20 results on '"De Stefano, Virgilio"'
Search Results
2. Will Aquablation Be the New Benchmark for Robotic Minimally Invasive Surgical Treatment for Benign Prostatic Hyperplasia?
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Nedbal, Carlotta, Castellani, Daniele, De Stefano, Virgilio, Giulioni, Carlo, Nicoletti, Rossella, Pirola, Giacomo, Teoh, Jeremy Yuen-Chun, Elterman, Dean, Somani, Bhaskar Kumar, and Gauhar, Vineet
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- 2024
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3. Dietary management of hypocitraturia in children with urolithiasis: results from a systematic review
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Castellani, Daniele, Giulioni, Carlo, De Stefano, Virgilio, Brocca, Carlo, Fuligni, Demetra, Galosi, Andrea Benedetto, Teoh, Jeremy Yuen-Chun, Sarica, Kemal, and Gauhar, Vineet
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- 2023
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4. Suction in Percutaneous Nephrolithotripsy: Evolution, Development, and Outcomes from Experimental and Clinical studies. Results from a Systematic Review
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De Stefano, Virgilio, Castellani, Daniele, Somani, Bhaskar K., Giulioni, Carlo, Cormio, Angelo, Galosi, Andrea Benedetto, Sarica, Kemal, Glover, Xavier, da Silva, Rodrigo Donalisio, Tanidir, Yiloren, Gadzhiev, Nariman, Pirola, Giacomo Maria, Mulawkar, Prashant Motiram, Teoh, Jeremy Yuen-Chun, Monga, Manoj, Herrmann, Thomas R.W., and Gauhar, Vineet
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- 2024
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5. Improving Outcomes of Same-sitting Bilateral Flexible Ureteroscopy for Renal Stones in Real-world Practice—Lessons Learnt from Global Multicenter Experience of 1250 Patients
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Castellani, Daniele, Traxer, Olivier, Ragoori, Deepak, Galosi, Andrea Benedetto, De Stefano, Virgilio, Gadzhiev, Nariman, Tanidir, Yiloren, Inoue, Takaaki, Emiliani, Esteban, Hamri, Saeed Bin, Lakmichi, Mohamed Amine, Vaddi, Chandra Mohan, Heng, Chin Tiong, Soebhali, Boyke, More, Sumit, Sridharan, Vikram, Gökce, Mehmet Ilker, Tursunkulov, Azimdjon N., Ganpule, Arvind, Pirola, Giacomo Maria, Naselli, Angelo, Aydin, Cemil, Ramón de Fata Chillón, Fernando, Mendoza, Catalina Solano, Candela, Luigi, Chew, Ben Hall, Somani, Bhaskar Kumar, and Gauhar, Vineet
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- 2023
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6. The influence of lead exposure on male semen parameters: A systematic review and meta-analysis
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Giulioni, Carlo, Maurizi, Valentina, De Stefano, Virgilio, Polisini, Giordano, Teoh, Jeremy Yuen-Chun, Milanese, Giulio, Galosi, Andrea Benedetto, and Castellani, Daniele
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- 2023
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7. The Significance of Stone Culture in the Incidence of Sepsis: Results from a Prospective, Multicenter Study on Infections Post Flexible UreteroreNescopy (I-FUN) and Laser Lithotripsy for Renal Stones.
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Castellani, Daniele, Brocca, Carlo, De Stefano, Virgilio, Mazzon, Giorgio, Celia, Antonio, Bosio, Andrea, Bertello, Glauco, Alessandria, Eugenio, Cormio, Luigi, Ratnayake, Runeel, Vismara Fugini, Andrea, Morena, Tonino, Tanidir, Yiloren, Sener, Tarik Emre, Choong, Simon, Ferretti, Stefania, Pescuma, Andrea, Micali, Salvatore, Pavan, Nicola, and Simonato, Alchiede
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LASER lithotripsy ,KIDNEY stones ,SEPSIS ,URINARY calculi ,SEPTIC shock ,LOGISTIC regression analysis ,RENAL colic ,VESICO-ureteral reflux - Abstract
Objective: Sepsis is the most serious complication of flexible ureteroscopy (F-URS) and laser lithotripsy. We assessed the influence of positive stone culture (SC) on major infectious complications (sepsis, septic shock). Methods: This prospective study enrolled adult patients deemed suitable for F-URS and laser lithotripsy from nine centers (January 2022–August 2023). Inclusion criteria were as follows: kidney stone(s), preoperative midstream urine culture (MSUC), stone(s) assessed at computed tomography scan, and SC. Exclusion criteria were as follows: bilateral procedures, ureteral stones, and children. Group 1 included patients with sterile SC. Group 2 included patients with positive SC. Data are presented as median (interquartile range). A multivariable logistic regression analysis was performed to evaluate factors associated with having a positive SC. Results: In total, 293 patients were included. Median age was 51.0 (24) years. There were 167 (57.0%) males. Group 2 included 32 (2.5%) patients. Group 2 patients were significantly older [75.0 (14) vs 51.0 (23) years, p = 0.02]. Stone features were similar. Major infectious complications were higher in Group 2 (15.6% vs 0.4%). One patient died because of sepsis in Group 2. Two out of 6 (33.3%) patients with major infectious complications had the same pathogen in MSUC and SC. In the multivariable regression analysis, diabetes (OR 3.23), symptomatic urinary infections within 3 months before operation (OR 4.82) and preoperative stent/nephrostomy (OR 2.92) were factors significantly associated with higher odds of positive SC. Conclusions: Patients with positive SC have a higher incidence of major infectious complications after F-URS lithotripsy. SC should be performed whenever feasible because there is a poor correlation between MSUC and SC. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Reoperation Rate for Residual/Regrowth Adenoma Following Transurethral Interventions for Benign Prostatic Enlargement: Results from a Systematic Review and Meta-Analysis of Comparative Randomized Studies.
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Castellani, Daniele, Tramanzoli, Pietro, Chiacchio, Giuseppe, Cormio, Angelo, Rubino, Arianna, Nedbal, Carlotta, Perpepaj, Leonard, Stramucci, Silvia, De Stefano, Virgilio, Teoh, Jeremy Yuen-Chun, Cormio, Lugi, Somani, Bhaskar K., Benedetto Galosi, Andrea, and Gauhar, Vineet
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BENIGN prostatic hyperplasia ,ENUCLEATION of the eye ,REOPERATION ,TRANSURETHRAL prostatectomy ,ADENOMA ,COMPARATIVE studies - Abstract
Objective: To perform a systematic review to assess the incidence of reoperation rate for residual/regrowth adenoma after transurethral surgeries for benign prostatic enlargement. Materials and Methods: A systematic literature search was performed on November 12, 2023, using Cochrane Central Register of Controlled Trials, PubMed, and Scopus. We only included randomized studies comparing monopolar (M)/bipolar (B) transurethral resection of the prostate (TURP) vs ablation vs enucleation procedures. Incidence of reoperation was assessed using the Cochran-Mantel-Haenszel Method and reported as risk ratio (RR), 95% confidence interval (CI), and p-values. Statistical significance was set at p < 0.05. Evidence synthesis: Forty-eight studies were included. Six studies compared enucleation vs TURP, 41 ablation vs TURP, and 1 study enucleation vs ablation vs TURP, encompassing 457 patients in enucleation, 2259 in ablation, and 2517 in the TURP group. The pooled incidence of reoperation was 6.2%, 0.7%, 2.3%, and 4.3% after ablation, enucleation, M-TURP, and B-TURP, respectively. Meta-analysis showed that the incidence of reoperation was significantly lower in the enucleation group (RR 0.28, 95% CI 0.10–0.81, p = 0.02), but the difference accounted only in studies with follow-up between 1 and 3 years (RR 0.18, 95% CI 0.04–0.85, p = 0.03). The incidence of reoperation was significantly lower in the enucleation compared with the B-TURP group (RR 0.14, 95% CI 0.03–0.77, p = 0.02). Meta-analysis showed that the incidence of reoperation was significantly higher in the ablation group (RR 1.81, 95% CI 1.33–2.47, p = 0.0002), but there was no difference in studies with follow-up up to 1 year (odds ratio 1.78 95% CI 0.97–3.29, p = 0.06) longer than 5 years (RR 2.02, 95% CI 0.71–5.79, p = 0.19). The incidence of reoperation was significantly higher in the ablation compared with the M-TURP group (RR 1.91, 95% CI 1.44–2.54, p < 0.0001). Conclusions: In mid-term follow-up, reoperation rate for residual/regrowth adenoma was significantly lower after enucleation, although was significantly higher after ablation compared with TURP. [ABSTRACT FROM AUTHOR]
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- 2024
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9. Scoping Review of Experimental and Clinical Evidence and Its Influence on Development of the Suction Ureteral Access Sheath.
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Yuen, Steffi Kar Kei, Traxer, Olivier, Wroclawski, Marcelo Langer, Gadzhiev, Nariman, Chai, Chu Ann, Lim, Ee Jean, Giulioni, Carlo, De Stefano, Virgilio, Nedbal, Carlotta, Maggi, Martina, Sarica, Kemal, Castellani, Daniele, Somani, Bhaskar, and Gauhar, Vineet
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TECHNOLOGICAL innovations ,KIDNEY stones ,URETEROSCOPY ,ENDOUROLOGY - Abstract
The ureteral access sheath (UAS) has been a boon and a bane in flexible ureteroscopy (FURS), with its merits and demerits well established. Its design and dimensions were instrumental in reshaping the way flexible scopes were used and were key adjuncts to establishing retrograde intrarenal surgery (RIRS) as a standard of care in the endourological management of renal stones. With the ever-changing landscape of RIRS over the decades shaped by technological advancements in lasers and flexible scopes, the UAS has also continuously evolved. The utility of suction in endourology has recently changed the way RIRS is performed and is a game changer for FURS outcomes. With strong clinical and experimental evidence to support its use, the UAS has undergone a transformative change in the recent past, with its ability to monitor intrarenal pressure and provide a superior vacuum-cleaner effect that improves the trifecta of RIRS, namely an improved single-stage stone-free rate (SFR), minimise complications, and reduce reinterventions. Our comprehensive review outlines the key clinical and experimental evidence and traces the developments that were key to modifying the traditional UAS into a flexible and navigable suction ureteric access sheath (FANS) and highlights how the design and modifications, in turn, influence the ability to push the boundaries of RIRS. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Pudendal nerve neurolysis outcomes for urogenital and rectal disorders in patients suffering from pudendal nerve entrapment: A systematic review.
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Giulioni, Carlo, Pitoni, Lucia, Fuligni, Demetra, Beltrami, Mattia, Passarella, Valeria, Palantrani, Vanessa, De Stefano, Virgilio, Castellani, Daniele, and Galosi, Andrea Benedetto
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PUDENDAL nerve ,ENTRAPMENT neuropathies ,URINATION disorders ,SEXUAL excitement ,AFFERENT pathways ,URINARY organs ,URINARY incontinence ,PENILE prostheses - Abstract
Purpose: Pudendal neuropathy is an uncommon condition that exhibits several symptoms depending on the site of nerve entrapment. This study aims to evaluate the efficacy of pudendal nerve neurolysis (PNN) in improving lower urinary tract symptoms, anal and/or urinary incontinence, and sexual dysfunctions. Materials and Methods: A systematic literature search was performed on 20 May 2023 using Scopus, PubMed, and Embase. Only English and adult papers were included. Meeting abstracts and preclinical studies were excluded. Results: Twenty-one papers were accepted, revealing significant findings in the field. The study identified four primary sites of pudendal nerve entrapment (PNE), with the most prevalent location likely being at the level of the Alcock canal. Voiding symptoms are commonly exhibited in patients with PNE. PNN improved both urgency and voiding symptoms, and urinary and anal incontinence but is less effective in cases of long-standing entrapment. Regarding sexual function, the recovery of the somatic afferent pathway results in an improvement in erectile function early after neurolysis. Complete relief of persistent genital arousal disorder occurs in women, although bilateral PNN is necessary to achieve the efficacy. PNN is associated with low-grade complications. Conclusions: PNN emerges as a viable option for addressing urinary symptoms, fecal incontinence, erectile dysfunction, and female sexual arousal in patients suffering from PNE with minimal postoperative morbidity. [ABSTRACT FROM AUTHOR]
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- 2024
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11. Pudendal Nerve Neurolysis in Patients Afflicted With Pudendal Nerve Entrapment: A Systematic Review of Surgical Techniques and Their Efficacy.
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Giulioni, Carlo, Pirola, Giacomo Maria, Maggi, Martina, Pitoni, Lucia, Fuligni, Demetra, Beltrami, Mattia, Palantrani, Vanessa, De Stefano, Virgilio, Maurizi, Valentina, Castellani, Daniele, and Galosi, Andrea Benedetto
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To assess the effectiveness and safety of various techniques of pudendal nerve neurolysis (PNN) in patients with pudendal nerve entrapment (PNE). A comprehensive literature search was conducted on May 20th, 2023, using Scopus, PubMed, and Embase databases. Only studies in English involving adults were accepted, while meeting abstracts and preclinical studies were excluded. A total of 34 papers were included. Transperineal PNN emerged as a promising technique, demonstrating significant potential in alleviating pain, restoring erectile function in males, and improving the resolution of urinary stress incontinence in females. Furthermore, the bilateral approach consistently yielded positive outcomes in addressing urinary symptoms. The transgluteal technique appeared particularly suitable for cases of posterior PNE, situated between the sacrospinous ligament and the lesser sciatic foramen. A progressive amelioration of painful symptoms was observed during follow-up. Minimally invasive PNN is evolving and enables decompression along the entire proximal tract up to the Alcock canal, minimizing the risk of comorbidities. In addition to reducing pudendal neuralgia, robot-assisted and laparoscopic approaches determined a reduction in lower urinary tract symptoms and an improvement in erectile function, though further studies are required to corroborate these findings. PNN emerges as an effective treatment for PNE with minimal morbidity. Therefore, PNN should be tailored according to the site of PNE to enhance functional outcomes and improve patient quality of life. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Extracorporeal shock wave lithotripsy, ureterolithotripsy, and percutaneous nephrolithotripsy challenges in managing spinal cord neuropathy patients. Lessons learned from a scoping review.
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Castellani, Daniele, Brocca, Carlo, Fuligni, Demetra, Giulioni, Carlo, Antezza, Angelo, Cormio, Angelo, Rubino, Arianna, Pitoni, Lucia, De Stefano, Virgilio, Milanese, Giulio, Cormio, Luigi, Somani, Bhaskar Kumar, Gauhar, Vineet, and Galosi, Andrea Benedetto
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LITHOTRIPSY ,SHOCK waves ,NEUROPATHY ,BLOOD transfusion ,KYPHOSIS - Abstract
Introduction We aim to review the outcomes of shock wave lithotripsy (SWL), ureteroscopy, and percutaneous nephrolithotripsy (PCNL) for renal and ureteral stones in spinal cord neuropathy patients (SNP). Material and methods A literature search was performed on 8th March 2023 using PubMed, EMBASE, and Google Scholar with no date limit. Preclinical/animal studies, reviews, letters to the editor, case reports, and meeting abstracts were excluded. Only English papers were accepted. Results Thirty-five articles were accepted. Five studies focused on SWL, 17 on PCNL, and 6 on ureteroscopy. The remaining articles employed more than one procedure. Stone composition has shifted from struvite to the more common calcium phosphate. SWL showed a very poor stone-free rate (SFR) likely due to challenges in patient positioning, stone visualization, localization, and inability to pass fragments spontaneously. Flexible ureteroscopy and PCNL were associated with a high incidence of infectious complications, long hospital stays, high blood transfusion rate, and intensive care admissions. There were also cases of death. Both procedures were challenging due to genitourinary reconstruction, scoliosis and kyphosis, rib-cage deformity, lower limb contractures, and severe comorbidity which also affected anesthesia. SFR was lower than in non-neurological patients. Conclusions SWL, ureterolithotripsy, and PCNL should be considered challenging procedures in SNP due to positioning issues, an increased risk of intra and peri-operative morbidity, and even mortality. Computed tomography should be recommended to assess residual fragments as it becomes imperative to minimize a re-intervention in SNP who should be preferably treated in referral centers. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Near-Infrared Fluorescence Imaging with Indocyanine Green for Robot-Assisted Partial Nephrectomy: A Systematic Review and Meta-Analysis.
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Giulioni, Carlo, Mulawkar, Prashant Motiram, Castellani, Daniele, De Stefano, Virgilio, Nedbal, Carlotta, Gadzhiev, Nariman, Pirola, Giacomo Maria, Law, Yu Xi Terence, Wroclawski, Marcelo Langer, Keat, William Ong Lay, Tiong, Ho Yee, Somani, Bhaskar Kumar, Galosi, Andrea Benedetto, and Gauhar, Vineet
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ONLINE information services ,PERIOPERATIVE care ,NEAR infrared spectroscopy ,INDOLE compounds ,NEPHRECTOMY ,META-analysis ,MEDICAL information storage & retrieval systems ,CONFIDENCE intervals ,SURGICAL robots ,SYSTEMATIC reviews ,POSTOPERATIVE care ,DIAGNOSTIC imaging ,TREATMENT effectiveness ,DISEASE relapse ,KIDNEY tumors ,DESCRIPTIVE statistics ,FLUORESCENT dyes ,MEDLINE - Abstract
Simple Summary: Renal cell cancer, constituting the predominant type of kidney malignancy, exhibits a global annual incidence increase of 2%. In the management of clinical T1 renal tumors, the recommended surgical approach is partial nephrectomy (PN). The primary objective of this procedure is the preservation of nephrons, thereby mitigating the risk of enduring kidney dysfunction and maintaining comparable oncological outcomes when contrasted with radical nephrectomy. Initially performed as an open surgery, PN has undergone significant evolution, with minimally invasive techniques, particularly robot-assisted ones, garnering recognition. Nonetheless, despite the inherent advantages, partial nephrectomy presents specific challenges, notably an elevated likelihood of incomplete tumor excision and positive surgical margins, which may have implications for cancer-specific outcomes. To address these challenges, the utilization of near-infrared fluorescence technology, involving the intravenous administration of indocyanine green (ICG), has been proposed. ICG, a water-soluble compound that binds to plasma albumin, emits near-infrared light, enabling the visualization of kidney vasculature and renal tumors. Background: We aimed to analyze the influence of near-infrared fluorescence (NIRF) using indocyanine green (ICG) with standard robot-assisted partial nephrectomy (RAPN) in patients with a kidney tumor (KT). Methods: We performed a literature search on 12 September 2023 through PubMed, EMBASE, and Scopus. The analysis included observational studies that examined the perioperative and long-term outcomes of patients with a KT who underwent RAPN with NIRF. Results: Overall, eight prospective studies, involving 535 patients, were eligible for this meta-analysis, with 212 participants in the ICG group and 323 in the No ICG group. For warm ischemia time, the ICG group showed a lower duration (weighted Mean difference (WMD) = −2.05, 95% confidence interval (CI) = −3.30–−0.80, p = 0.011). The postoperative eGFR also favored the ICG group (WMD = 7.67, 95% CI = 2.88–12.46, p = 0.002). No difference emerged for the other perioperative outcomes between the two groups. In terms of oncological radicality, the positive surgical margins and tumor recurrence rates were similar among the two groups. Conclusions: Our meta-analysis showed that NIRF with ICG during RAPN yields a favorable impact on functional outcomes, whereas it exerts no such influence on oncological aspects. Therefore, NIRF should be adopted when preserving nephron function is a paramount concern. [ABSTRACT FROM AUTHOR]
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- 2023
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14. Current Evidence on Surgical Management for Benign Prostatic Hyperplasia in Renal Transplant Recipients: A Systematic Review.
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Giulioni, Carlo, Palantrani, Vanessa, De Stefano, Virgilio, Cicconofri, Andrea, Antezza, Angelo, Beltrami, Mattia, Milanese, Giulio, Ranghino, Andrea, Gauhar, Vineet, Castellani, Daniele, and Galosi, Andrea Benedetto
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RETENTION of urine ,BENIGN prostatic hyperplasia ,KIDNEY transplantation ,BLADDER obstruction ,URINARY tract infections ,TRANSURETHRAL prostatectomy ,URINATION disorders ,OLDER men - Abstract
Background: Patients who have undergone renal transplant may have a concomitant benign prostatic hyperplasia (BPH), a condition that can potentially hinder the recovery of the renal graft and necessitate surgical intervention. However, endoscopic treatment of BPH should be performed carefully because of the associated perioperative risks. We aimed to systematically assess the factors affecting surgical indications and perioperative outcomes of BPH surgical treatment in renal transplantation (RT) recipients. Methods: A systematic literature search was performed on January 28, 2023, using Scopus, PubMed, and EMBASE with no date limit. Preclinical and animal studies, reviews, letters to the editor, case reports, and meeting abstracts were excluded. Results: Eighteen articles were accepted and included. Clinical BPH has a high incidence rate after RT, particularly in elderly men. Secondary events associated with BPH, such as acute urinary retention and urinary tract infections, can lead to a gradual decline of renal graft function and patient survival. BPH procedure can prevent these events and guarantee improvements in serum creatinine levels, voiding parameters, and lower urinary tract symptoms. When the urine culture is negative, the endoscopic procedure of the prostate may be performed within 1 month of the initial procedure, particularly in older patients, more prone to develop voiding dysfunction. Alternatively, a transurethral incision of the prostate may be recommended for patients with smaller prostates who wish to preserve ejaculatory function. Data on comparative BPH surgical procedures are lacking. Conclusions: BPH procedure should be offered in RT recipients who develop bladder outlet obstruction owing to BPH. Endoscopic treatment should be performed after a few weeks from RT to avoid further graft deterioration. [ABSTRACT FROM AUTHOR]
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- 2023
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15. An Update of In Vivo Application of Artificial Intelligence and Robotics for Percutaneous Nephrolithotripsy: Results from a Systematic Review.
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Gauhar, Vineet, Giulioni, Carlo, Gadzhiev, Nariman, De Stefano, Virgilio, Teoh, Jeremy Yuen-Chun, Tiong, Ho Yee, Taguchi, Kazumi, Milanese, Giulio, Galosi, Andrea Benedetto, Somani, Bhaskar Kumar, and Castellani, Daniele
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Purpose of Review: Kidney puncture is a key step in percutaneous nephrolithotomy (PCNL). Ultrasound/fluoroscopic-guided access to the collecting systems is commonly used in PCNL. Performing a puncture is often challenging in kidneys with congenital malformations or complex staghorn stones. We aim to perform a systematic review to examine data on in vivo applications, outcomes, and limitations of using artificial intelligence and robotics for access in PCNL. Recent Findings: The literature search was performed on November 2, 2022, using Embase, PubMed, and Google Scholar. Twelve studies were included. 3D in PCNL is useful for image reconstruction but also in 3D printing with definite benefits seen in improving anatomical spatial understanding for preoperative and intraoperative planning. 3D model printing and virtual and mixed reality allow for an enhanced training experience and easier access which seems to translate into a shorter learning curve and better stone-free rate compared to standard puncture. Robotic access improves the accuracy of the puncture for ultrasound- and fluoroscopic-guided access in both supine and prone positions. The potential advantage robotics are using artificial intelligence to do remote access, reduced number of needle punctures, and less radiation exposure during renal access. Summary: Artificial intelligence, virtual and mixed reality, and robotics may play a key role in improving PCNL surgery by enhancing all aspects of a successful intervention from entry to exit. There is a gradual adoption of this newer technology into clinical practice but is yet limited to centers with access and the ability to afford this. [ABSTRACT FROM AUTHOR]
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- 2023
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16. The use of renal biopsy in the kidney tumor management: A retrospective analysis of consecutive cases in a referral center.
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Galosi, Andrea Benedetto, Macchini, Marco, Candelari, Roberto, De Stefano, Virgilio, Stramucci, Silvia, Cammarata, Vanessa, Al Ayoubi, Omar, Cicconofri, Andrea, and Giulioni, Carlo
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RENAL biopsy ,NEPHRECTOMY ,KIDNEY tumors ,SECONDARY primary cancer ,ELECTRONIC health records ,RENAL cell carcinoma ,RETROSPECTIVE studies - Abstract
Introduction: Ultrasound-guided renal masses biopsy (RMB) is a useful and underestimated tool to evaluate suspected renal tumors. This study aimed to assess the safety and feasibility of this technique. Materials and Methods: Data of 80 patients with suspected primary or secondary kidney tumors who underwent RMB between January 2012 and December 2020 were included in this retrospective study. Twelve patients were excluded due to incomplete data. Biopsy outcomes were collected through our electronic medical records system and then compared with definitive pathology. Results: RMB was performed in 68 cases. Pathological examination reported 43 (63%) malignant cases, while RMB was negative in 15 (22%) samples. On the other hand, a benign lesion was present in 8 (12%) cases, and 2 (3%) biopsies were non diagnostic. One major and one minor post-procedure complication were reported among the patients. A total of 31 patients underwent renal surgery including 19 partial and 12 radical nephrectomies. Out of them, 4 patients had a negative biopsy, but radiological imaging strongly suggested malignancy. The concordance between biopsy and definitive pathology occurred in 22 out of 31 (71%) cases, with a higher rate among the masses greater than 4 cm, 9/11 (82%) compared to smaller ones 13/20 (65%). Pathologic examination of the 4 cases with negative biopsy showed 3 renal cell and a translocation renal cell carcinoma. Conclusions: Ultrasound-guided biopsy for renal masses is a safe and effective procedure. Its ability to identify malignancy is evident, especially for primary renal tumors. However, low concordance between biopsy and definitive pathology in cases with negative biopsies, especially for tumors < 4 cm, does not reliably guarantee the absence of tumor and, therefore, strict follow-up or repeat biopsy may be indicated. [ABSTRACT FROM AUTHOR]
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- 2023
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17. Radiomics vs radiologist in prostate cancer. Results from a systematic review.
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Chiacchio, Giuseppe, Castellani, Daniele, Nedbal, Carlotta, De Stefano, Virgilio, Brocca, Carlo, Tramanzoli, Pietro, Galosi, Andrea Benedetto, Donalisio da Silva, Rodrigo, Teoh, Jeremy Yuen-Chun, Tiong, Ho Yee, Naik, Nithesh, Somani, Bhaskar K., Merseburger, Axel S., and Gauhar, Vineet
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RADIOMICS ,PROSTATE cancer ,MAGNETIC resonance imaging ,RADIOLOGISTS ,IMAGE intensifiers - Abstract
Purpose: Radiomics in uro-oncology is a rapidly evolving science proving to be a novel approach for optimizing the analysis of massive data from medical images to provide auxiliary guidance in clinical issues. This scoping review aimed to identify key aspects wherein radiomics can potentially improve the accuracy of diagnosis, staging, and extraprostatic extension in prostate cancer (PCa). Methods: The literature search was performed on June 2022 using PubMed, Embase, and Cochrane Central Controlled Register of Trials. Studies were included if radiomics were compared with radiological reports only. Results: Seventeen papers were included. The combination of PIRADS and radiomics score models improves the PIRADS score reporting of 2 and 3 lesions even in the peripheral zone. Multiparametric MRI-based radiomics models suggest that by simply omitting diffusion contrast enhancement imaging in radiomics models can simplify the process of analysis of clinically significant PCa by PIRADS. Radiomics features correlated with the Gleason grade with excellent discriminative ability. Radiomics has higher accuracy in predicting not only the presence but also the side of extraprostatic extension. Conclusions: Radiomics research on PCa mainly uses MRI as an imaging modality and is focused on diagnosis and risk stratification and has the best future possibility of improving PIRADS reporting. Radiomics has established its superiority over radiologist-reported outcomes but the variability has to be taken into consideration before translating it to clinical practice. [ABSTRACT FROM AUTHOR]
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- 2023
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18. Radiomics vs radiologist in bladder and renal cancer. Results from a systematic review.
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Tramanzoli, Pietro, Castellani, Daniele, De Stefano, Virgilio, Brocca, Carlo, Nedbal, Carlotta, Chiacchio, Giuseppe, Galosi, Andrea Benedetto, Silva, Rodrigo Donalisio Da, Teoh, Jeremy Yuen-Chun, Tiong, Ho Yee, Naik, Nithesh, Somani, Bhaskar K., and Gauhar, Vineet
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RADIOLOGISTS ,RADIOMICS ,RENAL cancer ,DIAGNOSTIC imaging ,URINARY organs ,UROLOGY - Abstract
Introduction Radiomics in uro-oncology is a rapidly evolving science proving to be a novel approach for optimizing the analysis of massive data from medical images to provide auxiliary guidance in clinical issues. This scoping review aimed to identify key aspects wherein radiomics can potentially improve the accuracy of diagnosis, staging, and grading of renal and bladder cancer. Material and methods A literature search was performed in June 2022 using PubMed, Embase, and Cochrane Central Controlled Register of Trials. Studies were included if radiomics were compared with radiological reports only. Results Twenty-two papers were included, 4 were pertinent to bladder cancer, and 18 to renal cancer. Radiomics outperforms the visual assessment by radiologists in contrast-enhanced computed tomography (CECT) to predict muscle invasion but are equivalent to CT reporting by radiologists in predicting lymph node metastasis. Magnetic resonance imaging (MRI) radiomics outperforms radiological reporting for lymph node metastasis. Radiomics perform better than radiologists reporting the probability of renal cell carcinoma, improving interreader concordance and performance. Radiomics also helps to determine differences in types of renal pathology and between malignant lesions from their benign counterparts. Radiomics can be helpful to establish a model for differentiating low-grade from highgrade clear cell renal cancer with high accuracy just from contrast-enhanced CT scans. Conclusions Our review shows that radiomic models outperform individual reports by radiologists by their ability to incorporate many more complex radiological features. [ABSTRACT FROM AUTHOR]
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- 2023
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19. Do sclero‐embolization procedures have advantages over surgical ligature in treating varicocele in children, adolescents and adults? Results from a systematic review and meta‐analysis.
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Fabiani, Andrea, Pavia, Maria Pia, Stramucci, Silvia, Antezza, Angelo, De Stefano, Virgilio, and Castellani, Daniele
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HUMAN artificial insemination ,VARICOCELE ,RANDOM effects model ,THERAPEUTIC embolization ,ADULTS ,TEENAGERS ,SPERM motility - Abstract
We aimed to systematically review complications, and recurrence rate of varicocele treatment by comparing the surgical ligature versus sclero‐embolization techniques in children, adolescents and adults. The secondary outcomes were the evaluation of semen parameters and spontaneous pregnancy rate in adults. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses framework. Continuous variables were pooled using the inverse variance of the mean difference (MD) with a fixed effect, and 95% confidence interval (CI). The incidences of complications were pooled using the Cochran–Mantel–Haenszel Method with the random effect model and reported as Odds Ratio (OR), and 95% CI. Statistical significance was set two‐tail p‐value < 0.05. Twenty studies were included. Incidence of postoperative hydrocele was significantly higher in the surgical ligation group (OR 3.06 95% CI 1.06–8.88, p = 0.04). Incidence of postoperative orchiepidydimitys was significantly higher in sclero‐embolization group (OR 0.26 95% CI 0.08–0.85, p = 0.02). Presence of normal spermatozoa was significantly higher sclero‐embolization group compared with the surgical ligature group (MD 2.54% 95% CI 0.43–4.65, p = 0.02). No difference was found in overall complications, wound infection, testis pain, surgical site hematoma, total sperm count, sperm motility, pregnancy and recurrence rate. This review confirms that current data does still not support the superiority of one type of treatment over other ones. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
20. Predictive value of MCM5 (ADXBLADDER) analysis in urine of men evaluated for the initial diagnosis of bladder cancer: A comparative prospective study.
- Author
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Anastasi, Emanuela, Maggi, Martina, Tartaglione, Sara, Angeloni, Antonio, Gennarini, Giuseppina, Leoncini, Pier Paolo, Sperduti, Isabella, Di Lascio, Giovanni, De Stefano, Virgilio, Di Pierro, Giovanni Battista, Del Giudice, Francesco, Busetto, Gian Maria, De Berardinis, Ettore, and Sciarra, Alessandro
- Published
- 2020
- Full Text
- View/download PDF
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