bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Combined Technique for Radical Cystoprostatectomy and Orthotopic Ileal Neobladder
Authors: Simonato A. , Lissiani A. , Gregori A. , Bozzola A. , Galli S. , Gaboardi F. 
Published: June 2018

After anatomical and surgical studies on cadavers we developed a combined technique for radical cystoprostatectomy with orthotopic ileal neobladder labelled M.I. La. N. (Minimally Invasive Laparoscopic Neobladder). The aim of this technique is to combine the advantages of open and laparoscopic surgery. Between June 2001 and July 2002, 6 men aged 65 to 72 underwent combined radical cystoprostatectomy with orthotopic ileal neobladder for organ-confined bladder cancer. The M.I. La.N. consists of 3 steps: 1) laparoscopic radical cystoprostatectomy and bilateral pelvic lymph node dissection; 2) external partial fashioning of the neobladder and side-to-side bowel anastomosis; 3) laparoscopic lower urinary tract reconstruction. The mean time of the overall procedure was 425 minutes (range 360 to 510). Mean estimated blood loss was 312 mL (range 220 to 440). Mean hospital stay was 8.1 days (range 7 to 9). Histopathology revealed 1 pT1N0 G3 plus carcinoma in situ (Cis), 1 pT2aN0 G3 plus Cis, 4 pT2bN0 G2-3. The surgical margins were tumor free. At the time of analysis (October 2003) the mean follow-up is 18.1 months (range 15 to 21). Two patients respectively stage pT1N0 + Cis and pT2bN0 G2-3 died for metastatic disease at 20 and 18 months after the operation. One patient stage pT2aN0 plus Cis died for unrelated causes free from disease after 16 months from the procedure. The remaining 3 patients are alive and free from disease. The combined technique for radical cystoprostatectomy with orthotopic ileal neobladder (“M.I. La. N.”) can reproduce open surgery. Moreover, it provides an anatomic approach, familiar to most urologist and anatomical landmarks are easy to follow. In our opinion, the combined approach does not reduce the advantages of laparoscopy. We know that this technique may require a long learning curve and it is still a pioneristic procedure. A strict follow up is necessary to evaluate the oncological outcome that is still unpredictable for the low number of treated patients and for biology of bladder cancer.
A Comparative Study of Transurethral Resection of the Prostate versus “Less Invasive” Treatment Options
Authors: Salciccia P. , Salciccia S. , Cirocchi R. 
Published: June 2018

Management of lower urinary tract symptoms (LUTS) and BPH has been central to urology for decades. Open prostatectomy is the most efficient BPH treatment for relieving symptoms and improving uroflow, but is also the most invasive and morbid. Transurethral resection of the prostate (TURP) is still the “gold standard”, but the significant morbidity rate has provoked the development of alternative minimally invasive procedures. The aim of this study was to compare the efficacy of TURP versus less invasive treatment options, as TUVP and TUNA.
Simultaneous Surgical Treatment of Abdominal Aortic Aneurysm (AAA) and Invasive Transitional Cell Carcinoma
Authors: Bassi PF. , Deriu G.F. , Grego F. , Lepidi S. , DE Marco V. , Cisternino A. , Tavolini IM. , Dal Moro F. 
Published: June 2018

A prospective case-control study on simultaneously occurring abdominal aortic aneurysm (AAA) and invasive transitional cell carcinoma of the bladder (TCCB) was carried out to evaluate short- and long-term mortality and morbidity of the one-stage surgical treatment. Methods From January 1995 to December 2000 16 patients presented a concomitant AAA and TCCB. A standard operative protocol included AAA graft replacement before bladder resection and urinary reconstruction. Control patients (16 AAA and 16 TCCB alone) matched according to time of intervention, type of vascular and urinary procedure and pathologic staging. Results No vascular complications and graft infections were observed. Systemic and urologic complications were similar in study and control groups. One patient simultaneously treated for AAA and TCCB died of MI 32 days after surgery after an uncomplicated postoperative period. Estimated 6–year survival rate was 68% in AAA and TCCB patients simultaneously treated, 93% and 54% in matched control patients undergoing AAA and TCCB treatment alone respectively. Conclusions The present study shows that the one-stage is a safe approach to simultaneous occurring AAA and TCCB. Long-term survival of treated patients is dependent upon cancer progression. Whenever endovascular treatment is not advisable, the simultaneous surgical treatment of coexisting AAA and TCCB is recommended in highly specialized centers.
The Hereditary Renal Cancer Syndromes
Authors: Iafrate M. , Bratti E. , Prayer T. , Cisternino A. , Tavolini I.M. , Bassi P F. 
Published: June 2018

Although the majority of renal cell carcinomas (RCC) are sporadic, hereditary types of kidney cancer such as Von Hippel-Lindau (VHL) disease and hereditary papillary renal carcinoma syndromes are thought to account for approximately 4% of kidney cancers. A germline mutation seems to predispose to the development of specific histologic types of RCC. Hereditary kidney cancers are bilateral multifocal kidney tumors that, in some instances, occur at a younger age than do sporadic renal cancers. A better knowledge of the genetic basis of renal carcinogenesis has been useful in identifying genetic causes of renal tumorigenesis, such as inactivation of the VHL tumor suppressor gene in clear cell carcinoma. Moreover, the genes responsible for hereditary renal cancer syndromes seems to play a role in the development of sporadic counterparts. Knowledge of genetic cancer syndromes may allow clinicians to screen and counsel family members, identify those patients at risk for multiple cancer development, and give the chance to intervene therapeutically when cancers are still treatable by identifying localized tumors through early screening. This article reviews the current status and recent advances in the field of familial kidney cancer syndromes.
The Role of Histopathologic Grading in the Staging of Localized Prostate Cancer
Authors: Passavanti G. , Pizzuti V. , Costantini F. , Bragaglia A. , Minacci C C. , Stumpo M. , Paolini R. 
Published: June 2018

One of the most important parameters in the staging of prostate Cancer is the Gleason Grading, although the Gleason assessed In biopsy is not always the same as the final grading. We have therefore tried to find out whether the use of histopathologic grading might offer some extra information about the biological nature of prostate Cancer. 53 patients underwent a radical open prostatectomy for prostate Cancer. Mean age was 66.16ys; pre-biopsy PSA was 1.92-47 ng/mL. Histopathologic grading was assessed on the biopsy tissue, while grading, Gleason and the pathological stage were assessed on the operation piece. The 53 patients were classified according to their bioptic grading (BG), postoperative grading (PG), stage and PSA. BG=PG in 33 cases (62.26%). 17 patients (30.07%) showed a BG<PG and 3 (3.77%) BG>PG. If we analyze such data according to the stage: 1T1c:GB=GP. 9T2a: 6(66.6%)GB=GP, 2GB<GP and 1GB>GP. 19T2b:10(52.63%)GB=GP, 9(47.3%)GB<GP. 11T2c:11GB=GP. 13T3: 5GB=GP, 6GB<GP and 2GB>>GP. Prostate carcinoma staging still shows a large number of limits related to the unpredictability of neoplasm behaviour. The present trend is to use several parameters. We think that the use of the histopathologic grade can be a useful tool to be added to the ones we already employ. We think histopathologic grading should be used with other grading methods, instead of replacing Gleason, which is still quite effective.
Surgical Correction of Pyelo-Ureteral Junction Desease on Graft before Kidney Transplantation
Authors: Lasaponara F. , Graziano M.E. , Rossi R. , Morabito F. , Paradiso M. , Cucchiarale G. , Ferrando U. 
Published: June 2018

Before kidney transplantation, even without ultrasound alterations of donor urinary tract, we usually and carefully study kidney to be transplanted. We fill urinary tract retrogradly with physiological solution from distal ureter. With this method we can recognise stenosis, ectasis and, during a spontaneous emptying, an altered urinary flow due to a “pyelo-ureteral junction attitude”. After kidney transplantation, in fact, hyperdiuresis can unmask a pyelo-ureteral junction attitude with heavy functional rebounds. When, during graft's preparation, we recognize an altered flow, we operate it “on the bank” in order to a easier surgery than on a transplanted kidney, because of its site in iliac fossa, vascular anastomosis and fibrosis that will establish early. We don't use traditional pyeloplastic technique (Anderson Hynes). We use easier pyeloplastic techniques Y-V sec. Foley. Than we apply a ureteral catheter JJ Ch 6 to protect suture and finally we vitrify the suture with fibrin glue. Recently we operated on bank with pyeloplastic technique Y-V sec. Foley a kidney without pyelo-ureteral flow. After ureteral catheter removal, kidney scintigrafy show normal morphology and functionality of graft. Follow-up show a normal urinary flow and kidney function.
Environmental Risk Factors in Superficial Bladder Cancer
Authors: Serretta V. , Altieri V. , Morgia G. , Rinella M. , Abbadessa D. , DI Lallo A. , Testa G , Gallo A. , Melloni D. , Magno C. , Motta M. , Pavone-Macaluso M. , Selvaggi F.P. , Bartolotta A. , Sblendorio D. , Annese P. , Allegro R. ,   EI MEMBRI DEL GRUPPO STUDIO TUMORI UROLOGICI (GSTU) E DEL GRUPPO URO-ONCOLOGICO CAMPANO (GUOC), Vaccarella G. , Salzano L. , Ruggero G. , Zito A. , Borruso L. , Chincoli S. , Vacirca F. , Cammarata C. , Armenio A. , Simone N.S. , Falvo F. , Gentile M. , Nicolosi D. , Masala A. , Napoli M , Bizzini A. , D'Elia A. , Aragona F. , Gange E. , Barbini V. Ricci , Spampinato A. , Curto G. , Raguso G. , Paola Q. , Crimi A. , Cicalese V. 
Published: June 2018

As a preliminary approach to define the object of larger case-control studies, the distribution of potential risk factors coming from environmental pollution among patients affected by superficial bladder cancer (TCCB) has been analyzed. Material e Methods. The analysis included only patients affected by medium risk superficial TCCB. Forty Italian urological centres joined the study. Detailed information about age, sex, residency, employment, active and passive cigarette smoking, water resource, hair-dye use were centralized. All patients underwent TUR and early intravesical chemotherapy. The distribution of the above mentioned environmental factors was related to tumor characteristics such as multiplicity and previous natural history. Results. Until today 474 patients have been recruited, 182 (38.4%) with primary tumors and 293 (61.8%) with multiple lesions. Over 80% of the patients lived in urban areas, 20% were employed in industry at risk for bladder cancer and 8% used hair dye. Forty percent of the patients were smokers, with a median smoking period of 30 years. Bottled water was the only water resource in 42% of cases. At multivariate statistical analysis a significant correlation between tumor multiplicity and employment in industry (p<0.01) and between past natural history and period of cigarette smoking (p<0.05) was found. Preliminar/y, an interesting trend was detected for a correlation between water resource and bladder cancer in non-smoking patients. The municipal water system was the main water resource more frequently in non-smokers (75% vs 53%). This might imply a pathogenic role of water pollution and chlorination.
High Risk Superficial Bladder Tumours: Is a Second Transurethral Resection after Intravesical Bcg Necessary?
Authors: Mari M. , Ambu A. , Bellina M. 
Published: June 2018

According to some authors, residual tumour rate after superficial bladder cancer transurethral resection varies from 4–78%; among high risk superficial tumours (TaG3, T1G3, Tis) managed by transurethral resection of the bladder (TURB) and adjuvant immunotherapy, residual tumour rate varies from 57–76%. This study was aimed to evaluate residual tumour and/or tumour recurrence in 56 patients diagnosed with high risk superficial bladder tumour, who underwent transurethral resection, adjuvant 6-weekly course of intravesical bacille Calmette-Guérin (BCG) and second TURB on the first resection sites, and in other sites suspicious for recurrence. Overall, 7/56 patients (12.5%) had residual tumour and/or recurrent disease at second TURB; no histological progression was recorded. Disease persistence or recurrence was not related to tumour multifocality at first diagnosis. Our results appear to be consistent with other recent experiences, reporting low rates of residual tumour and disease progression in superficial bladder tumours after a first adequate resection and adjuvant immunotherapy. Thus, our current practice in management of high risk superficial bladder tumour is oriented towards routine cystoscopy within 3 months after first bladder tumour resection, completed by cold biopsies on previous resection sites. To our opinion, this approach provides adequate diagnostic reliability besides sparing the costs of a new resection and improving patients quality of life.
Morbility and Outcomes of Radical Prostatectomy in Patients with Clinically Advanced Prostatic Cancer
Authors: Zaramella S. , Monesi G. , Sala M. , Favro M. , Marchioro G. , Gontero P. , Kocjancic E. , Ceratti G. , Pisani R. , Maso G. , Frea B. 
Published: June 2018

In this study we have reviewed patients with prostate cancer clinically advanced at the diagnosis, and subjected at radical prostatectomy, to evaluate the morbility, mortality, and results of the surgery. We have subjected 38 patients with sure clinically advanced disease to radical prostectomy (PSA average 80 ng/mL). An ureteral injury and no rectal lesion have been observed. The rate of urinary incontinence have not been increased in comparison with the literature data, while more frequently are been developed stenosis of bladder neck (26%). At 2 years the 15% of the patients is disease free survival. Our opinion is that radical prostectomy in patients with locally advanced prostate cancer is feasible and the rate of the complications is acceptable.
Oxygenation Status of the Cavernosal Tissue after the Direct Action of the Vacuum Device
Authors: Austoni E. , Guarneri A. , Colombo F. , Cazzaniga A. , Goumas J. 
Published: June 2018

This study aims at comparing the oxygenation status of the cavernosal tissue after the direct action of the Vacuum device (VD) preceded or not by administration of Sildenafil. Patients and methods. We enrolled thirty patients who had undergone perineal radical prostatectomy. After four weeks from surgery we evaluated oxygen pressure (pO2), carbon dioxide pressure (pCO2) and O2 saturation in cavernosal blood. The pts were divided in 2 groups: 15 pts used only Vacuum device (first group), while the other 15 took Sildenafil 50 mg one hour before the exercise with VD (second group) for approximately 30 minutes without constriction band. Cavernous blood gas analyses pre- e post-exercising with the VD were repeated at the end of the complete 3-month rehabilitation program. The data obtained were processed by statistical analysis using the Student t test. Results During flaccidity at baseline, average levels of pO2, pCO2 and O2% saturation rates were respectively 30.07+/-2.91, 39.60+/-6.47, and 65.93+/-2.15 in the first group and 31.20+/-8.1, 42.64+/-7.64 and 52.87+/-8.95 in the second group. Mean values of pO2 rates increased after both treatments with higher oxygenation levels in the second group. At the end of the study pO2 and O2 saturation levels in the second group were found to be 68.5+/-6.87 (p>0.05) and 92.8+/- 2.66 (n.s.) versus levels of 63.8+/- 4.61 and 91.6+/-2.79 in the first group. No significant variations were found in partial CO2 pressure between the two groups (38.13+/-3.52 vs 38. 13+/-6.62). Conclusions In patients presenting with ED after radical prostatectomy, treatment with exercising of erectile tissue by means of an intermittent Vacuum device without constriction band can locally improve oxygenation levels. The addition of Sildenafil offers a further increase of oxygenation levels in the cavernosal tissue.
Reconstructive Technique for Partial Penile Amputation
Authors: Austoni E. , Guarneri A. , Colombo F. , Cazzaniga A. , Kartalas J. Goumas 
Published: June 2018

Partial or total penile amputation with resection of the corpora cavernosa and the urethra is a common and effective surgical procedure used to treat squamous cell cancer infiltrating the deep tissues of the penis. We describe an original method that allows for an aesthetic and functional restoration of the partially or total amputated penis. Surgical technique We performe a reconstructive technique for partial penile amputation by releasing the scarring tissue adhesions with cavernosal lysis and by advancing the penile stump with dissection of the suspensory ligament; implantation of soft but axially firm endocavernosal elastomer prostheses to maintain the corpora cavernosa extended; placement of split-thickness skin grafts to cover the shaft skin defects and glanduloplasty with oral mucosa grafting. In cases of total penile amputation, the method begins with the reconstruction of a new phallus using a rectoabdominalis flap; the new penis is then covered with split-thickness skin grafts and finally, at a later date, soft but axially firm endocavernosal elastomer prostheses are implanted. Results The success rate as be excellent compared with other complex reconstructive and remodelling procedures for the penis and the glans after partial or total penectomy described by several authors. Conclusions In cases of total or subtotal penile amputation, the use of our techniques provides satisfactory aesthetic and functional results, thus we consider it to be a simple solution since it is not too invasive, it is quick and can be carried out by urologists without recourse to sophisticated microsurgery techniques.
Treatment of Urolithiasis with Ureterocele: 5 Years of Experience (1998–2003)
Authors: Imbimbo C. , Cancelmo G. , Manno G. , Ranavolo R. , Piscopo A. , Ammendola C. 
Published: June 2018

To assess efficacy of Extracorporeal Shock Wave Lithotripsy (ESWL) about treatment of urolithiasis with ureterocele. Materials and Methods From January 1998 to July 2003, we have treated 6 adult patients (4 women and 2 men) with urolithiasis linked to ureterocele with mean age 35.8 years (range between 24–49 years). The patients showed dysuria, and pain during advanced stage of miction. The diagnosis of ureterocele was based by ultrasound and intravenous urography. The ureterocele appeared monolateral in 5 patients and bilateral in 1 patient. The stone is been treated with Extracorporeal Shock Wave Lithotripsy (4000 shocks; 9Kj), in mean 2 applications for patient. Results In 4 patients we have assessed breaking stone with expulsion of chips. In 2 patients, after treatment with ESWL, we have proceeded to extract the stone by endoscopic view, by small cut (“smile cut”) on ureterocele wall. Reflux was not present in these 2 patients after smile cut. Conclusions In patients with urolithiasis and ureterocele is recommended to perform a treatment of ESWL, that proved to be effectiveness, allowed by patients and without collateral effects.
Power Doppler Ultrasonografy (Pdu) as an Additional Tool to Increase Reliability of Systematic Biopsy of the Prostate
Authors: Passavanti G. , Pizzuti V. , Paolini R. 
Published: June 2018

Diagnosis of prostate cancer has until recently relied primarily on eight core TR biopsy. Tests are being carried out to verify whether PDU can effectively aid such diagnosis thereby reducing the number of biopsies and tissue samplings. This has also been our attempt. Two groups of patients were examined for increased PSA with or without a palpable prostatic nodule. The first group was composed by 52 patients between 55 and 83 years of age (av. 69.57) with PSA values between 0.87 and 94.91 ng/mL (r.8.085) of which 29 (55.75%) showed a palpable nodule. All patients underwent prostatic eight core TR ecobiopsy. The second group was composed by 56 patients between 49 and 84 years of age (av.69.19) with PSA values between 1.14 and 59.7ng/mL (r.8.74) of which 33 (58.97%) showed a palpable nodule. This group of patients underwent a PDU just before TR biopsy in order to assess prostatic blood supply and locate possible alterations. Prostatic volume in both groups was never higher than 50 cc. Of the first group 25 patients (48.08%) were prostate cancer positive. Of the second group 31 patients (55.36%) were positive to a biopsy for prostate cancer. In addition 22 out of the 31 showed a vascular irregularity. From the evidence above (tests carried out by the same operator with two homogeneous groups of patients-Wilcoxon test-) it is clear that PDU usefully worked in diagnosing a higher number of prostate cancers. Diagnostic sensitivity and specificity was markedly increased by the association of PDU and TR biopsy.
The Artificial Neural Network Utilization for the Diagnosis of Prostate Cancer
Authors: Benecchi L. , Pieri A.M. 
Published: June 2018

The Artificial Neural Network utilization is limited to its complexity. Aim of our study is to organize a simple ANN for a practical utilization. Methods We retrospectively reviewed from our database male patients (both outpatients and hospitalized patients) who underwent PSA and free PSA assay. Inclusion criteria was as follows: male older than 45, without a history of prostate cancer. Patients who rejected a proposed prostatic biopsy were excluded. 520 men were included in the study. There were 431 (83%) controls and 89 (17%) had prostate cancer. An ANN was constructed on the basis of data on PSA, fPSA, percentage of free PSA and age. Results Of the samples 200 random cases (38.5%) were used to train the system, 100 random cases (19.2%) were used for the test phase and the remains 220 (42.3%) were used for validation. At the ROC analysis the higher area under the curve was for ANN with a significant difference with that of PSA (p=0.022). Conclusions We developed a diagnostic algorithm based on both serum data (tPSA, fPSA and %fPSA) and clinical data (age) to enhance the performance of tPSA to discriminate prostate cancer patients. The predictive accuracy of the ANN was superior to that of tPSA. Limiting input neurons, the complexity is reduced so this ANN can be used for daily urological practice.