Minerva Urology and Nephrology最新文献

{"title":"Partial penectomy with reconstruction using a split-thickness skin graft: a multicenter experience.","authors":"Mateusz Czajkowski, Bartosz Małkiewicz, Katarzyna Czajkowska, Piotr M Wierzbicki, Adrian Poterek, Roman Sosnowski, Małgorzata Sokołowska-Wojdyło, Tomasz Szydełko, Marzena Kogut-Wierzbicka, Marcin Matuszewski","doi":"10.23736/S2724-6051.24.05924-X","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05924-X","url":null,"abstract":"<p><strong>Background: </strong>Penile cancer is a relatively rare neoplasm in developed countries, with the majority of newly diagnosed cases presenting as organ-confined, with a 5-year survival rate of 90%. Therefore, it is crucial to consider the impact of penile tumor resection on sexual and urinary function. Regrettably, the literature is devoid of comprehensive, step-by-step video instructions for the surgical procedure of partial penectomy with reconstruction using a split-thickness skin graft (0.3 mm). This study aimed to demonstrate a step-by-step video of the partial penectomy technique with reconstruction using a split-thickness skin graft and to present the outcomes of this procedure.</p><p><strong>Methods: </strong>This multicenter study was initiated in April 2019 and completed in February 2023, enrolling 54 male patients who underwent partial penectomy and reconstruction using a split-thickness skin graft (0.3 mm). The study collected data on the local recurrence rates, overall survival, sexual and voiding functions and complications.</p><p><strong>Results: </strong>The average patient age was 61.26 years old (range: 26-82 years). Following penile-sparing surgery, a substantial proportion of patients exhibited favorable results. Among the 54 patients, 37 (68.5%) were classified as sexually active and 50 (92.6%) demonstrated good voiding function. Excellent cosmetic outcomes were achieved in 52 patients (96.3%), and the average size of the negative resection margins was 4.75±4.162 mm (range: 0.5 to 20 mm). Notably, no positive margins were observed. Patient outcomes depend on the tumor stage and histologic grade rather than the size of the surgical margin.</p><p><strong>Conclusions: </strong>Partial penectomy with reconstruction using a split-thickness skin graft has excellent oncological, functional, and cosmetic outcomes.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between MET c.3328G>A p.Val1110Ile mutation and renal cell carcinomas in a specific population: data on histology, focality, onset and the need for surgery from a monocentric study.","authors":"Angelo Porreca, Stefania Zovato, Marco Rinaldi, Luca DI Gianfrancesco, Isabella Mammi, Filippo Marino, Gianluca Giannarini, Alessandro Crestani","doi":"10.23736/S2724-6051.24.05998-6","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05998-6","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of lymphovascular invasion as a predictor of lymph-node invasion in squamous cell carcinoma of the penis.","authors":"Letizia M Jannello, Mario DE Angelis, Carolin Siech, Francesco DI Bello, Natali Rodriguez Peñaranda, Zhe Tian, Jordan A Goyal, Stefano Luzzago, Francesco A Mistretta, Marco Tozzi, Fred Saad, Felix K Chun, Alberto Briganti, Stefano Puliatti, Nicola Longo, Ottavio DE Cobelli, Gennaro Musi, Pierre I Karakiewicz","doi":"10.23736/S2724-6051.24.05938-X","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05938-X","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to validate lymphovascular invasion (LVI) as a predictor of lymph-node invasion (LNI) in squamous cell carcinoma of the penis (SCCP).</p><p><strong>Methods: </strong>Within the Surveillance, Epidemiology, and End Results database (2010-2020), we identified SCCP patients who underwent lymphadenectomy with known LVI status. Univariable logistic regression models (LRMs) addressed LNI. Harrell's concordance index (c-index) quantified accuracy after 2000 bootstrap resamples for internal validation. Multivariable LRMs included the most informative, statistically significant predictors. Subgroup analyses were repeated in organ-confined (T1b-T2) and non-organ confined (T3-T4) stages.</p><p><strong>Results: </strong>Of 586 SCCP patients, 219 (37%) had LVI. LVI was associated with higher rate of LNI (66 vs. 43%; P<0.001). Positive predictive value of LVI was 66 vs. 57% for negative predictive value. In multivariable LRMs, LVI independently predicted LNI (Odds ratio [OR]: 2.41; P<0.001). Bootstrap-adjusted c-index of multivariable model was 0.570 without LVI vs. 0.639 with LVI. In subgroup analyses, LVI independently predicted LNI in organ-confined (OR: 2.23; P<0.001) and in non-organ confined stages (OR: 3.10; P<0.001). In subgroup analyses, addition of LVI increased c-index from 0.530 to 0.595 in organ-confined and from 0.599 to 0.682 in non-organ confined.</p><p><strong>Conclusions: </strong>The current study validates LVI as an independent predictor of LNI in SCCP. LVI increases the accuracy of LNI predictions in the overall cohort as well as in organ-confined and non-organ confined stages. However, stage and grade even with the added consideration of LVI are not accurate enough to provide LNI prediction in individual patients.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Water vapor thermal therapy (Rezūm System) in patients with large prostates: results from a prospective comparative study.","authors":"Raffaele Balsamo, Simone Tammaro, Massimiliano Trivellato, Felice Crocetto, Biagio Barone, Ferdinando Fusco, Davide Arcaniolo, Celeste Manfredi, Luca Cindolo, Raffaele Ranavolo, Francesco Uricchio","doi":"10.23736/S2724-6051.24.05883-X","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05883-X","url":null,"abstract":"<p><strong>Background: </strong>Rezūm is a novel minimally invasive surgical technique (MIST) useful for BPH patients with medium-sized prostate (30-80 cm³) refractory to medical treatment. The aim of this study was to evaluate the efficacy and safety of Rezūm as a treatment option in large-sized prostates (>80 cm³).</p><p><strong>Methods: </strong>We performed a prospective, comparative, single-center study from June 2022 to June 2023, including consecutive patients undergoing surgery with the Rezūm System. Enrolled men were classified into two subgroups based on prostate size: medium prostate (MP) (30-80 cm³) and large prostate (LP) (≥80 cm³). Inclusion criteria included an International Prostate Symptom Score (IPSS) Total score of ≥ 8 points. International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), post-void residual (PVR), and International Index of Erectile Function 5-item version (IIEF-5) were collected at baseline and at three, six, and 12 months post-procedure. Ejaculation presence was assessed at 3 months. Post-operative complications were described using the Clavien-Dindo (CD) classification. The primary outcome was the IPSS-Total score, with intraoperative and postoperative CD grade ≥III complications as secondary outcomes.</p><p><strong>Results: </strong>One hundred and twenty-one patients (PV 78.2±32.1 mL) were included in the study, 51 large prostate (LP) and 70 medium prostate (MP). The IPSS-Total score and Q<inf>max</inf> showed a statistically significant (P<0.0001) improvement at 3, 6, and 12 months respectively. PVR decreased at 3, 6, and 12 months; however, only at 3 months this variation was statistically significant (P<0.0001). At 3-month follow-up, anejaculation was detected in (3; 5.8% and 1; 1.4%) patients in LP and MP group respectively (P=0.86). IIEF-5 significantly improved 3 months after surgery in the LP subgroup (P<0.0001).</p><p><strong>Conclusions: </strong>Rezūm water vapor therapy appears to be effective for treating BPH in larger prostates. Additionally, it demonstrates a low risk of impairing sexual function, indicating a favorable safety profile.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmentation cystoplasty in children with neuropathic bladder: long-term outcomes after 30 years experience.","authors":"Carlos Delgado-Miguel, Virginia Amesty, Susana Rivas, Roberto Lobato, María J Martínez-Urrutia, Pedro López-Pereira","doi":"10.23736/S2724-6051.24.05919-6","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05919-6","url":null,"abstract":"<p><strong>Background: </strong>Augmentation cystoplasty (AC) is a useful alternative for the treatment of neuropathic bladder, although there are few studies reporting long-term results. We assess our experience over the last 30-years.</p><p><strong>Methods: </strong>A retrospective study was conducted in patients with neuropathic bladder in whom AC was performed in our institution between 1990-2020. Demographic variables, pre- and post- AC urodynamic studies, long-term outcomes and postoperative complications were collected.</p><p><strong>Results: </strong>Eighty-six patients (43 males and 43 females) underwent AC surgery with a median age of 12.8 years (interquartile range 9.6-15.1). Bladder augmentation was performed with ileum in 49 cases (57%), sigma in 32 cases (37.2%) and ureter in 5 cases (5.8%). In 27 patients an artificial urinary sphincter (AUS) was placed at the same intervention. The mean preoperative bladder capacity was 117 mL (SD 40), which was increased to 430 mL (SD 64) one year after surgery, this difference being statistically significant (P<0.001). Median follow-up was 24.5 years (interquartile range 17.5-26). Vesico-ureteral reflux improved after AC in 78.9% with no other surgical interventions. Seven mechanical complications associated with AUS were reported. Bladder lithiasis was reported in 9 patients. No bladder perforations were described. One patient developed bladder squamous cell carcinoma 16 years after AC, requiring radical cystectomy and Hautmann neobladder.</p><p><strong>Conclusions: </strong>Long-term results of this study demonstrate that AC is an effective surgical treatment in patients with neuropathic bladder patients without proper response to medical treatment. The risk of developing complications long after bladder augmentation makes close clinical follow-up of these patients essential.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative complications during radical cystectomy: a detailed analysis of intraoperative vascular injuries.","authors":"Kaushik P Kolanukuduru, Neeraja Tillu, Arjun Venkatesh, Osama Zaytoun, Maurizio Buscarini","doi":"10.23736/S2724-6051.24.06030-0","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.06030-0","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early prostatic artery control (EPAC) during robot-assisted radical prostatectomy: a new surgical technique aiming to improve early potency recovery.","authors":"Francesco Porpiglia, Daniele Amparore, Federico Piramide, Sabrina DE Cillis, Alberto Piana, Enrico Checcucci, Matteo Manfredi, Cristian Fiori","doi":"10.23736/S2724-6051.24.05997-4","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05997-4","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted T-plasty for recalcitrant bladder neck stenosis: description of technique and initial results.","authors":"Nicolaas Lumen, Zeyu Wang, Mieke Waterschoot, Thomas Tailly, Beatrice Turchi, Wesley Verla","doi":"10.23736/S2724-6051.24.05872-5","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05872-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to describe the technique and initial outcomes of robot-assisted T-plasty for recalcitrant bladder neck stenosis.</p><p><strong>Methods: </strong>Patients who underwent robot-assisted T-plasty for recalcitrant bladder neck stenosis in a single center were included. Presence of bladder neck stenosis was preoperatively confirmed by the combination of retrograde urethrography with voiding cysto-urethrography and flexible urethroscopy. Follow-up visits were performed with history taking, uroflowmetry and echographic residual urine measurement. Complications were graded according to the Clavien-Dindo classification. Patients without urinary symptoms and with a maximum uroflow of no less than 15mL/s were considered as successfully treated. Otherwise, cystoscopy would be performed, and recurrence was defined as the inability to pass a 14 French cystoscope through the bladder neck.</p><p><strong>Results: </strong>Since 2018, seven patients were treated. The etiologies were transurethral resection of the prostate and simple prostatectomy in respectively 6 patients and 1 patient. Cystoscopy was able to diagnose bladder neck stenosis in all cases whereas urethrography was equivocal in 3 out of 7 cases. Median (range) age at surgery was 60 (54-75) years, and median number of prior endoscopic treatment for bladder neck stenosis was 3 (1-16). The median operative time was 123 (110-159) minutes. No intraoperative complications were reported. Three patients suffered a grade 2 complication. After a median follow-up of 27 (4-74) months, the recurrence-free rate was 100% with no evidence of de-novo incontinence or erectile dysfunction.</p><p><strong>Conclusions: </strong>In our series, robot-assisted T-plasty suggests positive and safe outcomes in treating recalcitrant bladder neck stenosis with a good patency rate and low incontinence rate. Additionally, cystoscopy is reliable in the diagnosis of patients with inconclusive urethrography results.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could transperineal interstitial laser ablation of the prostate be the right option for highly-comorbid patients with lower urinary tract symptoms due to benign prostatic obstruction? A preliminary single-center experience focusing on functional and safety outcomes.","authors":"Paolo Polverino, Mattia Lo Re, Marco Saladino, Alessio Pecoraro, Luisa Moscardi, Anna Rivetti, Giulio R Resta, Marta Pezzoli, Andrea Romano, Bhaskar K Somani, Giampaolo Siena, Andrea Cocci, Mauro Gacci, Andrea Minervini, Sergio Serni, Riccardo Campi, Francesco Sessa","doi":"10.23736/S2724-6051.23.05479-4","DOIUrl":"10.23736/S2724-6051.23.05479-4","url":null,"abstract":"<p><p>In this paper, we aimed to highlight functional and safety outcomes of highly-comorbid patients undergoing transperineal laser ablation (TPLA) of prostate at a referral academic center. Patients undergoing TPLA from April 2021 and February 2023 with moderate to severe lower urinary tract symptoms (LUTS), prostate volume ranging from 30 to 100 mL, and an American Society of Anesthesiologists (ASA) Score ≥3 were included. All patients were evaluated as unfit for standard surgery. Procedures were performed in an outpatient setting using local anesthesia. Failure after the procedure was defined as the shift to other ultra-minimally invasive surgical treatment or the need for long-term indwelling catheter replacement. Overall, 23 patients were enrolled with a median age of 76 years. Median ASA Score and Charlson Comorbidity Index were 3 and 5, respectively. Of these, 11 (48%) were under antiplatelets, 4 (17%) under new oral anticoagulants (NOACs) and 3 (13%) under warfarin. Six (26%) patients had an indwelling catheter preoperatively. Median prostate volume was 42 mL. Median follow-up was 12 months. No Clavien-Dindo Grade ≥2 complications were recorded. Four/six (66%) patients with an indwelling catheter before TPLA achieved spontaneous micturition. Treatment failure occurred in 2 (8.5%) patients. Of the remaining 21 patients, 12/21 (57%) patients reported an improvement in International Prostate Symptoms Score (IPSS) symptoms class (i.e., severe to moderate, moderate to mild, etc.); all patients whose IPSS symptoms class remained stable (N.=8 [38%]) had a significant improvement of the IPSS score as compared to the preoperative period, while 1 (4.5%) patient reported worsening of LUTS. In conclusion, TPLA appears to be a safe and feasible ultra-minimally-invasive option for LUTS due to benign prostatic obstruction (BPO) in patients with significant comorbidities at high-risk for standard surgical options.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"646-649"},"PeriodicalIF":4.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138800110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of tolerance and efficacy of JJ and pigtail suture stents in acute ureteral obstruction.","authors":"Michal Fedorko, Viktor Adedokun, Tomas Adamkovic, Michal Majesky","doi":"10.23736/S2724-6051.24.05958-5","DOIUrl":"10.23736/S2724-6051.24.05958-5","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"650-652"},"PeriodicalIF":4.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}