bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adjustable Continence Therapy for Female Sui
Authors: Kocjancic E. , Carone R , Crivellaro S. , Gontero P. , Favro M. , Ceratti G. , Sala M. , Bodo G. , Giammò A. , Zaramella S. , Frea B. 
Published: June 2018

Since December 1999 a new adjustable device for female stress urinary incontinence called the ACT (Adjustable Continence Therapy) has been used in a multicentre study. The two year follow-up of the Italian multicentre study is presented. Material & Methods A group of 37 female patients, affected by SUI was evaluated before and after the positioning of the ACT with physical examination, urodynamic study and quality of life questionnaires (I-QOL) Mean age was 58,5 (range 21.9 – 84.6). 59% (22/37) had type II SUI while 42% (15/37) had type III SUI. 57% (21/37) had had prior urogenital surgery. The ACT device consists of an adjustable silicon balloon, a subcutaneously positioned titanium port and a two lumen tube in between. The devices are positioned via a percutaneous perineal approach, using either local or regional anaesthesia. A 2 cm skin incision is made on each labia majora and through these incisions a delivery trocar is directed toward the bladder neck. The trocar is manoeuvred into the desired position using tactile guidance and an image intensifier (III). Each ACT device is then inserted via the delivery tool. Each balloon is positioned lateral to the bladder neck, proximal to the vesico-vaginal space, below the endopelvic fascia. Each balloon is then filled with one to two millilitres of the isotonic contrast/sterile water mixture with X rays confirmation of the correct location. The injection ports attached to each balloon are then positioned subcutaneously in each labia majora; the balloons are subsequently adjusted, if this is required. Results 15 patients reached 24 months of follow-up. 46% of them were dry at physical examination and wear no pads. Additional 26% were significantly improved. This group of patients had to wear 1 pad/daily. 56% of the patients required one adjustment to achieve continence, 10% two adjustments, 10% three adjustments 24% need no adjustments. No cases of urinary retention were reported out of 37 cases. One patient had a transient dyspareunia. Conclusions 70 % of our patients where dry or substantially improved and the patients quality of life increases significantly, this results includes mainly the patient with sever intrinsic sphincter deficiency and failed previous incontinence surgery. The ability to post-operatively adjust the ACT permits to reach the appropriate volume to each patient. However a longer follow up and a bigger number of procedures are required for definitive conclusions.
Complications of Irrigations Solutions during Transurethral Resection of the Prostate in Spinal Anesthesia
Authors: Biamino C. , Gratarola A. , Gontero P. , Kocjancic E. , Frea B. , Corte F. Della 
Published: June 2018

Perspective study in order to estimate the incidence of TURP-Syndrome, in spinal anesthesia (SA) with volemic expansion with sodium chloride solution 0.9 % vs 3%. Materials and Methods Two groups (gr) of patients (pt) A (n=20) and B (n=20) in SA have received like respective 500 ml of NaCl 0.9% and 250 ml. of NaCl 3%. The bladder was irrigated with a solution containing 1.5% glycine (1). We estimated: weight of prostate adenoma and weight of removed tessue, Sodium (Na) preop - intraop - postop. and after 24 hours, Ammonium (NH4+) pre - postop, volumes (V) of dropped solutions, V of dropped glycine (gl), operation time, core body temperature intraop and postop, mental state intra and postop., osmolarity. Results We found no significant difference in weight of adenoma and removed tessue. We have not observed any differences in the V of infusive solutions in the periop. We have not observed any difference in the values of Na preop. and postop, in those of NH4+ preop and postop, in operation time and in the V of gl. During procedure 5 pz. (S group) showed: visual disturbances, mental confusion (TURP-Syndrome) and hypertention (2). No pz. have any Na and NH4+ intraop.values altered. Time of TURP appeared bigger in non symptomatic patients (69 mn gr S. vs 48.43 gr.A and 47.26 gr. B). The V of instilled gl. has appeared meaningfully more elevated in gr. S (21.4 / vs 12 in gr.A and 12.31 in gr. B). The Na and NH4+ postop., Na after 24 hours and core body temperature have turned out statistically omogenee in all pt. In the 5 symptomatic pt the osmolarity values entered in normality ranges and they did not show differences between the groups considered. Conclusions We have not noticed any differences in using of the NaCl solution 0.9% versus NaCl 3% like volemic prefilling; the symptomatic patients have endured one longer procedure and greater amount of irrigating solution; their values of Na and NH4+ were in the limits of the normality; for this reasons perhaps the cause of symptoms in our patients would be searched in direct toxicity of glycine as inhibitory neurotrasmitter in CNS.
Evaluation of Sexual Activity in Patients Treated with Tadalafil: A Randomized Prospective Placebo-Controlled Trial
Authors: De Rose A. F. , Gallo F. , Ninotta G. , Carmignani G. 
Published: June 2018

Evaluate the chronological distribution of sexual intercourses in a group of patients treated with Tadalafil versus placebo for three months. Methods 120 patients with ED were randomized in two groups and treated respectively with one pill of Tadalafil 20mg or placebo on Tuesday and on Friday. After three months we collected data using IIEF and SEP diaries. Results After three months, IIEF score and percentages of success SEP diaries increased in Tadalafil group (< 0.01) versus Placebo group. Considering all the successful intercourses of the three months of Tadalafil assumption, the highest percentages were reported within 6–12 hours range (35%) and 12–24 hours range (28%). In Tadalafil group, 41% of patients reported their first successful intercourse between 1–6 hours and 78% of patients reported the recovery of spontaneous erections. Conclusions After doing the first sexual attempt between 1–6 hours, patients engaged in sexual activity between 6–24 hours.
Adult Type Testicular Granulosa Cell Tumor: Case Report and Review of the Literature
Authors: Lucarelli G. , Mancini V. , Annunziata G. , Trabucco S. , Palazzo S. , Ditonno P. , Battaglia M. , Selvaggi F.P. 
Published: June 2018

Granulosa cell tumors represent a special group of the so-called sex cord-stromal tumors of the gonads, and are divided into 2 histological types: adult and juvenile. Adult type testicular granulosa cell tumor is a rare neoplasia: 22 cases of this testicular tumor only have been described in literature so far. They are often discovered accidentally and exhibit no endocrine-related symptoms. We report a case of adult type granulosa cell tumor in a 45-year-old man likely affected by a 15-year-old painless tumor with increased right testicular size; he underwent radical orchiectomy. This case and a review of the literature indicate that this kind of tumor is a rare, slow-growing neoplasm. Since distant metastases may occur late in the clinical course, long term follow-up of these patients is recommended.
The Long-Term Hormone Levels and Sexual Function of Monorchid Patients
Authors: Carmignani L. , Galasso G , Acquati P. , Gadda F. , Zambito S. , Salvioni R. , Nicolai N. , Rocco F. 
Published: June 2018

The purpose of this study was to evaluate monorchid patients’ long-term hormone levels and sexual function. Materials and Methods Between September and December 2005, 20 patients were reassessed, having undergone orchiectomy for testicular tumors at the Policlinico and at the National Tumor Institute in Milan between 1986 and 1996. Four patients had seminoma, three of them underwent radiotherapy; 15 patients with embryonal carcinoma subsequently underwent retroperitoneal lymphadenectomy, and one of them underwent chemotherapy; one patient had a Leydig cell tumour. The patients’ case histories were analysed; they underwent urological examination, endocrine test, scrotal ultrasound, and blood samples were taken for testosterone, FSH, LH, prolactin, E2, total cholesterol, triglyceride, beta-HCG, alpha-FP and LDH assays. Body mass index was calculated. Patients were also asked to fill in the IIEF questionnaire. Results Patients’ mean age was 30.7 years at the time of orchiectomy, and 44.7 at the time of endocrine/sexology follow up. Case histories showed that 2 patients suffered from arterial hypertension, for which they were receiving treatment, 2 patients were obese, none of the patients suffered from endocrine disorders. Upon ultrasound evaluation, the remaining testicle mean volume was 22.04 mL. All patients presented testosterone levels at the lower limits of the normal range (mean value 3.3 ng/ml). In 5 patients values were below the lower limit, indicating marked hypogonadism. Only one patient suffered from moderate erectile dysfunction. Conclusions Twenty-five per cent of patients showed low testosterone levels. In view of the long life expectancy of patients suffering from testicular tumors, it is fundamental to consider the long-term problems that a mutilation such as orchiectomy can involve. Patients undergoing orchidectomy in general should be considered to be at higher risk of andropause.
Radical Prostatectomy: Which Quality of Life?
Authors: Mercuriali M. , Lilli P. , Saltutti C. , Vivacqua C. , Zenico T. , Bercovich E. 
Published: June 2018

The aim of the present study was to evaluate quality of life in patients submitted to radical prostatectomy, by correlating the results of the post-operative condition with follow-up data at 6 and 12 months. Materials and Methods. Between october 2004 and december 2005, 68 patients - mean age 68 (range 49–76) - treated with radical retropubic prostatectomy for localized prostate cancer (T2a, T2b, No, Mo) were consecutively enrolled onto the study. All patients underwent sexual as well as urinary incontinence rehabilitation, showing good compliance. We evaluated quality of life before prostatectomy (T0), 6 (T1) and 12 (T2) months after surgery through the Short Form 36 questionnaire, for which an analysis of variance for repeated measures was carried out. Patients were interviewed by our department psychologist regarding urinary incontinence and erectile dysfunction. All patients were disease-free at the time of evaluation. Results. No significant differences were observed between physical and mental health indices. Conversely, a significant improvement (p<0.001) was seen in all SF-36-questionnaire 8 scales, comparing preoperative T0 values with T1 and T2 values. Of the 68 patients, 53 (78%) no longer needed pads at the T2 follow-up, while 15 (22%) reported using 3–4 pads/day A significant worsening of the sexual function (maintenance of erection) was observed in 51 (75%) patients, who had reported having normal sexual activity preoperatively (T0). On the other hand, 17 (25%) patients reported having an adequate erection to engage in sexual intercourse. Conclusions. Despite the differences observed in physical and mental health scores during the three periods evaluated (T0, T1 and T2), overall quality of life does not appear to have been greatly compromised by surgery. At T2 follow-up, in fact, all 68 patients reported to be satisfied with having undergone radical prostatectomy because of its benefits in terms of survival and its limited effects on their quality of life. (Urologia 2007; 74: 22–9)
Sexual rehabilitation with intracavernous PGE1 injections and oral drug administration in diabetic patients non-responder to oral therapy alone
Authors: Passavanti G. , Pizzuti V. , Carlucci M. , Aloisi A.M. , Costantini F.M. , Lia A. Bragag , Lini R. PAO 
Published: June 2018

Diabetes is an important risk factor in erectile dysfunction (ED), acting via several mechanisms. We assessed the efficacy of intracavernous injections (ICI) rehabilitation and oral systematic therapy in diabetic patients, as well as the response of controls to oral therapy ‘on demand’. Materials and Methods Sixteen diabetic patients with ED were treated with vasoactive drugs orally when needed, without satisfactory erections. The patients underwent then ICI rehabilitation with PGE1 20 mcg twice weekly for 4 weeks, followed by the administration of oral drugs twice weekly for 4 weeks. Before and after rehabilitation, the patients completed a detailed anamnestic protocol to study their libido (always present); they answered questions Q3 and Q4 of the IIEF questionnaire. During ICI, a study with dynamic echocolordoppler (ECCD) was carried out. All patients had Type 2 diabetes: 10 were treated with oral antidiabetics, 4 were treated with insulin, and in the other 2 patients, treated with insulin, a sensitive neuropathy of the lower limbs was diagnosed. Fourteen patients were treated with antihypertensive drugs. Results Before rehabilitation, the mean responses to questions 3 and 4 of the IIEF (International Index of Erectile Function) questionnaire were 1.6 and 1.5 respectively; after rehabilitation, the mean responses were 2.68 and 2.5, respectively. The ECCD test showed an arterial component in 4 cases and a high end-diastolic velocity (EDV) in 14 cases. Four patients (25%), 2 of which had neuropathy, and 2 were in advanced age, did not respond to PGE1 or to oral therapy, 4 patients (25%) (2 treated with insulin and 2 by oral therapy) responded to ICI but not to oral therapy, while 8 patients (50%) showed a good response to both injectable and oral therapy, with good Q3 and Q4 scores. Conclusions Good endothelial function appears to be essential for the maintenance of acceptable erectile function. Diabetes has a negative effect on this function, as does hypoxia and low perfusion. Based on the principle that a good erection improves endothelial function, we tried to determine if oral systematic and intracavernous rehabilitation would improve erectile function in diabetic patients. The results indicate that diabetes interferes with erectile function, compromising the effects of the vasoactive drugs. However, integrated systematic rehabilitation appears to allow a good erectile response to both intracavernous and oral therapy in a large number of cases. Therefore, we support this kind of rehabilitative protocol in the treatment of ED in diabetic patients.
Sensitivity and specificity evaluation of endorectal magnetic resonance imaging and transrectal sonography in the staging of prostate cancer
Authors: Mangiapia F. , Liotta RF , Palmieri A. , Imbimbo C. , Pavone C. , Melloni D. , Mirone V. 
Published: June 2018

Objectives Nowadays endorectal probes for Magnetic Resonance Imaging (MRI) have better resolutions, which allows to acquire high-level images of prostate and to improve the MRI sensitivity and specificity to determine the cancer volume and the extraprostatic extension. The objective of the present study is to evaluate the sensitivity and diagnostic accuracy of endorectal MRI for identifying the local extension of prostate carcinoma compared to transrectal sonography (TRUS) of prostate. Materials and Methods The study included 81 patients with clinical suspect of cancer and/or elevated values of serum prostate specific antigen (PSA), who underwent endorectal MRI with 1.5 T endorectal probe before transrectal biopsy. Patients with localized prostate cancer underwent radical surgery. The results of endorectal MRI were compared to those of TRUS and histopathological examination outcomes. Results 15 of the 81 enrolled patients had extraprostatic localization of cancer, which was assessed through TRUS in 4 cases only (26%), and through MRI in 7 cases (46%). A seminal vesicle involvement was present in 10 patients, detected by MRI in 5 cases and in no cases by TRUS. Discussion and Conclusions Data are similar to the findings collected by several Authors. The endorectal MRI has a better accuracy in staging prostate cancer compared to TRUS. Nevertheless, this procedure has some limits: little availability of equipment in hospitals, physicians’ little experience, and higher costs compared to TRUS.
The use of bipolar PlasmaKinetic resectoscope in endoscopic resection of the prostate: our experience
Authors: Passavanti G. , Pizzuti V. , Bragaglia A. , Mengoni F. , Costantini F.M. , Paolini R. 
Published: June 2018

Prostatic endoscopic resection (TURP) is a reference method in the treatment of prostatic obstruction. In the past decades, the method used a monopolar resectoscope. In the last years, various technologies have been studied to improve the efficacy of endoscopic resection. As per our experience, we have thence ascertained the variations of the hematic crasis and of the mictional asset in TURP patients treated with bipolar knives. 20 patients underwent bipolar plasmakinetic resection of the prostate. Their age ranged between 58 yrs and 82 yrs (av: 70.2 yrs), the adenoma volume, checked with TR ultrasound scanning, was between 33 and 44 cc (av: 37.6), the Qmax was between 6.4 and 9.0 mL/min (av.: 7.42 mL/min). A 24Ch resectoscope and spinal anesthesia were used. Bleeding during resection was never relevant; therefore resection never had to be stopped. After about 36 hours from surgery, the patients’ sanguification was checked again: a 6.53% reduction of the number of erythrocytes, compared to pre-surgery data, was observed, together with a 6.73% decrease of hemoglobin concentration, and a 6.3% decrease of hematocrit. Continuous irrigation was suspended during the first day, catheter was removed on the 48th hour in 15 cases, and on the 72nd in 5 cases: the patients were discharged on day 3 in 16 cases, and on day 4 in 4 cases. A flux evaluation was performed after 3 months, which showed a Qmax between 16.6 and 24 mL/min (av.: 19.11), with a significant increase in the maximum flow rate. The use of the new technologies in prostatic endoscopic resection has allowed us to improve the efficacy of such a method. Above all, the use of a bipolar electrosurgical knife enables us to associate a basal hemostasis with the resection of the prostatic tissue. Thus, the hematic loss is low, as we have been able to ascertain also in our own experience. This gave us the possibility to quickly stop continuous irrigation and to early remove the catheter. This way, hospitalization was sensibly reduced (av. 76.8 hours). The maximum flow rate, in the short term, has been good. We have been able, in our experience, to assess that this technology represents a useful guarantee to improve the results of prostatic endoscopic resection.
Laparoscopic Transperitoneal Radical Prostatectomy: Surgical Technique. A Personal Experience
Authors: Liotta R.F. , Tarantino M.L. , Melloni D. 
Published: June 2018

At present, radical prostatectomy is the standard of care for localized prostate cancer. Several mini-invasive urological procedures have been developed during the last years, such as the laparoscopic radical prostatectomy, which is nowadays an innovative technique for urologists. This procedure shows many benefits in terms of anatomic accuracy, reduction of hospitalization and transurethral catheterization, recovery of urinary continence and sexual potency. In this study we have described the laparoscopic radical prostatectomy technique which is carried out by urologists at the “Hôpital Henry Mondor” - Creteil, Paris, where the first author has worked for six months.
Regenerative Medicine: Applications and Development in Urology
Authors: Pinto F. , Calarco A. , Brescia A. , Sacco E. , D'addessi A. , Racioppi M. , Bassi P.F. 
Published: June 2018

Purpose Congenital abnormalities and acquired disorders can lead to organ damage and loss. Nowadays, transplantation represents the only effective treatment option. However, there is a marked decrease in the number of organ donors, which is even yearly worsening due to the population aging. The regenerative medicine represents a realistic option that allows to restore and maintain the normal functions of tissues and organs. This article reviews the principles of regenerative medicine and the recent advances with regard to its application to the genitourinary tract. Recent findings The field of regenerative medicine involves different areas of technology, such as tissue engineering, stem cells and cloning. Tissue engineering involves the field of cell transplantation, materials science and engineering in order to create functional replacement tissues. Stem cells and cloning permit the extraction of pluripotent, embryonic stem cells offering a potentially limitless source of cells for tissue engineering applications. Most current strategies for tissue engineering depend upon a sample of autologous cells from the patient's diseased organ. Biopsies from patients with extensive end-stage organ failure, however, may not yield enough normal cells. In these situations, stem cells are envisaged as being an alternative source. Stem cells can be derived from discarded human embryos (human embryonic stem cells), from fetal tissue or from adult sources (bone marrow, fat, skin). Therapeutic cloning offers a potentially limitless source of cells for tissue engineering applications. Regenerative medicine and tissue engineering scientists have increasingly applied the principles of cell transplantation, materials science and bioengineering to construct biological substitutes that will restore and maintain normal function in urological diseased and injured tissues such as kidney, ureter, bladder, urethra and penis. Conclusions Regenerative medicine offers several applications in acquired and congenital genitourinary diseases. Tissue engineering, stem cells and, mostly, cloning have been applied in experimental studies with excellent results. Few preliminary human applications have been developed with promising results.
Phytotherapy and Diet for And Rological Pathologies
Authors: Patelli E. , Nicola M. , Maggioni M. , Tombolini P. 
Published: June 2018

For long time the role of phytotherapy and diet has been known to be useful in managing and rological pathologies. Nowadays, phytotherapy knowledge among urologists is quite restricted; though, they are gaining more and more practice in relation to many different urological diseases, even though the mechanism of action and pharmacokinetics characteristics remain unknown. The mechanism of action is often represented by vasodilatation of genital area and stimulation of lumbar plexus. Many reports suggest that diet can reduce the incidence of prostate pathologies and improve sexual and reproductive activity. In this article the most common phytotherapy agents are presented, together with their mechanism of action, side-effects and toxicity characteristics.
Neuroendocrine bladder cancer: oncological emergency?
Authors: Fiorito C. , Lucca I. , Oderda M. , Mondino P. , Berta G. , Cattaneo E.A. , Valentino F. , Zitella A. , Pacchioni D. , Tizzani A. 
Published: June 2018

Neuroendocrine bladder cancer is extremely rare, with an estimated incidence of 0.5%- 0.7%. In bladder cancers there is no evident connection between the neuroendocrine phenotypic expression and the clinical history. However, prognosis is usually poor and the survival rate at 5 years does not exceed 8%, if untreated. Methods. We are here describing three case reports of bladder carcinoma with neuroendocrine differentiation, which is extremely aggressive and leads rapidly to death. At the present time, the local control of these tumors is achieved by radical cystectomy and radiotherapy; they can be both associated to chemotherapy. However, since these lesions are fairly rare, there is no gold standard therapy and there are no prospective studies on the management of these tumors. Conclusions. Considering the quick evolution and progression of any variant of the neuroendocrine tumors of the bladder, urologists and anesthetists should see them as real oncological emergencies. A prompt intervention through radical surgery with cystectomy and linfadenectomia, and the anathomo-pathologist's systematic investigation of the scraps could make the approach therapeutic and not only palliative. Prospective studies on neo-adjuvant chemotherapy as well as experimental studies about target therapies may yield new guidelines on the tumor management.