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Campobasso D, Zizzo M, Biolchini F, Castro-Ruiz C, Frattini A, Giunta A. Laparoscopic management of colovesical fistula in different clinical scenarios. J Minim Access Surg 2024; 20:175-179. [PMID: 37148104 PMCID: PMC11095798 DOI: 10.4103/jmas.jmas_245_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/18/2022] [Accepted: 03/03/2023] [Indexed: 05/07/2023] Open
Abstract
INTRODUCTION Colovesical fistula (CVF) is a condition with various aetiologies and presentations. Surgical treatment is necessary in most cases. Due to its complexity, open approach is preferred. However, laparoscopic approach is reported in the management of CVF due to diverticular disease. The aim of this study was to analyse the management and outcome of patients with CVF of different aetiologies treated with laparoscopic approach. PATIENTS AND METHODS This was a retrospective study. We retrospectively reviewed all patients undergoing elective laparoscopic management of CVF from March 2015 to December 2019. STATISTICAL ANALYSIS USED None. RESULTS Nine patients underwent laparoscopic management of CVF. There were no intraoperative complications or conversions to open surgery. A sigmoidectomy was performed in eight cases. In one patient, a fistulectomy with sigmoid and bladder defect closure was performed. In two cases of locally advanced colorectal cancer with bladder invasion, a multi-stage procedure with temporary colostomy was chosen. In three cases, with no intraoperative leakage, we did not perform bladder suture. Four Clavien I-II complications were recorded. Two fragile patients died in the post-operative period. No patients required re-operation. At a median follow-up of 21 months (interquartile range: 6-47), none of the patients had recurrence of fistula. CONCLUSIONS CVF can be managed with laparoscopic approach by skilled laparoscopic surgeons in different clinical scenarios. Bladder suture is not necessary if leakage is absent. Informed counselling to the patient must be guaranteed concerning the risk of major complications and mortality in case of CVF due to malignant disease.
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Affiliation(s)
- Davide Campobasso
- Department of Surgical, Urology Unit, Civil Hospital of Guastalla, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, ASMN-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
- Department of Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Federico Biolchini
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, ASMN-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Carolina Castro-Ruiz
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, ASMN-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
- Department of Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonio Frattini
- Department of Surgical, Urology Unit, Civil Hospital of Guastalla, Reggio Emilia, Italy
| | - Alessandro Giunta
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, ASMN-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
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Campobasso D, Barbieri A, Bocchialini T, Pozzoli GL, Dinale F, Facchini F, Grande MS, Kwe JE, Larosa M, Guarino G, Mezzogori D, Simonetti E, Ziglioli F, Frattini A, Maestroni UV. Safety profile of treatment with greenlight versus Thulium Laser for benign prostatic hyperplasia. Arch Ital Urol Androl 2023; 95:11101. [PMID: 36924373 DOI: 10.4081/aiua.2023.11101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 12/31/2022] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE The major strengths of surgical treatment of benign prostatic hyperplasia with laser are reduced morbidity compared to endoscopic resection. No studies analysed the different risk of intra/peri-operative events between patients undergoing Thulium and GreenLight procedures. MATERIALS AND METHODS We retrospectively reviewed 100 consecutive cases undergoing GreenLight vaporization and Thulium procedures performed during the learning curve of two expert endoscopic surgeons. Pre-operative data, intra and post-operative events at 90 days were analysed. RESULTS Patients on antiplatelet/anticoagulant therapy were pre-dominant in the Green group (p < 0.0001). Rates of blood transfusion (p < 0.0038), use of resectoscope (p < 0.0086), and transient stress urinary incontinence were statistically higher in the Thulium group. On the contrary conversions to TURP (p < 0.023) were more frequent in GreenLight patients. Readmissions were more frequently necessary in GreenLight group (24%) vs. Thulium group (26.6%). The overall complication rate in GreenLight and Thulium groups were 31% and 53% respectively; Clavien 3b complications were 13% in Thulium patients versus 1% in GreenLight patients. CONCLUSIONS GreenLight and Thulium treatments show similar safety profiles. Randomized controlled trial are needed to better clarify the rate of major complications in Thulium group, and the incidence of post-operative storage symptoms in these patients' populations.
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Affiliation(s)
- Davide Campobasso
- Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla; Department of Urology, University Hospital of Parma.
| | | | | | - Gian Luigi Pozzoli
- Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla.
| | | | - Francesco Facchini
- Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla.
| | - Marco Serafino Grande
- Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla.
| | - Jean Emmanuel Kwe
- Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla; Urological Residency School Network, Department of Urology, University Hospital of Modena and Reggio Emilia, Modena.
| | - Michelangelo Larosa
- Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla.
| | - Giulio Guarino
- Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla; Urological Residency School Network, Department of Urology, University Hospital of Modena and Reggio Emilia, Modena.
| | - Davide Mezzogori
- Department of Engineering and Architecture, University of Parma.
| | - Elisa Simonetti
- Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla.
| | | | - Antonio Frattini
- Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla.
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Calcagnile T, Sighinolfi MC, Rocco B, Assumma S, Di Bari S, Panio E, Pescuma A, Ticonosco M, Tosi G, Oltolina P, Resca S, Kaleci S, Galli R, Curti P, Schips L, Ditonno P, Villa L, Ferretti S, Bergamaschi F, Bozzini G, Eissa A, Zoeir A, Sherbiny AE, Frattini A, Prati A, Fedelini P, Okhunov Z, Tubaro A, Landman J, Bianchi G, Puliatti S, Micali S. Asymptomatic bacteriuria in candidates for active treatment of renal stones: results from an international multicentric study on more than 2600 patients. Urolithiasis 2022; 51:16. [PMID: 36512096 DOI: 10.1007/s00240-022-01385-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/17/2022] [Indexed: 12/15/2022]
Abstract
The occurrence of asymptomatic bacteriuria concomitant to urolithiasis is an issue for patients undergoing renal stone treatment. Disposing of a preoperative urine culture is essential to reduce the risk of septic events. The endpoint of the study is to report which characteristics of candidates for renal stone treatment are frequently associated with positive urine culture. 2605 patients were retrospectively enrolled from 14 centers; inclusion criteria were age > 18 and presence of a single renal stone 1-2 cm in size. The variables collected included age, gender, previous renal surgery, comorbidities, skin-to-stone distance, stone size, location, density, presence of hydronephrosis. After a descriptive analysis, the association between continuous and categorical variables and the presence of positive urine culture was assessed using a logistic regression model. Overall, 240/2605 patients (9%) had preoperative bacteriuria. Positive urine culture was more frequent in females, patients with previous renal interventions, chronic kidney disease, congenital anomalies, larger stones, increased density. Multivariate analysis demonstrated that previous renal interventions (OR 2.6; 95% CI 1.9-3.4; p < 0.001), renal-related comorbidities (OR 1.31; 95% CI 1.19-1.4; p < 0.001), higher stone size (OR 1.06; 95% CI 1.02-1.1; p = 0.01) and density (OR 1.00; 95% CI 1.0-1.00; p = 0.02) were associated with bacteriuria; male gender and lower caliceal location were inversely related to it. Beyond expected risk factors, such as female gender, other parameters are seemingly favoring the presence of positive urine culture. The awareness of variables associated with bacteriuria allows to assess which individuals are at increased risk of presenting bacteriuria and reduce the rate of septic complications.
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Affiliation(s)
- T Calcagnile
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.
- Department of Urology, ASST Santi Paolo e Carlo-University of Milan, Milan, Italy.
| | - M C Sighinolfi
- Department of Urology, ASST Santi Paolo e Carlo-University of Milan, Milan, Italy
| | - B Rocco
- Department of Urology, ASST Santi Paolo e Carlo-University of Milan, Milan, Italy
| | - S Assumma
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Urology, ASST Santi Paolo e Carlo-University of Milan, Milan, Italy
| | - S Di Bari
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - E Panio
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Urology, ASST Santi Paolo e Carlo-University of Milan, Milan, Italy
| | - A Pescuma
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - M Ticonosco
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - G Tosi
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - P Oltolina
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Resca
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Kaleci
- Clinical and Experimental Medicine (CEM), Department of Surgical, Medical, Dental and Morphological Sciences With Interest in Transplant, Oncology and Regenerative Medicine, University of Modena & Reggio Emilia, Modena, Italy
| | - R Galli
- Department of Urology, Policlinico San Pietro, Ponte San Pietro, Italy
| | - P Curti
- Ospedale "Mater Salutis"-AULSS 9 Scaligera, Verona, Italy
| | - L Schips
- Department of Urology, Ospedale SS. Annunziata, Chieti, Italy
| | - P Ditonno
- Department of Urology, University of Bari, Bari, Italy
| | - L Villa
- Department of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - S Ferretti
- Department of Urology, Ospedale Maggiore, Parma, Italy
| | - F Bergamaschi
- Department of Urology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - G Bozzini
- Department of Urology, Ospedale Sant'Anna, Como, Italy
| | - A Eissa
- Department of Urology, Tanta University, Tanta, Egypt
| | - A Zoeir
- Department of Urology, Tanta University, Tanta, Egypt
| | - A El Sherbiny
- Department of Urology, Tanta University, Tanta, Egypt
| | - A Frattini
- Department of Urology, Ospedale Civile di Guastalla, Guastalla, Italy
| | - A Prati
- Department of Urology, Ospedale di Vaio, Fidenza, Italy
| | - P Fedelini
- Department of Urology, AORN Antonio Cardarelli, Naples, Italy
| | - Z Okhunov
- Department of Urology, University of California, Irvine, CA, USA
| | - A Tubaro
- Department of Urology, Ospedale Sant'Andrea, la Sapienza" University, Rome, Italy
| | - J Landman
- Department of Urology, University of California, Irvine, CA, USA
| | - G Bianchi
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Puliatti
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Micali
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
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Inzillo R, Kwe JE, Simonetti E, Milandri R, Grande M, Campobasso D, Ferretti S, Rocco B, Micali S, Frattini A. Percutaneous and endoscopic combined treatment of bladder and renal lithiasis in mitrofanoff conduit. Int Braz J Urol 2022; 48:598-599. [PMID: 35263058 PMCID: PMC9060168 DOI: 10.1590/s1677-5538.ibju.2021.0815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/24/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction and Objectives: Treatment of bulky lithiasis in continent and non-continent urine storage reservoirs has been widely described and debated (1). Less is known about the optimal treatment in patients with a Mitrofanoff conduit. If voiding in these patients is incomplete, leading to recurrent symptomatic bacteriuria, formation of large lithiasis can be a common long-term complication (2, 3). Materials and Methods: This video describes a 19-year-old woman who underwent major open surgery at the age of six, with the configuration of a continent intestinal reservoir with a Mitrofanoff conduit. In 2020, she was referred to our center with a large stone in the reservoir and a minor stone in the inferior left renal calyx. We decided to proceed using a percutaneous approach with an “endovision technique” puncture for the bladder stone, combined with a retrograde intrarenal surgery for the renal stone. The MIP System “M size” was used to perform the percutaneous procedure, thus allowing a single-step dilation. The puncture and the dilation were followed endoscopically with a flexible ureterorenoscope avoiding the use of x-rays. The procedure was carried out as follows. The first step consisted in the insertion of a hydrophilic guidewire through the Mitrofanoff conduit. A flexible ureterorenoscope was then inserted coaxial to the guidewire. The percutaneous puncture, using an 80G needle, was followed endoscopically. Two guidewires were inserted, the first as a safety guidewire and the second for the tract dilation. The “single-step” dilation technique using the MIP system was performed and followed endoscopically. For the bladder lithotripsy, a dual-action lithotripter that combines ultrasonic and mechanical energy was used. Finally, a flexible ureterorenoscope and a basket for the retrieval of a single inferior caliceal stone were used. The procedure ended after positioning a single J stent in the left kidney and a nephrostomy tube in the reservoir. Results: The operative time was 80 minutes and the fluoroscopy time was 6 seconds. Hemoglobin and creatinine serum levels remained stable after the procedure and the patient was discharged on the third post-operative day, after removing both the single J and the nephrostomy tube. Follow-up lasted 12 months, with no bladder or renal stone recurrence, maintaining good continence of the Mitrofanoff conduit. Conclusion: In patients who have undergone several major surgeries a mini-invasive approach is advisable, not only for the morbidity of an open approach, but also for the increased risk of complications while handling an intestinal reservoir. Regarding a pure endoscopic approach, the passage of a nephroscope or a cystoscope through the Mitrofanoff conduit, combined with the continuous traction during the lithotripsy, could damage and compromise its continence. For this reason, the percutaneous approach is the most suitable method in these specific and rare cases.
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Affiliation(s)
- Raffaele Inzillo
- Department of Urology, Guastalla Hospital, Emilia-Romagna, Italy
| | | | - Elisa Simonetti
- Department of Urology, University of Modena and Reggio Emilia, Emilia-Romagna, Italy
| | | | - Marco Grande
- Department of Urology, Guastalla Hospital, Emilia-Romagna, Italy
| | | | | | - Bernardo Rocco
- Department of Urology, University of Modena and Reggio Emilia, Emilia-Romagna, Italy
| | - Salvatore Micali
- Department of Urology, University of Modena and Reggio Emilia, Emilia-Romagna, Italy
| | - Antonio Frattini
- Department of Urology, Guastalla Hospital, Emilia-Romagna, Italy
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5
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Calcagnile T, Sighinolfi M, Rocco B, Oltolina P, Di Bari S, Kaleci S, Galli R, Curti P, Schips L, Ditonno P, Villa L, Ferretti S, Bergamaschi F, Bozzini G, Zoeir A, El Sherbiny A, Frattini A, Fedelini P, Okhunov Z, Tubaro A, Landman J, Puliatti S, Bianchi G, Micali S. Asymptomatic bacteriuria in candidates for active treatment of renal stones: Results from an international multicentric study on more than 2600 patients. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00347-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Micali S, Calcagnile T, Sighinolfi M, Iseppi A, Morini E, Benedetti M, Oltolina P, Ragusa A, Kaleci S, Bevilacqua L, Puliatti S, De Nunzio C, Arada R, Chiancone F, Campobasso D, Eissa A, Bonfante G, Simonetti E, Cotugno M, Galli R, Curti P, Schips L, Ditonno P, Villa L, Ferretti S, Bergamaschi F, Bozzini G, Zoeir A, El Sherbiny A, Frattini A, Fedelini P, Okhunov Z, Tubaro A, Landman J, Bianchi G, Rocco B. Urinary tract infections in candidates to active treatment of renal stone: results from an international multicentric study on more than 2600 patients. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00867-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Campobasso D, Acampora A, De Nunzio C, Greco F, Marchioni M, Destefanis P, Altieri V, Bergamaschi F, Fasolis G, Varvello F, Voce S, Palmieri F, Divan C, Malossini G, Oriti R, Ruggera L, Tuccio A, Tubaro A, Delicato G, Laganà A, Dadone C, Pucci L, Carrino M, Montefiore F, Germani S, Miano R, Rabito S, De Rienzo G, Frattini A, Ferrari G, Cindolo L. Post-Operative Acute Urinary Retention After Greenlight Laser. Analysis of Risk Factors from A Multicentric Database. Urol J 2021; 18:693-698. [PMID: 34346047 DOI: 10.22037/uj.v18i.6489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE Greenlight laser is a mini-invasive technique used to treat Benign Prostatic Obstruction (BPO). Some of the advantages of GreenLight photoselective vaporization (PVP) are shorter catheterization time and hospital stay compared to TURP. Post-operative acute urinary retention (pAUR) leads to patients' discomfort, prolonged hospital stay and increased health care costs. We analyzed risk factors for urinary retention after GreenLight laser PVP. MATERIALS AND METHODS In a multicenter experience, we retrospectively analyzed the onset of early and late post-operative acute urinary retention in patients undergoing standard or anatomical PVP. The pre-, intra- and post-operative characteristics were compared betweene patients who started to void and the patients who developed post-operative urinary retention. RESULTS The study included 434 patients suitable for the study. Post-operative acute urinary retention occurred in 39 (9%). Patients with a lower prostate volume (P < .001), an adenoma volume lower than 40 mL (P < .001), and lower lasing time (P = .013) had a higher probability to develop pAUR at the univariate analysis. The multivariate logistic regression confirmed that lower lasing time (95% CI: 0.86-0.99, OR = 0.93, P = .046) and adenoma volume (95% CI: 0.89-0.98, OR = 0.94, P = .006) are correlated to pAUR. Furthermore IPSS ≥ 19 (95% CI: 1.19- 10.75, OR = 2.27, P = .023) and treatment with 5-ARI (95% CI: 1.05-15.03, OR = 3.98, P = .042) are risk factors for pAUR. CONCLUSION In our series, post-operative acute urinary retention was related to low adenoma volume and lasing time, pre-operative IPSS ≥ 19 and 5-ARI intake. These data should be considered in deciding the best timing for urethral catheters removal.
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Affiliation(s)
- Davide Campobasso
- Dept. of Urology, Ospedale Civile di Guastalla ed Ospedale Ercole Franchini di Montecchio Emilia, Azienda USL-IRCCS di Reggio Emilia, Italy .
| | - Anna Acampora
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Cosimo De Nunzio
- Dept of Urology, "Sant'Andrea" Hospital, Sapienza University, Roma, Italy .
| | | | - Michele Marchioni
- Dept. of Medical, Oral and Biotechnological Sciences,"G. D'Annunzio" University of Chieti, Chieti, Italy.
| | - Paolo Destefanis
- Dept. of Urology, Azienda Ospedaliera Città della Salute e della Scienza di Torino - Sede Molinette, Torino, Italy.
| | | | - Franco Bergamaschi
- Dept. of Urology, "Arcispedale Santa Maria Nuova", Reggio Emilia, Italy.
| | | | | | - Salvatore Voce
- Dept. of Urology, "Santa Maria delle Croci Hospital", Ravenna, Italy .
| | - Fabiano Palmieri
- Dept. of Urology, "Santa Maria delle Croci Hospital", Ravenna, Italy .
| | - Claudio Divan
- Dept. of Urology, "Rovereto Hospital", Rovereto, Italy.
| | | | - Rino Oriti
- Dept. of Urology, "Ulivella e Glicini Clinic", Florence, Italy.
| | - Lorenzo Ruggera
- Dept. of Urology, Clinica urologica azienda ospedaliera - University of Padova, Padova, Italy.
| | - Agostino Tuccio
- Department of Urology, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy. .
| | - Andrea Tubaro
- Dept of urology, "Sant'Andrea" Hospital, Sapienza University, Roma, Italy .
| | | | - Antonino Laganà
- Dept. of Urology, "S.Giovanni Evangelista" Hospital, Tivoli, Italy .
| | - Claudio Dadone
- Dept. of Urology, "Santa Croce e Carle" Hospital, Cuneo, Italy.
| | - Luigi Pucci
- Dept. of Urology, AORN "Antonio Cardarelli", Naples, Italy.
| | | | | | - Stefano Germani
- UOSD Urologia, Fondazione Policlinico Tor Vergata, Rome, Italy.
| | - Roberto Miano
- UOSD Urologia, Fondazione Policlinico Tor Vergata, Rome, Italy.
| | | | - Gaetano De Rienzo
- Dept. of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Bari, Italy .
| | - Antonio Frattini
- Dept. of Urology, Ospedale Civile di Guastalla ed Ospedale Ercole Franchini di Montecchio Emilia, Azienda USL-IRCCS di Reggio Emilia, Italy .
| | | | - Luca Cindolo
- Dept. of Urology, "Villa Stuart" Private Hospital, Rome, Italy .
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Campobasso D, Menozzi R, Marcato C, Frattini A. Subcostal artery bleeding after endoscopic combined intrarenal surgery: Signs and treatment. Asian J Urol 2021; 9:101-102. [PMID: 35198405 PMCID: PMC8841246 DOI: 10.1016/j.ajur.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 11/26/2022] Open
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9
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Grande MS, Campobasso D, Inzillo R, Moretti M, Facchini F, Kwe JE, Frattini A. The use of endoscopic combined intrarenal surgery as an additional approach to upper urinary tract urothelial carcinoma: Our Experience. Indian J Urol 2021; 37:187-188. [PMID: 34103806 PMCID: PMC8173945 DOI: 10.4103/iju.iju_71_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/28/2020] [Accepted: 12/27/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction With increasing experience and advancing technology, endoscopy for UTUC has become more common. Endoscopic Combined Intrarenal Surgery (ECIRS) could be an option for patients with low-grade and large-volume UTUC that could be either anatomically or technically challenging to manage by retrograde flexible ureterorenoscopy. Materials and Methods In this video, we describe, step by step, our ECIRS technique as applied to two selected clinical cases of UTUC. Conclusion ECIRS could represent a useful approach to UTUC in selected cases. The advantage of the "endovision" puncture and dilation technique is in the avoidance of entering the renal calyx at the level of the tumor. In addition, the combined approach, compared to the purely percutaneous approach, allows access to, and treatment of, neoplasms located in all renal calyces.
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Affiliation(s)
- Marco Serafino Grande
- Department of Urology, Civil Hospital of Guastalla, IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Davide Campobasso
- Department of Urology, Civil Hospital of Guastalla, IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Raffaele Inzillo
- Department of Urology, Civil Hospital of Guastalla, IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Matteo Moretti
- Department of Urology, Civil Hospital of Guastalla, IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Facchini
- Department of Urology, Civil Hospital of Guastalla, IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Jean Emmanuel Kwe
- Department of Urology, Civil Hospital of Guastalla, IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Antonio Frattini
- Department of Urology, Civil Hospital of Guastalla, IRCCS Reggio Emilia, Reggio Emilia, Italy
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Ferretti S, Cuschera M, Campobasso D, Gatti C, Milandri R, Bocchialini T, Simonetti E, Granelli P, Frattini A, Maestroni UV. Rigid and flexible ureteroscopy (URS/RIRS) management of paediatric urolithiasis in a not endemic country. ACTA ACUST UNITED AC 2021; 93:26-30. [PMID: 33754605 DOI: 10.4081/aiua.2021.1.26] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/27/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION In the last years due to miniaturization of endoscopic instruments and percutaneous surgery, endourology has become very popular in paediatric urinary stone managment. We reported our single-centre experience in retrograde endoscopic procedures in children. Results and complications of URS/RIRS are discussed. MATERIALS AND METHODS We retrospectively reviewed our experience in patients ≤ 16 years old affected by urinary stones who underwent URS/RIRS procedures performed by two surgeons with expertise in endourology. A total of 30 renal Units (RUs) underwent endoscopic procedures (URS, RIRS or both). Surgical complications according to the ClavienDindo's classification and stone-free rate were evaluated at 3 months follow-up. Success of URS was defined as stone-free status after single procedure while RIRS success rate was considered as presence of residual stone fragments smaller than 4 mm at first procedure. RESULTS The mean age of our patients was 8 years, range 2- 16 years. A total of 30 renal units (RUs) underwent 40 endourological procedures (23 URS and 17 RIRS; 10 children underwent both procedures at the same time). 17/30 (56.6%) RUs were pre-stented before surgery. The stone-free status was achieved in 23/30 renal units treated, with a 76.6% success rate. The remaining 7 patients had residual stones greater than 4 mm and underwent further treatments. After a second surgery the stone-free rate turned out to be 93.3% (28/30 renal units). CONCLUSIONS Rigid and flexible ureteroscopy (URS/RIRS) is a reliable technique for treatment of < 2 cm urinary stones in paediatric age group. It shows low rate of major complications and promising results in terms of stone-free rate.
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Affiliation(s)
| | | | - Davide Campobasso
- Urology Unit, Hospital of Guastalla, Azienda USL-IRCCS of Reggio Emilia.
| | - Claudia Gatti
- Paediatric Surgery Unit, University-Hospital of Parma.
| | | | | | | | | | - Antonio Frattini
- Urology Unit, Hospital of Guastalla, Azienda USL-IRCCS of Reggio Emilia.
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11
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Micali S, Sighinolfi MC, Iseppi A, Morini E, Calcagnile T, Benedetti M, Ticonosco M, Kaleci S, Bevilacqua L, Puliatti S, De Nunzio C, Arada R, Chiancone F, Campobasso D, Eissa A, Bonfante G, Simonetti E, Cotugno M, Galli R, Curti P, Schips L, Ditonno P, Villa L, Ferretti S, Bergamaschi F, Bozzini G, Zoeir A, Sherbiny AE, Frattini A, Fedelini P, Okhunov Z, Tubaro A, Landman J, Bianchi G, Rocco B. Initial Experience and Evaluation of a Nomogram for Outcome Prediction in Management of Medium-sized (1-2 cm) Kidney Stones. Eur Urol Focus 2021; 8:276-282. [PMID: 33419709 DOI: 10.1016/j.euf.2020.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/18/2020] [Accepted: 12/18/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The gold standard treatment for solitary medium-sized (1-2 cm) renal stones is not defined by recent guidelines, since management modalities including shockwave lithotripsy (SWL), retrograde intrarenal surgery (RIRS), and percutaneous nephrolithotomy (PNL) are recommended. Improved ability to predict patient outcomes would aid in patients' counseling and decision-making. OBJECTIVE To develop a nomogram predicting treatment failure, based on preoperative clinical variables, to be used in the preplanning setting. DESIGN, SETTING, AND PARTICIPANTS We recruited 2605 patients from 14 centers and carried out a multicenter retrospective analysis of 699 SWL, 1290 RIRS, and 616 PN L procedures performed as first-line treatment for 1-2-cm kidney stones. The variables evaluated included age, gender, previous renal surgery, body mass index, stone size, location, stone density, skin-to-stone distance, presence of urinary tract infections (UTIs), and hydronephrosis. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Multivariate logistic regression was fitted to predict treatment failure, defined as the presence of residual fragments >4 mm. A nomogram was developed based on the coefficients of the logit function. RESULTS AND LIMITATIONS A total of 2431 (93.3%) patients were stone free; 174 (6.7%) treatment failures were recorded and considered the event to be predicted. On univariate analysis, type of procedure, preoperative hydronephrosis, stone density, stone location, and laterality turned out to be statistically significant. Skin-to-stone distance, UTIs, and previous renal surgery were predictors of failure on multivariate analysis. Each variable was given a score based on statistical relevance. The main limitation of the current study is its retrospective nature. CONCLUSIONS This nomogram provides a prediction of treatment failure and need of reintervention for medium-sized kidney stones. External validation is needed to determine its reproducibility and validity. PATIENT SUMMARY We developed a preoperative model of treatment outcomes for 1-2-cm kidney stones. Its application may assist urologists to counsel patients with regard to stone management modality.
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Affiliation(s)
- Salvatore Micali
- Department of Urology, Azienda Ospedaliero-Universitaria, Urological Residency School Network, University of Modena & Reggio Emilia, Modena, Italy
| | - Maria Chiara Sighinolfi
- Department of Urology, Azienda Ospedaliero-Universitaria, Urological Residency School Network, University of Modena & Reggio Emilia, Modena, Italy.
| | - Andrea Iseppi
- Department of Urology, Azienda Ospedaliero-Universitaria, Urological Residency School Network, University of Modena & Reggio Emilia, Modena, Italy
| | - Elena Morini
- Department of Urology, Azienda Ospedaliero-Universitaria, Urological Residency School Network, University of Modena & Reggio Emilia, Modena, Italy
| | - Tommaso Calcagnile
- Department of Urology, Azienda Ospedaliero-Universitaria, Urological Residency School Network, University of Modena & Reggio Emilia, Modena, Italy
| | - Mattia Benedetti
- Department of Urology, Azienda Ospedaliero-Universitaria, Urological Residency School Network, University of Modena & Reggio Emilia, Modena, Italy
| | - Marco Ticonosco
- Department of Urology, Azienda Ospedaliero-Universitaria, Urological Residency School Network, University of Modena & Reggio Emilia, Modena, Italy
| | - Shaniko Kaleci
- Clinical and experimental medicine (CEM), Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena & Reggio Emilia, Modena, Italy
| | - Luigi Bevilacqua
- Department of Urology, Azienda Ospedaliero-Universitaria, Urological Residency School Network, University of Modena & Reggio Emilia, Modena, Italy
| | - Stefano Puliatti
- Department of Urology, Azienda Ospedaliero-Universitaria, Urological Residency School Network, University of Modena & Reggio Emilia, Modena, Italy
| | - Cosimo De Nunzio
- Department of Urology, Ospedale Sant'Andrea, "La Sapienza" University, Rome, Italy
| | - Raphael Arada
- Department of Urology, University of California, Irvine, Orange, CA, USA
| | | | - Davide Campobasso
- Department of Urology, Ospedale Civile di Guastalla, Urological Residency School Network, University of Modena & Reggio Emilia, Guastalla, Italy
| | - Ahmed Eissa
- Department of Urology, Tanta University, Tanta, Egypt
| | - Giulia Bonfante
- Department of Urology, Azienda Ospedaliero-Universitaria, Urological Residency School Network, University of Modena & Reggio Emilia, Modena, Italy
| | - Elisa Simonetti
- Department of Urology, Ospedale Maggiore, Urological Residency School Network, University of Modena & Reggio Emilia, Parma, Italy
| | - Michele Cotugno
- Department of Urology, Ospedale di Vaio, Urological Residency School Network, University of Modena & Reggio Emilia, Fidenza, Italy
| | - Riccardo Galli
- Department of Urology, Policlinico San Pietro, Ponte San Pietro, Italy
| | - Pierpaolo Curti
- Department of Urology, Ospedale Mater Salutis, Legnago, Italy
| | - Luigi Schips
- Department of Urology, Ospedale SS. Annunziata, Chieti, Italy
| | | | - Luca Villa
- Department of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Stefania Ferretti
- Department of Urology, Ospedale Maggiore, Urological Residency School Network, University of Modena & Reggio Emilia, Parma, Italy
| | - Franco Bergamaschi
- Department of Urology, Arcispedale S. Maria Nuova, Urological Residency School Network, University of Modena & Reggio Emilia, Reggio Emilia, Italy
| | - Giorgio Bozzini
- Department of Urology, ASST Valle Olona, Urological Residency School Network, University of Modena & Reggio Emilia, Busto Arsizio, Varese, Italy
| | - Ahmed Zoeir
- Department of Urology, Tanta University, Tanta, Egypt
| | | | - Antonio Frattini
- Department of Urology, Ospedale Civile di Guastalla, Urological Residency School Network, University of Modena & Reggio Emilia, Guastalla, Italy
| | - Paolo Fedelini
- Department of Urology, AORN Antonio Cardarelli, Naples, Italy
| | - Zhamshid Okhunov
- Department of Urology, University of California, Irvine, Orange, CA, USA
| | - Andrea Tubaro
- Department of Urology, Ospedale Sant'Andrea, "La Sapienza" University, Rome, Italy
| | - Jaime Landman
- Department of Urology, University of California, Irvine, Orange, CA, USA
| | - Giampaolo Bianchi
- Department of Urology, Azienda Ospedaliero-Universitaria, Urological Residency School Network, University of Modena & Reggio Emilia, Modena, Italy
| | - Bernardo Rocco
- Department of Urology, Azienda Ospedaliero-Universitaria, Urological Residency School Network, University of Modena & Reggio Emilia, Modena, Italy
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Castellucci R, Marchioni M, Fasolis G, Varvello F, Ditonno P, Di Rienzo G, Greco F, Altieri VM, Frattini A, Ferrari G, Schips L, Cindolo L. The safety and feasibility of the simultaneous use of 180-W GreenLight laser for prostate vaporization during concomitant surgery. ACTA ACUST UNITED AC 2020; 92. [PMID: 33348957 DOI: 10.4081/aiua.2020.4.297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/21/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To explore the safety and feasibility of photo-selective vaporization of the prostate (PVP) with GreenLight XPS 180 Watt laser (GL-180- W XPS) combined with other surgical procedures. MATERIAL AND METHODS Data on patients in whom GL-180-W XPS was performed to relieve lower urinary tract symptoms/ benign prostatic hyperplasia (LUTS/BPH) symptoms were extracted from a multi-institutional database (2011-2016). Patients were stratified into two groups. In the first all patients who had GL-180-W XPS with a concomitant procedure during the same surgical session were included as cases while those who underwent GL-180-W XPS PVP only were included as control. RESULTS A total of 487 patients were included. Fifty-eight (11.9%) patients underwent concomitant procedures. Multivariable linear regression models failed to find an association between concomitant procedures and longer laser time (p = 0.4). Similarly, multivariable linear regression models failed to find an association between concomitant procedures and laser time even when the analyses were repeated and stratified into endoscopic (p = 0.6) and open/laparoscopic (p = 0.4) procedures. Multivariable logistic regression models failed to demonstrate any association between concomitant procedures and early complications (OR:1.39, CI: 0.379-2.44, p = 0.2), late complications (OR:1.84, CI:0.78-3.98; p = 0.1) and acute urinary retention (OR:1.84, CI:0.78-3.98; p = 0.1). When the analyses were repeated and the concomitant procedures stratified into endoscopic and open/laparoscopic ones, they yielded virtually the same results. CONCLUSIONS GL-180-W XPS PVP could be safely performed in concomitant endoscopic or open/laparoscopic surgery. These results should be taken into consideration in the counseling of the patient who might choose to undergo simultaneous procedures.
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Affiliation(s)
| | - Michele Marchioni
- Department of Urology, SS Annunziata Hospital, "G. D'Annunzio" University, Chieti.
| | | | | | - Pasquale Ditonno
- Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari.
| | - Gaetano Di Rienzo
- Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari.
| | | | | | - Antonio Frattini
- Department of Urology, "Ercole Franchini" Hospital, Montecchio Emilia.
| | | | - Luigi Schips
- Department of Urology, SS Annunziata Hospital, "G. D'Annunzio" University, Chieti.
| | - Luca Cindolo
- Department of Urology, Private Hospital Villa Stuart, Rome.
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Campobasso D, Ferrari G, Frattini A. Greenlight laser: a laser for every prostate and every urologist. World J Urol 2020; 40:295-296. [PMID: 33104906 DOI: 10.1007/s00345-020-03499-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 10/23/2022] Open
Affiliation(s)
- Davide Campobasso
- Department of Urology, Ospedale Civile Di Guastalla and Ospedale Ercole Franchini Di Montecchio Emilia, Azienda USL-IRCCS Di Reggio Emilia, Via Donatori di Sangue 1, 42016, Guastalla, RE, Italy.
| | | | - Antonio Frattini
- Department of Urology, Ospedale Civile Di Guastalla and Ospedale Ercole Franchini Di Montecchio Emilia, Azienda USL-IRCCS Di Reggio Emilia, Via Donatori di Sangue 1, 42016, Guastalla, RE, Italy
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14
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Campobasso D, Acampora A, De Nunzio C, Greco F, Marchioni M, Destefanis P, Altieri V, Bergamaschi F, Fasolis G, Varvello F, Voce S, Palmieri F, Divan C, Malossini G, Oriti R, Ruggera L, Tuccio A, Tubaro A, Delicato G, Laganà A, Dadone C, Pucci L, Carrino M, Montefiore F, Germani S, Miano R, Rabito S, De Rienzo G, Frattini A, Ferrari G, Cindolo L. Predicting factors of post-operative acute urinary retention after Greenlight laser photoselective vaporization of the prostate. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35446-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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15
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Reale G, Marchioni M, Altieri V, Greco F, De Nunzio C, Destefanis P, Ricciardulli S, Bergamaschi F, Fasolis G, Varvello F, Voce S, Palmieri F, Divan C, Malossini G, Oriti R, Tuccio A, Ruggera L, Tubaro A, Delicato G, Laganà A, Dadone C, De Rienzo G, Ditonno P, Frattini A, Campobasso D, Pucci L, Carrino M, Montefiore F, Germani S, Miano R, Schips L, Rabito S, Ferrari G, Cindolo L. Greenlight laser standard vs anatomical vaporization: how long can time change our habits and results? analysis of temporal trends from the Italian Greenlight laser study group. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35438-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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16
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Reale G, Marchioni M, Greco F, De Nunzio C, Destefanis P, Bergamaschi F, Varvello F, Palmieri F, Divan C, Oriti R, Tuccio A, Ruggera L, Delicato G, Dadone C, De Rienzo G, Frattini A, Carrino M, Montefiore F, Miano R, Schips L, Rabito S, Ferrari G, Cindolo L. Surgical performance of greenlight laser therapy for benign prostatic hyperplasia: Preliminary results in terms of operative profile, safety and functional outcomes from a retrospective multicenter Italian database study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34054-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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17
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Reale G, Marchioni M, Altieri V, Greco F, De Nunzio C, Destefanis P, Ricciardulli S, Bergamaschi F, Fasolis G, Varvello F, Voce S, Palmieri F, Divan C, Malossini G, Oriti R, Tuccio A, Ruggera L, Tubaro A, Delicato G, Laganà A, Dadone C, De Rienzo G, Ditonno A, Frattini A, Pucci L, Carrino M, Montefiore F, Germani S, Miano R, Schips L, Rabito S, Ferrari G, Cindolo L. Operative profile, safety and functional outcomes after GreenLight laser prostate surgery: results from a 12 months follow-up multicenter Italian cohort analyses. MINERVA UROL NEFROL 2020; 72:622-628. [PMID: 32284526 DOI: 10.23736/s0393-2249.20.03597-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Over the two past decades, GreenLight laser therapy has been considered a valid alternative for the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia/benign prostatic obstruction (BPH/BPO). However, the debate on the effectiveness of laser therapy compared to conventional techniques is still open. The aim of our study is to analyze and describe the use of GreenLight laser prostate surgery in Italy, with regard to the surgical techniques performed and the surgical and functional outcomes at mid-term follow-up. METHODS From March 2012 to July 2018, patients who underwent GreenLight laser prostate surgery for LUTS due to BPH/BPO from 19 Italian centers were included. The following parameters were evaluated in the population: age, prostate volume, prostate adenoma volume, PSA tot, Q<inf>max</inf> at uroflowmetry (UFM), International Prostatic Symptoms Score (IPSS), previous therapy for LUTS, use of anticoagulants and antiplatelet drugs. We recorded also the kind of anesthesia, mean laser time (min), mean irradiation time (min), TURP conversion/completion rate, postoperative day of catheter removal, postoperative acute urinary retention (AUR), hospital stay, variation of hematocrit (Ht) and hemoglobin levels (Hb). Early complications were classified according to the Clavien-Dindo classification, the re-operation rate within 30 days and after 30 days, the late complications and the Patient Global Impression of Improvement were also collected. Changes over time in terms of blood loss and functional outcomes (IPSS and Q<inf>max</inf> at the UFM at 6 and 12 months) were tested with Student's test for paired samples. We assumed P≤0.05 as level of statistical significance. RESULTS Overall, 1077 were enrolled in the study, 554 (56.4%) were treated with standard vaporization and 523 (48.6%) with anatomical vaporization. Student's t-test for paired samples showed no statistically significant differences in terms of reduction of Ht preoperative vs. Ht postoperative (42.80±3.91 vs. 39.93±5.35 95% CI P=0.3) and preintervention and postintervention Hb levels (14.28±1.46 vs. 13.72 P=0.35). Compared with the preoperative Q<inf>max</inf> (8.60±2.64), the 6- and 12-month UFM showed a significant improvement [19.56±6.29, P<0.01 and 19.99±5.92 P<0.01]. In terms of IPSS variation, compared to the baseline level (22±5.51) the 6- and 12-month follow-up confirmed a significant reduction (8.01±4.41 P<0.01 and 5.81±4.12 P<0.01 respectively). Postoperative complications were CD0, CD1, CD2, CD3, CD4 in 33.0%,35.3%, 2.9%, 0.3%, and 0.6%. CONCLUSIONS To the best of our knowledge, this is one of the most numerous surgical series of GreenLight laser vaporization and with the longest follow-up. This technique should be considered as a safe and effective alternative in the treatment of secondary LUTS to BPH.
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Affiliation(s)
- Giulio Reale
- Department of Urology, S. Maria delle Croci Hospital, Azienda AUSL Romagna, Ravenna, Italy -
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti, Italy
| | | | | | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Paolo Destefanis
- Departement of Urology, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy
| | | | - Franco Bergamaschi
- Department of Urology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | | | | | - Salvatore Voce
- Department of Urology, S. Maria delle Croci Hospital, Azienda AUSL Romagna, Ravenna, Italy
| | - Fabiano Palmieri
- Department of Urology, S. Maria delle Croci Hospital, Azienda AUSL Romagna, Ravenna, Italy
| | - Claudio Divan
- Department of Urology, Hospital of Rovereto, Rovereto, Milan, Italy
| | - Gianni Malossini
- Department of Urology, Hospital of Rovereto, Rovereto, Milan, Italy
| | - Rino Oriti
- Department of Urology, Ulivella e Glicini Clinic, Florence, Italy
| | - Agostino Tuccio
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Lorenzo Ruggera
- Department of Urology, Urologic Clinic, University of Padua, Padua, Italy
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Giampaolo Delicato
- Department of Urology, S.Giovanni Evangelista Hospital, Tivoli, Rome, Italy
| | - Antonino Laganà
- Department of Urology, S.Giovanni Evangelista Hospital, Tivoli, Rome, Italy
| | - Claudio Dadone
- Department of Urology, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Gaetano De Rienzo
- Urology and Andrology Unit II, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Andrea Ditonno
- Urology and Andrology Unit II, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Antonio Frattini
- Department of Urology, Ospedale Civile di Guastalla, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Ercole Franchini di Montecchio Emilia Hospital, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Pucci
- Department of Urology, AORN Antonio Cardarelli, Naples, Italy
| | | | - Franco Montefiore
- Department of Urology, San Giacomo Hospital, Novi Ligure, Alessandria, Italy
| | - Stefano Germani
- Unit of Urology, Department of Surgery, Tor Vergata Polyclinic Foundation, Tor Vergata University, Rome, Italy
| | - Roberto Miano
- Unit of Urology, Department of Surgery, Tor Vergata Polyclinic Foundation, Tor Vergata University, Rome, Italy
| | - Luigi Schips
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti, Italy
| | | | | | - Luca Cindolo
- Department of Urology, Villa Stuart Private Hospital, Rome, Italy
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Campobasso D, Marchioni M, Altieri V, Greco F, De Nunzio C, Destefanis P, Ricciardulli S, Bergamaschi F, Fasolis G, Varvello F, Voce S, Palmieri F, Divan C, Malossini G, Oriti R, Tuccio A, Ruggera L, Tubaro A, Delicato G, Laganà A, Dadone C, De Rienzo G, Frattini A, Pucci L, Carrino M, Montefiore F, Germani S, Miano R, Schips L, Rabito S, Ferrari G, Cindolo L. GreenLight Photoselective Vaporization of the Prostate: One Laser for Different Prostate Sizes. J Endourol 2020; 34:54-62. [DOI: 10.1089/end.2019.0478] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Davide Campobasso
- Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Azienda USL-IRCCS di Reggio Emilia, Guastalla, Italy
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, “G. D'Annunzio” University of Chieti, Chieti, Italy
| | | | | | - Cosimo De Nunzio
- Department of Urology, “Sant'Andrea” Hospital, Sapienza University, Roma, Italy
| | - Paolo Destefanis
- Department of Urology, Azienda Ospedaliera Città della Salute e della Scienza di Torino—Sede Molinette, Torino, Italy
| | | | - Franco Bergamaschi
- Department of Urology, “Arcispedale Santa Maria Nuova,” Reggio Emilia, Italy
| | | | | | - Salvatore Voce
- Department of Urology, “Santa Maria delle Croci Hospital,” Ravenna, Italy
| | - Fabiano Palmieri
- Department of Urology, “Santa Maria delle Croci Hospital,” Ravenna, Italy
| | - Claudio Divan
- Department of Urology, “Rovereto Hospital,” Rovereto, Italy
| | | | - Rino Oriti
- Department of Urology, “Ulivella e Glicini Clinic,” Florence, Italy
| | - Agostino Tuccio
- Department of Urology, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Lorenzo Ruggera
- Department of Urology, Clinica urologica azienda ospedaliera, University of Padova, Padova, Italy
| | - Andrea Tubaro
- Department of Urology, “Sant'Andrea” Hospital, Sapienza University, Roma, Italy
| | - Giampaolo Delicato
- Department of Urology, “S. Giovanni Evangelista” Hospital, Tivoli, Italy
| | - Antonino Laganà
- Department of Urology, “S. Giovanni Evangelista” Hospital, Tivoli, Italy
| | - Claudio Dadone
- Department of Urology, “Santa Croce e Carle” Hospital, Cuneo, Italy
| | - Gaetano De Rienzo
- Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Bari, Italy
| | - Antonio Frattini
- Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Azienda USL-IRCCS di Reggio Emilia, Guastalla, Italy
| | - Lugi Pucci
- Department of Urology, AORN “Antonio Cardarelli,” Naples, Italy
| | | | | | - Stefano Germani
- UOSD Urologia, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Roberto Miano
- UOSD Urologia, Dipartimento di Scienze Chirurgiche, Fondazione Policlinico Tor Vergata, Università di Roma Tor Vergata, Rome, Italy
| | - Luigi Schips
- Department of Urology, ASL Abruzzo 2, Chieti, Italy
| | | | | | - Luca Cindolo
- Department of Urology, “Villa Stuart” Private Hospital, Rome, Italy
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Abstract
We report the third case of bilateral metastatic renal meningeal hemangiopericytoma (HPC) 16 years after initial intracranial presentation. A 47-year-old male patient presented with abdominal mass drew our attention. Computed tomography (CT) demonstrated bilateral renal masses and another mass caudal to the lower pole of left kidney from which it was separated. He had a previous history of meningeal HPC. Since 1996, he underwent four neurosurgical operations and three CyberKnife radiosurgery. He underwent bilateral nephron sparing surgery. Histopathology study deposed for HPC. After 12 months, a CT scan revealed three hepatic lesions, which resulted comparable with HPC metastasis at a fine needle biopsy. An imaging-guided radiofrequency ablation was programmed. The patient is metastatic disease-free after 46 months. Previous history of meningeal HPC in patient with kidney masses should raise the suspicion of renal metastasis. The treatment of choice is surgery. In these cases, abdominal imaging should be included in the follow-up.
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Affiliation(s)
| | | | - Francesco Paolo Pilato
- Department of Biomedical, Biotechnological and Translational Sciences, Surgical Pathology Unit, University Hospital of Parma, Parma, Italy
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Marchioni M, Schips L, Greco F, Frattini A, Neri F, Ruggera L, Fasolis G, Varvello F, Destefanis P, De Rienzo G, Ditonno P, Ferrari G, Cindolo L. Perioperative major acute cardiovascular events after 180-W GreenLight laser photoselective vaporization of the prostate. Int Urol Nephrol 2018; 50:1955-1962. [PMID: 30141122 DOI: 10.1007/s11255-018-1968-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 08/16/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Major acute cardiovascular events (MACE) prevalence after 180-W GreenLight (180-W GL) laser photoselective vaporization (PVP) have never been explored. Aim of our study is to evaluate perioperative MACE that occurred concomitantly with 180-W GL PVP. MATERIALS AND METHODS We relied on a multi-institutional database that included 14 centers. Data from 923 patients who underwent 180-W GL PVP were reviewed. We abstracted pre- and perioperative data of patients who experienced perioperative MACE, such as angina pectoris, acute myocardial infarction, other chronic ischemic heart disease, transient ischemic attack, or cerebrovascular accident as well as deep venous thrombosis with or without pulmonary embolism. We relied on a case-series format to report the main findings of our analyses. RESULTS 18 (1.9%) patients reported MACE in 7 centers. Median age was 69.5 (IQR 66.0-79.2) years. Of all, 7 patients underwent standard PVP and 11 anatomical PVP. Eleven patients (61.1%) were not under anticoagulant/antiplatelet treatment, 6 (33.3%) were under low dose aspirin, and 1 (5.6%) was under clopidogrel. Four patients (22.2%) had an instrumental and laboratory diagnosis of myocardial infarction, 7 (38.9%) had an episode of angina pectoris with or without rhythm alteration, 3 (16.7%) reported symptomatic deep venous thrombosis, and 4 (22.2%) had other MACE-like events. CONCLUSIONS Physician should take in consideration the possibility of MACE or MACE-like events. The real MACE rate may be different as only half of included centers reported MACE. Since the main target of laser surgery are high-risk bleeding patients, prospective observational trials focused on detection of these possible complications are warranted.
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Affiliation(s)
| | - Luigi Schips
- Department of Urology, "G. D'Annunzio" University, Chieti, Italy
| | - Francesco Greco
- Department of Urology, Humanitas Gavazzeni Hospital, Bergamo, Italy
| | - Antonio Frattini
- Department of Urology, "Ercole Franchini" Hospital, Montecchio Emilia and Civital Hospital of Guastalla, AUSL of Reggio Emilia, Reggio Emilia, Italy
| | - Fabio Neri
- Department of Urology, ASL Abruzzo2, Chieti, Italy
| | - Lorenzo Ruggera
- Department of Urology, Clinica urologica azienda ospedaliera - University of Padova, Padua, Italy
| | | | | | - Paolo Destefanis
- Department of Urology, Azienda Ospedaliera Città della Salute e della Scienza di Torino - Sede Molinette, Torino, Italy
| | - Gaetano De Rienzo
- Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Bari, Italy
| | - Pasquale Ditonno
- Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Bari, Italy
| | | | - Luca Cindolo
- Department of Urology, ASL Abruzzo2, Chieti, Italy. .,Urology Department, ASL Abruzzo2, Via S. Camillo de Lellis 1, 66054, Vasto, Italy.
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Campobasso D, Grande M, Ferretti S, Moretti M, Facchini F, Larosa M, Salsi P, Granelli P, Pozzoli GL, Frattini A. Subcapsular renal hematoma after retrograde ureterorenoscopic lithotripsy: our experience. MINERVA UROL NEFROL 2018; 70:617-623. [PMID: 30037212 DOI: 10.23736/s0393-2249.18.03199-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Ureterorenoscopy is the current standard treatment for ureteral and kidney stones, also stones greater than 2 cm can be removed. Complications linked to infectious processes or ureteral damage are the most frequently reported. Subcapsular renal hematoma is an extremely rare complication following this procedure. METHODS We report the retrospective experience of two urological referral units for stones disease by analyzing incidence, risk factors and management of subcapsular renal hematoma. RESULTS Between May 2011 and December 2017, 2497 consecutive ureteroscopies for urolithiasis were performed by 8 skilled endourologists. A subcapsular renal hematoma was diagnosed in four cases (0.12%). Symptoms appeared few hours after intervention in two patients and after 14 postoperative days in the remaining two. In all cases CT scan revealed a subcapsular renal hematoma without signs of active bleeding. Conservative treatment was successful. Two patients required blood transfusion. One patient developed renal hypotrophy. CONCLUSIONS Subcapsular renal hematoma represents a rare but potentially serious complication after ureterorenoscopic lithotripsy. Its real incidence and etiology still need to be clarified. The elevated intrarenal pressures play an important role. Persistent hematuria, flank pain and hemoglobin drop should guide prompt investigation to reach an early diagnosis. In most cases a conservative management is sufficient.
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Affiliation(s)
- Davide Campobasso
- Unit of Urology, Civil Hospital of Guastalla, AUSL Reggio Emilia, Reggio Emilia, Italy -
| | - Marco Grande
- Unit of Urology, Civil Hospital of Guastalla, AUSL Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Ferretti
- Service of Endourology and Mini-invasive Percutaneous Surgery, Unit of Urology, Parma University Hospital, Parma, Italy
| | - Matteo Moretti
- Unit of Urology, Civil Hospital of Guastalla, AUSL Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Facchini
- Unit of Urology, Civil Hospital of Guastalla, AUSL Reggio Emilia, Reggio Emilia, Italy
| | - Michelangelo Larosa
- Unit of Urology, Civil Hospital of Guastalla, AUSL Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Salsi
- Service of Endourology and Mini-invasive Percutaneous Surgery, Unit of Urology, Parma University Hospital, Parma, Italy
| | - Pietro Granelli
- Service of Endourology and Mini-invasive Percutaneous Surgery, Unit of Urology, Parma University Hospital, Parma, Italy
| | - Gian Luigi Pozzoli
- Unit of Urology, Civil Hospital of Guastalla, AUSL Reggio Emilia, Reggio Emilia, Italy
| | - Antonio Frattini
- Unit of Urology, Civil Hospital of Guastalla, AUSL Reggio Emilia, Reggio Emilia, Italy
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22
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Campobasso D, Lanzi A, Pozzoli GL, Frattini A. Prolapsed ureterocele in an adult woman after endoscopic incision. Urol Ann 2018; 10:100-102. [PMID: 29416284 PMCID: PMC5791444 DOI: 10.4103/ua.ua_117_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
A 44-year-old woman underwent endoscopic incision of a right simple ureterocele with hydronephrosis discovered during gynecological assessment for stress urinary incontinence with Stage I cystocele. At the postoperative visits, she has reported a persistent flap of mucosa coming out from her urethra protruding in the vagina despite manual reduction. An endoscopic resection of the mucosa flap was programmed. After 24 months, she was asymptomatic with no history of renal colic or urinary tract infection. In patients with a history of pelvic organ prolapse, the resection of the ureterocele in the first instance may be the optimal choice.
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Affiliation(s)
- Davide Campobasso
- Department of Surgery, Urology OU, Civil Hospital of Guastalla, AUSL of Reggio Emilia, Guastalla 42016 (RE), Italy
| | - Andrea Lanzi
- Department of Diagnostic Imaging and Laboratory Medicine, Radiology Unit, Civil Hospital of Guastalla, AUSL of Reggio Emilia, Guastalla 42016 (RE), Italy
| | - Gian Luigi Pozzoli
- Department of Surgery, Urology OU, Civil Hospital of Guastalla, AUSL of Reggio Emilia, Guastalla 42016 (RE), Italy
| | - Antonio Frattini
- Department of Surgery, Urology OU, Civil Hospital of Guastalla, AUSL of Reggio Emilia, Guastalla 42016 (RE), Italy
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23
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Valli R, Vinti L, Frattini A, Fabbri M, Montalbano G, Olivieri C, Minelli A, Locatelli F, Pasquali F, Maserati E. Bone marrow failure may be caused by chromosome anomalies exerting effects on RUNX1T1 gene. Mol Cytogenet 2018; 11:2. [PMID: 29344089 PMCID: PMC5765665 DOI: 10.1186/s13039-017-0352-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/26/2017] [Indexed: 12/22/2022] Open
Abstract
Background The majority of the cases of bone marrow failure syndromes/aplastic anaemias (BMFS/AA) are non-hereditary and considered idiopathic (80–85%). The peripheral blood picture is variable, with anaemia, neutropenia and/or thrombocytopenia, and the patients with idiopathic BMFS/AA may have a risk of transformation into a myelodysplastic syndrome (MDS) and/or an acute myeloid leukaemia (AML), as ascertained for all inherited BMFS. We already reported four patients with different forms of BMFS/AA with chromosome anomalies as primary etiologic event: the chromosome changes exerted an effect on specific genes, namely RUNX1, MPL, and FLI1, leading to the disease. Results We report two further patients with non-hereditary BM failure, with diagnosis of severe aplastic anaemia and pancytopenia caused by two different constitutional structural anomalies involving chromosome 8, and possibly leading to the disorder due to effects on the RUNX1T1 gene, which was hypo-expressed and hyper-expressed, respectively, in the two patients. The chromosome change was unbalanced in one patient, and balanced in the other one. Conclusions We analyzed the sequence of events in the pathogenesis of the disease in the two patients, including a number of non-haematological signs present in the one with the unbalanced anomaly. We demonstrated that in these two patients the primary event causing BMFS/AA was the constitutional chromosome anomaly. If we take into account the cohort of 219 patients with a similar diagnosis in whom we made cytogenetic studies in the years 2003–2017, we conclude that cytogenetic investigations were instrumental to reach a diagnosis in 52 of them. We postulate that a chromosome change is the primary cause of BMFS/AA in a not negligible proportion of cases, as it was ascertained in 6 of these patients. Electronic supplementary material The online version of this article (10.1186/s13039-017-0352-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- R Valli
- 1Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell'Insubria, Varese, Italy
| | - L Vinti
- 2Dipartimento di Onco-Ematologia Pediatrica, Ospedale Pediatrico Bambino Gesù, Roma, Università di Pavia, Pavia, Italy
| | - A Frattini
- 1Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell'Insubria, Varese, Italy.,3Istituto di Ricerca Genetica e Biomedica, CNR, Milan, Italy
| | - M Fabbri
- 1Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell'Insubria, Varese, Italy.,4Unit of Haematopathology, European Institute of Oncology, Milan, Italy
| | - G Montalbano
- 1Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell'Insubria, Varese, Italy
| | - C Olivieri
- 5Genetica Medica, Fondazione IRCCS Policlinico S. Matteo and Università di Pavia, Pavia, Italy
| | - A Minelli
- 5Genetica Medica, Fondazione IRCCS Policlinico S. Matteo and Università di Pavia, Pavia, Italy
| | - F Locatelli
- 2Dipartimento di Onco-Ematologia Pediatrica, Ospedale Pediatrico Bambino Gesù, Roma, Università di Pavia, Pavia, Italy
| | - F Pasquali
- 1Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell'Insubria, Varese, Italy
| | - E Maserati
- 1Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell'Insubria, Varese, Italy
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24
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Cindolo L, De Nunzio C, Greco F, Destefanis P, Bergamaschi F, Ferrari G, Fasolis G, Palmieri F, Divan C, Oriti R, Ruggera L, Tubaro A, Dadone C, De Rienzo G, Frattini A, Mirone V, Schips L. Standard vs. anatomical 180-W GreenLight laser photoselective vaporization of the prostate: a propensity score analysis. World J Urol 2017; 36:91-97. [DOI: 10.1007/s00345-017-2106-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 10/20/2017] [Indexed: 11/30/2022] Open
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25
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Tejada G, Barrera MG, Piccirilli GN, Sortino M, Frattini A, Salomón CJ, Lamas MC, Leonardi D. Development and Evaluation of Buccal Films Based on Chitosan for the Potential Treatment of Oral Candidiasis. AAPS PharmSciTech 2017; 18:936-946. [PMID: 28108973 DOI: 10.1208/s12249-017-0720-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 01/10/2017] [Indexed: 11/30/2022] Open
Abstract
In this work, chitosan films were prepared by a casting/solvent evaporation methodology using pectin or hydroxypropylmethyl cellulose to form polymeric matrices. Miconazole nitrate, as a model drug, was loaded into such formulations. These polymeric films were characterized in terms of mechanical properties, adhesiveness, and swelling as well as drug release. Besides, the morphology of raw materials and films was investigated by scanning electron microscopy; interactions between polymers were analyzed by infrared spectroscopy and drug crystallinity studied by differential scanning calorimetry and X-ray diffraction. In addition, antifungal activity against cultures of the five most important fungal opportunistic pathogens belonging to Candida genus was investigated. Chitosan:hydroxypropylmethyl cellulose films were found to be the most appropriate formulations in terms of folding endurance, mechanical properties, and adhesiveness. Also, an improvement in the dissolution rate of miconazole nitrate from the films up to 90% compared to the non-loaded drug was observed. The in vitro antifungal activity showed a significant activity of the model drug when it is loaded into chitosan films. These findings suggest that chitosan-based films are a promising approach to deliver miconazole nitrate for the treatment of candidiasis.
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Muslumanoglu AY, Fuglsig S, Frattini A, Labate G, Nadler RB, Martov A, Wong C, de la Rosette JJMCH. Risks and Benefits of Postoperative Double-J Stent Placement After Ureteroscopy: Results from the Clinical Research Office of Endourological Society Ureteroscopy Global Study. J Endourol 2017; 31:446-451. [PMID: 28292209 DOI: 10.1089/end.2016.0827] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Double-J stent placement after stone removal by ureteroscopy (URS) is common and recommended in many cases but debatable in others. In this study, the risks and benefits of postoperative Double-J stent placement in URS stone treatment procedures undertaken in current clinical practice are examined. MATERIALS AND METHODS The Clinical Research Office of Endourological Society (CROES) URS is a prospective, observational, international multicenter study, in which patients are candidates for URS as primary treatment or after failure of prior treatment for ureteral and renal stones. Baseline, intraoperative, and postoperative data were collected. Predictors and outcomes of postoperative stent placement were analyzed by inverse probability-weighted regression adjustment of the relationship between a Double-J stent placement and outcomes (complications, readmission [including retreatment], and length of hospital stay). RESULTS Significant predictors of postoperative Double-J stent placement in URS treatment of ureteral stones were intraoperative complications, impacted stones, operation time, stone burden, age, presence of a solitary kidney, and stone-free rate. In renal stone treatment, the predictors identified included operation time, age, preoperative stent placement, anticoagulant use, presence of a solitary kidney, and intraoperative complications. In both ureteral and renal stone treatment groups, postoperative placement of a Double-J stent resulted in significantly fewer postoperative complications (p < 0.001) compared with patients who did not receive a stent. CONCLUSIONS Patient- and procedure-related variables were identified, which may enable an individualized approach to postoperative stenting, resulting in improved clinical outcomes in urologic stone treatment by URS.
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Affiliation(s)
- Ahmet Y Muslumanoglu
- 1 Department of Urology, Haseki Training and Research Hospital , Istanbul, Turkey
| | - Sven Fuglsig
- 2 Department of Urology, University Hospital of Aarhus , Skejby, Aarhus, Denmark
| | - Antonio Frattini
- 3 Department of Urology, Guastalla Hospital , Reggio Emilia, Italy
| | - Gaston Labate
- 4 UROSALUD, Urology Center , Buenos Aires, Argentina
| | - Robert B Nadler
- 5 Department of Urology, Northwestern University Feinberg School of Medicine , Chicago, Illinois
| | - Alexey Martov
- 6 Department of Urology, Moscow City Hospital No 57 , Moscow, Russia
| | - Carson Wong
- 7 Division of Urology, University Hospitals Ahuja Medical Center , Beachwood, Ohio.,8 Minimally Invasive and Robotic Surgery, SouthWest Urology, LLC , Cleveland, Ohio
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Campobasso D, Prati G, Frattini A. Very high risk prostate cancer: multimodality treatment will be the new frontier. Cent European J Urol 2017; 70:324-325. [PMID: 29104799 PMCID: PMC5656377 DOI: 10.5173/ceju.2017.1535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 08/16/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
- Davide Campobasso
- Civil Hospital of Guastalla, Urology Unit, AUSL of Reggio Emilia, Italy
| | - Giuseppe Prati
- Civil Hospital of Guastalla, Oncology Unit, AUSL of Reggio Emilia, Italy
| | - Antonio Frattini
- Civil Hospital of Guastalla, Urology Unit, AUSL of Reggio Emilia, Italy
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28
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Campobasso D, Ciuffreda M, Maestroni U, Dinale F, Frattini A, Ferretti S. Laparoscopic removal of an intrauterine contraceptive device migrated into the bladder: a case report. Urol J 2014; 11:1847-1848. [PMID: 25194089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 04/26/2014] [Accepted: 05/24/2014] [Indexed: 06/03/2023]
Affiliation(s)
| | - Matteo Ciuffreda
- Department of Surgery, University Hospital of Parma, Parma, Italy
| | | | - Francesco Dinale
- Department of Surgery, University Hospital of Parma, Parma, Italy
| | - Antonio Frattini
- Department of Surgery, University Hospital of Parma, Parma, Italy
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Campobasso D, Pilato FP, Gnetti L, Thai E, Salsi PE, Frattini A, Ferretti S. Renal bone metaplasia: an incidental negligible finding or a disease to treat? Urolithiasis 2014; 42:469-70. [PMID: 25030094 DOI: 10.1007/s00240-014-0684-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 06/30/2014] [Indexed: 11/28/2022]
Abstract
Renal bone metaplasia (RBM) is a uncommon condition and is often an incidental finding. The pathogenesis of this phenomenon is not clearly understood. The radiological signs described are not always present and the diagnosis is challenging. In the literature, there is no any conclusion about the optimal management of this condition due to the absence of some conclusions regarding its etiology. In our opinion, no treatment should be applied to prevent its possible evolution into urolithiasis. Surgical removal of the RBM is an overtreatment for a phenomenon not understood and potentially insignificant. We report our experience with a watchful waiting approach in a case of incidental diagnosis of RBM. After 3 years, the patient is asymptomatic, with no evidence of malignancies evolution, new renal stones or growth of the residual RBM.
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Affiliation(s)
- Davide Campobasso
- Urology Unit, Surgical Department, University-Hospital of Parma, Via Gramsci 14, 43123, Parma, Italy,
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30
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Guven S, Frattini A, Onal B, Desai M, Montanari E, Kums J, Garofalo M, de la Rosette J. Percutaneous nephrolithotomy in children in different age groups: data from the Clinical Research Office of the Endourological Society (CROES) Percutaneous Nephrolithotomy Global Study. BJU Int 2012; 111:148-56. [PMID: 22578216 DOI: 10.1111/j.1464-410x.2012.11239.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To present the overall results of paediatric percutaneous nephrolithotomy (PCNL) compared with adults. To present the indications, complications and outcomes of patients treated in the participating centres in the PCNL Global Study, as categorised in different age groups. PATIENTS AND METHODS The Clinical Research Office of the Endourological Society (CROES) Study was conducted from November 2007 to December 2009, and included 96 centres and >5800 patients. All children aged ≤14 years in the PCNL Global Study database were the focus of the study. RESULTS In all, 107 children aged ≤14 years were included in the analysis. The PCNL procedure was conducted in 13 patients (12.1%) in the supine position; tubeless PCNL was performed in 15 patients (14%); and balloon dilatation was preferred in 22 patients (20.5%). The overall mean operative duration was 97.02 min; blood transfusion rate, fever and stone-free rates were 9%, 14% and 70.1%, respectively. A comparison of the paediatric PCNL cases according to age groups showed no statistically significant differences between the subgroups for patient characteristics, co-morbidities, renal anomalies, or previous surgical history. In the evaluation of the operative details, the mean sheath size and nephrostomy tube size were larger in school-age children than the preschool children (P = 0.01 and 0.002, respectively). There was a difference in the preferred methods for confirming stone-free status, with ultrasonography preferred more in preschool children (P < 0.001). The PCNL procedure position, puncture site, dilatation method, postoperative tube application, and surgical outcomes were comparable in school- and preschool-age children. While operative details showed some differences between children and adults, the surgical outcomes were comparable. CONCLUSIONS A considerable number (45.7%) of the paediatric patients had a previous history of stone intervention. Based on the findings of the present study, we can suggest that PCNL can be applied safely and effectively in children in different age groups. Outcomes appear comparable with those in adults for the success and complication rates, in the presence of substantial indications, appropriate equipment and adequate experience.
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Affiliation(s)
- Selcuk Guven
- Department of Urology, Konya University Meram Medical Faculty, Konya, Turkey
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31
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Olivani A, Iaria M, Missale G, Capocasale E, Biasini E, Mazzoni MP, Lombardelli L, Luzi E, Frattini A, Pelosi G. Percutaneous ultrasound-guided radiofrequency ablation of an allograft renal cell carcinoma: a case report. Transplant Proc 2012; 43:3997-9. [PMID: 22172886 DOI: 10.1016/j.transproceed.2011.08.089] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 08/29/2011] [Indexed: 12/29/2022]
Abstract
BACKGROUND Renal cell carcinomas (RCCs) are rarely described in transplanted kidneys. Available therapeutic strategies range from allograft nephrectomy to nephron-sparing procedures such as partial nephrectomy or image-guided thermal ablation. Percutaneous radiofrequency ablation (RFA) is a minimally invasive technique which provides promising oncologic outcomes in small allograft RCCs while preserving allograft function. So far, only a few cases have been reported in the transplant setting. We describe a renal transplant RCC successfully approached by ultrasound-guided RFA. METHODS A 42-year-old renal transplant recipient developed a small subcapsular allograft RCC at 11 years after transplantation. The decline in glomerular filtration rare prompted us to preserve as much parenchyma as possible. Ultrasound-guided RFA was performed under light sedation and local analgesia in a single session with a Starbust Talon needle. RESULTS Postablation contrast-enhanced ultrasound displayed a 25×23 mm avascular area of complete necrosis. After 3 months gadolinium-enhanced magnetic resonance imaging confirmed the absence of viable tumor tissue and while the patient did not experience any graft function reduction (serum creatinine 2.6 mg/dL). CONCLUSIONS Image-guided RFA represents a promising therapeutic modality for small allograft RCCs in recipients with mild graft dysfunction and/or elevated surgical risk. It is associated with low morbidity and parenchymal preservation.
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Affiliation(s)
- A Olivani
- Division of Infectious Diseases and Hepatology, Parma University Hospital, Parma, Italy
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32
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Terrinoni A, Pagani IS, Zucchi I, Chiaravalli AM, Serra V, Rovera F, Sirchia S, Dionigi G, Miozzo M, Frattini A, Ferrari A, Capella C, Pasquali F, Lo Curto F, Albertini A, Melino G, Porta G. Erratum: OTX1 expression in breast cancer is regulated by p53. Oncogene 2011. [DOI: 10.1038/onc.2011.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Borrelli I, Loffredo S, Staiano RI, Frattini A, Marone G, Triggiani M. Benzene metabolites inhibit the release of proinflammatory mediators and cytokines from human basophils. Int J Immunopathol Pharmacol 2010; 23:737-44. [PMID: 20943043 DOI: 10.1177/039463201002300307] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Benzene and its metabolites have been involved in the pathogenesis of chronic lung inflammation and allergic disorders such as bronchial asthma. However, the effects of these xenobiotics on human basophils, key cells in the development of respiratory allergy, have not been investigated. We examined the effects of hydroquinone (HQ) and benzoquinone (BQ), two important chemicals implicated in benzene toxicity, on the release of preformed (histamine) and de novo synthesized mediators (cysteinyl leukotriene C4, LTC4, and IL-4) from human basophils. Preincubation of basophils purified from normal donors with HQ (3-100 microM) inhibited up to 30% histamine release induced by anti-IgE and up to 55% of that induced by the Ca2+ ionophore A23187. HQ had no effect on histamine release induced by formyl-methionyl-leucyl-phenylalanine (f-Met-Leu-Phe). Preincubation of basophils with BQ (3-100 microM) resulted in the concentration-dependent inhibition of histamine release (up to 70%) induced by anti-IgE, A23187 and f-Met-Leu-Phe. HQ completely suppressed the de novo synthesis of LTC4 from basophils challenged with anti-IgE or f-Met-Leu-Phe and the production of IL-4 in cells stimulated with anti-IgE. These results indicate that two major benzene metabolites, HQ and BQ, inhibit the release of proinflammatory mediators and Th2-promoting cytokines from basophils activated by different stimuli. These results suggest that benzene metabolites interfere with multiple intracellular signals involved in the activation of human basophils.
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Affiliation(s)
- I Borrelli
- Institute of Occupational Health, Catholic University of the Sacred Heart, Rome, Italy
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Ziglioli F, Ferretti S, Salsi P, Dinale F, Ciuffreda M, Campobasso D, Frattini A. [Percutaneous nephrolithotomy (PCNL) in a 9-year-old patient with horseshoe kidney]. Urologia 2010; 77:150-153. [PMID: 20890874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2010] [Indexed: 05/29/2023]
Abstract
INTRODUCTION The horseshoe kidney is the most frequent renal anomaly, with a prevalence of 0.25% and a male to female ratio of 3:1. Although the pathogenesis remains controversial, the consequences of the impaired urinary drainage are well known: up to two third of patients present with urinary stasis, infection and urolithiasis. Percutaneous nephrolithotomy (PCNL) is a successful procedure for urolithiasis in horseshoe kidneys. MATERIALS AND METHODS A 9-year-old patient with a 4-cm stone associated with horseshoe kidney underwent Percutaneous nephrolithotomy (PCNL). During the procedure, a flexible uretheroscopy was performed in order to obtain a complete vision and an optimal management of the procedure. RESULTS At the end of the procedure, the patient was stone-free. We reported no hemorrhagic complications, no pain and no infection. The patient was discharged after 48 hours. CONCLUSIONS The procedure is safe and effective, as long as the surgeon pays attention to the recommendations below.
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Affiliation(s)
- F Ziglioli
- Unità Operativa di Urologia, Dipartimento Chirurgico, Azienda Ospedaliero-Universitaria di Parma, Parma - Italy
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Ziglioli F, Ferretti S, Salsi P, Dinaie F, Ciuffreda M, Campobasso D, Frattini A. Percutaneous Nephrolithotomy (PCNL) in a 9-year-old Patient with Horseshoe Kidney. Urologia 2010. [DOI: 10.1177/039156031007700212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Introduction The horseshoe kidney is the most frequent renal anomaly, with a prevalence of 0.25% and amale to female ratio of 3:1. Although the pathogenesis remains controversial, the consequences of the impaired urinary drainage are well known: up to two third of patients present with urinary stasis, infection and urolithiasis. Percutaneous nephrolithotomy (PCNL) is a successful procedure for urolithiasis in horseshoe kidneys. Materials and Methods A 9-year-old patient with a 4-cm stone associated with horseshoe kidney underwent Percutaneous nephrolithotomy (PCNL). During the procedure, a flexible uretheroscopy was performed in order to obtain a complete vision and an optimal management of the procedure. Results At the end of the procedure, the patient was stone-free. We reported no hemorrhagic complications, no pain and no infection. The patient was discharged after 48 hours. Conclusions The procedure is safe and effective, as long as the surgeon pays attention to the recommendations below.
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Affiliation(s)
- F. Ziglioli
- Unità Operativa di Urologia, Dipartimento Chirurgico,
Azienda Ospedaliero-Universitaria di Parma, Parma -Italy
| | - S. Ferretti
- Unità Operativa di Urologia, Dipartimento Chirurgico,
Azienda Ospedaliero-Universitaria di Parma, Parma -Italy
| | - P. Salsi
- Unità Operativa di Urologia, Dipartimento Chirurgico,
Azienda Ospedaliero-Universitaria di Parma, Parma -Italy
| | - F. Dinaie
- Unità Operativa di Urologia, Dipartimento Chirurgico,
Azienda Ospedaliero-Universitaria di Parma, Parma -Italy
| | - M. Ciuffreda
- Unità Operativa di Urologia, Dipartimento Chirurgico,
Azienda Ospedaliero-Universitaria di Parma, Parma -Italy
| | - D. Campobasso
- Unità Operativa di Urologia, Dipartimento Chirurgico,
Azienda Ospedaliero-Universitaria di Parma, Parma -Italy
| | - A. Frattini
- Unità Operativa di Urologia, Dipartimento Chirurgico,
Azienda Ospedaliero-Universitaria di Parma, Parma -Italy
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Frattini A, Ferretti S, Salvaggio A. Percutaneous nephrolithotripsy (PCNL) in children: experience of Parma. Arch Ital Urol Androl 2010; 82:51-52. [PMID: 20593722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
19 Percutaneous nephrolithotripsy procedures were done in 15 children aged from 8 months to 16 years with complex renal stones and/or extracorporeal shock wave lithotripsy refractory stones. The percutaneous techniques were done with the instrument and position (prone and supine) used in adults. 14/15 patients were stone-free (13 pts in one time, 1 pt in 2 procedures and 1 pt, with complex bilateral stones disease, in 5 endourological sessions). No relevant complications developed: 1 patient need a blood transfusion and 1 a temporary Indwelling catheter for colic pain due to oedema. We believe that in children the endourological approach is better than traditional open surgery or reiterated extracorporeal shock wave lithotripsy sessions which often need anaesthesia and can not guarantee a complete clearance of the stones.
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Ziglioli F, Frattini A, Maestroni U, Dinale F, Ciufifeda M, Cortellini P. Vanilloid-mediated apoptosis in prostate cancer cells through a TRPV-1 dependent and a TRPV-1-independent mechanism. Acta Biomed 2009; 80:13-20. [PMID: 19705615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Vanilloids are natural molecules identified in a plethora of foods normally ingested through the diet. They mediate apoptosis through a direct pathway (independent of TRPV-1, the receptor for vanilloids) and through an indirect pathway, i.e., thanks to the interaction with TRPV-1 and the successive intracellular calcium growth [Ca2+]i. Some vanilloids, such as capsaicin, dihydrocapsaicin and resiniferatoxin (the ultrapotent analogue of capsaicin, extractable from Euphorbia resinifera), may be considered as coenzyme Qantagonists: in fact, they inhibit the run of the electrons through the electron transport chain, so determining an excess of reactive oxygen species (ROS). A second effect of the interaction between the vanilloids and TRPV-1 receptor may be reported: it is the fast decrease of the transmembrane mitochondrial potential (delta psi m). Through the direct pathway, on the contrary, the vanilloids induce apoptosis also interacting with caspases, particularly caspase 1 and 3. On the whole, the vanilloids are able to lead to the intracellular calcium growth and consequently to the evidence of precocious and late elements of apoptosis.
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Affiliation(s)
- Francesco Ziglioli
- Unit of Urology, Surgical Department, University Hospital of Parma, Parma, Italy.
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Maestroni U, Ziveri M, Azzolini N, Dinale F, Ziglioli F, Campaniello G, Frattini A, Ferretti S. High Intensity Focused Ultrasound (HIFU): a useful alternative choice in prostate cancer treatment. Preliminary results. Acta Biomed 2008; 79:211-216. [PMID: 19260381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION AND AIMS High-Intensity Focused Ultrasound (HIFU) represents an alternative choice in mini-invasive treatment of prostate cancer. The technology of the device used to perform the treatment allows to exactly destroy a pre-selected area and to save all the tissues around it. We report our experience on the effectiveness and complications of this tecnique. MATERIALS AND METHODS From May 2006 to April 2007, 25 patients with prostate cancer were treated through Ablatherm (EDAP France) in spinal anesthesia. In the first six patients HIFU and TUR-P (Trans-Urethral Resection of Prostate) were performed in the same session and a suprapubic catheter was placed. In the other 14 patients HIFU was afterwards performed. In these patients a trans-urethral catheter was placed. All patients were divided into three groups: low risk (17 patients), intermediate risk (6 patients) and high risk (2 patients). The follow-up consisted in PSA evaluation after 1, 3, 6, 9, 12 months and in transrectal biopsy after six months. Complications related to the treatment, and symptomatological and sexual life tests were evaluated before and after the treatment. RESULTS HIFU overall success rate was 84% (biochemical relapses in only 4 patients out of 25). Success rate was represented as follows: 94.2% in the low risk group, 83.4% in the intermediate risk group and 0% in the high risk group. No complications occurred during the treatment nor in the immediately post-operative time. CONCLUSIONS We demonstrated that HIFU represents a useful alternative choice in mini-invasive therapy of prostate cancer. Particularly, results are remarkable in localized (low-intermediate risk) and low morbility prostate cancer. The role of this procedure in high risk patients needs to be further evaluated. Transrectal HIFU represents a mini-invasive therapeutic option that makes the treatment of prostate cancer possible in 84% of cases. Our results agree with the literature data and demonstrate that the success of the procedure depends on the correct indication of treatment and is strictly related to progression risk parameters.
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Affiliation(s)
- Umberto Maestroni
- Unit of Urology, Surgical Departement, University Hospital of Parma, Parma, Italy.
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Frattini A, Capocasale E, Granelli P, Mazzoni M, Maestroni U, Valle RD, Salsi P, Busi N, Ferreri G, Cortellini P, Sianesi M. Endourological Management of Ureteral Stenosis and Vesicoureteral Reflux after Renal Transplantation. Urologia 2007. [DOI: 10.1177/039156030707400404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction and Objectives Ureteral stenosis and vesicocoureteral reflux after renal transplantation represent a key concern because of their incidence and the associated morbidity. Prompt diagnosis and minimally invasive treatment are mandatory in immunosuppressed patients with single kidney. The aim of this study is to evaluate the success rate of the endourological techniques in the management of such complications. Materials and Methods Between January 1996 and December 2006, 647 kidney transplants were performed. Urinary tract continuity was re-established by ureteroneocystostomy according to Gregoir-Lich technique. We observed 13 cases of ureteral stenosis (2%) and 11 cases of symptomatic vesicoureteric reflux (1.7%). The endourogical procedure was performed in 13 patients: 5 cases of II-III grade vesicoureteric reflux, 4 early ureteral stenosis and 4 late ureteral stenosis. Patients with vesicoureteric reflux underwent endoscopic injection of macroplastique in 4 cases and Durasphere in 1. Early ureteral stenoses were treated using balloon dilation in 2 cases, balloon dilation and laser endoureterotomy in 3, ureteral stent placement in the other. Recipients with late stenosis underwent laser incision and balloon dilation in 2 cases, balloon dilation in 1 and a laser incision only in the last case. Combined antegrade and retrograde endoscopic approach was performed in 7 patients, whereas retrograde access in 1. Results Endourologic treatment was successful in 9 cases (69.2%); 2 patients required open reconstructive surgery due to endourological technique failure (early ureteropelvic junction stricture, late ureterovesical anastomotic stricture). Vesicoureteric reflux was corrected in 3 patients (60%), 2 patients underwent uretero-ureterostomy for recurrent reflux. No technique-related morbidity was observed. With a mean follow-up of 81.6 months, 8 patients show normal renal function, 5 patients have returned to haemodialysis (4 for chronic rejection, 1 for carcinoma in the graft). Conclusions Considering their low morbidity and the satisfactory success rate, we claim that endourological procedures should be considered the preferred treatment for ureteral stenosis and vesicoureteric reflux in selected patients.
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Affiliation(s)
- A. Frattini
- Dipartimento di Scienze Chirurgiche, Unità Operativa di Urologia
- Unità Operativa di Clinica Chirurgica Generale e dei Trapianti d'Organo
- Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliero-Universitaria di Parma
| | - E. Capocasale
- Dipartimento di Scienze Chirurgiche, Unità Operativa di Urologia
- Unità Operativa di Clinica Chirurgica Generale e dei Trapianti d'Organo
- Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliero-Universitaria di Parma
| | - P Granelli
- Dipartimento di Scienze Chirurgiche, Unità Operativa di Urologia
- Unità Operativa di Clinica Chirurgica Generale e dei Trapianti d'Organo
- Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliero-Universitaria di Parma
| | - M.P. Mazzoni
- Dipartimento di Scienze Chirurgiche, Unità Operativa di Urologia
- Unità Operativa di Clinica Chirurgica Generale e dei Trapianti d'Organo
- Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliero-Universitaria di Parma
| | - U. Maestroni
- Dipartimento di Scienze Chirurgiche, Unità Operativa di Urologia
- Unità Operativa di Clinica Chirurgica Generale e dei Trapianti d'Organo
- Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliero-Universitaria di Parma
| | - R. Dalla Valle
- Dipartimento di Scienze Chirurgiche, Unità Operativa di Urologia
- Unità Operativa di Clinica Chirurgica Generale e dei Trapianti d'Organo
- Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliero-Universitaria di Parma
| | - P Salsi
- Dipartimento di Scienze Chirurgiche, Unità Operativa di Urologia
- Unità Operativa di Clinica Chirurgica Generale e dei Trapianti d'Organo
- Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliero-Universitaria di Parma
| | - N. Busi
- Dipartimento di Scienze Chirurgiche, Unità Operativa di Urologia
- Unità Operativa di Clinica Chirurgica Generale e dei Trapianti d'Organo
- Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliero-Universitaria di Parma
| | - G. Ferreri
- Dipartimento di Scienze Chirurgiche, Unità Operativa di Urologia
- Unità Operativa di Clinica Chirurgica Generale e dei Trapianti d'Organo
- Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliero-Universitaria di Parma
| | - P Cortellini
- Dipartimento di Scienze Chirurgiche, Unità Operativa di Urologia
- Unità Operativa di Clinica Chirurgica Generale e dei Trapianti d'Organo
- Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliero-Universitaria di Parma
| | - M. Sianesi
- Dipartimento di Scienze Chirurgiche, Unità Operativa di Urologia
- Unità Operativa di Clinica Chirurgica Generale e dei Trapianti d'Organo
- Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliero-Universitaria di Parma
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Cavani F, Cortelli C, Frattini A, Puccinotti G, Ricotta M, Rodeghiero F, Trifirò F, Fumagalli C, Mazzoni G. The dilution of vanadyl pyrophosphate, catalyst for n-butane oxidation to maleic anhydride, with aluminum phosphate: unexpected reactivity due to the contribution of the diluting agent. Top Catal 2006. [DOI: 10.1007/s11244-006-0028-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cavallo D, Ursini CL, Bavazzano P, Cassinelli C, Frattini A, Perniconi B, Di Francesco A, Ciervo A, Rondinone B, Iavicoli S. Sister Chromatid Exchange and Oxidative DNA Damage in Paving Workers exposed to PAHs. ACTA ACUST UNITED AC 2005; 50:211-8. [PMID: 16344288 DOI: 10.1093/annhyg/mei072] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Paving workers are exposed during road paving to several polycyclic aromatic hydrocarbons (PAHs) contained in asphalt fumes. In this study early genotoxic and oxidative effects of exposure to bitumen fumes were evaluated in 19 paving workers and 22 controls. Environmental and biological monitoring of exposure was carried out, measuring, on personal air samples from exposed workers collected during three working days, the concentration of 14 PAHs and urinary OH-pyrene at the end of each of the three working days. Genotoxic effect was evaluated analysing sister chromatid exchange (SCE) frequency and direct-oxidative DNA damage by formamido-pyrimidine-glycosylase (Fpg)-modified comet assay on lymphocytes. Tail moment values from Fpg-enzyme treated cells (TMenz) and from untreated cells (TM) were used as parameters of direct and oxidative DNA damage, respectively. For each subject, the TMenz/TM ratio >2.0 was used to indicate the presence of oxidative damage. DNA damage was also evaluated analysing comet percentage. Personal air samples showed low level of total PAHs (2.843 microg m(-3)) with prevalence of 2-3 ring PAHs (2.693 microg m(-3)). Urinary OH-pyrene after work-shift of the three working days was significantly higher than that found at the beginning of the working week. SCE analysis did not show any difference between two groups while an oxidative DNA damage was found in 37% of exposed with respect to the absence in controls. Comet percentage was significantly higher (P = 0.000 ANOVA) in the exposed than in controls. The results demonstrate the high sensitivity of comet assay to assess early oxidative effects induced by exposure to bitumen fumes at low doses and confirm the suitability of urinary OH-pyrene as a biomarker of PAH exposure. In conclusion the study suggests the use of Fpg-modified comet test as a biomarker of early genotoxic effects and that of urinary OH-pyrene as a biomarker of PAH exposure to furnish indications in terms of characterization, prevention and management of risk in occupational exposure to mixtures of potentially carcinogenic substances.
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Affiliation(s)
- D Cavallo
- Department of Occupational Medicine, ISPESL Monteporzio Catone, Rome, Italy.
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Maestroni U, Dinale F, Frattini A, Cortellini P. Ureteral hemangioma: a clinical case report. Acta Biomed 2005; 76:115-7. [PMID: 16350557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The most greater part of the tumors ureteralis are of malignant nature, they are verified especially in the elderly patient and they have a preference for the distal third of the ureter. Of the tumors benign ureteral, the emangioma is a very rare vascular neoplasm. The symptoms aspecificis of presentation are: hematuria, colic type pains, hydronephrosis and bladder inflammation. Thanks to the refinement of the radiological techniques (Urography, CTscan and eventually the ascending pyelography) and also to the simultaneous aid of the anatomopathologist, it is possible to obtain an accurate description of this pathology in a precocious stage in order to carry out a conservative approach. The peculiarity of the clinical case from us described depends on the fact that it deals with an occasional find, reaches our observation for appearance of severe hydronephrosis caused by ureteral stones, resolved him with methodic endoscopic.
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Cavallo D, Ursini CL, Frattini A, Perniconi B, Ciervo A, Maiello R, Iavicoli S. [Study of genotoxic and oxidative effects induced by PAH exposure in paving workers]. G Ital Med Lav Ergon 2005; 27:297-9. [PMID: 16240578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Paving workers are exposed during road paving to several PAHs contained in asphalt fumes. We aimed to evaluate early genotoxic and oxidative effects in 19 paving workers and 22 controls. We analysed sister chromatide exchange (SCE) frequency as marker of genotoxicity. Moreover we assessed oxidative DNA damage by Fpg-modified comet assay on lymphocytes calculating tail moment values from fpg-enzyme treated cells (TMenz) and from untreated cells (TM). For each subject the TMenz/TM ratio higher than 2.0 was used to indicate the presence of oxidative damage. We also evaluated DNA damage analysing comet percentage. SCE analysis didn't show any difference between exposed and control groups. We found oxidative DNA damage in 37% of exposed in respect to the absence in controls. Comet percentage was significantly higher in the exposed than in controls. The results demonstrate the high sensitivity of comet assay to assess early oxidative effects induced by exposure to PAH mixtures at low doses and suggest the use of this biomarker in the characterization, prevention and management of risk induced by occupational exposure to mixtures of potentially carcinogenic substances.
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Affiliation(s)
- D Cavallo
- Dipartimento di Medicina del Lavoro, ISPESL Monteporzio Catone, Roma.
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Ferretti S, Azzolini N, Barbieri A, Frattini A, Cortellini P. Randomized comparison of loops for transurethral resection of the prostate: preliminary results. J Endourol 2005; 18:897-900. [PMID: 15659929 DOI: 10.1089/end.2004.18.897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To evaluate the comparative efficacy and morbidity of standard transurethral resection of prostate (TURP) and transurethral vaporesection (TUVRP) using four types of loops. PATIENTS AND METHODS In a one-to-one randomized study, 50 patients with lower urinary-tract symptoms suggestive of bladder outlet obstruction and benign prostatic enlargement underwent TURP. Clinical data were collected using digital rectal examination, transrectal ultrasonography for evaluation of prostate volume, IPSS and IIEF-5 questionnaires, and serum prostate specific antigen concentrations. Intraoperative blood loss and fluid absorption were evaluated by measuring serum hemoglobin and respiratory alcohol concentration. Patients were followed at 3 and 18 months with evaluation of clinical symptoms, flow rates, residual urine volumes, and complications. RESULTS There were no significant differences in blood loss, intraoperative fluid absorption, procedure time, or weight of the resected tissue between standard TURP and TUVRP with the various loops. No significant complications (infections, urethral stricture, reintervention) were seen. CONCLUSIONS In this comparison of the clinical outcome and morbidity of standard TURP versus different loops for TUVRP, there were no significant differences in any of the parameters evaluated.
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Affiliation(s)
- Stefania Ferretti
- Department of Urology, Hospital and University of Parma, Via Gramsci No. 14, 43100 Parma, Italy.
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Sobacchi C, Vezzoni P, Reid DM, McGuigan FEA, Frattini A, Mirolo M, Albhaga OME, Musio A, Villa A, Ralston SH. Association between a polymorphism affecting an AP1 binding site in the promoter of the TCIRG1 gene and bone mass in women. Calcif Tissue Int 2004; 74:35-41. [PMID: 14523594 DOI: 10.1007/s00223-002-0004-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2002] [Accepted: 02/07/2003] [Indexed: 11/28/2022]
Abstract
The TCIRG1 gene encodes a component of the osteoclast vacuolar proton pump and previous work has shown that inactivating mutations of the TCIRG1 cause autosomal recessive osteopetrosis. In order to determine whether allelic variation in TCIRG1 contributes to the regulation of bone mineral density (BMD) in normal individuals, we studied the relationship between polymorphisms of TCIRG1 and BMD in a population-based cohort of 739 perimenopausal women. Five common polymorphisms were identified: two in the promoter, a conservative change within exon 4, one within intron 4 and one within intron 11. One of the promoter polymorphisms (G-1102A) lay within a consensus recognition site for the AP1 transcription factor. There was a significant association between the G-1102A genotype and BMD at the lumbar spine ( P = 0.01) and femoral neck ( P = 0.03). The association remained significant after correcting for age, weight, height, menopausal status/HRT use and smoking ( P = 0.008 for spine BMD and P = 0.03 for hip BMD), and homozygotes for the -1100 "G" allele had BMD values significantly higher than individuals who carried the -1100 "A" allele at both spine ( P = 0.007) and hip ( P = 0.047). Subgroup analysis showed that the association between G-1102A and BMD was restricted to premenopausal women who comprised 50.6% of the study group. None of the other polymorphisms or haplotypes were significantly associated with BMD in the study group as a whole or in any subgroup. Functional studies will need to be performed to determine the mechanisms that underlie this association, but we conclude that, in this relatively large population, allelic variation at the G-1102A site of TCIRG1 accounts for part of the heritable component of BMD in Scottish women, possibly by affecting peak bone mass.
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Affiliation(s)
- C Sobacchi
- Instituto di Tecnologie Biomediche, CNR, Via Fratelli Cervi, 93, 20090 Segrate, Milano, Italy
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Minari R, Poletti F, Salsi P, Frattini A, Cortellini P. Coinvolgimento Ureterale Bilaterale Nella Sindrome di Churg-Strauss: Descrizione di un Nuovo Caso. Urologia 2004. [DOI: 10.1177/039156030407100116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report a case of Churg-Strauss syndrome, with bilateral ureteral involvement. We describe the endourological approach to the disease and we also discuss the literature about this argument.
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Affiliation(s)
- R. Minari
- Unità Operativa di Urologia, Azienda Ospedaliera di Parma
| | - F. Poletti
- Unità Operativa di Urologia, Azienda Ospedaliera di Parma
| | - P. Salsi
- Unità Operativa di Urologia, Azienda Ospedaliera di Parma
| | - A. Frattini
- Unità Operativa di Urologia, Azienda Ospedaliera di Parma
| | - P. Cortellini
- Unità Operativa di Urologia, Azienda Ospedaliera di Parma
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47
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Barbieri A, Simonazzi M, Marcato C, Larini P, Barbagallo M, Frattini A, Cortellini P. Massive hematuria after transurethral resection of the prostate: management by intra-arterial embolization. Urol Int 2003; 69:318-20. [PMID: 12444292 DOI: 10.1159/000066115] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A case of severe hemorrhage after TURP leading to hypovolemic shock and its successful management by superselective unilateral arterial embolization is described. The authors conclude that arterial embolization is a safe and effective procedure for severe prostatic hemorrhage that may be performed in selected cases when conservative means or fulguration of the prostatic fossa have failed to achieve the control of the bleeding. Adequate selection of the patients, correction of any underlying coagulation defects and a proper resection technique are surely the most important issues in preventing any postoperative bleeding.
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Affiliation(s)
- Antonio Barbieri
- Division of Urology, City Hospital of Parma, University of Parma, Italy.
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48
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Ferrari L, Meschi M, Musini S, Frattini A, Savazzi GM. [Etiopathogenesis and clinical aspects of nephrolithiasis--at present]. Recenti Prog Med 2003; 94:136-41. [PMID: 12677782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
This paper deals of kidney stones, hard concretions that grow within the urinary tract, 71.5% of which have calcium contents. A high rate of recurrences underscores the importance of medical prevention with a variety of conservative (increased fluid intake and dietary modifications) and drug therapy (potassium citrate, potassium magnesium citrate, thiazides, allopurinol). In single stone formers and mild recurrent diseases, the conservative therapy may alone be effective and should be maintained in more severe recurrent disease, together with drug treatment. In particular, in idiopathic calcium oxalate nephrolithiasis, the importance of sodium restriction in the diet, that should reduce calcium excretion, has been recently shown, limiting the old assumption of the value of dietary calcium restriction; in fact normal or higher calcium intake, binding oxalate in the intestinal tract, seems to confer protection against stone formation. The urologic approach to urolithiasis has changed with the introduction of extracorporeal shock wave lithotripsy (ESWL), a technique that allows a relatively noninvasive removal of stones. Nevertheless ESWL does not change the propensity of recurrence of stone formers, and the importance of medical prevention remains paramount in the management of renal stone disease.
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Affiliation(s)
- Lorenza Ferrari
- Dipartimento di Clinica Medica, Nefrologia e Scienze della Prevenzione, Università degli Studi di Parma
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Frattini A, Barbieri A, Salsi P, Sebastio N, Ferretti S, Bergamaschi E, Cortellini P. One shot: a novel method to dilate the nephrostomy access for percutaneous lithotripsy. J Endourol 2001; 15:919-23. [PMID: 11769847 DOI: 10.1089/089277901753284143] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND PURPOSE The creation of the nephrostomy access is a fundamental step of percutaneous nephrolithotripsy (PCNL). Dilation of the track is usually achieved with multiple incremental flexible exchange dilators of the Amplatz type, metal telescoping dilators of the Alken type, or a balloon. Currently, balloon dilation is regarded as the most modern and safest system, though it has the disadvantage of relatively high cost. The aim of this study was to demonstrate that a procedure that we named "one shot," which consists of a single dilation of the track with a 25F or 30F Amplatz dilator, compares favorably in terms of efficacy, costs, and length with the other techniques of track dilation, without a significant increase in morbidity. PATIENTS AND METHODS Seventy-eight consecutive patients who underwent PCNL for stone disease from June 1998 to July 1999 were considered and divided into three groups according to the type of tract dilation used: A (Alken telescoping dilators), B (balloon), or C (one shot). Radiologic exposure, blood loss, and costs were evaluated. RESULTS The one-shot procedure compared favorably with both of the other dilation techniques without an increase in morbidity and with significant reductions in X-ray exposure and costs. Indeed, significant differences in estimated blood loss were observed between groups B and C and the minor bleeding for group C. CONCLUSION Our experience indicates that one-shot dilation is feasible in the majority of patients. It is as safe and effective as the technique regarded today as the gold standard but less time consuming and less expensive. These encouraging results should be confirmed by further studies.
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Affiliation(s)
- A Frattini
- Division of Urology, Hospital of Parma, Italy.
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Sobacchi C, Frattini A, Orchard P, Porras O, Tezcan I, Andolina M, Babul-Hirji R, Baric I, Canham N, Chitayat D, Dupuis-Girod S, Ellis I, Etzioni A, Fasth A, Fisher A, Gerritsen B, Gulino V, Horwitz E, Klamroth V, Lanino E, Mirolo M, Musio A, Matthijs G, Nonomaya S, Notarangelo LD, Ochs HD, Superti Furga A, Valiaho J, van Hove JL, Vihinen M, Vujic D, Vezzoni P, Villa A. The mutational spectrum of human malignant autosomal recessive osteopetrosis. Hum Mol Genet 2001; 10:1767-73. [PMID: 11532986 DOI: 10.1093/hmg/10.17.1767] [Citation(s) in RCA: 174] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Human malignant infantile osteopetrosis (arOP; MIM 259700) is a genetically heterogeneous autosomal recessive disorder of bone metabolism, which, if untreated, has a fatal outcome. Our group, as well as others, have recently identified mutations in the ATP6i (TCIRG1) gene, encoding the a3 subunit of the vacuolar proton pump, which mediates the acidification of the bone/osteoclast interface, are responsible for a subset of this condition. By sequencing the ATP6i gene in arOP patients from 44 unrelated families with a worldwide distribution we have now established that ATP6i mutations are responsible for approximately 50% of patients affected by this disease. The vast majority of these mutations (40 out of 42 alleles, including seven deletions, two insertions, 10 nonsense substitutions and 21 mutations in splice sites) are predicted to cause severe abnormalities in the protein product and are likely to represent null alleles. In addition, we have also analysed nine unrelated arOP patients from Costa Rica, where this disease is apparently much more frequent than elsewhere. All nine Costa Rican patients bore either or both of two missense mutations (G405R and R444L) in amino acid residues which are evolutionarily conserved from yeast to humans. The identification of ATP6i gene mutations in two families allowed us for the first time to perform prenatal diagnosis: both fetuses were predicted not to be affected and two healthy babies were born. This study contributes to the determination of genetic heterogeneity of arOP and allows further delineation of the other genetic defects causing this severe condition.
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Affiliation(s)
- C Sobacchi
- Department of Human Genome and Multifactorial Disease, Istituto di Tecnologie, Biomediche Avanzate, Consiglio Nazionale delle Ricerche, via Fratelli Cervi 93, 20090 Segrate (MI), Italy
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