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The article discusses the feasibility, operative setup, and surgical outcomes of Retzius‐sparing robot‐assisted radical prostatectomy (RS‐RARP) using the Hugo robot‐assisted surgery system. The study evaluated 26 patients who underwent RS‐RARP with the Hugo system, reporting on patient characteristics, operative setup, complications, and outcomes. The findings suggest that RS‐RARP with the Hugo system is feasible and safe, with high rates of urinary continence recovery, but also highlight the need for a learning process due to higher positive surgical margin rates compared to other systems. Further research is needed to assess long-term outcomes and compare the Hugo system with other robotic platforms. [Extracted from the article]

Background: In patients with renal cell carcinoma (RCC) the role of the extent of tumor thrombus into the inferior vena cava (IVC) has never been addressed from a surgical and oncologic standpoint. This study aims to evaluate differences between level III–IV versus level I–II patients concerning peri- and postoperative morbidity, additional treatments and long-term oncological outcomes. Patients and Methods: Overall, 40 patients with RCC underwent radical nephrectomy (RN) with IVC thrombectomy at a single European institution between 2010 and 2023. Complications were reported according to the European Union (EAU) guidelines recommendations. Spider chart served as graphical depiction of surgical and oncologic outcomes. Results: Overall, 22 (55%) and 18 (45%) patients harbored level III–IV and I–II IVC thrombus. Level III–IV patients experienced significantly higher rates of intraoperative transfusions (68 vs 39%), but not significantly higher rates of intraoperative complications (32% vs 28%). Level III–IV patients had significantly higher rates of postoperative transfusions (82% vs 33%) and Clavien Dindo ≥3 complications (41% vs 15%). In level III–IV versus level I–II patients, median follow up was 482 and 1070 days, the rate of distant recurrence was 59% and 50%, the rate of systemic progression was 27% and 13%, and the rate of additional treatment/s was 64% and 61%, respectively (all p values > 0.05). Overall survival was 36% in level III–IV patients and 67% in level I–II (p = 0.001). Conclusions: Our findings suggest that patients with level III–IV RCC who are candidates for IVC thrombectomy should be counselled about the higher likelihood of postoperative severe adverse events and worse overall survival relative to level I–II counterparts. [ABSTRACT FROM AUTHOR]

Background and Aims: The aim of our study is to evaluate the possible urodynamic effect of prostatic urethral lift (PUL) in patients with lower urinary tract symptoms due to benign prostatic hyperplasia. Methods: A consecutive series of patients undergoing PUL placement were consecutively enrolled in two centers. Inclusion criteria: ≥50 years of age, benign prostatic obstruction (BPO), international prostate symptom score (IPSS) ≥ 13, prostate volume ≤ 60 mL, and no middle prostate lobe. All patients were evaluated using a detailed clinical history, a validated questionnaire, flexible cystoscopy, and pressure flow studies (PFS) at baseline. PFS were performed at 6 months to evaluate the urodynamic effect of PUL. Results: Overall, 20 patients with a median age of 63 were enrolled. At six months, statistically significant improvements in terms of median Qmax (11.5 vs. 8.5; p < 0.05) and median IPSS (16 vs. 10.5; p < 0.05) were recorded, and sexual function was maintained. All urodynamic parameters improved at 6 months, and significance was reached for all values except for PdetQmax. Finally, Schäfer's class improved from a median of III to a median of II. More specifically, 16/20 presented an improvement in the Schäfer class, and 12/20 patients presented a BOOI < 20 at 6 months. Conclusions: PUL represents an effective treatment in patients with LUTS due to BPH and improves bladder outlet obstruction without any effect on sexual function. [ABSTRACT FROM AUTHOR]

Simple Summary: Intraoperative complications during Retzius-sparing robot-assisted radical prostatectomy are uncommon, affecting 2.1% of patients in our series of almost two thousand cases. Only 0.37% of the patients treated with Retzius-sparing robot-assisted radical prostatectomy developed post-operative sequelae due to Intraoperative complications. When divided according to the time of the procedure 42% of the events were ePNLD-related, and the 58% were RARP-related Intraoperative complications are more likely to occur in older individuals with a higher BMI. Patient suffering intraoperative complications demonstrated a higher rate of intraoperative blood transfusion, and a longer length of stay. These complications are mostly of low severity but underline the need for careful monitoring and reporting. Background: Intraoperative complications (ICs) are invariably underreported in urological surgery despite the recent endorsement of new classification systems. We aimed to provide a detailed overview of ICs during Retzius-sparing robot-assisted radical prostatectomy (RS-RARP). Methods: We prospectively collected data from 1891 patients who underwent RS-RARP at a single high-volume European center from January 2010 to December 2022. ICs were collected based on surgery reports and categorized according to the Intraoperative Adverse Incident Classification (EAUiaiC). The quality criteria for accurate and comprehensive reporting of intraoperative adverse events proposed by the Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration Project were fulfilled. To better classify the role of the RS-RARP approach, ICs were classified into anesthesiologic and surgical ICs. Surgical ICs were further divided according to the timing of the complication in RARP-related ICs and ePNLD-related ICs. Results: Overall, 40 ICs were reported in 40 patients (2.1%). Ten out of thirteen ICARUS criteria were satisfied. According to EAUiaiC grading of ICs, 27 (67.5%), 7 (17.5%), 2 (5%), 2 (5%), and 2 (5%) patients experienced Grade 1, 2, 3, 4A, and 4B, respectively. When we classified the ICs, two cases (5%) were classified as anesthesiologic ICs. Among the 38 surgical ICs, 16 (42%) were ePNLD-related, and 22 (58%) were RARP-related. ICs led to seven (0.37%) post-operative sequelae (four non-permanent and three permanent). Patients who suffered ICs were significantly older (67 years vs. 65 years, p = 0.02) and had a higher median BMI (27.0 vs. 26.1, p = 0.01), but did not differ in terms of comorbidities or tumor characteristics (all p values ≥ 0.05). Conclusions: Intraoperative complications during RS-RARP are relatively infrequent, but should not be underestimated. Patients suffering from ICs are older, have a higher body mass index, a higher rate of intraoperative blood transfusion, and a longer length of stay. [ABSTRACT FROM AUTHOR]

In the framework of mapping underwater environments, Posidonia Oceanica (PO) is a fundamental indicator for environmental monitoring and related studies and analyses for climate change. The POSEIDON project aims to study, develop and test new methodologies to provide knowledge, as well as ultra-high-resolution (UHR) and beyond ultra-high-resolution (BUHR) mapping and monitoring data for the conservation of the PO and related meadows and banquettes in the Mediterranean area. The project is funded by the National Recovery and Resilience Plan and stems from the recommendation of international organizations (European Environmental Directives, Mediterranean PO Network, International Partnership for Blue Carbon, Intergovernmental Oceanographic Commission of UNESCO in the Save the Wave project). Starting from new integrated survey methods and legacy data, the PO, ichthyofauna and seagrass banquettes will be mapped to understand their evolution and extract indicators and useful trends. Furthermore, the produced information will be stored and shared in a webGIS and a dedicated app to prevent unexpected damages during sailing or other activities. POSEIDON will use imaging sensors (RGB and multi/hyperspectral cameras) to extract information. With specific lighting equipment for significant water depths, these sensors will be conducted (by scuba divers or Autonomous Underwater Vehicles) next to the object to acquire BUHR data. Finally, to monitor the fauna (fish, other species, invertebrates), terrestrial and underwater videogrammetry will be applied using mono and stereo-cameras with object detection algorithms. [ABSTRACT FROM AUTHOR]

Simple Summary: The current study is about Retzius Sparing Robot-Assisted Radical Prostatectomy, a surgical approach deemed capable of improving continence recovery after surgery due to the preservation of the structures surrounding the prostate. Specifically, the association between adjuvant Radiation Therapy and urinary continence after prostatectomy was the topic of interest of the study. Patients with prostate cancer treated at a high-volume European institution were analyzed. Based on the results of the study, Adjuvant Radiation Therapy does not significantly undermine urinary continence recovery. Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) allows the preservation of the structures advocated to play a crucial role in the continence mechanism. This study aims to evaluate the association between adjuvant radiation therapy (aRT) and urinary continence (UC) recovery after RS-RARP. For the purpose of the current study, all patients submitted to RS-RARP for prostate cancer (PCa) at a single high-volume European institution between January 2010 and December 2021 were identified. Only patients that harbored pT2 stage with positive surgical margins or pT3/pN1 stage with or without positive surgical margins were included in the analyses. Two groups of patients were identified as follows: patients who had undergone aRT and patients submitted to observation (no-aRT patients). As per definition, aRT was delivered within 1–6 months after surgery. After 1:1 propensity score matching, 124 aRT patients were compared with 124 no-aRT patients who continued standard follow-up protocol after surgery. UC recovery was 81 vs. 84% in aRT vs. no-aRT patients (p = 0.7). In multivariable Cox regression analyses, aRT did not reach the independent predictor status for UC recovery at 12 months. In the subgroup analysis including only aRT patients, only the nerve-sparing technique was independently associated with UC recovery at 12 months. Conversely, the type of aRT (IMRT/VMAT vs. 3D-CRT) did not reach the independent predictor status for UC recovery at 12 months. The current study is the first to address the association between aRT and UC recovery in patients treated with RS-RARP for PCa. Based on our data, aRT is not associated with worse UC recovery. In the cohort of patients treated with aRT, the nerve-sparing technique independently predicted UC recovery. [ABSTRACT FROM AUTHOR]

no data exist concerning functional and oncological outcomes of Retzius-sparing robot-assisted radical prostatectomy (RS-RARP), in patients previously treated with trans -urethral resection of the prostate (p-TURP), for benign prostate obstruction. Our study addressed the impact of p-TURP on immediate and 12-months urinary continence recovery (UCR), as well as peri-operative outcomes and surgical margins, after RS-RARP. all patients treated with RS-RARP for prostate cancer at a single high-volume European institution, between 2010 and 2021, were identified and stratified according to p-TURP status. Logistic, Poisson and Cox regression models were performed. Of 1386 RS-RARP patients, 99 (7%) had history of p-TURP. Between p-TURP and no-TURP patients no differences were detected regarding both intra- and post-operative complications (p values = 0.9). The rates of immediate UCR were 40 vs 67% in p-TURP vs no-TURP patients (p < 0.001). At 12 months from RS-RARP, the rates of UCR were 68 vs 94% in p-TURP vs no-TURP patients (p < 0.001). At multivariable logistic and Cox regression models, p-TURP was independently associated, respectively, with lower immediate (odds ratio [OR]: 0.32, p < 0.001) and 12-months UCR (hazard ratio: 0.54, p < 0.001). At multivariable Poisson analyses, p-TURP predicted longer operative time (rate ratio: 1.08, p < 0.001) but not longer length of stay or time to catheter removal (p values > 0.05). Positive surgical margins rates were 23 vs 17% in p-TURP vs no-TURP patients (p = 0.1), which translated in a non-statistically significant multivariable OR of 1.14 (p = 0.6). p-TURP does not increase surgical morbidity but portends longer operative time and worse urinary continence after RS-RARP. [ABSTRACT FROM AUTHOR]

The article discusses the emergence of the "Next Generation SNM Italian Group," comprising young urologists, coloproctologists, and gynecologists in Italy, aiming to standardize sacral neuromodulation (SNM) techniques and improve therapy availability. SNM, initially a niche procedure, has evolved into a minimally invasive treatment for bladder and bowel dysfunction, with over 400,000 global patients. The group facilitates training, mentorship, and data sharing to enhance surgical skills and expand SNM access, serving as a replicable model for cultivating expertise and offering life-changing therapy. [Extracted from the article]

In this study, we aimed to investigate the presence of an alteration in the feeding ecology of fish after the deployment of anti-trawling reefs at the Punta Tramontana site (Sardinia, Italy). To achieve this aim, we examined prey in the stomach contents of two target species of fish: Diplodus annularis and Mullus surmuletus. The samples were obtained from fishing activities carried out over one year from June 2017 to October 2018 at two impact sites, selected by the presence of artificial reefs, and two control sites. The results showed that installing these artificial devices increased the food spectrum availability of the target species and induced two different ecological feeding behaviors, probably derived from their different ecologies. D. annularis changed its alimentary strategy from generalist at control sites to specialist at impact sites, focusing its diet on the crustacean Gnathia maxillaris. Mullus surmuletus was not affected by the presence of the barriers, which constitute an additional site where the fish feed during their foraging activities. In conclusion, these anti-trawling reefs, in addition to the purpose for which they are designed (in this case, avoiding illegal trawling), did not produce any negative environmental impact on surrounding marine biota. [ABSTRACT FROM AUTHOR]