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1. Is There a Relevant Clinical Impact in Differentiating Idiopathic versus Unexplained Male Infertility?

Author

Christian Corsini, Luca Boeri, Luigi Candela, Edoardo Pozzi, Federico Belladelli, Paolo Capogrosso, Giuseppe Fallara, Nicolò Schifano, Daniele Cignoli, Eugenio Ventimiglia, Alessia D’Arma, Massimo Alfano, Francesco Montorsi, and Andrea Salonia

Subjects
andrology, infertility, infertility etiology, testis abnormalities, vitamin d, Medicine, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Purpose: Overall, male factor infertility (MFI) accounts for up to 50% of etiologies of couple’s infertility, with almost 30% of MFI cases being idiopathic in nature. Idiopathic MFI does not support a tailored treatment work-up in clinical practice. To investigate rates of and characteristics of men presenting for idiopathic versus unexplained primary infertility as compared with same-ethnicity, age-comparable fertile men. Materials and Methods: Demographic, clinical and laboratory data from 3,098 primary infertile men consecutively evaluated were analyzed and compared with those of 103 fertile controls. Idiopathic male infertility (IMI) was defined for abnormality at semen analysis with no previous history of diseases affecting fertility and normal findings on physical examination and genetic and laboratory testing. Unexplained male infertility (UMI) was defined as infertility of unknown origin with completely normal findings at semen analysis. Descriptive statistics and logistic regression models tested the association between clinical variables and idiopathic infertility status. Results: Overall, 570 (18.5%) and 154 (5.0%) patients depicted criteria suggestive for either IMI or UMI, respectively. Groups were similar in terms of age, BMI, CCI, recreational habits, hormonal milieu, and sperm DNA fragmentation indexes. Conversely, testicular volume was lower in IMI (p

Published
2023
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2. Does Air Pollution Impact on Semen Parameters? Findings from a Real-Life, Cross-Sectional Study in Italian Infertile Men

Author

Federico Belladelli, Christian Corsini, Edoardo Pozzi, Massimiliano Raffo, Giuseppe Fallara, Antonio Costa, Daniele Cignoli, Luca Boeri, Eugenio Ventimiglia, Paolo Capogrosso, Michael L. Eisenberg, Francesco Montorsi, and Andrea Salonia

Subjects
air pollution, infertility, risk factors, semen analysis, Medicine, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Purpose: In industrialized countries, air pollutants levels have been monitored closely for environmental and research issues. Using Italian data, we aimed to investigate the association between air pollutants levels and semen parameters in a cohort of non-Finnish white-European men presenting for couple’s infertility. Materials and Methods: Complete demographic and laboratory data from 1,152 infertile men consecutively assessed between January 2015 and January 2018 were analyzed. Semen analyses were based on the 2010 World Health Organization reference criteria. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). We analyzed the annual average level of the three main markers of air pollution (Pm10, Pm2.5, and NO2) between 2014 and 2018. Descriptive statistics, linear and logistic regression analyses tested the association between air pollutants levels and semen parameters. Results: Of 1,152 men, 87 (7.55%) had normal sperm parameters at first semen analysis. Of 1,065 patients with abnormal semen analyses, 237 (22.25%), 324 (30.42%), and 287 (26.95%) patients presented 1, 2 or 3 abnormalities, respectively, and 217 (20.38%) were azoospermic. At linear regression analysis, Pm10, Pm2.5, and NO2 were negatively associated with sperm morphology (Pm10: β=-0.5288 µg/m3, p=0.001; Pm2.5: β=-0.5240 µg/m3, p=0.019; NO2: β=-0.4396 µg/m3, p

Published
2023
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3. Infertile men with semen parameters above WHO reference limits at first assessment may deserve a second semen analysis: Challenging the guidelines in the real-life scenario.

Author

Luca Boeri, Edoardo Pozzi, Paolo Capogrosso, Giuseppe Fallara, Federico Belladelli, Luigi Candela, Nicolò Schifano, Christian Corsini, Walter Cazzaniga, Daniele Cignoli, Eugenio Ventimiglia, Marina Pontillo, Massimo Alfano, Francesco Montorsi, and Andrea Salonia

Subjects
Medicine, Science
Abstract

ObjectivesTo investigate which infertile men with semen parameters above WHO reference limits at first semen analysis deserve a second semen test.Materials and methodsData from 1358 consecutive infertile men were analysed. Patients underwent two consecutive semen analyses at the same laboratory. Descriptive statistics and logistic regression models tested the association between clinical variables and semen parameters. A new predicting model was identified through logistic regression analysis exploring potential predictors of semen parameters below WHO reference limits after a previously normal one. Diagnostic accuracy of the new model was compared with AUA/ASRM and EAU guidelines. Decision curve analyses (DCA) tested their clinical benefit.ResultsOf 1358, 212 (15.6%) infertile men had semen parameters above WHO reference limits at first analysis. Of 212, 87 (41.0%) had a second semen analysis with results above WHO reference limits. Men with sperm parameters below reference limits at second analysis had higher FSH values, but lower testicular volume (TV) (all pConclusionsApproximately 60% of infertile men with a first semen analysis above WHO limits have a second analysis with results below limits. The newly identified risk model might be useful to select infertile men with initial semen results above WHO limits who deserve a second semen analysis.

Published
2023
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4. Isolated ureteral malakoplakia: A conservative endoscopic approach with a strict follow-up

Author

Daniele Cignoli, Michele Manica, Federico Pellucchi, Lisa Licini, Luigi F. Da Pozzo, and Marco Roscigno

Subjects
Malakoplakia, Ureter, Uretero-renoscopy, Biopsy, Follow-up, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Ureteral malakoplakia is a rare pathological entity. We report the case of a 54-years-old woman with a single ureteral malakoplakic lesion. Patient presented with history of recurrent urinary tract infections and asymptomatic dilatation of right pelvis. Radiological investigations showed a right lower ureteric filling defect without bladder or kidney involvement. A first uretero-renoscopy allowed an extirpative biopsy, with a histopathologic diagnosis of malakoplakia. Second-look uretero-renoscopy showed only a minute area of hyperemic mucosa that was biopsied and coagulated, showing a residual focus of malakoplakia. At 12-months, imaging and blood test demonstrated reduction of hydronephrosis, serum creatinine recovery and no recurrences.

Published
2022
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5. Triglycerides/Glucose Index Is Associated with Sperm Parameters and Sperm DNA Fragmentation in Primary Infertile Men: A Cross-Sectional Study

Author

Federico Belladelli, Luca Boeri, Edoardo Pozzi, Giuseppe Fallara, Christian Corsini, Luigi Candela, Walter Cazzaniga, Daniele Cignoli, Luca Pagliardini, Alessia D’Arma, Paolo Capogrosso, Eugenio Ventimiglia, Francesco Montorsi, and Andrea Salonia

Subjects
infertility, semen parameters, insulin resistance, triglycerides/glucose index, risk factors, Microbiology, QR1-502
Abstract

Study question: we aimed to investigate the relationship between the tyg index and both semen and hormonal characteristics in a cohort of primary infertile men. Summary answer: almost one in two primary infertile men presented with a triglycerides/glucose index (tyg) suggestive of insulin resistance (ir). overall, patients with tyg suggestive of ir showed worse clinical, hormonal, and semen parameters. What is already known: male factor infertility (MFI) is often associated with metabolic disorders such as diabetes mellitus and metabolic syndrome, where insulin resistance (IR) plays a relevant pathological role. Recently, TyG has been suggested as a user-friendly IR marker. Study Design: serum hormones and the sperm DNA fragmentation index (SDF) were measured in every patient. The semen analysis was based on 2010 WHO reference criteria. Glucose and insulin levels were measured for every man after a 12-h overnight fast, and the homeostatic model assessment index (HOMA-IR) was then calculated and categorized using a 2.6 threshold. Similarly, fasting glucose and triglycerides levels were measured and the TyG index was calculated and categorized using an 8.1 threshold. Descriptive statistics and logistic regression models tested the association between the TyG and semen and hormonal characteristics. Participants: complete demographic, clinical, and laboratory data from 726 consecutive white European primary infertile men were considered for this analysis. Main results and the role of chance: the median (IQR) age was 39 (35–43) years. A TyG and HOMA suggestive for IR was found in 339 (46.6%) and 154 (21.2%) men, respectively. During the Spearman’s test, the TyG index was highly correlated with HOMA-IR (rho = 0.46, p < 0.001). Compared to men with a normal TyG, men with TyG > 8.1 were older, had greater BMI and CCI scores, and lower total testosterone and sperm concentration, but higher DFI, and presented a greater proportion of NOA (all p < 0.01). The multivariable logistic regression analysis showed that men with TyG > 8.1 were at higher risk of SDF > 30 (OR 1.92 (CI: 1.2–2.9)) and NOA (OR 1.78 (CI: 1.1–2.8)). Wider implications of the findings: the Tyng index may act as a reliable marker of IR in the clinical work-up of primary infertile men in real-life settings.

Published
2022
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6. Influences of Age and Comorbidities on Indication for Partial Nephrectomy: A Systematic Review

Author

Daniele Cignoli, Giuseppe Fallara, Chiara Re, Francesco Cei, Giacomo Musso, Giuseppe Basile, Giuseppe Rosiello, Andrea Salonia, Alessandro Larcher, Francesco Montorsi, and Umberto Capitanio

Subjects
Oncology, Nephrology
Abstract

BACKGROUND: The influence of age and comorbidities during decision-making for patients with renal cell carcinoma remains controversial. OBJECTIVE: To comprehensively review the available evidence regarding the impacts of age and comorbidities on the decision to perform partial nephrectomy (PN). EVIDENCE ACQUISITION: A systematic review was conducted in accordance with PRISMA and registered with PROSPERO (CRD42022344759). Only randomized control trials, prospective cohort studies, registry-based studies, or single/multi-institutional retrospective cohort studies comparing PN to other therapeutic options for cT1N0M0 renal masses were considered. The primary outcome was to assess differences in patients’ baseline characteristics between different treatments in order to investigate how those aspects have influenced clinical decision-making. Finally, perioperative outcomes were compared across the different options. EVIDENCE SYNTHESIS: Overall, patients who underwent PN were 3 to 11 years younger than those who underwent other treatments. Baseline renal function was slightly better in patients who underwent PN than in those who underwent radical nephrectomy (RN), active surveillance (AS), or tumor ablation. Patients undergoing PN had an average pre-treatment eGFR 4 to 6 points (mL/min/1.73 m2) higher than patients undergoing RN or tumor ablation. Likewise, the proportion of baseline chronic kidney disease (CKD) before treatment was higher in patients undergoing other treatments, with a rate of CKD between 6% and 56% higher compared with that for PN. A slightly higher proportion of baseline diabetes mellitus (DM) and cardiovascular comorbidities (CVD) were found in patients who underwent PN than in those who underwent RN (20% vs. 21% for DM and 37% vs. 41% for CVD). On average, patients who underwent AS and tumor ablation had more comorbidities, in terms of Charlson comorbidity index (CCI), DM, and CVD (50% vs. 38% for CCI ≥2; 25% vs. 20% for DM; and 43% vs. 37% for CVD). In terms of Eastern Cooperative Oncology Group (ECOG) Performance Status and American Society of Anesthesiologists (ASA) classification, no major differences were found between PN and other treatments, but a trend emerged whereby more fit patients underwent PN compared with RN (16% of ECOG >1 for PN vs. 18% for RN and 15% of ASA grade ≥3 for PN vs. 26% for RN). Again, tumor ablation was preferred for less fit patients (31% of ASA grade ≥3). No study included in our systematic review reported the baseline frailty status of patients treated for cT1 renal masses. The rates of perioperative complications and length of hospital stay (LOS) were similar between different techniques. CONCLUSIONS: Patients who underwent PN tended to be younger and fitter than those who underwent other available treatments for cT1 renal masses. Since this technique aims at reducing renal function impairment after surgery, a greater effort should be made to optimize patient selection to include more comorbid patients for whom PN might be useful.

Published
2023

7. High serum alpha‐fetoprotein levels in primary infertile men

Author

Christian Corsini, Giuseppe Fallara, Luigi Candela, Massimiliano Raffo, Edoardo Pozzi, Federico Belladelli, Paolo Capogrosso, Luca Boeri, Antonio Costa, Nicolò Schifano, Daniele Cignoli, Eugenio Ventimiglia, Alessia D'Arma, Francesco Montorsi, Andrea Salonia, Corsini, Christian, Fallara, Giuseppe, Candela, Luigi, Raffo, Massimiliano, Pozzi, Edoardo, Belladelli, Federico, Capogrosso, Paolo, Boeri, Luca, Costa, Antonio, Schifano, Nicolò, Cignoli, Daniele, Ventimiglia, Eugenio, D'Arma, Alessia, Montorsi, Francesco, and Salonia, Andrea

Subjects
alpha-fetoprotein, Endocrinology, Reproductive Medicine, Urology, Endocrinology, Diabetes and Metabolism, AFP, biomarker, infertility, Settore MED/24 - Urologia
Abstract

Alfa-fetoprotein (AFP) is a serum glycoprotein highly produced during fetal development. While AFP synthesis drops dramatically after birth, AFP production only persists or returns under specific pathological condition.We sought to investigate the rate of and the potential meaning of high AFP serum levels in men seeking first medical attention for couple's primary infertility.Socio-demographic and clinical data from 1803 non-Finnish, White-European primary infertile men were retrospectively analysed. AFP was routinely measured in each patient (high AFP was defined as 7 ng/ml). Men with history of liver diseases, testicular cancer, or other known causes of increased AFP levels were excluded from the final analysis. Semen analyses were based on the 2010 World Health Organization reference criteria. Descriptive statistics and logistic regression models tested the association between serum AFP and clinical variables. Possible nonlinear relationships were graphically explored with locally estimated scatterplot smoothing method.Overall, high serum AFP level was found in 29 (1.7%) patients. Normal versus high AFP levels patients were comparable in terms of body mass index (BMI), Charlson Comorbidity Index, waist circumference, smoking habits, history of cryptorchidism, testicular volume, and serum hormones (i.e., follicle-stimulating hormone, luteinizing hormone, and total testosterone). Conversely, men with higher AFP levels were older (p = 0.02), had lower sperm concentration (p = 0.003), and were more frequently oligozoospermic and azoospermic (all p ≤ 0.03). At multivariate analysis, high AFP levels were independently associated with oligozoospermia (OR 3.79; p = 0.033) and azoospermia (OR 3.29; p = 0.006). Likewise, if AFP levels increase, patients were found to be older, with higher BMI and to have more comorbidities (all p 0.05).Unexplained high AFP levels account for almost 2% of cases in primary infertile patients without a previous history of associated disorders. Higher serum AFP levels are linked with aberrant sperm counts, older age, obesity, and a greater amount of comorbid conditions.Despite the need for additional validation, these data suggest that serum AFP measurement might have a multifaceted role over the diagnostic work-up of males presenting for couple's infertility.

Published
2022

8. Pancreatic metastases after surgery for renal cell carcinoma: survival and pathways of progression

Author

Daniele Cignoli, Giuseppe Fallara, Francesca Aleotti, Alessandro Larcher, Giuseppe Rosiello, Isaline Rowe, Giuseppe Basile, Gianmarco Colandrea, Alberto Martini, Francesco De Cobelli, Giorgio Brembilla, Roberta Lucianò, Maurizio Colecchia, Marco Schiavo Lena, Stefano Partelli, Domenico Tamburrino, Giuseppe Zamboni, Corrado Rubini, Massimo Falconi, Francesco Montorsi, Andrea Salonia, Umberto Capitanio, Cignoli, Daniele, Fallara, Giuseppe, Aleotti, Francesca, Larcher, Alessandro, Rosiello, Giuseppe, Rowe, Isaline, Basile, Giuseppe, Colandrea, Gianmarco, Martini, Alberto, De Cobelli, Francesco, Brembilla, Giorgio, Lucianò, Roberta, Colecchia, Maurizio, Lena, Marco Schiavo, Partelli, Stefano, Tamburrino, Domenico, Zamboni, Giuseppe, Rubini, Corrado, Falconi, Massimo, Montorsi, Francesco, Salonia, Andrea, and Capitanio, Umberto

Subjects
Pancreatic Neoplasms, Lung metastasis, Overall survival, Pancreatic metastasis, Renal cell carcinoma, Urology, Humans, Prognosis, Carcinoma, Renal Cell, Kidney Neoplasms, Retrospective Studies
Abstract

Purpose Metastatic ccRCC has peculiar tropism in the pancreas. We describe the characteristics and pathways of progression of patients with PM in a large multi-institutional consortium and compare them to patients with metastases from ccRCC at other sites. Methods Detailed clinical and histopathological data were collected. To account for differences in baseline characteristics between the two groups, IPTW was used to compare the two groups in terms of PFS and OS. Results Of the 182 patients, 33 (18%) had pancreatic, 94 (52%) pulmonary, 30 (16%) bone, 13 (7%) hepatic, and 12 (7%) brain metastases. Patients with PM had less aggressive ccRCC at baseline compared to those with progression at other sites in terms of tumour stage and grade. Median time from ccRCC surgery to PM was 8 (95%CI 5-10) vs. 1 year (95%CI 1-2) for progression to other sites (p < 0.001). Median IPTW-weighted time to second progression was 4.3 years (95%CI 2.4-not reached) for patients with PM vs 1.1 year (95%CI 0.8-2.3) for those with progression in other sites (p < 0.001). The most frequent second progression sites were pancreas (24%) and liver (15%) in patients with PM, while progression to the pancreas was rare (4%) in those with a different first progression site. Surgery alone (55%) or in combination with medical therapy (30%) was more frequent in the PM group than in other sites (p < 0.001). Median IPTW-OS time was longer for patients with PM [8.8 years (95%CI 6.5-not reached)] compared to those with first progression in other sites [2.8 years (95%CI 1.9-4.3), p < 0.001]. Conclusion Pancreatic tropism is typical of ccRCC tumours with more indolent behaviour than those progressing to other sites. A long follow-up period is necessary to distinguish PM from ccRCC.

Published
2022

10. MP58-14 FRAILTY INDEX IN PREDICTING SURGICAL OUTCOMES AFTER PARTIAL NEPHRECTOMY IN PATIENTS WITH RENAL CELL CARCINOMA

Author

Giuseppe Rosiello, Chiara Re, Francesco Cei, Giuseppe Basile, Giacomo Musso, Giuseppe Fallara, Federico Belladelli, Daniele Cignoli, Daniela Canibus, Silvia Patricia Soares Pinto, Andrea Necchi, Laura Marandino, Pierre I. Karakiewicz, Isaline Rowe, Giulia Villa, Mattia Boarin, Natasha Disabato, Francesco Trevisani, Arianna Bettiga, Alberto Briganti, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2023

11. MP64-08 99m TC- SESTAMIBI SPECT/CT FOR THE CHARACTERIZATION OF SMALL RENAL MASSES: INITIAL EXPERIENCE FROM a TERTIARY REFERRAL CENTER

Author

Alessandro Bertini, Francesco Cei, Chiara Re, Giacomo Musso, Giuseppe Rosiello, Giuseppe Fallara, Giuseppe Basile, Daniele Cignoli, Daniela Canibus, Gino Pepe, Luigi Gianolli, Francesco DE Cobelli, Giorgio Brembilla, Roberta Lucianò, Nazario Tenace, Rayan Matloob, Roberto Bertini, Alberto Briganti, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2023

12. PD43-10 TEMPORAL TRENDS AND UTILIZATION RATES OF LYMPH NODE DISSECTION IN PATIENTS WITH RENAL CELL CARCINOMA: IMPLICATIONS FOR ADJUVANT THERAPIES

Author

Giacomo Musso, Giuseppe Rosiello, Giuseppe Fallara, Chiara Re, Francesco Cei, Giuseppe Basile, Daniele Cignoli, Daniela Canibus, Francesco De Cobelli, Giorgio Brembilla, Roberta Lucianò, Nazario Tenace, Rayan Matloob, Roberto Bertini, Alberto Briganti, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2023

13. Holmium Laser Enucleation of the Prostate Is Associated with Complications and Sequelae Even in the Hands of an Experienced Surgeon Following Completion of the Learning Curve

Author

Paolo Capogrosso, Eugenio Ventimiglia, Giuseppe Fallara, Nicolò Schifano, Antonio Costa, Luigi Candela, Francesco Pellegrino, Gianmarco Colandrea, Daniele Cignoli, Mario De Angelis, Federico Belladelli, Mattia Longoni, Giulio Avesani, Francesco Lanzaro, Vincenzo Scattoni, Federico Dehò, Andrea Salonia, Alberto Briganti, and Francesco Montorsi

Subjects
Urology
Published
2023

14. MP58-15 LAWTON INSTRUMENTAL ACTIVITIES OF DAILY LIVING SCALE IDENTIFIES PATIENTS AT HIGH-RISK OF ADVERSE OUTCOMES AFTER KIDNEY SURGERY FOR RENAL CANCER: A PROSPECTIVE CLINICAL STUDY

Author

Giuseppe Rosiello, Gianfranco Baiamonte, Giuseppe Basile, Giuseppe Fallara, Chiara Re, Giacomo Musso, Francesco Cei, Daniele Cignoli, Giulio Avesani, Natasha Disabato, Giulia Villa, Mattia Boarin, Daniela Canibus, Pierre I. Karakiewicz, Federico Dehò, Nazareno Suardi, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2023

15. MP58-19 DETECTION OF PULMONARY LESION DURING FOLLOW-UP AFTER SURGERY FOR LOCALIZED RENAL CELL CARCINOMA: DISEASE PROGRESSION OR A PRIMARY LUNG CANCER?

Author

Daniele Cignoli, Alessandro Bandiera, Giuseppe Fallara, Giuseppe Rosiello, Giuseppe Basile, Gianmarco Colandrea, Gianfranco Baiamonte, Francesco Cei, Giacomo Musso, Francesco De Cobelli, Giorgio Brembilla, Daniela Canibus, Roberto Bertini, Francesco Montorsi, Laura Marandino, Daniele Raggi, Andrea Salonia, Alberto Briganti, Giampiero Negri, Vanesa Gregorc, Andrea Necchi, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2023

16. MP58-12 VENOUS TUMOUR THROMBUS IN RENAL CELL CARCINOMA: LOCALLY ADVANCED OR METASTATIC DISEASE?

Author

Giacomo Musso, Giuseppe Basile, Alessandro Nini, Giuseppe Rosiello, Giuseppe Fallara, Chiara Re, Francesco Cei, Federico Belladelli, Daniele Cignoli, Roberta Lucianò, Nazario Tenace, Isaline Rowe, Silvia Patricia Soares Pinto, Daniela Canibus, Andrea Necchi, Laura Marandino, Daniele Raggi, Roberto Bertini, Rayan Matloob, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2023

17. MP58-08 CONCORDANCE OF RENAL SINUS OR CALYCES INVASION BETWEEN PREOPERATIVE IMAGING AND FINAL PATHOLOGY AFTER SURGERY FOR KIDNEY CANCER

Author

Francesco Cei, Nazario Tenace, Giuseppe Basile, Giacomo Musso, Chiara Re, Giuseppe Fallara, Giuseppe Rosiello, Federico Belladelli, Daniele Cignoli, Daniela Canibus, Isaline Rowe, Francesco De Cobelli, Giorgio Brembilla, Renato Pennella, Angelo Della Corte, Giorgia Guazzarotti, Roberto Bertini, Alberto Briganti, Maurizio Colecchia, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, Roberta Lucianò, and Umberto Capitanio

Subjects
Urology
Published
2023

18. MP58-13 FUNCTIONAL OUTCOMES AFTER SURGERY IN PATIENTS WITH RENAL CANCER AND TUMOR THROMBUS

Author

Giuseppe Rosiello, Francesco Cei, Nazario Tenace, Giuseppe Basile, Giacomo Musso, Chiara Re, Giuseppe Fallara, Rayan Matloob, Federico Belladelli, Daniele Cignoli, Daniela Canibus, Isaline Rowe, Francesco De Cobelli, Giorgio Brembilla, Roberta Lucianò, Roberto Bertini, Alberto Briganti, Renzo Colombo, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2023

20. Haemospermia in the Real- Life Setting: A New High-Risk Stratification

Author

Edoardo Pozzi, Eugenio Ventimiglia, Giuseppe Fallara, Paolo Capogrosso, Federico Belladelli, Luigi Candela, Massimiliano Raffo, Antonio Costa, Daniele Cignoli, Christian Corsini, Walter Cazzaniga, Luca Boeri, Rayan Matloob, Umberto Capitanio, Francesco Montorsi, and Andrea Salonia

Subjects
Urology, Settore MED/24 - Urologia
Abstract

To (i) identify a novel risk stratification for patients complaining of haemospermia; and, (ii) compare its predictive ability to select high-risk patients by retrospectively validating the EAU guidelines classification.Data from 283 consecutive patients complaining of a single episode/recurrent haemospermia were retrospectively analyzed. Patients were stratified into low vs high-risk according to EAU guidelines, whose diagnostic performance was then validated. We identified a new risk stratification model based on clinical factors associated with (i) positive semen culture and (ii) prostate cancer (PCa) and bladder cancer (BC). Diagnostic accuracy of the two predictive models (EAU vs New) was assessed and decision curve analyses (DCA) tested their clinical benefit.Overall, 259 (91.5%) were high-risk and 24 (8.5%) low risk according to the EAU guidelines. Recurrent haemospermia was reported by 134 (47.4%) patients. 126 (44.5%) had baseline CCI score ≥ 1. At MVA logistic regression analysis, history of recurrent genito - urinary tract infections was identified as a predictor for positive semen culture (OR: 3.39, 95% CI: 1.77 - 6.57, P =.002). Likewise, baseline CCI ≥ 1 was identified as a predictor for PCa and BC (OR: 1.55, 95% CI: 1.17 - 2.04, P =.009). Sensitivity, specificity, and AUC of the EAU guidelines were 13.3%, 89.2% and 51% respectively, whereas the new model performed substantially better: 98.9%, 58% and 78% respectively.The application of the EAU guidelines risk stratification does not ensure proper identification of high-risk patients complaining of haemospermia. We propose a novel, better performing and easily implementable risk stratification tool.

Published
2023

21. Combined plasma levels of IL-10 and testosterone, but not soluble HLA-G5, predict the risk of death in COVID-19 patients

Author

Giada Amodio, Paolo Capogrosso, Marina Pontillo, Michela Tassara, Luca Boeri, Cristina Carenzi, Daniele Cignoli, Anna Maria Ferrara, Giuseppe A. Ramirez, Cristina Tresoldi, Massimo Locatelli, Luca Santoleri, Antonella Castagna, Alberto Zangrillo, Francesco De Cobelli, Moreno Tresoldi, Giovanni Landoni, Patrizia Rovere‐Querini, Fabio Ciceri, Francesco Montorsi, Andrea Salonia, and Silvia Gregori

Subjects
Endocrinology, Reproductive Medicine, Urology, Endocrinology, Diabetes and Metabolism
Abstract

The identification of biomarkers correlated with coronavirus disease 2019 (COVID-19) outcomes is a relevant need for clinical management. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is characterized by elevated interleukin (IL)-6, IL-10, HLA-G, and impaired testosterone production.We aimed at defining the combined impact of sex hormones, interleukin-10, and HLA-G on COVID-19 pathophysiology and their relationship in male patients.We measured by chemiluminescence immunoassay, electrochemiluminescent assays, and enzyme-linked immunosorbent assay circulating total testosterone, 17β-estradiol (EWe found significantly higher levels of IL-10, HLA-G, and EOur findings indicate that combined evaluation of IL-10 and testosterone predicts the risk of death in men with COVID-19 and support the hypothesis that IL-10 fails to suppress excessive inflammation by promoting viral spreading.

Published
2022

22. Relevance of self-masturbation-related vs. coital erectile function in the real-life management of patients with erectile dysfunction

Author

Dr. Giuseppe Fallara, Dr. Edoardo Pozzi, Dr. Federico Belladelli, Dr. Christian Corsini, Dr. Daniele Cignoli, Dr. Luigi Candela, Dr. Massimiliano Raffo, Dr. Nicolò Schifano, Dr. Luca Boeri, Dr. Paolo Capogrosso, Dr. Alessia d'Arma, Prof. Francesco Montorsi, and Prof. Andrea Salonia

Subjects
Psychiatry and Mental health, Endocrinology, Reproductive Medicine, Urology, Endocrinology, Diabetes and Metabolism
Published
2022

23. Prevalence and predictors of unrecognized low sexual desire in men with new onset erectile dysfunction – findings from a cross-sectional, real-life study

Author

Dr. Luca Boeri, Dr. Paolo Capogrosso, Dr. Giuseppe Fallara, Dr. Luigi Candela, Dr. Nicolo Schifnao, Dr. Antonio Costa, Dr. Edoardo Pozzi, Dr. Federico Belladelli, Dr. Daniele Cignoli, Dr. Christian Corsini, Massimiliano Raffo, Dr. Walter Cazzaniga, Dr. Ryan Matloob, Dr. Eugenio Ventimiglia, Dr. Alessia D'arma, Prof. Francesco Montorsi, and Prof. Andrea Salonia

Subjects
Psychiatry and Mental health, Endocrinology, Reproductive Medicine, Urology, Endocrinology, Diabetes and Metabolism
Published
2022

24. Primary organic versus primary psychogenic erectile dysfunction: Findings from a real-life cross-sectional study

Author

Edoardo Pozzi, Giuseppe Fallara, Paolo Capogrosso, Luca Boeri, Federico Belladelli, Christian Corsini, Antonio Costa, Luigi Candela, Daniele Cignoli, Walter Cazzaniga, Nicolò Schifano, Eugenio Ventimiglia, Alessia d'Arma, Francesco Montorsi, Andrea Salonia, Pozzi, Edoardo, Fallara, Giuseppe, Capogrosso, Paolo, Boeri, Luca, Belladelli, Federico, Corsini, Christian, Costa, Antonio, Candela, Luigi, Cignoli, Daniele, Cazzaniga, Walter, Schifano, Nicolò, Ventimiglia, Eugenio, D'Arma, Alessia, Montorsi, Francesco, and Salonia, Andrea

Subjects
Male, primary psychogenic ED, Urology, Endocrinology, Diabetes and Metabolism, Libido, Penile Erection, Sexual Behavior, primary organic ED, Settore MED/24 - Urologia, Endocrinology, Cross-Sectional Studies, Reproductive Medicine, Erectile Dysfunction, Humans, EAU guidelines, erectile dysfunction
Abstract

Erectile dysfunction aetiology has been historically identified as organic, psychogenic and mixed.To stratify and compare a cohort of patients seeking medical help for erectile dysfunction for the first time according to the newly proposed binary classification of the European Association of Urology guidelines: 'primary organic' versus 'primary psychogenic'.Complete data from 2009 consecutive patients presenting for erectile dysfunction were analysed. All patients completed the International Index of Erectile Function at baseline. According to the presence of erectile dysfunction-related risk factors indexed by the European Association of Urology Guidelines on Sexual and Reproductive Health, patients were categorised as having primary organic (≥1 risk factor) or primary psychogenic (0 risk factor) erectile dysfunction. Descriptive statistics compared the two groups. Linear regression analysis tested the association between the number of risk factors and erectile dysfunction severity. Locally estimated scatterplot smoothing method graphically explored the relationship between the number of risk factors for erectile dysfunction and the International Index of Erectile Function domain scores.Median (interquartile range) age at first presentation was 50 (39-61) years. Of all, 1632 (86.2%) and 377 (13.8%) were identified as having primary organic and primary psychogenic erectile dysfunction, respectively. Overall, 1488 (74.1%) patients were40 years of age; in this subgroup, the most frequent risk factors were age, hypertension (29%), active smoking (42%) and alcohol intake (25.1%). Median (interquartile range) International Index of Erectile Function-erectile function score was 15 (7-22). Primary organic erectile dysfunction patients depicted lower International Index of Erectile Function-sexual desire and International Index of Erectile Function-orgasmic function scores (all p ≤ 0.02), whilst groups did not differ in terms of International Index of Erectile Function-erectile function, International Index of Erectile Function-intercourse satisfaction and International Index of Erectile Function-overall satisfaction scores.One out of nine patients complaining of erectile dysfunction depict criteria for primary psychogenic erectile dysfunction. Erectile function severity could be as severe as patients with organic erectile dysfunction. The single-centre-based cross-sectional nature of the study, raising the possibility of selection biases, is our main limitation.One out of nine patients presenting for erectile dysfunction depict criteria suggestive for primary psychogenic erectile dysfunction in the real-life setting. Patients with primary psychogenic and primary organic erectile dysfunction have comparable erectile dysfunction severity, thus outlining the importance of a comprehensive and tailored management work-up in every patient seeking medical help for the first time.

Published
2022

26. MP12-07 THE ANATOMICAL LOCATION OF LYMPHADENOPATHIES AT IMAGING PREDICTS THE RISK OF LYMPH NODE INVASION AT FINAL PATHOLOGY IN PATIENTS WITH RENAL CELL CARCINOMA

Author

Giuseppe Rosiello, Giuseppe Fallara, Giuseppe Basile, Daniele Cignoli, Francesco De Cobelli, Giorgio Brembilla, Luigi Nocera, Federico Belladelli, Gianmarco Colandrea, Daniela Canibus, Giacomo Musso, Francesco Cei, Chiara Re, Cristina Giancristofaro, Alberto Briganti, Roberto Bertini, Andrea Necchi, Daniele Raggi, Alexandre Mottrie, Pierre I. Karakiewicz, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2022

27. MP50-10 RISKS AND BENEFITS OF PARTIAL NEPHRECTOMY WITH LIMITED OR WITHOUT ISCHEMIA TIME

Author

Alessandro Larcher, Daniele Cignoli, Giuseppe Fallara, Giuseppe Rosiello, Giuseppe Basile, Gianmarco Colandrea, Gianfranco Baiamonte, Francesco Cei, Giacomo Musso, Daniela Canibus, Roberto Bertini, Pierre I. Karakiewicz, Alexandre Mottrie, Federico Dehò, Andrea Gallina, Francesco Montorsi, Andrea Salonia, and Umberto Capitanio

Subjects
Urology
Published
2022

30. PD59-07 NEGLECTED LYMPH NODAL METASTASES IN PATIENTS WITH RENAL CANCER: WHEN TO EXTEND THE ANATOMICAL TEMPLATE OF LYMPH NODE DISSECTION DURING NEPHRECTOMY

Author

Giuseppe Rosiello, Giuseppe Fallara, Giuseppe Basile, Daniele Cignoli, Alberto Martini, Francesco De Cobelli, Giorgio Brembilla, Luigi Nocera, Federico Belladelli, Gianmarco Colandrea, Daniela Canibus, Chiara Re, Giacomo Musso, Francesco Cei, Rayan Matloob, Alberto Briganti, Roberto Bertini, Andrea Necchi, Daniele Raggi, Pierre I. Karakiewicz, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2022

31. PD33-12 PRE-OPERATIVE RISK CALCULATOR OF THE PROBABILITY OF COMPLETING NEPHRON-SPARING SURGERY FOR KIDNEY CANCER BASED ON TUMOUR COMPLEXITY AND SURGICAL APPROACH

Author

Alessandro Larcher, Francesco Cei, Giuseppe Rosiello, Giacomo Musso, Giuseppe Fallara, Chiara Re, Daniele Cignoli, Giuseppe Basile, Gianmarco Colandrea, Gianfranco Baiamonte, Isaline Rowe, Daniela Canibus, Federico Dehò, Andrea Gallina, Alexandre Mottrie, Cristina Giancristofaro, Francesco De Cobelli, Giorgio Brembilla, Alberto Briganti, Roberto Bertini, Francesco Montorsi, Andrea Salonia, and Umberto Capitanio

Subjects
Urology
Published
2022

33. MP50-09 IMAGING INTENSITY AFTER SURGERY FOR CLEAR CELL RENAL CELL CARCINOMA

Author

Alberto Martini, Federico Belladelli, Daniele Cignoli, Giuseppe Rosiello, Giuseppe Fallara, Giuseppe Basile, Luigi Nocera, Gianmarco Colandrea, Daniela Canibus, Chiara Re, Giacomo Musso, Francesco Cei, Francesco De Cobelli, Giorgio Brembilla, Alberto Briganti, Roberto Bertini, Daniele Raggi, Andrea Necchi, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2022

34. PD47-10 THE ATHEROSCLEROTIC CARDIOVASCULAR DISEASE RISK SCORE IS A RELIABLE TOOL TO IDENTIFY PATIENTS WITH ARTERIOGENIC ERECTILE DYSFUNCTION AT DYNAMIC PENILE COLOR DOPPLER DUPLEX ULTRASOUND – FINDINGS FROM A REAL-LIFE CROSS-SECTIONAL STUDY

Author

Edoardo Pozzi, Massimiliano Raffo, Paolo Capogrosso, Giuseppe Fallara, Federico Belladelli, Christian Corsini, Daniele Cignoli, Luigi Candela, Nicolò Schifano, Alessia d'Arma, Luca Boeri, Eugenio Ventimiglia, Rayan Matloob, Vincenzo Mirone, Francesco Montorsi, and Andrea Salonia

Subjects
Urology
Published
2022

35. PD40-10 FORMAL VALIDATION AT FINAL PATHOLOGY AFTER RADICAL NEHRECTOMY OF NEPHROMETRY SCORES: DISCORDANCE RATES AND OVERTREATMENT RISK

Author

Francesco Cei, Giacomo Musso, Giuseppe Rosiello, Giuseppe Fallara, Daniele Cignoli, Giuseppe Basile, Gianmarco Colandrea, Gianfranco Baiamonte, Federico Belladelli, Isaline Rowe, Daniela Canibus, Chiara Re, Roberta Lucianò, Maurizio Colecchia, Francesco De Cobelli, Giorgio Brembilla, Federico Dehò, Vincenzo Mirone, Alberto Briganti, Roberto Bertini, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2022

36. PD20-04 DOES AIR POLLUTION IMPACT ON SEMEN PARAMETERS: FINDINGS FROM A REAL-LIFE CROSS-SECTIONAL STUDY IN WHITE-EUROPEAN INFERTILE MEN

Author

Federico Belladelli, Giuseppe Fallara, Edoardo Pozzi, Massimiliano Raffo, Christian Corsini, Luigi Candela, Antonio Costa, Daniele Cignoli, Nicolò Schifano, Alessia d'Arma, Paolo Capogrosso, Luca Boeri, Eugenio Ventimiglia, Rayan Matloob, Luca Pagliardini, Enrico Papaleo, Vincenzo Mirone, Francesco Montorsi, and Andrea Salonia

Subjects
Urology
Published
2022

37. MP47-12 FRAILTY STATUS PREDICTS WORSE POSTOPERATIVE AND LONG-TERM ONCOLOGIC OUTCOMES IN PATIENTS TREATED WITH PARTIAL NEPHRECTOMY FOR SMALL RENAL MASSES

Author

Giuseppe Rosiello, Giuseppe Fallara, Daniele Cignoli, Giuseppe Basile, Gianmarco Colandrea, Gianfranco Baiamonte, Isaline Rowe, Daniela Canibus, Giacomo Musso, Federico Belladelli, Francesco Cei, Cristina Giancristofaro, Pierre I. Karakiewicz, Alberto Briganti, Roberto Bertini, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2022

38. MP50-03 SYSTEMATIC DEFINITION OF TREATMENT MODALITY AND CLINICAL OUTCOMES REPORTING SYSTEM IN CASE OF SURGICAL TREATMENT FOR VON HIPPEL-LINDAU RENAL CELL CARCINOMA

Author

Alessandro Larcher, Federico Belladelli, Andrea Ieva, Isaline Rowe, Giuseppe Fallara, Daniele Cignoli, Gianmarco Colandrea, Miriam Santangelo, Roberta Lucianò, Claudio Doglioni, Stefano Clerici, Laura Castellino, Anna Damascelli, Giorgia Guazzarotti, Francesco De Cobelli, Andrea Necchi, Daniele Raggi, Roberto Bertini, Francesco Montorsi, Umberto Capitanio, and Andrea Salonia

Subjects
Urology
Published
2022

39. PD15-08 WHEN TO DE-INTENSIFY ONCOLOGIC SURVEILLANCE SCHEME FOR NON-CLEAR CELL RENAL CELL CARCINOMA

Author

Alberto Martini, Daniele Cignoli, Giuseppe Rosiello, Giuseppe Fallara, Giuseppe Basile, Luigi Nocera, Federico Belladelli, Gianmarco Colandrea, Daniela Canibus, Chiara Re, Giacomo Musso, Francesco Cei, Francesco De Cobelli, Giorgio Brembilla, Alberto Briganti, Andrea Necchi, Daniele Raggi, Roberto Bertini, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2022

41. MP41-14 THE LEARNING CURVE OF RADICAL NEPHRECTOMY FOR KIDNEY CANCER: IMPLICATIONS FOR SURGICAL TRAINING

Author

Federico Belladelli, Giuseppe Fallara, Giuseppe Rosiello, Daniele Cignoli, Giuseppe Basile, Gianmarco Colandrea, Giacomo Musso, Francesco Cei, Daniela Canibus, Walter Cazzaniga, Gianfranco Baiamonte, Chiara Re, Andrea Ieva, Pierre I. Karakiewicz, Federico Dehò, Patrizio Rigatti, Giorgio Guazzoni, Andrea Gallina, Alexandre Mottrie, Francesco Montorsi, Roberto Bertini, Andrea Salonia, Alberto Briganti, Umberto Capitanio, and Alessandro Larcher

Subjects
Urology
Published
2022

42. MP12-06 ONCOLOGIC OUTCOMES IN PATIENTS DIAGNOSED WITH pT3aN0M0 RENAL CELL CANCER ACCORDING TO RENAL VEIN THROMBUS OR FAT INVASION

Author

Giuseppe Fallara, Giuseppe Rosiello, Andrea Necchi, Daniele Raggi, Walter Cazzaniga, Alberto Martini, Giuseppe Basile, Daniele Cignoli, Gianmarco Colandrea, Gianfranco Baiamonte, Federico Belladelli, Giacomo Musso, Francesco Cei, Cristina Giancristofaro, Andrea Ieva, Daniela Canibus, Alberto Briganti, Roberto Bertini, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2022

44. PD59-04 APPLICATION OF THE KEYNOTE-564 TRIAL RESULTS TO REAL LIFE POPULATION: WHICH PATIENTS WITH ADVANCED KIDNEY CANCER SHOULD RECEIVE ADJUVANT PEMBROLIZUMAB

Author

Giuseppe Fallara, Giuseppe Rosiello, Daniele Raggi, Laura Marandino, Greta Malena, Giuseppe Basile, Gianmarco Colandrea, Daniele Cignoli, Federico Belladelli, Giacomo Musso, Francesco Cei, Roberto Bertini, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Alessandro Larcher, Andrea Necchi, and Umberto Capitanio

Subjects
Urology
Published
2022

45. PD09-01 LOW BIRTH WEIGHT IS ASSOCIATED WITH SPERM DNA FRAGMENTATION AND ASSISTED REPRODUCTIVE TECHNOLOGY OUTCOMES IN PRIMARY INFERTILE MEN—RESULTS OF A CROSS-SECTIONAL STUDY

Author

Luca Boeri, Federico Belladelli, Edoardo Pozzi, Giuseppe Fallara, Massimiliano Raffo, Christian Corsini, Luigi Candela, Antonio Costa, Daniele Cignoli, Nicolò Schifano, Alessia d'Arma, Paolo Capogrosso, Eugenio Ventimiglia, Luca Pagliardini, Enrico Papaleo, Vincenzo Mirone, Federico Dehò, Francesco Montorsi, and Andrea Salonia

Subjects
Urology
Published
2022

46. PD09-07 HYPERESTROGENISM IS ASSOCIATED WITH SEXUAL FUNCTION IMPAIRMENT IN MEN—FINDINGS FROM A CROSS-SECTIONAL, REAL-LIFE STUDY

Author

Luca Boeri, Paolo Capogrosso, Giuseppe Fallara, Walter Cazzaniga, Luigi Candela, Federico Belladelli, Edoardo Pozzi, Massimiliano Raffo, Antonio Costa, Christian Corsini, Daniele Cignoli, Nicolò Schifano, Gianmarco Colandrea, Alessia d'Arma, Eugenio Ventimiglia, Rayan Matloob, Federico Dehò, Francesco Montorsi, and Andrea Salonia

Subjects
Urology
Published
2022

47. PD56-02 THE DETRIMENTAL EFFECT OF FRAILTY STATUS ON RENAL FUNCTION RECOVERY AFTER PARTIAL NEPHRECTOMY – LONG-TERM RESULTS FROM A PROSPECTIVE SURGICAL COHORT

Author

Giuseppe Rosiello, Giuseppe Fallara, Giuseppe Basile, Alberto Martini, Daniele Cignoli, Luigi Nocera, Federico Belladelli, Gianmarco Colandrea, Daniela Canibus, Chiara Re, Giacomo Musso, Francesco Cei, Cristina Giancristofaro, Alberto Briganti, Roberto Bertini, Andrea Necchi, Daniele Raggi, Pierre I. Karakiewicz, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio

Subjects
Urology
Published
2022

48. MP04-14 PATIENTS ADHERING TO STANDARDIZED PROTOCOLS FOR PFMT AFTER HOLEP SHOW HIGHER RATES OF POSTOPERATIVE INCONTINENCE: REAL-LIFE IMPLICATIONS FOR A RATIONAL MANAGEMENT WORK-UP

Author

Giuseppe Fallara, Manuela Tutolo, Valentina Specchio, Donatella Giraudo, Shivani Ghazaleh Mathur, Federico Belladelli, Antonio Costa, Daniele Cignoli, Nicolò Schifano, Francesco Pellegrino, Luigi Candela, Mario De Angelis, Gianmarco Colandrea, Paolo Capogrosso, Eugenio Ventimiglia, Andrea Salonia, and Francesco Montorsi

Subjects
Urology
Published
2022

50. MP21-09 DRUG-RELATED SEXUAL DYSFUNCTION ISSUES AMONG PATIENTS UNDER TREATMENT OR PREVIOUSLY EXPOSED TO SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIS)—A MANAGEMENT CHALLENGE?

Author

Nicolò Schifano, Paolo Capogrosso, Giuseppe Fallara, Edoardo Pozzi, Federico Belladelli, Luigi Candela, Christian Corsini, Massimiliano Raffo, Antonio Costa, Daniele Cignoli, Alessia d'Arma, Luca Boeri, Eugenio Ventimiglia, Rayan Matloob, Vincenzo Mirone, Federico Dehò, Francesco Montorsi, and Andrea Salonia

Subjects
Urology
Published
2022

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