Archivio Italiano di Urologia e Andrologia最新文献

{"title":"Role of inflammatory markers in predicting spontaneous passage of ureteral stones less than 10 mm.","authors":"Ismaeel Aghaways, Rawa Bapir, Nabaz S Siwaily, Ahmed Mohammed Abdalqadir, Shakhawan Hamaamin Said, Ayman M Mustafa, Bryar Othman Muhammed, Hawbash M Rahim, Berun A Abdalla, Fahmi H Kakamad, Shvan H Mohammed","doi":"10.4081/aiua.2024.12997","DOIUrl":"10.4081/aiua.2024.12997","url":null,"abstract":"<p><strong>Introduction: </strong>In ureterolithiasis, the prediction of spontaneous passage poses a challenge for urologists. Moreover, there is controversy surrounding the preferred management approach, whether medical or surgical, as each approach has its disadvantages. Procalcitonin and other inflammatory markers were studied for predicting stone passage spontaneously, but their significance remains controversial. This study aims to assess the association between these markers, especially procalcitonin, and spontaneous ureteral stone passage.</p><p><strong>Materials and methods: </strong>In this multicenter prospective cohort study from March 2022 to October 2023, consecutive patients with a single unilateral distal ureteric stone less than 10 mm were enrolled. Exclusion criteria were specified. Patients underwent medical expulsive therapy (MET) and were monitored for stone passage. The significance level was set at p < 0.05.</p><p><strong>Results: </strong>Out of 94 patients enrolled, 72.3% were male and 27.7% were female, with a mean age of 38.84± 10.41 years. Stone sizes varied, with the most common range being 4 mm- 5.9 mm. Participants were categorized based on spontaneous stone passage as spontaneous stone passage (SSP) and non-SSP. No significant differences were observed in most demographic and laboratory variables. However, serum procalcitonin and C-reactive protein showed significant differences between the SSP and non-SSP groups.</p><p><strong>Conclusions: </strong>Although several inflammatory markers were studied to predict the spontaneous passage of the ureteral stone, the current study concluded that only elevated procalcitonin, C-reactive protein, and large stone diameter decrease the chance of spontaneous ureteral stone passage.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"12997"},"PeriodicalIF":1.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single site multi puncture supine (SMS) PCNL procedure in patient with complex renal stone: One incision, why should more?","authors":"Paksi Satyagraha, Reza Amorga, Taufiq Nur Budaya","doi":"10.4081/aiua.2024.13156","DOIUrl":"https://doi.org/10.4081/aiua.2024.13156","url":null,"abstract":"<p><strong>Introduction: </strong>Since percutaneous nephrolithotomy (PCNL) was introduced in 1976, it has been the standard procedure for large renal stones. Over time, the PCNL technique changed and developed into various techniques. We introduce single-site multipuncture supine (SMS) PCNL to give a cosmetic advantage due to less tissue injury in complex renal stones. This study aimed to determine the outcome of SMS PCNL procedure in patients with complex renal stones diseases.</p><p><strong>Materials and methods: </strong>This study was a retrospective study including all patients with kidney stones who had undergone SMS PCNL at the Urology Department of Saiful Anwar General Hospital from March 2019 until December 2022. All SMS PCNL procedures were performed by a single operator. The patients were divided into three groups that included that were treated with 2, 3, and 4 punctures. The data were collected using SPSS ver. 25.</p><p><strong>Result: </strong>Ninety-three patients were included in this study. The characteristics of the patient, such as gender, age, and BMI, were not significantly different among the groups. The outcome of the SMS PCNL procedure showed a low complication rate during operation in 2-,3-, and 4-puncture groups (3.2%, 7.4%, and 0%, respectively). The Stone Free Rate (SFR) showed no significant difference between the 3 groups (p = 0.496). The SFR was 85.7% in 2-puncture, 77.8% in 3-puncture, 66.7% in 4-puncture group. The AUC of Guy's Stone Score with cut-off value was 3.5 (AUC = 0.549, p-value = 0.541, CI 95%).</p><p><strong>Conclusions: </strong>Single-Site Multi Puncture PCNL is a safe and efficient approach to complex renal stones. Single-Site Multipunctures Supine PCNL is comparable with other techniques of PCNL and gives minimal tissue injury that would benefit for cosmetic.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"13156"},"PeriodicalIF":1.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic floor contraction as an initial response to psycho-sensory sexual stimulation in men and a trigger for male sexual behaviour.","authors":"Giuseppe La Pera, Sabrina Anticoli, Marilena Mangiardi, Stefano Livi","doi":"10.4081/aiua.2024.13119","DOIUrl":"https://doi.org/10.4081/aiua.2024.13119","url":null,"abstract":"<p><strong>Introduction: </strong>This study is based on the hypothesis that, in men, the initial sexual response to erotic stimuli is triggered by a psycho-sensory pelvic reflex, mediated by the contraction of the pelvic floor muscles (PFM), rather than by an erection.</p><p><strong>Objective: </strong>The objective is to determine, using a questionnaire that evokes an erotic image, whether there is a correlation between an erotic psycho-sensory stimulus and PFM contraction in men and females and whether this contraction encourages the subject to seek sexual activity.</p><p><strong>Materials and methods: </strong>An online questionnaire was administered to 270 respondents (134 males, 136 females; mean age = 36.53, SD = 10.7; range 19-63). The questionnaire assessed the relationship between the perception of anterior PFM contraction and an evocative erotic image.</p><p><strong>Results: </strong>The results show that following an evoked erotic stimulus, there is a significantly higher prevalence of perceived genital sexual responses in males compared to females through PFM contraction. A statistically significant difference was also observed in the desire to engage in sexual activity when perceiving PFM contraction (mean: Males 2.04 ± 0.95 vs. Females 1.02 ± 0.88; p < 0.001).</p><p><strong>Conclusions: </strong>In this sample, an evocative erotic image triggers the perception of the genital sexual response via PFM contraction in more males than females. Additionally, PFM contraction, when perceived, prompts more males to seek sexual activity. These findings support the hypothesis that Pelvic Floor Muscles contraction is the initial response to psycho-sensory stimulation in men and a trigger for male sexual behaviour.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"13119"},"PeriodicalIF":1.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should patients with encrusted JJ stents involving the proximal/renal loop undergo primarily endoscopic combined intrarenal surgery?","authors":"Alexandra Rocha, Gonçalo Mendes, Sofia Mesquita, Mariana Madanelo, João Vital, Miguel Marques-Monteiro, Nuno Vinagre, Martinha Magalhães, Beatriz Oliveira, Guilherme Gonçalves, Vítor Cavadas, Avelino Fraga","doi":"10.4081/aiua.2024.13163","DOIUrl":"https://doi.org/10.4081/aiua.2024.13163","url":null,"abstract":"<p><strong>Background: </strong>Ureteral stents are one of the most used devices in Urology, allowing drainage of the upper urinary system, and can be used either in elective or emergency procedures. However, as a foreign body inside the urinary system, they are subject to encrustation. Encrustation is one of the burdens seen with double-J stents and, to date, there is no consensus about its best management. This study aims to prove that Endoscopic Combined Intra-Renal Surgery (ECIRS) is the best choice when there's an encrusted proximal loop of a ureteral stent.</p><p><strong>Methods: </strong>The authors conducted a retrospective cohort study of patients with an encrusted proximal loop of the ureteral stent who underwent surgery at a single center, comparing ECIRS with other procedures.</p><p><strong>Results: </strong>Between July 2011 and June of 2024, 33 patients (18 females and 15 males) were submitted to surgery. The median indwelling time of the stent was 11 (8-19) months and a stentfree rate of 100% was achieved. The authors demonstrated a significant stone-free rate of 61.1% following ECIRS compared to merely 20% with other procedures (p = 0.023). Notably, while the complication rate was low across all procedures, the ECIRS group exhibited fewer complications (5.6%) than those undergoing alternate techniques (13.3%), though this difference was not statistically significant (p = 0.439).</p><p><strong>Conclusions: </strong>Our study advocates for ECIRS as the preferred initial treatment for encrusted proximal ureteral stents, as it facilitates superior stone clearance, minimizes complications, and maintains comparable operative efficiency. This research contributes valuable insights into the management of challenging cases involving encrusted ureteral stents, calling for future studies to further validate these findings.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"13163"},"PeriodicalIF":1.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiparametric MRI targeted prostate biopsy: When omit systematic biopsy?","authors":"Pietro Pepe, Ludovica Pepe, Vincenzo Fiorentino, Mara Curduman, Filippo Fraggetta","doi":"10.4081/aiua.2024.12992","DOIUrl":"https://doi.org/10.4081/aiua.2024.12992","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the detection rate for prostate cancer (PCa) performing multiparametric magnetic resonance imaging (mpMRI) fusion targeted biopsy (TPBx) combined only with ipsilateral systematic prostate biopsy (SPBx).</p><p><strong>Materials and methods: </strong>From January 2023 to December 2023, 495 men with clinical suspicion of PCa underwent transperineal SPBx plus TPBx in the presence of PI-RADS score lesions ≥ 3.</p><p><strong>Results: </strong>In 250/495 men (50.5%) a PCa was found, while 36/250 (14.4%) men had negative mpMRI. In comparison to TPBx, SPBx diagnosed a higher number of indolent PCa, 38.5 vs. 5.8%, respectively; conversely, SPBx demonstrated a higher detection rate for clinically significant PCa (97.3 vs. 85.4%) in the presence of ISUP Grade Group 2 (GG2). In details, rates were higher in the presence of GG2 (100 vs. 76%), GG3 (85.7 vs. 75.8%) and GG4 (100 vs. 86.4%) tumors. However, in GG5, both SPBx and TPBx diagnosed 100% of csPCa. Furthermore, 89.4% of the cases showed csPCa on the negative mpMRI side.</p><p><strong>Conclusions: </strong>SPBx combined with TPBx maximized csPCa diagnosis; the use of reduced biopsy scheme limited to ipsilateral side of mpMRI lesion plus TPBx missed 11.6% csPCa. Only in the presence of PI-RADS score 5 SPBx and TPBx diagnosed both 100% of csPCa.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"12992"},"PeriodicalIF":1.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The learning curve for robotic-assisted pyeloplasty in urologists with no prior robotic experience using an ex-vivo model: A prospective, controlled study.","authors":"Abdullah Ayed, Panagiotis Kallidonis, Vasileios Tatanis, Angelis Peteinaris, Evangelos Liatsikos, Gilles Natchagande","doi":"10.4081/aiua.2024.12990","DOIUrl":"https://doi.org/10.4081/aiua.2024.12990","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the increasing trend of utilizing robotic techniques in pyeloplasty, little is known about the learning curve for robot-assisted pyeloplasty (RAP) amongst urologists with no prior robotic experience. Therefore, the present study aimed to evaluate the learning curve of residents in the last year or recently appointed urologists performing RAP using an ex-vivo model.</p><p><strong>Methods: </strong>A prospective ex-vivo model study was conducted including participants who were either residents in the last year or recently appointed urologists. All participants had obtained the E-BLUS certification, or they were able to complete its 4 tasks successfully in a dry lab, without prior robotic experience. Each participant performed four consecutive RAPs using the avatera system on an ex-vivo porcine model. The primary endpoint of the present study was the change in the average time to complete the anastomosis from the first to the fourth attempt.</p><p><strong>Results: </strong>Nine urologists and 8 residents were enrolled in this study. Each surgeon demonstrated a reduction in the time to complete anastomosis from the 1st to 4th attempt with an average of value of 4.41 ± 1.06 minutes (p = 0.003). The decrease in time was statistically significant in both urologists and residents subgroups (4.5 ± 1.41 minutes p = 0.049 and 4.33 ± 0.71 minutes p = 0.035 respectively).</p><p><strong>Conclusions: </strong>The training on the ex-vivo model could lead, in only a few attempts, to a significant improvement in skills and in the required time of experienced-naïve surgeons to complete an RAP.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"12990"},"PeriodicalIF":1.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promising selective alpha-1 blocker silodosin as a new therapeutic strategy for premature ejaculation and analysis of its drug adverse effect: A systematic review and meta-analysis of randomized controlled trials.","authors":"Muhammad Ilham Fauzan, Besut Daryanto, Taufiq Nur Budaya, Moh Anfasa Giffari Makkaraka, Muhammad Fakhri, Ilham Akbar Rahman","doi":"10.4081/aiua.2024.12984","DOIUrl":"10.4081/aiua.2024.12984","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Premature Ejaculation (PE) occurs in 31% of men aged 18-59 years, leading to disappointment and avoidance of sexual relations. The current guideline of treatment for PE is Dapoxetine, which possesses several adverse effects causing the limitation of its long-term use. Silodosin, an alpha-1 blocker, has been proposed as a new option for treating PE due to its minimal side effects. Therefore, our study aims to assess the efficacy of silodosin in treating PE.</p><p><strong>Materials and methods: </strong>This systematic review and meta-analysis was in accordance with Cochrane Handbook guidelines. Comprehensive literature search was conducted in several databases including PubMed, ScienceDirect, and Cochrane Central Register of Controlled Trials. The studies were included if they met the following criteria: (1) Involving premature ejaculation patients; (2) Intervention using silodosin; (3) Comparing placebo or other therapies for PE (4) Outcome includes the Intravaginal Ejaculation Latency Time (IELT) and reported adverse events related to the therapy. Study quality was assessed using Cochrane risk-of-bias criteria. Statistical analysis in this study was performed using Review Manager 5.4 Results: A total of four studies were included in this meta-analysis. Our study showed that patients who received silodosin had a significantly longer IELT compared to control (MD: 132.54, 95% CI 51.51-213.57, p < 0.001). However, patient treated with silodosin also possessed significantly higher risk of adverse event for developing reduced semen ejaculation (OR 10.79, 95% CI 3.46-33.67, p < 0.0001).</p><p><strong>Conclusions: </strong>Silodosin significantly increased IELT. However, it also reduced semen ejaculation as its drug adverse effect. This result supports the clinical use of silodosin as an alternative treatment for premature ejaculation.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"12984"},"PeriodicalIF":1.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effect of daily tadalafil 5 mg versus daily sildenafil 25 mg on neutrophil-lymphocyte and platelet-lymphocyte ratios in patients with erectile dysfunction: A comparative randomized controlled study.","authors":"Abdel Rahman Bakry, Ali Mohamed Mahran, Hisham Diab Gaber, Mohamed Ismail Sedek, Sameh Fayek GamalEl Din, Ahmad Tarek Motawi, Mohamed Diab Mohamed, Ahmed Elshebany","doi":"10.4081/aiua.2024.12756","DOIUrl":"10.4081/aiua.2024.12756","url":null,"abstract":"<p><strong>Background: </strong>Previous studies had shown that the neutrophils/lymphocytes (NLR) and platelets/lymphocytes (PLR) ratios could be used as markers of inflammatory load as well as prognostic factors in several medical conditions. The current study aimed to compare the effect of using daily tadalafil 5 mg/day versus daily sildenafil 25 mg/day in improving erectile function as well as their ability to reduce NLR and PLR.</p><p><strong>Methods: </strong>One hundred and four participants were recruited. Seventy-four randomized patients with erectile dysfunction were equally divided into 2 groups. Patients in group A used daily tadalafil 5 mg for 2 months while patients in group B used daily sildenafil 25 mg for 2 months. Patients were collected from June 2022 to June 2023. Thirty healthy individuals served as controls. All patients and controls were evaluated using the validated Arabic version of the international index of erectile function (ArIIEF-5) at baseline and after 2 months of medical treatment. Five cc of venous blood sample was obtained before and after 2 months of medical treatment to compare the effect of phosphodiesterase type 5 inhibitors (PDE-5Is) intake for erectile dysfunction on PLR and NLR before and after treatment.</p><p><strong>Results: </strong>The current study showed that there were no statistically significant differences between the cases and the controls apart from the ArIIEF-5 scores. Moreover, there was no significant difference between patients in group A and those in group B regarding PLR and NLR post administration of PDE-5Is. Interestingly, patients in group A demonstrated a highly significant difference between the ArIIEF-5 scores as well as the PLR and the NLR before and 2 months after administration of daily tadalafil 5 mg. On the other hand, patients in group B who were administrated daily sildenafil 25 mg for 2 months demonstrated only a highly significant difference between the ArIIEF-5 scores before and after administration. Meanwhile, patients in group B did not reveal any statistically significant difference in the PLR and the NLR before and 2 months after administration of sildenafil 25 mg. Further regression analysis after adjustment of different variables of the study showed a significant correlation between ArIIEF-5 and PLR in patients who received daily tadalafil 5 mg (r=0.430, p=0.004).</p><p><strong>Conclusions: </strong>Tadalafil and sildenafil have similar clinical efficacy in treating erectile dysfunction. However, tadalafil is more effective in lowering PLR and NLR compared to sildenafil.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"12756"},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healing of Peyronie's disease after multimodal antioxidant treatment. A case series.","authors":"Gianni Paulis, Giovanni De Giorgio, Andrea Paulis","doi":"10.4081/aiua.2024.12956","DOIUrl":"https://doi.org/10.4081/aiua.2024.12956","url":null,"abstract":"<p><strong>Introduction: </strong>Peyronie's disease (PD) is characterized by fibrosis of the penile tunica albuginea. Conservative treatment options may involve oral and/or injectable medications.</p><p><strong>Materials and methods: </strong>This case series includes four patients with PD in the first phase. The diagnosis of PD included a medical history; penile palpation; a physical examination of the penis, documenting penile deformity (Kelâmi method); penile dynamic Doppler ultrasound (PDDU) + elastography, measuring the plaque and calculating its volume (cm3), and the deformation index (strain ratio); and the completion of the following questionnaires: IIEF to assess erectile function, VAS to assess pain, and Peyronie's Disease Questionnaire (PDQ) symptom bother to evaluate the psychosexual impact of the disease. Diagnostic follow-up evaluations were conducted before and every 6-12 months throughout the conservative treatment. The four patients were treated at our andrology clinic between January 2019 and November 2023. Our treatment included the following: bilberry, propolis, ginkgo biloba, silymarin, L-carnitine, coenzime Q-10, Boswellia, superoxide dismutase, vitamin E, vitamin C, topical diclofenac gel, propolis cream, and perilesional penile injections with pentoxifylline for cases involving penile plaques with volumes of > 0.100 cm3.</p><p><strong>Results: </strong>Complete resorption of the PD plaque after treatment occurred in all cases. The disappearance of Peyronie's plaque occurred over a period ranging from 18 to 36 months, in relation to the volume of the plaque.</p><p><strong>Conclusions: </strong>Despite the limited sample size in our study, these patients verifiably achieved the complete resorption of the affected disease area. Our results will provide useful insights for uroandrological clinical practice. Nevertheless, randomized controlled trials with a larger number of PD patients are needed to demonstrate the effectiveness of multimodal antioxidant treatment.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"12956"},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altieri modified Nesbit corporoplasty for the treatment of penile curvature: Comparison of local anesthesia vs loco-regional anesthesia on the clinical outcomes.","authors":"Vincenzo Maria Altieri, Pietro Saldutto, Vittore Verratti, Roberto La Rocca, Ernesto Di Mauro, Giuseppe Celentano, Marco Capece, Vincenzo Morgera, Gianluigi Cacace, Walter Vena, Francesco Mastrangelo, Luigi Napolitano, Fabrizio Iacono","doi":"10.4081/aiua.2024.12957","DOIUrl":"https://doi.org/10.4081/aiua.2024.12957","url":null,"abstract":"<p><strong>Objective: </strong>To compare the safety profile and clinical outcomes of Altieri-modified Nesbit corporoplasty using two different anesthesia methods including spinal anesthesia and local anesthesia.</p><p><strong>Materials and methods: </strong>A total of 40 patients with congenital penile curvature (CPC) and Peyronie's disease (PD) underwent Altieri-modified Nesbit corporoplasty. Group 1 (n = 20) received spinal anesthesia, and Group 2 (n = 20) received local anesthesia. The patients were categorized into age groups (< 30 years, 31-45 years, 46-60 years, and 61-75 years) for analysis. Clinical outcomes, post-operative complications, hospital stay, pain levels, and other parameters were assessed.</p><p><strong>Results: </strong>The results showed that 2 patients (10%) reported postoperative complications, including headache, arterial hypotension, and penile foreskin necrosis from the spinal anesthesia group. Whereas, in the local anesthesia group, 1 patient (5%) reported scar phimosis. Further, post-operative pain was predominantly very mild, with 16 patients (80%) in the spinal anesthesia group and 14 patients (70%) in the local anesthesia group experiencing minimal discomfort. Age did not significantly impact hospital stay, post-operative intestinal disorders, constipation, lower urinary tract symptoms, voiding burning, or dysuria.</p><p><strong>Conclusions: </strong>Spinal anesthesia may lead to more post-operative complications and longer hospital stays compared to local anesthesia. Age does not significantly affect most clinical outcomes but can influence post-operative pain in patients receiving local anesthesia.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"12957"},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}