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1. How radical prostatectomy procedures have changed over the last 10 years in Italy: a comparative analysis based on more than 1500 patients participating in the MIRROR-SIU/LUNA and the Pros-IT CNR study

Author

Gacci, M., Artibani, W., Bassi, P., Bertoni, F., Bracarda, S., Briganti, A., Carmignani, G., Carmignani, L., Conti, G., Corvo, R., De Nunzio, C., Fusco, F., Graziotti, P., Greco, I., Maggi, S., Magrini, S. M., Mirone, V., Montironi, R., Morgia, G., Muto, G., Noale, M., Pecoraro, S., Porreca, A., Ricardi, U., Russi, E., Russo, G., Salonia, A., Simonato, A., Serni, S., Tomasini, D., Tubaro, A., Zagonel, V., Crepaldi, G., Conti, G. N., Alitto, A. R., Ambrosi, E., Antonelli, A., Aristei, C., Bardari, F., Bardoscia, L., Barra, S., Bartoncini, S., Basso, U., Becherini, C., Bellavita, R., Bergamaschi, F., Berlingheri, S., Berruti, A., Borghesi, M., Bortolus, R., Borzillo, V., Bosetti, D., Bove, G., Bove, P., Brausi, M., Bruni, A., Bruno, G., Brunocilla, E., Buffoli, A., Buglione, M., Buttigliero, C., Cacciamani, G., Caldiroli, M., Cardo, G., Carrieri, G., Castelli, E., Castrezzati, E., Catalano, G., Cattarino, S., Catucci, F., Cavallini Francolini, D., Ceccarini, O., Celia, A., Chiancone, F., Chini, T., Cianci, C., Cisternino, A., Collura, D., Corbella, F., Corinti, M., Corsi, P., Cortese, F., Corti, L., Decosimo, N., Cristiano, O., Rolando, D. A., Da Pozzo, L., D'Agostino, D., D'Elia, C., Dandrea, M., De Angelis, M., De Angelis, P., De Cobelli, O., De Concilio, B., De Lisa, A., De Luca, S., De Stefani, A., Deantoni, C. L., Degli Esposti, C., Destito, A., Detti, B., Di Muzio, N., Di Stasio, A., Di Stefano, C., Di Trapani, D., Difino, G., Falivene, S., Farullo, G., Fedelini, P., Ferrari, I., Ferrau, F., Ferro, M., Fodor, A., Fontana, F., Francesca, F., Francolini, G., Frata, P., Frezza, G., Gabriele, P., Galeandro, M., Garibaldi, E., Gennari, P. G., Gentilucci, A., Giacobbe, A., Giussani, L., Giusti, G., Gontero, P., Guarneri, A., Guida, C., Gurioli, A., Huqi, D., Imbimbo, C., Ingrosso, G., Iotti, C., Italia, C., La Mattina, P., La Rocca, R., Lamanna, E., Lastrucci, L., Lazzari, G., Liberale, F., Liguori, G., Lisi, R., Lohr, F., Lombardo, R., Lovisolo, J. A., Ludovico, G. M., Macchione, N., Maggio, F., Malizia, M., Manasse, G., Mandoliti, G., Mantini, G., Marafioti, L., Marciello, L., Marconi, A. M., Martilotta, A., Marzano, S., Masciullo, S., Maso, G., Massenzo, A., Mazzeo, E., Mearini, L., Medoro, S., Mole, R., Monesi, G., Montanari, E., Montefiore, F., Montesi, G., Moro, G., Muscas, G., Musio, D., Muto, P., Muzzonigro, G., Napodano, G., Negro, C. L. A., Nidini, M., Ntreta, M., Orsatti, M., Palazzolo, C., Palumbo, I., Parisi, A., Parma, P., Pavan, N., Pericolini, M., Pinto, F., Pistone, A., Pizzuti, V., Platania, A., Polli, C., Pomara, G., Ponti, E., Porcaro, A. B., Porpiglia, F., Pugliese, D., Pycha, A., Raguso, G., Rampini, A., Randone, D. F., Roboldi, V., Roscigno, M., Ruggieri, M. P., Ruoppo, G., Sanseverino, R., Santacaterina, A., Santarsieri, M., Santoni, R., Scagliarini, S., Scagliotti, G. V., Scanzi, M., Scarcia, M., Schiavina, R., Sciarra, A., Sciorio, C., Scolaro, T., Scuzzarella, S., Selvaggio, O., Serao, A., Signor, M. A., Silvani, M., Silvano, G., Silvestris, F., Simeone, C., Simone, V., Spagnoletti, G., Spinelli, M. G., Squillace, L., Tombolini, V., Toninelli, M., Triggiani, L., Trinchieri, A., Trodella, L., Luca, E., Trombetta, C., Tronnolone, L., Tucci, M., Urzi, D., Valdagni, R., Valeriani, M., Vanoli, M., Vitali, E., Volpe, A., Zaramella, S., Zeccolini, G., Zini, G., Acanfora, F., Aiello, E., Alchiede, S., Altieri, V., Anceschi, C., Aragona, F., Balloni, F., Barasolo, E., Barba, G., Bartoletti, R., Bigazzi, B., Belgrano, E., Salvatore, S., Battaglia, M., Bellei, L., Bettin, A., Bianchi, G., Bombieri, L., Brancato, T., Breda, G., Caggiano, S., Calabro, A., Caldironi, M., Campo, B., Capobianco, S., Capparelli, F., Carbone, A., Carlo, D., Catanzaro, F., Ciaraldi, F., Cicalese, V., Corbu, C., Cosciani Cunico, S., Cosentino, V., Crimi, A., Cucchiarale, G., Cuscuna, D., Damiano, R., D'Armiento, M., De Dominicis, C., De Grande, G., Del Boca, C., D'Elia, A., De Mayo, E., De Martin, M., Di Clemente, L., Di Meo, S., Di Monaco, G., Di Nicola, G., Di Silverio, A., Di Silverio, F., Fabri, F., Falsaperla, M., Fanciullacci, F., Ferrari, G., Fiaccavento, G., Filoni, A., Fontana, D., Fontana, G., Ghabin, H., Frea, B., Gaboardi, F., Gentile, V., Giandotti, M., Grasso, M., Grosso, G., Guazzieri, S., Isaia, A., Landi, G., Landolfi, R., Larcher, P., Laurenti, C., Lavelli, D., Leidi, G. L., Lembo, A., Leoni, S., Maffei, N., Maffezzini, M., Martinengo, C., Manieri, C., Martorana, G., Mazza, R., Medica, M., Melloni, D., Miano, L., Micheli, E., Milesi, R., Minervini, M. S., Minocci, D., Molon, A., Morello, P., Motta, M., Narcisi, F., Nicita, G., Palermo, S., Paoluzzi, M., Pompa, P., Porena, M., Raciti, G., Rizzotto, A., Rocco, F., Romano, M., Rossini, L., Russo, G. R., Salvioni, R., Sandri, S., Savoca, G., Selli, C., Selvaggi, F. P., Sercia, F., Tallarigo, C., Tanello, M., Tasca, A., Tenaglia, R., Tensi, M., Terrone, C., Tralce, L., Vagge, A., Valenti, P., Varaldo, M., Vespasiani, G., Vicentini, C., Vicirca, F., Vigano, P., Zaccone, V., Zartar, C., Gacci, M., Artibani, W., Bassi, P., Bertoni, F., Bracarda, S., Briganti, A., Carmignani, G., Carmignani, L., Conti, G., Corvo, R., De Nunzio, C., Fusco, F., Graziotti, P., Greco, I., Maggi, S., Magrini, S. M., Mirone, V., Montironi, R., Morgia, G., Muto, G., Noale, M., Pecoraro, S., Porreca, A., Ricardi, U., Russi, E., Russo, G., Salonia, A., Simonato, A., Serni, S., Tomasini, D., Tubaro, A., Zagonel, V., Crepaldi, G., Conti, G. N., Alitto, A. R., Ambrosi, E., Antonelli, A., Aristei, C., Bardari, F., Bardoscia, L., Barra, S., Bartoncini, S., Basso, U., Becherini, C., Bellavita, R., Bergamaschi, F., Berlingheri, S., Berruti, A., Borghesi, M., Bortolus, R., Borzillo, V., Bosetti, D., Bove, G., Bove, P., Brausi, M., Bruni, A., Bruno, G., Brunocilla, E., Buffoli, A., Buglione, M., Buttigliero, C., Cacciamani, G., Caldiroli, M., Cardo, G., Carrieri, G., Castelli, E., Castrezzati, E., Catalano, G., Cattarino, S., Catucci, F., Cavallini Francolini, D., Ceccarini, O., Celia, A., Chiancone, F., Chini, T., Cianci, C., Cisternino, A., Collura, D., Corbella, F., Corinti, M., Corsi, P., Cortese, F., Corti, L., Decosimo, N., Cristiano, O., Rolando, D. A., Da Pozzo, L., D'Agostino, D., D'Elia, C., Dandrea, M., De Angelis, M., De Angelis, P., De Cobelli, O., De Concilio, B., De Lisa, A., De Luca, S., De Stefani, A., Deantoni, C. L., Degli Esposti, C., Destito, A., Detti, B., Di Muzio, N., Di Stasio, A., Di Stefano, C., Di Trapani, D., Difino, G., Falivene, S., Farullo, G., Fedelini, P., Ferrari, I., Ferrau, F., Ferro, M., Fodor, A., Fontana, F., Francesca, F., Francolini, G., Frata, P., Frezza, G., Gabriele, P., Galeandro, M., Garibaldi, E., Gennari, P. G., Gentilucci, A., Giacobbe, A., Giussani, L., Giusti, G., Gontero, P., Guarneri, A., Guida, C., Gurioli, A., Huqi, D., Imbimbo, C., Ingrosso, G., Iotti, C., Italia, C., La Mattina, P., La Rocca, R., Lamanna, E., Lastrucci, L., Lazzari, G., Liberale, F., Liguori, G., Lisi, R., Lohr, F., Lombardo, R., Lovisolo, J. A., Ludovico, G. M., Macchione, N., Maggio, F., Malizia, M., Manasse, G., Mandoliti, G., Mantini, G., Marafioti, L., Marciello, L., Marconi, A. M., Martilotta, A., Marzano, S., Masciullo, S., Maso, G., Massenzo, A., Mazzeo, E., Mearini, L., Medoro, S., Mole, R., Monesi, G., Montanari, E., Montefiore, F., Montesi, G., Moro, G., Muscas, G., Musio, D., Muto, P., Muzzonigro, G., Napodano, G., Negro, C. L. A., Nidini, M., Ntreta, M., Orsatti, M., Palazzolo, C., Palumbo, I., Parisi, A., Parma, P., Pavan, N., Pericolini, M., Pinto, F., Pistone, A., Pizzuti, V., Platania, A., Polli, C., Pomara, G., Ponti, E., Porcaro, A. B., Porpiglia, F., Pugliese, D., Pycha, A., Raguso, G., Rampini, A., Randone, D. F., Roboldi, V., Roscigno, M., Ruggieri, M. P., Ruoppo, G., Sanseverino, R., Santacaterina, A., Santarsieri, M., Santoni, R., Scagliarini, S., Scagliotti, G. V., Scanzi, M., Scarcia, M., Schiavina, R., Sciarra, A., Sciorio, C., Scolaro, T., Scuzzarella, S., Selvaggio, O., Serao, A., Signor, M. A., Silvani, M., Silvano, G., Silvestris, F., Simeone, C., Simone, V., Spagnoletti, G., Spinelli, M. G., Squillace, L., Tombolini, V., Toninelli, M., Triggiani, L., Trinchieri, A., Trodella, L., Luca, E., Trombetta, C., Tronnolone, L., Tucci, M., Urzi, D., Valdagni, R., Valeriani, M., Vanoli, M., Vitali, E., Volpe, A., Zaramella, S., Zeccolini, G., Zini, G., Acanfora, F., Aiello, E., Alchiede, S., Altieri, V., Anceschi, C., Aragona, F., Balloni, F., Barasolo, E., Barba, G., Bartoletti, R., Bigazzi, B., Belgrano, E., Salvatore, S., Battaglia, M., Bellei, L., Bettin, A., Bianchi, G., Bombieri, L., Brancato, T., Breda, G., Caggiano, S., Calabro, A., Caldironi, M., Campo, B., Capobianco, S., Capparelli, F., Carbone, A., Carlo, D., Catanzaro, F., Ciaraldi, F., Cicalese, V., Corbu, C., Cosciani Cunico, S., Cosentino, V., Crimi, A., Cucchiarale, G., Cuscuna, D., Damiano, R., D'Armiento, M., De Dominicis, C., De Grande, G., Del Boca, C., D'Elia, A., De Mayo, E., De Martin, M., Di Clemente, L., Di Meo, S., Di Monaco, G., Di Nicola, G., Di Silverio, A., Di Silverio, F., Fabri, F., Falsaperla, M., Fanciullacci, F., Ferrari, G., Fiaccavento, G., Filoni, A., Fontana, D., Fontana, G., Ghabin, H., Frea, B., Gaboardi, F., Gentile, V., Giandotti, M., Grasso, M., Grosso, G., Guazzieri, S., Isaia, A., Landi, G., Landolfi, R., Larcher, P., Laurenti, C., Lavelli, D., Leidi, G. L., Lembo, A., Leoni, S., Maffei, N., Maffezzini, M., Martinengo, C., Manieri, C., Martorana, G., Mazza, R., Medica, M., Melloni, D., Miano, L., Micheli, E., Milesi, R., Minervini, M. S., Minocci, D., Molon, A., Morello, P., Motta, M., Narcisi, F., Nicita, G., Palermo, S., Paoluzzi, M., Pompa, P., Porena, M., Raciti, G., Rizzotto, A., Rocco, F., Romano, M., Rossini, L., Russo, G. R., Salvioni, R., Sandri, S., Savoca, G., Selli, C., Selvaggi, F. P., Sercia, F., Tallarigo, C., Tanello, M., Tasca, A., Tenaglia, R., Tensi, M., Terrone, C., Tralce, L., Vagge, A., Valenti, P., Varaldo, M., Vespasiani, G., Vicentini, C., Vicirca, F., Vigano, P., Zaccone, V., Zartar, C., Gacci M., Artibani W., Bassi P., Bertoni F., Bracarda S., Briganti A., Carmignani G., Carmignani L., Conti G., Corvo R., De Nunzio C., Fusco F., Graziotti P., Greco I., Maggi S., Magrini S.M., Mirone V., Montironi R., Morgia G., Muto G., Noale M., Pecoraro S., Porreca A., Ricardi U., Russi E., Russo G., Salonia A., Simonato A., Serni S., Tomasini D., Tubaro A., Zagonel V., Crepaldi G., Conti G.N., Alitto A.R., Ambrosi E., Antonelli A., Aristei C., Bardari F., Bardoscia L., Barra S., Bartoncini S., Basso U., Becherini C., Bellavita R., Bergamaschi F., Berlingheri S., Berruti A., Borghesi M., Bortolus R., Borzillo V., Bosetti D., Bove G., Bove P., Brausi M., Bruni A., Bruno G., Brunocilla E., Buffoli A., Buglione M., Buttigliero C., Cacciamani G., Caldiroli M., Cardo G., Carrieri G., Castelli E., Castrezzati E., Catalano G., Cattarino S., Catucci F., Cavallini Francolini D., Ceccarini O., Celia A., Chiancone F., Chini T., Cianci C., Cisternino A., Collura D., Corbella F., Corinti M., Corsi P., Cortese F., Corti L., deCosimo N., Cristiano O., Rolando D.A., Da Pozzo L., D'Agostino D., D'Elia C., Dandrea M., De Angelis M., De Angelis P., De Cobelli O., De Concilio B., De Lisa A., De Luca S., De Stefani A., Deantoni C.L., Degli Esposti C., Destito A., Detti B., Di Muzio N., Di Stasio A., Di Stefano C., Di Trapani D., Difino G., Falivene S., Farullo G., Fedelini P., Ferrari I., Ferrau F., Ferro M., Fodor A., Fontana F., Francesca F., Francolini G., Frata P., Frezza G., Gabriele P., Galeandro M., Garibaldi E., Gennari P.G., Gentilucci A., Giacobbe A., Giussani L., Giusti G., Gontero P., Guarneri A., Guida C., Gurioli A., Huqi D., Imbimbo C., Ingrosso G., Iotti C., Italia C., La Mattina P., La Rocca R., Lamanna E., Lastrucci L., Lazzari G., Liberale F., Liguori G., Lisi R., Lohr F., Lombardo R., Lovisolo J.A., Ludovico G.M., Macchione N., Maggio F., Malizia M., Manasse G., Mandoliti G., Mantini G., Marafioti L., Marciello L., Marconi A.M., Martilotta A., Marzano S., Masciullo S., Maso G., Massenzo A., Mazzeo E., Mearini L., Medoro S., Mole R., Monesi G., Montanari E., Montefiore F., Montesi G., Moro G., Muscas G., Musio D., Muto P., Muzzonigro G., Napodano G., Negro C.L.A., Nidini M., Ntreta M., Orsatti M., Palazzolo C., Palumbo I., Parisi A., Parma P., Pavan N., Pericolini M., Pinto F., Pistone A., Pizzuti V., Platania A., Polli C., Pomara G., Ponti E., Porcaro A.B., Porpiglia F., Pugliese D., Pycha A., Raguso G., Rampini A., Randone D.F., Roboldi V., Roscigno M., Ruggieri M.P., Ruoppo G., Sanseverino R., Santacaterina A., Santarsieri M., Santoni R., Scagliarini S., Scagliotti G.V., Scanzi M., Scarcia M., Schiavina R., Sciarra A., Sciorio C., Scolaro T., Scuzzarella S., Selvaggio O., Serao A., Signor M.A., Silvani M., Silvano G., Silvestris F., Simeone C., Simone V., Spagnoletti G., Spinelli M.G., Squillace L., Tombolini V., Toninelli M., Triggiani L., Trinchieri A., Trodella L., Luca E., Trombetta C., Tronnolone L., Tucci M., Urzi D., Valdagni R., Valeriani M., Vanoli M., Vitali E., Volpe A., Zaramella S., Zeccolini G., Zini G., Acanfora F., Aiello E., Alchiede S., Altieri V., Anceschi C., Aragona F., Balloni F., Barasolo E., Barba G., Bartoletti R., Bigazzi B., Belgrano E., Salvatore S., Battaglia M., Bellei L., Bettin A., Bianchi G., Bombieri L., Brancato T., Breda G., Caggiano S., Calabro A., Caldironi M., Campo B., Capobianco S., Capparelli F., Carbone A., Carlo D., Catanzaro F., Ciaraldi F., Cicalese V., Corbu C., Cosciani Cunico S., Cosentino V., Crimi A., Cucchiarale G., Cuscuna D., Damiano R., D'Armiento M., De Dominicis C., De Grande G., Del Boca C., D'Elia A., De Mayo E., De Martin M., Di Clemente L., Di Meo S., Di Monaco G., Di Nicola G., Di Silverio A., Di Silverio F., Fabri F., Falsaperla M., Fanciullacci F., Ferrari G., Fiaccavento G., Filoni A., Fontana D., Fontana G., Ghabin H., Frea B., Gaboardi F., Gentile V., Giandotti M., Grasso M., Grosso G., Guazzieri S., Isaia A., Landi G., Landolfi R., Larcher P., Laurenti C., Lavelli D., Leidi G.L., Lembo A., Leoni S., Maffei N., Maffezzini M., Martinengo C., Manieri C., Martorana G., Mazza R., Medica M., Melloni D., Miano L., Micheli E., Milesi R., Minervini M.S., Minocci D., Molon A., Morello P., Motta M., Narcisi F., Nicita G., Palermo S., Paoluzzi M., Pompa P., Porena M., Raciti G., Rizzotto A., Rocco F., Romano M., Rossini L., Russo G.R., Salvioni R., Sandri S., Savoca G., Selli C., Selvaggi F.P., Sercia F., Tallarigo C., Tanello M., Tasca A., Tenaglia R., Tensi M., Terrone C., Tralce L., Vagge A., Valenti P., Varaldo M., Vespasiani G., Vicentini C., Vicirca F., Vigano P., Zaccone V., Zartar C., Gacci, Mauro, Artibani, Walter, Bassi, Pierfrancesco, Bertoni, Filippo, Bracarda, Sergio, Briganti, Alberto, Carmignani, Giorgio, Carmignani, Luca, Conti, Giario, Corvò, Renzo, De Nunzio, Cosimo, Fusco, Ferdinando, Graziotti, Pierpaolo, Greco, Isabella, Maggi, Stefania, Magrini, Stefano Maria, Mirone, Vincenzo, Montironi, Rodolfo, Morgia, Giuseppe, Muto, Giovanni, Noale, Marianna, Pecoraro, Stefano, Porreca, Angelo, Ricardi, Umberto, Russi, Elvio, Russo, Giorgio, Salonia, Andrea, Simonato, Alchiede, Serni, Sergio, Tomasini, Davide, Tubaro, Andrea, Zagonel, Vittorina, and Crepaldi, Gaetano

Subjects
Male, Nephrology, medicine.medical_specialty, Time Factors, Urology, medicine.medical_treatment, 030232 urology & nephrology, Lymph node dissection, Logistic regression, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Internal medicine, LUNA study, Biopsy, Humans, Medicine, Prospective Studies, Nerve sparing, Lymph node, Aged, Prostatectomy, medicine.diagnostic_test, business.industry, MIRROR SIU/LUNA study, Lymph node dissection, MIRROR SIU/LUNA study, Nerve sparing, Pros-IT CNR study, Prostate cancer, Robotic procedures, Prostatic Neoplasms, Cancer, Pros-IT CNR study, Middle Aged, medicine.disease, MIRROR SIU, Dissection, Robotic procedures, Logistic Models, medicine.anatomical_structure, Italy, 030220 oncology & carcinogenesis, business
Abstract

Purpose Therapeutic strategies for prostate cancer (PCa) have been evolving dramatically worldwide. The current article reports on the evolution of surgical management strategies for PCa in Italy. Methods The data from two independent Italian multicenter projects, the MIRROR-SIU/LUNA (started in 2007, holding data of 890 patients) and the Pros-IT-CNR project (started in 2014, with data of 692 patients), were compared. Differences in patients' characteristics were evaluated. Multivariable logistic regression models were used to identify characteristics associated with robot-assisted (RA) procedure, nerve sparing (NS) approach, and lymph node dissection (LND). Results The two cohorts did not differ in terms of age and prostate-specific antigen (PSA) levels at biopsy. Patients enrolled in the Pros-IT-CNR project more frequently were submitted to RA (58.8% vs 27.6%,p < 0.001) and NS prostatectomy (58.4% vs. 52.9%,p = 0.04), but received LND less frequently (47.7% vs. 76.7%,p < 0.001), as compared to the MIRROR-SIU/LUNA patients. At multivariate logistic models, Lower Gleason Scores (GS) and PSA levels were significantly associated with RA prostatectomy in both cohorts. As for the MIRROR-SIU/LUNA data, clinical T-stage was a predictor for NS (OR = 0.07 for T3, T4) and LND (OR = 2.41 for T2) procedures. As for Pros-IT CNR data, GS >= (4 + 3) and positive cancer cores >= 50% were decisive factors both for NS (OR 0.29 and 0.30) and LND (OR 7.53 and 2.31) strategies. Conclusions PCa management has changed over the last decade in Italian centers: RA and NS procedures without LND have become the methods of choice to treat newly medium-high risk diagnosed PCa.

Published
2021

3. Epithelkörperchen-Autotransplantation: Langzeitergebnisse und direkte Überprüfung der Funktion des Implantates durch selektive Parathormonbestimmung und Belastungstests

Author

P. Puppo, Giuliani L, Belgrano E, Carmignani G, and U. Repetto

Subjects
Gynecology, medicine.medical_specialty, business.industry, medicine, business
Abstract

Die Kombination der totalen Parathyreoidektomie mit sofortiger Transplantation von autologem Epithelkorperchengewebe in die Beugenmuskulatur des Unterarms stellt eine vorteilhafte Losung des Problems der chirurgischen Behandlung der multiplen Nebenschilddrusenhyperplasie dar. Die Funktion des Implantates ist leicht kontrollierbar und es besteht die Moglichkeit, die endokrine Aktivitat zu steuern, sowohl durch die Entnahme von Gewebsstuckchen in Lokalanasthesie bei erneut auftretendem Hyper parathyreoidismus als auch durch zusatzliche Implantation von tiefgefrorenem aufbewahrtem Gewebe, falls das ursprungliche Transplantat nicht angegangen oder zugrunde gegangen ist.

Published
1982
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4. Is Health-Related Quality of Life after Radical Cystectomy Using Validated Questionnaires Really Better in Patients with Ileal Orthotopic Neobladder Compared to Ileal Conduit: A Meta-Analysis of Retrospective Comparative Studies

Author

Michele Rizzo, Cristina Lonardi, Walter Artibani, Ciro Imbimbo, Mauro Niero, Davide De Marchi, Emanuele Belgrano, Marco Racioppi, Antonio Benito Porcaro, Maria Angela Cerruto, Renato Talamini, Giovanni Cacciamani, Paolo Verze, Pierfrancesco Bassi, Stefano Ciciliato, Laura Toffoli, Salvatore Siracusano, Massimo Iafrate, Carolina D'Elia, Francesco Visalli, Cerruto, M. A., D'Elia, C., Siracusano, S., Porcaro, A. B., Cacciamani, G., De Marchi, D., Niero, M., Lonardi, C., Iafrate, M., Bassi, P., Belgrano, E., Imbimbo, C., Racioppi, M., Talamini, R., Ciciliato, S., Toffoli, L., Rizzo, M., Visalli, F., Verze, P., and Artibani, W.

Subjects
medicine.medical_specialty, medicine.medical_treatment, Urology, 030232 urology & nephrology, Health related quality of life, Ileal conduit, Neobladder, Radical cystectomy, Urinary diversion, Reproductive Medicine, Oncology, Review, Cystectomy, 03 medical and health sciences, 0302 clinical medicine, medicine, In patient, business.industry, Settore MED/24 - UROLOGIA, Health related, 030220 oncology & carcinogenesis, Meta-analysis, business
Abstract

Introduction: From the most recent systematic revision of the literature, an orthotopic neobladder would seem to show marginally better health related quality of life (HR-QoL) scores compared with an ileal conduit. The aim of this study was to review all relevant published studies about the comparison between ileal orthotopic neobladder (IONB) and ileal conduit using validated HR-QoL questionnaires. Materials and Methods: Studies were identified by searching multiple literature databases. Data were synthesized using meta-analytic methods conformed to the PRISMA statement. Results: The literature search identified 10 papers; pooled effect sizes of combined quality of life outcomes for ileal conduit versus IONB showed a significantly better HR-QoL in patients with IONB (Hedges' g = 0.278; p = 0.000);. The present study has an important limitation due to the type of the analyzed comparative studies, all retrospective and not randomized. Conclusion: This meta-analysis of not-randomized, retrospective comparative studies on the impact of ileal conduit versus IONB on HR-QoL showed a significant advantage of IONB subgroups.

Published
2017

5. Open Radical Nephrectomy: 35 Years of Experience at the 'Luciano Giuliani' Urological Department of the University of Genoa

Author

Gabriele Ruggiero, Paolo Traverso, Paolo Vota, Andrea Romagnoli, C. Corbu, Giorgio Carmignani, Alchiede Simonato, R. Pizzorno, Giuseppe Martorana, Emanuele Belgrano, Carmignani, G. a., Simonato, A. a, Corbu, C. a, Traverso, P. a, Ruggiero, G. a, Pizzorno, R. a, Vota, P. a, Martorana, G. b, Belgrano, Emanuele, Romagnoli, A., Carmignani G., Simonato A., Corbu C., Traverso P., Ruggiero G., Pizzorno R., Vota P., Martorana G., Belgrano E., and Romagnoli A.

Subjects
Nephrology, cancer incidence, medicine.medical_treatment, kidney carcinoma, morbidity, sepsis, Renal cell carcinoma, cancer diagnosis, cancer mortality, nephrectomy, postoperative complication, Myocardial infarction, cancer survival, disease free survival, cancer diagnosi, adrenalectomy, article, cancer size, cancer staging, cancer surgery, heart infarction, human, lung embolism, lymphadenectomy, metastasis, partial nephrectomy, priority journal, spleen injury, splenectomy, surgical technique, thrombectomy, Radical nephrectomy, Incidence (epidemiology), Nephrectomy, sepsi, medicine.medical_specialty, Urology, Internal medicine, medicine, Carcinoma, business.industry, medicine.disease, Surgery, metastasi, business, Kidney cancer, Kidney disease
Abstract

Objective: Radical nephrectomy remains the gold standard for surgically resectable kidney neoplasms > 4 cm and, in selected cases, also in presence of metastatic disease. We reviewed the records of the patients having surgery at the University of Genoa in the last 35 yr. Methods: We have retrospectively assessed all the radical nephrectomies performed between 1970 and 2005. Among tumours of the kidney subjected to surgical treatment during this period, we found 1105 cases of histologically proven renal cell carcinoma (RCC), 965 of which had records available for the study. The number of cases per year, symptoms at diagnosis, surgical strategy, staging of the tumour, and survival were reviewed. Results: Among 965 patients, radical nephrectomy was performed in 825 (85.5%) with a mean age of 61.26 yr (range, 20-88 yr) and partial nephrectomy in 140 (14.5%) with a mean age of 59.4 yr (range, 20-86 yr). Metastases at diagnosis were present in 81 patients (9.8%). The surgical approach was transperitoneal in 484 (58.6%) and extraperitoneal in 341 (41.4%) of the 825 patients. A transperitoneal approach was preferred for all tumours > 10 cm in diameter. No postoperative deaths occurred due to technical complications but 15 patients (1.8%) died in the 30 d following the operation due to myocardial infarction, pulmonary embolus, or sepsis. At the last follow-up, the 5-yr overall survival rate was 56% and the 5-yr cancer-specific survival and disease-free survival rates were 70% and 65%, respectively. Conclusions: The incidence of RCC has slowly increased in recent years in our department. Surgical extirpation remains the most widely accepted and potentially curative treatment option for renal neoplasms with a good efficacy and low mortality and morbidity rates. (c) 2006 Published by Elsevier B.V. on behalf of European Association of Urology.

Published
2006
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6. 372 COMBINED ORAL THERAPY WITH TADALAFIL AND ALFUZOSIN IN PATIENTS WITH LOWER URINARY TRACT SYMPTOMS AND ERECTILE DYSFUNCTION

Author

Giangiacomo Ollandini, Emanuele Belgrano, G. De Giorgi, Stefano Bucci, Giorgio Pomara, Giuseppe Maio, Giuseppe Ocello, Giovanni Liguori, Daniele Vecchio, Carlo Trombetta, Liguori, G., Trombetta, C., DE GIORGI, Gioacchino, Pomara, Giorgio, Maio, Giuseppe, Vecchio, D., Ocello, Giuseppe, Ollandini, G., Bucci, S., and Belgrano, E.

Subjects
medicine.medical_specialty, LOWER URINARY TRACT SYMPTOMS, business.industry, Urology, ALFUZOSIN, TADALAFIL, ALFUZOSIN, LOWER URINARY TRACT SYMPTOMS, ERECTILE DYSFUNCTION, medicine.disease, Tadalafil, Erectile dysfunction, Lower urinary tract symptoms, TADALAFIL, ERECTILE DYSFUNCTION, Medicine, In patient, business, Oral therapy, Alfuzosin, medicine.drug
Published
2009

7. Tissue-resonance interaction method for the noninvasive diagnosis of prostate cancer: analysis of a multicentre clinical evaluation

Author

Emanuele Belgrano, Vincenzo Scattoni, Domenico Prezioso, Patrizio Rigatti, Donata Villari, Fabio Manferrari, Giulio Nicita, T. Lotti, Luigi E Da Pozzo, Francesco Pietropaolo, Giuseppe Martorana, Bruno Mazzoccoli, Da Pozzo, L, Scattoni, V, Mazzoccoli, B, Rigatti, P, Manferrari, F, Martorana, G, Pietropaolo, F, Belgrano, E, Prezioso, D, Lotti, T, Villari, D, Nicita, G, Prezioso, Domenico, DA POZZO, L, Nicita, G., and Belgrano, Emanuele

Subjects
Nephrology, Male, medicine.medical_specialty, Urology, Biosensing Techniques, Sensitivity and Specificity, Prostate cancer, PSA, Electromagnetic Fields, Prostate, Predictive Value of Tests, Internal medicine, Biopsy, Diagnosis, medicine, tissueresonance method, cancer, Humans, Prospective Studies, Aged, Digital Rectal Examination, Aged, 80 and over, prostate, medicine.diagnostic_test, business.industry, Biopsy, Needle, Cancer, Prostatic Neoplasms, Rectal examination, DRE, Middle Aged, Prostate-Specific Antigen, medicine.disease, Surgery, Prostate-specific antigen, medicine.anatomical_structure, Adenocarcinoma, prostate cancer, diagnosis, noninvasive diagnosis, business, Diagnosi
Abstract

OBJECTIVE To determine, in a multicentre prospective study, the accuracy of the tissue‐resonance interaction method (TRIMprob, new technology developed for the noninvasive analysis of electromagnetic anisotropy in biological tissues) in the diagnosis of prostate cancer. PATIENTS AND METHODS Two hundred patients (mean age 67.4 years) scheduled to have prostatic biopsies (because of a prostate‐specific, PSA, antigen level of ≥4 ng/mL or a suspicious digital rectal examination, DRE) were preliminarily examined while unaware of their clinical details using TRIMprob in five different centres. The final diagnosis obtained with TRIMprob was compared with the final histological diagnosis after extended biopsies. RESULTS Of the 188 evaluable patients (mean PSA level 9.3 ng/mL, sd 8.8; mean prostate volume 62.0 mL, sd 32.4), 61 (32.4%) had a positive biopsy for adenocarcinoma of the prostate. The overall sensitivity, specificity, positive predictive value, negative predictive value (NPV) and accuracy of TRIMprob were 80%, 51%, 44%, 84% and 60%, respectively. The prostate cancer detection rate after biopsy was significantly higher in patients with a positive examination (49/111, 44%) than in patients with a negative TRIMprob (12/77, 15%; P

Published
2007

8. Surgical Management of Renal Cell Carcinoma (RCC) with Vena Cava Tumour Thrombus

Author

Carlo Trombetta, Giorgio Carmignani, Salvatore Siracusano, Emanuele Belgrano, Giovanni Liguori, Giuseppe Martorana, Belgrano, Emanuele, Trombetta, Carlo, Siracusano, Salvatore, Carmignani, G., Martorana, G., Liguori, Giovanni, Belgrano E., Trombetta C., Siracusano S., Carmignani G., Martorana G., and Liguori G.

Subjects
medicine.medical_specialty, inferior cava vein, Urology, overall survival, kidney carcinoma, laparoscopy, vein bypass, Renal cell carcinoma, Thrombus, Tumour invasion, Vena cava involvement, Inferior vena cava, Adipose capsule of kidney, computer assisted tomography, tumor thrombus, Carcinoma, Medicine, follow up, cardiovascular diseases, human, sternotomy, business.industry, artificial embolism, cancer classification, cancer invasion, cancer surgery, hepatic vein, priority journal, vascular tumor, medicine.disease, Surgery, Venous thrombosis, medicine.vein, cardiovascular system, business, Kidney cancer, Kidney disease, tumor thrombu
Abstract

Objectives: Renal cell carcinoma (RCC) propagation into the inferior vena cava is rare (10-25%) and is described as an extension above the hepatic veins up to the right atrium or even into the right ventricle. Venous tumour invasion is associated with several prognostic factors such as local infiltration of perinephric tissue, lymph nodes metastases, caval infiltration, and the presence of distant metastases. We reviewed our experience with surgical treatment of RCC with vena cava involvement. Methods: We analysed the Urological Genoa School results from 1970 to 1985 on 28 consecutive cases (Giuliani's series) and between 1986 and 2005 on 59 of 81 cases from three Italian urologic academic centres (Trieste, Bologna, and Genoa). Results: For 1970-1985, the overall survival rate for all patients was 30% at follow-up periods of 36-66 mo. With caval infiltration, the overall survival rate at 12 mo was 0%. For the period 1986-2005, the overall survival rate at 8 yr was about 80%. Nonsignificant differences for nodal stage and caval infiltration were observed during the two time periods. Conclusions: Our data confirm, as reported by others, that nonmetastatic RCC with extension into vena cava is potentially curable. © 2006 European Association of Urology.

Published
2006

9. Transverse retubularized ileal vaginoplasty: A new application of the Monti principle - Preliminary report

Author

Emanuele Belgrano, Salvatore Siracusano, Carlo Trombetta, Marina Bortul, Giovanni Liguori, Trombetta, C., Liguori, G., Siracusano, S., Bortul, M., and Belgrano, E.

Subjects
Nephrology, Sampling Studie, Vaginal Diseases, Constriction, Pathologic, Severity of Illness Index, Gynecologic Surgical Procedures, Gynecologic Surgical Procedure, Medicine, Vaginal Disease, Bowel, Constriction, Magnetic Resonance Imaging, Transplantation, Autologou, medicine.anatomical_structure, Treatment Outcome, Surgery, Vaginal stenosis, Vaginoplasty, Adult, Female, Follow-Up Studies, Humans, Ileum, Reconstructive Surgical Procedures, Risk Assessment, Sampling Studies, Transplantation, Autologous, Vagina, Urology, Vaginal stenosi, Autologous, Human, medicine.medical_specialty, Follow-Up Studie, Patient satisfaction, Vaginal disease, Internal medicine, Severity of illness, Reconstructive Surgical Procedure, Pathologic, Transplantation, business.industry, Plastic Surgery Procedures, medicine.disease, Stenosis, business, Complication
Abstract

Objective The surgical management of the absence of the vagina is a complex problem and constitutes a significant technical challenge. Herein we present our successful experience with vaginal reconstruction by the use of a modified ileal segment according to the Monti principle. Methods Six patients aged from 23 to 41 years (mean 33 years) were referred to our institution for vaginal stenosis. In our series, ileum has been used to create the neovagina: the isolated segment has been longitudinally detubularized and transversally retubularized in order to configure the roof of the neovagina. Results The mean operating time was 220min. No intra-operative complication occurred. The mean follow-up of this series was 16 months. At the latest follow-up, all patients had patent moist neovaginas, but excessive vaginal mucous was not a problem in any patient in our series. Conclusions Neovaginal creation using isolated ileal segments according to the Monti channel principle provide excellent tissue for vaginal replacement, providing excellent patient satisfaction and relatively low morbidity. Cosmetic, functional and anatomical results were encouraging. In our opinion our technique may be indicated for all cases of vaginal absence: congenital abnormalities in the pediatric population, vaginal stenosis after treatment of pelvic tumors, severe vaginal scarring secondary to chronic inflammatory disease or in case of secondary correction after failure gender surgery.

Published
2005

10. The application of ultrasound contrast agents in the characterization of renal tumors

Author

Emanuele Belgrano, Michele Bertolotto, Salvatore Siracusano, A. Tiberio, Stefano Ciciliato, Emilio Quaia, Siracusano, S, Quaia, Emilio, Bertolotto, Michele, Ciciliato, S, Tiberio, A, Belgrano, E., Siracusano, Salvatore, Ciciliato, Stefano, and Belgrano, Emanuele

Subjects
Nephrology, Male, Angiomyolipoma, Renal angiomyolipoma, Metanephric adenoma, Contrast Media, urologic and male genital diseases, " ultrasound ", Renal cell carcinoma, Contrast (vision), Renal masse, Prospective Studies, media_common, Ultrasonography, Aged, 80 and over, Kidney, Ultrasound contrast agent, Ultrasound, Delayed phase, Ultrasound contrast agents, Middle Aged, Kidney Neoplasms, medicine.anatomical_structure, Female, Radiology, Kidney ", medicine.medical_specialty, Contrast enhancement, Pulse inversion imaging, Urology, media_common.quotation_subject, Second-harmonic imaging microscopy, " tumor ", " contrast, Renal masses, Polysaccharides, Internal medicine, Renal mass, medicine, Humans, Aged, business.industry, medicine.disease, business, Kidney cancer, Arterial phase
Abstract

The aim of this article is to describe the current ultrasound (US) contrast agents employed in the characterization of renal tumors and to report our experience in the use of a contrast-specific ultrasound technique pulse inversion harmonic imaging (PIHI).A total of 23 renal masses were prospectively evaluated by conventional US, CDUS, PIHI and finally by helical-CT (HCT). The study was performed using a wideband convex array 2-5 MHz transducer and a US digital apparatus . PIHI scanning of each renal mass was performed before and after the injection of Levovist. To reach a definitive diagnosis HCT and/or histological findings were considered as the reference procedures. Eleven solid renal cell carcinomas (RCCs), one embryonal metanephric adenoma (EMA), seven angiomyolipomas (AMLs), and four cystic RCCs were analyzed. Solid RCCs revealed a higher contrast enhancement than AMLs with a typical pattern on conventional US. The EMA and AML with an atypical pattern revealed intense contrast enhancement during the arterial phase, progressively decreasing during the delayed phase. Cystic RCCs showed intense contrast enhancement on the peripheral thick wall during the arterial phase decreasing during the delayed phase. PIHI with Levovist may differentiate solid RCCs from AMLs with no hypervascular pattern while solid RCCs show a higher intensity of contrast enhancement than hypervascular AML.

Published
2004

11. Radiological evaluation of vaginal width and depth in male-to-female transsexuals by the use of magnetic resonance imaging

Author

Emanuele Belgrano, Stefano Bucci, Giovanni Liguori, Giulio Garaffa, L. Salamè, Carlo Trombetta, Maria Assunta Cova, Trombetta, C., Liguori, G., Bucci, S., Salamè, L., Garaffa, G., Cova, M., and Belgrano, E.

Subjects
Adult, medicine.medical_specialty, Magnetic resonance imaging, Neovagina, Transsexualism, Female, Humans, Middle Aged, Vagina, Magnetic Resonance Imaging, Urology, medicine, Sex reassignment surgery (male-to-female), medicine.diagnostic_test, business.industry, Sagittal plane, medicine.anatomical_structure, Radiological weapon, Coronal plane, Vaginoplasty, Radiology, Male to female, business, Human
Abstract

Nowadays, the surgical treatment of male-to-female transsexuals is not rare, but few studies have reported on postoperative results. The aim of this study was to determine the role of magnetic resonance imaging (MRI) in the evaluation of the results of sex reassignment surgery (SRS) in male-to-female transsexual patients. Ten such patients (median age 28 years, range 21-47), who had undergone SRS using an inversion of combined penile and scrotal skin flaps for vaginoplasty, were examined with MRI after the operation. Turbo spin-echo T2-weighted and spin-echo T1-weighted images were obtained on sagittal, coronal, and axial planes with a 1.5 T superconducting magnet. The images were acquired on the sagittal, coronal and axial planes, by using TSE T2 weighted and SG T1 weighted images. MRI was performed within 2 weeks after the operation in six patients and after 1 year in the other four. In all cases, the images were obtained with and without an inflatable silicon vaginal tutor. The average neovaginal depth was 7.9 cm (range 6-10 cm). In four patients, MRI showed the presence of cavernosal rests, and in two there were remnants of the corpus spongiosus. In another patient, an abnormal anterior inclination of the neovagina was present. The average distance of the recto-vaginal septum was 4 mm (range 3-6 mm). No major complications were noted. Our study allowed not only a detailed assessment of the pelvic anatomy after genital reconfiguration, but also provided valuable information on possible complications.

Published
2004

12. Surgery for invasive urologic cancer in the octagenarian

Author

U. Caramuta, Stefano Bucci, Carlo Trombetta, Emanuele Belgrano, Giovanni Liguori, Giulio Garaffa, Liguori, G., Trombetta, C., Bucci, S., Caramuta, U., Garaffa, G., and Belgrano, E.

Subjects
medicine.medical_specialty, Surgery for invasive urologic cancer in the octagenarian, business.industry, Urology, Urologic cancer, medicine, business, Surgery
Published
2003

13. Value of magnetic resonance imaging in the evaluation of sex-reassignment surgery in male-to-female transsexuals

Author

R Pozzi-Mucelli, E Mosconi, Stefano Bucci, Emanuele Belgrano, Maria Assunta Cova, Carlo Trombetta, Giovanni Liguori, Cova, M., Mosconi, E., Liguori, G., Bucci, S., Trombetta, C., Belgrano, E., and Pozzi-Mucelli, R.

Subjects
Adult, Male, Radiology, Nuclear Medicine and Imaging, medicine.medical_specialty, Magnetic resonance imaging, female pelvi, Urology, Magnetic resonance imaging, Magnetic resonance imaging, female pelvis, Neovagina, Sex-reassignment surgery, Transsexualism, Radiological and Ultrasound Technology, Medicine (all), Gastroenterology, Surgical Flaps, female pelvis, Nuclear Medicine and Imaging, medicine, Humans, Radiology, Nuclear Medicine and imaging, magnetic resonance imaging, magnetic resonance imaging, female pelvis, transsexualism, neovagina, sex-reassignment surgery, medicine.diagnostic_test, business.industry, Sex reassignment surgery (female-to-male), General Medicine, Middle Aged, equipment and supplies, Transsexual, Vagina, Female, Radiology, business, Nuclear medicine, Male to female, human activities
Abstract

Background: We investigated the value of magnetic resonance imaging (MRI) in the evaluation of sex-reassignment surgery in male-to-female transsexual patients. Methods: Ten male-to-female transsexual patients who underwent sex-reassignment surgery with inversion of combined penile and scrotal skin flaps for vaginoplasty were examined after surgery with MRI. Turbo spin-echo T2-weighted and spin-echo T1-weighted images were obtained in sagittal, coronal, and axial planes with a 1.5-T superconductive magnet. Images were acquired with and without an inflatable silicon vaginal tutor. The following parameters were evaluated: neovaginal depth, neovaginal inclination in the sagittal plane, presence of remnants of the corpus spongiosum and corpora cavernosa, and thickness of the rectovaginal septum. Results: The average neovaginal depth was 7.9 cm (range 5–10 cm). The neovagina had a correct oblique inclination in the sagittal plane in four patients, no inclination in five, and an incorrect inclination in one. In seven patients, MRI showed remnants of the corpora cavernosa and/or of the corpus spongiosum; in three patients, no remnants were detected. The average thickness of the rectovaginal septum was 4 mm (range 3– 6 mm). Conclusion: MRI allows a detailed assessment of the pelvic anatomy after genital reconfiguration and provides information that can help the surgeon to adopt the most correct surgical approach.

Published
2003

14. Observational multicentric trial performed with doxazosin: evaluation of sexual effects on patients with diagnosed benign prostatic hyperplasia

Author

Armando Maver, Dario Fontana, Vincenzo Mirone, Angelo Naselli, Costanzo Catuogno, Paolo Traverso, Emanuele Belgrano, Aldo Franco De Rose, Daniele Di Trapani, Giovanni Muzzonigro, Fabio Bonini, Matteo Giglio, C. Corbu, Giorgio Carmignani, DE ROSE, Af, Carmignani, G, Corbu, C, Giglio, M, Traverso, P, Naselli, A, Belgrano, E, Catuogno, C, Fontana, D, Maver, A, Mirone, Vincenzo, Muzzonigro, G, DI TRAPANI, D, and Bonini, F.

Subjects
Male, medicine.medical_specialty, Time Factors, Adenoma, Urology, Prostatic Hyperplasia, urologic and male genital diseases, Prostate, medicine, Doxazosin, Humans, Adrenergic alpha-Antagonists, Gynecology, urogenital system, business.industry, Penile Erection, Hyperplasia, medicine.disease, medicine.anatomical_structure, Erectile dysfunction, Case-Control Studies, Observational study, Sexual function, business, medicine.drug, Cohort study, Follow-Up Studies
Abstract

Introduction: The aim of our study is to verify the effects of doxazosin on sexual function in patients with benign prostatic hyperplasia (BPH). Materials and Methods: We enrolled 102 patients with BPH, selected by nine Italian Urology Departments. Patients were evaluated with the International Prostatic Symptom Score (I-PSS) and divided into two groups: those with intact sexual activity and those with erectile dysfunction. According to the International Index of Erectile Function (IIEF), the second cohort was divided into three subgroups on the basis of the degree of erectile dysfunction degree (severe, moderate or mild). All patients underwent 3 months of therapy with doxazosin. The effects of doxazosin on sexual activity and on voiding symptoms were monitored at 1, 2 and 3 months with IIEF and I-PSS scales. Results: Eighty-six of the 102 initial patients (84%) were monitored until follow-up was completed. The follow-up at 1 month showed a significant decrease in the I-PSS (p < 0.0001) from 20.2 ± 2.01 (base visit) to 13.1 ± 2.21. The mean IIEF was 19.24 ± 6.59 at baseline and 1 month later the score reached 21.44 ± 5.40, thus showing a statistically significant increase (p = 0.0177). This is more evident in the group presenting with severe to moderate erectile dysfunction. I-PSS and IIEF do not significantly change at the 2- and 3-month follow-ups. Conclusions: The use of doxazosin improved sexual function in patients with BPH.

Published
2002

15. Surgical therapy in transsexual patients: A multi-disciplinary approach

Author

Giovanni Liguori, Stefano Bucci, Emanuele Belgrano, Carlo Trombetta, Trombetta, C., Liguori, G., Bucci, S., and Belgrano, E.

Subjects
Transsexual, medicine.medical_specialty, Surgical therapy, Surgical therapy, transsexual, Multi disciplinary, business.industry, transsexual, Urology, General surgery, Medicine, business
Published
2003
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16. Bilateral laparoscopic retroperitoneal lymph node dissection (RPLND) in a patient with metachronous bilateral NSGCTT

Author

Giovanni Liguori, Carlo Trombetta, F. Scieri, Stefano Bucci, Emanuele Belgrano, Trombetta, C., Liguori, G., Bucci, S., Scieri, Francesco, and Belgrano, E.

Subjects
Retroperitoneal lymph node dissection, medicine.medical_specialty, RPLND, metachronous bilateral NSGCTT, business.industry, Urology, medicine.medical_treatment, General surgery, medicine, metachronous bilateral NSGCTT, Radiology, RPLND, business
Published
2003
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17. A new microsurgical technique for varicocele correction

Author

Paolo Puppo, Emanuele Belgrano, C. Trombetta, F. Gaboardi, Belgrano, E., Puppo, P., Gaboardi, F., and Trombetta, Carlo

Subjects
medicine.medical_specialty, business.industry, Urology, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Varicocele, Hemodynamics, Venous drainage, Microsurgery, Anastomosis, medicine.disease, Surgery, Endocrinology, Reproductive Medicine, medicine, Venous hypertension, business, Spermatic Vein, Epigastric Vein
Abstract

Varicocele is the consequence of a hemodynamic abnormality causing venous hypertension and consequent dilatation of the spermatic veins. In many cases, the correction of varicocele has led to improvement in semen quality. Conventional techniques of varicocele correction have the sole aim of occluding a nonfunctioning venous pathway, but do not attempt restoration of a hemodynamically correct venous drainage of the testis. We propose a new microsurgical technique for varicocele correction that achieves anastomosis between the spermatic vein and the epigastric vein. Either stump of the epigastric vein can be used, depending on the type of varicocele. In this way, a hemodynamically correct surgical solution can be achieved.

Published
1984

18. Development of a questionnaire specifically for patients with Ileal Orthotopic Neobladder (IONB)

Author

Carolina D'Elia, Davide De Marchi, Tommaso Silvestri, Walter Artibani, Giovanni Cacciamani, Francesco Visalli, Emanuele Belgrano, Ciro Imbimbo, Salvatore Siracusano, Maria Angela Cerruto, Massimo Iafrate, Renato Talamini, Stefano Ciciliato, Marco Racioppi, Laura Toffoli, Paolo Verze, Cristina Lonardi, Davide Massidda, Mauro Niero, Pierfrancesco Bassi, Siracusano, S, Niero, M, Lonardi, C, Cerruto, M, Ciciliato, S, Toffoli, L, Visalli, F, Massidda, D, Iafrate, M, Artibani, W, Bassi, P, Imbimbo, Ciro, Racioppi, M, Talamini, R, D., Elia C, Cacciamani, G, De Marchi, D, Silvestri, T, Verze, Paolo, Belgrano, E., Siracusano, Salvatore, Niero, Mauro, Lonardi, Cristina, Cerruto, Maria A., Ciciliato, Stefano, Toffoli, Laura, Visalli, Francesco, Massidda, Davide, Iafrate, Massimo, Artibani, Walter, Bassi, Pierfrancesco, Racioppi, Marco, Talamini, Renato, D'Elia, Carolina, Cacciamani, Giovanni, De Marchi, Davide, Silvestri, Tommaso, and Belgrano, Emanuele

Subjects
Male, Psychometrics, Radical cystectomy, Ileal orthotopic neobladder, Quality of life, Specific questionnaire, medicine.medical_treatment, Urinary Diversion, Surveys and Questionnaires, Surveys and Questionnaire, Health Status Indicators, Health Status Indicator, Settore MED/24 - UROLOGIA, Medicine (all), General Medicine, Middle Aged, humanities, Female, Public Health, Psychometric, Human, Adult, medicine.medical_specialty, Reproducibility of Result, Cystectomy, Follow-Up Studie, Interviews as Topic, Ileum, medicine, Humans, In patient, Aged, Follow-Up Studies, Reproducibility of Results, Quality of Life, Psychometric testing, Face validity, Rasch model, business.industry, questionnaire, Research, Urinary diversion, Environmental and Occupational Health, Public Health, Environmental and Occupational Health, Surgery, Physical therapy, business
Abstract

Background The ileal orthotopic neobladder (IONB) is often used in patients undergoing radical cystectomy. The IONB allows to void avoiding the disadvantages of the external urinary diversion. In IONB patients the quality of life (QoL) appears compromised by the need to urinate voluntarily. The patients need to wake up at night interrupting the sleep-wake rhythm with consequences on social and emotional life. At present the QoL in IONB patients is evaluated by generic questionnaires. These are useful when IONB patients are compared with patients with different urinary diversions but they are less effective when only IONB patients are evaluated. To address this problem a specific questionnaire—the IONB-PRO—was developed. Methods A) Based on a conceptual framework, narrative-based interviews were conducted on 35 IONB patients. A basic pool of 43 items was produced and organized throughout two clinical and four QoL dimensions. An additional 15 IONB patients were interviewed for face validity testing. B) Psychometric testing was conducted on 145 IONB patients. Both classic test strategy and Rasch analysis were applied. Psychometric properties of the resulting scales were comparatively tested against other QoL-validated scales. Results The IONB-PRO questionnaire includes two sections: one on the QoL and a second section on the capability of the patient to manage the IONB. For evaluation of the QoL, three versions were delivered: 1) a basic 23-item QoL version (3 domains 23-items; alpha 0.86÷ 9.69), 2) a short-form 12-item QoL scale (alpha = 0.947), and 3) a short-form 15-item Rasch QoL scale (alpha = 0.967). Correlations of the long version scales with the corresponding dimensions of the EORTC-QLQ C30 and the EORTC-BLM30 were significant. The short forms exhibited significant correlations with the global health dimension of the EORTC-QLQ and with the urinary subscales of the EORTC-BLM30. The effect size was approximately 1.00 between patients at the 1-year follow-up period and those with 3, 5, and > 5-year follow-up periods for all scales. No relevant differences were observed between the 12-item short-form and the Rasch scale. Conclusions The IONB-PRO long and short-forms demonstrated a high level of internal consistency and reliability with an excellent discriminanting validity.

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