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Mariotti A, Spatafora P, Sessa F, Saieva C, Galli IC, Roviello G, Doni L, Zaccaro C, Bisegna C, Conte FL, Mariottini R, Marzocco A, Masieri L, Vignolini G, Minervini A, Serni S, Carini M, Nesi G, Villari D. Gender and cystectomy for bladder cancer: A high-volume tertiary urologic care center experience. Eur J Surg Oncol 2023; 49:107034. [PMID: 37639860 DOI: 10.1016/j.ejso.2023.107034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/23/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Differences have often been reported in the outcomes of bladder cancer (BC) patients according to gender. OBJECTIVE This study aims to provide data on patients undergoing radical cystectomy (RC) in a high-volume tertiary urologic center and to assess whether gender discrepancies do exist in terms of surgical options and clinical outcomes. MATERIALS AND METHODS Consecutive BC patients treated between 2016 and 2020 at a single center (Careggi University Hospital, Florence, Italy) were included in the study. The impact of gender on disease stage at diagnosis, overall survival (OS), and type of surgery was analyzed. RESULTS The study series comprised 447 patients (85 females and 362 males). At a median follow-up of 28.3 months (IQR: 33.5), OS was 52.6% and cancer-specific survival was 67.6%. Significant differences in OS emerged for age, acute myocardial infarction (AMI), Charlson Comorbidity Index (CCI), pT, and pN. OS rates were higher in patients undergoing robot-assisted surgery and in those receiving open orthotopic neobladder (ONB) (p = 0.0001). No statistically significant differences were found between male and female patients regarding surgical offer in any age group, surgical time, early postoperative complications, pathologic stage, and OS. CONCLUSIONS After adjustment for pathologic tumor stage and treatment modalities, female and male patients showed similar oncologic outcomes. Further studies should be undertaken to evaluate functional results in women subjected to RC.
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Affiliation(s)
- A Mariotti
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
| | - P Spatafora
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - F Sessa
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - C Saieva
- Cancer Risk Factors and LifeStyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - I C Galli
- Histopathology and Molecular Diagnostics, Careggi Hospital, Florence, Italy
| | - G Roviello
- Department of Health Sciences, University of Florence, Florence, Italy
| | - L Doni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - C Zaccaro
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - C Bisegna
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - F L Conte
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - R Mariottini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - A Marzocco
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - L Masieri
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy; Department of Pediatric Surgery, Pediatric Urology Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - G Vignolini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - A Minervini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - S Serni
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - M Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - G Nesi
- Histopathology and Molecular Diagnostics, Careggi Hospital, Florence, Italy
| | - D Villari
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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Pili A, Bonutto A, Marzocco A, Peschiera F, Olivera L, Viola L, Livio V, Salamone V, Mazzola L, Lo Re M, Vignolini G, Gacci M, Minervini A, Serni S, Masieri L. Robot-assisted ureterectomy with Boari flap reconstruction for distal ureteral stenosis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01442-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Sforza S, Marco B, Haid B, Baydilli N, Donmez I, Spinoit A, Paraboschi I, Masieri L, Luksteinkellner L, Comez Y, Lammers R, ‘t Hoen L, O’kelly F, Bindi E, Kibar Y, Silay M. Comparison of open and robotic-assisted laparoscopic ureteral reimplantation in children with high grade (IV-V) vesicoureteral reflux: A multi-institutional comparative study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00620-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Pili A, Lo Re M, Livio V, Olivera L, Viola L, Peschiera F, Salamone V, Mazzola L, Marzocco A, Bonutto A, Gacci M, Minervini A, Serni S, Masieri L. Robot-assisted surgery for retrocaval ureter: a single center experience. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01408-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Mantovani A, Bortota G, Cinia C, Landia L, Taverna M, Olivera L, Elia A, Masieri L. Hidden incision endoscopic surgery (HIDES) in pediatric urology: initial experience in a single center. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00815-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Grosso A, Tellini R, Verrienti P, Salvi M, Sessa F, Campi R, Di Maida F, Di Camillo M, Lambertini L, Mormile N, Nardoni S, Olivera L, Valastro F, Cangemi V, Viola L, Scelzi S, Mari A, Masieri L, Carini M, Minervini A, Tuccio A. Predictors of early catheter replacement after HoLEP: results from a high-volume laser center. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00799-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Gemma L, Di Maida F, Mari A, Grosso A, Verrienti P, Lambertini L, Bacchiani M, Valastro F, Bisegna C, Bossa R, Lapini A, Scelzi S, Masieri L, Carini M, Minervini A. Robot assisted radical cystectomy with florence robotic intracorporeal neobladder (FloRIN): a six-month assessment of functional and urodynamic features compared with a contemporary series of open vescica ileale padovana (VIP). EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00862-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Di Maida F, Mari A, Grosso A, Lambertini L, Valastro F, Bisegna C, Giudici S, Cangemi V, Viola L, Tellini R, Fantechi R, Vittori G, Masieri L, Carini M, Minervini A. Robot assisted radical cystectomy with florence robotic intracorporeal neobladder (FloRIN): analysis of survival and functional outcomes after first 100 consecutive patients upon accomplishment of phase 3 ideal framework. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00857-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Cocci A, Russo G, Sessa F, Tuccio A, Masieri L, Sforza S, Viola L, Cito G, Salamanca JM, Cindolo L, Ferrari G, Siena G. Functional and sexual symptoms improvement after Rezum water vapor therapy for the treatment of LUTS/BPE: 1-year results from a longitudinal multi-center italian study. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00882-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Grosso A, Di Maida F, Tellini R, Mari A, Sforza S, Campi R, Valastro F, Lambertini L, Polverino P, Verrienti P, Presutti M, Masieri L, Carini M, Minervini A. Robot-assisted partial nephrectomy with 3D preoperative surgical planning: Video presentation of the florentine experience. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01621-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sforza S, Manera A, Lambertini L, Alfonso C, Cini C, Mantovani A, Cocci A, Minervini A, Carini M, Masieri L. Treatment of ureteropelvic junction obstruction and urolithiasis in children with minimally invasive surgery. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01445-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sforza S, Tuccio A, Zammarchi L, Verrienti P, Rinaldi F, Tilli M, Di Maida F, Mari A, Masieri L, Carini M, Bartoloni A, Minervini A. Urological management and surgical procedures in migrants from Sub-Saharan Africa with urogenital schistosomiasis. Actas Urol Esp 2021; 45:309-319. [PMID: 33685664 DOI: 10.1016/j.acuro.2020.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/12/2020] [Accepted: 03/22/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND OBJECTIVES An increasing number of urogenital schistosomiasis (UGS) is being diagnosed in Europe following the unprecedented migratory flux from Sub-Saharan Africa (SSA). This phenomenon represent a challenge for urologists working in a non-endemic area. The aim of this study is to describe the urological management and the surgical procedures of patients with UGS in a tertiary referral centre. PATIENTS All subjects from SAA diagnosed with UGS from January 2011 to November 2018 were enrolled retrospectively. Detailed data of patients with UGS undergoing to urological procedures were collected and analysed. RESULTS Thirty patients were diagnosed with UGS, among them 12 (42.8%) were submitted to surgery. The most common surgical procedure was trans urethral resection of bladder (TURB) for suspected lesions persisted after praziquantel treatment performed in 7cases (58%). Other surgical procedure were TURB and concomitant ureteroscopy with laser fragmentation for suspected bladder neoplasm with renal stone, endoscopic lithotripsy and percutaneous nephrolithotomy for bladder and renal stones, laparoscopic nephrectomy for end-stage kidney disease, placement of bilateral nephrostomy for hydroureteronephrosis, explorative testicular surgery for a suspected testicular torsion in one case each. Four patients (33%) were lost at the follow up. CONCLUSION An increasing number of migrants from SSA diagnosed with UGS has been observed. Some patients required a surgical intervention for suspected neoplastic lesions or end-stage organ damage. It was particularly difficult to perform a regular follow-up in several patients. Further multicentric studies are needed to reach a proper standard in diagnosis, treatment and follow-up of subjects with UGS.
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Affiliation(s)
- S Sforza
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
| | - A Tuccio
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia.
| | - L Zammarchi
- Infectious and Tropical Diseases Unit, Careggi Hospital, University of Florence, Florencia, Italia; Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, University of Florence, Florencia, Italia
| | - P Verrienti
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
| | - F Rinaldi
- Infectious and Tropical Diseases Unit, Careggi Hospital, University of Florence, Florencia, Italia; Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, University of Florence, Florencia, Italia
| | - M Tilli
- Infectious and Tropical Diseases Unit, Careggi Hospital, University of Florence, Florencia, Italia; Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, University of Florence, Florencia, Italia
| | - F Di Maida
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
| | - A Mari
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
| | - L Masieri
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
| | - M Carini
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
| | - A Bartoloni
- Infectious and Tropical Diseases Unit, Careggi Hospital, University of Florence, Florencia, Italia; Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, University of Florence, Florencia, Italia
| | - A Minervini
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
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Sforza S, Tellini R, Grosso A, Cito G, Cocci A, Di Maida F, Mari A, Di Biblio E, Valastro F, Carini M, Minervini A, Masieri L. Robotic correction of ureteral iatrogenic stricture after pelvic surgery: experience from a single referral center. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35645-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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14
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Lambertini L, Sforza S, Tuccio A, Crisci A, Muto G, Mari A, Tellini R, Di Maida F, Salvi M, Carini M, Minervini A, Masieri L. Ureteropelvic Junction Obstruction with urolithiasis: experience from a single tertiary referral center of robotic assisted pyeloplasty with endoscopic removal of stones. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35416-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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15
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Becherucci F, Zuccato A, Sforza S, Roperto R, Cini C, Minervini A, Materassi M, Masieri L. Diagnostic pathway, clinical management and surgical considerations in pediatric patient with a solitary functioning kidney. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34004-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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16
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Sforza S, Negri E, Cini C, Rosi E, Di Maida F, Landi L, Tellini R, Grosso A, Mari A, Minervini A, Carini M, Masieri L. Ureteral reimplantation for primary obstructive megaureter in paediatric patient: Is it the age for robotic approach? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33993-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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17
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Sforza S, Tellini R, Grosso A, Zaccaro C, Viola L, Rosi E, Di Maida F, Muto G, Salvi M, Tuccio A, Carini M, Minervini A, Masieri L. Can we predict the development of symptomatic lymphocele following robot-assisted radical prostatectomy and lymph node dissection? Results from a high-volume tertiary referral centre. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34031-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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18
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Cito G, Becatti M, Natali A, Fucci R, Picone R, Cocci A, Falcone P, Criscuoli L, Mannucci A, Argento F, Bertocci F, Micelli E, Serni S, Masieri L, Minervini A, Carini M, Fiorillo C, Coccia M. P-02-67 Redox Status Assessment in Infertile Patients With Non-Obstructive Azoospermia Undergoing Testicular Sperm Extraction: A Prospective Study. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lippi D, Masieri L, Perciaccante A, Charlier P, Asensi V, Appenzeller O, Bianucci R. Unilateral cryptorchidism in a 16 th Florentine painting. J Matern Fetal Neonatal Med 2019; 34:3994-3996. [PMID: 31795781 DOI: 10.1080/14767058.2019.1698542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- D Lippi
- Dipartimento Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Firenze, Italy
| | - L Masieri
- Azienda Ospedaliera Universitaria Meyer, Firenze, Italy.,Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - A Perciaccante
- Department of Medicine, San Giovanni di Dio Hospital, Gorizia, Italy
| | - P Charlier
- Section of Medical and Forensic Anthropology (UVSQ & EA4498 DANTE Laboratory), UFR of Health Sciences, Montigny-le-Bretonneux, France.,Musée du quai Branly - Jacques Chirac, Paris, France
| | - V Asensi
- Infectious Diseases Unit, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Oviedo, Spain
| | - O Appenzeller
- New Mexico Health Enhancement and Marathon Clinics Research Foundation, Albuquerque, New Mexico, USA.,New Mexico Museum of Natural History and Science, Albuquerque, New Mexico, USA
| | - R Bianucci
- Legal Medicine Section, Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy.,Biomedical Sciences, Warwick Medical School, University of Warwick, Warwick, UK.,UMR7268, Laboratoire d'Anthropologie bio-culturelle, Droit, Etique & Santé (Adés), Faculté de Médecine de Marseille, Marseille, France
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Masieri L, Sforza S, Di Maida F, Grosso AA, Mari A, Rosi EM, Tellini R, Carini M, Minervini A. Robotic correction of iatrogenic ureteral stricture: preliminary experience from a tertiary referral centre. Scand J Urol 2019; 53:356-360. [PMID: 31469016 DOI: 10.1080/21681805.2019.1651390] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Iatrogenic stenosis is a relatively common complication and it could happen after urological procedures in the entire course of the ureter. The aim of this study is to report the surgical outcomes of 36 consecutive patients (period April 2013-November 2018) submitted to robot-assisted correction of benign stricture with previous urological surgery in a tertiary referral center.Methods: Elective criteria were to have had a benign ureteral stricture development after at least one urological procedure. Patients were classified as failures in the event of post-operative ultrasound demonstrating persistent hydronephrosis with or without symptoms or persistent symptoms with renal scan evidence of obstruction or redo procedures.Results: Eighteen patients (50%) were treated for calculosis, seven (19.4%) patients were submitted to double J ureteral stenting and previous pyeloplasty was performed in 11 (30.5%) patients. Overall median operative time was 160 min (IQR = 120-180). Five (13.8%) complications with three (8.3%) surgical post-operative complications occurred. Length of stay was 6 (IQR = 5-7) days. At last follow-up, ranging between 7-60 months, the overall success rate was 86.1% (31/36): three of them (8.3%) were submitted to retrograde holmium laser endopyelotomy, while two (5.5%) underwent a redo robot-assisted correction.Conclusions: Robot-assisted correction procedures can be done safely with good perioperative outcomes and a high post-operative success rate in a tertiary referral center. Further randomized clinical trials are mandatory to confirm the safety of this procedure.
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Affiliation(s)
- L Masieri
- Department of Pediatric Urology, University of Florence, Meyer Hospital, Florence, Italy.,Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - S Sforza
- Department of Pediatric Urology, University of Florence, Meyer Hospital, Florence, Italy.,Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - F Di Maida
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - Antonio Andrea Grosso
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - A Mari
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - Emma Maria Rosi
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - R Tellini
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - M Carini
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - A Minervini
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
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Esposito C, Masieri L, Bagnara V, Tokar B, Golebiewski A, Escolino M. Ureteroscopic lithotripsy for ureteral stones in children using holmium: yag laser energy: results of a multicentric survey. J Pediatr Urol 2019; 15:391.e1-391.e7. [PMID: 31182399 DOI: 10.1016/j.jpurol.2019.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Holmium:YAG (Ho:YAG) laser lithotripsy has broadened the indications for ureteroscopic stone managements in adults, but few evidence are currently available in the pediatric population. OBJECTIVE This article aimed to assess the outcome of Ho:YAG laser lithotripsy during retrograde ureteroscopic management of ureteral stones in different locations in children. STUDY DESIGN The medical records of 149 patients (71 boys and 78 girls; median age 9.2 years) treated with Ho:YAG laser ureteroscopic lithotripsy in five international pediatric urology units over the last 5 years were retrospectively reviewed. Exclusion criteria included patients with renal calculi and/or with a history of ipsilateral stricture, renal failure, active urinary tract infection, or coagulation disorder. RESULTS Stones were treated with dusting technique in all cases. The median stone size was 10.3 mm (range 5-17). Stones were located in the distal ureter in 77 cases (51.7%), in the middle ureter in 23 cases (15.4%), and in the proximal ureter in 49 cases (32.9%). The median operative time was 29.8 min (range 20-95). Intra-operative complications included five bleedings (3.3%) and seven stone retropulsions (4.7%). Overall stone-free rate was 97.3%. Overall postoperative complications rate was 4.0% and included two cases of stent migration (1.3%) (Clavien II) and four residual stone fragments (2.7%) that were successfully treated using the same technique (Clavien IIIb). On multivariate analysis, re-operation rate was significantly dependent on the proximal stone location and presence of residual fragments >2 mm (P = 0.001). DISCUSSION This study is one of the largest pediatric series among those published until now. The study series reported a shorter operative time, a higher success rate, and a lower postoperative complications rate compared with previous series. A limitation of this study is that stone-free rates may be somewhat inaccurate using ultrasonography and plain X-ray compared with computed tomography (CT); the study's 97.3% success rate may be overestimated because no CT scan was done postoperatively to check the stone-free rate. Other limitations of this article include its retrospective nature, the multi-institutional participation, and the heterogeneous patient collective. CONCLUSION The Ho:YAG laser ureteroscopic lithotripsy seems to be an excellent first-line treatment for children with ureteral stones, independently from primary location and size. However, patients with proximal ureteral stones and residual fragments >2 mm reported a higher risk to require a secondary procedure to become stone-free. Combination of techniques as well as appropriate endourologic tools are key points for the success of the procedure regardless of stones' size and location.
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Affiliation(s)
- C Esposito
- Division of Pediatric Surgery, Federico II University of Naples, Naples, Italy.
| | - L Masieri
- Division of Pediatric Urology, Meyer Children Hospital, Florence, Italy
| | - V Bagnara
- Division of Pediatric Urology, Morgagni Policlinico Hospital, Catania, Italy
| | - B Tokar
- Division of Pediatric Surgery, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - A Golebiewski
- Division of Pediatric Urology, Medical University in Gdansk, Pomerania, Poland
| | - M Escolino
- Division of Pediatric Surgery, Federico II University of Naples, Naples, Italy
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Bianchi F, Dugheri S, Musci M, Bonacchi A, Salvadori E, Arcangeli G, Cupelli V, Lanciotti M, Masieri L, Serni S, Carini M, Careri M, Mangia A. Fully automated solid-phase microextraction-fast gas chromatography-mass spectrometry method using a new ionic liquid column for high-throughput analysis of sarcosine and N-ethylglycine in human urine and urinary sediments. Anal Chim Acta 2011; 707:197-203. [PMID: 22027139 DOI: 10.1016/j.aca.2011.09.015] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 09/08/2011] [Accepted: 09/13/2011] [Indexed: 11/26/2022]
Abstract
A fully automated, non invasive, rapid and high-throughput method for the direct determination of sarcosine and N-ethylglycine in urine and urinary sediments using hexyl chloroformate derivatization followed by direct immersion solid-phase micro extraction and fast gas chromatography-mass spectrometric analysis was developed and validated. The use of a new ionic liquid narrow bore column, as well as the automation and miniaturization of the preparation procedure by a customized configuration of the utilized XYZ robotic system, allowed a friendly use of the GC apparatus achieving a quantitation limit of 0.06 μg L(-1) for sarcosine, good repeatability with CV always lower than 7% and reduced analysis times useful for point-of-care testing. The method was then applied for the analysis of 56 samples of urine and urinary sediments in healthy subjects, in those with benign prostatic hypertrophy and in patients with clinically localized prostate cancer. The results obtained showed that the medians of sarcosine/creatinine in urine were 103, 137 and 267 μg g(-1) respectively, thus assessing the potential use of sarcosine as urinary biomarker for prostate cancer detection. The highest values of sensitivity (79%) and specificity (87%) were obtained in correspondence of a cut-off value of 179 μg sarcosine(g creatinine)(-1), thus by using this cut-off threshold, sarcosine was significantly associated with the presence of cancer (p<0.0001). Finally, ROC analyses proved that the discrimination between clinically localized prostate cancer and patients without evidence of tumor is significantly correlated with sarcosine.
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Affiliation(s)
- F Bianchi
- Dipartimento di Chimica Generale ed Inorganica, Chimica Analitica, Chimica Fisica, Università degli Studi di Parma, Parma, Italy.
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23
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Gacci M, Corona G, Apolone A, Lanciotti M, Tosi N, Giancane S, Masieri L, Serni S, Maggi M, Carini M. Erratum: Influence of serum testosterone on urinary continence and sexual activity in patients undergoing radical prostatectomy for clinically localized prostate cancer. Prostate Cancer Prostatic Dis 2010. [PMCID: PMC3065060 DOI: 10.1038/pcan.2010.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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24
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Gacci M, Corona G, Apolone G, Apolone A, Lanciotti M, Tosi N, Giancane S, Masieri L, Serni S, Maggi M, Carini M. Influence of serum testosterone on urinary continence and sexual activity in patients undergoing radical prostatectomy for clinically localized prostate cancer. Prostate Cancer Prostatic Dis 2010; 13:168-72. [PMID: 20212520 PMCID: PMC2871074 DOI: 10.1038/pcan.2010.4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of the present study was to evaluate how serum testosterone level (T) can affect urinary continence and erectile function in patients undergoing radical prostatectomy (RP). We included 257 patients with clinically localized prostate cancer, those who had filled out preoperative quality of life questionnaires (University of California, Los Angeles Prostate Cancer Index, International Index of Erectile Function (IIEF)), and those who had T and total PSA sampled the day before surgery. We calculated correlations between T and age, body mass index (BMI), PSA, urinary function or bother (UF, UB) and sexual function or bother (SF, SB) and IIEF-5 in the whole population and in sub-populations with normal (⩾10.4 nmol l−1) and low (<10.4 ng ml−1) T using Pearson's and Spearman's correlation coefficients. We evaluated differences in these parameters between patients with low and normal T using the unpaired samples t-test and Mann–Whitney test, and finally the correlation between UF and SF, UB and SB, and between PSA and T in the overall population, and separately in patients with low and normal T using the Pearson's correlation coefficient. Mean preoperative T was 13.5 nmol l−1 and 23.7% of patients presented a low T. Mean age, mean BMI and mean preoperative total PSA at RP were 64.3 years, 25.9 kg m−2 and 9.0 ng ml−1, respectively. BMI was negatively correlated with T in the overall population (r=−0.266; P=0.02); moreover, patients with normal T presented lower BMI compared with patients with low T (25.7 vs 27.6: P=0.02). We found a significant correlation between SF scores and T in patients with normal T (r=0.1777: P=0.05). SF was significantly higher in patients with normal T compared with those with low T (74.8 vs 64.8: P=0.05). Furthermore, UF and UB were significantly correlated with SF (r=0.2544: P<0.01) and SB (r=0.2512: P=0.01), respectively, in men with normal T. Serum T was significantly correlated with PSA in men with low T (r=0.3874: P=0.0029), whereas this correlation was missed in the whole population and in men with normal T. The correlation between preoperative PSA and T in men with low T is in agreement with the ‘saturation' model proposed by Morgentaler. The correlation between basal T and preoperative erectile function and urinary continence underlines the importance of assessing T before RP.
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Affiliation(s)
- M Gacci
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy.
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25
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Bonaccorsi L, Nesi G, Nuti F, Paglierani M, Krausz C, Masieri L, Serni S, Proietti-Pannunzi L, Fang Y, Jhanwar SC, Orlando C, Carini M, Forti G, Baldi E, Luzzatto L. Persistence of expression of the TMPRSS2:ERG fusion gene after pre-surgery androgen ablation may be associated with early prostate specific antigen relapse of prostate cancer: preliminary results. J Endocrinol Invest 2009; 32:590-6. [PMID: 19494719 DOI: 10.1007/bf03346514] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The recently identified TMPRSS2: ERG fusion gene is a candidate oncogene for prostate cancer (PCa). SUBJECTS AND METHODS We have tested for the presence of this gene in tumor samples from 84 patients who had radical prostatectomy in 1998-2000. Sixty patients (group A) had surgery only; 24 patients (group B) received androgen ablation therapy for 3 months before surgery. The occurrence of the rearrangement was evaluated by RT-PCR and by fluorescent in situ hybridization analysis. RESULTS A TMPRSS2:ERG fusion gene was present and expressed, as demonstrated by RT-PCR, in 84% of patients in group A and in 54% of patients in group B (p=0.01). The presence of TMPRSS2:ERG transcripts and the levels of ERG RNA, measured by quantitative Real Time-PCR, did not correlate significantly with clinical and pathologic characteristics of the tumors. In patients of group A, but not in those of group B, ERG expression showed a negative correlation with the Gleason score (p=0.0001). Histochemical analysis showed that ERG expression is limited to tumor cells, and in group A patients (but not in group B patients) it is limited to those glands that express TMPRSS2:ERG. CONCLUSION The lower proportion of patients expressing TMPRSS2: ERG in group B suggests that androgen ablation inhibits the expression of TMPRSS2:ERG. Moreover, in group B, but not in group A, patients with expression of the fusion gene had earlier prostate specific antigen recurrence (p=0.007). Although preliminary, the data indicate that tumors in which pre-surgery androgen ablation fails to suppress expression of the fusion gene have a higher risk of recurrence.
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Affiliation(s)
- L Bonaccorsi
- Unit of Andrology, Department of Clinical Physiopathology, University of Florence, Florence, Italy.
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26
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Serni S, Masieri L, Lapini A, Nesi G, Carini M. A low incidence of positive surgical margins in prostate cancer at high risk of extracapsular extension after a modified anterograde radical prostatectomy. BJU Int 2004; 93:279-83. [PMID: 14764123 DOI: 10.1111/j.1464-410x.2004.04602.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the incidence of positive surgical margins (and associated risk factors) in patients with localized prostate cancer at high preoperative risk of extracapsular disease treated using a modified anterograde radical retropubic prostatectomy technique. Positive surgical margins are an important risk factor for disease recurrence after radical prostatectomy, particularly in patients with extracapsular disease. PATIENTS AND METHODS In total, 84 patients with clinically localized prostate cancer and a preoperative prostate-specific antigen (PSA) level > 10 ng/mL and/or a biopsy Gleason score > or = 7 were evaluated. The surgical technique allows easy, wide resection of the posterolateral prostatic pedicles, and good mobilization and exposure of the apex before the urethra transection. Prostatectomy specimens were examined for extracapsular tumour spread and positive surgical margins. Differences in putative risk factors (Gleason score, preoperative PSA level, prostate weight) between the positive- and negative-margin groups were evaluated using the Mann-Whitney test. RESULTS Overall, 11 of the 84 (13%) patients had positive surgical margins and of these a single site was involved in six. In total, 15 positive-margin sites were identified (five apical, four basal, three posterolateral, two anterior and one posterior). All patients with positive margins had histological extracapsular disease. The preoperative PSA level and Gleason score were significantly higher in the positive- than in the negative-margin group (P = 0.025 and 0.035, respectively). CONCLUSIONS The anterograde radical prostatectomy minimizes the incidence of positive surgical margins in patients at high risk of extracapsular disease.
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Affiliation(s)
- S Serni
- Department of Urology, University of Florence, Santa Maria Annunziata Hospital, Florence, Italy
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27
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Corvino C, Meliani E, Masieri L, Lapini A, Serni S, Carini M. Squamous cell carcinoma of the renal pelvis: nephrostomy tract tumour seeding. BJU Int 2003; 92 Suppl 3:e15. [PMID: 19125466 DOI: 10.1111/j.1464-410x.2003.02947.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C Corvino
- UO di Urologia, Ospedale Santa Maria Annuziata, Bagno a Ripoli, Firenze, Italy
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Abstract
OBJECTIVE The knowledge of normal variations in the size of male external genitalia is of considerable interest to several disciplines. We carried out an extensive study in young Italian males to provide estimates of normal variations of penile dimensions. METHODS The penile length in flaccid and stretched states and the penile circumference were measured in a random group of 3,300 young men aged 17-19 years and free from endocrine disorders and from congenital or acquired abnormalities of the penis. In a random sample of 325 subjects of the same set of people, penile length and circumference were also correlated with weight and height. Statistical analysis was performed with the Sperman test, because our data were not normally distributed as tested by the Kolmogorov-Smirnov test (p < 0.01). RESULTS The median values of penile dimensions recorded in the present study are flaccid length 9.0 cm, flaccid circumference, at the middle of the shaft, 10.0 cm, and stretched length 12.5 cm. We also observed that the penile dimensions are highly correlated with height and weight. CONCLUSIONS Since penile length and circumference correlate with anthropometric parameters such as weight and height, we suggest to consider themselves as two bodily measures which display a wide extent of normal variability along the general population.
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Affiliation(s)
- R Ponchietti
- Department of Urology, University of Florence, Italy
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29
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Mondaini N, Bonafè M, Di Loro F, Biscioni S, Masieri L, Ponchietti R. [Andrologic pathology discovered druing conscription screening: how many young men were unaware?]. MINERVA UROL NEFROL 2000; 52:63-6. [PMID: 11085062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND In Italy the visit during conscription is a valid instrument for epidemiologic research. The aim of this study was to evaluate the incidence of andrologic diseases in a population of 18 years old young Italian men and to estimate in how many of them it was a first diagnosis. METHODS This randomized study was conducted during 1998 at the Military District of Florence where an andrological visit was performed on 11,649 young men living in Tuscany. An evaluation of external genitals and secondary sexual characters was made. All the visits were performed by the same doctor. They were requested to specificity if they were familiar with the professional figure of the andrologist. RESULTS Some andrological disorders were found in 3892 (33.4%) of them and in 3469 (89.2%) it was the first diagnosis. Only 3.7% knew the role of the andrologist and 70% didn't know where to apply for their problems. CONCLUSIONS The results of this study showed a poor familiarity with the figure of the andrologist even though about 1/3 of them should be treated for an andrologic disease which is often undiagnosed. It is personal opinion that these results should make us to think about the consequences that the abolition of male conscription may have given that, for many young Italians, the medical check-up for military service is the first, and often the last, occasion for a control of the genital system.
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Affiliation(s)
- N Mondaini
- Clinica Urologica I, Università degli Studi, Firenze.
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