bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Approach to the Ureter by Ureteroscopy
Authors: Zattoni F. , Zanin M. 
Published: June 2018

Ureteroscopy has an important role in the practice of the modern urologist. The procedure is usually performed under locoregional anaesthesia even if general anaesthesia is still considered the standard. Placement of a guide wire (safety guide wire) represents the starting point to perform safely a ureteroscopy, just in case of complications during the endoscopic manoeuvres. There is no consensus on dilation of the ureteral orifice and on ureteral stenting at the end of the procedure. Dilation of the ureteral lumen directly under vision as well as the use of ureteral sheath can be considered in particular cases. Ureteroscopy is largely performed in many urologic centers at the present, but it requires ability and experience.
Preoperative Prediction of Pathological Stage by Quantitative Histology in 102 Patients with Prostate Cancer (PCa) and Serum PSA ≤10 ng/mL
Authors: Pepe P. , Panella P. , Motta L. , Savoca F. , D'Arrigo L. , Candiano G. , Pennisi M. , Aragona F. 
Published: June 2018

Purpose. To find a predictor of extraprostatic extension in clinically localized prostate cancer (PCa), preoperative ultrasound-guided prostate needle biopsies and clinicopathological data were reviewed. Materials and Methods 102 consecutive patients (median age 63 years) with serum PSA ≤10 ng/mL who underwent radical retropubic prostatectomy were included. Preoperative prostate biopsies according to an extended protocol were performed and whole-mount prostatectomy specimens were processed. One or more of the following biopsy variables were considered predictive of locally andvanced PCa: more than 2/12 cancer-positive cores, total percentage of cancer (TPC) >20%, greatest percentage of cancer (GPC) >50%, bilateral PCa, presence of cancer in both lateral portions, Gleason score >6. Results Only 32/102 (31.4%) specimens showed an organ-confined PCa; the remaining were pT3a in 30 (29.4%) cases, pT3b in 6 (5.9%) and pT2–T3 with positive surgical margins in 34 (33.3%). Quantitative histology predicted an organ-confined PCa in 41.2% of patients. In all 102 patients and in 56 with T1c clinical stage, the positive predictive value (PPV) and negative predictive value (NPV) of biopsy findings, to predict an organ confined PCa, was 81.2 vs 92% and 91.6 vs 93.4%, respectively. The PPV and NPV to predict a locally advanced PCa was 92.8 and 86.5%, respectively. Conclusions Quantitative histology seems to be helpful for locally staging of PCa in patients with T1c clinical stage and PSA ≤10 ng/mL.
Focus on 5 Years of the Acceptance and Adhesion to Prostaglandin El Auto-Intracavernosal Injection in Patients with Erectile Disfunction
Authors: Rosini R. , DE Luca V. , Teppa A. , Feroldi L. , Mirabella G. , Cosciani Cunico S. 
Published: June 2018

From 5/98 to 5/03, of the 1310 patients taking a medical therapy for erectile dysfunction (E.D.), only 137 took autointracavernosal injection (auto. ICI). 134 patients were contacted by phone and were asked to answer a definite questionnaire. Results 49 patients (36.5%) still perform auto-ICI therapy while 85 (63.5%) had given up. 53% of the patients still using auto-ICI make the injection 4, or more times a month, with an erection lasting a considerable time (30–60 minutes). Nobody referred the presence of corpora cavernosa fibrosis. The reasons put forward by patients who stopped the therapy were: a perception of ineffectiveness, therapy rejection, fear of injections and the appearance of intolerable side effects. Conclusions Auto-ICI therapy remains a valid option for patients with E.D. not responding to oral therapy but it needs greater involvement by the physician in order to evaluate the patient's psychological discomfort and reduce or eliminate intolerable side effects.
Survellaince Program for Prostate Carcinoma: Preliminary Results on 585 Blood Donors
Authors: Fandella A. , Maccatrozzo L. , Merlo F. , Collodel L. , Durante E. , Anselmo G. 
Published: June 2018

Population screening for prostatic carcinoma (CP) is a struggled subject, and we don't know the real utility of it. Nowadays the Authors suggest only survey on little groups. In this study the male population of blood donors of our hospital between 45 and 65 years underwent a complete valutation for CP. From this study we hope to obtain the following results: a) early diagnosis of CP (eradicable); b) eliminate keeper of neoplastic pathology from blood donations (theoretic risk of transmission of neoplastic cells in immunodepressed patients); c) studying the practicability, if we achieve a high percentage of ahdesions at this program, our model could be exportable.
Colpopromontoriosacropexy with Stratasis Bandage in Anterior Vaginal Prolapse in Kidney Transplanted Patients
Authors: Lasaponara F. , Squintone L. , Cucchiarale G. , Graziano M.E. , Ferrando U. 
Published: June 2018

Women with kidney transplant and anterior vaginal wall prolapse should be operated early. Infact the anatomical and functional alteration of pelvis, in this case, can cause urological diseases which can deteriorate antireflux system of kidney transplant. These women can be submitted to colpopromontoriosacropexy using a Stratasis bandage. Stratasis, is a biomaterial derived from submucosa of pig bowel. It is inert, not immunogenic, it does not cause sensitization or extra body reaction, it will be biotransformed, it is progressively colonised and substituted by tissue where it is placed. It is suitable to be used in transplanted patients, because of its early colonisation and rapid neo-vascularization, that means supply of nutritive substance and infection resistance. We operated with this technique two women with kidney transplanted six years before. They were 47 and 55 years old with III-IV degree cystocele. We made hysterectomy, adnexectomy and indirect colpopromontoriosacropexy with Stratasis bandage. Both patients have no complications, no urinary infections, no altered renal function, no changes in immunosuppressive therapy, bladder catheter was removed on sixth day. They were dismissed in eighth and fourteenth day. Patients have spontaneous and regular micturition, they are continent, post-micturition residual is less than 30 cc.
La Tossina Botulinica Tipo a Nel Trattamento Della Prostatite non Batterica: Studio Prospettico di Fase II
Authors: Lacquaniti S. , Fasolo P.P. , Conti E. , Sebastiani G. , Mandras R. , Puccetti L. , Fasolis G. 
Published: June 2018

Nowadays aetiology, diagnosis and therapy of chronic non bacterial prostatitis are not still universally valuated in international urologic consensus. Recently, the National Institute of Health (N.I.H.) of USA suggested new staging of prostatitis. The aim of the study was to demonstrate the effectiveness of american botulinum toxin injected in external striated urinary sphincter in stage 3a and 3b patients according to NIH classification, with high medium and maximal closure pression of the external anal sphincter, demonstrated at the anorectal manometry. Methods. In our ongoing prospectic phase II study, the patients diagnosed to have 3a e 3b prostatis according to NIH classification after Meares-Stamey test, underwent ultrasonography of the whole abdomen, anorectal manometry, uroflowmetry, NIH symptom score (NIH-CPSI). Twentyone patients had elevated medium and maximal closure pressure of the striated anal sphincter and were included in the study. American botulinum toxin 100 unit intraperineal injection was given in these patients. One and six months control uroflowmetry and NIH-CPSI were evaluated. Results were processed with chi-square test (significant for p<0.05). Results. One and six months results were significant in respect to baseline values regarding TQ (p<0.0001), max TQ (p=0.0002) e NIH-CPSI (p<0.0001). Conclusion. Botulinum toxin is safe and effective in relieving symptoms of 3a and 3b prostatitis patients with high striated anal sphincter pressure.
Lumbar Ureteral Lithiasy: Therapeutical Options
Authors: Sebastiani G. , Fasolo PP. , Conti E. , Lacquaniti S. , Mandras R. , Puccetti L. , Fasolis G. 
Published: June 2018

Patients with lumbar ureteral stones larger than 5 mm should be addressed towards ESWL. It is an effective nonintrusive modality with limited adverse effects. In our study we matched treatment effectiveness and patients compliance in standard ESWL versus ureteroscopy with lithotripsy. Material and Methods. Since January 2001 to March 2003 72 patients with middle ureteral calculi underwent ESWL treatment, and 48 patients with the same stone location were submitted to ureteroscopy with lithotripsy. It was the first choice modality in strongly symptomatic patients. A 1–5 score system was employed to assess the compliance degree. Patients with the highest compliance were referred as 1 and patients with the lowest one were regarded as 5. Results. A 96% stone free rate (46/48) was achieved in the ureteroscopy arm. The stone was pushed back in the lower calyx of the kidney only in 2 (4%) patients. 37 (52%) out of 72 patients in ESWL arm were stone free at the 1st ESWL treatment. 14 (19%) patients were stone free at the 2nd one, and 8 patients (12%) were stone free at the 3rd one. 13 patients (18%) were never stone free and underwent ureteroscopy. The means of compliance degree were 1.6 in the ureteroscopy with lithoripsy, and 3.8 in the ESWL treatment. Conclusions. Ureteroscopy with lithotripsy may effectively replace ESWL in the lumbar ureteral lithiasy treatment, because of high stone free rate and low morbility. Expenditure is almost the same in both modalities.
Is Early Forceps Application Necessary in the Treatment of Distal Ureteral Stone with Dye-Laser and Pneumatic Lithotripsy?
Authors: Kiper A. , Tuygun C. , Imamoglu M. Abdurrahim , Yigitbasi O. , Eroglu M. 
Published: June 2018

We report the success and complication rates of pulsed dye-laser and pneumatic lithotripsy methods, as well as emphasizing the importance of early forceps application. Materials and Methods We retrospectively evaluated ureterorenoscopy performed in 900 patients, between April 1996 and May 2004, due to distal ureter stones. Following stone fragmentation, patients with stones ≤4 mm in diameter were accepted as stone-free and patients with stones >4 mm had them removed with forceps. Results In the laser treated group, the 1st stone-free rate in patients with a stone diameter ≤4 mm was 56.9%. In this group, when forceps were used in patients after fragmentation, the total stone-free rate increased to 96.8%. Likewise, while the 1st stone-free rate in the pneumatic group was 71.56%, the total stone-free rate increased to 96.73% after forceps application. Conclusion Both success and complication rates were found to be significantly higher in the pneumatic lithotriptor applied group.
Intravesical Instillation of Gemcitabine in Patients with SBC
Authors: De Berardinis E. , Antonini G. , Di Monaco F. , Pisanelli G. Codacci , Di Silverio F. 
Published: June 2018

To determine, in phase I trial, the local and systemic toxicity and pharmacodynamics of intravesical Gemcitabine in patients with superficial bladder cancer. To evaluate, in phase II trial, the activity of this treatment against superficial bladder cancer, measuring the response of a marker lesion. Patients and methods In phase I trial, twelve patients with histologically confirmed carcinoma to the bladder wall (stage Ta-T1) resistant to previous administration of anti-cancer drugs or BCG were enrolled. They received intravesical Gemcitabine starting at 500 mg and increased in 500 mg increments to 2000 mg. Three patients were treated at each dose level. In phase II trial twenty four patients with superficial bladder cancer resistant to previous treatments were treated by endoscopic resection, but a single lesion less than 1 cm was left in site. Patients then received Gemcitabine 2000 mg weekly for six weeks. The marker lesion was re-analyzed by cistoscopy and patients were re-evaluated every month. Results The phase I trial showed no evidence of systemic toxicity and minimal local toxicity. Gemcitabine was undetectable in plasma and its inactive metabolite (2’,2’-Difluorodeoxiuridine) was present at a mean concentration of 1.39 (1.05) μmol/L. In phase II trial, a complete response was obtained in 50% and a partial response in 29%. No response was seen in 5 patients (21%). No patient showed signs of progression of the marker lesion nor the appearance of new lesions. Conclusions Intravesical Gemcitabine appears to be well tolerated with no systemic and minimal local toxicity, even at the highest dose (2000 mg). At this dose, it also shows a good ablative action on marker lesions.
The Use of Human Dermal Allograft Material for Transvaginal Slings
Authors: Crivellano S. , Smith J.J. , Kocjancic E. , Bresette J. 
Published: June 2018

We evaluated the safety and efficacy of using human dermal allograft material for transvaginal slings to treat female stress urinary incontinence (SUI). Materials and Methods We present a prospective series of 253 patients with SUI treated with a transvaginal sling using a Repliform cadaveric human dermal allograft (LifeCell Corp., The Woodlands, Texas) and a bone anchor fixation kit. Clinical history, urogynecologic examination and videourodynamics were performed preoperatively. Results were assessed by a third party through validated quality of life questionnaires (Incontinence Impact Questionnaire and Urogenital Distress Inventory), overall impression and percent of improvement as perceived by the patients, and pad use. Scheduled follow-up examination were performed to rule out erosion, infection, obstruction, pain or recurrent incontinence. Results Complete follow-up was available on 234 of 253 patients. Average follow-up was 18 months. Of the patients 78% were cured or improved according to the questionnaires. The average improvement was 80%. At 18 months of follow-up incontinence average distress and scores decreased 10 and 7 points, respectively. Complications were de novo urgency in 5% of cases, recurrent SUI in 15% with no cases of persistent SUI, retention in 2% and slow vaginal wall healing in 1.7%. Of 156 patients 51 (22%) had persistent urgency. There were no cases of vaginal or urethral erosion, osteitis pubis or osteomyelitis. Conclusions Our data indicate that use of human dermal allograft for transvaginal slings is associated with low complication rates and favorable outcomes at an average of 18 months of follow-up.
Prophylaxis in Female Urinary Infections in Women
Authors: Costantini E. , Vianello A. , Saccomanni M. , Tascini M.C. , Ioannidou K. , Guercini F. 
Published: June 2018

Recurrent urinary tract infections (UTI) in women cost billions of euro annually. E. Coli causes 70–95% of these infections and it has been observed, in vitro and in vivo, to have the capability to develop bacterial biofilms in the bladder: polysaccharide-rich matrix. At the present, the only way to overcome this mucopolysaccaride barrier is to administer long repeated cycles of chemotherapy. We submit prophylaxis to patients with recurrent UTI to sterilize urine for at least 6 consecutive months. Materials and Methods 42 women with recurrent UTI have been selected according to: urine culture, vaginal swabs, and DNA-probe for Chlamydia, Gonococcus, Mycoplasma. After giving informed consent patients were assigned to treatment group A and B. For the first 10 days both groups received ciprofloxacin 500 mg bid, and then group A received ciprofloxacin 250 mg on alternate days and 1 cpr before every sexual intercourse. The group B received placebo in the same modality. Every sexual intercourse had to be safe. All the patients, after the initial screening, repeated an urine culture every 10 days for the first 6 months and every 20 days for the next 6 months. The statistical analysis was performed by chi-square test. Results 44 patients finished the study. 23 pt of group A had sterile urine for the first 6 months of the study and 81% for the next 6 months; 1/23 had 2 episodes of symptomatic UTI. 71% of the 21 patients of group B had symptomatic bacteriuria 20 days after the first treatment (p<0.001). 16/21 patients had symptomatic UTI in the first 6 months of the study and the 90% in the 12 months of the study (p<0.001), in spite of every poussèe was treated with the same antibiotic scheme. Conclusions This kind of prophylaxis has few collateral effects, and it appears to be effective in the treatment of recurrent UTI in women.
Transition Zone Carcinoma of the Prostate Gland: Evaluation of the Incidence and Biological Behaviour
Authors: De Luca S. , Caccia P. , Giargia E. , Randone D.E. 
Published: June 2018

About 25% of all prostate cancers occur in the transition zone (TZ). TZ carcinoma are often well differenziateci and considered clinically unimportant. On the other site a subset of these tumours characterized by high tumour grade has a significant risk of extraprostatic spread, margin positivity and possible biochemical failure. Routine TZ biopsy does not substantially increase the prostate cancer detection rate; however, it can be useful in patients that require repeat biopsy. We retrospectively analyzed 13 patients with TZ prostate carcinoma in order to evaluate the incidence and the biological behaviour of these types of neoplasm.
Risk Factors for Female Urinary Incontinence and Pad-Test: Our Experience
Authors: Pizzorno R. , Arancio M. , Ninotta G. , Risso D. , Carmignani G. 
Published: June 2018

If urinary incontinence in females is present upon effort or exertion, or on sneezing or coughing it is called stress urinary incontinence. If it is accompanied or immediately preceded by urgency it is called urge urinary incontinence. Many studies have shown that risk factors (age, parity, obstetric traumas, body mass index and others) are associated with the prevalence and severity of female urinary incontinence (any type), while other studies do not support this correlation. We reviewed the records at our institution to investigate the relationship between risk factors and severity of stress urinary incontinence. Patients and methods In the year 2002, we examined 118 consecutive patients - mean age 59 years SD ± 10.6 years (range 29 – 80 years) with urodynamic stress incontinence, at the Urodynamic Unit of our institution. The severity of stress incontinence was evaluated by Pad-test performed after cystometry (350 ml or maximum cystometric filling). Only results > 3 g were considered positive - mean 37.8 g SD ± 55.7 g (range 3 –281 g, Median ± MAD 17.0 g ± 10.0 g). Results We did not find any correlation between severity of incontinence and parity, obstetric traumas, or body mass index. However, we did find a statistically significant correlation between age and severity of urinary incontinence (Spearman Rank Correlation = 0.401, P=0.0014), whereas no association was found among women over 70 years of age. Conclusions Our study supports the association between age and severity of urodynamic stress incontinence, while we cannot confirm the correlation between severity of urinary incontinence and other risk factors.
The Role of 5αR Inhibitors in the Early Growth of Pca Cells
Authors: Gravina G.L. , Festuccia C. , Angelucci A. , Muzi P. , Galatioto G. Paradiso , Costa A.M. , Pace G. , Vicentini C. , Bologna M. 
Published: June 2018

Aim of this study is to investigate the efficacy of Finasteride (MK906), a selective 5α reductase type 2(5αR2) inhibitor, and of MK386, a selective 5α reductase type 1 (5αR1), on the cellular proliferation of primary cell cultures derived from patients with prostatic diseases. Methods We evaluated the effects of Finasteride and MK386 in 30 primary cultures obtained from prostatic carcinoma (PCa), 6 from high grade intraepithelial neoplasia (HGPIN) and 10 from benign prostatic hyperplasia (BPH). Results Primary cultures require testosterone (T) for optimal growth and both 5αR inhibitors decreased cell proliferation of primary cultures of PCa cells. IC50 values of Finasteride were lower when compared to those of MK386. In particular, Finasteride was more active in cultures derived from Gleason 2–6 PCa, compared to those derived from Gleason 7–10 PCa. On the contrary, we observed higher effectiveness of MK386 in Gleason 7–10 PCa derived cultures compared to those derived from Gleason 2–6 PCa tissues. The growth of PCa primary cultures was down-modulated by MK386 through a direct inhibition of the epithelial 5αR1, whereas the anti-proliferative activity of Finasteride seems to be mediated by stromal cells present in the primary cultures. Conclusions We found biological evidence for an important role of 5αR inhibitors in the early growth of PCa cells and for the necessity of combining anti-hormonal treatment for a sustained inhibition of PCa through the inhibition of stromal cell function even in advanced and androgen-resistant tumor progression phases.
New Metastatic Models in Vivo of Prostate Cancer
Authors: Angelucci A. , Gravina G.L. , Rucci N. , Festuccia C. , Muzi P. , Gaiatioto G. Paradiso , Costa A.M. , Ronchi P. , Fabiani F. , Teti A. , Vicentini C. , Bologna M. 
Published: June 2018

Experimental prostate cancer bone metastases are difficult to form in vivo, and some typical clinical patterns remain irreproducible. In our work we describe new metastatic models in vivo using different experimental approaches. Methods We injected prostate cancer cells in the left cardiac ventricle or in the medullar cavity of tibia of male nude mice. Results Mice were monitored by x-ray analysis and 70% of them revealed osteolytic lesions 40 days after heart injection. By scintigraphy and alu-PCR we were able to identify early a higher number of metastatic loci than by x-ray. Conclusions Heart and intratibial injection of prostate cancer cells in nude mice may represent a good experimental model to investigate the pathophysiology of bone and bone marrow metastases in vivo.
Rehabilitation Therapy and Urinary Incontinence Post Radical Prostatectomy
Authors: Viola D. , Comerci F. , Franceschelli A. , Sanguedolce F. , Ronci L. , Brunocilla E. , Concetti S. , Bertaccini A. , Martorana G. 
Published: June 2018

Urinary incontinence rates after radical retropubic prostatectomy vary widely among the different series and depending on the different scoring systems, from 2–10% up to 87%. Rehabilitation therapy is the safest and simplest treatment available so far, although a wide consensus on the efficacy of its results is still lacking. In our experience, treating post radical prostatectomy incontinent patients with rehabilitation therapy has been safe, reproducible and without side effects; nevertheless, our results suggest its use only in mild to moderate cases of post radical prostatectomy urinary incontinence.