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Patelli G, Altieri VM, Ierardi AM, Carnevale A, Chizzoli F, Baronchelli G, Trimarchi R, Carrafiello G. Transperineal Laser Ablation of the Prostate for Symptomatic Benign Prostatic Hyperplasia: Long-Term Follow-Up in 40 Patients. J Vasc Interv Radiol 2024:S1051-0443(24)00326-9. [PMID: 38705571 DOI: 10.1016/j.jvir.2024.04.023] [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: 10/10/2023] [Revised: 04/09/2024] [Accepted: 04/25/2024] [Indexed: 05/07/2024] Open
Abstract
PURPOSE To evaluate the long-term efficacy and safety of proprietary transperineal laser ablation (TPLA) of the prostate. MATERIALS AND METHODS Patients with symptomatic benign prostatic hyperplasia underwent TPLA with a 1064-nm continuous-wave diode laser. IPSS, QoL, PVR and prostate volume were evaluated at baseline and successive timepoints. RESULTS Forty prospectively enrolled patients had post-TPLA follow-up of ≥ 36 months. Median duration of follow-up was 56.5 months (range: 36-76 months). Compared with baseline, the median reduction in IPSS at 12-month follow-up was 74% (interquartile range [IQR]: 60-81%) (P < .001). Median QoL score at 12 months was improved from 5 (IQR: 4-5) at baseline to 1 (IQR: 0-1) (P < .001). Median PVR at 12 months decreased from 108 mL (IQR: 38-178 mL) to 13.5 mL (IQR: 0-40.5 mL) (P < .001), a median reduction of 88% (IQR: 61-100%). At 12 months, median prostate volume was significantly reduced from 66 mL (IQR: 48.5-86.5 mL) to 46 mL (IQR 36-65 mL) (P < .001), a median reduction of 32% (IQR: 21-45%). For all of these parameters, the benefit of TPLA persisted at last follow-up and all changes were statistically significant vs baseline. There were no intraoperative adverse events; perioperative adverse events consisted of one case of prostatitis and one case of urinary tract infection (both mild according to the modified SIR classification system). CONCLUSION TPLA for symptomatic BPH produced durable benefits across a range of clinical outcomes and was well tolerated in 56.5 months median duration follow-up.
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Affiliation(s)
| | - Vincenzo Maria Altieri
- Urology Department, Humanitas Gavazzeni, Bergamo, Italy - Università degli Studi del Molise
| | - Anna Maria Ierardi
- Radiology Department, Università Statale degli Studi Di Milano, IRCCS Policlinico, Milano, Italy
| | - Aldo Carnevale
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | | | | | | | - Gianpaolo Carrafiello
- Radiology Department, Università Statale degli Studi Di Milano, IRCCS Policlinico, Milano, Italy
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Marino C, Iaconis S, Di Bello F, Cacace G, Fusco G, Romano L, Di Mauro E, Cirillo L, Altieri VM, Mastrangelo F, Napolitano L, Palmieri A. Iron homeostasis alterations and erectile dysfunction: A new issue in erectile disfunction treatment? Arch Ital Urol Androl 2024; 96:12245. [PMID: 38363230 DOI: 10.4081/aiua.2024.12245] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 01/13/2024] [Indexed: 02/17/2024] Open
Abstract
To the Editor, Erectile dysfunction (ED) is one of the most prevalent conditions affecting men globally, with significant psychological and social consequences. The prevalence varies across different populations, and it is estimated around 50% in men aged between 40 to 70. The etiology of ED is multifactorial, involving a complex crosstalk between psychological, hormonal, neurogenic, vascular, and structural factors [...].
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Affiliation(s)
- Claudio Marino
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples.
| | - Salvatore Iaconis
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples.
| | - Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples.
| | - Gianluigi Cacace
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples.
| | - Giovanni Fusco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples.
| | - Lorenzo Romano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples.
| | - Ernesto Di Mauro
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples.
| | - Luigi Cirillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples.
| | - Vincenzo Maria Altieri
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso; Department of Urology, Humanitas Gavazzeni, Bergamo.
| | - Francesco Mastrangelo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples.
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples.
| | - Alessandro Palmieri
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples.
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Ditonno F, Franco A, Manfredi C, Fasanella D, Abate M, La Rocca R, Crocerossa F, Iossa V, Falagario UG, Cirillo L, Altieri VM, Di Mauro E, Crocetto F, Barone B, Cilio S, Pandolfo SD, Aveta A, Mirone V, Franzese CA, Arcaniolo D, Napolitano L. The Role of miRNA in Testicular Cancer: Current Insights and Future Perspectives. Medicina (Kaunas) 2023; 59:2033. [PMID: 38004082 PMCID: PMC10672751 DOI: 10.3390/medicina59112033] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/09/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Despite advancements in the diagnosis and treatment of testicular germ cell tumours (TGTCs), challenges persist in identifying reliable biomarkers for early detection and precise disease management. This narrative review addresses the role of microRNAs (miRNAs) as potential diagnostic tools and therapeutic targets in the treatment of TGCTs. Materials and Methods: Three databases (PubMed®, Web of Science™, and Scopus®) were queried for studies investigating the utility of miRNA as diagnostic tools, assessing their prognostic significance, and evaluating their potential to guide TGCT treatment. Different combinations of the following keywords were used, according to a free-text protocol: "miRNA", "non-coding RNA", "small RNA", "Testicular Cancer", "seminomatous testicular germ cell", "non-seminomatous testicular germ cell". Results: The potential of miRNAs as possible biomarkers for a non-invasive diagnosis of TGCT is appealing. Their integration into the diagnostic pathway for TGCT patients holds the potential to enhance the discriminative power of conventional serum tumour markers (STMs) and could expedite early diagnosis, given that miRNA overexpression was observed in 50% of GCNIS cases. Among miRNAs, miR-371a-3p stands out with the most promising evidence, suggesting its relevance in the primary diagnosis of TGCT, particularly when conventional STMs offer limited value. Indeed, it demonstrated high specificity (90-99%) and sensitivity (84-89%), with good positive predictive value (97.2%) and negative predictive value (82.7%). Furthermore, a direct relationship between miRNA concentration, disease burden, and treatment response exists, regardless of disease stages. The initial evidence of miRNA decrease in response to surgical treatment and systemic chemotherapy has been further supported by more recent results suggesting the potential utility of this tool not only in evaluating treatment response but also in monitoring residual disease and predicting disease relapse. Conclusions: MiRNAs could represent a reliable tool for accurate diagnosis and disease monitoring in the treatment of TGCT, providing more precise tools for early detection and treatment stratification. Nevertheless, well-designed clinical trials and comprehensive long-term data are needed to ensure their translation into effective clinical tools.
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Affiliation(s)
- Francesco Ditonno
- Department of Urology, Rush University Medical Center, Chicago, IL 60612-3833, USA
- Department of Urology, University of Verona, 37126 Verona, Italy
| | - Antonio Franco
- Department of Urology, Rush University Medical Center, Chicago, IL 60612-3833, USA
- Department of Urology, Sant'Andrea Hospital, La Sapienza University, 00189 Rome, Italy
| | - Celeste Manfredi
- Department of Urology, Rush University Medical Center, Chicago, IL 60612-3833, USA
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, "Luigi Vanvitelli" University, 81100 Naples, Italy
| | - Daniela Fasanella
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Marco Abate
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Roberto La Rocca
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
| | - Vincenzo Iossa
- Department of Andrology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Ugo Giovanni Falagario
- Department of Urology and Organ Transplantation, University of Foggia, 71122 Foggia, Italy
| | - Luigi Cirillo
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Vincenzo Maria Altieri
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100 Campobasso, Italy
- Department of Urology, Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Ernesto Di Mauro
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Felice Crocetto
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Biagio Barone
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Simone Cilio
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Savio Domenico Pandolfo
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Achille Aveta
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Vincenzo Mirone
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | | | - Davide Arcaniolo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, "Luigi Vanvitelli" University, 81100 Naples, Italy
| | - Luigi Napolitano
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
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Altieri VM, Greco F, Lisanti RC, Altieri B, Esperto F, Cindolo L, Castellucci R, Della Camera PA, Sangiorgi GM, Verratti V. Clinical and penile Doppler outcomes using a modified, tourniquet free, Nesbit plication for severe Peyronie's disease. Transl Androl Urol 2021; 10:2857-2870. [PMID: 34430388 PMCID: PMC8350228 DOI: 10.21037/tau-20-1338] [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: 10/13/2020] [Accepted: 05/10/2021] [Indexed: 11/21/2022] Open
Abstract
Background Penile curvature (PC) can be surgically corrected by plication techniques or Nesbit corporoplasty. These shortening techniques can be complicated by post-operative: penile shortening, recurrent PC, palpable suture knots and erectile dysfunction. Furthermore, Nesbit procedures require the use of a penile tourniquet to avoid intraoperative bleeding. This observational study aims to assess the results of Nesbit modified corporoplasty, avoiding intraoperative use of tourniquet without risk of bleeding. The objective is to reduce penile ischemic anatomical and functional damages such as long-term erectile dysfunction. Methods Between January 2010 and March 2019, a total of 64 patients with congenital penile curvature (CPC) and Peyronie’s disease (PD) underwent surgical correction with a Nesbit modified technique first time described by Rolle et al., with minimal technical differences. The operation notes were retrospectively reviewed. In particular, we evaluated pre- and post-operative erectile functions using IIEF-5 score, penile Doppler ultrasonography and overall patient satisfaction. Results During operations, no intraoperative bleeding was noted, and no short-term complications such as hematomas or neurovascular bundle lesions were reported. At 6 months, no palpable subcutaneous indurations and no sensory change were detected. Post-operative penile shortening was reported in 38 (59.4%) patients (mean 0.83±0.79 cm), but it did not influence the high overall satisfaction rate of 91.4%. Only 2 patients reported a slightly partial recurrence of curvature (<15%) with no need for a redo surgery. Mean IIEF-5 score increased from 17.1±5.2 to 20.8±3.9 at 6 months and 21.8±3.4 at 12 months (P<0.001 in both cases). Mean PSV also significantly increased at the end of follow-up (28.5±6.1 at baseline vs. 31.0±7.1 at 12 months, P=0.03). Conclusions Considering the optimal results in terms of erectile functions increasing and absence of PC recurrence (>15°), we think that Nesbit modified corporoplasty without tourniquet application during reconstruction is a safe and effective surgical procedure for all kind of shortening corporoplasty to reduce the time of penile ischemia, preventing even serious consequences for the normal physiology of erection.
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Affiliation(s)
| | | | | | - Barbara Altieri
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | - Francesco Esperto
- Department of Urology, Campus Biomedico, University of Rome, Rome, Italy
| | - Luca Cindolo
- Department of Urology, "Villa Stuart" Private Hospital, Rome, Italy
| | | | | | | | - Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, 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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Verratti V, Bondi D, Shakir A, Pietrangelo T, Piccinelli R, Altieri VM, Migliorelli D, Tafuri A. Uroflowmetry and Altitude Hypoxia: A Report from Healthy Italian Trekkers and Nepali Porters During Himalayan Expedition. Adv Exp Med Biol 2020; 1289:99-105. [PMID: 32648247 DOI: 10.1007/5584_2020_543] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Hypoxia alters micturition, which influences bladder function by involving different neurological and humoral systems. In this study we assessed the mid-term effects of altitude hypoxia on uroflowmetry in healthy male lowlander native Nepali porters and Italian trekkers, four each, who coattended a Himalayan expedition. All the participants completed a 19-day trek along a demanding route with ascent and descent at the Kanchenjunga Mountain. They underwent micturition and urodynamic analysis twice, at low altitude of 665 m a.s.l. and high altitude of 4,750 m a.s.l. Statistical comparisons considered the altitude effects (low vs. high) and ethnicity (Italian vs. Nepali). Food consumption was recorded, and water and energy intake were calculated. We found trends of borderline significance in the mean urinary flow rate (Qmean) (p = 0.058; effect size η2 p = 0.478) and in Qmax to the advantage of the Nepali. There was no evidence of differences when comparing time to Qmax and urine volume at Qmax and Qmean for altitude or altitude × ethnicity. In addition, there was a lonely female participant, who, analyzed as a case report, showed increased Qmean at high altitude. Older age mitigated while energy intake potentiated the ethnic differences noted in uroflowmetry. We conclude that altitude hypoxia rather inappreciably affects micturition in healthy men. However, a trend for possible ethnic differences raises worthy of note perspectives on adaptive ability of micturition. Also, dietary intake and age should be considered as confounding elements when evaluating micturition.
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Affiliation(s)
- Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
| | - Danilo Bondi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Aliasger Shakir
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Tiziana Pietrangelo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Raffaela Piccinelli
- Research Center for Food and Nutrition, Council for Agricultural Research and Economics, Rome, Italy
| | | | | | - Alessandro Tafuri
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.,USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA.,Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
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Della Camera PA, Tellini R, Cito G, Rastrelli G, Maggi M, Chini T, Nunzio CD, Altieri VM, Serni S, Gacci M, Natali A. Efficacy and safety of avanafil 200 mg versus sildenafil 100 mg in the treatment of erectile dysfunction after robot-assisted unilateral nerve-sparing prostatectomy: A prospective multicentre study. Urologia 2019; 87:23-28. [PMID: 31441379 DOI: 10.1177/0391560319867809] [Citation(s) in RCA: 4] [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] [Indexed: 11/16/2022]
Abstract
Phosphodiesterase type 5 inhibitors represent the standard treatment of erectile dysfunction after nerve-sparing prostatectomy. Avanafil is a second-generation phosphodiesterase type 5 inhibitor with a high selectivity for phosphodiesterase type 5 isoform. To date, there are no studies comparing the outcomes of avanafil versus sildenafil in this scenario. In this study, we evaluated the efficacy and safety of avanafil versus sildenafil as a drug for post-prostatectomy rehabilitation. Overall, 160 patients submitted to robot-assisted nerve-sparing prostatectomy for localized prostate cancer at three hospitals were enrolled for the present study. After 6 months of treatment, patients in the two groups showed no significantly different sexual function scores, except for the Erection Hardness Score and Sexual Encounter Profile-Q2 that were higher in the Sildenafil group. Adverse events in the Avanafil group occurred in four (5%) patients and in 16 (20%) patients in the Sildenafil group. According to our experience, in patients undergoing nerve-sparing prostatectomy, penile rehabilitation with avanafil compared to sildenafil showed a lower ability to produce a valid erection in the initial phase of sexual intercourse, a difference that disappears in the continuation of the same. Avanafil showed a greater tolerance profile with a lower rate of AEs and discontinuation of therapy due to AEs.
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Affiliation(s)
| | - Riccardo Tellini
- Department of Urology, University of Florence, Careggi University Hospital, Florence, Italy
| | - Gianmartin Cito
- Department of Urology, University of Florence, Careggi University Hospital, Florence, Italy
| | - Giulia Rastrelli
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Tommaso Chini
- Department of Urology, University of Siena, Le Scotte Hospital, Siena, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital and Faculty of Health Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Sergio Serni
- Department of Urology, University of Florence, Careggi University Hospital, Florence, Italy
| | - Mauro Gacci
- Department of Urology, University of Florence, Careggi University Hospital, Florence, Italy
| | - Alessandro Natali
- Department of Urology, University of Florence, Careggi University Hospital, Florence, Italy
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Castellani D, Cindolo L, De Nunzio C, Di Rosa M, Greco F, Gasparri L, Altieri VM, Schips L, Tubaro A, Dellabella M. Comparison Between Thulium Laser VapoEnucleation and GreenLight Laser Photoselective Vaporization of the Prostate in Real-Life Setting: Propensity Score Analysis. Urology 2018; 121:147-152. [DOI: 10.1016/j.urology.2018.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/03/2018] [Accepted: 09/06/2018] [Indexed: 12/22/2022]
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Greco F, Pini G, Alba S, Altieri VM, Verze P, Mirone V. Minilaparoendoscopic Single-site Pyeloplasty: The Best Compromise Between Surgeon's Ergonomy and Patient's Cosmesis (IDEAL Phase 2a). Eur Urol Focus 2016; 2:319-326. [DOI: 10.1016/j.euf.2015.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 07/31/2015] [Accepted: 09/07/2015] [Indexed: 12/28/2022]
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10
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Castellucci R, Altieri VM, Marchioni M, Castellan P, Pellegrini M, Álvarez-Maestro M, Sánchez-Gómez J, De Francesco P, Ingrosso M, Tartaro A, Tenaglia RL. Magnetic resonance spectroscopic imaging 3T and prostate cancer: correlation with transperineal ultrasound guided prostate biopsy. ARCH ESP UROL 2015; 68:493-501. [PMID: 26102053] [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: 06/04/2023]
Abstract
OBJECTIVES The aim of our study was to correlate the results obtained by 3T Magnetic Resonance Spectroscopic Imaging (MRSI3T) with those obtained by histological examination of samples of the trans-perineal ultrasound-guided prostate biopsy (TPUS-B). METHODS 34 patients were enrolled in the study. All patients had a clinical suspicion of cancer due to increased PSA and/or positive digital rectal examination. Patients were subjected to an MRSI 3T examination and subsequently to TPUS-B. RESULTS Of the 22 (22/34) patients who presented abnormalities MRSI at 3T, 9 had a histological diagnosis of Prostate adenocarcinoma. Of the remaining 13 patients, 6 were found to be histologically positive for Benign Prostatic Hypertrophy and 7 Chronic Interstitial Inflammation or High Grade Prostatic Intraepithelial Neoplasia. 12 (12/34) patients found to have no peripheral alterations in their prostate on 3T MRSI, none were positive for ADK or inflammation on histology. The sensitivity, specificity, positive predictive value and negative predictive value were 100%, 48%, 40% and 100% respectively. DISCUSSION In this study, we correlated the values obtained from 3T MRSI with the results of histologically examined prostate biopsies. Our work shows that 72.8% of the voxels in which there was a change in ratio of Cit/(Cho + Cr), corresponded to areas of prostate tissue disease. Of these, 73.2% were positive for ADK and 26.8% for CII or HG PIN. In literature, it is noted that PCa can be distinguished from areas of benign tissue, in the peripheral zone, on the basis of the values of the ratio Cit/(Cho + Cr) (17), although some benign conditions, such as prostatitis or PINHG, can alter these values (18-19). CONCLUSIONS In conclusion, the use of MRSI 3T before performing prostate biopsies may represent a valid aid for the urologist in the diagnosis of PCa, allowing them to avoid unnecessary prostate biopsies that may be negative. Furthermore, it would also be possible to reduce the total number of biopsies, thus decreasing patient exposure to the unnecessary risks associated with biopsy.
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Affiliation(s)
| | | | | | - Pietro Castellan
- Department of Urology. Universita 'G. D'annunzio'. Chieti. Italy
| | | | | | | | | | - Manuela Ingrosso
- Department of Urology. Universita 'G. D'annunzio'. Chieti. Italy
| | - Armando Tartaro
- Department of Urology. Universita 'G. D'annunzio'. Chieti. Italy
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Springer C, Mohammed N, Alba S, Theil G, Altieri VM, Fornara P, Greco F. Laparoscopic radical cystectomy with extracorporeal ileal neobladder for muscle-invasive urothelial carcinoma of the bladder: technique and short-term outcomes. World J Urol 2013; 32:407-12. [PMID: 23817890 DOI: 10.1007/s00345-013-1122-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 06/21/2013] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To report the surgical outcomes of laparoscopic radical cystectomy (LRC) with extracorporeal orthotopic ileal neobladder (OIN) in patients with muscle-invasive urothelial carcinoma of the bladder (UCB). MATERIALS AND METHODS Between October 2009 and December 2011, 37 patients with muscle-invasive UCB underwent a LRC with OIN. Indications included (a) muscle-invasive UCB T2-4a, N0-Nx, M0; (b) high-risk and recurrent non-muscle-invasive tumors; (c) T1G3 plus CIS; and (d) extensive non-muscle-invasive disease that could not be controlled by transurethral resection and intravesical therapy. Demographic data, perioperative, and postoperative variables were recorded and analyzed. RESULTS The median operating time was 330 min, with a median estimated blood loss of 410 ml. Median length of stay was 12 days, and the mean length of the skin incision to extract the specimen and for the configuration of the neobladder was 7 ± 1 cm. The complication rate was 21.6 % (Clavien II). No Clavien III-V complications were reported. Daytime and nocturnal continence were preserved in 95 and 78 %, respectively. No local recurrence or port site metastasis occurred. Median time to disease recurrence was 14 months (IQR 9-24), and 1-year cancer-specific survival was 91.9 %. CONCLUSIONS Laparoscopic radical cystectomy with extracorporeal ileal neobladder is a challenging procedure but technically feasible, allowing low morbidity and oncological safety. Long-term oncological results are required to definitely recognize this procedure as a standard treatment for bladder cancer.
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Affiliation(s)
- Christopher Springer
- Department of Urology and Kidney Transplantation, Martin-Luther-University, Ernst-Grube-Strasse 40, 06120, Halle/Saale, Germany
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Altieri VM, Castellucci R, Palumbo P, Verratti V, Sut M, Olivieri R, Manco R, Ricciardulli S, Nicolai M, Criniti P, Tenaglia RL. Recurrence and Progression in Non-Muscle-Invasive Bladder Cancer Using EORTC Risk Tables. Urol Int 2012; 89:61-6. [DOI: 10.1159/000336516] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 01/16/2012] [Indexed: 11/19/2022]
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Altieri VM, Castellucci R, Zezza A, Manco R, Altieri B, Angelucci D, Tenaglia RL. Inverted papilloma of the upper urinary tract. Cent European J Urol 2010. [DOI: 10.5173/ceju.2010.02.art9] [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: 11/22/2022] Open
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