bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fournier's gangrene: our experience of 10 cases
Authors: Rahmati M. , Sarti A. , Rubilotta E. , Chierigo P. , Lazzarotto M. , Franzolin N. 
Published: June 2018

Fournier's gangrene, described for the first time by Alfred Jean Fournier in 1883, is a very uncommon disease. It is characterized by an acute process of cellulites and necrotizing fasciitis of the external genitalia, perineum and abdominal wall; its mortality rate is about 30–50%. We retrospectively reviewed 10 patients affected by Fournier's gangrene admitted to our Department of Urology from 1997 to 2006. At a mean follow-up of 37 months (range 0–108) 7 patients are alive and disease free, 1 patient is alive bearing the signs of the gangrene, and 2 patients died because of the disease complications. We have noted that patients’ survival depends on early intervention and extremely aggressive approach. The combination of these factors with antibiotic therapy and supportive care have made this disease treatable and curable.
Scritti in ricordo del Professor Giorgio Ravasini nel quindicesimo anniversario della Sua scomparsa
Authors: Anselmo Giuseppe 
Published: June 2018

Il 1 dicembre 2007 si è tenuto a Treviso il 61° Convegno dell'Associazione Triveneta di Urologia in onore del Professor Giorgio Ravasini nel XV anniversario della Sua scomparsa per iniziativa di un gruppo di allievi, fra cui i Direttori di questa Rivista fanno parte, e che si fanno portavoce nel ringraziare Guglielmo Breda, Presidente dell'Associazione Triveneta, per aver accettato la proposta di ospitare questa iniziativa nell'ambito dell'Associazione, e Luigi Maccatrozzo, Presidente e organizzatore del Convegno, per avervi aderito con entusiasmo e disponibilità, modificando un precedente programma scientifico. Abbiamo pensato di pubblicare su Urologia i testi degli interventi fatti da alcuni relatori su “I diversi aspetti delle neoplasie vescicali”, tema caro al Professor Ravasini e per questo scelto come filo conduttore del Convegno. Sergio Cosciani Cunico Antonino Lembo
Contrast Media in Urogenital Radiology
Authors: Foschi N. , Totaro A. , Brescia A. , Gulino G. , Bassi P.F. 
Published: June 2018

Background Contrast media are widely used in urogenital radiology. The ideal contrast agent should be totally inert, causing no interactions with organism, and with a rapid and complete excretion. Adverse reactions could occur after using any type of contrast media. Contrast enhanced procedures are performed with increasing frequency and the patients population is progressively older and with multiple co-morbid conditions, thus contrast media toxicity is becoming a serious problem. Contrast media-induced nephropathy (CIN) is considered an important cause of hospital-acquired renal failure. The administration of gadolinium-based contrast agents has been recently associated with the development of a serious adverse reaction, potentially lethal in patients with renal insufficiency, named nephrogenic systemic fibrosis (NSF). Methods Literature review on contrast media in urogenital radiology, CIN, NSF. Conclusions Since 1996, the Contrast Media Safety Committee of the European Society of Urogenital Radiology (ESUR) has released its guidelines regarding safety about the use of contrast media. CIN, and the emerging NSF, are topics of increasing interest for urologists, radiologists, nephrologists, dermatologists and all the clinicians. Contrast media have progressively become safer in the last years. Even if rare, some adverse reactions still occurr up to now. CIN and its prevention remain an issue under debate. In the past, whenever a patient required a contrast-enhanced imaging study, the trend was to select magnetic resonance imaging with gadolinium-based contrast agents in order to avoid the well-known CIN of iodinated-based contrast agents. The awareness of NFS is changing the contrast–enhanced imaging in patients with renal failure. At present we have to investigate NSF etiopathogenesis, in order to prevent and eventually to cure it. The understanding of the risk factors for both CIN and NSF is an emerging need, the adoption of all preventive measures to reduce the risks remain a mandatory issue.
Management, and Prevention, of Intravesical Therapy Complications
Authors: Serretta V. 
Published: June 2018

The urologist must prevent, identify and properly treat the complications of intravesical chemotherapy and immunotherapy. Both local and systemic toxicity of adjuvant intravesical therapy is herein analyzed. Topical toxicity is mainly due to the inflammation induced by the contact between the instilled agent and the bladder mucosa. Material and Methods The factors predisposing to topical toxicity must be identified and removed before starting the treatment. The choice of the agent, its dose, concentration and dosage must be tailored, whenever possible, to the presence of the above mentioned factors. Mitomycin and BCG can rarely provoke chronic cystitis, severely compromising bladder function. Results The most dangerous complication of early intravesical chemotherapy is the instillation in presence of an unrecognized bladder perforation. Flu-like syndrome, fever, chills, arthralgia are reported in almost 20% of patients receiving BCG. If fever persists for more than 48 hours or exceeds 38.5 °C, isoniazid must be administered and BCG stopped until complete remission. BCG sepsis is a rare but severe complication that must be promptly recognized and treated. If not, a life-threatening multi-organ failure syndrome can arise. Isoniazid and rifampicin, adding ethambutol when required, must be administered for a prolonged period until complete remission. Conclusions Granulomatous lesions represent the main other rare systemic complications of BCG therapy. Systemic toxicity of intravesical chemotherapy is rare, due to the high molecular weight of the drugs, limiting systemic absorption.
Living Donor Nephrectomy: Open versus Laparoscopic Technique
Authors: Franceschin M. , Capocasale E. , Valle DALLA R. , Mazzoni M.P. , Busi N. , Sianesi M. 
Published: June 2018

Background The living donor nephrectomy has to be safe and effective, allowing a good graft function in the recipient. In the past, donor nephrectomy was performed only by open technique; more recently this nephrectomy has also been performed by laparoscopic technique. The best technique has not been established in literature. The purpose of this study is to report the results of open and laparoscopic nephrectomy in living donors. Materials and Methods From January 1992 to August 2008, 37 living donor nephrectomies were performed. 23 nephrectomies were achieved by laparoscopic procedure (LDN) and 14 by open technique (ODN). The 2 groups were comparable regarding both donor and recipient characteristics. Results All laparoscopic nephrectomies were successfully performed without conversion to open procedure. No donor deaths were reported in either groups. 3 complications (13%) in the LDN group and 1 (7.1%) in the ODN group (p=0.6) were observed. Mean operative time was higher in the LDN group (p<0.036). Mean warm and cold ischemia time, resumption of oral intake and hospital stay were shorter in the LDN group (p<0.04)(p<0.03) (p<0.0001), whereas the return to normal occupational life was similar (p<0.52). We had no significant differences in the surgical complication rates, graft and patient survival. Conclusions Our experience suggests that both procedures can be used safely and efficiently, and assure a good renal function in the recipient. Laparoscopic nephrectomy, although more difficult, provides post-operative advantages. However, laparoscopic procedure must be performed by experienced centres only to prevent serious complications in the donor.
Conservation of Erectile Function following Brachytherapy for Low-Risk Prostate Cancer
Authors: Giberti C. , Rosso G. , Gallo F. , Chiono L. , Gastaldi E. , Ninotta G. 
Published: June 2018

Brachytherapy (BT) is an effective option to treat low-risk prostate cancer (CaP). While oncological results are consistent with those reported following radical retropubic prostatectomy (RRP), attention may be given to the advantages in terms of functional results that a less invasive approach can ensure. The aim of this study is to assess the impact of the conservation of erectile function (EF) in patients who underwent BT with a short and medium term follow-up. Materials and Methods Between May 1999 and January 2005, 170 patients underwent BT for low-risk CaP (intracapsular prostate cancer, PSA, 10 ng/mL, Gleason score, 6). Among them, 58 patients (average age 65.6) with good preoperative erectile function (IIEF>22) and a minimum follow-up of 5 years were selected. The results were evaluated by comparing the values of pre- and postoperative IIEF questionnaire at 3 months, 1 and 5 years of medium follow-up. Results At a mean 3-month follow-up, a spontaneous recovery of EF (IIEF> 17), strongly influenced by urinary irritative disorders, was reported by 34/58 patients (58%). At 1 and 5 years, good EF (IIEF >22) was reported by 45/58 (78%) and 39/58 (68%) patients, respectively. Discussion and Conclusions The recovery of EF was good one year after BT (78%). Urinary disorders are a significant limiting factor on this recovery. The deterioration of EF during the follow-up, which was already described in literature, is due not only to ageing but also to a delayed radioactive effect on pelvic structures.
Second-Line Intravesical Gemcitabine in High Risk Superficial Bladder Cancer: Our Experience
Authors: Aloisi A. , Ruggera L. , Beltrami P. , Cerruto M.A. , Zattoni F. 
Published: June 2018

Purpose Intravesical instillation of Gemcitabine may represent a useful second-line chemotherapy in case of non-muscle-invasive bladder cancer. Herein, we reported our experience with intravesical Gemcitabine in a group of patients affected by high-grade transitional cell carcinoma (TCC) of the bladder. Materials and Methods We retrospectively analyzed a total of 17 patients (15 males and 2 females), affected by high-risk superficial bladder cancer, who were refractory, intolerant or not eligible to intravesical BCG immunotherapy. Each patient received 2000 mg of Gemcitabine diluted in 100 mL of 0.9% saline solution, administered twice a week for 6 weeks. At start, TCC stage and grade were: CIS in 10 patients, TaG3 in 5 and T1G3 in the remaining 2 cases. Those with no macroscopic lesion and negative cytology and histology were considered as complete responders; those with only positive cytology as partial responders, and those with positive biopsy or evidence of macroscopic lesions as non-responders. Results Patients’ mean age was 71.5 yrs (± 7.3 yrs standard deviation). Overall, median follow-up was 12 months [interquartile range (IQR) 9–15 months]. A complete remission was achieved in 10 cases (58.8%), a partial response in 2 (11.8%), while 5 patients (29.4%) were considered as non-responders. Tumor stage and/or grade progression was observed in 26.7% of the cases. Overall, the 6-month recurrence-free survival was 33.3%. Drug toxicity was relatively low: 2 patients developed a grade II dysuria (NCI-CTC criteria); fever >38° was observed in 1 case. Conclusions Although our experience and follow-up are still rather limited to formulate any conclusive assessment, our study seems to confirm that Gemcitabine could be used as a safe and efficient intravesical chemotherapy agent even in high grade TCCs, representing a promising second-line option in those cases who failed, were intolerant or not eligible to BCG therapy. (Urologia 2009; 76: 178–84)
X-Ray Diffraction Study on Human Male Reproductive Tract and Semen
Authors: Skandhan K.P. , Amith S. , Avni K.P.S. 
Published: June 2018

In the present study authors had separated testis, epididymis-caput, corpus, cauda, vas deferens, seminal vesicle, prostate gland and bulbourethral gland from human male reproductive tract, made it to ash form. Semen also underwent same procedure. All samples had undergone X-ray diffraction analysis. Results Results showed there where two distinct rings for each sample. We named it is “A” &” B”. Under “A” Barium silicate, Barium silicate hydrate and three metal complexes of copper, gold and zinc were seen. Under “B” Calcium silicate and calcium silicate hydrate were observed. Both “A” and “B” were seen throughout the length (expect for “A” is seminal vesicle) and in semen. Conclusions A tri metal complex of copper, gold and zinc is reported in this study, is first of its kind in Biology.
Positioning of a Malleable Penile Prosthesis. Solving an Intraoperative Complication
Authors: Pavone C. , Coraci G. , Karydi M. , Scarcella A. , Melloni C. , Melloni D. 
Published: June 2018

We report a technique for the solution of an intraoperative complication occurred during penile prosthetic surgery. Materials and Methods A 70-year-old patient underwent open radical retropubic prostatectomy in 2004 due to a prostate cancer - Gleason 6 (3+3) pT2N0M0. The erectile dysfunction subsequently observed was not responsive to oral or intracavernosal drug administration, so a malleable penile implant surgery was recommended. Results During the positioning of the left penile cylinder, a septum perforation (cross-over) occurred. Instead of interrupting and postpone surgery in order to allow the septum to recover, we decided to proceed utilizing our technique for a safe positioning of the implants. As far as we know, this is the first detailed report on the technique. Conclusions Septum perforation during a penile prosthesis implant does not represent an absolute contraindication to terminating surgery. Our technique allows a safe placing of the cylinders after septum perforation with optimal functional and aesthetic results at long-term follow-up.
Painful Ejaculation: A Review
Authors: Pescatori E.S. , Farina F. Pirozzi 
Published: June 2018

Background Pain at ejaculation/orgasm perceived in perineum, urethra and/or urethral meatus, has a profound impact on the quality of life of the affected man. Although underestimated, this condition is reported to have a 1–9.7% prevalence over the general population. Methods Structured review of the relevant available literature. Results Among the main causes of pain experienced at ejaculation/orgasm are: prostatevesicular causes (LUTS/BPH, prostatitis, ejaculatory duct obstruction, vesicular stone), postsurgical causes (radical prostatectomy, inguinal hernioplasty), pharmacologic causes (antidepressants), psychogenic causes (psychosexual conflicts, sexual abuse), rare causes. For these pathologies, diagnostic and therapeutic strategies have been proposed. Conclusions Ejaculatory pain is associated with a high level of personal distress, and represents a possible request for help within the andrologic/urologic area. Each field specialist should be competent in correctly interpreting every single case, in order to manage it appropriately.
4 Hands/4 Ports Laparoscopic Radical Prostatectomy
Authors: Aliberti M. , Bianchetti G. , Ferraris C. , Raineri F. , Vottero M. , De Zan A. 
Published: June 2018

Introduction Radical laparoscopic prostatectomy is a challenging procedure, which requires a steep learning curve and involves normally three operators. Consequently this is an expensive procedure due both to the time spent for surgery in the operating theatre and the number of operators involved. But time consumption and consequently money costs can be reduced thanks to the learning curve enhancement and, moreover, by reducing the number of operators involved. This work is based on the idea of performing laparoscopic prostatectomy with two operators only. Material and Methods Our cases are 124 radical laparoscopic prostatectomies, performed from January 2004 until April 2009; of these, 13 non-consecutive, were carried out with 2 operators and 4 ports. The first attempt - not totally successful due to time spent in the operating theatre and to some operational difficulty - was carried out as 60th procedure (learning curve was not complete). Once the method was applied as 103rd procedure, it could then be constantly implemented. Results We demonstrate that this option is feasible once the team performing the laparoscopic radical prostatectomy has acquired a good level in the learning curve. The outcomes are very interesting with regard to time consumption (205’ minutes: one minute more than the 3 operators/5 ports procedure) and early oncological and functional results.
The LESS (Laparo-Endoscopic Single-Site) Procedure in Urology. Technical and Clinical Aspects
Authors: Neri F. , Cindolo L. , Gidaro S. , Schips L. 
Published: June 2018

Background Minimally invasive urology is rapidly advancing, and single-site laparoscopic surgery is being explored clinically. Such laparoscopic procedures are technically challenging and require an experienced laparoscopic surgeon due to the lack of port placement triangulation and instrument clashing. Methods In the last years several surgeons all over the world have explored the feasibility and safety of LESS using several and different ports, approaches and devices. Hundereds of procedures have been described with overall favorauble intraoperative and postoperative outcomes. Results Our experience consists of more than 30 procedures successifully completed for adrenal, kidney disease and varicocele. Conclusions To date, LESS could be considered feasible and effective using currently available devices, however it is to be considered as an initial status technique requiring further confirmatory studies and advanced laparoscopic skills.
Doping and Urologic Tumors
Authors: Pinto F. , Sacco E. , Volpe A. , Gardi M. , Totaro A. , Calamo A. , Racioppi M. , Gulino G. , D'Addessi A. , Bassi P.F. 
Published: June 2018

Several substances such as growth hormone (GH), erythropoietin (Epo), and anabolic steroids (AS) are improperly utilized to increase the performance of athletes. Evaluating the potential cancer risk associated with doping agents is difficult since these drugs are often used at very high doses and in combination with other licit or illicit drugs. The GH, via its mediator, the insulin-like growth factor 1 (IGF-1), is involved in the development and progression of cancer. Animal studies suggested that high levels of GH/IGF-1 increase progression of androgen-independent prostate cancer. Clinical data regarding prostate cancer are mostly based on epidemiological studies or indirect data such as IGF-1 high levels in patients with prostate cancer. Even if experimental studies showed a correlation between Epo and cancer, no clinical data are currently available on cancer development related to Epo as a doping agent. Androgens are involved in prostate carcinogenesis modulating genes that regulate cell proliferation, apoptosis and angiogenesis. Most information on AS is anecdotal (case reports on prostate, kidney and testicular cancers). Prospective epidemiologic studies failed to support the hypothesis that circulating androgens are positively associated with prostate cancer risk. Currently, clinical and epidemiological studies supporting association between doping and urological neoplasias are not available. Nowadays, exposure to doping agents starts more prematurely with a consequent longer exposition period; drugs are often used at very high doses and in combination with other licit or illicit drugs. Due to all these elements it is impossible to predict all the side effects, including cancer; more detailed studies are therefore necessary.
Prostatitis Syndromes and Sporting Activities
Authors: Sacco E. , Totaro A. , Marangi F. , Pinto F. , Racioppi M. , Gulino G. , Volpe A. , Gardi M. , Bassi P.F. 
Published: June 2018

Introduction Prostatitis-like syndromes are high prevalent health problems and frequently considered by patients and physicians as strictly correlated to sports causing perineal compression. These syndromes and their relationships with sporting activities have been discussed in this report. Methods We reviewed peer-reviewed scientific articles published by May 2009 and searched according to the following term selection: prostatitis, pudendal nerve, sport, cycling. Results Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a major healthcare burden heavily affecting patients’ Quality of Life. No clear evidence of any direct etiologic relationship has been found in literature between prostatitis, either bacterial or non-bacterial, and sports activities. On the other hand, some types of sport causing perineal compression, such as cycling, can exacerbate symptoms of acute and chronic prostatitis; a temporary sport discontinuation is justified in these patients. CP/CPPS may be often caused by pudendal nerve entrapment (PNE). Prostatitis-like urogenital neuropathic pain together with voiding and sexual dysfunctions are the hallmark of PNE. A common feature is that flexion activities of the hip, such as climbing, squatting, cycling provoke or worsen urogenital pain or pelvic pain. Many of the patients with PNE are cyclists, played American football, lifted weights, or wrestled as teenagers and young adults. PNE represents the most common bicycling associated urogenital problems. Conclusions Overall, studies show that no causal relationship has been demonstrated between prostatitis and sporting activities. Conversely, urologists should be aware that sports involving vigorous hip flexion activities or prolonged perineal compression are a potential and not an infrequent cause of uroand rological symptoms caused by pudendal nerve entrapment.
Article
Authors: Di Tonno F. , Mazzariol C. , Piazza N. , Murer B. 
Published: June 2018

A 25-year-old man from Bangla Desh with acute right scrotal pain was subjected to scrotal surgical exploration because of the suspicion of testicular torsion. The testicle appeared normally positioned; an epididymal nodule was removed, and pathology showed the presence of the filaria worm. Filariasis is a tropical disease which has been estimated to affect 120 millions people throughout the world. Lymphadenitis and lymphangitis are the more common clinical settings; in men, there is a frequent scrotal involvement. In some cases, acute scrotal pain may lead to the suspicion of testicular torsion. The observation of patients with genital filariasis is likely to become more frequent in an era of massive immigration from different countries; nowadays, the disease should always be taken into consideration in the differential diagnosis in patients with acute scrotal pain coming from tropical areas.
Correlation between pathologic features and perfusion CT of renal cancer: A feasibility study
Authors: Gigli Francesca , Zattoni Fabio , Zamboni Giulia , Valotto Claudio , Bernardin Livia , Mucelli Roberto Pozzi , Zattoni Filiberto 
Published: June 2018

Objectives The computerized tomography with perfusion technique (pCT) has proved to have some potentialities in the oncologic field as a possible tool to identify neoangiogenesis in vivo. The purpose of the present job is to test the correlations existing between perfusion data and pathologic features in the evaluation of vascularization in kidney cancer. Methods 6 patients with clinical diagnosis of renal tumor awaiting surgical treatment underwent preoperatively pCT scans. Axial images encompassing the greatest diameter of the cancer were compared with the respective histological sections. Results A correlation between tumor histological subtype and perfusion index was observed and shown. Moreover, clear cell RCC of different Fuhrman grades showed statistically significant differences in perfusion values (T test). Specifically, high perfusion indexes were associated with high density of microvessels with abnormal architecture at the microscopic evaluation of tumor specimen. Conversely, lower perfusion index were detected in tumors with lower microvascular density. Conclusions pCT scans can provide significant data on tumor angiogenesis and, eventually, suggest tumor histological subtype. The possibility of identifying preoperatively tumor histotype can be of particular relevance in patients with small renal tumors, suitable for minimally-invasive surgery or active surveillance program.