunction with high prevalence. According to some reports, it is present in about 20-30% of the male population. Since 2009 PE has been treated with a novel inhibitor of serotonin re-uptake, Dapoxetine, which has been reported to be specifically active for PE. Materials and Methods 59 patients have been selected among the patients affected by PE observed at the outpatient department of Urology and Andrology of the “Paolo Giaccone” University Policlinic Hospital of Palermo. Diagnosis was confirmed unequivocally in all patients, who were suitable for drug treatment and accepted to participate in the study. They were divided in 2 groups: on…

The "serpent sign" in hydatid disease.

Mitomycin C from birth to adulthood.

Mitomycin C (MMC) intravesical therapy for “superficial” papillary bladder tumors was firstly introduced in the early seventies with promising results. In the following years, several pharmacokinetic studies investigated its mechanism of action to optimize the intravesical administration. Numerous studies confirmed thereafter both the ablative and the prophylactic efficacy and the low toxicity of MMC when intravesically given. In 1984, a complete response rate of 42% in 60 patients not responsive to thiotepa was reported with intravesical MMC at the dose of 40 mg diluted in 40 ml for 8 weeks. In the following decades, many large randomized studies showed the benefit of intravesical prophyla…

Correlation between leptin plasmatic levels in non-obese patients and detection rate at prostate biopsy”- Poster P147

Liver stiffness quantification in biopsy-proven nonalcoholic fatty liver disease patients using shear wave elastography in comparison with transient elastography

Purpose: This study prospectively assessed the performance of liver stiffness measurements using point shear-wave elastography (p-SWE) in comparison with transient elastography (TE) in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD). Methods: Fifty-six consecutive adult patients with a histological diagnosis of NAFLD prospectively underwent TE and p-SWE on the same day. The median of 10 measurements (SWE-10), the first five (SWE-5), and the first three (SWE-3) measurements were analyzed for p-SWE. Liver biopsy was considered as the reference standard for liver fibrosis grade. Receiver operating characteristic (ROC) curves and areas under the ROC curves (AUROCs) were cal…

The genitourinary diseases health-care among patients and general practitioner

Introduction: A general awareness of the most common genitourinary diseases is often lacking.The aim of the present study was to investigate the attention of the general practitioner and of the patient to the genitourinary diseases. An incomplete medical history and/or an inadequate physical examination might be responsible of late diagnosis and improper management. Patients and Methods: A self administered questionnaire was obtained by our outpatients before the urological visit. As a preliminary step we administered a very simple questionnaire consisting of four multiple choice questions: 1) Did your general practitioner examine your external genitalia in the last five years? Did you ask …

Derivazioni urinarie

The “geographic” liver

LIMITS OF TRANSURETHRAL RESECTION IN DETECTING RARE HISTOLOGICAL VARIANTS WITHIN LARGE UROTHELIAL BLADDER TUMORS

Cytokines gene expression in the tunica albuginea in patients with Peyronie’s disease. Pilot study with a control group

INTRODUCTION: We decided to conduct a study to investigate the presence of cytokines in the albuginea of subjects with Peyronie's disease (PD). Cytokines, as responsible for intercellular communication, maybe involved in the pathogenesis of the disease. The identification of one or more involved cytokines may, in fact, be useful in the pharmacological treatment with biologic drugs that are able to interfere with specific cytokines. MATERIALS AND METHODS: Between January 2009 and Decembre 2010 at the Clinic of Urological outpatients clinic of the Policlinico of Palermo were recruited 20 subjects with PD, mean age 62.3 years (range 51-70) and 8 subjects with congenital recurvatum penis (mean …

PANCREATICODUODENAL ARTERIES ANEURYSMS: EVALUATION OF FREQUENCY AND ASSOCIATION WITH CELIAC ARTERY STENOSIS DUE TO COMPRESSION BY MEDIAN ARCUATE LIGAMENT

The aim of the study is to evaluate the prevalence of pancreaticoduodenal arteries (PDA) aneurysms in a large population, and to define possible correlations with celiac artery stenosis due to compression by the median arcuate ligament. Radiological reports of abdominal contrast-enhanced CT scans of 18,180 patients were scrutinized to identify patients with true PDA aneurysms. Two abdominal radiologists classified the aneurysms according to size, location and morphology and scored the presence of celiac artery stenosis due to either median arcuate ligament compression or atherosclerotic disease. Eleven true PDA aneurysms were identified in 10 patients. Nine out of 10 patients had stenosis o…

Correlation between BMI and the pathological features of prostate cancer at biopsy

Introduction/Aim: Numerous clinical trials investigated the association between obesity and prostate cancer, but they yielded inconsistent results (1). Obesity has been found to be related to prostatic tumors at more advanced stages and higher Gleason grade when compared with normal population (2). An increased number of biopsy cores has been advocated by some Authors in obese and overweight men due to an increased difficulty and delay in cancer detection (3). The main aim of our research was to correlate Body Mass Index (BMI) with the pathological characteristics of prostate cancer at biopsy. Patients and Methods: Patients with positive prostate biopsy performed for palpable prostate nodul…

Può la TECAR (Trattamento Energetico Capacitivo Resistivo) Terapia avere un effetto terapeutico sulla malattia di La Peyronie? Studio di fase 2, randomizzato, in singolo cieco, con gruppo di controllo sham su 96 pazienti: rapida riduzione del dolore.

The “caput medusae” sign in portal hypertension

Does Transfer Capacitive Resistive Energy Has a Therapeutic Effect on Peyronie's Disease? Randomized, Single-Blind, Sham-Controlled Study on 96 Patients: Fast Pain Relief.

&lt;b&gt;&lt;i&gt;Background/Aims/Objectives:&lt;/i&gt;&lt;/b&gt; We have investigated the clinical and physiological effects of Transfer Capacitive Resistive Energy (TCARE) therapy on men with Peyronie's disease (PD). &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Ninety-six men with PD have been randomized in a 2:1 ratio to receive 3 sessions of TCARE therapy or sham therapy. Pain, penile curvature and erectile function have been assessed before the first treatment and up to 9 months after the end of treatment, using the Visual Analogue Scale for the pain, a goniometer to measure the degree of curvature using at-home photography and an International Index of Erectile Function (IIEF-5) que…

Effetti antalgici della TECAR terapia nel trattamento della patologia di La Peyronie. Studio randomizzato a singolo cieco con gruppo sham su un totale di 96 pazienti - Poster P44

Scopo del lavoro Abbiamo condotto uno studio randomizzato a singolo cieco con gruppo sham per valutare gli effetti terapeutici della TECAR terapia su 96 pazienti affetti dalla malattia di La Peyronie (IPP) vista l’efficacia di questo trattamento sulle patologie fibrose. Materiali e metodi Novantasei pazienti affetti da IPP randomizzati con rapporto 2:1 sono stati suddivisi in 2 gruppi: gruppo trattato e gruppo sham. Abbiamo valutato l’efficacia TECAR sul dolore, sul grado di incurvamento penieno e sul deficit erettile (DE) al termine del trattamento ed a 1 (FU1) e 3 (FU3) mesi dal termine del trattamento mediante l’utilizzo della scala VAS per il dolore e di questionari specifici per l’IPP …

IS VISCERAL ADIPOSITY INDEX (VAI)RELATED TO PROSTATE CANCER DETECTED BY BIOPSY?

association between obesity and prostate cancer, yielding inconsistent results. Metabolic syndrome has been suggested to promote aggressive prostate tumors. In a previous study we failed to detect a relation between Body Mass Index (BMI) and prostate cancer Gleason score (1). BMI, although routinely adopted to measure obesity, has low sensitivity and specificity. A novel sex-specific obesity index, based on waist circumference (WC), BMI, triglycerides (TGs) and high density lipoproteins (HDL), the Visceral Adiposity Index (VAI), has been proposed to estimate the visceral adiposity dysfunction (2). The aim of our preliminary research was to correlate VAI and BMI with the presence of prostate…

The starry sky liver: multiple biliary hamartomas on MR cholangiopancreatography

The starry sky liver: multiple biliary hamartomas on MR cholangiopancreatography

Cytokines gene expression in the tunica albuginea of patients with Peyronie’s disease. Pilot study with a control group

INTRODUCTION & OBJECTIVES: Cytokines may be involved in the pathogenesis of the Peyronie's disease (PD). Cytokines levels in tunica albuginea (TA) specimens were measured by Real Time PCR in PD patients and in control group. MATERIAL & METHODS: Between January 2009 and December 2010 20 PD patients affected by PD and 8 patients affected by congenital recurvatum penis (control group) undergoing surgery were entered in the study. Routine histological examination and measurement by Real Time PCR of the expression of the encoding genes for IL-2, IL-4, IL-6, IL-10, IL-13, TGF-β1, TNF-α, IFN-γ and Metalloproteinase (MMP-2) were performed. For the normalization of data, GAPDH (glucerldehyde-3 fosfa…

Cytokine gene expression in the tunica albuginea of patients with Peyronie's disease. Pilot study with a control group.

Introduction and objective Cytokines may be involved in the pathogenesis of Peyronie's disease (PD). In this case, biological drugs, acting on specific cytokines, could be adopted in the pharmacological treatment of the disease. Materials and Methods Twenty PD patients and 8 patients affected by congenital recurvatum penis (control group) who underwent corporoplasty were enrolled in the study Histological examination and measurement by Real Time PCR of the expression of the encoding genes for IL-2, IL-4, IL-6, IL-10, IL-13, TGF-β, TNF-α and IFN-γ were performed on the removed tunica albuginea (TA). For the normalization of data GAPDH (glucerldehyde-3fosfatehydrogenase) and GUSB (β-glucuroni…

CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain

AbstractEpiploic appendagitis is a rare cause of acute abdominal pain, determined by a benign self-limiting inflammation of the epiploic appendages. It may manifest with heterogeneous clinical presentations, mimicking other more severe entities responsible of acute abdominal pain, such as acute diverticulitis or appendicitis. Given its importance as clinical mimicker, imaging plays a crucial role to avoid inaccurate diagnosis that may lead to unnecessary hospitalization, antibiotic therapy, and surgery. CT represents the gold standard technique for the evaluation of patients with indeterminate acute abdominal pain. Imaging findings include the presence of an oval lesion with fat-attenuation…

Safety and tolerability of local treatment with iloprost, a prostacyclin analogue, in patients with Peyronie's disease: a phase I study

CT angiography for the assessment of EVAR complications : a pictorial review

Aortic aneurysm; Blood vessel prosthesis implantation; Endovascular procedures Aneurisma aórtico; Implantación de prótesis de vasos sanguíneos; Procedimientos endovasculares Aneurisma aòrtic; Implantació de pròtesis de vasos sanguinis; Procediments endovasculars Endovascular aneurysm repair (EVAR) is a minimally invasive treatment proposed as an alternative to open repair in patients with abdominal aortic aneurysms. EVAR consists in a stent-graft placement within the aorta in order to exclude the aneurysm from arterial circulation and reduce the risk of rupture. Knowledge of the various types of devices is mandatory because some stents/grafts are more frequently associated with complication…

Varicocele ed Infertilità

[Penile Flexiflate® Surgitek prosthesis explant and simultaneous three-component hydraulic Titan® Alpha 1 prosthesis implantation, with double incision technique in a patient with kidney and pancreas transplant].

Introduction and Objectives We treated a 45 years old patient, suffering from diabetes mellitus since childhood, with retinal, neurovascular and kidney complications. In 1988, for erectile dysfunction (ED) resistant to medical injective treatment, the patient underwent ligation of the dorsal vein of the penis without any result. In 1989 a Flexiflate® hydraulic prosthesis was implanted with resolution of ED. In 2005 the patient underwent simultaneous kidney and pancreas transplant with a trans-laparotomic approach for end stage renal disease and diabetes mellitus. In 2009, because of the Flexiflate® Surgitek malfunction, the patient underwent explantation of the Flexiflate® prosthesis and si…

Congenital Cystic Lesions of the Bile Ducts: Imaging-Based Diagnosis

Congenital cystic lesions of the bile ducts represent a spectrum of liver and biliary system lesions, resulting from abnormal embryologic development of the ductal plate. These disorders include Caroli disease, choledochal cysts, autosomal dominant polycystic liver disease, congenital hepatic fibrosis, and biliary hamartomas. Each disorder carries a peculiar clinical presentation, prognosis, and risk of complications. Knowledge of radiological findings of fibropolycystic liver diseases is crucial for their appropriate detection and for differential diagnosis with other similar hepatic cystic lesions, in order to avoid relevant misdiagnosis. The aim of this review is to provide an illustrati…

Peyronie’s disease: Cytokines genes expression in tunica albuginea

Sexual dysfunctions after transurethral resection of the prostate (TURP): evidence from a retrospective study on 264 patients

Objectives: Benign prostatic hyperplasia (BPH) and sexual dysfunctions are diseases with a high prevalence in aged men. Several studies have found a link between BPH and LUTS resulting from deterioration in sexual function in men aged 50 years and older for whom TURP is considered the gold standard. The impact of TURP on sexual functions still remain uncertain, nor is it clear what pathophysiological mechanism underlying the emergence of new episodes of Erectile Dysfunction (ED) following TURP in patients with normal sexual function before surgery, while retrograde ejaculation and ejaculate volume reduction represent a clear side effect; derived from BPH treatment. The aim of this study was…

Genitourinary Symptoms—Patient Help-Seeking and General Practitioner Management: An Outpatient Based Survey at a Tertiary Hospital in Southern Italy

Abstract Introduction General knowledge of most common genitourinary diseases is often lacking. In this survey we evaluated the attention given by patients and general practitioners to genitourinary symptoms, and particularly to hematuria and potential early signs of genitourinary cancer. Methods A structured self-administered questionnaire was administered to outpatients before the urological consultation. The questionnaire consisted of 4 multiple choice questions to record the level of patient awareness of urological symptoms, the importance given to gross hematuria, the interval between the onset and the visit, the regularity of physical examination and the first-level investigations ind…

"Nodule-in-nodule" architecture of hepatocellular carcinoma.

Modified Danielson Technique for Prosthetic Aortic Valve Endocarditis and Aortoventricular Discontinuity

Endocarditis is a devastating complication of prosthetic aortic valve replacement. The infective process can destroy aortic annulus tissue, making conventional surgical valve replacement difficult or impossible and causing aortoventricular discontinuity. Several treatment techniques have been proposed. One of these, the Danielson technique, involves translocating the aortic valve to the native ascending aorta, débriding the abscess cavity, closing the coronary ostia, and bypassing the coronary arteries with a Y anastomosis between 2 vein grafts. We describe our use of a modified Danielson technique in a 68-year-old man with advanced prosthetic valve endocarditis that was associated with aor…

Cytokine gene expression in the tunica albuginea in patients with Peyronie's disease. Pilot study with a control group

INTRODUZIONE: Abbiamo pensato di effettuare uno studio che indagasse circa la presenza delle citochine nell’albuginea di soggetti affetti da malattia di La Peyronie. Le citochine, in quanto responsabili della comunicazione intercellulare, potrebbero essere coinvolte nella patogenesi della malattia. L’individuazione di una o più citochine responsabili potrebbe, infatti, risultare utile nel trattamento farmacologico grazie ai c.d. farmaci biologici, in grado di interferire con le citochine. MATERIALI E METODI: Per lo studio sono stati reclutati tra gennaio 2009 e dicembre 2010 presso l’Ambulatorio di Chirurgia Andrologica del Policlinico di Palermo 20 soggetti affetti da malattia di La Peyron…

The “bouquet of flowers” appearance in medullary sponge kidney

The “bouquet of flowers” appearance is a radiological finding described for the intravenous pyelography (IVP) diagnosis of medullary sponge kidney (MSK). It refers to contrast pooling in dilated tubular structures in renal papillae, giving a striated pattern to the renal medulla, which resembles a “bouquet of flowers”