bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nephron-sparing surgery versus radical nephrectomy in the treatment of renal cell carcinoma up to 7 cm
Authors: Antonelli A. , Zani D. , Nicolai M. , Cozzoli A. , Zanotelli T. , Perucchini L. , Cunico S. Cosciani , Simeone C. 
Published: June 2018

Purpose To compare the oncological outcome of nephron-sparing surgery versus radical nephrectomy in renal cell carcinoma up to 7 cm by retrospectively reviewing our surgical experience. Materials and Methods Data collected from 1290 consecutive patients, who underwent surgery for renal carcinoma, have been stored since 1983 into a dedicated database. The cases with unilateral carcinoma up to 7 cm, pT1a/pT1b/pT3a N0/Nx M0, followed up for a minimum of 12 months if disease-free were reviewed. Results 732 patients were selected (mean follow-up: 72 months); 329 had a tumor less than 4 cm in diameter (182 cases of nephron-sparing surgery, 147 cases of nephrectomy), while for 403 of them the tumor was 4 cm or more (57 cases of nephron-sparing surgery, 346 cases of nephrectomy). The comparison between tumors less and equal to/more than 4 cm showed worse progression and disease-free survival rates for the latter, even though the type of surgery (nephron-sparing or radical) had no significant impact. Patients with extracapsular carcinoma >4 cm, treated with nephron-sparing surgery, had a particularly poor prognosis. Conclusions The conservative management can be cautiously suggested for renal cancers up to 7cm, since the prognosis worsens proportionally with the diameter increase, with no statistical difference for both nephron-sparing and radical surgery. Nephron-sparing surgery proved to be the suitable treatment modality also for pT3a tumors measuring <4 cm, whereas when the tumor size increases, an adequate intraoperative evaluation of peritumoral tissues is essential to rule out fat infiltration. These results comply with the few similar studies available in literature, and suggest the possibility of designing a prospective study aiming at comparing conservative and radical surgery in the management of renal carcinoma up to 7 cm.
Blind Traumas of the Scrotum: Three Case Reports
Authors: Ventimiglia B. , Santangelo G. , Failla F. , Consoli S. 
Published: June 2018

The blind traumas of the scrotum are an uncommon event; references, iconography and descriptions of the clinical development of scrotal syndromes are poor. The scrotum and the didimal or funicular structures are often involved in different conditions. The authors are reporting on three interesting cases (for patients’ age, mechanism of traumatism and anatomic damage), gathered from a series of 12 cases of blind traumas of the scrotum, observed during 2 years (2005–2006). They include the iconography related to each single case, and emphasize the uncertain role of ultrasonography with color Doppler for a correct diagnosis. The clinical evolution and the long-term damage to gonad functionality are presented.
Balanitis Xerotica Obliterans
Authors: Calcagno C. 
Published: June 2018

Balanitis xerotica obliterans (BXO), first described by Stuhmer in 1928, is a chronic, progressive, atrophic, sclerosing process involving prepuce, glans and urethra. Its aetiology is unknown. After a short terminological excursus and a review of the aetiological hypothesis, we have focused on BXO in daily urological practice. We are here describing the clinical presentation and its differential diagnosis with premalignant and malignant lesions of the penis. We tried to define the relationship between BXO and squamous cell carcinoma of the penis. Particular attention was then cast on urethral stenosis. Finally, we focused on the treatment of BXO: corticosteroid local therapy as first line treatment or as adjuvant therapy after circumcision, surgical therapy including circumcision, laser therapy of the glans lesions, meatoplasty in the stenosis of the anterior urethra. We also stressed the need for histological examination of the preputial specimen for a correct follow-up and for medicolegal reasons.
Amikacin: A Novel Modulator of Vesical and Prostate Efferences. An in vitro Experimental Study
Authors: Gardi M. , Nigro F. , Ragazzi E. , Volpe A. , Totaro A. , Sacco E. , Pinto F. , Bassi PF. 
Published: June 2018

The autonomic efferent neurotransmission to the bladder and prostate smooth muscle is a potential target for drug therapy of specific low urinary tract disfunction (LUTD). Since amikacin and other amynoglicosides were reported to affect neurotransmission by a pre-junctional mechanism, we investigated the effect of amikacin on isolated rat and human detrusor smooth muscle contraction and on isolated rat and human prostate contraction, to further evaluate its potential relaxant properties. Materials and Methods Samples of detrusor smooth muscle and prostate tissue, obtained from 97 rats and 16 patients undergoing surgery, were studied through the measurement of isometric contraction induced by electrical field stimulation (EFS) and other pharmacological stimuli in the presence or absence of 1mM amikacin in a low-Ca medium. Results Amikacin 1 mM significantly reduced contraction of isolated rat and human detrusor muscle and prostate, achieved with pre-junctional stimulation, while no significant effect was observed on contraction induced by pharmacological post-junctional stimulators. EFS contraction inhibited by amikacin was restored after addition of calcium chloride. The amikacin effect was comparable to the effect of magnesium ions, which are known to exert a pre-junctional inhibition of neurotransmitter release. Conclusions Amikacin significantly inhibited rat and human detrusor and prostate contraction evoked by pre-junctional stimulation in vitro, suggesting a depressant effect on autonomic efferent neurotransmission. Further pharmacokinetics studies and researches on related compounds may hold potential for future development in the treatment of specific low urinary tract disfunction (LUTD).
History and Evolution of Dorsal Onlay Urethroplasty for Bulbar Urethral Stricture Repair using Skin or Buccal Mucosal Grafts
Authors: Barbagli G. , Lazzeri M. 
Published: June 2018

Objectives To illustrate the history and the evolution over time of bulbar dorsal onlay urethroplasty, comparing outcomes when using buccal mucosa or skin grafts. Materials and Methods Ninety-four patients underwent bulbar urethral reconstruction using two dorsal onlay techniques, namely augmented anastomotic urethroplasty and dorsal onlay graft urethroplasty. Preoperative evaluation included clinical history, physical examination, urine culture, residual urine measurement, uroflowmetry and urethrography. Thirty-four patients underwent augmented anastomotic urethroplasty using penile skin (10 cases) or buccal mucosa (24 cases) grafts. Sixty patients underwent dorsal onlay graft urethroplasty using penile skin (38 cases) or buccal mucosa (22 cases) grafts. Forty-eight out of 94 patients received skin grafts and 46 buccal mucosal grafts. Results Sixty-four (68%) out of 94 cases were successful, whereas 30 (32%) failed. The 34 augmented anastomotic urethroplasties provided successful outcomes in 24 cases (70.6%), but poor outcomes in 10 (29.4%) cases. The 60 dorsal onlay graft urethroplasty proved to be successful in 42 cases (70%), failing in 18 (30%) cases. Twenty-eight (58.3%) out of 48 penile skin grafts were successful and 20 (41.7%) failed. Thirty-six (78.3%) out of 46 buccal mucosa grafts were successful and 10 (21.7%) failed. The 30 failed cases were then treated with internal urethrotomy in 14 cases (46.7%), perineal urethrostomy in 8 cases (26.7%), two-stage repair in 4 cases (13.3%), and one-stage repair in 4 cases (13.3%). Conclusions The dorsal onlay technique used for bulbar urethral stricture repair has changed over time. In our experience, the buccal mucosa seems to be the best substitute graft material for bulbar urethroplasty using dorsal approach.
Clinical evaluation of nuclear matrix protein 22 as urinary marker of transitional cell carcinoma of bladder
Authors: Liotta R.F. , Mangiapia F. , Tarantino M.L. , Di Meo S. , Mirone V. , Pavone C. 
Published: June 2018

Objectives. Biomarkers (BTA, NMP22, FDP etc.) have been and continue to be evaluated as adjuncts or substitutes for cystoscopy, which is invasive and uncomfortable for some patients. Nuclear matrix protein-22 (NMP22) is involved in the regulation of nuclear processes. The main objective of the present study is to evaluate the clinical utility of urinary NMP22 as a tumor marker in the follow-up of transitional cell carcinoma (TCC) of the bladder. Materials and Methods. The study included 62 patients undergoing follow-up, who had had TCC of bladder but who were disease-free at the beginning of the study, as confirmed by cystoscopy. Urine samples were collected for urinary cytology and NMP22 test before the cystoscopy. All samples were processed according to the instructions provided with the manufacturer's kit instructions. Results. 12 cases of TCC recurrences were detected with biopsy. Cystoscopy was positive in 8 cases, NMP22 test was positive in 11 cases, and in only one case the cytopathology yielded positive results. In 14 cases NMP22 resulted as false positive. Conclusions. Urinary NMP22 appeared to be a potential tumor marker for detecting TCC of the bladder, which might rise the sensitivity of cystoscopy especially in high-grade cancer surveillance more than cytology might do.
Tadalafil versus sildenafil citrate in the treatment of ED: Italian patients’ preferences and explanatory notes
Authors: Fusco F. , Lembo A. , Ludovico G.M. , Farina F. Pirozzi , Montorsi F. , Fabris G.F. Menchini , Soli M. , Scarpa R. M. , Gentile V. , Motta M. , Spera E. , Casarico A. , Sicuteri R. , Rossi A. , Mirone V. 
Published: June 2018

This is an open, multicentre, randomized, crossover study having the aim to evaluate the preference for sildenafil citrate or tadalafil in a population of Italian patients affected by ED, and to compare the efficacy and safety of these two drugs. Material and Methods. From October 2003 to November 2004, thirteen Italian centers enrolled ED patients (age >18) being in steady and naïve relation to ED treatment, both through PDE5 inhibitors and any other treatment option. These patients were randomized to sildenafil or tadalafil for 12 weeks, after which they were switched to the alternative treatment for a further 12 weeks. The preference was evaluated through the Treatment Preference Question (TPQ): “During this clinical trial you have taken tadalafil and sildenafil for the treatment of erectile dysfunction. Which medication do you prefer to take for the next 8 weeks of treatment?”. Moreover, patients were asked to express their preference as “strong” or “moderate” and to answer some questions to clarify the reasons behind their preference. SEP and IIEF-EF questionnaires were used for a comparison of efficacy. Results. 167 patients were enrolled, 144 of whom completed both treatment periods. On being asked the TPQ, 75% of patients (n=108) decided to continue treatment with tadalafil, in particular because it made it possible to have an erection many hours after taking the medication (first or second preference reason for 64.8% of patients), while 25% (n=36) preferred sildenafil (p=0.001). Both drugs improved the IIEF-EF and SEP scores compared to baseline, with a slightly but significantly greater improvement with tadalafil for both parameters. Conclusions. Tadalafil and sildenafil are both effective and well tolerated. Most of the patients prefer tadalafil thanks to the possibility of having sexual intercourse many hours after taking the medication.
Vesico-sphincter dysfunctions in Pure Cerebellar Syndrome (PCS): a possible basis for the study of anatomo-functional correlations
Authors: Pea U. , Zago T. , Areta L. , Marzorati G. 
Published: June 2018

The neurological polymorphism of Pure Cerebellar Syndromes (not including the heredodegenerative patterns) led the Authors to try to verify the possible correlations between neurological damages and urodynamic findings. Material and Methods. From 2001 to 2006 thirty patients affected by PCS were studied. They underwent several neurological and urological investigations, including videourodynamics. Results. Sixteen cases (76%) showed urinary incontinence due to non-inhibited detrusor contractions, with no evidence of vesico-sphincter dyssynergia; the remaining patients showed a moderate degree of incoordination. Conclusions. The authors highlight the basic role of cerebellum in modulating the motor activities and the coordination of the bladder-sphincter structures, also in the light of the outcomes gathered in these patients, who were not suffering from other superior structure deficiencies.
Angiomyofibroblastoma of the Spermatic Funiculus. A Case Report of this Lesion of the Spermatic Funiculus
Authors: Calabrò G. , Vallone A. , Vitale F. , Calabrò V. , Pizzarelli M. , Spampinato A. 
Published: June 2018

The authors are hereby presenting a rare case of angiomyofibroblastoma of the funiculus in a 20-year-old patient, having a non-aching tumefaction at the left region of the scrotum. This tumefaction was solid and non homogeneous, both on ultrasonography and MRI, of about 5cm in diameter, fully separated from the testicle. The markers were all negative. We proceeded with surgical treatment of the neoformation. It is mandatory to include this lesion within the differential diagnosis of testicle masses. The case is presented for its absolute histopathologic rarity and for the difficulty in diagnosis.
Phytotherapy in urology
Authors: Dalfrà S. , Bassi P.F. 
Published: June 2018

Complementary and alternative medicine (CAM) includes various practices, measures and products which are not presently considered as part of the conventional (mainstream) medicine. Herbal products, vitamins, minerals and amino acids are increasingly popular as dietary supplements for the treatment, improvement and prophylaxis of urological diseases, and as therapeutic options to improve general health and well-being. As these products are available for free without prescription, conventional healthcare providers are often unaware that their patients are using CAM. A particular attention is paid to herbal products by the public. For this reason it is essential to know that some herbal supplements may act in the same way as chemical drugs, and that the fact that they originate ‘from nature’ does not mean that they are safe and/or with no potential harmful effects and/or toxicity. The possible interactions with conventional medications and contamination with prescription drugs and metals have been reported. The active components of many phytotherapeutic preparations and their mechanism(s) of action are still being determined and evaluated. There is scientific evidence for the effectiveness of some treatments, but for most of them, many important key questions still need to be answered through basic research and well-designed studies, according to established guidelines. Because of the increasing popularity and use of Phytotherapy, urologists should not ignore it, and be well informed about its benefits and potential risks.
Chronic prostatitis and PSA values
Authors: Liotta R.F. , Tarantino M.L. 
Published: June 2018

Objectives. There is evidence of a clinical correlation between chronic prostatitis and elevated serum levels of prostate specific antigen (PSA). In the present study a system was developed to stage inflammation in benign prostate hyperplasia (BPH), which correlates with serum PSA. Materials and Methods. We retrospectively studied 98 patients undergoing transurethral resection of prostate. In all patients, histological sections of prostate showed BPH and inflammatory cell infiltration, which could be graded as G1, G2 and G3, according to involvement of epithelium. PSA levels were assessed pre- and postoperatively by the Immulite 2000 PSA assay. Results. The difference in mean serum PSA values between groups G1 and G3 was highly significant (G1 = 3.3±2.1; G3 = 7.1 ±3.9 ng/mL; p<0.05). Mean age, prostatic weight and PSA density were similar in the three groups (p<0.05). Conclusions. We concluded that in patients with BPH and prostatitis on pathological examination there is an associated PSA elevation when glandular epithelium is disrupted.
Is phlebography crucial in Tauber varicocele sclerotherapy?
Authors: Pecoraro G. , Motta L. , Olivo G. , Bertoloni R. 
Published: June 2018

Objectives. Our aim was to discover whether it is possible to eliminate retrograde phlebography in the treatment of varicocele by using Tauber procedure. Methods. We treated 102 consecutive left varicocele patients between November 2003 and May 2007. In 72 patients (Group A) we used the Tauber procedure, without performing preliminary retrograde phlebography, and injecting saline solution instead of contrast medium; in 30 patients (Group B) we performed the standard Tauber procedure. We followed up with scrotal color Doppler Ultrasonography and spermograms at 6 months. Results. The patients who underwent the Tauber procedure without phlebography (Group A) obtained results similar to those treated with phlebography (Group B). With our technique, surgical time and costs are reduced and, most importantly, exposure to radiation is avoided. Conclusions. We believe that Tauber procedure for the treatment of varicocele can be performed without retrograde phlebography.
Synchronous bilateral percutaneous nephrolithotomy (PCNL)
Authors: Gigli F. , Cerruto M.A. , Zattoni F. 
Published: June 2018

Background. The management of bilateral renal stones still represents a therapeutic challenge and synchronous bilateral percutaneous nephrolithotomy (PCNL) appears to be a well tolerated, safe and relatively rapid procedure with a favorable cost-benefit ratio. The purpose of the present study is to report our experience in the synchronous percutaneous treatment of bilateral renal stones. Methods. We retrospectively evaluated clinical files from 4 consecutive patients (BS, BE, OCB, FL), who underwent a synchronous bilateral PCNL, performed by the same operator (ZF), for the management of renal persistent and/or recurrent stones after extracorporeal shock wave lithotripsy, or other surgical maneuvers. From each patient's file we recorded a clinical history, any peri- and post-operative complication, any therapeutic resolution employed and the outcomes in terms of stones persistence/recurrence. Results. Overall, 3 men (BS, BE, FL) and 1 woman (OCB), their age ranging from 31 up to 76 years, consecutively underwent synchronous bilateral PCNL. In 75% of cases a calcium-oxalate nephrolithiasis was found. We did not find any peri- or post-operative complication. All patients were stone-free after a mean follow-up of 12 months (range: 3–24 months). Conclusions. Synchronous bilateral PCNL is a relatively safe procedure; it may be performed in selected patients without increasing the morbidity of this surgical maneuver. The simultaneous treatment of the contra-lateral kidney may be taken into account only when the PCNL of the first side has been performed quickly and easily without any peri-operative complication.
Minimal invasiveness of radical laparoscopic prostatectomy: dreams or reality?
Authors: Greco F. , Wagner S. , Hamza A. , Fornara P. 
Published: June 2018

To determine the systemic response to extraperitoneal laparoscopic (eLRP) and open retropubic radical prostatectomy (RRP). Materials and Methods. In all, 430 patients who had eLRP (200) or open RRP (230) were recruited; patients in both groups had similar preoperative staging. In addition to peri-operative variables (operative duration, complications, blood loss, transfusion rate, hospitalization, catheterization), oncological data (Gleason score, pathological stage, positive margins) were also compared. The extent of the systemic response to surgery-induced tissue trauma was measured in all patients, by assessing the levels of acute-phase markers C-reactive protein (CRP), serum amyloid A (SAA), interleukin-6 (IL-6) and IL-10 before, during and after RP. Results. The duration of surgery, transfusion rate, hospital stay and duration of catheterization were comparable with those of previous studies. There was an increase in IL-6, CRP and SAA but no change in IL-10, and no differences between eLRP and RRP over the entire period assessed. Conclusion. The invasiveness of eLRP could not be substantiated objectively on the basis of the variables measured in this study. The surgical trauma and the associated invasiveness of both methods were equivalent.
Bladder and buccal mucosa graft in urethral stricture reconstruction
Authors: Marzorati G. , Ghinolfi G. , Pachera F. , Meazza A. 
Published: June 2018

Purpose. Our aim was to determine the success of urethroplasty using a free graft of buccal or bladder mucosa for the treatment of complex anterior urethral stricture in adults. Materials and Methods. From October 2000 to February 2005, 11 patients with complex anterior urethral stricture underwent substitution urethroplasty, using mucosal grafts, 6 buccal and 5 bladder. Results. The mean follow-up time was 50 months for 8 out of 11 patients (range 24 to 72). The procedure was successful for 6 patients (75%). Urethral stricture recurred in 2 patients (25%) and was treated by urethrotomy or meatoplasty with positive outcomes. Conclusion. Our limited experience with the reconstruction of a complex stricture of the anterior urethra confirmed that buccal and bladder mucosa grafts are excellent materials for substitution urethroplasty but that case selection is important.
High-intensity focused ultrasound and prostate cancer: technology, state of the art and future
Authors: Vespasiani G. , Asimakopoulos A.D. , Agrò E. Finazzi , Virgili G. 
Published: June 2018

Background. The potential applications of the high-intensity focused ultrasound (HIFU) as a minimally invasive therapy of the localized prostate cancer explain the growing interest of the urologic community towards this technique. HIFU has been assessed for its role in the treatment of localized prostate cancer in patients who otherwise would not have benefited from surgery, and in local recurrences after radiation failure. Methods. Relevant information on HIFU treatment was identified through a literature search of published studies. Results. High biochemical efficacy, excellent tumor local control and favorable mid- and long-term oncological data with a low morbidity rate have been shown in many series of patients. Conclusions. Although HIFU is a recent and emerging technology, it has been well studied and developed to a point that HIFU will undoubtedly be an effective alternative to radiation therapy.
Adenoid cystic/basal cell carcinoma of the prostate: case report
Authors: Tonini G. , Rosini R. , Teppa A. , Aulenti V. , Kalantary F. , Tosana M. , Bianchi D. , Zorzi F. 
Published: June 2018

Although most prostate carcinomas belong to the conventional acinar type, unusual variants have been reported. The adenoid cystic/basal cell carcinoma of the prostate is a rare tumor with distinctive histopathologic features. There are quite few publications in the literature concerning the diagnosis, treatment, and prognosis of this neoplasm. Methods. A 71-year-old man had an increased PSA value (5.11 ng/dL); the prostatic biopsy examination was positive for adenoid cystic/basal cell carcinoma. For this reason we proceeded with radical prostatectomy. The histology examination showed an acinar conventional carcinoma and adenoid cystic/basal cell carcinoma. At eight months the patient did not show any recurrence. Conclusions. Various histologic and immunohistochemical features are helpful in recognizing the adenoid cystic/basal cell carcinoma of the prostate. Clinically, the only difference from a conventional adenocarcinoma is that the PSA value is usually normal or only slightly increased. This tumor has a biological potential that can result in metastases in some cases; the current treatment consists primarily in the surgical resection. A close, long-term follow-up is strongly recommended.