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Introduction: The management of localized penile cancer is based on organ-sparing approaches. Our aim is to report surgical outcomes of glansectomy (GS) and split thickness skin graft (STSG) reconstruction in a consecutive series of penile cancers.Patients and Methods: Patients with a localized penile cancer underwent GS and STSG reconstruction in tertiary referral center. Data were extrapolated from a single center prospective database starting from May 2013 to August 2019. Two different techniques are presented in the video abstract: - a standard GS with dissection over the Bucks' fascia. - a salvage GS with dissection under Bucks' fascia.Results: A total of 34 patients were enrolled. 30 patients underwent a standard GS, whether a salvage GS was performed in the remainders. The apex of corpora cavernosa was transected in 5 cases due to suspicious of local invasion. Median follow-up was 12 (12-41) months. Operative time was 150 (105-180) minutes. Hospital stay was 2 (1-3) days. A modified TODGA compressive dressing and a catheter were applied and left in place for 5 days. After that a saline washing was used for 2 weeks. The incidence of intraoperative complications was minimal (2.9%). Positive surgical margins were detected in 2.9% of cases, requiring a salvage surgery. The incidence of postoperative complications was 29.4%: 11.7% were classified as Grade 1, 8.8% as Grade 2 and 8.8% as Grade 3a according to Clavien-Dindo classification. 1-year recurrence free-survival (RFS) was 88.2%. 1-y cancer-specific (CSS) and overall survival (OS) resulted 91.2% in both cases. Limitations of the study were the retrospective and single centre nature of the study, the lack of comparative group, the limited number of cases and of follow-up.Conclusions: GS and STSG reconstruction represents a safe procedure burden by a low incidence of postoperative complications providing a satisfactory cancer control, with a minimal risk of local recurrence. [ABSTRACT FROM AUTHOR]

Objectives: To report surgical and oncological outcomes of total glans resurfacing in a consecutive series of superficial penile cancers., Design, Settings and Partecipants: 26 patients were enrolled in the present trial. A retrospective analysis was conducted. Inclusion criteria were age < 80, "de novo" malignancy, clinically suspected superficial disease and disease confirmation by a penile biopsy. Clinically palpable corporeal or urethral involvement, high histological grade, clinically palpable nodes on physical examination and unwillingness to comply with follow-up were considered as exclusion criteria., Outcome Measurements and Statistical Analysis: Descriptive features and surgical outcomes were extrapolated from the clinical records. The categorical variables were described using frequency and percentage, and the continuous variables were described using median and interquartile range (IQR) value. Kaplan-Meier analysis was used to estimate survival over time., Results and Limitations: Median follow-up was 38 (IQR 13-86) months. Median age was 65 (IQR 55-68). An history of lichen sclerosus was reported by 50% of patients. No intraoperative complications were reported. Median hospital stay was 5 (IQR 2-6) days. Final histology confirmed superficial disease in 42.4% and T1 in 53.8%. T2 was detected in a single case. Postoperative complications were minimal (3.8%). No regional nodal recurrence was reported. At Kaplan-Meier analysis, overall survival rate was 100% at 1 year, 1-year recurrence free survival was 96.1% and 2-year recurrence free survival was 88.5%., Conclusion: Total glans resurfacing may represent an excellent option for organ preserving surgery in patients with a superficial penile cancer. Surgical and oncological outcomes proved to be satisfactory., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To evaluate the feasibility of "in-office" TPFBx under local anesthesia (LA)., Materials and Methods: We prospectively screened for eligibility data of 724 consecutive men undergoing either TPFBx (target and systematic cores) or TPSBx (systematic cores only) from September 2016 to June 2018 due to suspicion of prostate cancer (CaP), according to predefined exclusion criteria., Results: We included 459 men (TPFBx n = 279 including n = 338 mpMRI lesions, Pi-RADS 4 in 63.6%; TPSBx n = 180). Median procedural time and maximum pain were 19 minutes and 5 numeric rating scale (NRS) points; pain was highest at the time of LA. Only 1 major complication occurred (Clavien 3a). Hematuria and hematospermia were frequent (72.6% and 54.2%). Vaso-vagal reactions and AUR were rare (0.7% and 0.4%). No cases of UTI and 1 case of fever were recorded. No significant changes in erectile and urinary functions were noted from baseline compared to 40 days after TPFBx (P = .86 and P = .89). In comparison with TPSBx the sole differences were pain during prostatic sampling (P = .03), duration of hematospermia (P <.0001) and procedural time (P <.001) all higher for TPFBx. Clinically significant (cs) CaP was detected in n = 150 (53.8%) patients in the TPFBx group (34.9%, 51.7%, and 75% of Pirads 3, 4, and 5, respectively). Addition of systematic cores detected n = 25 csCaP that were missed by targeted cores (17.4% of all csCaP)., Conclusion: TPFBx under LA are feasible, yielding high tolerability, low complications, no impact on erectile and urinary function and good csCaP detection. Addition of systematic to targeted cores remains recommended. Further studies are needed to confirm our findings., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To assess whether cell-cycle progression (CCP)-score (Prolaris) can improve the current risk assessment in newly diagnosed prostate cancer (PCa) patients. CCP-score is a well-validated prognostic assay predictive of PCa death, biochemical recurrence, and progression., Methods: We evaluated CCP-score at biopsy in 52 patients newly diagnosed with PCa who underwent radical prostatectomy. CCP-score was calculated as average RNA expression of 31 CCP genes, normalized to 15 housekeeping genes. The predictive ability of CCP-score was assessed in univariate and multivariate analyses, and compared to that of Ki-67 levels and traditional clinical variables including prostate-specific antigen, Gleason score, stage, and percentage of positive cores at biopsy., Results: In spite of an overall good accuracy in attributing the correct risk class, 7 high-risk and 13 intermediate-risk patients were misclassified by the Prolaris test. On analysis of variance, mean CCP-score significantly differed across different risk classes based on pathologic results (-1.2 in low risk, -0.444 in intermediate risk, 0.208 in high risk). CCP-score was a significant predictor of high-risk PCa both on univariate and multivariate analyses, after adjusting for clinical variables. Combining CCP-score and the European Association of Urology clinical risk assessment improved the accuracy of risk attribution by around 10%, up to 87.8%. CCP-score was a significant predictor of biochemical recurrence, but only on univariate analysis., Conclusion: The CCP-score might provide important new information to risk assessment of newly diagnosed PCa in addition to traditional clinical variables. A correct risk attribution is essential to tailor the best treatment for each patient., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: To asses and quantify the learning curve (LC) of the penoscrotal inversion flap vaginoplasty (PSV)., Patients and Methods: We retrospectively reviewed clinical records of 69 patients who underwent PSV from January 2005 to January 2015. Two validated methods were used: a scatterplot representation and a splitting group. We selected as primary outcomes the operative time and vaginal depth. Surgical outcomes including blood losses, hospital stay, and postoperative complications such as vaginal stenosis or atresia or urethral meatus stenosis were also evaluated., Results: The overall median operative time was 245 minutes. Severe intraoperative complications were not reported. The overall incidence of postoperative major complications was 21.7 %, most of them being urethral issues. The splitting group analysis revealed a statistically remarkable difference between groups for the operative time (P < .01), the vaginal depth (P = .01), the hospital stay (P < .01), and the intraoperative complication rate (P = .01). On the contrary, no differences were evidenced between the cohorts for the amount of blood loss (P = .08). The scatterplot logarithmic analysis demonstrated a clear visible LC for most parameters. The operative time showed a sharp decrease within the first 20-30 cases, reaching a plateau after 40 cases. Considering the analysis of the vaginal depth, the logarithmic scatterplot curve evidenced a slight increase within the first 10 cases, reaching a clear stabilization after nearly 30-40 cases., Conclusion: An evident LC for PSV is detectable, consisting of at least 40 cases needed to the surgical team to develop adequate skills to guarantee a safe and high-quality procedure., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: To report the feasibility of a novel robotic technique for intracorporeal construction of a double Yang-Monti ileal conduit with bladder augmentation in an adult patient., Methods: The Yang-Monti procedure can be considered as an alternative to Mitrofanoff appendicovesicostomy when the appendix is not available or in obese patients. To date, the robotic approach has not been described. We have described all the steps of our surgery, performed on a 35-year-old obese patient with post-traumatic paraplegia and a neurogenic bladder. We focused on the technical tips and highlighted all the differences with the standard open technique., Results: Our technique provided satisfactory results. No intraoperative complications occurred. The operative time was 250 minutes, and the intraoperative blood loss was 200 mL. The clinical course was uneventful., Conclusion: We have shown that robotic intracorporeal realization of a double Yang-Monti ileal conduit with bladder augmentation is feasible, extending the potential indications of robot-assisted surgery. The evaluation of more cases is advised., (Copyright © 2013 Elsevier Inc. All rights reserved.)