bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracorporeal Shock Wave Therapy as First Line Treatment in Patients with Peyronie's Disease
Authors: Palmieri A. , Imbimbo C. , Longo N. , Creta M. , Buonopane R. , Dalena G. , Vivaldi O. , Riccio R. , Mirone V. 
Published: June 2018

Introduction Extracorporeal Shock Wave Therapy (ESWT) is a minimal invasive treatment for patients with Peyronie's Disease (PD). Currently, however, controversial data exist on the efficacy of ESWT as first-line treatment. Methods We performed a prospective, randomized, double blind, placebo-controlled trial to evaluate the efficacy of ESWT in a group of 100 patients with disease duration <12 months, naive to previous treatments, with a single plaque, erectile dysfunction and/or painful erections and/or penile recurvatum. Patients were randomized to undergo ESWT or Placebo. The Storz Duolith device was employed for treatments. A non-functioning probe was employed as placebo. Treatments were administered in four sessions at weekly intervals. The following evaluations were performed at baseline and at 12- and 24-week intervals from treatment: IIEF-5 (International Index of Erectile Function) questionnaire, VAS (Visual Analogue Scale), plaque size measurement, penile curvature measurement. Results Only patients treated with ESWT reported a significant improvement of mean VAS score and of mean IIEF-5 score at a 12-week follow-up. Mean plaque size and mean curvature degree did not improved significantly in patients treated with ESWT but showed a significant worsening at the 24-week follow up compared to baseline values in the placebo group. Conclusions ESWT can improve significantly painful erections and erectile functions in patients with PD naive to other treatments. Moreover, ESWT can stabilize plaque size and penile curvature thus preventing disease progression.
Associating Serenoa Repens, Urtica Dioica and Pinus Pinaster. Safety and Efficacy in the Treatment of Lower Urinary Tract Symptoms. Prospective Study on 320 Patients
Authors: Pavone C. , Abbadessa D. , Tarantino M.L. , Oxenius I. , Laganà A. , Lupo A. , Rinella M. 
Published: June 2018

Introduction Serenoa repens (saw palmetto) has been employed for the treatment of lower urinary tract symptoms (LUTS) for several years. Its mechanism of action is believed to be due to antiandrogenic, antiproliferative and antinflammatory properties. An association of Serenoa with the nettle “Urtica dioica” showing antiproliferative activity and the pine “Pinus pinaster” derivative, showing antinflammatory action, has been proposed in recent years. Such an action is hoped to act not only by reducing LUTS but also by preventing the development of prostate cancer. Material and Methods During the years 2007 and 2008, 320 patients suffering from LUTS were treated with an association of Serenoa repens 320 mg, Urtica dioica 120 mg and Pinus pinaster 5 mg, named IPBTRE. This treatment was administered to all patients for a minimal duration of 30 days to a maximum of a year, either alone or in association with antibiotics or alpha-blockers, if needed. Outcome analysis was based on evaluation of symptoms, prostate volume and maximum flow rate (Qmax). Results From a careful analysis of the data collected in our database, the following observations can be made: ages varied between 19 and 78 years. The patients were affected by BPH in 46% of cases, chronic prostatitis syndrome in 43%, chronic genital-pelvic pain in 7% and other conditions in 4%, the absolute numbers being 147, 138, 22 and 7 patients, respectively. No untoward side effect was reported in any case. Variations in symptom score could be fully evaluated only in 80 of 320 patients (25%), of whom 68 (85%) reported a significant benefit, with special reference to an improvement of pain, urgency, strangury and nocturia. Data on variations in prostate volume, as measured by digital rectal examination, were available in 84 (26.5%) patients. No significant change was observed. Qmax after treatment was measured in 83 (26%) patients. It did not show significant changes from the initial values. Discussion The association tested in our study appeared to be safe and well tolerated. No changes in flow rate and prostate volume were observed, but a marked reduction of LUTS was observed in 85% of evaluable cases, especially with regard to pain and irritative symptoms. Whether or not such an association may display a prevention of prostate cancer, may be investigated in additional studies.
Can Hyperbaric Oxygenation Therapy (HOT) Modify the Blood Testosterone Concentration?
Authors: Passavanti G. , Tanasi P. , Brauzzi M. , Pagni M.R. , Norgini E. , Aloisi A.M. 
Published: June 2018

Introduction Testosterone has a modulating effect on inflammatory and healing processes. In this study, we evaluate whether hyperbaric oxygenation therapy (HOT) modifies the blood concentration of total testosterone (TT) in patients treated for different pathologies. Materials and Methods Fourteen male patients (23–72 years old) were treated with 90-min HOT sessions (range 4 to 23 sessions) as an adjuvant to the following conditions: leg fractures, osteonecrosis, diabetic foot, firearm injuries, complicated arthroprosthesis and underwater diving embolism. As controls, six healthy male volunteers (37–51 years old) were subjected to 10 HOT sessions. Testosterone plasma levels were determined immediately before the first HOT session and the day after the last session. Results At the end of treatment, 12 patients fully recovered and 2 (diabetic foot patients) showed a marked improvement. Testosterone significantly increased after hyperbaric oxygenation therapy in both patients and controls (ANOVA, p<0.004). Discussion We conclude that hyperbaric oxygenation therapy increases the blood concentration of total testosterone in patients as well as in healthy men. This finding raises new questions and indicates the need to investigate the causes of this increase and its therapeutic significance. Since testosterone modulates inflammation and healing processes, it is possible that hormonal changes are the mechanisms affected by hyperbaric oxygenation therapy.
Laparoscopic Radicai Prostatectomy without Ligation of the Santorini's VenousPlexus
Authors: Ferrara V. , Giannubilo W. , Azizi B. , Scaldazza C. Vecchioli , Garritano A. 
Published: June 2018

Background The goal of our work is to demonstrate how, in the approach to laparoscopic radical prostatectomy, the ligation of Santorini's dorsal venous complex is not necessary. The retrospective evaluation of video-laparoscopich radical prostatectomy performed at UOC of Jesi with this technical device, showed an increased blood loss compared to a technique that provides for the ligation of Santorini's plexus and, overall, reduced blood loss compared with the average radical open prostatectomy. Material and Methods 50 video-laparoscopic extraperitoneal radical prostatectomies were evaluated, which were performed with the same technique and by the same operator. The technique involves the non-ligation of Santorini's venous plexus. Surgical, oncological, functional outcomes were considered and in particular blood loss. Results The results are consistent with those reported in literature, and without ligation of the Santorini's venous plexus, there has been no increase in blood loss intra-and / or post-operatively or in the percentage of patients with hemotransfusion. Conclusion The video-laparoscopic radical prostatectomy, although a not yet codified and standardized technique for the treatment of organ-confined prostate cancer, did show oncological and functional results basically I similar to open-sky technique. But compared to this, it has certainly demonstrated a lower blood loss and a reduction of morbidity. The non ligation of Santorini's venous plexus, always necessary during open prostatectomy, in our experience is not necessary in video-laparoscopy
Sports and Genitourinary Traumas
Authors: Sacco E. , Marangi F. , Pinto F. , D'Addessi A. , Racioppi M. , Gulino G. , Volpe A. , Gardi M. , Bassi P.F. 
Published: June 2018

Introduction Statistical data referring to sports-related traumas of the urinary tract are quite scarce; nevertheless, it is possible to draw general data on the relationship between sports and urological traumas. Methods Literature review of peer-reviewed articles published by May 2009. Results Urological traumas account for about 10% of all traumas, and about 13% of them is sports-related. Genitourinary traumas are among the most common cause of abdominal injuries in sports. Blunt injuries are more common than penetrating ones and renal injuries are by far the most common, followed by testicular injuries; ureters, bladder and penis injuries are much more infrequent. Considering chronic microtraumas, injuries of bulbar urethra are also common in sports that involve riding. Overall, the incidence of genitourinary trauma due to sports is low. Renal traumas in sports injuries usually consist of grade 1–11 lesions and usually do not require surgical treatment. Cycling is the sporting activity most commonly associated with genitourinary injuries, followed by winter sports, horse riding and contact/collision sports. Literature data suggest that significant injuries are rare also in athletes with only one testicle or kidney. General preventive measures against sport-related injuries, along with the use of protective cups for male external genitalia, are generally sufficient to reduce the incidence of urogenital trauma. Conclusions Overall, studies show that urogenital injuries are uncommon in team and individual sports, and that most of them are low-grade injuries. Participation in sports that involve the potential for contact or collision needs to be carefully assessed in the athletes with only one testicle or kidney, even though urogenital injuries should not preclude sports participation to an appropriately informed and counseled patient. Further research is needed to acquire more knowledge on genitourinary injuries according to age, sports type and technical skill.
Occurrence Rates and Predictors of Lower Urinary Tract Symptoms and Incontinence in Female Athletes
Authors: Simeone C. , Moroni A. , Pettenò A. , Antonelli A. , Zani D. , Orizio C. , Cunico S. Cosciani 
Published: June 2018

Introduction and hypothesis To assess the prevalence of lower urinary tract symptoms (LUTS) and incontinence in female athletes and to determine the etiological factors. Methods An anonymous self-questionnaire was collected from 623 casual female athletes aged 18 to 56 years, who were involved in 12 different sports. The surveys were distributed by hand to the athletes, during their sports fitness tests, in a sports center. We investigated the relationship between urinary disorders and factors such as age, body mass index (BMI), parity, duration of physical exercise, and type of sport. Results The prevalence of LUTS was 54.7%, and 30% for urinary incontinence. Changes in urinary frequency were detected in 91 (14.6%) women. Prevalence of dysuria was 13.3%, urinary straining was present in 173 (27.8%) athletes, whereas urinary urgency had an estimated prevalence of 37.2% with 232 athletes suffering from this disorder. Urgency was very common in volleyball players, as was dysuria among hockey and basketball players, whereas straining mainly affected aerobic participants and cyclists. Long training hours and competitive practices were correlated with the onset of LUTS. High-impact sports were more frequently associated with incontinence, while low-impact sports with LUTS. The sport with the main number of incontinent people was football. Urge incontinence affected a lot of athletes, mainly cyclists and football players. Stress incontinence was more frequent in hockey and volleyball players. Conclusions LUTS and incontinence are prevalent in female athletes. In many cases, the disorders were present only during sports activities. In this sample, the presence of urinary disorders did not seem to be a barrier during sports or exercise.
Percutaneous Nephrolithotomy (PCNL) in a 9-year-old Patient with Horseshoe Kidney
Authors: Ziglioli F. , Ferretti S. , Salsi P. , Dinaie F. , Ciuffreda M. , Campobasso D. , Frattini A. 
Published: June 2018

Introduction The horseshoe kidney is the most frequent renal anomaly, with a prevalence of 0.25% and amale to female ratio of 3:1. Although the pathogenesis remains controversial, the consequences of the impaired urinary drainage are well known: up to two third of patients present with urinary stasis, infection and urolithiasis. Percutaneous nephrolithotomy (PCNL) is a successful procedure for urolithiasis in horseshoe kidneys. Materials and Methods A 9-year-old patient with a 4-cm stone associated with horseshoe kidney underwent Percutaneous nephrolithotomy (PCNL). During the procedure, a flexible uretheroscopy was performed in order to obtain a complete vision and an optimal management of the procedure. Results At the end of the procedure, the patient was stone-free. We reported no hemorrhagic complications, no pain and no infection. The patient was discharged after 48 hours. Conclusions The procedure is safe and effective, as long as the surgeon pays attention to the recommendations below.
Wunderlich Syndrome. Clinical and Therapeutic Aspects of a Long-Term Experience
Authors: Marino Gaetano , Pedalino Marco , Di Primio Otello Giovanni , Piras Dorino , Vella Riccardo , Verces Enrico , Carbonatto Paolo 
Published: June 2018

Introduction Wunderlich's syndrome is defined as a clinical manifestation secondary to sudden spontaneous rupture of renal parenchyma in the absence of injury, resulting in hemoretroperitoneum. This syndrome may occur in patients with benign or malignant neoplasm of the kidney, arterial venous fistulae, immunovasculitis and other phlogosis of the kidney. Materials and Methods We present 19 cases of acute spontaneous hemoretroperitoneum or Wunderlich's syndrome diagnosed from 1996 to 2009, related to the following conditions: 7 renal carcinomas, 4 angiomyolipomas, 2 adrenal hemorrhages, 1 bleeding polycystic kidney, 2 hemorrhagic renal cysts and three cases of immunovasculitis. Overall, 6 patients were treated with acetylsalicylic acid and 4 with dicumarolics for cardiovascular disease, while 13 patients were suffering from hypertension Results In 19 cases there was no mortality and the following treatment was performed: 11 nephrectomy, 4 partial nephrectomy, 2 adrenalectomy, 2 selective embolization of intrarenal branches as single treatment, while in three other cases, the embolization was carried out from a surgical procedure, conservative (partial nephrectomy) in one case, ablative (nephrectomy) in two other cases. Conclusions The spontaneous hemoretroperitoneum is a rare syndrome associated with acute kidney disease often unknown to the patient and only in selected cases with small hematoma; it is possible to perform arteriography with selective embolization of branches avoiding renal access surgery. So far, it is unknown to which extent anti-platelet and anticoagulant drug treatment contributes to this syndrome but, in our experience, they have increased the morbidity of the clinical condition.
Laparoscopic Removal of Voluminous Right Seminal Vesicle Neoplasm
Authors: Parma Paolo , Dall'oglio Bruno , Samuelli Alessandro , Bondavalli Candido , Bellomi Alberto 
Published: June 2018

Introduction We present the case of a male adnexal tumor of probable Wolffian origin occurred to the right seminal vesicle of a 47–year-old man. Materials and Methods The patient presented with a 2–month history of hematospermia. The diagnosis was achieved by transrectal ultrasound, CT of the abdomen and pelvis, and biopsy of both prostate and seminal vesicle. The patient was counseled for laparoscopic excision of the right seminal vesicle. Results The right seminal vesicle, along with the tumor and the right vas deferens, were excised and clear margins were ensured by frozen section. Total operative time was 180 with 200 mL blood loss. The patient's recovery was uncomplicated and he was discharged on the fourth post-operative day. The histologic examination demonstrated a male adnexal tumor of probable Wolffian origin, which is a rare low-grade malignant neoplasm that has been previously described in the broad ligament, ovaries and retroperitoneum of females. The patient is free of relapse at a 20–month follow-up. Conclusions This is the second report of this entity in a male. The laparoscopic approach for the excision of seminal vesicle neoplasms is a good treatment for its obvious benefits of minimal blood loss, short hospital stay and quick return to normal activity. The magnifications of the anatomical details of the pelvic floor help the surgeon in the dissection of the seminal vesicle from the other structures.
Neuroendocrine Small-Cell Bladder Cancer: Our Experience
Authors: Ruoppolo M. , Pezzica E. , Milesi R. , Corti D. , Mercurio P. , Fragapane G. 
Published: June 2018

Introduction Neuroendocrine bladder cancer is extremely rare, with an estimated incidence of 0.35–0.70% of all bladder tumors. The small-cell carcinoma represents the most frequent histologic variant described. Small-cell carcinoma is an epithelial tumor associated with a more aggressive behavior and poorer prognosis than transitional cell bladder carcinoma. The overall survival rate at 5 years does not exceed 8%. At the time of presentation 59% of patients have clinical stage >T2 and 56% show metastatic disease. In 50% of the patients, fatal progression occurrs within 6 months. Local recurrence after radical surgery occurred in 50–70% of cases. Patients and Methods We report three cases of pure neuroendocrine small-cell bladder cancer. Hematuria was the most common presenting symptom. Local advanced disease was present in all the cases with stage >T2, metastatic disease in 1 case, lymph node involvement and ureteral bilateral obstruction in 2. Two patients were treated by radical cystectomy, bilateral pelvic limph node resections and urinary derivation. Platinum-based adjuvant chemotherapy was proposed but only two patients received the treatment. One patient with liver metastasis was managed only by extensive TUR and support regimen. Results In 2 patients residual or relapsed cancer reappered within 2 months after surgery. All of the three patients died of metastatic disease at 5, 7, and 13 months. Median overall survival was 7 months. The most common site of relapse and spread of disease was the peritoneum and intestinal tract, and the reason of death was uncontrolled acute hemorrhage from gastro-intestinal district. Conclusions In the absence of a prospective study, and because of the rarity of the disease, the best treatment for small-cell bladder cancer remains uncertain. Neoadjuvant chemoterapy with platinum regimen plus aggressive surgical approach will be the treatment of choice. The association of chemotherapy and radiotherapy should also be considered.
Urologia funzionale: Nuove acquisizioni scientifiche al servizio della clinica
Authors: Porena Massimo 
Published: June 2018

Questo seminar monografico di Urologia, dedicato all'urologia funzionale del basso tratto urinario, ospita quattro articoli che aprono a nuove prospettive sulla comprensione della fisiopatologia dei LUTS e del loro trattamento, alla luce delle recenti acquisizioni neurofisiologiche, di imaging e di biologia molecolari. Il progressivo allungarsi della vita media registratosi nell'ultima metà del secolo è destinato a diventare un fenomeno caratteristico della nostra epoca, portando all'attenzione dell'urologo nuovi contesti precedentemente considerati di scarso rilievo. L'intera comunità scientifica, e la comunità urologica nello specifico, appare oggi unanime nel considerare necessario incrementare i propri sforzi verso un costante supporto verso la qualità di vita. Questa volontà è particolarmente evidente per quelle patologie, come i disturbi del baso tratto urinario, che non minacciano direttamente la quantità di vista del singolo soggetto, ma minano profondamente la sua realizzazione individuale e sociale determinando profonde alterazioni qualitative. Succede così che dopo aver saputo opporsi con efficacia e prontezza inaspettate all'attacco di patologie infettive e neoplastiche, l'urologo si confronta oggi con altre sfide. I quattro lavori presentati in questo volume testimoniano l'impegno e il contributo dell'urologia funzionale italiana che con instancabile dedizione alla causa della salute dei propri pazienti, verso le patologie funzionali del basso tratto urinario. La comprensione che l'urotelio, in passato considerato alla stregua di una semplice barriera fisica, che separava le urine dal corpo, partecipi alla regolazione neurologica periferica del riflesso minzionale, che cellule epiteliali assumano la capacità di svolgere un ruolo sensorio afferenziale e che da questo ne derivi una nuova prospettiva terapeutica, rappresentano i principali avanzamenti nella gestione del paziente con vescica neurologica. Se in passato la correzione anatomia del difetto/descensus degli organi pelvici costituiva la prima ed unica soluzione, oggi siamo consapevoli che la correzione anatomica è un momento chirurgico che deve guardare ed ottenere un miglioramento dei sintomi. I quattro lavori, scritti da autori il cui valore è riconosciuto a livello nazionale ed internazionale, ci fanno comprendere come l'aumento dei valori relativi agli anni di vita media nei paesi più industrializzati sia un bene incompleto se non è accompagnato da un miglioramento della qualità di vita stessa delle persone. Come urologi, abbiamo motivi di ritenere — certo ognuno potrà considerare dentro di sé quanto tutto ciò sia reale — che la tutela della qualità di vita rappresenti il problema di primaria ed imprescindibile importanza in ogni nostro reparto ed è per questo che siamo orgogliosi di ospitare su Urologia un contributo clinico-scientifico in tal senso.
Unusual metastatic localization to the kidney of basaloid squamous cell carcinoma of the oropharynx
Authors: Ricci Costantino , Rossi Martina S , De Stefano Roberta , Fiorentino Michelangelo , Vasuri Francesco 
Published: June 2018

Case presentation: A 55-year-old man with a history of basaloid squamous cell carcinoma of the oropharynx with laterocervical lymph node metastases 6 years before (and treated with chemoradiation) presented with flank pain and hematuria. Computed tomography scan found a renal lesion, with radiological features more suspicious for primitive renal neoplasia. Histopathological and immunohistochemical examination after surgical excision revealed a basaloid squamous cell carcinoma involving renal parenchyma. Conclusion: Basaloid squamous cell carcinoma is a rare tumor but with a high percentage of distant metastasis, and it is mandatory, also for a general pathologist, to know this disease. Moreover, in a patient with renal metastases, any type of cancer should be taken into account, and this case is emblematic of why the previous medical history is crucial for differential diagnosis.