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Canale V, Sciarra A, Frisenda M, Scarrone E, Viscuso P, Rosati D, Moriconi M, Bevilacqua G, Di Pierro G, Gentilucci A, Cattarino S, Busetto G, Carrieri G, Cormio L, Carbone A, Pastore A, De Nunzio C, Tubaro A, Salciccia S, Leonardo C, Franco G, De Berardinis E, Panebianco V. Predictive role of node-rads score in patients with prostate cancer candidates for radical prostatectomy with extended lymph node dissection: comparative analysis with validated nomograms. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01170-3] [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: 11/05/2022] Open
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Proietti F, Licari LC, Flammia RS, Bologna E, Palombi V, Scarrone E, Tufano A, De Nunzio C, Leonardo C. Pregnancy after sexuality preserving cystectomy with urinary diversion for bladder cancer: case report and review of the literature. BMC Urol 2022; 22:143. [PMID: 36064399 PMCID: PMC9442980 DOI: 10.1186/s12894-022-01076-7] [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] [Received: 12/28/2021] [Accepted: 07/06/2022] [Indexed: 11/29/2022] Open
Abstract
Background Radical cystectomy for bladder cancer represents a high demolitive surgical procedure with a significative impact on quality of life. Sexuality preserving techniques have been proposed in order to improve functional outcomes. Although sex-sparing techniques would provide women with the chance of having pregnancy, experience is still limited when malignant conditions are considered. We report the outcomes of pregnancy and delivery in a 43-year-old woman with a Padua ileal orthotopic neobladder after robot-assisted sexuality preserving cystectomy for muscle-invasive urothelial bladder cancer performed four years earlier, at age 39. Case presentation Since pregnancy was confirmed, the patient had been under close urological and gynecological observation. Hydronephrosis and voiding-relating complications were reported and treated by inserting a nephrostomy tubes and indwelling bladder catheter. At the time of delivery, elective caesarian section was performed without complications. Conclusions Sexuality preserving cystectomy could be an option in selected and highly motivated young patients with diagnosis of bladder cancer. A multidisciplinary team of experts included gynecologists, urologists, radiologists, anesthesiologists and neonatologists is required for the optimal management of pregnancy and peripartum care in women with urinary diversion.
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Affiliation(s)
- Flavia Proietti
- Unit of Urology - Policlinico Umberto I, Department of Maternal-Infant and Urological Sciences, La Sapienza University of Rome, Rome, Italy.
| | - Leslie Claire Licari
- Unit of Urology - Policlinico Umberto I, Department of Maternal-Infant and Urological Sciences, La Sapienza University of Rome, Rome, Italy
| | - Rocco Simone Flammia
- Unit of Urology - Policlinico Umberto I, Department of Maternal-Infant and Urological Sciences, La Sapienza University of Rome, Rome, Italy
| | - Eugenio Bologna
- Unit of Urology - Policlinico Umberto I, Department of Maternal-Infant and Urological Sciences, La Sapienza University of Rome, Rome, Italy
| | - Veronica Palombi
- Unit of Urology - Policlinico Umberto I, Department of Maternal-Infant and Urological Sciences, La Sapienza University of Rome, Rome, Italy
| | - Emiliano Scarrone
- Unit of Urology - Policlinico Umberto I, Department of Maternal-Infant and Urological Sciences, La Sapienza University of Rome, Rome, Italy
| | - Antonio Tufano
- Unit of Urology - Policlinico Umberto I, Department of Maternal-Infant and Urological Sciences, La Sapienza University of Rome, Rome, Italy
| | - Cosimo De Nunzio
- Department of Urology - Sant'Andrea Hospital, La Sapienza University of Rome, Rome, Italy
| | - Costantino Leonardo
- Unit of Urology - Policlinico Umberto I, Department of Maternal-Infant and Urological Sciences, La Sapienza University of Rome, Rome, Italy
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Maggi M, Rosati D, Viscuso P, Canale V, Frisenda M, Catuzzi R, Moriconi M, Asero V, Scarrone E, Carbone A, Pastore A, Fuschi A, Di Pierro G, Busetto G, De Berardinis E, Ricciuti G, Panebianco V, Magliocca F, Del Giudice F, Chung B, Sciarra A, Salciccia S. The influence of operative time and blood loss on surgical margins and functional outcomes at laparoscopic versus robotic-assisted radical prostatectomy: A prospective multicenter study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01243-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: 11/04/2022]
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Salciccia S, Rosati D, Viscuso P, Canale V, Scarrone E, Frisenda M, Catuzzi R, Moriconi M, Asero V, Signore S, De Dominicis M, Emiliozzi P, Carbone A, Pastore AL, Fuschi A, Di Pierro GB, Gentilucci A, Cattarino S, Mariotti G, Busetto GM, Ferro M, De Berardinis E, Ricciuti GP, Panebianco V, Magliocca FM, Del Giudice F, Maggi M, Sciarra A. Influence of operative time and blood loss on surgical margins and functional outcomes for laparoscopic versus robotic-assisted radical prostatectomy: a prospective analysis. Cent European J Urol 2022; 74:503-515. [PMID: 35083069 PMCID: PMC8771133 DOI: 10.5173/ceju.2021.0177] [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] [Received: 07/03/2021] [Revised: 08/22/2021] [Accepted: 11/06/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction The aim of this article was to analyze whether operative time and blood loss during radical prostatectomy (RP) can significantly influence surgical margins (SM) status and post-operative functional outcomes. Material and methods We prospectively analyzed prostate cancer (PC) patients undergoing RP, using robot-assisted (RARP) or laparoscopic (LRP) procedures. Blood loss was defined using the variation in hemoglobin (Hb, g/dl) values from the day before surgery and no later than 4 hours after surgery. Results From a whole population of 413 cases considered for RP, 67% underwent LRP and 33.0% RARP. Positive SM (SM+) were found in 33.9% of cases. Mean surgical operative time was 172.3 ±76 min (range 49–485), whereas blood loss was 2.3 ±1.2 g/dl (range 0.3–7.6). Operative time and blood loss at RP were not significantly correlated (r = -0.028275; p = 0.684). SM+ rates significantly (p = 0.002) varied by operative time; a higher SM+ rate was found in cases with an operative time <120 min (41.2%) and >240 min (53.4%). The risk of SM+ significantly increased 1.70 and 1.94 times in cases with an operative time <120 min and >240 min, respectively, independently to the surgical approach. The rate of erectile disfunction (ED) varied from 22.4% to 60.3% between <120 min and >240 min procedures (p = 0.001). According to blood loss, SM+ rates slightly but significantly (p = 0.032) varied; a higher rate of SM+ was found in cases with a Hb variation between 2–4 g/dl (35.9%). Conclusions Independently to the surgical approach, operative time, more than blood loss at RP, represents a significant variable able to influence SM status and post-operative ED.
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Affiliation(s)
- Stefano Salciccia
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Davide Rosati
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Pietro Viscuso
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Vittorio Canale
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Emiliano Scarrone
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Marco Frisenda
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Roberta Catuzzi
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Martina Moriconi
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Vincenzo Asero
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Stefano Signore
- Department of Urology, S. Eugenio Hospital, ASL Rome 2, Rome, Italy
| | | | - Paolo Emiliozzi
- Department of Urology, San Camillo Forlanini Hospital, Rome, Italy
| | - Antonio Carbone
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza Rome University, Polo Pontino, Latina, Italy
| | - Antonio Luigi Pastore
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza Rome University, Polo Pontino, Latina, Italy
| | - Andrea Fuschi
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza Rome University, Polo Pontino, Latina, Italy
| | - Giovanni Battista Di Pierro
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | | | | | - Gianna Mariotti
- Department of Urology, University Sapienza Rome, Rome, Italy
| | - Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, Foggia, Italy
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology (IEO) IRCCS, Milan, Italy
| | - Ettore De Berardinis
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Gian Piero Ricciuti
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Valeria Panebianco
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Fabio Massimo Magliocca
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Francesco Del Giudice
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Martina Maggi
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Alessandro Sciarra
- Department of Maternal-Infant and Urological Sciences, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
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