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1. Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

Author

Andrea Cocci, Marta Pezzoli, Fernando Bianco, Franco Blefari, Pierluigi Bove, Francois Cornud, Gaetano De Rienzo, Paolo Destefanis, Danilo Di Trapani, Alessandro Giacobbe, Luca Giovanessi, Antonino Laganà, Giovanni Lughezzani, Guglielmo Manenti, Gianluca Muto, Gianluigi Patelli, Novello Pinzi, Stefano Regusci, Giorgio I. Russo, Juan I.M. Salamanca, Matteo Salvi, Luigi Silvestri, Fabrizio Verweij, Eric Walser, Riccardo G. Bertolo, Valerio Iacovelli, Alessandro Bertaccini, Debora Marchiori, Hugo Davila, Pasquale Ditonno, Paolo Gontero, Gennaro Iapicca, Theo M De Reijke, Vito Ricapito, Pierluca Pellegrini, Andrea Minervini, Sergio Serni, and Francesco Sessa

Subjects
Transperineal laser ablation, Prostate cancer, Benign prostatic hyperplasia, Delphi consensus, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method. Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized. Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from 80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations. Conclusion: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes.

Published
2024
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2. Diagnostic and prognostic potential of the proteomic profiling of serum-derived extracellular vesicles in prostate cancer

Author

Michele Signore, Romina Alfonsi, Giulia Federici, Simona Nanni, Antonio Addario, Lucia Bertuccini, Aurora Aiello, Anna Laura Di Pace, Isabella Sperduti, Giovanni Muto, Alessandro Giacobbe, Devis Collura, Lidia Brunetto, Giuseppe Simone, Manuela Costantini, Lucio Crinò, Stefania Rossi, Claudio Tabolacci, Marco Diociaiuti, Tania Merlino, Michele Gallucci, Steno Sentinelli, Rocco Papalia, Ruggero De Maria, and Désirée Bonci

Subjects
Cytology, QH573-671
Abstract

Abstract Extracellular vesicles (EVs) and their cargo represent an intriguing source of cancer biomarkers for developing robust and sensitive molecular tests by liquid biopsy. Prostate cancer (PCa) is still one of the most frequent and deadly tumor in men and analysis of EVs from biological fluids of PCa patients has proven the feasibility and the unprecedented potential of such an approach. Here, we exploited an antibody-based proteomic technology, i.e. the Reverse-Phase Protein microArrays (RPPA), to measure key antigens and activated signaling in EVs isolated from sera of PCa patients. Notably, we found tumor-specific protein profiles associated with clinical settings as well as candidate markers for EV-based tumor diagnosis. Among others, PD-L1, ERG, Integrin-β5, Survivin, TGF-β, phosphorylated-TSC2 as well as partners of the MAP-kinase and mTOR pathways emerged as differentially expressed endpoints in tumor-derived EVs. In addition, the retrospective analysis of EVs from a 15-year follow-up cohort generated a protein signature with prognostic significance. Our results confirm that serum-derived EV cargo may be exploited to improve the current diagnostic procedures while providing potential prognostic and predictive information. The approach proposed here has been already applied to tumor entities other than PCa, thus proving its value in translational medicine and paving the way to innovative, clinically meaningful tools.

Published
2021
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3. Minimally Invasive Buccal Mucosa Dorsal Graft for Female Distal Urethroplasty

Author

Elisa Berdondini, Lorenzo Tosco, Andrea Margara, Alessandro Giacobbe, Devis Collura, Federico Germinale, Marisa Kurti, Gianluca Muto, and Giovanni Muto

Subjects
Urethral, Stricture, Female, Urethroplasty, Buccal mucosa, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Background: Female urethral stricture (FUS) represents a sporadic condition. There is a lack of data and standardized guidelines on diagnostics and therapeutics. Several surgical techniques have been described for FUS urethroplasty, among which the flap-based or graft-based ones are most reported. Buccal mucosa graft (BMG) represents the gold standard for male urethroplasty, and this can theoretically be applied also to FUS treatment. Objective: To describe and present preliminary results of a novel minimally invasive technique for buccal mucosa dorsal graft (mini-dorsal BMG) urethroplasty for the treatment of FUS. Design, setting, and participants: This is a retrospective study on buccal mucosa dorsal graft urethroplasty for the treatment of FUS. Surgical procedure: Every patient was placed in lithotomic position. Two stiches were placed at 10 and 2 o’clock positions to facilitate the dorsal median urethrotomy. The margins of the incised dorsal urethra at the 12 o’clock position are then dissected from the periurethral tissue. This dissection results in an elliptical raw area between the edges of the urethra over the periurethral tissue. The harvested BMG was fixed with several quilting sutures, using 5-0 and 4-0 absorbable sutures, to cover the raw area. The margins of the graft were sutured to the edges of the incised urethra. Measurements: A chart review was performed. Results and limitations: Thirteen patients underwent the mini-dorsal-BMG technique. The median preoperative uroflow was 5.6 (3–13) ml/s, and the median postoperative value was 23.4 (14–58) ml/s. Conclusions: The mini-dorsal-BMG technique for the treatment of FUS gives good results with low complication rates. Other series and long-term follow-up are necessary to confirm the reproducibility of this technique. Patient summary: We present the technical aspects and the promising preliminary results of a novel surgical technique for the treatment of female urethral stricture by using the buccal mucosa to correct this invalidating disease.

Published
2021
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6. Could We Safely Avoid a Second Resection in Selected Patients With T1 Non-Muscle-Invasive Bladder Cancer? Preliminary Results of Cost-Effectiveness Study From HUmanitas New Indications for ReTUR (HuNIRe) Multicenter Prospective Trial

Author

Roberto Contieri, Giovanni Lughezzani, Nicolò Maria Buffi, Gianluigi Taverna, Alessandro Giacobbe, Emanuele Micheli, Sabato Barra, Piergiuseppe Colombo, Elena Vanni, Giorgio Guazzoni, Massimo Lazzeri, Rodolfo Hurle, HuNIRe Study Group, Paolo Casale, Alberto Saita, Andrea Gobbo, Edoardo Beatrici, Pier Paolo Avolio, Alessandro Uleri, Marco Paciotti, Vittorio Fasulo, Nicola Frego, Davide Maffei, Pietro Diana, Matteo Zanoni, Luigi Domanico, Devis Collura, Maria Grazia Elefante, and Miriam Cieri

Subjects
second resection, outcome, cystoscopy, urine cytology, non-muscle-invasive bladder cancer, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

ObjectivesThe aim of this study is to assess whether restaging transurethral resection (ReTUR) could be safely replaced with urine cytology (UC) and in-office fiexible cystoscopy in selected T1 non-muscle-invasive bladder cancer (NMIBC).Materials and MethodsThis is an ongoing prospective multicenter trial enrolling patients diagnosed with T1 BC from 5 Italian centers. Patients with a macroscopically incomplete initial resection or absence of detrusor muscle were subjected to ReTUR according to European Association of Urology (EAU) guidelines. Conversely, those with a complete tumor resection at initial TUR underwent UC at 3–4 weeks and in-office fiexible white-light and narrow-band cystoscopy at 4–6 weeks. In case of positive UC, or evidence of recurrence at cystoscopy, ReTUR was performed within 2 weeks. Otherwise, patients started Bacillus Calmette–Guérin (BCG) induction course without ReTUR. The primary endpoint was to determine the feasibility and the clinical utility of not performing ReTUR in selected T1 NMIBC patients. The secondary endpoint was to perform a cost–benefit analysis of this alternative approach.ResultsSince May 2020, among 87 patients presenting with T1, 76 patients were enrolled. Nineteen (25%) patients underwent standard ReTUR after initial resection, 10 (13.2%) due to the absence of the detrusor muscle and 9 (11.8%) due to a macroscopically incomplete initial TUR. Overall, 57 (75%) patients initially avoided immediate ReTUR and underwent UC plus in-office flexible cystoscopy. Among them, 38 (66.7%) had no evidence of residual disease and immediately started the BCG induction course. Nineteen patients (33.3%) underwent “salvage” ReTUR due to either positive UC (7; 12.3%) or suspicious cystoscopy (12; 21%). Considering only the patients who initially avoided the ReTUR, disease recurrence was observed in 10/57. The saving of resource for each safely avoided ReTUR was estimated to be 1,759 €. Considering the entire sample, we estimated a saving of 855 € per patient if compared with the EAU guideline approach.ConclusionThe preliminary results of our trial suggested that ReTUR might be safely avoided in highly selected T1 BC patients with a complete resection at first TUR. Longer follow-up and larger sample size are needed to investigate the long-term oncological outcomes of this alternative approach.

Published
2022
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7. Computer-Aided Diagnosis Improves the Detection of Clinically Significant Prostate Cancer on Multiparametric-MRI: A Multi-Observer Performance Study Involving Inexperienced Readers

Author

Valentina Giannini, Simone Mazzetti, Giovanni Cappello, Valeria Maria Doronzio, Lorenzo Vassallo, Filippo Russo, Alessandro Giacobbe, Giovanni Muto, and Daniele Regge

Subjects
computer aided diagnosis, prostate cancer, artificial intelligence, assisted reading, Medicine (General), R5-920
Abstract

Recently, Computer Aided Diagnosis (CAD) systems have been proposed to help radiologists in detecting and characterizing Prostate Cancer (PCa). However, few studies evaluated the performances of these systems in a clinical setting, especially when used by non-experienced readers. The main aim of this study is to assess the diagnostic performance of non-experienced readers when reporting assisted by the likelihood map generated by a CAD system, and to compare the results with the unassisted interpretation. Three resident radiologists were asked to review multiparametric-MRI of patients with and without PCa, both unassisted and assisted by a CAD system. In both reading sessions, residents recorded all positive cases, and sensitivity, specificity, negative and positive predictive values were computed and compared. The dataset comprised 90 patients (45 with at least one clinically significant biopsy-confirmed PCa). Sensitivity significantly increased in the CAD assisted mode for patients with at least one clinically significant lesion (GS > 6) (68.7% vs. 78.1%, p = 0.018). Overall specificity was not statistically different between unassisted and assisted sessions (94.8% vs. 89.6, p = 0.072). The use of the CAD system significantly increases the per-patient sensitivity of inexperienced readers in the detection of clinically significant PCa, without negatively affecting specificity, while significantly reducing overall reporting time.

Published
2021
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8. Diagnostic and prognostic potential of the proteomic profiling of serum-derived extracellular vesicles in prostate cancer

Author

Giulia Federici, Lucia Bertuccini, Lucio Crinò, Steno Sentinelli, Romina Alfonsi, Devis Collura, Antonio Addario, Michele Gallucci, Giuseppe Simone, Claudio Tabolacci, Aurora Aiello, Giovanni Muto, Michele Signore, Rocco Papalia, Désirée Bonci, Marco Diociaiuti, Simona Nanni, Alessandro Giacobbe, Tania Merlino, Anna Laura Di Pace, Isabella Sperduti, Stefania Rossi, Ruggero De Maria, Manuela Costantini, and Lidia Brunetto

Subjects
Adult, Male, Proteomics, Cancer Research, Proteome, Immunology, Protein Array Analysis, Article, Tumour biomarkers, Cellular and Molecular Neuroscience, Prostate cancer, Extracellular Vesicles, Settore MED/04 - PATOLOGIA GENERALE, Predictive Value of Tests, Cell Line, Tumor, medicine, Biomarkers, Tumor, Humans, Liquid biopsy, PI3K/AKT/mTOR pathway, Aged, Retrospective Studies, QH573-671, Proteomic Profiling, business.industry, Prostatic Neoplasms, Reproducibility of Results, Cell Biology, Middle Aged, medicine.disease, Neoplasm Proteins, Protein-protein interaction networks, Cancer research, Protein microarray, Cancer biomarkers, business, Cytology
Abstract

Extracellular vesicles (EVs) and their cargo represent an intriguing source of cancer biomarkers for developing robust and sensitive molecular tests by liquid biopsy. Prostate cancer (PCa) is still one of the most frequent and deadly tumor in men and analysis of EVs from biological fluids of PCa patients has proven the feasibility and the unprecedented potential of such an approach. Here, we exploited an antibody-based proteomic technology, i.e. the Reverse-Phase Protein microArrays (RPPA), to measure key antigens and activated signaling in EVs isolated from sera of PCa patients. Notably, we found tumor-specific protein profiles associated with clinical settings as well as candidate markers for EV-based tumor diagnosis. Among others, PD-L1, ERG, Integrin-β5, Survivin, TGF-β, phosphorylated-TSC2 as well as partners of the MAP-kinase and mTOR pathways emerged as differentially expressed endpoints in tumor-derived EVs. In addition, the retrospective analysis of EVs from a 15-year follow-up cohort generated a protein signature with prognostic significance. Our results confirm that serum-derived EV cargo may be exploited to improve the current diagnostic procedures while providing potential prognostic and predictive information. The approach proposed here has been already applied to tumor entities other than PCa, thus proving its value in translational medicine and paving the way to innovative, clinically meaningful tools.

Published
2021

9. Minimally Invasive Buccal Mucosa Dorsal Graft for Female Distal Urethroplasty

Author

Federico Germinale, Andrea Margara, L. Tosco, Devis Collura, Giovanni Muto, Marisa Kurti, Alessandro Giacobbe, Elisa Berdondini, and Gianluca Muto

Subjects
Dorsum, medicine.medical_specialty, Urethroplasty, Urethral, Urethrotomy, Urethral stricture, Urology, medicine.medical_treatment, lcsh:RC870-923, Buccal mucosa, lcsh:RC254-282, Surgery in Motion: Open Science, medicine, business.industry, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Surgery, Dissection, Urethra, medicine.anatomical_structure, Female, business, Complication, Stricture
Abstract

Background Female urethral stricture (FUS) represents a sporadic condition. There is a lack of data and standardized guidelines on diagnostics and therapeutics. Several surgical techniques have been described for FUS urethroplasty, among which the flap-based or graft-based ones are most reported. Buccal mucosa graft (BMG) represents the gold standard for male urethroplasty, and this can theoretically be applied also to FUS treatment. Objective To describe and present preliminary results of a novel minimally invasive technique for buccal mucosa dorsal graft (mini-dorsal BMG) urethroplasty for the treatment of FUS. Design, setting, and participants This is a retrospective study on buccal mucosa dorsal graft urethroplasty for the treatment of FUS. Surgical procedure Every patient was placed in lithotomic position. Two stiches were placed at 10 and 2 o’clock positions to facilitate the dorsal median urethrotomy. The margins of the incised dorsal urethra at the 12 o’clock position are then dissected from the periurethral tissue. This dissection results in an elliptical raw area between the edges of the urethra over the periurethral tissue. The harvested BMG was fixed with several quilting sutures, using 5-0 and 4-0 absorbable sutures, to cover the raw area. The margins of the graft were sutured to the edges of the incised urethra. Measurements A chart review was performed. Results and limitations Thirteen patients underwent the mini-dorsal-BMG technique. The median preoperative uroflow was 5.6 (3–13) ml/s, and the median postoperative value was 23.4 (14–58) ml/s. Conclusions The mini-dorsal-BMG technique for the treatment of FUS gives good results with low complication rates. Other series and long-term follow-up are necessary to confirm the reproducibility of this technique. Patient summary We present the technical aspects and the promising preliminary results of a novel surgical technique for the treatment of female urethral stricture by using the buccal mucosa to correct this invalidating disease.

Published
2021

10. Computer-aided diagnosis improves the detection of clinically significant prostate cancer on multiparametric-mri: A multi-observer performance study involving inexperienced readers

Author

Valeria Maria Doronzio, Filippo Russo, Alessandro Giacobbe, Giovanni Muto, Daniele Regge, Simone Mazzetti, Valentina Giannini, Giovanni Cappello, and Lorenzo Vassallo

Subjects
medicine.medical_specialty, Medicine (General), Artificial intelligence, Clinical Biochemistry, CAD, computer aided diagnosis, prostate cancer, artificial intelligence, assisted reading, Article, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, R5-920, Observer performance, medicine, Assisted reading, Computer aided diagnosis, business.industry, Multiparametric MRI, medicine.disease, Cad system, Predictive value, 3. Good health, Computer-aided diagnosis, 030220 oncology & carcinogenesis, Radiology, business
Abstract

Recently, Computer Aided Diagnosis (CAD) systems have been proposed to help radiologists in detecting and characterizing Prostate Cancer (PCa). However, few studies evaluated the performances of these systems in a clinical setting, especially when used by non-experienced readers. The main aim of this study is to assess the diagnostic performance of non-experienced readers when reporting assisted by the likelihood map generated by a CAD system, and to compare the results with the unassisted interpretation. Three resident radiologists were asked to review multiparametric-MRI of patients with and without PCa, both unassisted and assisted by a CAD system. In both reading sessions, residents recorded all positive cases, and sensitivity, specificity, negative and positive predictive values were computed and compared. The dataset comprised 90 patients (45 with at least one clinically significant biopsy-confirmed PCa). Sensitivity significantly increased in the CAD assisted mode for patients with at least one clinically significant lesion (GS > 6) (68.7% vs. 78.1%, p = 0.018). Overall specificity was not statistically different between unassisted and assisted sessions (94.8% vs. 89.6, p = 0.072). The use of the CAD system significantly increases the per-patient sensitivity of inexperienced readers in the detection of clinically significant PCa, without negatively affecting specificity, while significantly reducing overall reporting time.

Published
2021

11. Postoperative moderate to severe LUTS probability after three to six months follow up after THUVARP or THUVEP

Author

F. Cavacece, Devis Collura, N. Faraone, E. Giargia, F. Germinale, L. Tosco, M. Kurti, E. Berdondini, P. Caccia, Alessandro Giacobbe, and G. Muto

Subjects
Moderate to severe, medicine.medical_specialty, business.industry, Urology, Medicine, business, lcsh:Diseases of the genitourinary system. Urology, lcsh:RC870-923, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, lcsh:RC254-282, Surgery
Published
2020

12. Autologous nanofat grafting in the managenent of complex lichen sclerosus urethral stricture

Author

G. Muto, Alessandro Giacobbe, F. Cavacece, A. Sica, F. Germinale, Devis Collura, M. Kurti, L. Tosco, A. Margara, and E. Berdondini

Subjects
medicine.medical_specialty, Urethral stricture, business.industry, Urology, Grafting (decision trees), Lichen sclerosus, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, lcsh:RC870-923, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, lcsh:RC254-282, Surgery, medicine, business
Published
2020

13. Disease-specific and general health-related quality of life in newly diagnosed prostate cancer patients: The Pros-IT CNR study

Author

Angelo, Porreca, Marianna, Noale, Walter, Artibani, Pier Francesco Bassi, Filippo, Bertoni, Sergio, Bracarda, Giario Natale Conti, Renzo, Corvò, Mauro, Gacci, Pierpaolo, Graziotti, Magrini, STEFANO MARIA, Vincenzo, Mirone, Rodolfo, Montironi, Giovanni, Muto, Stefano, Pecoraro, Umberto, Ricardi, Elvio, Russi, Andrea, Tubaro, Vittorina, Zagonel, Gaetano, Crepaldi, Stefania, Maggi, Pierfrancesco, Bassi, Stefano Maria Magrini, Anna Rita Alitto, Enrica, Ambrosi, Alessandro, Antonelli, Cynthia, Aristei, Michele, Barbieri, Franco, Bardari, Lilia, Bardoscia, Salvina, Barra, Sara, Bartoncini, Umberto, Basso, Carlotta, Becherini, Rita, Bellavita, Franco, Bergamaschi, Stefania, Berlingheri, Berruti, Alfredo, Marco, Borghesi, Roberto, Bortolus, Valentina, Borzillo, Davide, Bosetti, Giuseppe, Bove, Pierluigi, Bove, Maurizio, Brausi, Alessio, Bruni, Giorgio, Bruno, Eugenio, Brunocilla, Alberto, Buffoli, BUGLIONE DI MONALE E BASTIA, Michela, Consuelo, Buttigliero, Giovanni, Cacciamani, Michela, Caldiroli, Giuseppe, Cardo, Giorgio, Carmignani, Giuseppe, Carrieri, Emanuele, Castelli, Elisabetta, Castrezzati, Gianpiero, Catalano, Susanna, Cattarino, Francesco, Catucci, Francolini Dario Cavallini, Ofelia, Ceccarini, Antonio, Celia, Francesco, Chiancone, Tommaso, Chini, Claudia, Cianci, Antonio, Cisternino, Devis, Collura, Franco, Corbella, Matteo, Corinti, Paolo, Corsi, Fiorenza, Cortese, Luigi, Corti, Cosimo de Nunzio, Olga, Cristiano, Rolando, M D'Angelillo, Luigi Da Pozzo, Daniele, D'Agostino, Carolina, D'Elia, Matteo, Dandrea, Michele De Angelis, Paolo De Angelis, Ottavio De Cobelli, Bernardino De Concilio, Antonello De Lisa, Stefano De Luca, Agostina De Stefani, Chiara Lucrezia Deantoni, Esposti Claudio Degli, Anna, Destito, Beatrice, Detti, Nadia Di Muzio, Andrea Di Stasio, Calogero Di Stefano, Danilo Di Trapani, Giuseppe, Difino, Sara, Falivene, Giuseppe, Farullo, Paolo, Fedelini, Ilaria, Ferrari, Francesco, Ferrau, Matteo, Ferro, Andrei, Fodor, Francesco, Fontanta, Francesco, Francesca, Giulio, Francolini, Paolo, Frata, Giovanni, Frezza, Pietro, Gabriele, Maria, Galeandro, Elisabetta, Garibaldi, Pietro Giovanni Gennari, Alessandro, Gentilucci, Alessandro, Giacobbe, Laura, Giussani, Giuseppe, Giusti, Paolo, Gontero, Alessia, Guarneri, Cesare, Guida, Alberto, Gurioli, Dorijan, Huqi, Ciro, Imbimbo, Gianluca, Ingrosso, Cinzia, Iotti, Corrado, Italia, Pierdaniele La Mattina, Enza, Lamanna, Luciana, Lastrucci, Grazia, Lazzari, Fabiola, Liberale, Giovanni, Liguori, Roberto, Lisi, Frank, Lohr, Riccardo, Lombardo, Jon A, J Lovisolo, Giuseppe Mario Ludovico, Nicola, Macchione, Francesca, Maggio, Michele, Malizia, Gianluca, Manasse, Giovanni, Mandoliti, Giovanna, Mantini, Luigi, Marafioti, Luisa, Marciello, Alberto Mario Marconi, Antonietta, Martilotta, Salvino, Marzano, Stefano, Masciullo, Gloria, Maso, Adele, Massenzo, Ercole, Mazzeo, Luigi, Mearini, Serena, Medoro, Rosa, Molè, Giorgio, Monesi, Emanuele, Montanari, Franco, Montefiore, Giampaolo, Montesi, Giuseppe, Morgia, Gregorio, Moro, Giorgio, Muscas, Daniela, Musio, Paolo, Muto, Giovanni, Muzzonigro, Giorgio, Napodano, Carlo Luigi Augusto Negro, Mattia, Nidini, Maria, Ntreta, Marco, Orsatti, Carmela, Palazzolo, Isabella, Palumbo, Alessandro, Parisi, Paolo, Parma, Nicola, Pavan, Martina, Pericolini, Francesco, Pinto, Antonio, Pistone, Valerio, Pizzuti, Angelo, Platania, Caterina, Polli, Giorgio, Pomara, Elisabetta, Ponti, Antonio Benito Porcaro, Francesco, Porpiglia, Dario, Pugliese, Armin, Pycha, Giuseppe, Raguso, Andrea, Rampini, Donato Franco Randone, Valentina, Roboldi, Marco, Roscigno, Maria Paola Ruggieri, Giuseppe, Ruoppo, Roberto, Sanseverino, Anna, Santacaterina, Michele, Santarsieri, Riccardo, Santoni, Sarah, Scagliarini, Giorgio Vittorio Scagliotti, Mauro, Scanzi, Marcello, Scarcia, Riccardo, Schiavina, Alessandro, Sciarra, Carmine, Sciorio, Tindaro, Scolaro, Salvatore, Scuzzarella, Oscar, Selvaggio, Armando, Serao, Sergio, Serni, Marco Andrea Signor, Mauro, Silvani, Giovanni, Silvano, Franco, Silvestris, Simeone, Claudio, Valeria, Simone, Girolamo, Spagnoletti, Matteo Giulio Spinelli, Luigi, Squillace, Vincenzo, Tombolini, Mariastella, Toninelli, Triggiani, Luca, Alberto, Trinchieri, Luca Eolo Trodella, Lucio, Trodella, Carlo, Trombetta, Lidia, Tronnolone, Marcello, Tucci, Daniele, Urzì, Riccardo, Valdagni, Maurizio, Valeriani, Maurizio, Vanoli, Elisabetta, Vitali, Alessandro, Volpe, Stefano, Zaramella, Guglielmo, Zeccolini, Giampaolo, Zini, Porreca, Angelo, Noale, Marianna, Artibani, Walter, Bassi, Pier Francesco, Bertoni, Filippo, Bracarda, Sergio, Conti, Giario Natale, Corvò, Renzo, Gacci, Mauro, Graziotti, Pierpaolo, Magrini, Stefano Maria, Mirone, Vincenzo, Montironi, Rodolfo, Muto, Giovanni, Pecoraro, Stefano, Ricardi, Umberto, Russi, Elvio, Tubaro, Andrea, Zagonel, Vittorina, Crepaldi, Gaetano, Maggi, Stefania, Gaetano, Crepaldi, Umberto, Basso, Luigi, Corti, D'Agostino, Daniele, Matteo, Dandrea, Davide, Bosetti, Gianpiero, Catalano, Ottavio, De Cobelli, Lucrezia, Deantoni Chiara, Nadia, Di Muzio, Ferro, Matteo, Andrei, Fodor, Pierdaniele, La Mattina, Emanuele, Montanari, Barbieri, Michele, Valentina, Borzillo, Chiancone, Francesco, Sara, Falivene, Paolo, Fedelini, Imbimbo, Ciro, Paolo, Muto, Sarah, Scagliarini, Giovanni, Muzzonigro, Enrica, Ambrosi, Alessandro, Antonelli, Lilia, Bardoscia, Stefania, Berlingheri, Alfredo, Berruti, Alberto, Buffoli, Michela, Buglione, Mauro, Scanzi, Elisabetta, Castrezzati, Paolo, Frata, Giulio, Francolini, Beatrice, Detti, Tommaso, Chini, Carlotta, Becherini, Olga, Cristiano, Cesare, Guida, Sara, Bartoncini, Consuelo, Buttigliero, Emanuele, Castelli, Devis, Collura, Stefano, De Luca, Pietro, Gabriele, Elisabetta, Garibaldi, Alessandro, Giacobbe, Paolo, Gontero, Alessia, Guarneri, Alberto, Gurioli, Francesco, Porpiglia, Franco, Randone Donato, Vittorio, Scagliotti Giorgio, Cynthia, Aristei, Rita, Bellavita, Isabella, Palumbo, Franco, Bardari, Augusto, Negro Carlo Luigi, Franco, Bergamaschi, Maria, Galeandro, Cinzia, Iotti, Giuseppe, Raguso, Paola, Ruggieri Maria, Giuseppe, Ruoppo, Marco, Borghesi, Eugenio, Brunocilla, Claudio, Degli Esposti, Giovanni, Frezza, Michele, Malizia, Maria, Ntreta, Alessandro, Parisi, Riccardo, Schiavina, Roberto, Bortolu, Giuseppe, Bove, Antonio, Cisternino, Carrieri, Giuseppe, Giuseppe, Difino, Oscar, Selvaggio, Maurizio, Brausi, Alessio, Bruni, Frank, Lohr, Ercole, Mazzeo, Enza, Lamanna, Calogero, Di Stefano, Giorgio, Bruno, Michela, Caldiroli, Ilaria, Ferrari, Laura, Giussani, Lovisolo Jon, A. J., Mario, Marconi Alberto, Giuseppe, Cardo, Mario, Ludovico Giuseppe, Marcello, Scarcia, Giorgio, Carmignani, Salvina, Barra, Dario, Cavallini Francolini, Franco, Corbella, Ofelia, Ceccarini, Luigi, Da Pozzo, Agostina, De Stefani, Corrado, Italia, Stefano, Masciullo, Valentina, Roboldi, Marco, Roscigno, Antonio, Celia, Bernardino, De Concilio, Claudia, Cianci, Francesco, Francesca, Giorgio, Pomara, Michele, Santarsieri, Fiorenza, Cortese, Andrea, Di Stasio, Franco, Montefiore, Armando, Serao, D'Elia, Carolina, Armin, Pycha, Dorijan, Huqi, Paolo, De Angeli, Nicola, Macchione, Francesco, Fontanta, Giorgio, Monesi, Antonello, De Lisa, Giuseppe, Giusti, Giorgio, Musca, Anna, Destito, Rosa, Molè, Danilo, Di Trapani, Francesco, Ferrau, Carmela, Palazzolo, Angelo, Platania, Anna, Santacaterina, Grazia, Lazzari, Fabiola, Liberale, Gregorio, Moro, Giovanni, Liguori, Nicola, Pavan, Francesca, Maggio, Marco, Orsatti, Giovanni, Mandoliti, Giampaolo, Montesi, Luigi, Marafioti, Antonietta, Martilotta, Adele, Massenzo, Luisa, Marciello, Salvino, Marzano, Caterina, Polli, Gloria, Maso, Serena, Medoro, Giuseppe, Morgia, Napodano, Giorgio, Pistone, Antonio, Roberto, Sanseverino, Mattia, Nidini, Paolo, Parma, Valerio, Pizzuti, Sciorio, Carmine, Scuzzarella, Salvatore, Tindaro, Scolaro, Porreca A, Noale M, Artibani W, Bassi PF, Bertoni F, Bracarda S, Conti GN, Corvò R, Gacci M, Graziotti P, Magrini SM, Mirone V, Montironi R, Muto G, Pecoraro S, Ricardi U, Russi E, Tubaro A, Zagonel V, Crepaldi G, Maggi S, Crepaldi G, Maggi S, Noale M, Porreca A, Artibani W, Bassi P, Bracarda S, Conti GN, Corvò R, Graziotti P, Russi E, Mirone V, Montironi R, Bertoni F, Gacci M, Magrini SM, Muto G, Pecoraro S, Ricardi U, Tubaro A, Zagonel V, Alitto AR, Ambrosi E, Antonelli A, Aristei C, Barbieri M, Bardari F, Bardoscia L, Barra S, Bartoncini S, Basso U, Becherini C, Bellavita R, Bergamaschi F, Berlingheri S, Berruti A, Borghesi M, Bortolus R, Borzillo V, Bosetti D, Bove G, Bove P, Brausi M, Bruni A, Bruno G, Brunocilla E, Buffoli A, Buglione M, Buttigliero C, Cacciamani G, Caldiroli M, Cardo G, Carmignani G, Carrieri G, Castelli E, Castrezzati E, Catalano G, Cattarino S, Catucci F, Cavallini FD, Ceccarini O, Celia A, Chiancone F, Chini T, Cianci C, Cisternino A, Collura D, Corbella F, Corinti M, Corsi P, Cortese F, Corti L, de Nunzio C, Cristiano O, D'Angelillo RM, Da Pozzo L, D'agostino D, D'Elia C, Dandrea M, De Angelis M, De Angelis P, De Cobelli O, De Concilio B, De Lisa A, De Luca S, De Stefani A, Deantoni CL, Degli EC, Destito A, Detti B, Di Muzio N, Di Stasio A, Di Stefano C, Di Trapani D, Difino G, Falivene S, Farullo G, Fedelini P, Ferrari I, Ferrau F, Ferro M, Fodor A, Fontanta F, Francesca F, Francolini G, Frata P, Frezza G, Gabriele P, Galeandro M, Garibaldi E, Gennari PG, Gentilucci A, Giacobbe A, Giussani L, Giusti G, Gontero P, Guarneri A, Guida C, Gurioli A, Huqi D, Imbimbo C, Ingrosso G, Iotti C, Italia C, La Mattina P, Lamanna E, Lastrucci L, Lazzari G, Liberale F, Liguori G, Lisi R, Lohr F, Lombardo R, Lovisolo JAJ, Ludovico GM, Macchione N, Maggio F, Malizia M, Manasse G, Mandoliti G, Mantini G, Marafioti L, Marciello L, Marconi AM, Martilotta A, Marzano S, Masciullo S, Maso G, Massenzo A, Mazzeo E, Mearini L, Medoro S, Molè R, Monesi G, Montanari E, Montefiore F, Montesi G, Morgia G, Moro G, Muscas G, Musio D, Muto P, Muzzonigro G, Napodano G, Negro CLA, Nidini M, Ntreta M, Orsatti M, Palazzolo C, Palumbo I, Parisi A, Parma P, Pavan N, Pericolini M, Pinto F, Pistone A, Pizzuti V, Platania A, Polli C, Pomara G, Ponti E, Porcaro AB, Porpiglia F, Pugliese D, Pycha A, Raguso G, Rampini A, Randone DF, Roboldi V, Roscigno M, Ruggieri MP, Ruoppo G, Sanseverino R, Santacaterina A, Santarsieri M, Santoni R, Scagliarini S, Scagliotti GV, Scanzi M, Scarcia M, Schiavina R, Sciarra A, Sciorio C, Scolaro T, Scuzzarella S, Selvaggio O, Serao A, Serni S, Signor MA, Silvani M, Silvano G, Silvestris F, Simeone C, Simone V, Spagnoletti G, Spinelli MG, Squillace L, Tombolini V, Toninelli M, Triggiani L, Trinchieri A, Trodella LE, Trodella L, Trombetta C, Tronnolone L, Tucci M, Urzì D, Valdagni R, Valeriani M, Vanoli M, Vitali E, Volpe A, Zaramella S, Zeccolini G, Zini G, Porreca, A., Noale, M., Artibani, W., Bassi, P. F., Bertoni, F., Bracarda, S., Conti, G. N., Corvo, R., Gacci, M., Graziotti, P., Magrini, S. M., Mirone, V., Montironi, R., Muto, G., Pecoraro, S., Ricardi, U., Russi, E., Tubaro, A., Zagonel, V., Crepaldi, G., Maggi, S., Alitto, A. R., Ambrosi, E., Antonelli, A., Aristei, C., Barbieri, M., Bardari, F., Bardoscia, L., Barra, S., Bartoncini, S., Basso, U., Becherini, C., Bellavita, R., Bergamaschi, F., Berlingheri, S., Berruti, A., Borghesi, M., Bortolus, R., Borzillo, V., Bosetti, D., Bove, G., Bove, P., Maurizio, B., Alessio, B., Giorgio, B., Eugenio, B., Alberto, B., Michela, B., Consuelo, B., Giovanni, C., Michela, C., Giuseppe, C., Giorgio, C., Emanuele, C., Elisabetta, C., Gianpiero, C., Susanna, C., Catucci, F., Dario, C. F., Ofelia, C., Antonio, C., Francesco, C., Tommaso, C., Claudia, C., Devis, C., Franco, C., Matteo, C., Paolo, C., Fiorenza, C., Luigi, C., Cosimo, N., Cristiano, O., D'Angelillo, R. M., Da Pozzo, L., D'Agostino, D., D'Elia, C., Dandrea, M., De Angelis, M., De Angelis, P., De Cobelli, O., De Concilio, B., De Lisa, A., De Luca, S., De Stefani, A., Deantoni, C. L., Degli, E. C., Destito, A., Detti, B., Di Muzio, N., Di Stasio, A., Di Stefano, C., Di Trapani, D., Difino, G., Falivene, S., Farullo, G., Fedelini, P., Ferrari, I., Ferrau, F., Ferro, M., Fodor, A., Fontanta, F., Francesca, F., Francolini, G., Frata, P., Frezza, G., Gabriele, P., Galeandro, M., Garibaldi, E., Gennari, P. G., Gentilucci, A., Giacobbe, A., Giussani, L., Giusti, G., Gontero, P., Guarneri, A., Guida, C., Gurioli, A., Huqi, D., Imbimbo, C., Ingrosso, G., Iotti, C., Italia, C., La Mattina, P., Lamanna, E., Lastrucci, L., Lazzari, G., Liberale, F., Liguori, G., Lisi, R., Lohr, F., Lombardo, R., Lovisolo, J. A. J., Ludovico, G. M., Macchione, N., Maggio, F., Malizia, M., Manasse, G., Mandoliti, G., Mantini, G., Marafioti, L., Marciello, L., Marconi, A. M., Martilotta, A., Marzano, S., Masciullo, S., Maso, G., Massenzo, A., Mazzeo, E., Mearini, L., Medoro, S., Mole, R., Monesi, G., Montanari, E., Montefiore, F., Montesi, G., Morgia, G., Moro, G., Muscas, G., Musio, D., Muto, P., Muzzonigro, G., Napodano, G., Negro, C. L. A., Nidini, M., Ntreta, M., Orsatti, M., Palazzolo, C., Palumbo, I., Parisi, A., Parma, P., Pavan, N., Pericolini, M., Pinto, F., Pistone, A., Pizzuti, V., Platania, A., Polli, C., Pomara, G., Ponti, E., Porcaro, A. B., Porpiglia, F., Pugliese, D., Pycha, A., Raguso, G., Rampini, A., Randone, D. F., Roboldi, V., Roscigno, M., Ruggieri, M. P., Ruoppo, G., Sanseverino, R., Santacaterina, A., Santarsieri, M., Santoni, R., Scagliarini, S., Scagliotti, G. V., Scanzi, M., Scarcia, M., Schiavina, R., Sciarra, A., Sciorio, C., Scolaro, T., Scuzzarella, S., Selvaggio, O., Serao, A., Serni, S., Signor, M. A., Silvani, M., Silvano, G., Silvestris, F., Simeone, C., Simone, V., Spagnoletti, G., Spinelli, M. G., Squillace, L., Tombolini, V., Toninelli, M., Triggiani, L., Trinchieri, A., Trodella, L. E., Trodella, L., Trombetta, C., Tronnolone, L., Tucci, M., Urzi, D., Valdagni, R., Valeriani, M., Vanoli, M., Vitali, E., Volpe, A., Zaramella, S., Zeccolini, G., Zini, G., Porreca, A, Noale, M, Artibani, W, Bassi, P, Bertoni, F, Bracarda, S, Conti, G, Corvò, R, Gacci, M, Graziotti, P, Magrini, S, Mirone, V, Montironi, R, Muto, G, Pecoraro, S, Ricardi, U, Russi, E, Tubaro, A, Zagonel, V, Crepaldi, G, Maggi, S, and Da Pozzo, L

Subjects
Male, 030232 urology & nephrology, Severity of Illness Index, Prostate cancer, 0302 clinical medicine, Quality of life, Activities of Daily Living, Diagnosis, Medicine, Age Factor, Prospective Studies, Prospective cohort study, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, Age Factors, Pros-IT CNR study, General Medicine, Health Survey, Middle Aged, Neoadjuvant Therapy, 3. Good health, Italy, 030220 oncology & carcinogenesis, lcsh:R858-859.7, Regression Analysis, Public Health, Human, Diagnosi, prostate cancer, survival, quality of life, medicine.medical_specialty, lcsh:Computer applications to medicine. Medical informatics, Regression Analysi, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, Severity of illness, Humans, Aged, Cancer staging, business.industry, Research, Environmental and Occupational Health, Public Health, Environmental and Occupational Health, Prostatic Neoplasms, Cancer, medicine.disease, Health Surveys, Comorbidity, Quality of Life, Prospective Studie, Settore MED/24, Prostatic Neoplasm, business, Sexual function
Abstract

Background The National Research Council (CNR) prostate cancer monitoring project in Italy (Pros-IT CNR) is an observational, prospective, ongoing, multicentre study aiming to monitor a sample of Italian males diagnosed as new cases of prostate cancer. The present study aims to present data on the quality of life at time prostate cancer is diagnosed. Methods One thousand seven hundred five patients were enrolled. Quality of life is evaluated at the time cancer was diagnosed and at subsequent assessments via the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and the Short Form Health Survey (SF-12). Results At diagnosis, lower scores on the physical component of the SF-12 were associated to older ages, obesity and the presence of 3+ moderate/severe comorbidities. Lower scores on the mental component were associated to younger ages, the presence of 3+ moderate/severe comorbidities and a T-score higher than one. Urinary and bowel functions according to UCLA-PCI were generally good. Almost 5% of the sample reported using at least one safety pad daily to control urinary loss; less than 3% reported moderate/severe problems attributable to bowel functions, and sexual function was a moderate/severe problem for 26.7%. Diabetes, 3+ moderate/severe comorbidities, T2 or T3-T4 categories and a Gleason score of eight or more were significantly associated with lower sexual function scores at diagnosis. Conclusions Data collected by the Pros-IT CNR study have clarified the baseline status of newly diagnosed prostate cancer patients. A comprehensive assessment of quality of life will allow to objectively evaluate outcomes of different profile of care.

Published
2018

14. A multicentric study on accurate grading of prostate cancer with systematic and MRI/US fusion targeted biopsies: comparison with final histopathology after radical prostatectomy

Author

Thierry Piechaud, David Eldred-Evans, Giuseppe Simone, Marco Oderda, Mariaconsiglia Ferriero, Gaelle Fiard, Jean-Luc Descotes, Emanuela Altobelli, Romain Diamand, Thierry Roumeguere, Giovanni Muto, Valerio Beatrici, Alexandre Peltier, R. Van Velthoven, Jean Baptiste Roche, Giuseppe Fasolis, Rocco Papalia, Alessandro Giacobbe, Pardeep Kumar, W. Al Hajj Obeid, V. Lacetera, Antonio Luigi Pastore, Paolo Gontero, Simone Albisinni, Antonio Carbone, Giancarlo Marra, CHU Grenoble, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), National Physical Laboratory [Teddington] (NPL), Dipartimento di Scienze della Terra e dell'Ambiente [Pavia], Università degli Studi di Pavia, Dipartimento di Matematica e Informatica, Università di Catania, Università degli studi di Catania [Catania], Observatoire Volcanologique du Piton de la Fournaise (OVPF), and Institut de Physique du Globe de Paris

Subjects
Image-Guided Biopsy, Male, medicine.medical_specialty, Urology, medicine.medical_treatment, Concordance, Biopsy, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, MRI/US fusion, Prostate cancer, Targeted, Aged, Humans, Multimodal Imaging, Neoplasm Grading, Prostatic Neoplasms, Reproducibility of Results, Retrospective Studies, Magnetic Resonance Imaging, Interventional, Prostatectomy, Ultrasonography, Interventional, 03 medical and health sciences, 0302 clinical medicine, McNemar's test, medicine, Grading (tumors), Ultrasonography, Interventional, medicine.diagnostic_test, business.industry, Retrospective cohort study, medicine.disease, Magnetic Resonance Imaging, 3. Good health, 030220 oncology & carcinogenesis, Histopathology, Radiology, business
Abstract

International audience; OBJECTIVE:To evaluate the accuracy in histologic grading of MRI/US image fusion biopsy by comparing histopathology between systematic biopsies (SB), targeted biopsies (TB) and the combination of both (SB + TB) with the final histopathologic outcomes of radical prostatectomy specimens.MATERIALS AND METHODS:Retrospective, multicentric study of 443 patients who underwent SB and TB using MRI/US fusion technique (Urostation® and Trinity®) prior to radical prostatectomy between 2010 and 2017. Cochran's Q test and McNemar test were conducted as a post hoc test. Uni-multivariable analyses were performed on several clinic-pathological variables to analyze factors predicting histopathological concordance for targeted biopsies.RESULTS:Concordance in ISUP (International Society of Urological Pathology) grade between SB, TB and SB + TB with final histopathology was 49.4%, 51.2%, and 63.2% for overall prostate cancer and 41.2%, 48.3%, and 56.7% for significant prostate cancer (ISUP grade ≥ 2), respectively. Significant difference in terms of concordance, downgrading and upgrading was found between SB and TB (ISUP grade ≥ 2 only), SB and SB + TB, TB and SB + TB (overall ISUP grade and ISUP grade ≥ 2) (p

Published
2019
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15. Effect of Tamsulosin in Preventing Ureteral Stent-Related Morbidity A Prospective Study.

Author

Rocco Damiano, Riccardo Autorino, Marco De Sio, Alessandro Giacobbe, Italo Michele Palumbo, and Massimo D'Armiento

Subjects
URETERIC obstruction, SURGICAL stents, LONGITUDINAL method, QUALITY of life
Abstract

Purpose We conducted a randomized study to evaluate the effect of tamsulosin in improving symptoms and quality of life (QoL) in patients with indwelling double-pigtail ureteral stents, using both generic and specific questionnaires.Materials and Methods We prospectively enrolled 75 patients (29 men, 46 women; mean age, 42.3 years), who underwent ureteral stent positioning and were assigned to one of two study groups. In group A (n 38), patients were discharged with a prescription for tamsulosin, 0.4 mg once daily. In group B (n 37), patients received no α1-blocker (control group).Results One week after stent placement (visit week 1 [W1]), analysis of the ureteral stent symptoms questionnaire showed a significant worsening of urinary symptoms (13.1 v26.4, P 0.008) and pain (4.1 v21.6, P 0.002) in patients not receiving tamsulosin. There was also a significant difference in the mean visual analog score (VAS) of health scale between the two groups (P< 0.001) compared with the result obtained at the W4 evaluation (visit). The proportion of patients reporting level 2 or 3 for the paindiscomfort domain in the QoL questionnaire from W4 to W1 varied between the two groups in a highly statistically significant manner (P 0.006).Conclusions Our findings indicate that administration of tamsulosin has a positive effect on stent-related urinary symptoms and QoL. Further clinical research in this area is warranted to better define the role of α1-blockers in current clinical practice. [ABSTRACT FROM AUTHOR]

Published
2008
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16. (194) EXTERIORIZATION OF ADULT-ACQUIRED BURIED PENIS WITH SCROTAL FLAP AND SKIN MESH-GRAFT, GLANS MUCOSECTOMY, AND VENTRAL MEATOTOMY.

Author

Omid, Sedigh, Andrea, Gobbo, Nicola, Faraone, Ernesto, Giargia, Devis, Collura, Marisa, Kurti, Paolo, Caccia, Andrea, Formiconi, and Alessandro, Giacobbe

Subjects
*PENIS, *HEALTH self-care, *SURGICAL wound dehiscence, *SKIN grafting, *HEALING, *PENILE transplantation
Abstract

Objectives: We present the treatment of a patient with partial Adult-acquired buried penis (AABP) and extreme tissue retraction, complaining of genital skin tension and LUTS. Methods: Penile exteriorization was performed after circumcision. Glans mucosectomy was carried out because of suspicious glans mucosa. Ventral meatotomy was performed because of the stenotic meatus. For penile covering, we used scrotal skin for the shaft and skin mesh-graft for the glans. The scrotum was positioned around the penile shaft with a rotation flap. For the skin mesh graft we chose as donator the anterior thigh. Harvesting with a scalpel was preferred, so closure by primary intention was possible. We did not use the dermatome considering the low general self-care of the patient and the likely inadequate management of the wound with subsequent risk of infection or dysfunctional scarring. For the same reason we decided to use the smallest graft possible and to mesh it, to allow a better attachment and prevent hematoma or seroma under the graft. After the surgery the medication was sutured to the penis and maintained for one week, afterwards medications were performed 2 times per week for 21 days. Results: The operation lasted 165 minutes. No complications occurred intraoperatively. Stretched penis measured 7cm before surgery and 14cm after. At the first medication there was scrotum necrosis with wound dehiscence, it was removed entirely and exudative material covering the graft was cleaned. At successive medications, the genitals showed good healing process and minimum scarring of the mesh-graft. The patient referred good urinary function and aesthetic satisfaction without genital discomfort. Conclusions: For AABP at risk of non-optimal management of the wound after the operation, tissues with good attachment proprieties like scrotum and mesh-grafts can be safely used with good functional results. Conflicts of Interest: none [ABSTRACT FROM AUTHOR]

Published
2023
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17. (185) SELF-EXPANDABLE, METALLIC, PTFA-COVERED URETHRAL STENT WITH ANTI-MIGRATION FLAPS (UVENTA). COMPLICATION REPORT AND OUTCOMES FROM THE LARGEST MULTICENTER SERIES.

Author

Omid, Sedigh, Ettore, Dalmasso, Andrea, Gobbo, Devis, Collura, Andrea, Formiconi, Marisa, Kurti, Ernesto, Giargia, Nicola, Faraone, Paolo, Caccia, Alessandro, Giacobbe, and Maria, Buffi Nicolò

Subjects
*URETHROPLASTY, *PATIENT preferences, *TREATMENT failure, *LOGISTIC regression analysis, *CONFLICT of interests
Abstract

Objectives: In the last years a new generation of temporary urethral stent was designed. We report complications and outcomes from the largest case history available of self-expandable, metallic, PTFA-covered urethral stents with anti-migration flaps. Methods: 225 patients that underwent urethrotomy with Uventa stent placement between April 2016 and August 2021 in 7 different centers were included. Indication was patient preference as a first surgical approach or failed urethroplasty not willing to undergo a second invasive surgery. Surgical success was defined as absence of strictures requiring further treatments. The outcomes measured were complications during the stent indwelling time and treatment success. Results: The stricture was located at a proximal bulbar level in 190 patients, distal bulbar in 29 and penile in 6. Median follow-up was 37.9m. 109 (48.4%) patients had at least 1 complication, the figure shows the percentage distribution. Low flow (LF) after stent placement (17, 7.6%) was reported in a significantly higher proportion in penile strictures (2/6, p=0.025). Proximal bulbar strictures had a higher number of per-patient complications (p=0.024). 23 patients (12.9%) underwent early stent removal (ER, before 6m), of these 20 stents were dislocated. ER was more likely in penile strictures (3/6, p=0.047). LF and penile strictures were predictors of ER at univariable logistic regression (p<0.001, p=0.017). Penile stricture was also predictor of LF occurrence (p=0.034). 32/150 (21.3%) experienced treatment failure. Kaplan-Meier estimates by LF occurrence were significantly different (cumulative treatment success: 80.4% vs 42.8%; p=0.011) and Cox regression HR was 3.4 (p=0.022). Conclusions: Urethrotomy with Uventa placement is a feasible treatment for simple strictures. A detailed discussion about complications, with particular attention to stent displacement, and expectations should be carried out. LF after placement is suggestive of a subsequent ER and treatment failure. Penile strictures should not undergo urethral stent placement considering the association with ER and LF. Conflicts of Interest: None. [ABSTRACT FROM AUTHOR]

Published
2023
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