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Background: Prostate cancer is the most commonly diagnosed neoplasm in men. From the introduction of PSA testing, an increasing number of men undergoes prostate biopsy (PBX). While the physical side effects of PBx have been well investigated, its psychological impact has been under-evaluated. Aim: The aim of our study is to investigate the presence of psychological distress (anxiety and depression) in patients waiting for histopathological results after prostate biopsy (PBx). Methods: From February to April 2019, 51 consecutive patients undergoing prostate biopsies at our institution were included. Age, PSA, DRE, familiarity for prostate cancer, number of previous biopsies, type of anesthesia, number of cores were recorded. All patients filled the Hospital Anxiety and Depression Scale (HADS), a psychometric Likert-scale questionnaire, before receiving the histopathological results of their PBx. Results: The prevalence of psychological distress among patients awaiting histopathologic results is 41% (21/51 patients), with anxiety being the main component of their distress. On multivariate analysis, PSA, family history, and repeat biopsy were significantly associated with anxiety and depression. Conclusion: Patients undergoing PBx experience a burden of psychological distress waiting for histopathologic results, especially anxiety. Appropriate counseling should be offered to patients at high risk of developing psychological distress after PBx. Future goals would include technological improvements to shorten the time between biopsy and definitive results. [ABSTRACT FROM AUTHOR]

Introduction and aim: The urodynamic study is an invasive examination that allows a thorough evaluation of the functional activity of the lower urinary tract (bladder, urethra). The execution of urodynamic study exposes the patient to the risk of contracting infections of the lower urinary tract. Prevention of urinary tract infections consists in the avoidance of risk factors and prophylaxis with antimicrobial and non-antimicrobial measures. In this article, we aimed to evaluate the effectiveness of a phytotherapeutic product composed of D-mannose, Hibiscus sabdariffa, and Lactobacillus plantarum in the prevention of infectious events following invasive urodynamic examination. Materials and methods: We selected 100 female consecutive patients (age 19–87 years) that underwent urodynamic invasive procedure. We prescribed 14-day therapy with D-mannose, H. sabdariffa, and L. plantarum to these 100 patients after urodynamic invasive test. After that, we have examined urine cultures and urinary symptoms through telephone interviews and hospital outpatient visits to evaluate the possible presence of urinary tract infections. Results: Urinary tract infections were observed through urine culture in 13% of the selected patients; of the 13 urinary tract infections, 9 were observed in patients with urinary tract recurrent infections in the last year and the other 4 cases were associated with patients with no urinary infection in the last year. Three women reported some urinary symptoms and underwent antibiotic therapy. The other 10 cases were classified as asymptomatic bacteriuria. Three cases were related to patients presenting with pelvic organ prolapse. Eight cases were instead related to significant post-voiding residue (>100). Six patients with urinary tract infection reported constipation in the last year. All patients completed the prescribed therapy due to the affordable price of the product and no side effects have been reported. Conclusion: Our study about the administration of D-mannose, H. sabdariffa, and L. plantarum after invasive urodynamic examination underlined how this phytotherapeutic product can reduce the risk of bacteriuria and urinary tract infection in women. [ABSTRACT FROM AUTHOR]

Introduction: Two cases of severe ureteral obstruction following nonspecific, postinfectious, chronic retroperitoneal fibrosis are described, which both originated by a primitive intestinal pathology. Patients: This complication was observed in two women: first, 65 years old, submitted for ulcerative colitis to a total proctocolectomy, with ileo-pouch-anal anastomosis, complicated by an anastomotic fistula; and second, 66 years old, operated with an extended left hemicolectomy, for an adenocarcinoma of the recto-sigmoid colon complicated with a vaginal fistula. In these cases, computerized tomography demonstrated a unilateral hydronephrosis, secondary to a complete obstruction of the ureter; a subsequent nephro-ureterectomy became necessary. Histology demonstrated nonspecific inflammatory lesions. Discussions: Postinfectious, chronic inflammation of the retroperitoneum acts on the ureteral and peri-ureteral tissues, inducing an inflammatory and then a fibrotic process. Conclusions: We underline the opportunity of a precocious and radical treatment of every retroperitoneal infection. [ABSTRACT FROM AUTHOR]

Percutaneous nephrolithotomy (PCNL) is an endourological technique for the treatment of kidney stones. Its goal is their complete clearance via percutaneous access. The technique as we know it today was developed by Johansson and Fernstrom in 1976. They used the technological advances in percutaneous fluoroscopy of the time to obtain percutaneous access. Following the application of various sources of energy (including ultrasound) for the fragmentation of calculi, PCNL gained worldwide acclaim thanks to Alken and Marbergen in Europe and Segura and Clayman in the US. Although in the early 1980s PCNL lost the initial momentum in favor of shock wave lithotripsy, it had a revival in the 1990s as a result of the application of emerging technologies such as computed tomography, new percutaneous access techniques, flexible instrumentation, laser energy and, more recently, robotic surgery and virtual reality. All of these have contributed to steering PCNL towards mini-invasiveness, culminating in the development of microperc. Microperc allows the treatment of calculi as large as 2 cm, obtaining access under ultrasound, fluoroscopy and direct vision guidance. A complete system comprising micro-optics, laser fiber and irrigation is then inserted into a needle with a diameter of 4.85, 8 or 10 Fr . The Clinical Research Office of the Endourological Society (CROES) has made use of the logistic developments to create a global network and a multicenter database. The PCNL study, which was concluded in 2009, has led to the publication of as many as 27 scientific papers on the subject. [ABSTRACT FROM AUTHOR]