bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eswl for Ureteral Calculi
Authors: Ayyoub M. , Usai M. , Malloci S. , Solinas A. , Atzori G. , Frongia M. 
Published: June 2018

The role of extracorporeal shockwave lithotripsy (ESWL) for ureteral calculi is still being debated. We evaluated our results in a large series to clarify the role of this modality. Patients and methods Between September 1997 and December 2004, 657 patients (414 males, 243 females) with ureteral calculi were treated with extracorporeal shock-wave lithotripsy (ESWL) in situ with 2 types of lithotripters (Wolf Piezolith-3000 e Storz Modulith SLX) that offers simultaneously X-ray and ultrasound for stone localization. 971 interventions were performed, with an average of 1.47 sessions/patients. Stone size ranged from a minimum of 5 to 20 mm. Only in one case neuroleptoanalgesia was performed. Targeting was done both by ultrasound and radioscopically. Results 449 (68.3%) patients were stone-free after a single ESWL session, whereas, for the rest, more than one session was required. Auxiliary measures (double J ureteral stent, nephrostomy) were necessary for 32 (4.8%) patients. In 3 cases, infectious complicantions occurred in patients who had not received any antibiotics prophylaxis. Ureterolithotripsy was performed to resolve the case in 9 patients and in 2 was needed to do ureterolithotomy. A 68.3% success rate was achieved with a single ESWL session, it rose to 94% if we considered patients who required max. 3 treatments. Conclusions The results prove that the success rate in ureteral calculi is very high if the indications for ESWL are correctly made. Considering that ESWL is performed under no anaesthesia, with short hospitalization (ambulatory care), and with no endoscopic manouvres, it is concluded that extracorporeal lithotripsy is a cost-effective and efficient method to treat and resolve ureteral calculi.
Diagnostic and Prognostic Value of Testicular Fine Needle Aspiration in Non-Obstructive Azoospermia
Authors: Bettella A. , Tavolini I. M. , Boscolo B.R. , Menegazzo M. , Rossato M. , Bassl P.F. , Foresta C. 
Published: June 2018

Modern techniques of assisted reproduction may be useful also in non obstructive azoospermic men using sperm extracted from the testis (TESE). However, no clinical or hormonal parameter has reliable prognostic value in predicting the presence of testicular sperm. We report here our experience with fine needle aspiration cytology (FNAC) of the testes used as a diagnostic tool in non obstructive azoospermic patients looking at its possible role as prognostic parameter for the presence of testicular sperm at TESE. Methods One hundred and twenty-five non obstructive azoospermic men candidates to ICSI were analysed for FSH, LH, testosterone, and inhibin B plasma levels, and classified in three groups on the basis of FNAC: Sertoli cell-only syndrome (70), severe hypospermatogenesis (42), and maturation arrest (13). After that, all men underwent TESE for sperm recovery for ICSI. Results FNAC detected sperm in 24 of 42 men with severe hypospermatogenesis and 9 of 13 men with maturation arrest. TESE retrieved sperm in all such patients, as well as in additional 29 of 70 men with Sertoli cell-only syndrome, additional 11 cases of severe hypospermatogenesis (35 of 42 in total) and 1 additional case of maturation arrest (10 of 13 in total). Testicular volume and hormonal parameters were not different in men with and without sperm retrieved. Conclusion These findings suggest that FNAC may be a simple and valid diagnostic parameter in non obstructive azoospermic men, and it may represent a valid positive prognostic parameter for sperm recovery at TESE.
Microfocal Prostate Cancer
Authors: Montanari E. , Del Nero A. , Mangiarotti B. , Bernardini P. , Confalonieri S. , Grisotto M. , Marchesotti F. 
Published: June 2018

To determine whether microfocal prostate cancer on needle biopsy predicts clinically insignificant prostate cancer. Patients and Methods We reviewed the records of 257 patients who underwent radical retropubic prostatectomy between January 1999 to September 2003. 18 patients had preoperative diagnosis of microfocal prostate cancer defined as 1 positive core/8 cores, cancer length < 3 mm and Gleason score less than/equal to 6. Results Of the 18 patients with preoperative microfocal cancer, only 1 case had clinically insignificant disease. 15 pts had organ confined disease (pT2) and 3 pts had capsular penetration (pT3). The lesion was bioptic undergraded in 33% of cases. Conclusions Microfocal prostate cancer as determined by needle biopsy does not predict clinically insignificant disease.
Evidence for the Presence of α1 Adrenoceptor Subtypes in the Human Ureter
Authors: Palazzolo F. , Sigala S. , Dellabella M. , Milanese G. , Faccoli S. , Peroni A. , Mirabella G. , Cunico S. Cosciani , Spano P.F. , Muzzonigro G. 
Published: June 2018

Several studies proposed a role for α1 adrenoceptors (α1 ARs) in the ureteral physiology, indicating that they are present in the ureter; however, few studies have been made to identify α1 AR subtypes present in this area. Thus, this study was carried out to characterize the α1 AR subtype gene and protein expression in proximal, medial and distal region of the human ureter. Methods Molecular characterization of α1 AR subtypes was done by semi-quantitative RT-PCR. The α1 AR protein expression was studied by saturation binding curves using the α1 AR antagonist 125I-HEAT. Analysis of data was performed using the GraphPad PRISM 4 software. Results Analysis of saturation binding curves revealed an heterogeneous distribution of α1 AR binding sites; the Bmax for the distal ureter was indeed 52.5 ±5.4 fmol/mg prot, while a lower similar density of α1 ARs was demonstrated in the medial (25.2 ±1.7 fmol/mg prot) and proximal (23.4 ±0.4 fmol/mg prot) ureters. Molecular characterization of α1 AR subtypes indicated that each receptor was present, although with differences in term of the amount expressed. Conclusions Human ureter was endowed with each α1 AR subtype, although α1D and α1A ARs were prevalent over α1B ARs. Radioligand binding results revealed that there were no significant differences in the Kd between ureteral regions, while an heterogeneous distribution of α1 AR binding sites was detected, with the highest density of α1 ARs in the distal ureter and a lower similar density in the medial and proximal ureter.
Involvement of β3-Adrenergic Receptor Activation in Human Corpus Cavernosum Function
Authors: Verze P. , Cirino G. , Imbimbo C. , Di Villa Bianca R. D'Emmanuele , Buonopane R. , Ignarro L.J. , Mirone V. 
Published: June 2018

β3 adrenergic receptors are extensively studied, and in animal model it was demostrated their involvement in the vasorelaxation of smooth muscle cells. However the precise role and their exact distribution in human body is almost unknown. We studied the presence of β3 adrenergic receptors in human corpus cavernosum and the pathways involved in their activation: Materials and Methods Using strips isolated from human corpus cavernosum obtained from transsexual surgical procedures, we tested this receptors with a specific agonist BRL-37344 (10–5 −10–8) to understand their precise role. Removing endothelium and using L-NAME (100 μM), we tested the involvement of NO in the pathways of activation of this receptors. Results We demostrated the presence of β3 adrenergic receptors in the human corpora cavernosa and their mainly localization in the smooth muscle cells of vascular vessels. Our results dimostrated, making a stimulation with BRL-37344, that exists a mechanism of smooth muscle relaxation concentration-dependent. This relaxation is endothelium-indipendent too, like we showed removing it or using L-NAME. The vasorelaxation induced by BRL-37344 is realized by the increase of cGMP level of 7-fold like it was dimostrated by ELISA. Moreover the use of SR-59230A, an antagonist of β3 adrenergic receptors, removes the relaxant effect. Conclusions The vascular smooth muscle in human corpus cavernosum possesses tonic or continuous β3-adrenergic receptor activity (mediating relaxation), as suggested by the vasoconstrictor effect that results from selectively antagonizing the β3-adrenergic receptors. The presence of β3-adrenergic receptors in human corpus cavernosum and their possible involvement in promoting erectile function via cGMP but NO-indipendent, may open new approaches to develop new treatment of E.D.
Retrograde Ureteroscopy for Distal Ureteral Stones Removal in Childhood
Authors: De Dominicis M. , Matarazzo E. , Defidio L. , Collura G. , Caione P. 
Published: June 2018

Distal ureteral stones are commonly treated by extracorporeal shock wave lithotripsy (ESWL) as first option in adult age patients, but no agreement is achieved about the treatment in children. Efficacy and safety of ureteroscopy with ureterolithotripsy (ULT) was compared with ESWL results for distal ureteral calculi treatment in childhood. Materials e Methods From July 2002 to July 2003, paediatric patients presenting ureteral stones were consecutively randomized for treatment, using ULT or ESWL. The success rate, effectiveness quotient, complication rate and hospitalization length were evaluated. T-Student test (chi-square) was adopted for statistical analysis. Results A total of 31 patients, aged 2 to 17 years (mean age 7.2 years) were recruited. ULT was performed in 17 children. All the females (100%) and 4 males (80%) were stone-free in a single endoscopic procedure. ESWL was performed as a primary procedure in 14 cases, 5 males and 9 females. Four females (44.4%) and 2 males (40%) resulted stone-free at first treatment. The total stone-free rate was 94.1% for ULT and 42.8% for ESWL (p=0.004). Eight patients (57%) underwent a second ESWL and 3 of them (37.5%) became stone-free súbsequently. The 5 patients (62.5%) with failed double ESWL underwent ULT successfully. The calculated efficiency quotient for treating distal ureteral calculi was significantly lower in the ESWL than in the ULT group (p=0.05). Conclusions ULT should be recommended as treatment of choice for distal ureteral calculi in childhood. Using small ureteroscopes the target stone was treated safety and effectively in our patients.
Trans Obturator Tape for Female SUI
Authors: Kocjancic E. , Costa P. , Crivellaro L.S. , Gontero P. , Favro M. , Ceratti G. , Zaramella S. , Maso G. , Tarrano E. , Gherzi R. , Frea B. 
Published: June 2018

The Trans Obturator Tape (TOT) is a new technique, based on positioning of a tape under the middle urethra through the obturator foramina. The outcomes and complications of the TOT at 1 year follow up were evaluated. Materials and Methods 50 patients underwent to TOT for stress urinary incontinence (SUI) have been prospectively evaluated. In the first 6 patients was used the Uratape, a polypropylene tape covered by silicon in the middle part. Eventually, because of 1 case of extrusion due to the silicon part, it was created and used the Obtape, the same tape without the silicon part. The patient was positioned in lithotomy position and a Foley catheter was inserted. A small (2 cm) incision was performed 1 cm below the external meatus in order to allow the digital dissection of the paraurethral. Through the skin the obturator foramen was identified and a small incision was done in the medial part just above the level of the urethral meatus bilaterally. Eventually a hooked tunneler was inserted through the incision at the level of the obturator foramen and the obturator fascia is perforated anteroposteriorly. The tunneler is than directed medially in the paraurethral space previously prepared and under direct digital control. The tape is inserted into the eye of the tunneler to retract the tape through the obturator foramina. The procedure is repeated on the other side. Patients were evaluated preoperatively, at 1, 6, 12 months of follow up with a physical examination, validated questionnaire (AUA score) and reported percentage of improvement, and uroflowmetry. Results The mean age was 57 (range 36 – 76). 70% of the patients had urodynamic stress incontinence, 30% had stress incontinence associated with urgency. The median follow up was 12 months (range 1–24 months). - The average of the AUA score has been decreased of 13 points (form 16 to 3) and the average percentage of improvement was 81 % up to a maximum follow up of 18 months. - 88% (44/50) patients were dry one year after the surgery and 12% (6/50) were improved.- No significant changes in uroflowmetry parameters. One case of extrusion have been reported, using the Uratape, no cases of extrusion have been reported using the Obtape. One patient had developed new urgency. Conclusions The Trans Obturator Tape is a simple, direct and quick procedure. It is associated with good outcomes and high patient satisfaction up to an average follow up of 12 months. Additionally the Obtape does not seem associate to erosion, extrusion or alteration of the normal voiding.
Urethroplasty with a Buccal Mucosa for Treatment of Anterior Urethral Strictures
Authors: Gaffi M. , Anceschi C. , D'Amico F. , Lentini M. 
Published: June 2018

We report the early results of urethroplasty with a buccal mucosa free graft as a dorsal onlay for treatment of anterior urethral strictures. Materials and Methods Since February 1997 to December 2003, 22 patients with recurrent anterior urethral strictures have been treated with buccal mucosa urethroplasty. Mean age of patients was 48.7 years (range 20 – 71). The etiology of strictures was inflammatory (7), iatrogenic (6), traumatic (3), idiopathic (6). Urethroplasty was performed with a free graft of buccal mucosa using dorsal onlay. The buccal mucosa onlay was sutured to the urethra and corpora cavernosa. Results At 37 month mean follow-up (range 5 to 83) the success rate was 95.5%. Conclusions Buccal mucosa free graft represents a simple surgical option and although longer follow up is needed preliminary results are excellent.
Urinary Tract Infections after Extracorporeal Shock Wave Lithotripsy
Authors: Carlino F. , Pichierri G. , Pomara G. , Foti G. , Tanzilli P. , Costarelli S. , Selli C. , Bonadio M. 
Published: June 2018

Extracorporeal shock wave lithotripsy (ESWL) has been using since a long time in the treatment of urolithiasis; until now it is not universally stated if such a procedure represents a risk factor for the development of complications (such as pyelonephritis) and if the same procedure needs an antimicrobial prophylaxis. We began a prospective study in order to evaluate the clinical and microbiological follow-up of all the patients undergoing ESWL at the Centre of urologic lithotripsy of the University of Pisa into a two months period. Methods Fifty-four consecutive patients were enrolled (38 males and 16 females). All the patients were studied, examining their urine samples before ESWL and after one week and evaluating their risk factors for urinary tract infections. Results 12 (22.2 %) out of 54 patients had a significant bacteriuria (≥ 104 CFU/mL) before undergoing ESWL; such bacteriuria persisted in eight of the twelve patients even though they received an appropriate antimicrobial therapy. 41 (75.9%) patients without a significant bacteriuria at the enrollment remained asymptomatic –with sterile urine- after ESWL and they did not receive therapy. One patient with multiple stones, who had a clinical history of previous urinary infections, developed an acute pyelonephritis after ESWL when she stopped the antibiotic terapy. Conclusions Such preliminary data seem to show that the risk of developing urinary infections after ESWL is represented primarily by a history of previous urinary infections and by the presence of an asymptomatic urinary tract infection before ESWL. The decision about the need of an antimicrobial prophylaxis should be taken in every single case basing on the peculiar clinic history of the patient.
Perineal Magnetic Stimulation for Female Urinary Incontinence
Authors: Sandri S.D. , De Francesco O. , Sommariva M. , Confalonieri S. , Nervi S. , Zanollo L. 
Published: June 2018

Perineal Magnetic Stimulation (PMS) is a new technique in pelvic floor rehabilitation which produces magnetic fields that induce involuntary perineal muscles contraction. Our aims were to evaluate efficacy and tolerability in different types of female urinary incontinence. Material and Methods 104 consecutive female outpatients complaining of urinary incontinence were enrolled, 53 suffered of stress urinary incontinence (SUI), 37 of mixed urinary incontinence (MUI) and 14 of urge incontinence (UI). The whole treatment consists of two sessions a week of PMS for a total of six weeks. Results After one course of treatment 8 patients (8%) were cured, 53 (51%) felt improved and 43 (41%) were unchanged. Better results were obtained in pure stress urinary incontinence, while the presence of bladder overactivity reduced the cure dramatically. If the subjective results were related to the entity of the incontinence, evaluated with the one hour weighting pad test, we could see that only a urinary leakage superior to 50 g makes resulted very poor. Conclusions PMS is a new simple perineal rehabilitative technique with instrumental higher costs but less nurse time involvement, with similar results to the usual pelvic floor fisiotherapy and without side effects.
Evaluation of Psa Kinetic after Radical Prostatectomy
Authors: Benecchi L. , Cantoni F. , Prati A. , Arnaudi R. , Pastizzaro C. Destro , Savino A. , Uliano N. , Pieri A. M. , Martens D. , Potenzoni D. 
Published: June 2018

The aim of our study is evaluate PSA kinetics after radical prostatectomy for localized prostate cancer. Materials and Methods We evaluated PSA kinetic in 101 patients who underwent radical prostatectomy for localized prostate cancer. Only patients in whom one or more measurable PSA values available postoperatively (from day 2 to day 10) were included in our study group. We calculated the PSA half-life after radical prostatectomy. Results The median PSA half-life after radical prostatectomy was 2.2 days (range 0.97 to 6.73 days). We found a statistical difference in PSA half-life between patients with and without positive surgical margins; the group with positive surgical margins showed a slower reduction of PSA than the other, probably due the presence of residual cancer tumor. Conclusions. PSA half-life differs during the beta-phase after radical prostatectomy, it is longer in patients with positive surgical margins than those with negative surgical margins. This difference is probably due to the presence of residual prostate cancer after surgery.
Psa Elevation during Intravesical Therapy for Superficial Bladder Carcinoma
Authors: Beltrami P. , Ruggera L. , Cazzoletti L. , Schiavone D. , Artibani W. 
Published: June 2018

PSA is commonly accepted as an indication for prostate biopsy. We determined PSA value in 81 consecutive patients treated with intravesical immuno- (59 cases) or chemotherapy (22 cases) for superficial bladder cancer. Blood samples were obtained before and after the induction course of instillation therapy and at 3, 6 and 12 months. We observed a clinical significant elevation of average PSA in 27 cases (45%) during BCG therapy and a return at the baseline levels within 12 months. Histological findings obtained in 10 patients shown inflammatory pictures in 9 cases. Prostate carcinoma was found only in one case with elevated PSA at 12 months. No significant differences of PSA levels were noted in patients treated with chemotherapy. Our findings confirm that PSA increase in patients during intravesical BCG therapy is self-limited. Prostate biopsies in these patients are not mandatory and could be delayed while monitoring PSA.
Angiomyolipoma in a Patient with Tuberous Sclerosis
Authors: Antonelli A. , Zani D. , Portesi E. , Cozzoli A. , Maroldi R. , Battaglia G. , Chiesa A. , Cunico S. Cosciani 
Published: June 2018

Angiomyolipoma (AML) is a benign hamartoma with two distinct clinical settings, one sporadic with no underlying predisposing conditions, and another linked to the tuberous sclerosis complex in which lesions tend to be larger, multifocal and bilateral and more likely to cause spontaneous hemorrhage. Due to the benign nature of the disease the elective treatment of AML, which is conventionally required for neoplasms with diameter greater that 4 centimeters, should have the aim of lowering the risk of bleeding without sacrifice of the normal renal parenchyma and with the minimum of invasiveness. The bleeding from AML, the lack of a pseudocapsule and the collocation of the tumour can be a limit to a correct nephron sparing surgery. For these reasons a selective angiographic embolization, which allows the vascular exclusion and the lowering of the risk of bleeding with reduced invasiveness, is actually indicated to treat AML. A case of successful embolization of AML in a patient with tuberous sclerosis is presented.
Renal and Lymph-Node Inflammatory Pseudotumor
Authors: Ronci L. , Viola D. , Comerci F. , De Stefano R. , Emili E. , Sanguedolce F. , Franceschelli A. , Marlia E. , Martorana G. 
Published: June 2018

Inflammatory pseudotumor (IP) is a benign uncommon tumour with uncertainly aetiology. Aetiology may be an inflammatory process due to small traumas, surgery, or malignancy. Some studies showed that patients affected by IP were also affected by wide vasculities and genetics abnormalities, strengthening the hypothesis of an aetiology of this disease from an autoimmune pathology or a true tumour respectively. The bladder localization is the most frequently localisation in the genital-urinary apparatus, while the kidney localization is very uncommon. The IP consist of inflammatory and myofibroblastic cells. Material and Methods A 69 years old affected with inhomogeneous mass in the right kidney of about 8 cm, calcify lymph-node of the mesentery of about 28 mm. Results The patient was undergone to right nephrectomy and removal of mesenteric lymph-node. Histological issue showed a renal cells carcinoma G2 associated to IP. Mesenteric lymph-node with ossification and associated to IP. Conclusions This case is interesting for the simultaneous finding of the IP placed to right kidney and mesenteric lymph-node. Similar wide IP have already described in other studies like true tumour with more biological aggressivity. The differential diagnosis of IP with other neoformations is still difficult. We consider an optimal indication to perform a radical surgery therapy in any case, because IP may be associated with a malignancy and because sometime IP may increases progressively its aggressiveness. The histological diagnosis achieved by bioptical sample may be risky because biopsy cannot exclude all doubt about the existence of a mixed neoformations with IP and malignancy like our case.