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Bebi C, Turetti M, Lievore E, Ripa F, Bilato M, Rocchini L, Gallioli A, Spinelli MG, De Lorenzis E, Albo G, Longo F, Gadda F, Dell'Orto PG, Montanari E, Boeri L. Sexual and ejaculatory function after holmium laser enucleation of the prostate and bipolar transurethral enucleation of the prostate: a single-center experience. Int J Impot Res 2020; 34:71-80. [PMID: 33082545 DOI: 10.1038/s41443-020-00366-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/29/2020] [Accepted: 10/09/2020] [Indexed: 12/20/2022]
Abstract
Currently available surgical treatments for Lower Urinary Tract Symptoms (LUTS) due to Benign Prostatic Obstruction (BPO) are associated with an increased risk of sexual dysfunction. The aim of our study is to compare sexual and ejaculatory function after Holmium Laser Enucleation of the Prostate (HoLEP) and Bipolar Transurethral Enucleation of the Prostate (B-TUEP). We performed a retrospective analysis of data prospectively collected from 62 (44.9%) and 76 (55.1%) patients who underwent HoLEP and B-TUEP, respectively. Erectile function and ejaculation characteristics were assessed with the International Index of Erectile Function-Erectile Function (IIEF-EF) domain and the Male Sexual Health Questionnaire-Ejaculatory function (MSHQ-EJ) questionnaires. Our study recorded no change in erectile function and no significant difference in rates of preserved antegrade ejaculation after both surgeries. One month after surgery, rates of physical pain/discomfort and perceived decreased physical pleasure during ejaculation were higher in HoLEP than B-TUEP patients (all p < 0.03). Moreover, HoLEP patients were more bothered by their ejaculatory difficulties than B-TUEP men (p = 0.03). At 3- and 12-months follow-up, all ejaculation-related differences disappeared. In conclusion, both procedures are valid alternatives for BPO treatment as they offer comparable urinary and sexual outcomes in the long term. However, in the first month after surgery, HoLEP patients present with more ejaculatory difficulties.
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Affiliation(s)
- Carolina Bebi
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Matteo Turetti
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Elena Lievore
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Francesco Ripa
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Marco Bilato
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Lorenzo Rocchini
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Andrea Gallioli
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Matteo Giulio Spinelli
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Elisa De Lorenzis
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giancarlo Albo
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Fabrizio Longo
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Franco Gadda
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Guido Dell'Orto
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Emanuele Montanari
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Luca Boeri
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
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Spinelli MG, Lorusso V, Palmisano F, Morelli M, Dell'Orto PG, Tremolada C, Montanari E. Endoscopic repair of a vesicouterine fistula with the injection of microfragmented autologous adipose tissue (Lipogems ®). Turk J Urol 2020; 46:398-402. [PMID: 32744991 DOI: 10.5152/tud.2020.20170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/18/2020] [Indexed: 11/22/2022]
Abstract
Vesicouterine fistula (VUF) is a rare extra-anatomical communication developing between the uterus or cervix and the urinary bladder, most commonly after an iatrogenic injury during a cesarean section. Patients with VUF may have various clinical presentations, ranging from Youssef's syndrome (vaginal urine leakage, amenorrhea, and menouria) to urinary tract infection and infertility. Quality of life for patients having this pathology is strongly affected owing to the psychological burden. Treatment is surgery based because low success rates have been reported for conservative or minimally invasive approaches. Herein, we present a case of a 35-year-old woman successfully treated by a minimally invasive endoscopic repair procedure with the injection of microfragmented autologous adipose tissue (Lipogems®).
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Affiliation(s)
- Matteo Giulio Spinelli
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Vito Lorusso
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.,University of Milan, Milan, Italy
| | - Franco Palmisano
- Department of Urology, Andrology Unit, St. Orsola University Hospital, Bologna, Italy
| | - Michele Morelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.,University of Milan, Milan, Italy
| | - Paolo Guido Dell'Orto
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Emanuele Montanari
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,University of Milan, Milan, Italy
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Lorusso V, Palmisano F, Morelli M, Spinelli MG, Dell'Orto PG, Montanari E. Life-threatening Double-J stent migration with helicoidal appearance: Length matters. Urologia 2019; 87:83-85. [PMID: 31303124 DOI: 10.1177/0391560319860650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/17/2022]
Abstract
BACKGROUND The Double-J stent is one of the most commonly used devices in urologic practice. Due to its widespread use, numerous common complications have been reported, such as irritative symptoms, infection, and encrustation. More rare complications have also been described, such as up or downward migration and displacement outside the urinary tract. We present a rare case of downward migration of a Double-J stent in a 21-year-old Caucasian female. CASE PRESENTATION A 21-year-old female with a solitary kidney presented to the emergency department with acute renal failure, left flank pain, and fever. She had undergone left Double-J stenting 1 week earlier in her homeland for left renal colic and anuria. A kidney-ureter-bladder X-ray revealed a 10-mm lumbar ureteral stone and the proximal coil of the Double-J stent making multiple loops along the ureter, resulting in a helical appearance. She underwent surgery to remove the previous stent and to place a new one. She was discharged 2 days later and her renal function had returned to normal values at her 1-week follow-up. CONCLUSIONS Double-J Stent placement is a common procedure in the management of urinary tract diseases but is not devoid of life-threatening complications. Regular follow-up of stents and on-time evaluation of clinical complaints are mandatory for an aggressive treatment of complications.
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Affiliation(s)
- Vito Lorusso
- University of Milan, Milan, Italy.,Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Franco Palmisano
- University of Milan, Milan, Italy.,Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Michele Morelli
- University of Milan, Milan, Italy.,Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Matteo Giulio Spinelli
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Guido Dell'Orto
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Emanuele Montanari
- University of Milan, Milan, Italy.,Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Spinelli MG, Palmisano F, Zanetti SP, Boeri L, Gadda F, Talso M, Dell'Orto PG, Montanari E. Spontaneous upper urinary tract rupture caused by ureteric stones: A prospective high-volume single centre observational study and proposed management. ARCH ESP UROL 2019; 72:590-595. [PMID: 31274124] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate incidence, clinical, radiological and laboratory features of spontaneous upper urinary tract rupture (s-UUTR) due to ureteric stones and discuss their management. METHODS Out of 1629 patients admitted to the Emergency Department (ED) for renal colic from January 2015 to December 2016 and studied by kidney US and contrast enhanced CT (CECT), 31 patients had a s-UUTR categorized in 3 stages: a) local spread, b) free fluid, c) urinoma. Presentation, therapeutic procedures and outcomes were registered. RESULTS S-UUTR is reported in 1.9% of renal colic. The stone was most commonly identified at the vesicoureteric junction (VUJ) (61.3%) and mean (standard deviation, SD) stone size was 5.71 mm (2.31). S-UUTR was most frequently located in a calyx (54.84%). 26 patients (83.87%) had a clinical presentation of a renal colic, 3 cases (9.68%) had an atypical presentation and 2 (6.45%) presented an acute abdomen. In 26 cases a J-J stent (83,87%) was placed, 3 patients underwent primary ureteroscopic lithotripsy (9.67%); in 1 patient (3.23%) a nephrostomy was inserted and in 1 case (3.23%) active surveillance was adopted. Cases who underwent sole urinary derivation were revaluated after 30 days: ureteroscopic lithotripsy was performed in 48.15% of the cases; extracorporeal shock wave lithotripsy in 3.7%; in 22.2% of cases a CT demonstrated the spontaneous expulsion of the stone. 7 patients were lost at follow-up. The patient undergoing an active surveillance spontaneously expelled the stone. CONCLUSIONS S-UUTR is a rare radiological sign of a renal colic most commonly located in a calyceal fornix. A high incidence of s-UUTR is caused by small distal ureteral stones in which a spontaneous passage is reasonable. Clinical presentation usually does not arise the suspicion of s-UUTR. In our experience, most patients were actively treated with good results but a conservative approach can be offered in selected cases.
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Affiliation(s)
- Matteo Giulio Spinelli
- Department of Urology. IRCCS Ca' Granda Ospedale Maggiore Policlinico. University of Milan. Milan. Italy
| | - Franco Palmisano
- Department of Urology. IRCCS Ca' Granda Ospedale Maggiore Policlinico. University of Milan. Milan. Italy
| | - Stefano Paolo Zanetti
- Department of Urology. IRCCS Ca' Granda Ospedale Maggiore Policlinico. University of Milan. Milan. Italy
| | - Luca Boeri
- Department of Urology. IRCCS Ca' Granda Ospedale Maggiore Policlinico. University of Milan. Milan. Italy
| | - Franco Gadda
- Department of Urology. IRCCS Ca' Granda Ospedale Maggiore Policlinico. University of Milan. Milan. Italy
| | - Michele Talso
- Department of Urology. IRCCS Ca' Granda Ospedale Maggiore Policlinico. University of Milan. Milan. Italy
| | - Paolo Guido Dell'Orto
- Department of Urology. IRCCS Ca' Granda Ospedale Maggiore Policlinico. University of Milan. Milan. Italy
| | - Emanuele Montanari
- Department of Urology. IRCCS Ca' Granda Ospedale Maggiore Policlinico. University of Milan. Milan. Italy
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Palmisano F, Lorusso V, Spinelli MG, Dell'Orto PG, Montanari E. Blastoid variant of mantle cell lymphoma of the female urethra mimicking a caruncle: A rare but highly aggressive subtype case with literature review. ACTA ACUST UNITED AC 2019; 91:49-50. [PMID: 30932430 DOI: 10.4081/aiua.2019.1.49] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 09/27/2018] [Indexed: 11/23/2022]
Abstract
Primary urethral lymphoma is a rare entity without a standardized treatment protocol. We report a case of an elderly woman presenting with a caruncle associated with vaginal spotting and intermittent dysuria. She underwent surgical excision of the lesion. Histological analysis revealed a blastoid variant of mantle cell lymphoma, a previously unreported subtype. The patient received chlorambucil assisting a rapid local disease progression. She died of disseminated disease 6 months after diagnosis. A review of the lymphomas of the urethra is included.
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Affiliation(s)
- Franco Palmisano
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, Milan; University of Milan.
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Boeri L, Capogrosso P, Ventimiglia E, Fontana M, Sampogna G, Zanetti SP, Pozzi E, Zuabi R, Schifano N, Chierigo F, Longo F, Gadda F, Dell'Orto PG, Scattoni V, Montorsi F, Montanari E, Salonia A. Clinical Comparison of Holmium Laser Enucleation of the Prostate and Bipolar Transurethral Enucleation of the Prostate in Patients Under Either Anticoagulation or Antiplatelet Therapy. Eur Urol Focus 2019; 6:720-728. [PMID: 30872124 DOI: 10.1016/j.euf.2019.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 02/18/2019] [Accepted: 03/01/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND A significant number of patients who require surgery for benign prostatic hyperplasia are under either anticoagulation (AC) or antiplatelet (AP) therapy. OBJECTIVE To assess the efficacy and morbidity of holmium laser enucleation of the prostate (HoLEP) and bipolar transurethral enucleation of the prostate (B-TUEP) in patients who required AC/AP therapy. DESIGN, SETTING, AND PARTICIPANTS This study included 296 (67.6%) and 142 (32.4%) patients who underwent HoLEP and B-TUEP, respectively. The AC/AP group included patients whose AP therapy was not interrupted pre-, peri-, and/or postoperatively, and patients who underwent perioperative AC therapy bridging with low-molecular-weight heparin. INTERVENTION HoLEP and B-TUEP. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS We tested the hypothesis that AC/AP therapy had a limited impact on the efficacy of HoLEP and B-TUEP. To adjust for potential baseline confounders, propensity-score matching was performed. Clinical characteristics were compared among groups using the Kruskal-Wallis or chi-square test. Logistic regression analyses tested the association between clinical variables and the odds of Clavien-Dindo ≥2 complications after surgery. RESULTS AND LIMITATIONS Overall, 28 (9.5%) and 46 (15.5%) patients in the HoLEP group and 15 (10.5%) and 24 (16.9%) men in the B-TUEP group had AC and AP therapy, respectively (p=0.9). HoLEP patients under either AC or AP therapy deserved longer catheter maintenance and a longer hospital stay (HS) than those without AC/AP therapy (all p≤0.01). Operative time, rates of postoperative complications, and 2-mo International Prostate Symptoms Score (IPSS) were similar between patients with and without AC/CP. Among B-TUEP patients, HS was longer (p=0.03) and the rate of complications was higher (p<0.001) in patients under AC or AP therapy. Postoperative haemoglobin drop and 2-mo IPSS were similar among groups and surgical techniques. Limitations are the retrospective nature of the study, and the lack of long-term complications and functional outcomes. CONCLUSIONS HoLEP and B-TUEP can safely be performed in patients deserving continuous AP/AC therapy with only a slight increase in HS and catheterisation time. PATIENT SUMMARY We assessed the safety and efficacy of holmium laser enucleation of the prostate (HoLEP) and bipolar transurethral enucleation of the prostate (B-TUEP) in men under chronic anticoagulation/antiplatelet therapy. Both HoLEP and B-TUEP could safely be performed as minimally invasive treatment options in this subset of patients at a high risk of bleeding from benign prostatic hyperplasia surgery.
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Affiliation(s)
- Luca Boeri
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Capogrosso
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Eugenio Ventimiglia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Matteo Fontana
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Gianluca Sampogna
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Stefano Paolo Zanetti
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Rani Zuabi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Nicolò Schifano
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Chierigo
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Fabrizio Longo
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Franco Gadda
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Guido Dell'Orto
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Vincenzo Scattoni
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Emanuele Montanari
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy.
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Palmisano F, Spinelli MG, Luzzago S, Boeri L, De Lorenzis E, Albo G, Gadda F, Gelosa M, Longo F, Dell'Orto PG, Montanari E. Medical Expulsive Therapy for Symptomatic Distal Ureter Stones: Is the Combination of Bromelain and Tamsulosin More Effective than Tamsulosin Alone? Preliminary Results of a Single-Center Study. Urol Int 2018; 102:145-152. [PMID: 30227429 DOI: 10.1159/000493158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/21/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To assess the safety and efficacy of bromelain plus tamsulosin versus tamsulosin alone as medical expulsive therapy (MET) for promoting spontaneous stone passage (SSP) of symptomatic distal ureter stones. PATIENTS AND METHODS One-hundred-fourteen patients with a 4-10 mm distal ureteral stone were enrolled (Group A). Patients self-administered daily bromelain with tamsulosin for 30 days or until SSP or intervention was mandatory. Patients were compared to those from a control group taking tamsulosin as MET (Group B) and matched for the following factors: sex, age ±10%, stone diameter. A logistic regression model evaluated bromelain and the ureteral stone diameter as explanatory variables. RESULTS SSP rates were 87.7 vs. 75.4% for group A vs. group B respectively (p = 0.016); with no difference observed for the time to self-reported stone expulsion (11.68 vs. 11.57 days; p = 0.91). Considering larger stones (> 5 mm), the SSP rate was 83.3% in group A and 61% in group B (p < 0.01). With each millimeter increment of stone diameter, the probability of SSP decreased by 59.1% (p < 0.0001), while it increased of 3.3 when bromelain was present. Only 3 cases of tamsulosin-related adverse events were recorded. CONCLUSION The association of bromelain and tamsulosin as MET increases the probability of SSP of symptomatic distal ureteral stones, with no bromelain-related side effects recorded.
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Fontana M, Boeri L, Gallioli A, De Lorenzis E, Palmisano F, Zanetti SP, Sampogna G, Albo G, Longo F, Gadda F, Dell'Orto PG, Montanari E. Prevalence and predictors of being lost to follow-up after transurethral resection of the prostate. Sci Rep 2018; 8:6406. [PMID: 29686229 PMCID: PMC5913257 DOI: 10.1038/s41598-018-24869-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 04/11/2018] [Indexed: 11/29/2022] Open
Abstract
Patient follow-up after transurethral resection of the prostate (TURP) is crucial to evaluate treatment-related outcomes and potential adverse events. We sought to determine the rate of, and factors associated with, patient nonadherence to follow-up after TURP. Data from 180 patients who underwent TURP were analysed. Patient counselling and follow-up were standardized among the cohort. Patients were considered lost to follow-up (LTF) if they were at least 30 days from their first scheduled follow-up appointment. Descriptive statistics and logistic regression analyses were performed to determine the impact of predictors on the rate of compliance with prescribed follow-up. Of 180 patients, 55 (30.5%) were LTF. LTF patients were younger (p < 0.001), had lower educational status (p = 0.007) and were more frequently single (p = 0.03) than those who were not LTF. Importantly, patients who experienced a postoperative-related event (PRE) were more likely to follow-up (p = 0.04). Multivariable analysis revealed that younger age (p < 0.001) and low educational status (p < 0.001) were independent predictors of being LTF. One out of three men submitted to TURP is lost to follow-up in the real-life setting. Noncompliance to follow-up was more frequent among young, single patients with low educational status. On the contrary, patients who experienced a PRE were more likely to follow-up.
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Affiliation(s)
- Matteo Fontana
- IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy
| | - Luca Boeri
- IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy.
| | - Andrea Gallioli
- IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy
| | - Elisa De Lorenzis
- IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy
| | - Franco Palmisano
- IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy
| | - Stefano Paolo Zanetti
- IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy
| | - Gianluca Sampogna
- IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy
| | - Giancarlo Albo
- IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy
| | - Fabrizio Longo
- IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy
| | - Franco Gadda
- IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy
| | - Paolo Guido Dell'Orto
- IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy
| | - Emanuele Montanari
- IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy
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