Assessment of SARS-CoV-2 RNA shedding in semen of 36 males with symptomatic, asymptomatic, and convalescent infection during the first and second wave of COVID-19 pandemic in Italy

: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) receptor, angiotensin-converting enzyme 2 (ACE2), has been identified in the human testis, but the risk of transmission of SARS-CoV-2 through sexual intercourse still needs to be defined. The goal of our study was to determine if SARS-CoV-2 is detectable in the semen of patients suffering or recovering from coronavirus disease-19 (COVID-19), still testing positive at nasopharyngeal swabs but showing mild or no symptoms at the time of sampling. Detection of SARS-CoV-2 RNA in semen was performed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and nested PCR targeting open reading frame (ORF) 1ab. Medical …

An uncommon case of sarcomatoid urothelial carcinoma in covered bladder exstrophy

Abstract We report a case of a woman affected by covered exstrophy, uterus didelphys and external genital malformation presenting with advanced bladder cancer. After neoadjuvant therapy and anterior pelvic exenteration, the abdominal wall was reconstructed with a pedicled myocutaneous muscle-sparing vastus lateralis flap.

Premature ejaculation: Pharmacotherapy vs group psychotherapy alone or in combination

Objectives: Premature Ejaculation (PE), the commonest sexual dysfunction in males, is generally treated with local anesthetic and SSRI (Dapoxetine). The aim of our study was investigate Group Psychotherapy as an alternative treatment for PE and compare the efficacy of pharmacological treatment and psychotherapy, either alone or in combination, in terms of response and improved Quality of Life (QoL). From a male outpatient population screened for PE, those who received a diagnosis of PE were proposed for the study, enrolled and divided into 3 groups (A, B and C). Each group was treated with Dapoxetine, Group Psychotherapy alone and Dapoxetine and Group Psychotherapy, respectively. Materials …

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).

Ipertermia e chemioterapia nel tumore vescicale superficiale a medio rischio di recidiva:esperienza preliminare

Cateteri e tecniche di cateterismo

Uroteliomi

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…

Appunti di Andrologia Chirurgica e Urologia

Preme sottolineare il grande impatto sociale di molte patologie urologiche sulla popolazione, come le malattie prostatiche, l'anuria ostruttiva o l'ematuria o ancora le infezioni urinarie o il deficit erettile: non si può esercitare con coscienza la professione del medico senza conoscere le cause, i sintomi e la terapia di queste problematiche. Per tale motivo abbiamo voluto aggiornare la pubblicazione del I° vol. già pubblicato, in maniera che lo studente abbia un riferimento semplice e chiaro per preparare l'esame di Urologia, integrando i testi ufficiali.

Anatomia e fisiologia della disfunzione erettile

Intravesical gemcitabine in superficial bladder tumours preliminary results of a phase I-II study

INTRODUCTION & OBJECTIVES: Gemcttabme is a pro-drug requmng intracellular phosphorylation by deoxycytidine kinase to be activated. Preliminary experiences. suggesting the activtty and the good tolerability of the drug on superficial transitional cell carcinoma of the bladder (TCCB) when administered by intravesical route, have been recently published. The mm of the present study was to evaluate the ablative efftcacy of weekly intravesical instillations of gemcitabine against paptllary marker lesions left after TUR of superficial TCCB. The scientific background and the ethical acceptability of thts approach have been balidated by the European Organization for Research and Treatment ot Cancer…

Anuria (uropatia) ostruttiva

Hilar Fusion: A Rare Renal Malformation

An uncommon case of a 42-year-old man with hilar renal symphysis in association with lithiasis and 'tubular precalyceal ectasia' is described.

Carcinoma of the prostate. Guidelines for treatment: the role of antiandrogens.

Our preliminary experience shows that flutamide is effective in patients with stage C or D prostate cancer. Local and distant response rates are comparable to those obtained with "classic" hormone therapy. Libido and sexual potency generally are unaffected. Palliation of symptoms, which is frequent, is usually accompanied by improved performance status and quality of life. Side effects are slight or moderate, but elevated transaminase levels in patients with borderline liver insufficiency are possible.

Smoking, diabetes, blood hypertension: possible etiologic role for Peyronie’s disease? Analysis in 279 patients with a control group in Sicily

Objective: To assess the proportion of patients with Peyronie’s Disease (PD) and the possible association with its potential risk factors in the general population of the central and western Sicily in our weekly andrological outpatient clinic. Materials and methods: We recruited a sample of 279 consecutive patients consulting our andrological outpatient clinic. Two arms were created: the first one composed by PD patients (men with symptoms suggestive for PD), the second one composed by patients with other andrological diseases (control arm). For each patient we evaluated the age, cigarette smoking, diabetes, blood hypertension and erectile function. In the PD arm we administered validated q…

PROSPECTIVE, RANDOMIZED, CROSSOVER COMPARISON OF SUBLINGUAL APOMORPHINE (3 mg) WITH ORAL SILDENAFIL (50 mg) FOR MALE ERECTILE DYSFUNCTION

Abstract: Purpose: We established the efficacy and safety of sublingual apomorphine compared with oral sildenafil. in comparable groups of patients with erectile dysfunction (ED). Materials and Methods: This prospective, randomized, crossover study included 77 heterosexual men with ED of various etiologies and severities. A total of 62 men were randomized but only 34 were evaluable for efficacy and tolerability. The study started with a run-in period of 2 to 4 weeks. The first 4 weeks of treatment were followed by a washout period of 4 weeks, after which patients changed to the alternate treatment for an additional 4-week period. The sequence of the 2 treatments was established by a randomi…

Long-term consequences of bilateral cavernous crush injury in normal and diabetic rats: a functional study

A recent statement from the European-Society-for-Sexual-Medicine has highlighted the limitations of using the rat model for nerve-sparing prostatectomy. The use of young rats with no comorbidities and the early evaluation of the erectile function (EF) are deemed a source of bias. Our aim was to evaluate the long-term consequences in EF of bilateral nerve cavernous crush- injury (BNCI) in type 1 diabetic (DM) rats 30-male/12-week-old rats were divided into four groups: Sham, BNCI, DM, and BNCI + DM. Sham group underwent an intraperitoneal injection (IP) of saline solution and after 1 month underwent a sham laparotomy. BNCI underwent an IP of saline solution and after 1 month to BNCI. DM unde…

Segmental Ureterectomy Versus Radical Nephroureterectomy in Older Patients Treated for Upper Tract Urothelial Carcinoma

Introduction: The world population is ageing and surgical procedures for older patients are associated with higher perioperative morbidity and mortality rates than in younger patients. Segmental ureterectomy (SU) has been proposed as an alternative to radical nephroureterectomy (RNU) for selected upper tract urothelial carcinomas (UTUC), to reduce post-operative morbidity, and preserve renal function. The aim of this study was to compare RNU and SU in terms of post-operative complications, functional outcomes, and overall survival (OS) in older patients treated for UTUC. Materials and methods: Data of patients aged 75 years or older and treated for UTUC were included. The primary outcome wa…

Carcinoma della prostata

Plasma levels of angiogenetic markers in men candidate to prostate biopsy

Time to safely omit bladder cuff removal for low-risk upper tract urothelial carcinoma

Long-term outcome of antiandrogen monotherapy in advanced prostate carcinoma: 12-year results of a phase II study

OBJECTIVE To present the long-term outcome of patients with locally advanced or metastatic prostate carcinoma treated by first-line antiandrogen monotherapy. PATIENTS AND METHODS From 1983 to 1990, 41 patients with advanced prostate carcinoma were treated with flutamide monotherapy until progression or the appearance of toxicity. Twenty-five patients (61%) had T3-T4N0M0 and 16 (39%) T2–4N0–3M1 prostate carcinoma. Consensus criteria were adopted to evaluate the response. Plasma testosterone and sexual function were recorded for the first 3 years. RESULTS Flutamide was administered for up to 147 months; seven patients (17%) interrupted the treatment because of toxicity. There was an objective…

Le disfunzioni sessuali maschili I

ANALOGHI DELLA SOMATOSTATINA:NUOVA TERAPIA DI SALVATAGGIO NEL CARCINOMA PROSTATICO ORMONO-RESISTENTE

ADO: Attività didattica opzionale in Chirurgia andrologica

Italian males recovering from mild COVID-19 show no evidence of SARS-CoV-2 in semen despite prolonged nasopharyngeal swab positivity.

A phase I-II study on intravesical Gemcitabine in superficial bladder papillary tumors

INTRODUCTION AND OBJECTIVE: The possible role of gemcitabine inintravesical therapy of superficial transitional cell carcinoma of the bladder (TCCB) has been suggested. The European Organization for Research and Treatment of Cancer Urological Group validated the use of papillary marker lesion left in the bladder after TUR as the best tool to measure the efficacy of a drug by intravesical route against TCCB. The rsults on 27 patients are herein presented. METHODS: Twenty-seven patients, with recurrent superficial TCCB (Ta-T1, G1-G2), were treated with intravesical gemcitabine for 1 to 3 papillary marker lesions (5-15 mm) left unreseacted after TUR. Twenty-one patients (78%) had recurrent tum…

La cistectomia seminal-sparing nelle patologie non neoplastiche.

PURPOSE. Seminal-sparing cystectomy is reported in literature only with reference to oncological conditions. However, it can be applied also in non-neoplastic conditions in young patients with good renal function. In the present report we will describe our experience in this field, with special reference to erectile function, urinary continence, fertility and feasibility. MATERIALS AND METHODS. Between 2000 and 2009 we have treated five patients with seminalsparing cystectomy for benign conditions, namely sclerosing cystitis, tuberculosis and a benign paraganglioma. All patients underwent a complete diagnostic evaluation including CT of upper abdomen and pelvis, and bone scintigraphy. Digit…

uso degli alfa-bloccanti nell'ipertrofia prostatica benigna: il problema della "floppy iris syndrome". Risultati di uno studio caso-controllo per la valutazione del rischio pre-operatorio con la misura del diametro pupillare.

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Chirurgia delle derivazioni urinarie continenti

GRAVE EMORRAGIA RICORRENTE DEL CONDOTTO ILEALE DA IPERTENSIONE PORTALE: PRIMA ESPERIENZA MONDIALE CON SCLEROTIZZAZIONE VASALE ECOGUIDATA.

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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…

Intravesical gemcitabine in superficial bladder tumors. Results of a phase I-II study

the good tolerability of intravesical gemcitabine have been recently published. The evaluation of the activity on a papillary marker lesion is the best tool to measure the efficacy of a drug by intravesical route against superficial transitional cell carcinoma of the bladder (TCCB). The scientific background and the ethical acceptability of this approach have been validated by the European Organization for Research and Treatment of Cancer Urological Group. The aim of the present study was to evaluate the ablative efficacy of weekly intravesical instillations of gemcitabine against a histologically proven papillary marker lesion. MATERIAL & METHODS: Twenty-seven patients, affected by recurre…

Antiepileptic Drugs, Sexual Functions and Serum Hormonal Profile in Males with Epilepsy

Sexual dysfunctions are a common problem in epileptic men. Etiology is multifactorial involving both epilepsy and antiepileptic drugs. Purpose of this study was to evaluate incidence of sexual dysfunctions in epileptic men, assessing epilepsy, antiepileptic drugs, serum hormonal profile, psychiatric disorders.

Chronic Prostatitis and Prostatodynia: Ultrasonographic Alterations of the Prostate, Bladder Neck, Seminal Vesicles and Periprostatic Venous Plexus

Transrectal ultrasonography was performed in 121 patients with the chronic prostatitis syndrome (CPS), and in 20 patients with urological pathology not involving the prostate gland. The ultrasonographic aspects of the seminal vesicles (SV) in normal subjects and in patients with the CPS are described. In the latter group, characteristic ultrasonographic patterns can often be obtained, even in patients affected by prostatodynia, in whom all the other clinical and laboratory findings were absent. They consisted of: (a) dyshomogeneous echo-structure of the prostate; (b) constant dilatation of the periprostatic venous plexus, greater than 150 mm2; (c) dilated, elongated SV, with thickening of t…

MP43-14 COMPARISON BETWEEN QUINOLONES AND OTHER ANTIBIOTICS IN PREVENTING INFECTIVE COMPLICATIONS IN TRANSRECTAL PROSTATE BIOPSY

INTRODUCTION AND OBJECTIVE:Sepsis is one of the most feared complications of prostate biopsy: it’s incidence is 1-3%. Prevention of infection after biopsy procedure consists in prophylactic antibio...

The Prognostic Value of P53 in Predicting of Bladder Carcinoma

The prognostic value of p53 in predicting recurrence and progression of superficial transitional cell carcinoma of the bladder (TCCB) is still uncertain. Materials and methods P53 expression was retrospectively assessed in 160 patients. At a median follow-up of 45 months, (up to years) 84 patients (53%) recurred and 13 (8%) progressed. Adjuvant intravesical chemotherapy after TUR was adopted in 51 patients (32%). The correlations between p53 and G-grade, T-category, risk of recurrence and progression, and intravesical chemotherapy were investigated. Similarly, the correlations between variations in grade and stage at recurrence and modifications in p53 expression were also studied. Results…

Segmental ureterectomy vs. radical nephroureterectomy for ureteral carcinoma in patients with a preoperative glomerular filtration rate less than 90 ml/min/1.73 m2: A multicenter study

Objectives: To compare segmental ureterectomy (SU) and radical nephroureterectomy (RNU) in terms of overall survival (OS) and impact on postoperative renal function in patients treated for upper tract urothelial carcinoma (UTUC) of the ureter with preoperatively reduced estimated glomerular filtration rate (eGFR). Materials and methods: We retrospectively collected the data of consecutive patients treated for UTUC, in 6 Italian tertiary referral centers, from 2003 to 2013, and analyzed those treated with RNU or SU for ureteral cancer and with a preoperative eGFR &lt;90 ml/min/1.73m2. The primary outcome was to compare the postoperative eGFR variation and the OS according to the surgical tec…

Osservational Study on Early Diagnosis of Prostate Carcinoma in Sicily and Calabria

The diagnosis of prostate carcinoma has been monitored in Sicily and Calabria for one year. Material e Methods Twenty-seven urological centres of Sicily and Calabria joined the study. Detailed informations about age, familiarity, PSA, Gleason score and TNM stage at diagnosis were centralized between november 2001 and november 2002. Results 721 patients have been recruited. The median age was 73 years. More than 80% of the patients were older than 65 years. Median PSA was 14 ng/ml. The clinical stage at diagnosis was T1c in 33% of patients and 67% had an organ confined prostate cancer (T1-T2). Familiarity was detected in 8% of cases. Age and PSA at diagnosis in these patients were similar t…

Smoking cessation and outcome of patients affected by non muscle invasive bladder cancer (NMI-BC)

Introduction: Does a correlation exist between smoking cessation and recurrence of non muscle invasive bladder carcinoma (NMI-BC) after TUR and adjuvant intravescical chemotherapy? Up today just few retrospective studies tried to answer this question. There is evidence that quitting decreases the risk of recurrence but nowadays it is still controversial how and how long it takes from quitting to reduce the risk (1-3). The aim of the present study is to compare the recurrence rate in smokers, non smokers and former smokers and in particular to evaluate if and how the decision of quitting at diagnosis could change the patients’outcome. Patients and Methods: We retrospectively analyzed the out…

VALUTAZIONE DELLA TERAPIA A LUNGO TERMINE CON TADALAFIL IN PZ CON DISFUNZIONE ERETTILE: UPDATE DOPO 6 MESI

Introduzione e obiettivi Caratterizzare, in uno studio prospettico longitudinale su pazienti (pz) con disfunzione erettile (DE) trattati per 6 mesi con Tadalafil (Tad), efficacia, sicurezza, e grado di soddisfazione per il trattamento del pz e della partner. Materiali e metodi Furono arruolati 155 pz (età media 67 anni, range 26-75) con DE, mai trattati (naïve) nel 74% dei casi. La DE, presente da 2 (10%). Del piano terapeutico previsto (totale 9 m) (posologia Tad: iniziale, costante, 20 mg x 2/sett. x 6 m.; proseguimento: 20 mg x 1-2/sett. x altri 3 m. in base a risposta dei primi 6 m. e/o opzione motivata dal pz) riportiamo i dati su efficacia (IIEF5) e soddisfazione (EDITS-paziente; EDIT…

Penile Enhancement Procedures: Urological And Ethicolegal Issues

Phalloplasty procedures for most men requiring penile augmentation surgery are cos-metic procedures; generally the patients have a normal-sized and fully functional penis but they think that their penis is too small. There are not well defined indications for penile enhancement surgery and, except for the treatment of “micropenis”, there are not established guidelines and the outcome measures for success are still unclear. All penile enhancement techniques often do not reach the expected result and the grade of pa-tient’s satisfaction is frequently poor. Phalloplasty procedures for psychological dys-morfism are not approved by any scientific society and the majority of these procedures are …

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

Serum levels of angiogenetic cancer biomarkers in men undergoing prostate biopsy. Preliminary data

Background: The reduction of the number of negative prostate biopsies in patients with elevated serum PSA represents a major challenge. Several angiogenetic biomarkers are involved in carcinogenesis and cancer progression. The aim of our preliminary study was to investigate if their serum levels might be related to prostate cancer detection. Patients and Methods: Angiopoietin 2, Follistatin, G-CSF, HGF, IL-8, Leptin, PDGF- BB, PECAM-1, VEGF, PTH were the selected biomarkers for our research. They were measured by BioPlex immunoassay. As a preliminary step, consecutive unselected patients undergoing prostate biopsy for palpable prostate nodule and/or elevated PSA levels were entered. A 12-co…

Lower plasma testosterone levels enhance the predictive value of endothelial dysfunction for future cardiovascular events: A 5-year prospective study.

LETTER TO EDITOR

Circumcision in Nesbit Corporoplasty: A Mandatory Time? Our Experience on 158 Patients

Introduction The Nesbit procedure is the most common surgical technique to correct congenital or acquired penile curvature. It is a common opinion that this surgical procedure has to be completed with a circumcision to prevent foreskin necrosis or phimosis. According to our experience we believe that some procedural “tricks” could strongly reduce that mechanical and ischemic trauma on the foreskin responsible for these complications. Materials and Methods From 1988 to 2010 we selected 158 patients treated with Nesbit's corporoplasty. The procedure was recommended to patients who presented a penile curvature wider than 30° and reporting however some difficulty or pain at coitus, or to patien…

POSIZIONAMENTO DI PROTESI PENIENA MALLEABILE. RISOLUZIONE DI COMPLICANZA INTRAOPERATORIA

The adventures of a future urologist in the first world war: Medical lieutenant michele pavone and the liberation of Udine

The adventures of a future urologist in the first world war: Medical lieutenant michele pavone and the liberation of Udine

Spontaneous extrusion of male genital pearling

Pearling is a practice of inserting small beads beneath the skin of the genitalia. Patients generally underwent this practice believing that this would have made their penis bigger and able to better satisfy their partners during intercourse. Pearling can cause complications. We report a case of spontaneous extrusion of genital pearling exiting in a granuloma of the inner face of the foreskin.

Efficacy and safety of Cyprofloxacin XR 1000mg once daily versus Ciprofloxacin 500mg twice daily in the treatment of complicated urinary tract infections

The aim of this trial was to compare the efficacy and safety of extended-release ciprofloxacin (CIPRO XR) versus the immediate-release formulation (CIPRO IR) in the treatment of complicated urinary tract infections (UTIs). 212 patients were randomized to CIPRO XR 1,000 mg tablet once daily or CIPROXIN IR 500 mg tablet twice daily. Treatment efficacy was evaluated by bacteriological outcome. Safety was measured by recording adverse events. The rate of bacteriological eradication was 83% in the CIPRO XR group and 75% in the CIPRO IR. the overall incidence of adverse events reported was higher in the CIPRO IR group. The authors conclude that CIPRO XR is a safe and effective treatment for compl…

Intravesical mitoxantrone in superficial bladder tumours (Ta-T1)

Abstract 36 patients with histologically proven grade G1–G2, Ta-T1 transitional cell carcinoma of the bladder were introduced, after transurethral resection (TUR), into a study of intravesical chemoprophylaxis with mitoxantrone (20 mg diluted in 50 ml). After a mean follow-up of 23 months, 16 (50%) patients showed a superficial recurrence with a mean recurrence rate of 0.56 per year. In 19 patients with recurring tumours the mean recurrence rate decreased from 1.65 to 0.58 per year. 9 patients (25.7%) suffered from a chemical cystitis that in 2 cases (5.7%) required treatment interruption.

Pharmacologic pupil dilation as a predictive test for the risk for intraoperative floppy-iris syndrome.

PURPOSE: To evaluate the effect of α1-adrenergic receptor antagonists (α1-ARAs) on pupil diameter and determine whether the diameter predicts intraoperative floppy-iris syndrome (IFIS). SETTING: Ophthalmology Section, Palermo University, Palermo, Italy. DESIGN: Prospective cohort study. METHODS: Male outpatients taking tamsulosin, α(1)-ARAs, or no α(1)-ARAs having phacoemulsification were recruited. Pupils were measured 1 month preoperatively, immediately preoperatively, and postoperatively under mesopic low (0.4 lux) and high (4.0 lux) illumination after pharmacologic dilation. The IFIS severity was graded. RESULTS: Each group comprised 50 patients. Pharmacologic dilation in both α(1)-ARA …

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 …

Intravesical gemcitabine is superficial bladder tumours. Results of a phase I-II study

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ESTRAMUSTINA FOSFATO VS ASSOCIAZIONE A BASSA DOSE DI ESTRAMUSTINA FOSFATO E ETOPOSIDE NEL CARCINOMA PROSTATICO ORMONOREFRATTARIO (HRPC). STUDIO RANDOMIZZATO DI FASE II DEL GRUPPO STUDI TUMORI UROLOGICI (GSTU)

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Five-year prospective study on cardiovascular events, in patients with erectile dysfunction and hypotestosterone.

Objective: Testosterone levels play a role in cardiac and vascular pathology. In the present study we investigated the prognostic significance of this hormone for cardiovascular outcome, in a 5-year follow-up. Materials and methods: Our cohort included 802 adult subjects, from 40 to 80 years. Patients were excluded if they had a past history of peripheral or coronary artery disease, and revascularization. A blood sample was drawn to valuate testosterone level, and we considered normal testosterone levels 300 ng/dl. FMD (flow mediated dilatation) of the brachial artery was assessed by measuring the increase of the brachial artery diameter during reactive hyperemia after transient forearm isc…

Derivazioni urinarie

Le prostatiti.

Correlation between GP-170 expression, prognosis, and chemoresistance of superficial bladder carcinoma.

To study GP-170 in superficial bladder cancer at initial diagnosis and at recurrence and to evaluate if intravesical chemoprophylaxis modifies the expression of GP-170 in tumor recurrences. GP-170 was retrospectively assessed in 160 patients affected by primary superficial transitional cell carcinoma of the bladder and followed for up to 10 years. Eighty-four patients (52.5%) recurred after transurethral resection (TUR). Adjuvant intravesical chemotherapy after TUR was adopted in 52 patients. The correlations between GP-170 and G-grade, T-category, risk of recurrence and of progression, and adoption of adjuvant intravesical chemotherapy were investigated. The correlations between variations…

Terapia delle anomalie dell' eiaculazione

Eiaculazione precoce: Trattamenti a confronto. Terapia medica vs terapia medica in associazione con Psicoterapia di gruppo vs Psicoterapia di Gruppo - Poster P45

Scopo del lavoro Scopo dello studio è valutare in pz affetti da Eiaculazione Precoce (EP) il trattamento associato Farmaco+Psicoterapia di gruppo, vs Farmaco, vs Psicoterapia di gruppo in termini di aumento del Tempo di latenza eiaculatoria intravaginale (IELT) e migliore Qualità di vita (QoL). Materiali e metodi Tra gennaio e dicembre 2012 sono stati osservati tra la popolazione maschile afferita all’U.O.C. di Urologia del Policlinico P. Giaccone di Palermo 540 pz affetti da EP. Da questa popolazione selezionata è stato arruolato un campione di 270 pz secondo i criteri di inclusione: IELT ≤ a 2 minuti, Premature Ejaculation Diagnostic Tool (PEDT) ≥9, età 18-70 anni. Criteri di esclusione: …

INCIDENC, LIFESTYLE AND SUBJECTIVE SYMPTOMS IN PATIENTS WITH PROSTATITIS: RESULTS OF THE ITALIAN OBSERVATIONAL STUDY

Semeiotica Fisica, funzionale, di laboratorio, radioisotopica, endoscopica e per immagini

PSA E PROSTATITE CRONICA CLINICAMENTE SILENTE IN PZ CON SOSPETTO CARCINOMA PROSTATICO T1C

Does hyperthermia improve the results of intravesical chemotherapy?

Ipertrofia prostatica benigna

PSA and second-line therapy of hormone refractory prostate carcinoma

The aim of the present study was to correlate PSA response with subjective response (bone pain and performance status), in patients treated for hormone refractory carcinoma of the prostate. Twenty-four patients were introduced into the study. Median PSA was 198 ng/ml. Symptom score, performance status and PSA were monitored monthly for 3 months and then 3-monthly. Sixteen patients (66%) showed a PSA response (median value 10 ng/ml). In 8 patients (33%) PSA was 4 ng/ml. In conclusion, PSA response is not always related to subjective improvement and does not always implicate a beneficial effect of the therapy for the patient. Copyright © 2001 S. Karger AG, Basel.

Low levels of testosterone levels increase the risk of major cardiovascular events in a follow-up to 5 years

Materials and Methods. We evaluated a series of 802 patients with intermediate cardiovascular risk according to the Framingham Risk Score (FRS). The endothelial function through flow-mediated vasodilatation (FMD), the erectile function (EF), and the total serum testosterone levels were assessed. Patients were followed for up to 5 years and the prevalence and predictors of MACEs were evaluated. Results. The levels of serum testosterone are related with both endothelial function (FMD) (t=9,4080, 95% CI= 0,9318 to 1,4234, p<0,0001) and erectile function (FMD) (t=8,9584, 95% CI= 0,7642 to 1,1932, p<0,0001). Analysis of variance (ANOVA) of serum testosterone levels are related with the MACEs (F-…

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 …

Infezioni e flogosi delle vie urinarie nella donna

Risultati a lungo termine del trattamento con TUR e terapia endovescicale adiuvante nell’urotelioma vescicale T1G3. Recidiva, progressione e sopravvivenza in 236 pazienti

IS IT POSSIBLE TO PREDICT CHEMORESISTANCE OF SUPERFICIAL BLADDER CARCINOMA?

Urological dysfunctions in patients with Parkinson’s disease: clues from clinical and non-invasive urological assessment

Abstract Background Autonomic nervous system dysfunction, common in patients with Parkinson’s disease (PD), causes significant morbidity and it is correlated with poor quality of life. To assess frequency of urinary symptoms in patients with PD, without conditions known to interfere with urinary function. Methods Non-demented PD patients were consecutively enrolled from the outpatients clinic of our department. Scales investigating motor and non-motor symptoms were carried out. Evaluation of urinary dysfunctions was carried out using the AUTonomic Scale for Outcomes in Parkinson’s disease (SCOPA-AUT) questionnaire. Patients underwent noninvasive urological studies (nUS), including uroflowme…

Sindrome prostatica cronica II

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…

Antiandrogens alone or in combination for treatment of prostate cancer: The European experience

Abstract In Europe, antiandrogens have been used for many years to treat prostate cancer, either as monotherapy or as part of a “combination therapy” with either surgical or chemical castration. However, considerable debate still exists regarding the relative benefits of combination therapy versus antiandrogen monotherapy or castration alone. This article reviews the European experience with antiandrogen therapy, including the personal experiences of the authors.

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.

VALUTAZIONE DELLA SENSIBILITà E SPECIFICITà DELLA RISONANZA MAGNETICA ENDORETTALE E DELLA ECOGRAFIA TRANSRETTALE NELLA STADIAZIONE DELL'ADENOCARCINOMA PROSTATICO

OBJECTIVES. Nowadays endorectal probes for Magnetic Resonance Imaging (MRI) have better resolutions, which allows to acquire high-level images of prostate and to improve the MRI sensitivity and specificity to determine the cancer volume and the extraprostatic extension. The objective of the present study is to evaluate the sensitivity and diagnostic accuracy of endorectal MRI for identifying the local extension of prostate carcinoma compared to transrectal sonography (TRUS) of prostate. MATERIALS AND METHODS. The study included 81 patients with clinical suspect of cancer and/or elevated values of serum prostate specific antigen (PSA), who underwent endorectal MRI with 1.5 T endorectal probe…

LA CHIRURGIA NELLA MALLATTIA DI LA PEYRONIEE NEL RECURVATUM CONGENITO: IMMAGINI INEDITE

Uretroplastica con innesto dorsale di mucosa buccale: è ancora il metodo di scelta nella stenosi uretrale a lungo termine? – P18.

INTRODUZIONE E OBIETTIVO DELLO STUDIO: Risultati a lungo termine dell'uretroplastica con innesto dorsale di mucosa buccale e fattori predittivi negativi della metodica. MATERIALI E METODI: Analisi retrospettiva di 27 pazienti sottoposti a uretroplastica con innesto di mucosa buccale (prelievo del graft della guancia di circa 4x2,5 cm) per stenosi uretrale nel periodo 2010-2015 (mediana 42 mesi). Flusso massimo (Qmax), residuo post-minzionale (RPM), ecografia del corpo spongioso uretrale, test IPSS (solo domanda su QoL) e percezione soggettiva allo svuotamento sono stati ottenuti prima e dopo l’intervento (un mese e dopo mediana di 3,5 anni). L’età media del campione era di 43,2 anni (range …

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…

Sindromi prostatitiche croniche (SPC), Chronic Pelvic Pain Syndrome e cistite interstiziale. Semplice analogia o unità patogenetica? Risultati di uno studio pilota sul trattamento delle SPC con associazione di un anti-istaminico ed un eparinoide.

Sildenafil orodispersible film in the treatment of erectile dysfunction after radical prostatectomy: A single‐centre open‐label uncontrolled trial

Phosphodiesterase-5 inhibitors are the first-line therapy for erectile dysfunction (ED) after radical prostatectomy (RP). This single-centre open-label uncontrolled study evaluated the efficacy and safety of the new sildenafil orodispersible film (ODF) in ED treatment after RP. Sildenafil 100 mg ODF was administered twice a week for 3 months to patients under 75 years of age, with a Framingham cardiovascular risk score &lt; 20% and a pre-operative International Index of Erectile Function (IIEF)-5 score ≥ 17, who had undergone open RP between 2016 and 2018. Erectile function was assessed pre-operatively, post-operatively and after treatment through the IIEF-5 score, the Sexual Encounter Prof…

Urethroplasty with dorsal buccal mucosa graft. Is it still the method of choice in long term urethral stenosis?

The aim of our work was to evaluate the long-term changes in symptoms (median 42 months) and to analyze data for any negative predictive factors for the application of the procedure, in patients who underwent to urethroplasty with dorsal buccal mucosa graft. During the period from 2010 to 2015 27 patients were examined. Than they underwent urethroplasty using dorsal buccal mucosa graft (graft of 4 x 2.5 cm). The evaluation of symptoms has been addressed through the application of the IPSS Quality of Life Questionnaire (International Prostatic Symptoms Score) and the evaluation of urinary flow has been carried out by a comparative analysis between the pre- and post-operative uroflowmetry. As…

Adjuvant Intravesical Chemotherapy in Patients with Primary T1 G3 Transitional Cell Carcinoma of the Bladder

The Authors present their experience with TUR plus adjuvant intravesical chemotherapy in 50 patients affected by primary T1 G3 bladder tumours without previous or concomitant carcinoma in situ. At a mean follow-up of 36 months, 84% of the patients are alive and tumour-free. Cystectomy was performed in three patients due to locally invasive disease. Five patients (10%) died of bladder cancer.

TERAPIA CONSERVATIVA CON TUR E TERAPIA ENDOVESCICALE ADIUVANTE IN UNA POPOLAZIONE SELEZIONATA DI PAZIENTI AFFETTI DA CARCINOMA VESCICALE T1G3

SAFETY AND TOLERABILITY OF LOCAL TREATMENT WITH ILOPROST, A PROSTACYCLIN ANALOGUE, IN PATIENTS WITH PEYRONIE'S DISEASE. A PHASE I STUDY

Objective. To assess the possibility of intralesional therapy for the treatment of Peyronie's disease, we have verified the safety and tolerability of intralesional injections of Iloprost ( an I 2 Prostacyclin analogue) for its property to suppress the production of CTFG in fibroblasts. CTFG is a connective tissue growth factor that acts in concert with TGF-β to stimulate the fibrotic process. Materials and methods. 38 patients with Peyronie’s disease were preliminarily evaluated by considering the symptoms, the degree of penile curvature, and the size of the plaque. Each patient received weekly intralesional injections of 200 ng of Iloprost in 1 ml normal saline for 5 weeks. If tolerated, …

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 …

"LUTS E DE NELLA PRATICA CLINICA ANDROLOGICA IN SICILIA: ANALISI EPIDEMIOLOGICA SU CONDIZIONI DI FAMILIARITA' (PATOLOGIE URO-GENITALI), COMORBIDITA', ALTERAZIONI" (C33) ALL'ESAME OBIETTIVO.

Sindrome prostatica cronica I

How Can the COVID-19 Pandemic Lead to Positive Changes in Urology Residency?

The COVID-19 outbreak, in a few weeks, overloaded Italian hospitals, and the majority of medical procedures were postponed. During the pandemic, with hospital reorganization, clinical and learning activities performed by residents suffered a forced remodulation. The objective of this study is to investigate how urology training in Italy has been affected during the COVID-19 era. In this multi-academic study, we compared residents' training during the highest outbreak level with their previous activity. Overall 387 (67.1%) of the 577 Italian Urology residents participated in a 72-h anonymous online survey with 36 items sent via email. The main outcomes were clinical/surgical activities, soci…

Problem Based Learning (PBK)

Vaginal Metastasis from Renal Cell Carcinoma: The Role of Electron Microscopy

A case of vaginal metastasis from a renal cell carcinoma is reported. This rare localization is often the first clue leading to the diagnosis of an occult renal adenocarcinoma. The role of electron microscopy is emphasized, since the histologic aspect of the lesion is similar to that of a primary vaginal mesonephric adenocarcinoma.

Fisiologia della minzione e concetto continenza/incontinenza urinaria

ESTRAMUSTINA FOSFATO VS ASSOCIAZIONE A BASSA DOSE DI ESTRAMUSTINA FOSFATO ED ETOPOSIDE NEL CARCINOMA PROSTATICO ORMONOREFRATTARIO. STUDIO RANDOMIZZATO IN FASE II DEL GRUPPO STUDI TUMORI UROLOGICI (GSTU)

La circoncisione nella corporoplastica secondo Nesbit: tempo obbligatorio? Esperienza su 158 pazienti (Circumcision in Nesbit corporoplasty: a mandatory time? Our experience on 158 patients)

INTRODUCTION: The Nesbit procedure is the most common surgical technique to correct congenital or acquired penile curvature. It is a common opinion that this surgical procedure has to be completed with a circumcision to prevent foreskin necrosis or phimosis. According to our experience we believe that some procedural "tricks" could strongly reduce that mechanical and ischemic trauma on the foreskin responsible for these complications. MATERIALS AND METHODS: From 1988 to 2010 we selected 158 patients treated with Nesbit's corporoplasty. The procedure was recommended to patients who presented a penile curvature wider than 30° and reporting however some difficulty or pain at coitus, or to pati…

La p53 nel tumore vescicale superficiale (Ta-T1, G1-3)

SINGOLARE CASO DI TRAUMA PENIENO

INTRODUZIONE Descriviamo il caso di un paziente con presentazione clinica come da rottura dei corpi cavernosi e diagnosi conclusiva di lacerazione della fascia di Buck con associata lesione vascolare. MATERIALI E METODI Paziente di 36 anni, che giunge alla nostra osservazione con ematoma penieno da trauma intercorso durante rapporto sessuale. Dopo esecuzione in urgenza di ecocolor-doppler penieno sospetto per lesione di tonaca albuginea del pene, il paziente viene immediatamente sottoposto a esplorazione chirurgica che rivela la presenza di lacerazione della fascia di Buck con contestuale lesione vascolare; la tonaca albuginea risulta integra. RISULTATI Riportiamo la tecnica chirurgica util…

Commentary on “Effects of patients' understanding and choice of surgical types on postoperative outcomes of Peyronie's disease: a single-center retrospective study of 108 patients” – the right choice in Peyronie's disease surgery

Surgical correction can be considered for treating patients with a chronic phase of Peyronie's disease (PD) and persistent penile curvature. In clinical practice, some patients pay too much attention to surgical complications and refuse the recommended feasible surgical types. Meanwhile, they require operations according to their preferences. This study aimed to evaluate the effects of patients’ own choice of surgical type on postoperative satisfaction. This retrospective study analyzed data from 108 patients with PD who underwent surgical correction according to doctors’ recommendations or patients’ own demands. The objective and subjective surgical outcomes were assessed. Patients’ unders…

LA RIDUZIONE DEL PSA DOPO TERAPIA ANTIBIOTICA NON HA VALORE PREDITTIVO IN SOGGETTI CANDIDATI ALLA AGOBIOPSIA PER SOSPETTO TUMORE PROSTATICO T1C

La dismorfofobia peniena, i traumi del pene, la torsione del testicolo, gli incurvamenti del pene, la chirurgia del transessualismo

246 Premature ejaculation: Comparison of treatment. Pharmacotherapy vs pharmacotherapy in association with group psychotherapy vs group psychotherapy

Gemcitabine in intravesical treatment of Ta-T1 transitional cell carcinoma of the bladder: Phase I-II study on marker lesions

Abstract Objectives To study the ablative activity of intravesical gemcitabine against superficial transitional cell carcinoma of the bladder at different doses and concentrations. Methods A total of 27 patients were treated with intravesical gemcitabine after transurethral resection during which one to three papillary marker lesions were left unresected. Starting 14 days after transurethral resection, six instillations of gemcitabine were given at weekly intervals. Gemcitabine, diluted in 50 mL of saline solution and maintained for 2 hours, was given at the dose of 500 mg, 1000 mg, and 2000 mg in groups of 9 patients each. A complete response (CR) was defined as negative cytology, cystosco…

Postoperative complications and 90-day mortality in radical cystectomy in high-risk patients: A monocentric retrospective observational study.

Aim: Assessing the incidence of immediate postoperative complications and 90-day mortality in high-risk patients who have undergone radical cystectomy; evaluating the correlation between preoperative conditions and surgery outcomes. Materials and methods: This is a monocentric retrospective observational study in which data of 65 patients have been analyzed. High-risk criteria: (a) Age ≥75 years, (b) obesity, (c) age-adjusted Charlson Comorbidity Index ≥8, (d) anemic status, and (e) pT ≥3. More than 50% of patients had two or more “high-risk” indicators. Postoperative complications were assessed through Clavien–Dindo classification. Results: Average age of patients was 70.4 years, average a…

A pilot study comparing different dose levels and administration schedules of interferon-α2b combined with epirubicin for prevention of recurrence in bladder cancer

A pilot study in 62 patients has been carried out to evaluate the combination of epirubicin and interferon (IFN)-alpha 2b using different doses and schedules of intravesical administration in the prevention of recurrence of bladder cancer. Preliminary results show greater prophylactic efficacy not only when higher doses of epirubicin and IFN-alpha 2b are used but also when a larger interval between instillation of the compounds was used.

PROSTATA (PROSTATITI, IPERTROFIA PROSTATICA, CANCRO DELLA PROSTATA)

ESTRAMUSTINE PHOSPATE VERSUS INTERMITTENT LOW DOSE ORAL COMBINATION OF ESTRAMUSTINE PHOSPATE AND ETOPOSIDE IN HORMONE REFRACTORY PROSTATE CARCINOMA. A PHASE II STUDY OF GSTU FOUND.

A prospective observational study on oral administration of Ellagic Acid and Annona Muricata in patients affected by non-muscle invasive bladder cancer not undergoing maintenance after 6-week intravesical prophylaxis

Introduction: BCG and MMC shortage and Covid-19 pandemic, more recently, limit accessibility to maintenance regimen in intravesical prophylaxis against recurrence of non-muscle invasive bladder cancer (NMIBC). Ellagic acid (EA) and Annona muricata (AM) exert antitumor activity against different human tumours. An observational prospective study on the prophylactic effect of oral administration of EA+AM in patients avoiding maintenance regimen is presented. Materials and methods: Patients affected by NMIBC and not undergoing maintenance after a 6-week course of intravesical prophylaxis with MMC or BCG were entered. Tis and very high-risk tumours were excluded. After informed consent, the pati…

Erectile dysfunction is associated with low total serum testosterone levels and impaired flow-mediated vasodilation in intermediate risk men according to the framingham risk score

Background: The role erectile dysfunction (ED) coupled with low testosterone levels as early markers of atherosclerosis is not well understood. Objectives: To analyze the relationship between serum testosterone levels with both ED and brachial artery flow-mediated vasodilation (FMD), in a primary prevention sample of men. Methods: We enrolled 802 asymptomatic, intermediate CV risk patients, according to the Framingham Risk Score, aged 40e80 years, who underwent the ultrasound examination of FMD, the evaluation of ED and the assessment of total serum testosterone levels. Results: Testosterone levels correlated both with FMD (r ¼ 0.85; p &lt; 0.0001) and IIEF-5 score (rs ¼ 0.65; p &lt; 0.0001…

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…

Diagnosi della disfunzione erettile

Anatomia dell’apparato genito–urinario in breve

Terapia della disfunzione erettile

Ipertermia e chemioterapia nel tumore vescicale superficiale a medio-alto rischio:esperienza preliminare sulla tollerabilità.

The relationship between endothlial ABD erectile dysfunction, levels of testosterone and cardiovascular events in the follow-up

Background: Clinical and experimental evidence suggest that testosterone levels play a role in cardiac and vascular pathology. A long history of observational studies investigating serum testosterone level and cardiovascular risks, specifically mortality, reveals important associations between low testosterone and mortality, while higher serum testosterone level appear to be predictive in the majority of studies. On the other hand, it is well documented and accepted that endothelial dysfunction is expression of preclinical atherosclerosis and it is associated with an increased amount of CV events in the follow-up. Erectile dysfunction is also an early manifestation of arteriosclerosis assoc…

Microwave-Induced Hyperthermia and Cytostatic Agent for Superficial Bladder Cancer

The efficacy and local toxicity of the intravesical combination of microwave-induced hyperthermia with a cytostatic agent in patients affected by superficial bladder cancer is presented. Between 1994 and 2002, two studies were performed on ablative and adjuvant intravesical thermo-chemotherapy. The ablative study demonstrated complete tumor eradication in 88% of patients who should have undergone cystectomy due to diffuse multiple papillary tumors non-responsive TUR and intravescical adjuvant therapy. In a randomized study, comparing adjuvant thermo-chemotherapy vs. standard chemotherapy with mitomycin C, recurrence-free survival analysis at 24 months revealed a significant difference in f…

low dose oral chemotherapy for hormone refractory prostate carcnoma.Estramustine phosphate versus estramustine phosphate and etoposide. A randomised phase II study of GSTU Found.

Role of antimicrobial tratment in patients with elevated PSA and normal digital rectal examination.

Relation between Sexual Dysfunctions and Epilepsy, Type of Epilepsy, Type of Antiepileptic Drugs: A Prospective Study

Introduction The aim of this study was to evaluate the incidence of sexual dysfunctions in males with epilepsy, the type of epilepsy, the frequency of seizures, the type of antiepileptic drugs (AEDs), the serum hormonal profile and the presence of psychiatric comorbidity. Methods Sixty-one patients focused on type of epilepsy, frequency of seizures, AEDs, hormonal profile and presence of mood disorders. We excluded all patients with severe neurologic and psychiatric impairment and patient who were not able to fill questionnaires. Mean age was 31.2 years (range 18-50 years); 31 patients (50.8%) had an idiopathic generalised epilepsy and 30 (49.2%) a focal epilepsy; among them, latter 18 (60%…

Sexual dysfunction in dialytic patients. A prospective cross-sectional observational study in two hemodialysis centers

Objectives: Incidence and prevalence of patients in dialytic therapy increased considerably in recent years. The onset of new issues, once overshadowed, linked to a lower quality of life like sexual dysfunction became increasingly common. The first study in this area, dating back to the 1970s, shows the high prevalence of sexual dysfunction among patients in dialytic therapy of both sexes. Later studies proved an association of sexual dysfunction with psyche disorders, anxiety, depression and lack of self-confidence. The aim of this study is to describe the incidence of male and female sexual main dysfunctions, the latter not least in literature, in patients in hemodialytic therapy. With th…

Prevalence, Incidence Estimation, Risk Factors and Characterization of Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Urological Hospital Outpatients in Italy: Results of a Multicenter Case-Control Observational Study

Abstract: Purpose: We evaluated the prevalence and estimated the incidence and risk factors of chronic prostatitis/chronic pelvic pain syndrome in urological hospital outpatients in Italy. Materials and Methods: From January to June 2006 patients from 28 Italian urological centers who were between 25 and 50 years old with symptoms of chronic prostatitis/chronic pelvic pain syndrome were consecutively enrolled in this prospective epidemiological case-control study. A total of 152 subjects of similar age, race and area of origin who were investigated for infertile couples but were otherwise healthy served as controls. All subjects provided a medical history and underwent different symptom sco…

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…

La DE nel paziente urooncologico

FEMALE GENITAL MUTILATIONS: GENITO-URINARY COMPLICATIONS AND ETHICAL-LEGAL ASPECTS

Many women in the world are still undergoing female genital mutilations (FGMs) even if in almost all the countries, the practice of FGM is illegal. The increase of immigration, particularly from African Countries, to Europe, and Italy too, led to consider this phenomenon with particular attention and skill. All the operators in health services need to know the different types of FGMs and the related complications and the psychological and sexual sequels. Urological complications, in particular, are not rare and the changing anatomy of the external genital apparatus can also make the catheter insertion sometimes difficult. This review analyzes the epidemiology of FGMs, the reasons why the p…

Premature Ejaculation: Comparison of treatment. Pharmacotherapy vs Pharmacotherapy in association with group psychotherapy vs group psychotherapy

Introduction & Objectives: The aim of our study was to compare and analyse the effectiveness of pharmacological treatment and the psychotherapy alone or in association in terms of increase of Quality of Life (QoL) measured through Premature Ejaculation Diagnostic Tool (PEDT) and increase of intravaginal eiaculation latency time (IELT) in patients affected by primitive premature ejaculation(PE). Material & Methods: Between January and December 2012, in our department underwent to medical examination 540 patients complaining PE. Criteria for enrollment were primitive PE with IELT ≤ 2 minutes, PEDT > 9 and absence of psychiatric disease, severe chronic disease, drugs and alcool abuse. Out of 5…

Casi clinici “insoliti”

Risultati di uno studio pilota di fase I-II con gemcitabina endovescicale nel tumore vescicale superficiale (TA-T1)

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

Varicocele ed Infertilità

Segmental resection of distal ureter with termino-terminal ureteric anastomosis vs bladder cuff removal and ureteric re-implantation for upper tract urothelial carcinoma: results of a multicentre study

OBJECTIVES: To compare overall (OS), cancer-specific (CSS), recurrence free survival (RFS) and post-operative renal function among patients affected by upper tract urothelial carcinoma (UTUC) of the distal (lower lumbar and pelvic) ureter, electively treated with segmental resection and termino-terminal anastomosis (TT) vs bladder cuff removal and ureteral re-implantation (RR). PATIENTS AND METHODS: A multicentre retrospective study, including 84 patients diagnosed with UTUC of the distal ureter and treated with TT or RR, is presented. The primary endpoint was to compare TT and RR in terms of OS, CSS and RFS. As a secondary outcome we compared the post-operative creatinine values as an inde…

ACCESSO PENO-SCROTALE NELLA CHIRURGIA DEI TRAUMI PENIENI

INTRODUZIONE La traumatologia peniena rappresenta una rara entità che si configura all'interno delle urgenze in urologia. La presentazione clinica è tipica e richiede una terapia chirurgica precoce al fine di evitare alterazioni estetiche e funzionali (1). MATERIALI E METODI Si riporta la nostra esperienza nel trattamento chirurgico dei traumi penieni con tecnica di accesso chirurgico mediano peno-scrotale in sostituzione della classica incisione circonferenziale subcoronale con conseguente degloving penieno. RISULTATI Tutti i pazienti trattati venivano alla nostra osservazione con ematoma penieno, in alcuni casi diffuso anche in sede scrotale e perineale. In un caso non era presente rottur…

TUR and Adjuvant Intravesical Chemotherapy in T1G3 Bladder Tumors: Recurrence, Progression and Survival in 137 Selected Patients Followed Up to 20 Years

Abstract OBJECTIVES: To evaluate a highly selected population of patients affected by T1G3 bladder transitional cell carcinoma (TCCB) treated by transurethral resection (TUR) and adjuvant intravesical chemotherapy. MATERIALS AND METHODS: Between January 1976 and April 1999, 137 patients with T1G3 TCCB were treated by TUR plus intravesical chemotherapy. Particularly, a sequential combination of mitomycin C (MMC) and epirubicin (EPI) was adopted in 91 patients (66.4%). The main exclusion criteria were concomitant or previous Tis, previous T1G3 TCCB, tumor size greater than 3 centimeters and number of tumors more than 3. TUR was repeated if a superficial tumor recurred. Patients went off study…

[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…

Treatment with abiraterone in metastatic castration-resistant prostate cancer patients progressing after docetaxel: a retrospective study.

The aim of this study was to evaluate abiraterone's efficacy in Italian patients affected with metastatic prostate cancer progressing after treatment with docetaxel. We conducted a retrospective analysis of 60 patients. Prostate-specific antigen (PSA) reduction in serum was the primary endpoint for evaluating the efficacy of abiraterone in combination with prednisone treatment, whereas reduced pain, safety, progression-free survival, response rate, and overall survival (OS) were secondary endpoints. A significant correlation was noticed between PSA response and OS. Further, the Index Bravais-Pearson (r) correlation allowed us to observe a significant negative interdependence between PSA res…

NEW TRENDS IN PROSTATE CANCER

Relazione tra disfunzione erettile, livelli di testosterone e funzione endoteliale in pazienti a rischio cardiovascolare intermedio secondo le stime della Carta di Framingham” – P259

Scopo del lavoro Il ruolo dei livelli di testosterone plasmatico e della disfunzione erettile come marcatori precoci di disfunzione endoteliale non è ben definito. Pertanto, abbiamo cercato di analizzare la relazione tra testosterone plasmatico e disfunzione erettile, in rapporto alla funzione endoteliale. Materiali e metodi Abbiamo quindi arruolato 802 pazienti in prevenzione primaria, con una stima di rischio cardiovascolare (CV) intermedio secondo la carta del rischio di Framingham, di età compresa fra 40 e 80 anni, che si sono sottoposti all’esame ecografico della dilatazione flusso mediata dell’arteria brachiale destra, alla valutazione della disfunzione erettile attraverso il question…

Peyronie’s disease: Cytokines genes expression in tunica albuginea

Ruolo prognostico della p53 nel tumore vescicale superficiale. Correlazione con recidiva e progressione –

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TERAPIE CONSERVATIVA DELL'UROTELIOMA VESCICALE T1G3. RISULTATI SU 235 PAZIENTI

Correlation between Chronic Prostatitis Syndrome and Pelvic Venous Disease

Objectives: In this study we evaluated the association between chronic prostatitis syndrome (CPS), varicocele and hemorrhoids as manifestations of a pelvic venous disease.<b&g

GRAVE EMORRAGIA RICORRENTE DEL CONDOTTO ILEALE DA IPERTENSIONE PORTALE . PRIMA ESPERIENZA MONDIALE CON SCLEROTIZZAZIONE ECOGUIDATA

The fate of patients with locally advanced bladder cancer treated conservatively with neoadjuvant chemotherapy, extensive transurethral resection and radiotherapy: 10-year experience

Purpose: We assess the results of bladder preservation for infiltrating bladder cancer. The potential for neoadjuvant chemotherapy followed by extensive transurethral resection and radiotherapy was evaluated in 40 patients with T2-T4a G2-G3 bladder carcinoma. Materials and Methods: From 1983 to 1995, 40 patients with bladder cancer underwent bladder sparing treatment, consisting of neoadjuvant chemotherapy, extensive transurethral resection and radiotherapy. Most patients had T3G3 cancer. A deep transurethral resection biopsy was performed before and after chemotherapy, and an extensive transurethral resection was repeated at the end of radiotherapy. Of the patients 30 received cisplatin an…

Expression patterns and prognostic role of transketolase-like 1 in muscle-invasive bladder cancer

PURPOSE: The pentose phosphate pathway (PPP) has been shown to play an important role in the metabolism of cancer cells. The transketolase-like 1 gene (TKTL1) encodes an enzyme representing an essential component of this pathway. Its expression has been demonstrated to correlate with stage and outcome in various tumors. The aim of the present study was to assess expression patterns and the prognostic role of TKTL1 in muscle-invasive bladder cancer (MIBC). PATIENTS AND METHODS: The expression of TKTL1 was assessed in a tissue microarray consisting of histopathologically benign and malign tissue of 112 patients who underwent radical cystectomy due to MIBC. Cytoplasmatic and nuclear expression…

Interactive computerized morphometric analysis for the differential diagnosis between dysplasia and well differentiated adenocarcinoma of the prostate

To distinguish prostatic dysplasia (or adenosis) from well differentiated adenocarcinoma on transrectal needle biopsy, a morphometric study was conducted on 20 cases of adenosis and 20 cases of well differentiated adenocarcinoma of the prostate. About 100 cells for each patient were analyzed by means of a computerized image analyzer, and mean nuclear diameter, mean nuclear area, mean form factor and number of cells in eight classes of nuclear diameter were studied. The best predictors of malignancy (evaluated by means of Receiver Operating Characteristics curves) were mean nuclear area greater than 28 mu2, presence of more than 5% of cells with nuclear diameter greater than 6.15 mu, and mea…

Disfunzioni sessuali, farmaci antiepilettici e profilo ormonale sierico negli uomini affetti da epilessia. Sexual disfunctions, antiepileptic drugs, blood hormonal profile in epileptic men

Sexual dysfunctions (SD) are a relatively common problem in men with epilepsy; the prevalence ranges from 38-71%. Etiology may be multifactorial and may involve both the epilepsy and the use of antiepileptic drugs. The purpose of this study was to evaluate the incidence of SD in epileptic men, assessing the type of epilepsy, seizures frequency, antiepileptic drugs used, the serum hormonal profile and the presence of psychiatric disorders.

Infezioni delle vie urinarie (IVU) “in pillole”

Neoadjuvant chemotherapy, TUR and radiotherapy in T2-T4 NO MO bladder carcinoma

– Forty patients affected by locally advanced carcinoma of the bladder were submitted to up-front chemotherapy followed by TUR and radiotherapy. A complete response was obtained in 27 patients (67.5%). A residual mass was present in 13 (32.5%) patients. At a mean follow-up of 38 months (range: 18–112 months), 7 patients showed a recurrence that was superficial in 3 cases and infiltrating the muscular layer in 4. Fifteen patients (37.5%), 12 of whom disease-free, are alive with a mean survival of 65 months. Five more patients died of non-related disease.

ASSOCIAZIONE DI SERENOA REPENS, URTICA DIOICA E PINUS PINASTER. SICUREZZA ED EFFICACIA NEL TRATTAMENTO DEI SINTOMI DEL BASSO TRATTO URINARIO. STUDIO PROSPETTICO SU 320 PAZIENTI

INTRODUCTION. Serenoa repens (saw palmetto) has been employed for the treatment of lower urinary tract symptoms (LUTS) for several years. Its mechanism of action is believed to be due to antiandrogenic, antiproliferative and antinflammatory properties. An association of Serenoa with the nettle “Utica dioica” showing antiproliferative activity and the pine “Pinus pinaster” derivative, showing antinflammatory action, has been proposed in recent years. Such an action is hoped to act not only by reducing LUTS but also by preventing the development of prostate cancer. MATHERIAL AND METHODS. During the years 2007 and 2008, 320 patients suffering from LUTS were treated with an association of Seren…

INTRAVESICAL GEMCITABINE IN SUPERFICIAL BLADDER TUMOURS.RESULTS OF A PHASE I-II STUDY

Results of a Phase I-II Pilot Study with Intravescical Gemcitabine in Superficial Bladder Cancer (Ta-T1)

To study the ablative activity of intravescical gemcitabine against superficial transitional cell carcinoma of the bladder at different doses and concentrations. Methods Twenty-seven patients were treated with intravescical gemcitabine after transurethral resection, during which one to three papillary marker lesions were left unresected. Starting 14 days after transurethral resection, six gemcitabine instillations were given at weekly intervals. Gemcitabine, diluted in 50 mL of saline solution and maintained for 2 hr, was given at a dose of 500, 1000 and 2000 mg in groups of nine patients each. A complete response (CR) was defined as negative cutologycystoscopy and biopsy findings. Results…

Evaluation of an alternative dosing regimenwith tadalafil, three times per week, for men with erectile dysfunction: SURE study in Italy.

AIM: To examine the preference for two dosing regimens of 20 mg of tadalafil, on demand or three times per week, in men affected with erectile dysfunction (ED) in Italy. METHODS: Scheduled Use versus on demand Regimen Evaluation (SURE) is a multicenter, crossover and open-label study, involving 94 urology centers in Italy. Patients aged 18 years or older affected with ED for at least 3 months were enrolled and randomized to 20 mg of tadalafil treatment on demand or three times per week for 5-6 weeks. After a 1-week washout, patients were crossed over to the alternate regimen for 5-6 weeks. A treatment preference question was used to determine the preferred treatment regimen. International I…

SICUREZZA E TOLLERABILITA' DEL TRATTAMENTO LOCALE CON ILOPROST IN PAZIENTI AFFETTI DA MALATTIA DI LA PEYRONIE. STUDIO PILOTA DI FASE 1 E PROPOSTA DI NUOVO QUESTIONARIO PER LA VALUTAZIONE SINTOMATOLOGICA

Purpose. Intralesional therapy is a less invasive method for the treatment of Peyronie's disease. The objective of this study was to evaluate safety and tolerability of intralesional injections of Iloprost (I2 Prostacyclin analogue) for its property to suppress in fibroblasts CTFG (Connective tissue growth factor) production, which acts in concert with TGF-ß to stimulate the fibrotic process.?Methods. Nineteen patients with Peyronie's disease were preliminarily evaluated by considering the degree of penile curvature, plaque size and local and systemic symptoms. Each patient then received weekly intralesional injections of 200ng of Iloprost in 1 ml of normal saline for 4-5 weeks. If tolerate…

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…

Effetto antalgico “immediato” nella malattia di La Peyronie: TECAR Terapia. Studio di fase uno

Introduzione. Con lo scopo di valutare la TECAR terapia quale nuovo possibile trattamento medico della malattia di La Peyronie (PD), abbiamo condotto uno studio di fase uno senza placebo né gruppo di controllo. La TECAR terapia si basa sull’utilizzo di radiofrequenze in grado di trasferire energia ai tessuti trattati causando movimenti ionici. Ciò provoca una stimolazione cellulare in senso replicativo e riparativo. La TECAR terapia ha ottenuto risultati eccellenti nel trattamento di alcune patologie del tesuto connettivo, così abbiamo deciso di condurre uno studio circa l’applicabilità e la sicurezza della TECAR nel trattamento della PD. MATERIALI E METODI. Da giugno a settembre 2012 sono …

Testosterone levels are directly related with erectile function and endothelial function in men with intermediate risk according to the Framingham score

Background. The value of testosterone levels and erectile dysfunction (ED) as early markers of atherosclerosis is not well understood. Objectives. To analyze the relationship between plasma testosterone levels in men with both endothelial function (F) and ED. Methods. We enrolled 802 asymptomatic, intermediate cardiovascular risk patients, according to the Framingham Risk Score, aged 40 to 80 years, who underwent the study of EF, evaluation of ED and dosage of plasma testosterone. Results. At linear regression, EF (t=9.40; 95% CI from 0.9318 to 1.4234; p<0.0001) and erectile function (t=8.96; 95% CI from 0.7642 to 1.1932; p<0.0001) statistically increased with increasing levels of testoster…

Long-term outcome of antiandrogen monotherapy in advanced prostate carcinoma. Twelve-year’s results of a phase II study.

OBJECTIVE: To present the long-term outcome of patients with locally advanced or metastatic prostate carcinoma treated by first-line antiandrogen monotherapy. PATIENTS AND METHODS: From 1983 to 1990, 41 patients with advanced prostate carcinoma were treated with flutamide monotherapy until progression or the appearance of toxicity. Twenty-five patients (61%) had T3-T4N0M0 and 16 (39%) T2-4N0-3M1 prostate carcinoma. Consensus criteria were adopted to evaluate the response. Plasma testosterone and sexual function were recorded for the first 3 years. RESULTS: Flutamide was administered for up to 147 months; seven patients (17%) interrupted the treatment because of toxicity. There was an object…

Storia della Scuola Urologica Palermitana

L’agobiopsia prostatica

Studio clinico randomizzato, cross over, in aperto con Tadalafil per valutare uno schema ottimale di trattamento in pazienti con DE: nostra esperienza

Retropubic, laparoscopic and mini-laparoscopic radical prostatectomy: a prospective assessment of patient scar satisfaction

Published online: 26 October 2014

Is Kelami's Method Still Useful in the Smartphone Era? The Virtual 3-Dimensional Reconstruction of Penile Curvature in Patients With Peyronie's Disease: A Pilot Study

Abstract Background Peyronie's disease is an idiopathic fibrotic disease affecting the penile tunica albuginea. Among other resulting deformities, the more common penile curvature should be assessed preferentially with in-office goniometric estimation after pharmacologically induced erection, although clearly invasive and uncomfortable. Aim In the present pilot study, we investigated the usefulness for the patient and the surgeon of a 3-dimensional (3D) reconstruction of the penile curvature obtained through photogrammetry software in clinical evaluation and surgical planning. Methods Enrolled patients received alprostadil 10 μg by intracavernous injection. Then, the medical personnel took …

CONSENSUS CONFERENCE INFEZIONI DELLE BASSE VIE URINARIE

Study of Cellular DIMA Content by Flow Cytometry in Primary Bladder Carcinomas

A prospective study of cellular DNA content by flow cytometry was performed on a nonconsecutive series of 67 patients undergoing diagnostic and/or therapeutic transurethral resection for primary urothelial bladder carcinoma. DNA-aneuploidy was present in 82% of the cases (55/67), while multiclonality was found in 45% of the DNA-aneuploid cases (25/55). DNA-ploidy was much more strictly correlated with histological grading (p less than 0.005) than with papillary or non-papillary growth pattern (p less than 0.05) or T staging (p less than 0.05). Of 26 patients with a minimum follow-up of 24 months, 100% (6/6) of cases with DNA-diploid neoplasias showed no signs of disease relapse, versus 10% …

Preliminary Results of ERAS Protocol in a Single Surgeon Prospective Case Series

Background and Objectives: The aim was to compare the intra and postoperative outcomes between the Enhanced Recovery After Surgery (ERAS) protocol versus the standard of care protocol (SCP) in patients who underwent radical cystectomy performed by a single surgeon. Materials and Methods: A retrospective comparative study was conducted including patients who underwent radical cystectomy from 2017 to 2020. Length of stay (LOS), incidence of ileus, early postoperative complications, and number of re-hospitalizations within 30 days were considered as primary comparative outcomes of the study. Results: Data were collected for 91 patients who underwent cystectomy, and 70 and 21 patients followed …

LA VARICOCELECTOMIA SUBINGUINALE SECONDO MARMAR: IMMAGINI INEDITE

Is there a role for recombinant tumor necrosis factor alpha in the intravesical treatment of superficial bladder tumors?--a phase II study

Clinical use of recombinant tumor necrosis factor-alpha is strongly limited by its severe toxicity, mainly cardiovascular, when systemically administered. Recent studies suggest that topical (intrapleural, intraperitoneal, intratumoral) administration is free of significant toxicity. Human recombinant tumor necrosis factor-alpha was administered intravesically, at a dose of 500 mg dissolved in 30 ml of phosphate buffer (pH7.6-7.8) plus 0.25% human albumin, weekly for two months to 18 patients with papillary transitional cell carcinoma of the bladder. Of the 15 evaluable patients, four (26%) achieved a complete response. Systemic and local tolerability were excellent. Int J Urol 1995;2:100-1…

Can We Clinically Distinguish Anejaculation From Retrograde Ejaculation in Patients on α1A-Blockers Therapy for Lower Urinary Tract Symptoms?

To investigate the physiopathology of ejaculatory disorders (EjD) and discriminate between retrograde ejaculation (REj) and anejaculation (AEj) induced by α1A-blockers, through the association between the mean postorgasm seminal vesicle volume and the presence of sperm in midstream urine, in patients with moderate-to-severe lower urinary tract symptoms (LUTS) secondary to benign prostatic enlargement.Therapy-naïve male patients with LUTS and without previous EjD were treated with α1A-blockers. Pre- and post-treatment EjD were investigated through question 4 of the 4-item Male Sexual Function questionnaire and the Male Sexual Health Questionnaire for Ejaculatory Dysfunction Short Form (MSHQ-…

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…

Masse scrotali e scroto acuto

Intravesical bleomycin in bladder tumour prophylaxis.

The authors have evaluated the efficacy, tolerability and systemic absorption of bleomycin administered by intravesical route in the prophylaxis of recurrences of superficial vesical tumours after endoscopic resection (TUR). Thirty mg of bleomycin dissolved in 30 ml of saline solution were instilled in the bladder once a week for the first month and then once a month for 12 months. The instilled fluid was held in the bladder for 1 hour. The systemic absorption of the drug was evaluated by a microbiological assay of bleomycin in plasma and in the perfusion liquid recovered from the bladder. Fifteen patients were treated; most had a long history of multiple recurrent tumours despite previous …

Correlation between chronic prostatitis syndrome and pelvic venous disease: a survey of 2,554 urologic outpatients.

Objectives: In this study we evaluated the association between chronic prostatitis syndrome (CPS), varicocele and hemorrhoids as manifestations of a pelvic venous disease. Methods: Our retrospective study was based upon 2554 patients treated in two general urology clinics over the past 10 years. We have assessed the incidence of CPS among urological patients. Results: We found 483 patients with CPS, representing 18.9% of the total number of visits at the outpatient clinic. In this group the percentage of varicocele and hemorrhoids was 14.69 and 8.48%, whereas in a control group these figures were 5.02 and 5.84%, respectively (p &lt; 0.001 and 0.1054). Such a difference is statistically sign…

Note orientative per l’assistente di reparto

LA CHIRURGIA NELLA MALATTIA DI LA PEYRONIE NEL RECURVATUM CONGENITO: IMMAGINI INEDITE

Ematuria

VALUTAZIONE CLINICA DELLA PROTEINA 22 DELLA MATRICE NUCLEARE COME MARCATORE TUMORALE NEL FOLLOW-UP DEI TUMORI A CELLULE TRANSIZIONALI DELLA VESCICA

OBJECTIVES. Biomarkers (BTA, NMP22, FDP etc.) have been and continue to be evaluated as adjuncts or substitutes for cystoscopy, which is invasive and uncomfortable for some patients. Nuclear matrix protein-22 (NMP22) is involved in the regulation of nuclear processes. The main objective of the present study is to evaluate the clinical utility of urinary NMP22 as a tumor marker in the follow-up of transitional cell carcinoma (TCC) of the bladder. MATERIALS AND METHODS. The study included 62 patients undergoing follow-up, who had had TCC of bladder but who were disease-free at the beginning of the study, as confirmed by cystoscopy. Urine samples were collected for urinary cytology and NMP22 t…

Complications in radical cystectomy and their prevention

We wish to dedicate this review article on radical cystectomy, its complications and their prevention to the memory of Prof. Luciano Giuliani. The article is based on a work written originally by Jim Montie and many other authors for the consensus meeting on bladder cancer held in Antwerp in 1994 and recently published in a booklet entitled “Global strategy for bladder cancer” (1). With the consent of Montie and the other co-authors, we have prepared on updated Italian version, inserting some parts (such as vascular complications) which were treated more superficially in the preliminary text.

Esame delle urine

APPUNTI DI ANDROLOGIA CHIRURGICA E UROLOGIA

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Results of conservative treatment (transurethral resection plus adjuvant intravesical chemotherapy) in patients with primary T1, G3 transitional cell carcinoma of the bladder

Objectives. To evaluate a selected population of 50 consecutive patients with primary T1, G3 bladder transitional cell carcinoma in the absence of carcinoma in situ (Tis) treated with a bladder-sparing approach. Methods. Between January 1983 and December 1992, all patients were treated by transurethral resection (TUR) plus adjuvant intravesical chemotherapy over 1 year. In most cases, doxorubicin, epirubicin, and mitomycin were used alone or in combination. Results. At a mean follow-up period of 52 months (range, 18 to 126), 16 of 50 patients (32%) showed a recurrent superficial tumor. The recurrent lesion was of Stage T1 in 11 (22%) cases, but was a T1, G3 tumor only in 5 cases (10%). In 2…

TERAPIA CONSERVATIVA DELL'UROTELIOMA VESCICALE T1G3. RISULTATI SU 235 PAZIENTI

Le disfunzioni sessuali maschili II

Does Smoking Cessation at Primary Diagnosis Reduce the Recurrence Risk of Nonmuscle-Invasive Bladder Cancer? Results of a Prospective Study.

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; Evidence that smoking cessation at first diagnosis of nonmuscle-invasive bladder cancer (NMIBC) reduces the risk of recurrence is lacking. The aim of our prospective study was to analyze the association between patients’ changes in smoking habits after diagnosis and recurrence-free survival (RFS). &lt;b&gt;&lt;i&gt;Patients:&lt;/i&gt;&lt;/b&gt; After transurethral resection of primary NMIBC, patients were classified as “ex-smokers,” i.e., those definitively stopping, and as “active smokers,” i.e., those continuing or restarting to smoke. Smoking status was reassessed every 3 months during the first year and every 6 months thereafter. Data …

The potential role of COVID-19 hygienic measures in reducing infective complications during hospitalization

Posizionamento di protesi peniena malleabile. Risoluzione di complicanza intraoperatoria.

ABSTRACT. We report a technique for the solution of an intraoperative complication occurred during penile prosthetic surgery. MATERIALS AND METHODS. A 70-year-old patient underwent open radical retropubic prostatectomy in 2004 due to a prostate cancer - Gleason 6 (3+3) pT2N0M0. The erectile dysfunction subsequently observed was not responsive to oral or intracavernosal drug administration, so a malleable penile implant surgery was recommended. RESULTS. During the positioning of the left penile cylinder, a septum perforation (cross-over) occurred. Instead of interrupting and postpone surgery in order to allow the septum to recover, we decided to proceed utilizing our technique for a safe pos…

Effetti sulla disfunzione erettile dell'associazione di dialliltiosulfinato, nuciferina e diosgenina in pazienti pretrattati con inibitori della 5 fosfodiesterasi once a day. Studio randomizzato versus placebo singolo cieco.

Prologo. Andrologia “in pillole”

Espianto di protesi peniena Flexiflater® AMS e contemporaneo impianto di protesi tricomponente idraulica Titan ® Alpha 1, con tecnica a doppia incisione in paziente con trapianto di rene e pancreas

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 s…

Risultati di uno studio randomizzato singolo cieco placebo versus Diallil-Tiosulfinato, Nuciferina e Diosgenina in pazienti responders a Tadalafil 5 mg; Results of a single blind study placebo vs Diallil-Tiosulphinate, Nucipherine and Diosgenin in patients reponders to Tadalafil 5 mg

The aim of the study is to evaluate the efficacy of Diallil-Tiosulphinate, Nuciepherine and Diosgenin in the treatment of erectile dysfunction. In our study were selected 120 men affected by erectile dysfunction. They were filled in a self-administered questionnaire International Index of Sexual Medicine. 74 of them reported a moderate erectile dysfunction and 46 reported a severe ED. All patients were treated with Tadalafil 5 mg once a day for 90 days. They were re-evaluated with the same questionnaire after three months of therapy. In 75% of the patients there was an improvement of IIEF-5 score. Only the 90 patients responders to Tadalafil once a day were randomized and divided into two g…

IMMAGINI DI CHIRURGIA ANDROLOGICA

IMMAGINI DI CHIRURGIA ANDROLOGICA