Minerva Urologica E Nefrologica最新文献

{"title":"The timing of initial imaging in testicular cancer: impact on radiological findings and clinical decision making.","authors":"R. Dotzauer, A. Salamat, N. D. Nabar, A. Thomas, K. Böhm, M. Brandt, R. Mager, H. Borgmann, M. Kurosch, T. Hoefner, I. Tsaur, A. Hötker, A. Haferkamp, W. Jäger","doi":"10.23736/S0393-2249.20.03877-1","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03877-1","url":null,"abstract":"BACKGROUND\u0000In testicular cancer determination of clinical stage and recommendation of therapeutic strategy after inguinal orchiectomy are based on primary imaging by CT-scan of the chest and CT- or MRI- abdomen. It has not been investigated so far, whether the imaging should be performed before or after primary testicular surgery. Staging before surgery means exposing all patients to CT radiation irrespective of ensured histologic malignancy while postoperative staging could pose a risk in biased clinical decision making by increased presence of unspecific lymph node enlargement caused by postsurgical effects. Therefore, we aimed to investigate the association between the timing of initial staging and occurrence of unspecific lymph node enlargement and adjuvant therapies after inguinal orchiectomy.\u0000\u0000\u0000METHODS\u0000We retrospectively evaluated clinical and radiological data from 236 patients who had undergone inguinal orchiectomy for testicular cancer at our department. Statistical analysis was performed to determine whether the occurrence of unspecific lymph node enlargement or the rate of adjuvant therapies were influenced by timing of initial staging (preoperative vs. postoperative).\u0000\u0000\u0000RESULTS\u0000The postoperative imaging cohort showed significant more inguinal, pelvic and retroperitoneal unspecific lymph node enlargement than the preoperative imaging cohort. Simultaneous occurrence of inguinal or pelvic lymph node enlargement together with retroperitoneal enlargements could only be found in the postoperative imaging cohort. No difference regarding adjuvant therapies could be found.\u0000\u0000\u0000CONCLUSIONS\u0000Timing of imaging affects the detection rate of unspecific lymph node enlargements but does not show a significant effect on the rate of adjuvant therapies.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"58 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87723237","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 role of RENAL score in predicting complications after robotic partial nephrectomy.","authors":"J. Daza, K. Okhawere, Olajumoke A. Ige, Amr E. Elbakry, J. Sfakianos, R. Abaza, A. Bhandari, D. Eun, A. Hemal, J. Porter, K. Badani","doi":"10.23736/S0393-2249.20.03608-5","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03608-5","url":null,"abstract":"BACKGROUND\u0000The aim of this study is to evaluate the association between tumor complexity based on RENAL nephrometry score and complications.\u0000\u0000\u0000METHODS\u0000We retrospectively identified 2555 patients who underwent RPN for renal cell carcinoma. Major complication was defined as clavien grade≥3. The relationship between baseline demographic, clinical characteristics, perioperative and postoperative outcomes, and tumor complexity were assessed using Chi-square test of independence, Fishers exact and Kruskal Wallis test. An unadjusted and adjusted logistic regression model was used to assess the relationship between major complication and demographic, clinical characteristics, and perioperative outcomes.\u0000\u0000\u0000RESULTS\u0000There was a significant relationship between tumor complexity and WIT(p<0.001), operative time(p<0.001), estimated blood loss (p<0.001), and major complication(p=0.019). However, there was no relationship with overall complications(p=0.237) and length of stay (LOS) (p=0.085). In the unadjusted model, higher tumor complexity was associated with major complication (p=0.009). Controlling for other variables, there was no significant difference between major complication and tumor complexity (low vs. moderate, p=0.142 and high, p=0.204). LOS (p <0.001) and operative time (p=0.025) remained a significant predictor of major complication in the adjusted model.\u0000\u0000\u0000CONCLUSIONS\u0000Tumor complexity is not associated with an increase in overall or major complication rate after RPN. Experience in high-volume centers is demonstrating a standardization of low complications rates after RPN independent of tumor complexity.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86768309","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":"External validation of SPARE nephrometery score in predicting overall complications, trifecta and pentafecta outcomes following robot-assisted partial nephrectomy.","authors":"G. Sharma, S. Tyagi, R. Mavuduru, G. Bora, A. Sharma, S. Devana, U. Gorsi, N. Kakkar, S. Singh","doi":"10.23736/S0393-2249.20.03972-7","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03972-7","url":null,"abstract":"BACKGROUND\u0000There is an ongoing need and search for a simple yet accurate nephrometry scoring system for predicting the postoperative outcomes after partial nephrectomy (PN). SPARE, a simplified version of PADUA has been proposed as a predictor of postoperative complications following PN recently. However, this score has never been externally validated and assessed as a predictor of trifecta and pentafecta outcomes of PN. In the current study, we applied the SPARE scoring system to our robot-assisted PN cohort (RAPN).\u0000\u0000\u0000METHODS\u0000Prospectively maintained data of patients, who underwent RAPN between November 2014 to December 2018, was abstracted. Imaging was analyzed to calculate SPARE and RENAL nephrometry scores (RNS) by two Urologists independently. SPARE was compared with complications, trifecta outcomes, pentafecta outcomes, and RENAL nephrometry scoring (RNS).\u0000\u0000\u0000RESULTS\u0000Data of 201 RAPN patients were analyzed. The mean SPARE score was 3 (range 0-11). 113 patients were classified as low risk, 64 as intermediate risk, and 24 as high risks. On multivariate analysis SPARE score alone predicted complications (OR 1.37, p=0.014) and trifecta outcomes (OR 0.75, p=0.000) while age (OR 0.96, p=0.042), preoperative eGFR (OR 0.97, p=0.001) and SPARE scores (OR 0.81, p=0.016) were predictors for pentafecta outcomes. Receiver operated curve (ROC) analysis between SPARE and RNS in predicting the complications; trifecta and pentafecta outcomes had a comparable area under the curve.\u0000\u0000\u0000CONCLUSIONS\u0000Our study validates the SPARE nephrometry scoring system in predicting postoperative complications, trifecta, and pentafecta outcomes in a RAPN cohort. The predictive accuracy of SPARE is similar to RNS.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78272787","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 chronic exposure to 5-alpha reductase inhibitors on the risk of hospitalization for COVID-19: a case-control study in male population from two COVID-19 regional centers of Lombardy (Italy).","authors":"M. Lazzeri, S. Duga, E. Azzolini, V. Fasulo, N. Buffi, A. Saita, G. Lughezzani, E. Paraboschi, R. Hurle, A. Nobili, M. Cecconi, G. Guazzoni, P. Casale, R. Asselta","doi":"10.23736/S0393-2249.20.04081-3","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04081-3","url":null,"abstract":"BACKGROUND\u0000There are sex differences in vulnerability to Coronavirus disease 2019 (COVID-19). The coronavirus S protein mediates viral entry into target cells employing the host cellular serine protease TMPRSS2 for S-protein priming. The TMPRSS2 gene expression is responsive to androgen stimulation and it could partially explain sex differences. We hypothesized that men chronically exposed to 5-alpha reductase inhibitors (5ARIs) for benign prostate hyperplasia (BPH) have a lower risk of hospitalization for COVID-19.\u0000\u0000\u0000METHODS\u0000This is a population-based case-control study on consecutive patients positive for SARS-CoV-2 virus who required hospitalization for COVID-19 (cases), age-matched to beneficiaries of the Lombardy Regional Health Service (controls). Data were collected by two high-volume COVID-19 regional centers of Lombardy (Italy). The primary outcome was to compare the prevalence of patients chronically exposed to 5ARIs, who required hospitalization for COVID-19, with the one of controls.\u0000\u0000\u0000RESULTS\u0000Overall, 943 males were enrolled; 45 (4.77%) were exposed to 5ARI. COVID-19 patients aged >55 years under 5ARI treatment were significantly less than expected on the basis of the prevalence of 5ARI treatment among age-matched controls (5.57 vs. 8.14%; p=0.0083, 95%CI=0.75-3.97%). This disproportion was higher for men aged >65 (7.14 vs. 12.31%; p=0.0001, 95%CI=2.83-6.97%). Eighteen 5ARIs-patients died; the mean age of men who died was higher than those who did not: 75.98±9.29 vs. 64.78±13.57 (p<0.001). Cox-regression and multivariable models did not show correlation between 5ARIs exposure and protection against intensive care unit admission/death.\u0000\u0000\u0000CONCLUSIONS\u0000Men exposed to 5ARIs might be less vulnerable to severe COVID-19, supporting its use in disease prophylaxis.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"121 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80188138","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":"Classification and Standardized Reporting of Percutaneous Nephrolithotomy (PCNL): International Alliance of Urolithiasis (IAU) consensus statements.","authors":"S. Choong, J. J. de la Rosette, J. Denstedt, G. Zeng, K. Sarıca, G. Mazzon, I. Saltirov, S. K. Pal, M. Agrawal, J. Desai, A. Petřík, N. Buchholz, M. Maroclo, S. Gordon, A. Sridhar","doi":"10.23736/S0393-2249.20.04107-7","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04107-7","url":null,"abstract":"BACKGROUND\u0000To reach a consensus in the classification and standardized reporting for the different types of PCNLs.\u0000\u0000\u0000METHODS\u0000The RAND/UCLA appropriateness methodology was used to reach a consensus. Thirty-two statements were formulated reviewing the literature on guidelines and consensus on PCNLs, and included procedure specific details, outcome measurements and a classification for PCNLs. Experts were invited to two rounds of input, the first enabled independent modifications of the proposed statements and provided the option to add statements. The second round facilitated scoring of all statements. Each statement was discussed in the third round to decide which statements to include. Any suggestion or disagreement was debated and discussed to reach a consensual agreement.\u0000\u0000\u0000RESULTS\u0000Twenty-five recommendations were identified to provide standardised reporting of procedure and outcomes. Consensual scoring above 80% were strongly agreed upon by the panel. The top treatment related outcomes were size of sheath used (99.1%) and position for PCNL (93.5%). The highest ranked Outcome Measures included definition of post-operative hospital length of stay (94.4%) and estimated blood loss (93.5%).\u0000\u0000\u0000CONCLUSIONS\u0000The consensus statements will be useful to clarify operative technique, in the design of clinical trials and standardized reporting, and presentation of results to compare outcomes of different types of PCNLs.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88017348","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":"Systematic review of neoadjuvant therapy by immune checkpoint inhibitors before radical cystectomy: where do we stand?","authors":"Simone Albisinni,&nbsp;Fouad Aoun,&nbsp;Romain Diamand,&nbsp;Georges Mjaess,&nbsp;Francesco Esperto,&nbsp;Nieves Martinez Chanza,&nbsp;Thierry Roumeguère,&nbsp;Cosimo De Nunzio","doi":"10.23736/S0393-2249.20.03833-3","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03833-3","url":null,"abstract":"<p><strong>Introduction: </strong>After demonstrating their efficacy in metastatic urothelial cancer (UC), immune checkpoint inhibitors (ICI) are currently being tested in the neoadjuvant setting before radical cystectomy. In this systematic review, we analyze current available data and ongoing trials exploring the efficacy and safety of ICI neoadjuvant therapy in UC.</p><p><strong>Evidence acquisition: </strong>A systematic search was performed including the combination of the following words: ([\"neoadjuvant\" AND \"immunotherapy\"] AND [\"bladder\" AND \"cancer\"]). Three search engines (PubMed, Embase^®, and Web of Science) were queried up to January 1, 2020. Study selection followed the PRISMA guidelines. After screening, 9 articles and abstracts fully compatible with the PICOS were included in the systematic review.</p><p><strong>Evidence synthesis: </strong>The PURE-01 trial showed a 37% complete response (pT0) after neoadjuvant pembrolizumab. In the ABACUS trial, atezolizumab determined a complete response in 31% of patients. In both trials, an increased expression of PD-1 or PD-L1 was associated to an improved response to ICI. Moreover, ICI are well tolerated with grade III-IV adverse events in 6% of cases. In the PURE-01 trial, radical cystectomy after neoadjuvant ICI presents a similar complication rate compared to neoadjuvant chemotherapy, with fever (N.= 35, 52%) and ileus (N. = 21, 31%) being the most common postoperative complications. Numerous trials are currently recruiting to test ICI in the neoadjuvant setting, either alone, in combination immunotherapy or with chemotherapy.</p><p><strong>Conclusions: </strong>Pembrolizumab and atezolizumab single agent demonstrated favorable results for ICI in the neoadjuvant setting. Patients with a higher tumor expression of PD-L1 appear to experience a higher response to ICI, although the adequate biomarker remains to be identified. Radical cystectomy appears to be safe after ICI treatment. The results of the currently ongoing prospective trial are awaited with impatience by the uro-oncologic community.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"72 6","pages":"663-672"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10756061","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":"Active treatment of renal stones in pelvic ectopic kidney: systematic review of literature.","authors":"Matteo Salvi,&nbsp;Gianluca Muto,&nbsp;Agostino Tuccio,&nbsp;Antonio A Grosso,&nbsp;Andrea Mari,&nbsp;Alfonso Crisci,&nbsp;Marco Carini,&nbsp;Andrea Minervini","doi":"10.23736/S0393-2249.20.03792-3","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03792-3","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic obstruction and stones formation are common in pelvic ectopic kidney (PEK), and stone treatment in such conditions can be challenging. Aim of this systematic review was to examine all the available active treatment modalities for PEK stones in order to critically appraise their advantages and limitations.</p><p><strong>Evidence acquisition: </strong>A search on Medline, Embase, and the Cochrane Library databases was performed to identify literature focused on the active treatment of PEK stones. Original articles, case report and case series were included in the search. The systematic review was conducted in accordance to the PRISMA checklist. The study period went from inception of databases to October 2019.</p><p><strong>Evidence synthesis: </strong>Of the 256 articles identified, 23 met the inclusion criteria. 334 patients were included in the studies and 119 had stones in PEK. Five patients were treated with SWL, 40 with ureterorenoscopy, 37 with percutaneous nephrolithotomy both by ultrasound/X-Ray or lap-assisted puncture, and 37 with minimally invasive laparoscopic or robot assisted pyelolithotomy. Overall, stone free rate after first treatment was higher in minimally invasive laparoscopic or robot assisted pyelolithotomy (97.2%) compared to percutaneous nephrolithotomy (84.96%) and ureterorenoscopy studies (65.94%). The higher complication rate was reported in percutaneous nephrolithotomy not lap-assisted (33.3%).</p><p><strong>Conclusions: </strong>The choice of the approach depends on different factors such as stone size, density and location in accordance with upper urinary tract alterations, kidney anatomy and operator experience. The choice of a retrograde, percutaneous or lap/robot approach should be carefully selected evaluating upper urinary tract anatomy and stone features.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"691-697"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37840759","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":"Functional and oncological outcomes of 3D clampless sutureless laparoscopic partial nephrectomy for renal tumors with low nephrometry score.","authors":"Carlo Introini,&nbsp;Antonia Di Domenico,&nbsp;Marco Ennas,&nbsp;Fabio Campodonico,&nbsp;Claudia Brusasco,&nbsp;Andrea Benelli","doi":"10.23736/S0393-2249.20.04005-9","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04005-9","url":null,"abstract":"<p><strong>Background: </strong>Renal cell carcinoma still represents 2-3% of all tumors but its mortality is decreased in the last decades due to the early detection of small masses and to the innovative surgical techniques. The aim of our study was to evaluate safety and feasibility of clampless and sutureless laparoscopic partial nephrectomy (CSLPN) in terms of intra- and postoperative functional results, complication rate and oncological outcome.</p><p><strong>Methods: </strong>We evaluated patients undergoing CSLPN between July 2013 and December 2019. Inclusion criteria were single, organ confined tumor with size ≤4 cm, intraparenchymal depth ≤1.5 cm, renal nephrometry score between 4 and 6 and no close contact with the collecting system.</p><p><strong>Results: </strong>Overall, 62 patients underwent CSLPN. Mean operative time was 105 minutes, mean intraoperative blood loss was 165 mL. Mean drain time and hospital stay were respectively 2.5 and 4.2 days. Mean 24 hours hemoglobin (Hb) decrease was 2.5 g/dL. No significative variations are described in pre- and postoperative renal function. Twelve patients had postoperative complications. At a median follow-up of 38.5 months all the patients are alive and disease free.</p><p><strong>Conclusions: </strong>Different techniques have been proposed to reduce warm ischemia time (WIT). In our experience we found many benefits in an off-clamp procedure: it gives an ischemia-related advantage, reduces the overall operating time, eliminates the risks associated with the isolation of hilar vessels. In conclusion CSLPN is a safe and effective procedure for selected renal masses; it does not increase complication rate and offers excellent functional and oncological outcomes.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"723-728"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38233477","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 urothelium, the urinary microbioma and men LUTS: a systematic review.","authors":"Riccardo Lombardo,&nbsp;Giorgia Tema,&nbsp;Jean N Cornu,&nbsp;Ferdinando Fusco,&nbsp;Kevin McVary,&nbsp;Andrea Tubaro,&nbsp;Cosimo De Nunzio","doi":"10.23736/S0393-2249.20.03762-5","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03762-5","url":null,"abstract":"<p><strong>Introduction: </strong>The pathophysiology and management of male patients with lower urinary tract symptoms (LUTS) is still a matter of debate. In the past few years, the urothelium and the urinary microbiota represented important areas of research to improve the understanding and management of these patients. Aim of the present review was to summarize the available data on the urothelium and the microbiota related to male LUTS.</p><p><strong>Evidence acquisition: </strong>A National Center for Biotechnology Information (NCBI) PubMed search for relevant articles published between January 2000 and December 2019 was performed using the medical subjects heading \"urothelium,\" \"microbioma,\" \"microbiota,\" \"urobioma,\" \"urobiota,\" \"benign prostatic hyperplasia,\" \"benign prostatic enlargement,\" \"lower urinary tract symptoms,\" \"lower urinary tract dysfunction,\" \"men,\" \"male,\" \"overactive bladder,\" \"receptors.\" Exclusion criteria included: animal studies and studies on muscarinic and adrenergic pathways.</p><p><strong>Evidence synthesis: </strong>The urothelium has been recently evaluated in humans to evaluate new possible markers and pathways. New possible targets for the treatment of male LUTS include the neural growth factor, the cannabinoid, the vanilloid and the ATP pathways. However, studies in humans are still needed to elucidate the exact role of these pathways in the management of male patients with LUTS. The available evidence on the urinary microbioma in male is poor. Standing to the available, urinary microbioma is evident in healthy urine in males. Moreover, the urinary microbioma varies depending on the method of collection, sexually transmitted disease status, inflammation and urinary symptoms. A possible role of probiotics in the management of LUTS in women has been proposed and may have a role in male patients as well.</p><p><strong>Conclusions: </strong>The urothelium and the urinary microbiota are still poorly studied in men with LUTS. Most of the evidence and the hypothesis on the relationship between urothelium/urinary microbiota and LUTS comes from animal/in-vitro evidence while clinical trials are lacking. These pathways seem interesting even in LUTS pathogenesis in men but their possible role as a new therapeutic target is still an open debate.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"712-722"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38056838","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":"Non-papillary percutaneous nephrolithotomy for treatment of staghorn stones.","authors":"P. Kallidonis, A. Vagionis, Marco Lattarulo, C. Adamou, A. Tsaturyan, D. Liourdi, T. Vrettos, C. Simeone, E. Liatsikos","doi":"10.23736/S0393-2249.20.04124-7","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04124-7","url":null,"abstract":"BACKGROUND\u0000To evaluate the non-papillary puncture for Percutaneous Nephrolithotomy (PCNL) for the treatment of staghorn stones in terms of safety and efficacy.\u0000\u0000\u0000METHODS\u0000Data of 53 patients undergoing PCNL for staghorn stones were retrospectively collected from January 2015 to December 2019. A non-papillary puncture was performed with a two- step track dilation technique up to 30Fr. A 26 Fr semirigid nephroscope and an ultrasonic lithotripter with integrated suction (Swiss Lithoclast master, EMS S.A, Switzerland) were used for the treatment. Demographics and perioperative data were retrospectively gathered from an institutional board approved database.\u0000\u0000\u0000RESULTS\u0000The average stone size was 60.1±16.1 mm. Mean operative time was 54.57±14.83 minutes, while mean time using fluoroscopy was 2.67±1.02 minutes. Mean number of accesses was 1.2 (a total of 64 accesses). Flexible nephroscope was never used. Primary stone-free rate after PCNL was 81.1% (43 patients). Mean hemoglobin drop was 1.6±1.86 gr/dl. Overall patient stay was 3.94±0.82 days, while overall complication rate was 20.7% (11 patients), with only one patient requiring blood transfusion due to pseudoaneurysm.\u0000\u0000\u0000CONCLUSIONS\u0000The use of non-papillary access for PCNL in the treatment of staghorn stones resulted in promising results in terms of stone-free rate, operating time, complication rate, hemoglobin drop and reduced the number of percutaneous tracts. These parameters of the current investigation were directly comparable to current literature. The safety and efficacy of a non-papillary approach for the treatment of staghorn stones could be advocated.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75941723","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}