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 …

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

Socio-Demographic Characteristics and Sexual Behavioral Factors of Patients with Sexually Transmitted Infections Attending a Hospital in Southern Italy

Sexually transmitted infections (STIs) are a serious global health problem. In Italy, data describing the vulnerability to STIs of specific sexual minorities and the influence of sociodemographic and behavioral determinants are limited, as most infections are not subject to mandatory notification. This retrospective study describes the sociodemographic profile and main sexual behaviors of patients attending a hospital in Palermo (Sicily, Italy) from January 2018 to March 2019 as predictors of STI risk. Patients were divided in subgroups: men-who-have-sex-with-men (MSM), men-who-have-sex-with-women (MSW), bisexual men and females. Data were obtained through an anonymous questionnaire. Patien…

Ruolo dell'ecografia con mezzo di contrasto ecografico nella stadiazione dei tumori vescicali.

Dall'erba spaccapietre alla medicina ayurvedica. Attualità sulle cosiddette medicine non convenzionali in urologia.

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…

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

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

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…

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

-

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…

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 <90 ml/min/1.73m2. The primary outcome was to compare the postoperative eGFR variation and the OS according to the surgical tec…

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…

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 …

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.

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

-

L'anestesia pericapsulare in corso di biopsia prostatica transrettale sotto guida ecografica

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…

Emergenze-urgenze urologiche e dell'apparato genitale maschile

EMATURIA - Il termine “ematuria” indica la presenza di globuli rossi (GR) nelle urine. Può essere visibile a occhio nudo (macroematuria o ematuria macroscopica) o solo al microscopio (microematuria)5 LA COLICA RENALE - La colica reno-ureterale, nella sua manifestazione tipica, è un dolore acuto che dalla regione lombare s’irradia, anteriormente, al fianco e alla regione inguinale omolaterale (fino al testicolo nell’uomo, alle grandi labbra nelle donne). Talvolta si associa a nausea e vomito, ematuria e sintomi disurici (similcistitici). Ha una durata variabile da alcuni minuti ad alcune ore. L’alvo può essere temporaneamente chiuso ai gas. Eventuali brividi e febbre indicano un’infezione se…

[S1 Herpes zoster localization: acute urinary retention in woman].

Acute urinary retention in women is rare. The varicella-zoster virus causes inflammatory lesions of the sensory-root ganglions, meninges and, less frequently, spinal cord. Herpes zoster has been reported to affect, although rarely, lower urinary tract innervations, and acute urinary retention can be thought to occur in the presence of sacral dermatome involvement. Usually it is located in S2–4 dermatome and the prognosis for acute urinary retention is benign resolving in about 20 days. We present a case in which the S1 dermatome was interested and acute urinary retention developed. After 10 days of specific therapy and self catheterism the problem resolved.

Treatment of Severe Post-Prostatectomy Stress Urinary Incontinence Using Advance Sling

Severe stress urinary incontinence (SUI) is usually treated by the implant of artificial sphincter positioned around bulbar urethra. AdVance sling is a functional, non-obstructive, anti-incontinence device that showed good results especially for mild and moderate SUI. We present our experience with AdVance sling in 7 patients with severe SUI unfit for artificial sphincter. Our results, after a follow-up of more than 6 months, showed a continence rate of 28% and an improvement rate of 43%, while 2 patients did not show any benefit. The success of AdVance sling depends on the integrity of urethral sphincter and can be applied also in selected cases for the treatment of severe post-prostatect…

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: …

LOWER RESPONSE TO INTRAVESICAL ADJUVANT THERAPY IN HIGH-RISK BLADDER CANCER COULD BE RELATED TO THE UROTHELIAL EXPRESSION OF EGFR

Quality-of-Life Outcomes in Female Patients With Ileal Conduit or Orthotopic Neobladder Urinary Diversion: 6-Month Results of a Multicenter Prospective Study

Radical cystectomy (RC) often affects patients’ life as this surgery is a traumatic and invasive event for the patients, with drawbacks on their daily, social, working, and sex life. Such changes in the quality of life (QoL) of patients are commonly studied through retrospective clinical evaluations and rarely with longitudinal studies. To date, studies focusing on functional outcomes, sexual function, and health-related QoL for female patients are lacking. We evaluated 37 patients using EORTC QLQ-C30 (QLQ-30) and Short-Form 36 (SF-36) questionnaires, before and after surgery, at 3 and 6 months of follow-up. The mean values for the emotional functioning in QLQ-C30 as well as the mental heal…

Role of hygienic measures against COVID-19 on infective complications after urological interventions.

Segreto Professionale e diritto alla privacy

OBIETTIVI DEL CAPITOLO • Definire i concetti di “segreto professionale” e “diritto alla privacy” • Esaminare le norme del Codice deontologico e le norme giuridiche di riferimento • Acquisire la consapevolezza del valore etico della riservatezza nella condotta sanitaria • Fornire una Scheda sinottica di consultazione rapida

IS IT POSSIBLE TO PREDICT CHEMORESISTANCE OF SUPERFICIAL BLADDER CARCINOMA?

Localizzazione S1 di Herpes Zooster: un raro caso di ritenzione urinaria.

Donna di 46 anni con ritenzione urinaria acuta e stipsi. Presentava piccola vescicola sul dorso del piede sinistro quale unica manifestazione di localizzazione di virus Herpes Zooster a livello sacrale S1. Viene riportato l'esame urodinamico e le risultanze dei test sierologici seriati specifici per l'infezione da virus Varicella Zooster. La paziente è guarita a seguito di terapia specifica con Acyclovir. Il caso riportato dimostra che anche il segmento sacrale S1 contribuisce al controllo della dinamica minzionale

Characterization of human infiltrating and circulating gamma-delta T cells in prostate cancer

Purpose The aim of our study was to prospectively evaluate the distribution of gamma-delta (γδ)1 and γδ2 T cells and their phenotypes in peripheral blood and prostate samples of patients diagnosed with or without prostate cancer (PCa) at prostate biopsy. Materials and methods A consecutive series of 43 outpatients underwent trans-rectal echo-guided prostate biopsy for suspected PCa. Flow cytometry analysis was used to identify and characterize the γδ T cells populations in peripheral blood and tissue samples. Patients were stratified according to the presence or not of PCa, and its International Society of Urological Pathology (ISUP) grade (1 vs. ≥2). Results The distribution of γδ T cells …

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 …

Potential impact of a nonavalent anti HPV vaccine in Italian men with and without clinical manifestations

AbstractHuman papilloma virus infection (HPV) is the most common sexually transmitted disease. Little is known about male infection. Nonavalent vaccine against types 6/11/16/18/31/33/45/52/58 was approved and neutral gender immunization programs have been proposed. This study evaluates the potential impact of nonavalent vaccine compared to quadrivalent in male living in Sicily (Italy). 58.7% of samples were HPV positive and forty-four types of HPV were identified. A significant higher estimated coverage of nonavalent vaccine than quadrivalent was observed (64.3% vs. 45.8%), with absolute and relative additional impact of 20.1% and 47.2%, respectively. Low impact of the vaccine were calculat…

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 < 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…

PATHOPHYSIOLOGY AND CLINICAL ASPECTS OF URINARY LITHIASIS

Urine is a complex balanced solution containing dissociated and non-dissociated solutes. Any variation in urine saturation grade (number of crystals dissolved in a volume of urine), urinary pH and the concentration of crystallization inhibitors can break the normal existing balance and lead to urolithiasis. In the present article we analyze the principal mechanisms (absorptive, renal, resorptive) of hypercalciuria. It will be also shown how heredity directly influences the clinical aspects of cystine, xanthine and oxalate lithiasis and how diet, in association with metabolic disorders, interferes in uric acid and oxalate stone formation. Finally, we report on the roles of urinary tract malf…

Vinflunine in Metastatic Urothelial Carcinoma of the Bladder in Progression after a Platinum-Containing Regimen

<b><i>Background:</i></b> Vinflunine is a microtubule inhibitor of the vinca alkaloid class approved for the treatment of urothelial bladder carcinoma after a platinum-containing regimen. <b><i>Methods:</i></b> To evaluate the effectiveness of vinflunine, we enrolled 80 subjects with a histologically confirmed diagnosis of metastatic urothelial bladder carcinoma that had previously undergone chemotherapy with a platinum-containing regimen and had measurable lesions according to the Response Evaluation Criteria in Solid Tumors (RECIST). The patients (<i>n</i> = 80) received vinflunine (Javlor®) every 3 weeks at 320 mg/m<sup>2&…

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

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

Traumi del rene, della vescica, delle vie urinarie

Classificazione dei traumi del rene e delle vie urinarie e algoritmi diagnostico-terapeutici

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

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…

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%…

Circumcision and Sexually Transmitted Disease Prevention: Evidence and Reticence

Circumcision is one of the oldest surgical procedures and the most common surgical procedure performed on males. It is practiced for three main reasons: ritual or religious meanings, prophylactic hygienic purposes, and therapeutic indications. Male circumcision is advocated as an efficacious prevention strategy against sexually transmitted diseases. One of the main biological mechanisms responsible for the lower human immunodeficiency virus (HIV) infection rate in heterosexual circumcised men is the protective effect of keratinization of the glans. Moreover, male circumcision removes the inner part of the prepuce containing Langerhans cells that are targeted by HIV. Several observational st…

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…

Trattamento dell'incontinenza urinaria post-prostatectomia di grado severo mediante l'uso di sling tipo "AdVance"

ESWL Prediction of outcome and failure Prevention

Based on our own experiences and a review of the recent literature, this article evaluates recent developments in predicting outcomes and failures of shockwave lithotripsy when treating patients with urinary tract stones. After a detailed MEDLINE research, the authors identified several variables that influence and predict extracorporeal shockwave lithotripsy (ESWL) success. These variables may be categorized as stone variables, patient variables and operator variables. Only multivariate analysis on a large number of homogenous patients may offer an objective evaluation of the factors conditioning ESWL outcome.

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…

Diagnostic tools for female urethral diverticulum: Current perspectives

Although once considered quite a rare condition in the past, female urethral diverticulum (UD) would now appear to have a higher frequency, perhaps due to greater attention from physicians. To date, there is no agreement on which is the best method for diagnosis of female UD. Traditionally, the approach was based on quite invasive techniques, such as voiding cystourethrography, and double-balloon urethrography, with satisfactory results but relevant limitations. More recent high-resolution imaging techniques, such as 2D-3D ultrasonography (US) and magnetic resonance imaging (MRI) have also been applied in the study of the abnormalities of the female urethra. US had the advantage of the outp…

Urodynamics and Overactive Bladder (OAB). What's the incidence of detrusorial overactivity (DO) and What's the role of isometric detrusorial pressure? A prospective stdy.

Images - Computed tomography urographic appearance of traumatic rupture of renal cyst into the pyelocaliceal system.

Spontaneous or traumatic rupture of renal cysts, documented by radiological imaging, occurs infrequently. The pathogenesis of a cyst rupture is still unclear, except when it has occurred following trauma or when the cyst has become infected. Imaging plays a crucial role in the diagnosis, management, surveillance, and choice of lesions that need treatment.

Clinical and biochemical markers of visceral adipose tissue activity: Body mass index, visceral adiposity index, leptin, adiponectin, and matrix metalloproteinase-3. Correlation with Gleason patterns 4 and 5 at prostate biopsy

Context: The correlation between aggressive prostate cancer and obesity mainly based on body mass index (BMI) and pathology after surgery remains controversial. Aims: The aim of the study was to correlate BMI, visceral adiposity index (VAI), and the plasmatic levels of leptin, adiponectin, and matrix metalloproteinase-3 (MMP-3), and biomarkers of adipose tissue function, with the detection of Gleason patterns 4 and 5 at biopsy. Subjects and Methods: Consecutive patients with prostate cancer at 12-core transrectal biopsy were enrolled. BMI, waist circumference (WC), blood samples to evaluate the plasmatic levels of triglycerides (TG) and high-density lipoproteins (HDL), adiponectin, leptin, …

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

-

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

Calcolosi urinaria

VENGONO AFFRONTATI GLI ASPETTI EPIDEMIOLOGICI E LA FISIOPATOLOGIA CHE SOTTENDE LA CALCOLOSI URINARIA. LA CLINICA DELLA LITIASI URINARIA, LE SUE COMPLICANZE E LE DIVERSE STRATEGIE TERAPEUTICHE RICCA L''ICONOGRAFIA E LA PRESENZA DI TABELLE RIASSUNTIVE.

Carcinoma Uroteliale in Cisti Pielogena

Urothelial carcinoma in a pyelocaliceal cyst Renal complex cysts are lesions whose nature can be either benign or malignant. Depending on the presence of septa, solid components, enhancement or calcifications, they are distinguished according to the Bosniak classi- fication based on CT findings, as well as MRI and ETG. We report a rare case of urothelial carcinoma, originating over a pyelocalyceal cyst in a 50-year-old man, and classified as Bosniak IIF by CT and MRI investigations.

Violence against women in heterosexual couples: A review of psychological and medico-legal considerations.

Intimate partner violence against women (IPVAW) is the most pervasive violation of women’s rights worldwide, causing devastating lifelong damage. Victims can suffer physical, emotional or mental health problems, and experience detrimental effects in social, psychological and relational health with their families, especially children. Due to the complexity regarding violence against women in heterosexual couples, it is important to make a clear distinction between psychological and physical mistreatment, which also includes psychological violence. This differentiation is important in determining different emotional and psychological aspects of mistreatment in order to understand the reasons …

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 …

Predictive variables of spontaneous micturition recovery after acute urinary retention in men with benign prostatic enlargement: An observational prospective study

Objective: Acute urinary retention (AUR) is the sudden and painful inability to urinate spontaneously. AUR is one of the most significant complications of benign prostatic enlargement. The management of AUR is based on transurethral catheterization. Subsequent therapy is uncertain, but AUR seems to benefit from the use of alpha-blockers. The aim of this study was to evaluate the variables that could predict which patients would recover spontaneous micturition after trial without catheter. Methods: The present prospective observational study included men with AUR in an Italian tertiary care institute in 2016. Patients were catheterized and treated orally with fluoroquinolones, alpha-blockers…

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 …

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-…

Patterns urodinamici in pazienti con prostatodinia

The Authors report their experience on 24 patients with prostatodynia. The Adynamic alterations, which occur in most cases, show the usefulness of cystomanometry and pressure-flow study for providing a better nosological picture and therapeutic management.

PRELIMINARY DATA ON PSA CHANGES DURING INTRAVESICAL THERAPY FOR NON-MUSCLE INVASIVE BLADDER CANCER

Introduction/Aim: Many factors can cause an increase of PSA independently from the presence of prostate cancer . The objective was to evaluate the fluctuation of the serum levels of PSA during adjuvant intravesical chemotherapy or immunotherapy. An increase of PSA due to intravesical BCG and up to 3 months later has been reported (1). Patients and Methods: Patients treated with intravesical chemotherapy or immunotherapy for non- muscle invasive bladder cancer (NMIBC) were entered in the study. Serum samples were collected before starting intravesical therapy, during therapy (within 3rd and 6th instillation) and 30 days after the end of the 6-week induction regimen and during maintenance reg…

Aspetti Medico-Legali in uro-riabilitazione. Aspetti urologici

Urodinamica

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

<b><i>Introduction:</i></b> 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). <b><i>Patients:</i></b> 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

Can we ameliorate the compliance to intravesical bcg maintenance? Analysis of the causes of treatment interruption in 160 consecutive patients.