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Objective: To evaluate the efficacy and tolerability of a complementary and alternative medicine (CAM) called Kubiker (Naturmed, Montegranaro, FM, Italy), consisting of vitamins (C and D), herbal products (cucurbita maxima, capsicum annum, polygonum cuspidatum), and amino acid L-Glutamine, as first line treatment of (OAB) Materials and methods: According to institutional protocols, data on patients addressing to a tertiary referral centre for OAB symptoms were recorded. OAB was evaluated through validated questionnaires including ICIQ-SF, USS, and OAB-q-SF. Patients with previous antimuscarinic or β3 agonist treatment, neurological disease or pathologies which may mimic OAB, including infections, were excluded. Only unobstructed patients were considered and were given CAM twice daily for 12 weeks. After treatment, symptoms were re-evaluated repeating previous questionnaires and PGI-I was given to evaluate perceived improvement. Results: A total of 41 patients were evaluated and 35 respected inclusion criteria and were enrolled. All subjects had a full compliance and adherence with CAM medication intake. The median patient's age was 65 (56–73). Male were 8 (22.9%) while females were 27 (77.1%). Median baseline OAB-q SF and ICIQ-SF scores were 18 (15–25) and 9 (6–13), respectively. After treatment, 85.7% patients had a clinical benefit, with a significant reduction of OAB symptoms, also according to USS (p < 0.01). The median OAB-q SF and ICIQ-SF scores were 10 (7–15) and 6 (0–8) (p < 0.01). CAM was successful with an improvement in subjective patient's satisfaction, with a median PGI-I score of 2 (1–3). Patients (men and women) who still had UUI after 3 months CAM medication were eight (22.8%), and among them, those who did not refer any therapeutic benefit were five (14.3%) Conclusions: According to our study, CAM may be useful medication for a first line treatment of uncomplicated idiopathic OAB cases, providing a nonnegligible effects on symptoms. However, further studies are mandatory to draw definitive conclusions [ABSTRACT FROM AUTHOR]

Aims: To investigate the impact of COVID‐19 pandemic on health‐care provision to patients suffering from pelvic floor dysfunctions in Italy. Methods: A retrospective web‐based interdisciplinary survey was mailed by the Italian Society of Urodynamics to members involved in pelvic floor dysfunctions management from June 22, 2020 to July 17, 2020. The 84‐item questionnaire investigated the period March–June 2020 (first epidemic wave) and showed high content validity. The primary outcome was the mean rate of cancellation for health‐care services. Secondary outcomes included estimation of the accumulated surgeries backload until return to baseline activity and of the recovery pattern, using linear regression and scenario‐based forecasting. Results: A total of 85 participants provided complete responses. Respondents were mostly urologists (47%), followed by gynecologists (29.5%) and physiatrists (17.6%). On average, 78.4% of outpatient services and 82.7% of functional surgeries were canceled, without significant differences by geographical distribution. An impact on patients' quality of life was anticipated by most of the respondents (87%) and 48.2% also reported potentially serious health risks for patients. Thirty‐three percent of the respondents reported the use of telemedicine. If the nation‐wide surgical activity increases by 20% postpandemic, it would take 37 months to clear the backlog of functional surgeries. We acknowledge the inherent limitations of the survey methodology and retrospective design. Conclusions: Access to care for patients suffering from pelvic floor dysfunctions has been dramatically affected by the COVID‐19 outbreak. The indirect effects of this unprecedented disruption on pelvic floor dysfunctions care may last for several months. [ABSTRACT FROM AUTHOR]

Aim: to analyze the prevalence of nocturia and its possible neuro-urological correlations in patients with a history of acquired brain injury (ABI). Methods: a single-centre population-based prospective study involving outpatients who were previously admitted to our Rehabilitation Hospital for acute ABI ≥ 18 months and ≤2 years prior. Impact of nocturia on QoL was evaluated by the standardized International Consultation on Incotinence Nocturia Quality of Life (ICIQ N-QoL). All participants were given a three-day frequency chart. Probability value <0.05 was statistically significant. Results: 48/138 subjects (35%) showed nocturia at 2-year follow-up visit. No, significant differences in age, gender, duration of coma, state of consciousness, disability, cognitive impairment and stroke severity were found in patients with or without nocturia. Subarachnoid haemorrhage (ESA) was the main reason for ABI in subjects showing nocturia (p =.037). The overall ICIQ N-QOL score ranged from 12 to 50 (mean 30.12 ± 8.87). Of them, 75% showed a total score >26. Increased diurnal frequency and small bladder capacity was statistically significantly associated with nocturia (p <.05). Conclusions: the rate of nocturia 2 years following ABI was lower compared to other neurological populations, although it was significantly associated with other storage urinary symptoms. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate outcomes and quality of life in patients operated transvaginally with an original mesh shape for uterus-sparing prolapse surgery and to demonstrate the safety and efficacy of the technique.Study Design: We prospectively evaluated 66 postmenopausal patients (POP-Q Stage III: 32, IV: 34) operated between May 2008 and December 2013. We used wide weave polypropylene monofilament mesh that functions as a hammock anchored posteriorly to sacrospinous ligaments, its anterior wings exit the pelvis through the obturatory membrane. Follow-up was scheduled at 3-, 12- months and in May 2016. Prolapse-Quality of Life Questionnaire (P-QoL) was administered preoperatively, at 12 months and in May 2016. The chi square and Wilcoxon test were used for statistical analysis.Results: Mean follow-up was 5.6 (SD: 1.6, Range: 1.1-8.1) years. The overall success rate (POP-Q ≤ 2) was 92.5% at 12 months and 84.4% at May 2016, these data remained stable over time (p > 0.05). Early complications occurred in 2 (3%) patients, late in 5 (7.8%) of which mesh extrusion in 4 (6.3%). Data from P-QoL showed significant improvement between preoperative and postoperative data (P < 0.01 for all domains) and they remained stable with time (p > 0.05). De-novo dyspareunia was 17.6% at 12 months and 10.3% at May 2016.Conclusions: The low rate and grade of complications demonstrates the safety of the procedure, which offers stable anatomical correction with significant improvement in QoL. [ABSTRACT FROM AUTHOR]

Introduction Although several new measurements for female sexual dysfunction ( FSD) have recently been developed, the Female Sexual Function Index ( FSFI) remains the gold standard for screening and one of the most widely used questionnaires. The Italian translation of the FSFI has been used in several studies conducted in Italy, but a linguistic validation of the Italian version does not exist. Aim The aim of this study was to perform a linguistic validation of the Italian version of the FSFI. Methods A multicenter cross-sectional study conducted in 14 urological and gynecological clinics, uniformly distributed over Italian territory. We performed all steps necessary to determine the reliability and the test-retest reliability of the Italian version of the FSFI. The study population was a convenience sample of 409 Italian women. Main Outcome Measures The reliability of the questionnaire was calculated using Cronbach's alpha, which was considered weak, moderate, or high if its value was found less than 0.6, between 0.6 and 0.8, or equal to or greater than 0.8, respectively. The test-retest reliability was assessed for all women in the sample by calculating Pearson's concordance correlation coefficient for each domain and for the total score, both at baseline and after 15 days (r range between −1.00 to +1.00, where +1.00 indicates the strongest positive association). Results Cronbach's alpha coefficents for total and domain score were sufficiently high, ranging from 0.92 to 0.97 for the total sample. The test-retest procedure revealed that the concordance correlation coefficient was very high both for FSFI- I total score ( Pearson's P = 0.93) and for each domain ( Pearson's P always >0.92). Conclusion For the first time in the literature, our study has produced a validated and reliable Italian version of the FSFI questionnaire. Consequently, the Italian FSFI can be used as a reliable tool for preliminary screening for female sexual dysfunction for Italian women. Filocamo MT, Serati M, Li Marzi V, Costantini E, Milanesi M, Pietropaolo A, Polledro P, Gentile B, Maruccia S, Fornia S, Lauri I, Alei R, Arcangeli P, Sighinolfi MC, Manassero F, Andretta E, Palazzetti A, Bertelli E, Del Popolo G, and Villari D. The Female Sexual Function Index (FSFI): Linguistic validation of the Italian version. J Sex Med 2014;11:447-453. [ABSTRACT FROM AUTHOR]

Introduction: Although antibiotic prophylaxis (AB) demonstrated a statistically significant reduction in bacteriuria after invasive urodynamics (UDS), no significant decrease in the incidence of urinary tract infections (UTI) has been confirmed. No absolute recommendations on the use of AB in case of relevant potential risk of UTI have been reported, though some categories of patients at increased infective probability after UDS have been recognized. The aim of this study is to report the experts' consensus on the best practice for the use of AB before UDS in the main categories of patients at potential risk of developing UTI., Materials and Methods: A systematic literature review was performed on AB before UDS in males and females. A panel of experts from the Italian Society of Urodynamics, Continence, Neuro-Urology, and Pelvic Floor (SIUD) assessed the review data and decided by a modified Delphi method on 16 statements proposed and discussed by the panel. The cut-off percentage for the consensus was a ≥70% of positive responses to the survey. The study was a Delphi consensus with experts' opinions, not a clinical trial involving directly patients., Results: The panel group was composed of 57 experts in functional urology and UDS, mainly urologists, likewise gynaecologists, physiatrists, infectivologists, pediatric urologists, and nurses. A positive consensus was achieved on 9/16 (56.25%) of the statements, especially on the need for performing AB before UD in patients with neurogenic bladder and immunosuppression. Urine analysis and urine culture before UDS are mandatory, and in the event of their positivity, UDS should be postponed. A consensus was reached on avoiding AB in menopausal status, diabetes, age, gender, bladder outlet obstruction, high postvoid residual, chronic catheterization, previous urological surgery, lack of urological abnormalities, pelvic organ prolapse, and negative urine analysis., Conclusions: Antibiotic prophylaxis is not recommended for patients without notable risk factors and with a negative urine test due to the potential morbidities that may result from antibiotic administration. However, AB can be used for risk categories such as neurogenic bladder and immunosuppression. The evaluation of urine analysis and urine culture and postponing UDS in cases of positive tests were considered good practices, as well as performing AB in the neurogenic bladder and immunosuppression., (© 2024 Wiley Periodicals LLC.)

Purpose: Aim of the study was to evaluate the prevalence of LUTS in taxi drivers., Methods: Between February 24th 2021 and March 26th 2021 a web based survey was administered to Taxi drivers in the city of Florence. Taxi drivers were evaluated with baseline characteristics such as: age, BMI, smoking, career length, comorbidities, and treatment. LUTS were evaluated using the international prostate symptom score (IPSS) and the overactive bladder (OAB) score. As well sexual function was evaluated using the international index erectile function (IIEF) and female sexual function index (FSFI) questionnaires. Risk factors for LUTS were evaluated using regression analysis., Results: The overall response rate was 64.6% (537/830 taxi drivers filled the questionnaires). Among them, 449 (83.6%) were men and 88 (16.4%) females. Overall, median IPSS was 5 (2/9) and median OAB score was 10 (7/14). On multivariate binary regression analysis age > 50 (OR:1.60; p < 0,05), Smoking (OR:1.57; p < 0,05), chronic treatment (OR:1.57; p < 0,05), recurrent cystitis (OR: 2.66; p < 0,05) and chronic pelvic pain (OR:4.94; p < 0,05) were independent risk factors for moderate/severe LUTS. On multivariate binary logistic regression analysis, risk factors for erectile dysfunction were age older than 50 years (OR = 3.64; p < 0.05) and urinary incontinence (OR = 5.53; p = 0.005)., Conclusions: According to our web-based survey, Taxi drivers in the metropolitan city of Florence had non-negligible symptomatic LUTS and even sexual dysfunction. Our data suggest as LUTS are particular influenced by several life-style and behavioural factors as type and duration of work., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Introduction: Pelvic floor disorders (PFDs), which include urinary incontinence, pelvic organ prolapse, sexual dysfunction and gastrointestinal disorders, affect over 20% of the adult population. Prevalence may also be underestimated, since a certain portion of patients may be reluctant to talk to physicians about PFDs due to embarrassment. Consequently, there is a need for self-assessed diagnostic tools with the capability to screen population and collect clinical information. Symptom and quality of life (QoL) questionnaires - also identified as patient-reported outcomes (PROs) - have been developed with this purpose. Despite the large number of questionnaires available for the assessment of PFDs and QoL-related issues in the English language, few of them have been validated for the Italian language. The objective of this article is to update the list of Italian-validated PROs for PFDs along with practical information concerning literature references and suggestions on how to obtain every single questionnaire., Evidence Acquisition: PubMed/MEDLINE databases and websites were used to update the list of available Italian-validated questionnaires about PFDs. Once identified, the possibility to get a copy of the questionnaire was verified and steps to obtain it are reported in the tables., Evidence Synthesis: Eight additional questionnaires validated into the Italian language, for diagnosis and overall management of common urinary, vaginal, sexual and bowel conditions, were retrieved. The complete list of PFDs PROS is reported in a modular format for consultation., Conclusions: This format is intended to serve as a tool to promote appropriateness in PROs adoption while investigating PFDs in Italian patients.

Background: Donation after circulatory death (DCD) is an emerging way to implement organ procurement for transplantation. In Italy, until June 2016, the only formal DCD program was implemented in Pavia, the so-called "Alba program.", Methods: We describe our one-year experience of the DCD program implemented at the Careggi Teaching Hospital (Florence, Italy) since June 2016. We specifically describe organizational changes induced by the DCD program on our pre-existing Donation After Brain Death (DBD) program and DCD activity., Results: Eighteen activations were recorded (i.e. 18 DCD donors), among whom Seven donors were discarded due to opposition in five patients and failure to meet activation criteria in two (inability to contact relatives). Our population comprises 11 donors among whom eight patients were Maastricht type II donors while three were Maastricht type III donors. 22 kidneys and six livers were retrieved, while 13 kidneys and two liver were transplanted., Conclusions: A DCD program was feasible and increased procurement of splancnic organs (kidney and liver). Starting a DCD program in a traditionally oriented to DBD poses some organizational and cultural problems. A skilled, experienced ECMO team is necessary to guarantee organ ex vivo perfusion. Another important aspect for the implementation of a DCD program is the collaboration with the emergency system which allows a therapeutic approach of patients with cardiac arrest.