Archivio Italiano di Urologia e Andrologia最新文献

{"title":"Comments on \"Barts flank-free modified supine position <i>vs</i> prone position in percutaneous nephrolithotomy: Systematic review and meta-analysis\".","authors":"Khaled Ghanem, Damiete Harry, Junaid Masood","doi":"10.4081/aiua.2025.14075","DOIUrl":"https://doi.org/10.4081/aiua.2025.14075","url":null,"abstract":"<p><p>To the Editor, We read the meta-analysis by Ananda et al. with great interest and congratulate the authors on their contribution...</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"97 3","pages":"14075"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201710","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":"Beyond germ cell tumors: focus on Leydig cell neoplasms from a single-center experience.","authors":"Rosario Leonardi, Alessandro D'Angelo, Guglielmo Mantica, Francesca Ambrosini, Alessandro Calarco, Dorotea Sciacca, Gabriele Iacona, Dario Giuffrida","doi":"10.4081/aiua.2025.13978","DOIUrl":"10.4081/aiua.2025.13978","url":null,"abstract":"<p><strong>Introduction: </strong>Leydig cell tumors (LCTs) are rare testicular neoplasms that account for a small proportion of testicular tumors and are often diagnosed incidentally or on investigation of infertility or hormonal symptoms. Despite their generally benign behaviour, a small percentage may have malignant potential, which poses a diagnostic and therapeutic challenge due to the lack of standardizedguidelines.</p><p><strong>Materials and methods: </strong>We retrospectively analysed four casesof histologically confirmed LCTs diagnosed and treated at a single institution between 2000 and 2024. Clinical, biochemical, radiologic, surgical, and pathologic data were collected and analysed.</p><p><strong>Results: </strong>Patients presented with a variety of clinical histories, including testicular swelling, infertility, or incidental findings. Tumor size ranged from 1.8 to 3.5 cm. All patients underwent radical inguinal orchiectomy, and histology confirmed benign LCTs without high-risk features such as necrosis, mitotic activity, or vascular invasion. Hormonal profiles and imaging were key to the diagnostic process, although findings sometimes mimicked germ cell tumors. Adjuvant therapy was not required, and all patients remained disease-free at follow-up.</p><p><strong>Conclusions: </strong>This case series highlights the heterogeneity of LCT presentations and emphasizes the importance of accurate diagnosis, individualized treatment, and multidisciplinary management. Standardized protocols, greater awareness and timely imaging are essential to avoid overtreatment and improve outcomes in LCT patients.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13978"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691918","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":"Impact of tryptophan and trehalose on post-thaw sperm quality and apoptotic gene expression in Wistar albino rats.","authors":"Firdevs Yilmaz Dayanc, Oguz Kaan Yalcin, Aysel Eraslan Sakar","doi":"10.4081/aiua.2025.14101","DOIUrl":"10.4081/aiua.2025.14101","url":null,"abstract":"<p><strong>Background: </strong>Cryopreservation of rat sperm cells and development of new diluents are very important in biotechnology.</p><p><strong>Methods: </strong>In the current study, 25 mM tryptophan and 100 mM trehalose were added separately to the cryopreservation medium containing 8% lactose monohydrate, 23% egg yolk, and 10% tris aminomethane to evaluate the cryopreservation capability of rat sperms. After freeze-thawing, motility, viable spermatozoon ratio, plasma membrane integrity, abnormal acrosome ratio, and apoptotic cell ratio and levels of Bax, Bcl-2, and Caspase-3 mRNA involved in the apoptosis pathway were evaluated.</p><p><strong>Results: </strong>The highest viability ratio was detected in the trehalose group (26.25 ± 3.10), which was significantly higher than that in the control group (19.62 ± 1.51) (p<0.05). When compared to the tryptophan group (11.87 ± 3.07), plasma membrane integrity was statistically higher in the trehalose group (20.25 ± 3.65) (p<0.05). The rate of apoptotic cells was lower in the trehalose group than in the control group. Then, the effect of tryptophan and trehalose, which were added to the sperm diluent, on the expression levels of genes in the apoptosis pathway was evaluated through the RT-qPCR technique. The expression of the anti-apoptotic gene Bcl-2 increased by 25 mM tryptophan and 100 mM trehalose, while the expression of the pro-apoptotic genes Bax and Caspase-3 decreased (p<0.01).</p><p><strong>Conclusions: </strong>As a result, it was determined that trehalose, a isaccharide sugar, added to the rat sperm diluent provided more effective protection against cryodamage in the cryopreservation process than tryptophan, an aromatic amino acid, according to the parameters evaluated. From a molecular biotechnology perspective, these findings lay a valuable foundation for research on the development of next generation media for sperm cryopreservation.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"14101"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875946","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":"Learning curve of a multidisciplinary team for magnetic resonance imaging/transperineal ultrasonography fusion prostate biopsy.","authors":"Marcello Scarcia, Vincenzo Andracchio, Alberto Piana, Roberto Calbi, Michele Zazzara, Francesco Chiaradia, Antonio Greco, Flavio Sidoti, Gianluca Scarpelli, Pierluigi Rizzo, Guglielmo Mantica, Alessandro Calarco, Rosario Leonardi, Giuseppe Mario Ludovico, Stefano Alba","doi":"10.4081/aiua.2025.13933","DOIUrl":"10.4081/aiua.2025.13933","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the learning curve of transperineal magnetic resonance imaging (MRI)/ultrasound (US) fusion biopsy performed by a multidisciplinary team comprising a single urologist, radiologist, and pathologist. We analyzed the temporal changes in overall prostate cancer detection rates and clinically significant prostate cancer (csPCa) detection rates.</p><p><strong>Methods: </strong>We retrospectively enrolled consecutive patients with clinically suspected prostate cancer (PCa) who underwent MRI/US fusion prostate biopsy at a single center from January 2019 to December 2022. The patients were divided into four cohorts based on the year of biopsy to assess temporal variations in the outcomes. Univariate and multivariate analyses were performed to model detection rate curves.</p><p><strong>Results: </strong>Overall, 291 patients underwent targeted biopsy (TBx) and standard biopsy (SBx) during the study period. Multivariate analysis showed that the overall PCa diagnosis was significantly higher when prostate biopsy was performed after the first year (2019; 74 patients), particularly in 2022 (OR 11.68, CI 3.08-49.1). The csPCa detection rate increased significantly from 13.5% to 40.0%, p=0.03).</p><p><strong>Conclusions: </strong>Cumulative experience and teamwork may increase the overall PCa detection rate, specifically csPCa detection rate. Transperineal MRI fusion-guided biopsies combined with a standard template provided a higher overall cancer and csPCa detection rate than the standard template or targeted biopsy alone. Multidisciplinary team meetings and procedure standardization are key factors in overcoming the learning curve.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13933"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875947","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":"Correction. Current status of management and outcomes of muscle-invasive bladder cancer in Yemen: a retrospective observational study.","authors":"The Publisher","doi":"10.4081/aiua.2025.14449","DOIUrl":"10.4081/aiua.2025.14449","url":null,"abstract":"<p><p>In the Article titled \"Current status of management and outcomes of muscle-invasive bladder cancer in Yemen: a retrospective observational study\" published on May 5, 2025, in the issue 2, vol. 97 of Archivio Italiano di Urologia e Andrologia, an author's affiliation was misspelled. In the byline, the author Faisal Ahmed's affiliation should have been \"Department of Urology, Faculty of Medicine, Sana'a University, Sana'a, Yemen\". Reference Al-Kohlany K, Al-Maleki A, Al-Shami M, Hussein H, Ahmed F. Current status of management and outcomes of muscle-invasive bladder cancer in Yemen: a retrospective observational study.  Arch Ital Urol Androl 2025;97:13760.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"97 3","pages":"14449"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201714","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":"Transcutaneous perineal-ultrasound guided prostate biopsy in men with rectal amputation.","authors":"Pietro Pepe, Ludovica Pepe, Vincenzo Fiorentino, Mara Curduman, Filippo Fraggetta","doi":"10.4081/aiua.2025.14047","DOIUrl":"10.4081/aiua.2025.14047","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the use of transcutaneous perineal ultrasound to guide prostate biopsy in men previously submitted to rectal amputation.</p><p><strong>Materials and methods: </strong>From January 2018 to January 2025, 10 men aged between 47 and 76 years (median age: 56 years) previously submitted to proctocolectomy (7 men for rectum cancer and 3 men for benign disease) were evaluated for the suspicion of prostate cancer (PCa). The indications for biopsy were PSA >10 ng/mL or PSA values between 4.1-10 ng/mL with free/total PSA <25% and/or PSA density >0.20. All the patients submitted for the first time to biopsy underwent extended scheme (ePBx: 12-18 cores); in addition, all the patients underwent multiparametric magnetic resonance (mpMRI) and in the presence of a Prostate Imaging-Reporting and Data System-version 2 (PI-RADS) score ≥3 a cognitive targeted biopsy (TPBx:  4 cores) was added to the systematic prostate biopsy. Biopsies were freehand using 18-gauge automatic biopsy needles under perineal real-time ultrasound guidance (3.5 MHz convex probe).</p><p><strong>Results: </strong>Median PSA was 9.7 (range: 4.8-27 ng/mL); in 1/10 (10%) patient mpMRI was negative, conversely in 3 (30%) vs 3 (30%) vs 3 (30%) men, PIRADS score was 3 vs 4 vs 5, respectively. Overall, a csPCa (ISUPGrade Group > 2/Gleason score > 3+4) was found in 5/10 (50%) patients; PCa was located in the peripheric zone in 4 (80%) cases and 1 (20%) case in the anterior zone of the gland. In detail, ePBx vs. TPBx biopsies diagnosed 5/5 (100%) and 4/5 (90%) csPCa. One patient diagnosed with csPCa had negative mpMRI, 1 and 3 men had PIRADS score 4 and 5, respectively. None had clinical complications that needed hospital admission.</p><p><strong>Conclusions: </strong>Transcutaneous perineal ultrasound-guided prostate biopsy allows for the performance of accurate systematic and targeted biopsies in men with suspicious PCa previously submitted to rectal amputation.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"14047"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691920","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":"P-wave dispersion in patients with premature ejaculation.","authors":"Ali Akkoç, Can Ramazan Öncel, Cemal Köseoğlu","doi":"10.4081/aiua.2025.14073","DOIUrl":"10.4081/aiua.2025.14073","url":null,"abstract":"<p><strong>Background: </strong>Premature ejaculation (PE) is one of the common male sexual disorders and is associated with autonomic nervous system imbalance. P-wave dispersion (PWD), a marker of atrial electrical heterogeneity and a predictor of atrial arrhythmias, has not been previously investigated in the PE population. This study aimed to investigate PWD in patients with PE and to evaluate whether the subtypes of PE, namely acquired (APE) and lifelong (LLPE), differ in terms of atrial conduction parameters.</p><p><strong>Methods: </strong>Seventy-eight male patients were included in the study. The distribution of patients was 40 healthy controls, 21 patients with APE, and 17 patients with LLPE. All patients underwent 12-lead electrocardiography to evaluate PWD. Echocardiographic, hormonal, and biochemical parameters were recorded to exclude confounding factors. PWD was defined as the difference between the maximum (Pmax) and minimum P-wave durations (Pmin).</p><p><strong>Results: </strong>PWD was significantly increased in both PE groups compared to the control group (APE: 44.4 ± 4.1 ms; LLPE: 48.1 ± 2.1 ms; control: 38.2 ± 3.4 ms; p<0.001). Pmin was significantly lower in the PE groups, while Pmax remained comparable among all groups. There was no significant difference in PWD between the PE groups (p=0.38). All patients had normal echocardiographic and hormonal parameters, and there were no significant differences in age, body mass index, blood pressure, or heart rate between the groups.</p><p><strong>Conclusions: </strong>PWD was significantly higher in patients with PE. This indicates that patients with PE are at a higher risk of developing cardiovascular diseases like atrial fibrillation.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"14073"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875915","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":"Strategies for preventing port-site hernia following robot-assisted radical prostatectomy: a systematic review.","authors":"Pier Paolo Prontera, Francesca Romana Prusciano, Marco Lattarulo, Gianluigi Califano, Francesco Di Bello, Claudia C Ruvolo, Simone Morra, Angelo D'Elia, Angelo Porreca, Luca Di Gianfrancesco, Filippo Marino, Giulia Marino, Francesco Saverio Grossi","doi":"10.4081/aiua.2025.13934","DOIUrl":"10.4081/aiua.2025.13934","url":null,"abstract":"<p><strong>Background: </strong>Trocar site hernia is a recognized but often underreported complication of minimally invasive surgery, including robotic-assisted radical prostatectomy. While relatively rare, trocar site hernia can lead to severe complications such as bowel obstruction, strangulation, and the need for emergency surgical intervention. Trocar size has been identified as a primary risk factor, with hernias occurring predominantly at sites where 10 mm or larger trocars are used. However, the role of fascial closure is still debated.</p><p><strong>Methods and results: </strong>A systematic literature review (1992-2022) identified 21 cases of trocar site hernia in 13 studies. Only 8 papers provided data on the total number of RaRP procedures which were associated to the reported cases of TSH, with 15 cases of TSH identified out of 3,418 RaRP procedures. Statistical analyses were conducted to assess significant risk factors and potential prevention strategies. Specifically, of the 19 cases in which trocar size was explicitly reported, 15 hernias were associated with 12 mm trocars and 4 with 8 mm trocars (p<0.001). Fascial closure was not performed in all reported cases involving 12 mm trocars. No significant correlations were found between trocar site hernia incidence and patient-related factors such as age, body mass index, or prior hernias. Additionally, we report a case of trocar site hernia following RARP in a 67-year-old male with a BMI of 33.46 and a history of prior abdominal hernioplasty. The patient developed bowel obstruction on postoperative day 4 due to a hernia at a 12 mm trocar site, requiring emergency laparotomy and bowel resection with end-to-end anastomosis.</p><p><strong>Conclusions: </strong>Given the strong association between TSH and 12 mm trocars, we suggest routine fascial closure at these sites to reduce the risk of postoperative complications. Further studies are necessary to confirm these findings. Additionally, other potential risk factors and mechanisms contributing to trocar site hernia development in patients undergoing robot-assisted radical prostatectomy should be investigated.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13934"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875916","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":"UrOP position paper in support of the new classification of urinary tract infections: from \"uncomplicated/complicated\" to localized/systemic\".","authors":"Guglielmo Mantica, Stefano Alba, Andrea Alfarone, Umberto Capitanio, Donato Dente, Carlo Giulioni, Carmelo Morana, Serena Maruccia, Gabriella Mirabile, Gennaro Musi, Mauro Ragonese, Mauro Silvani, Antonio Tufano, Angelo Cafarelli, Alessandro Calarco, Ottavio De Cobelli, Ferdinando De Marco, Giovanni Ferrari, Giuseppe Mario Ludovico, Stefano Pecoraro, Domenico Tuzzolo, Renzo Colombo, Nazareno Suardi, Rosario Leonardi","doi":"10.4081/aiua.2025.14280","DOIUrl":"10.4081/aiua.2025.14280","url":null,"abstract":"<p><p>Dear Editor, For a few decades, urinary tract infections (UTIs) have been classified according to the dichotomy \"uncomplicated\" and \"complicated\"...</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"14280"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041852","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":"Diode laser enucleation prostate for benign prostatic hyperplasia: outcomes of the Leonardi ejaculation sparing technique.","authors":"Rosario Leonardi, Guglielmo Mantica, Francesca Ambrosini, Antonio Tufano, Gabriele Iacona, Alessandro Calarco","doi":"10.4081/aiua.2025.14296","DOIUrl":"10.4081/aiua.2025.14296","url":null,"abstract":"<p><strong>Introduction: </strong>Benign prostatic hyperplasia (BPH) significantly impairs quality of life and may lead to complications such as urinary retention and recurrent infections. While endoscopic enucleation techniques provide effective relief, they are frequently associated with loss of antegrade ejaculation. The Leonardi Ejaculation-Sparing Technique (LEST) was developed to preserve ejaculatory function during diode laser enucleation of the prostate (DILEP).</p><p><strong>Methods: </strong>We conducted an observational, retrospective analysis of 99 men undergoing DILEP with LEST between January 2018 and June 2020. Inclusion criteria were symptomatic BPH refractory to medical therapy, prostate volume ≥40 mL, and suitability for endoscopic surgery. Functional outcomes (IPSS, Qmax, PVR), erectile function (IIEF-5), and ejaculatory status (MSHQEjD) were assessed preoperatively and at 6 months. Patient satisfaction was evaluated with a dedicated 5-item questionnaire.</p><p><strong>Results: </strong>Mean age was 48.1 years, and median prostate volume was 67 mL. At 6 months, IPSS decreased from 21.6 to 3.8, Qmax improved from 9.1 to 25.7 mL/s, and PVR decreased from 103 to 6.8 mL (all p<0.01). Erectile function showed modest improvement (IIEF-5: 14.4 to 16.2; p<0.01). Antegrade ejaculation was preserved in 94.1% of patients. Satisfaction was high, with > 80% willing to repeat the procedure and denying regret. No major complications occurred.</p><p><strong>Conclusions: </strong>DILEP with LEST provides excellent functional results with high rates of ejaculatory preservation and patient satisfaction. This technique may represent a patient-centered alternative for BPH surgery, especially in younger men prioritizing sexual function.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"14296"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041916","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}