Minerva Urologica E Nefrologica最新文献

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Efficacy of modified radical prostatectomy technique for recovery of urinary incontinence in high-grade prostate cancer. 改良根治性前列腺切除术对恢复高级别前列腺癌患者尿失禁的疗效。
Minerva Urologica E Nefrologica Pub Date : 2020-10-01 Epub Date: 2020-04-16 DOI: 10.23736/S0393-2249.20.03633-4
Jae W Chung, Sang W Kim, Ho W Kang, Yun S Ha, Seock H Choi, Jun N Lee, Bum S Kim, Hyun T Kim, Tae H Kim, Ghil S Yoon, Tae G Kwon, Sung K Chung, Eun S Yoo
{"title":"Efficacy of modified radical prostatectomy technique for recovery of urinary incontinence in high-grade prostate cancer.","authors":"Jae W Chung, Sang W Kim, Ho W Kang, Yun S Ha, Seock H Choi, Jun N Lee, Bum S Kim, Hyun T Kim, Tae H Kim, Ghil S Yoon, Tae G Kwon, Sung K Chung, Eun S Yoo","doi":"10.23736/S0393-2249.20.03633-4","DOIUrl":"10.23736/S0393-2249.20.03633-4","url":null,"abstract":"<p><strong>Background: </strong>This study was conducted to evaluate predictive factors of urinary continence recovery after radical prostatectomy (RP) for high-grade prostate cancer (PCa).</p><p><strong>Methods: </strong>A total of 241 patients with high-grade (Gleason Score 8 or 9) PCa who underwent RP in a single Korean center between January 2011 and May 2018 were retrospectively reviewed. Urinary continence was defined as no pads use. Urinary continence was evaluated at 1, 3, 6, and 12 months after RP. Univariate and multivariate analyses were performed to determine the predictive factors of urinary continence recovery after RP.</p><p><strong>Results: </strong>The mean age was 67.6±6.4 years, and the mean PSA was 18.7±21.1 ng/dL. A total of 197 (81.7%) patients underwent nerve-sparing RP, and 198 patients (82.2%) were continent 1 year after RP. Multivariate analysis showed that the age (odds ratio [OR]=1.091 [1.015-1.172], P=0.018), Body Mass Index (BMI) (OR=1.227 [1.057-1.424], P=0.007), and modified surgical technique (OR=0.109 [0.044-0.267], P<0.001) were independent factors for predicting urinary continence recovery after RP.</p><p><strong>Conclusions: </strong>Younger age, low BMI, and modified surgery were independent predictors of urinary continence recovery after RP in patients with high-grade PCa. These findings may help surgeons to give pre- and postoperative advice to patients with high-grade PCa about urinary continence recovery after RP.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"605-614"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37840797","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}
引用次数: 0
Persistence and adherence to androgen deprivation therapy in men with prostate cancer: an administrative database study. 前列腺癌患者雄激素剥夺治疗的持久性和依从性:一项行政数据库研究。
Minerva Urologica E Nefrologica Pub Date : 2020-10-01 Epub Date: 2019-12-12 DOI: 10.23736/S0393-2249.19.03595-1
Luca Cindolo, Piergustavo De Francesco, Nicola Petragnani, Felice Simiele, Michele Marchioni, Andrea Logreco, Caterina Di Fabio, Michele De Tursi, Nicola Tinari, Luigi Schips
{"title":"Persistence and adherence to androgen deprivation therapy in men with prostate cancer: an administrative database study.","authors":"Luca Cindolo,&nbsp;Piergustavo De Francesco,&nbsp;Nicola Petragnani,&nbsp;Felice Simiele,&nbsp;Michele Marchioni,&nbsp;Andrea Logreco,&nbsp;Caterina Di Fabio,&nbsp;Michele De Tursi,&nbsp;Nicola Tinari,&nbsp;Luigi Schips","doi":"10.23736/S0393-2249.19.03595-1","DOIUrl":"https://doi.org/10.23736/S0393-2249.19.03595-1","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess adherence to and persistence with androgen deprivation therapy (ADT) in a large cohort of prostate cancer (PCa) patients selected from an administrative database, with special attention to elderly patients.</p><p><strong>Methods: </strong>Patients treated with LHRH analogues, LHRH antagonists, the novel androgen antagonist enzalutamide, and the CYP17 inhibitor abiraterone were included spanning the years 2011-2017. Descriptive statistics were used to analyze persistence and adherence in older patients stratified by age (46-55, 56-65, 66-75, 76-85, and >85 years). The effect of persistence duration on overall survival in super-elderly patients was analyzed by the Kaplan-Meier method, together with the influence of multiple prescriptions on overall survival.</p><p><strong>Results: </strong>A total of 1160 male patients were treated with ADT. Of these, 1075 were given LHRH analogues, 80 LHRH antagonists, 14 novel androgen antagonists, and 109 the CYP17 inhibitor. Median adherence values were 0.93, 0.97, 0.95, and 0.99 respectively. The highest persistence was recorded for LHRH analogues/antagonists (24 months), followed enzalutamide and abiraterone (8 months). A total of 107 patients (9.2%) were classified as super-elderly (age range 85-97 years). Median persistence and OS in this group were 13 months and 29 months, respectively. The adherence was 0.92. Overall survival was significantly associated with additional prescriptions for other conditions-indications (P=0.0047) but not with differences in adherence rates (P=0.98).</p><p><strong>Conclusions: </strong>Our data showed high adherence and persistence rates in men on ADT. The overall survival in the super-elderly is not influenced by persistence and/or adherence but rather by coprescriptions.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"615-621"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37454528","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}
引用次数: 9
Overview of potential determinants of radical prostatectomy versus radiation therapy in management of clinically localized prostate cancer: results from an Italian, prospective, observational study (the Pros-IT CNR study). 前列腺癌根治术与放射治疗在临床局部前列腺癌治疗中的潜在决定因素概述:一项意大利前瞻性观察研究(Pros-IT CNR 研究)的结果。
Minerva Urologica E Nefrologica Pub Date : 2020-10-01 Epub Date: 2020-01-07 DOI: 10.23736/S0393-2249.19.03637-3
Alessandro Antonelli, Carlotta Palumbo, Marianna Noale, Walter Artibani, Pierfrancesco Bassi, Filippo Bertoni, Sergio Bracarda, Alessio Bruni, Renzo Corvò, Mauro Gacci, Stefano M Magrini, Rodolfo Montironi, Angelo Porreca, Andrea Tubaro, Vittorina Zagonel, Stefania Maggi
{"title":"Overview of potential determinants of radical prostatectomy versus radiation therapy in management of clinically localized prostate cancer: results from an Italian, prospective, observational study (the Pros-IT CNR study).","authors":"Alessandro Antonelli, Carlotta Palumbo, Marianna Noale, Walter Artibani, Pierfrancesco Bassi, Filippo Bertoni, Sergio Bracarda, Alessio Bruni, Renzo Corvò, Mauro Gacci, Stefano M Magrini, Rodolfo Montironi, Angelo Porreca, Andrea Tubaro, Vittorina Zagonel, Stefania Maggi","doi":"10.23736/S0393-2249.19.03637-3","DOIUrl":"10.23736/S0393-2249.19.03637-3","url":null,"abstract":"<p><strong>Background: </strong>We assessed patients and tumor characteristics, as well as health-related quality of life (HRQoL) items, associated with curative intent treatment decision-making in clinically localized prostate cancer (PCa) patients.</p><p><strong>Methods: </strong>Clinically localized PCa treated with either radical prostatectomy (RP) or radiation therapy (RT) within 12 months from diagnosis were abstracted from The PROState cancer monitoring in ITaly, from the National Research Council (Pros-IT CNR) database. Multivariable logistic regression (MLR) models predicting RT vs. RP were fitted, after adjustment for HRQoL items, patients and tumor characteristics.</p><p><strong>Results: </strong>Of 1041 patients, 631 (60.2%) were treated with RP and 410 (39.8%) with RT. Relative to RT, RP patients were younger age (mean age 64.5±6.6 vs. 71.4±4.9, P<0.001) and had higher rates of D'Amico low-intermediate risk groups (31.8 vs. 21.9% low, 46.3% vs. 43.5% intermediate and 21.9% vs. 34.6% high risk, P<0.001). Overall, 93.2% of RP patients were enrolled by urologists and 82.7% of RT patients by radiation oncologists. RP patients had generally higher means values of HRQoL items. In MLR models, higher RT rates were independently associated with more advanced age (odds ratio [OR] 6.14, P<0.001) and BMI≥30 kg/m<sup>2</sup> (OR 1.78, P<0.001). Conversely, lower rates of RT were independently associated with married (OR 0.55, P=0.01) and worker status (OR 0.52, P=0.004), enrollment in academic centers (OR 0.59, P=0.005) and higher physical composite score (OR 0.88, P=0.03) and baseline sexual function items (OR 0.92, P<0.001).</p><p><strong>Conclusions: </strong>Most patients with clinically localized prostate cancer undergoing definitive treatment at Italian institutions receive RP instead of RT. Moreover, those who are younger, married, working, as well as those with better physical and sexual function are more likely to undergo surgery.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"72 5","pages":"595-604"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10772961","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}
引用次数: 0
Semi-closed-circuit vacuum-assisted mini percutaneous nephrolithotomy in the pediatric population: the initial experience of two tertiary referral centers. 半闭路真空辅助微型经皮肾镜取石术在儿科人群:两个三级转诊中心的初步经验。
Minerva Urologica E Nefrologica Pub Date : 2020-10-01 DOI: 10.23736/S0393-2249.20.03951-X
A. Gallioli, A. Berrettini, G. Sampogna, E. Llorens, Y. Quiroz, M. Gnech, E. De Lorenzis, G. Albo, J. Palou, G. Manzoni, A. Bujons, E. Montanari
{"title":"Semi-closed-circuit vacuum-assisted mini percutaneous nephrolithotomy in the pediatric population: the initial experience of two tertiary referral centers.","authors":"A. Gallioli, A. Berrettini, G. Sampogna, E. Llorens, Y. Quiroz, M. Gnech, E. De Lorenzis, G. Albo, J. Palou, G. Manzoni, A. Bujons, E. Montanari","doi":"10.23736/S0393-2249.20.03951-X","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03951-X","url":null,"abstract":"BACKGROUND\u0000Percutaneous nephrolithotomy (PCNL) is the gold-standard for complex renal stones treatment in the pediatric population. While the miniaturization of PCNL reduces the risk of bleeding, it can hinder surgical and functional outcomes. The aim of the study is to assess the safety and feasibility of semiclosed-circuit vacuum-assisted Mini-PCNL (vmPCNL) in pediatric patients.\u0000\u0000\u0000METHODS\u0000From January 2017 to December 2018, we prospectively collected data on consecutive vmPCNLs from two European tertiary referral centers. The procedure was performed with the ClearPetra® access sheath equipped with a lateral arm connected to the aspiration system (pressure setting ~ 120-150 cmH2O) by a 200 ml plastic stone collector. Pre-, intra- and post-operative data and costs were analyzed. The stone-free rate (SFR) was defined as absence of residual fragments > 4 mm with either ultrasound or kidney, ureter, and bladder x-ray.\u0000\u0000\u0000RESULTS\u0000Eighteen vmPCNLs were performed in 16 renal units of 13 children. The median age was 119 months (IQR: 97-160) and the weight was 29 Kg (IQR: 25-40). The median cumulative stone size was 32 mm (22-46) with 8 (44.4%) cases of staghorn stones. The OT was 128 min (IQR: 99-167). The basketing was unnecessary in 6/18 (33%) cases. Neither intra-operative complications nor blood transfusions occurred. Post-operative fever was observed in 5/18 (27.8%) cases; in one case a double J ureteral stent was placed for concomitant hydronephrosis. The SFR was 81.3% (13/16), rising to 93.8% (15/16) after ancillary procedures. The materials costs of a vmPCNL (734.8 €) were comparable to mini-PCNL using a reusable set (710.7 €).\u0000\u0000\u0000CONCLUSIONS\u0000The vmPCNL seems to be sustainable, safe and feasible for kidney stones treatment in the pediatric population.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84054236","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}
引用次数: 6
Bowel suture technique for bladder neck reconstruction during RALP and its impact on early continence recovery. 肠缝合技术在RALP膀胱颈重建术中的应用及其对早期失禁恢复的影响。
Minerva Urologica E Nefrologica Pub Date : 2020-10-01 Epub Date: 2020-09-29 DOI: 10.23736/S0393-2249.20.03880-1
Matteo Massanova, Maida Bada, Felice Crocetto, Biagio Barone, Davide Arcaniolo, Tommaso Silvestri, Bernardino De Concilio, Guglielmo Zeccolini, Giorgio Mazzon, Antonio Celia
{"title":"Bowel suture technique for bladder neck reconstruction during RALP and its impact on early continence recovery.","authors":"Matteo Massanova,&nbsp;Maida Bada,&nbsp;Felice Crocetto,&nbsp;Biagio Barone,&nbsp;Davide Arcaniolo,&nbsp;Tommaso Silvestri,&nbsp;Bernardino De Concilio,&nbsp;Guglielmo Zeccolini,&nbsp;Giorgio Mazzon,&nbsp;Antonio Celia","doi":"10.23736/S0393-2249.20.03880-1","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03880-1","url":null,"abstract":"","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"640-641"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38530857","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}
引用次数: 3
Management of erectile dysfunction following robot-assisted radical prostatectomy: a systematic review. 机器人辅助根治性前列腺切除术后勃起功能障碍的管理:一项系统综述。
Minerva Urologica E Nefrologica Pub Date : 2020-10-01 Epub Date: 2020-08-04 DOI: 10.23736/S0393-2249.20.03780-7
Michele Marchioni, Piergustavo De Francesco, Roberto Castellucci, Rocco Papalia, Selçuk Sarikaya, Juan Gomez Rivas, Luigi Schips, Roberto M Scarpa, Francesco Esperto
{"title":"Management of erectile dysfunction following robot-assisted radical prostatectomy: a systematic review.","authors":"Michele Marchioni,&nbsp;Piergustavo De Francesco,&nbsp;Roberto Castellucci,&nbsp;Rocco Papalia,&nbsp;Selçuk Sarikaya,&nbsp;Juan Gomez Rivas,&nbsp;Luigi Schips,&nbsp;Roberto M Scarpa,&nbsp;Francesco Esperto","doi":"10.23736/S0393-2249.20.03780-7","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03780-7","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to summarize evidences about the efficacy of available treatments for erectile disfunction after robotic assisted radical prostatectomy (RARP).</p><p><strong>Evidence acquisition: </strong>A systematic literature review searching on PubMed (Medline), Scopus, and Web of Science databases was performed in December 2019. PRISMA guidelines were followed. Population consisted of patients with erectile disfunction after RARP (P), conservative and surgical intervention were considered of interest (I). No comparator was considered mandatory (C). Outcomes of interest were the recovery of erectile function after conservative treatments and sexual function after surgical treatments (O).</p><p><strong>Evidence synthesis: </strong>Eleven studies were included. Seven studies focused on the use of phosphodiesterase-5 inhibitors (PDE5i) alone (five studies) or associated with other treatments (two studies). All the studies confirmed the efficacy of PDE5i, while the most promising association is with vacuum pump erectile devices. Two studies investigated topical treatments, namely low intensity extracorporeal shock wave therapy and alprostadil. Low intensity extracorporeal shock wave therapy may be a promising option in patients in whom nerve-sparing surgery was performed. The use of alprostadil could be an effective alternative to intracorporeal injection in those who underwent non-nerve-sparing surgery. One study focused and confirmed the efficacy of penile implants. Furthermore, one study reported the efficacy of a multi-modal treatment with preoperative medication, showing the benefits of a multimodal approach.</p><p><strong>Conclusions: </strong>Penile rehabilitation with PDE5i is effective after nerve sparing RARP. The association of PDE5i with vacuum devices could led to a faster recovery. A multimodal approach with preoperative specific care seems to be effective to fasten erectile function recovery.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"543-554"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38225280","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}
引用次数: 7
Efficacy and safety of renal drainage options for percutaneous nephrolithotomy. 经皮肾镜取石术中肾引流方法的有效性和安全性。
Minerva Urologica E Nefrologica Pub Date : 2020-10-01 Epub Date: 2020-01-07 DOI: 10.23736/S0393-2249.19.03643-9
João Pimentel Torres, João N Oliveira, Nuno Morais, Sara Anacleto, Ricardo M Rodrigues, Paulo Mota, Ricardo Leão, Estevão Lima
{"title":"Efficacy and safety of renal drainage options for percutaneous nephrolithotomy.","authors":"João Pimentel Torres,&nbsp;João N Oliveira,&nbsp;Nuno Morais,&nbsp;Sara Anacleto,&nbsp;Ricardo M Rodrigues,&nbsp;Paulo Mota,&nbsp;Ricardo Leão,&nbsp;Estevão Lima","doi":"10.23736/S0393-2249.19.03643-9","DOIUrl":"https://doi.org/10.23736/S0393-2249.19.03643-9","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous nephrolithotomy (PCNL) is the gold-standard for treatment of renal stones larger than 20 mm. Traditionally, a nephrostomy tube (NT) is placed, causing discomfort and prolonged hospitalization but some surgeons prefer the tubeless technique (TL). Simultaneously, the effectiveness of ureteral stents after PNCL is doubtful. We investigated the safety of the TL technique as well as that of the single loop (SL) over double loop (DL) stents.</p><p><strong>Methods: </strong>Three hundred and twenty-one individuals submitted to PCNL in a single center were retrospectively reviewed. Statistical analysis was performed to compare procedures regarding safety and effectiveness (stone size, residual stones, operative time, peri- and post-operative complications, need for blood transfusion and length of hospital stay) between two groups regarding presence or absence of NT placement (NT [N.=198] vs. TL [N.=123]); and according to the type of stent used (SL [N.=74] vs. DL [N.=247]).</p><p><strong>Results: </strong>NT was associated with a higher complications rate compared to the TL (30.3% and 13%, respectively; P=0.001) and longer hospitalization (4 vs. 2 days; P=0.001). Regarding ureteral stents, they cause similar morbidities (20.7% and 24.4%; P=0.881), and median length of stay (3 days; P=0.947). NT and DL were more frequent in patients with higher stone burden.</p><p><strong>Conclusions: </strong>Tubeless PCNL encompasses lower morbidity and should be considered as an option for select patients, particularly with less stone burden and uncomplicated procedures. Regarding ureteral stents, SL is a safe option and does not require further procedures for removal.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"629-636"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37528458","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}
引用次数: 4
Minimally invasive strategies for the treatment of prostate cancer recurrence after radiation therapy: a systematic review. 前列腺癌放射治疗后复发的微创治疗策略:系统综述。
Minerva Urologica E Nefrologica Pub Date : 2020-10-01 Epub Date: 2020-08-04 DOI: 10.23736/S0393-2249.20.03783-2
Guglielmo Mantica, Francesco Chierigo, Nazareno Suardi, Juan Gomez Rivas, Veeru Kasivisvanathan, Rocco Papalia, Cristian Fiori, Francesco Porpiglia, Carlo Terrone, Francesco Esperto
{"title":"Minimally invasive strategies for the treatment of prostate cancer recurrence after radiation therapy: a systematic review.","authors":"Guglielmo Mantica,&nbsp;Francesco Chierigo,&nbsp;Nazareno Suardi,&nbsp;Juan Gomez Rivas,&nbsp;Veeru Kasivisvanathan,&nbsp;Rocco Papalia,&nbsp;Cristian Fiori,&nbsp;Francesco Porpiglia,&nbsp;Carlo Terrone,&nbsp;Francesco Esperto","doi":"10.23736/S0393-2249.20.03783-2","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03783-2","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this review was to conduct a comprehensive analysis of the role of minimally invasive salvage modalities in radio-recurrent prostate cancer and the associated clinical outcomes and toxicity profiles.</p><p><strong>Evidence acquisition: </strong>A systematic review of the current literature was conducted through the Medline and NCBI PubMed, Scopus databases in January 2020. All papers published after 2000, concerning studies conducted on humans for radio-recurrent prostate cancer were considered for the review.</p><p><strong>Evidence synthesis: </strong>Overall, 545 studies were identified. After duplicate exclusion, initial screening, and eligibility evaluation, a total of 80 studies were included in the qualitative analysis, corresponding to a cohort of 6681 patients. The median age at initial diagnosis ranged from 59 to 75.5. Pre-treatment PSA ranged from 6.2 to 27.4 ng/mL. All patients underwent primary radiotherapy for localized prostate cancer. Cryotherapy, Brachytherapy, EBRT, HIFU were the minimally invasive options mostly used as salvage therapy. They showed to be promising approaches for recurrent prostate cancer (PCa) control, with acceptable toxicities.</p><p><strong>Conclusions: </strong>Minimally invasive therapeutic options offer promising results in terms of biochemical control in the local recurrence setting. Unfortunately, the absence of high quality and comparative studies makes it difficult to establish which method is the best in terms of oncological and safety outcomes.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"563-578"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38225281","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}
引用次数: 3
Operative profile, safety and functional outcomes after GreenLight laser prostate surgery: results from a 12 months follow-up multicenter Italian cohort analyses. GreenLight激光前列腺手术后的手术概况、安全性和功能结局:来自12个月随访的意大利多中心队列分析结果
Minerva Urologica E Nefrologica Pub Date : 2020-10-01 Epub Date: 2020-04-10 DOI: 10.23736/S0393-2249.20.03597-3
Giulio Reale, Michele Marchioni, Vincenzo Altieri, Francesco Greco, Cosimo De Nunzio, Paolo Destefanis, Stefano Ricciardulli, Franco Bergamaschi, Giuseppe Fasolis, Francesco Varvello, Salvatore Voce, Fabiano Palmieri, Claudio Divan, Gianni Malossini, Rino Oriti, Agostino Tuccio, Lorenzo Ruggera, Andrea Tubaro, Giampaolo Delicato, Antonino Laganà, Claudio Dadone, Gaetano De Rienzo, Andrea Ditonno, Antonio Frattini, Luigi Pucci, Maurizio Carrino, Franco Montefiore, Stefano Germani, Roberto Miano, Luigi Schips, Salvatore Rabito, Giovanni Ferrari, Luca Cindolo
{"title":"Operative profile, safety and functional outcomes after GreenLight laser prostate surgery: results from a 12 months follow-up multicenter Italian cohort analyses.","authors":"Giulio Reale,&nbsp;Michele Marchioni,&nbsp;Vincenzo Altieri,&nbsp;Francesco Greco,&nbsp;Cosimo De Nunzio,&nbsp;Paolo Destefanis,&nbsp;Stefano Ricciardulli,&nbsp;Franco Bergamaschi,&nbsp;Giuseppe Fasolis,&nbsp;Francesco Varvello,&nbsp;Salvatore Voce,&nbsp;Fabiano Palmieri,&nbsp;Claudio Divan,&nbsp;Gianni Malossini,&nbsp;Rino Oriti,&nbsp;Agostino Tuccio,&nbsp;Lorenzo Ruggera,&nbsp;Andrea Tubaro,&nbsp;Giampaolo Delicato,&nbsp;Antonino Laganà,&nbsp;Claudio Dadone,&nbsp;Gaetano De Rienzo,&nbsp;Andrea Ditonno,&nbsp;Antonio Frattini,&nbsp;Luigi Pucci,&nbsp;Maurizio Carrino,&nbsp;Franco Montefiore,&nbsp;Stefano Germani,&nbsp;Roberto Miano,&nbsp;Luigi Schips,&nbsp;Salvatore Rabito,&nbsp;Giovanni Ferrari,&nbsp;Luca Cindolo","doi":"10.23736/S0393-2249.20.03597-3","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03597-3","url":null,"abstract":"<p><strong>Background: </strong>Over the two past decades, GreenLight laser therapy has been considered a valid alternative for the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia/benign prostatic obstruction (BPH/BPO). However, the debate on the effectiveness of laser therapy compared to conventional techniques is still open. The aim of our study is to analyze and describe the use of GreenLight laser prostate surgery in Italy, with regard to the surgical techniques performed and the surgical and functional outcomes at mid-term follow-up.</p><p><strong>Methods: </strong>From March 2012 to July 2018, patients who underwent GreenLight laser prostate surgery for LUTS due to BPH/BPO from 19 Italian centers were included. The following parameters were evaluated in the population: age, prostate volume, prostate adenoma volume, PSA tot, Q<inf>max</inf> at uroflowmetry (UFM), International Prostatic Symptoms Score (IPSS), previous therapy for LUTS, use of anticoagulants and antiplatelet drugs. We recorded also the kind of anesthesia, mean laser time (min), mean irradiation time (min), TURP conversion/completion rate, postoperative day of catheter removal, postoperative acute urinary retention (AUR), hospital stay, variation of hematocrit (Ht) and hemoglobin levels (Hb). Early complications were classified according to the Clavien-Dindo classification, the re-operation rate within 30 days and after 30 days, the late complications and the Patient Global Impression of Improvement were also collected. Changes over time in terms of blood loss and functional outcomes (IPSS and Q<inf>max</inf> at the UFM at 6 and 12 months) were tested with Student's test for paired samples. We assumed P≤0.05 as level of statistical significance.</p><p><strong>Results: </strong>Overall, 1077 were enrolled in the study, 554 (56.4%) were treated with standard vaporization and 523 (48.6%) with anatomical vaporization. Student's t-test for paired samples showed no statistically significant differences in terms of reduction of Ht preoperative vs. Ht postoperative (42.80±3.91 vs. 39.93±5.35 95% CI P=0.3) and preintervention and postintervention Hb levels (14.28±1.46 vs. 13.72 P=0.35). Compared with the preoperative Q<inf>max</inf> (8.60±2.64), the 6- and 12-month UFM showed a significant improvement [19.56±6.29, P<0.01 and 19.99±5.92 P<0.01]. In terms of IPSS variation, compared to the baseline level (22±5.51) the 6- and 12-month follow-up confirmed a significant reduction (8.01±4.41 P<0.01 and 5.81±4.12 P<0.01 respectively). Postoperative complications were CD0, CD1, CD2, CD3, CD4 in 33.0%,35.3%, 2.9%, 0.3%, and 0.6%.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is one of the most numerous surgical series of GreenLight laser vaporization and with the longest follow-up. This technique should be considered as a safe and effective alternative in the treatment of secondary LUTS to BPH.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"622-628"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37830106","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}
引用次数: 8
Focal irreversible electroporation for localized prostate cancer management: prospective assessment of efficacy and safety. 局部不可逆电穿孔治疗局限性前列腺癌:疗效和安全性的前瞻性评估。
Minerva Urologica E Nefrologica Pub Date : 2020-10-01 Epub Date: 2020-07-07 DOI: 10.23736/S0393-2249.20.03840-0
Dmitry Enikeev, Mark Taratkin, Andrey Morozov, Anastasia Shpikina, Nirmish Singla, Juan Gomez Rivas, Eric Barret, Petr Glybochko
{"title":"Focal irreversible electroporation for localized prostate cancer management: prospective assessment of efficacy and safety.","authors":"Dmitry Enikeev,&nbsp;Mark Taratkin,&nbsp;Andrey Morozov,&nbsp;Anastasia Shpikina,&nbsp;Nirmish Singla,&nbsp;Juan Gomez Rivas,&nbsp;Eric Barret,&nbsp;Petr Glybochko","doi":"10.23736/S0393-2249.20.03840-0","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03840-0","url":null,"abstract":"","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"644-645"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38136552","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}
引用次数: 3
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