32 results on '"Sepich CA"'
Search Results
2. Bladder replacement with modified studer pouch using absorbable staples
- Author
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Pagni Gl, Sepich Ca, L. Fiorentini, and Cecchi M
- Subjects
Male ,medicine.medical_specialty ,Surgical stapling ,business.industry ,Urology ,Urinary Reservoirs, Continent ,Middle Aged ,Absorption ,Surgery ,Postoperative Complications ,Urinary Bladder Neoplasms ,Nephrology ,Surgical Stapling ,Bladder replacement ,medicine ,Operating time ,Humans ,Pouch ,business ,Aged - Abstract
The use of absorbable staples may allow to reduce the operating time of orthotopic bladder replacement. We report our experience in 14, patients with a modification of the Studer technique using absorbable PolyGIA instruments. The technique has been shown to be simple and quick to perform (time for pouch creation 15–40 minutes, mean 16 minutes) with no significant intraoperative difficulties. Urodynamic data and continence are satisfactory and seem comparable to different procedures and not related to staples' use. The main question remains if the reduced operating time equalizes the high cost of staple devices.
- Published
- 1997
3. Painless treatment of hydrocele: EMLA cream anaesthesia and fibrin adhesive sclerotherapy
- Author
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L. Fiorentini, Ippolito C, Riccardo Minervini, Sepich Ca, Cecchi M, and Pagni Gl
- Subjects
Male ,medicine.medical_specialty ,Fibrin adhesive ,Lidocaine ,Urology ,medicine.medical_treatment ,Fibrin Tissue Adhesive ,Emla cream ,Fibrin ,Prilocaine ,Sclerotherapy ,Hydrocele ,medicine ,Humans ,Anesthetics, Local ,skin and connective tissue diseases ,Lidocaine, Prilocaine Drug Combination ,Aged ,biology ,business.industry ,digestive, oral, and skin physiology ,food and beverages ,Middle Aged ,medicine.disease ,Anesthetics, Combined ,Testicular Hydrocele ,Surgery ,Nephrology ,Anesthesia ,biology.protein ,Tissue Adhesives ,Needle insertion ,business ,medicine.drug - Abstract
Sclerotherapy for hydroceles was performed in 18 patients. Cutaneous anaesthesia was induced with an anaesthetic cream (lidocaine and prilocaine, EMLA cream) and a fibrin sealant (Tissucol) was injected into the sac after fluid aspiration. Patients experienced no pain during needle insertion and sclerosant procedure; 2 recurrences were observed during follow-up. EMLA cream anaesthesia and fibrin adhesive sclerotherapy represent a useful alternative to surgical treatment of hydroceles.
- Published
- 1997
4. Correlation between Gleason score of needle biopsy and radical prostatectomy tissue
- Author
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Ippolito C, Summonti D, A Di Benedetto, Pagni Gl, Riccardo Minervini, Cecchi M, Sepich Ca, and L. Fiorentini
- Subjects
Nephrology ,Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,urologic and male genital diseases ,Surgical specimen ,Prostate cancer ,Predictive Value of Tests ,Internal medicine ,Medicine ,Humans ,neoplasms ,Aged ,Neoplasm Staging ,Prostatectomy ,business.industry ,Biopsy, Needle ,Prostatic Neoplasms ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Prostate-specific antigen ,surgical procedures, operative ,Needle biopsy ,Lymphatic Metastasis ,business - Abstract
Gleason score has been identified as an important variable to predict disease extent and biologic behaviour of prostate cancer. However, the correlation between Gleason score of needle biopsy and surgical specimen is often poor. We studied 72 patients who underwent needle biopsy and radical prostatectomy to correlate Gleason score with PSA, clinical and pathological tumour stage. Only 47.2% of Gleason scores were identical in the biopsy and specimens, 37.5% were undergraded and 15.2% were overgraded. Correlations between clinical and pathological stage were identical in 30.5% of patients, 61.1% of patients were understaged and 8.3% overstaged. In conclusion, accuracy of clinical staging and grading of prostate cancer is low. Although the Gleason score on needle biopsy might be useful to predict the final stage and grade, correlation with surgical specimen is poor.
- Published
- 1999
5. Prevalence of the prospatic incidentaloma: Analysis of 162 patients
- Author
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Pagni Gl, Sepich Ca, R. Felipetto, L. Vigano, L. Fiorentini, Riccardo Minervini, and M. Cecchi
- Subjects
Pharmacology ,Pediatrics ,medicine.medical_specialty ,business.industry ,Incidentaloma ,medicine ,General Medicine ,business - Published
- 1993
6. Incidental asymptomatic adrenal masses: Is operation required
- Author
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L. Fiorentini, Pagni Gl, Riccardo Minervini, L. Vigano, M. Cecchi, Sepich Ca, and R. Felipetto
- Subjects
Pharmacology ,medicine.medical_specialty ,Adrenal masses ,business.industry ,medicine ,General Medicine ,Radiology ,medicine.symptom ,business ,Asymptomatic - Published
- 1993
7. Bladder preservation in patients with infiltrating neoplasm
- Author
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L. Vigano, Pagni Gl, M. Cagnoni, M. Cecchi, Sepich Ca, R. Felipetto, Riccardo Minervini, and L. Fiorentini
- Subjects
Pharmacology ,Oncology ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Neoplasm ,In patient ,General Medicine ,Radiology ,business ,medicine.disease ,Bladder preservation - Published
- 1993
8. PSA or PSAD for the diagnosis of prostate cancer?
- Author
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Sepich Ca, M. Cagnoni, L. Vigano, Riccardo Minervini, M. Cecchi, L. Fiorentini, R. Felipetto, and Pagni Gl
- Subjects
Pharmacology ,Oncology ,PCA3 ,medicine.medical_specialty ,Prostate cancer ,business.industry ,Internal medicine ,medicine ,General Medicine ,medicine.disease ,business - Published
- 1993
9. Bladder replacement after radical cystectomy for cancer
- Author
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L. Fiorentini, L. Vigano, M. Cagnoni, Pagni Gl, R. Felipetto, Sepich Ca, M. Cecchi, and Riccardo Minervini
- Subjects
Pharmacology ,Cystectomy ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Bladder replacement ,Urology ,Medicine ,Cancer ,General Medicine ,business ,medicine.disease - Published
- 1993
10. Urinary Leakage after Robot-Assisted Radical Prostatectomy: Is Always Predictive of Functional Results?
- Author
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Fiorello N, Zucchi A, Gregori F, Romei G, Fiorenzo S, Di Benedetto A, Bossa R, Mogorovich A, Summonti D, Benvenuti S, Pastore AL, and Sepich CA
- Abstract
Introduction: The aim of the study was to evaluate if and when the presence of radiological urinary leakages of vesico-urethral anastomosis, after robotic radical prostatectomy, could provoke urethral strictures or affect continence recovery., Methods: We enrolled 216 patients, undergoing robot-assisted radical prostatectomy between January 2020 and December 2022 in three high-volume referenced centres for robotic surgery. Before removal of the bladder catheter, all patients underwent a cystourethrography in which the presence/absence of leakage was assessed at level of vesico-urethral anastomosis. Based on degree of severity of urinary leakage on cystourethrography, patients were classified as no leakage or grade 0, grade 1 with transversal diameter ≤1 cm, and grade 2 with transversal diameter ≥1 cm. At follow-up, urethral stenosis formation and urinary continence recovery were assessed; furthermore, post-operative 12-month functional outcome was determined using EORTC-QLQ-PR25 questionnaire., Results: Radiological urinary leakage was found in 30 patients with grade 1 and 33 patients with grade 2, for a total of 63 patients. Only 1 patient (1.5%), grade 2 urinary leakage, developed significant urethral stricture and required endoscopic urethrotomy after 6 months. Analysing the differences in those who removed the bladder catheter after 7-9 days and those who kept it longer, we found no statistically significant differences regarding recovery of continence (p = 0.23) or about urinary symptoms (p = 0.94)., Conclusions: RARP remains gold-standard approach for treatment of localized prostate cancer and the superiority of this technique is safe in preventing urethral strictures and continence recovery, even in presence of significant anastomotic urinary leakage., (© 2024 S. Karger AG, Basel.)
- Published
- 2024
- Full Text
- View/download PDF
11. Impact of positive surgical margins (PSMs) after robotic prostatectomy on biochemical recurrence (BCR): Multicenter analysis.
- Author
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Fiorello N, Di Benedetto A, Brizzi L, Mogorovich A, Summonti D, Silvestri G, Benvenuti S, and Sepich CA
- Subjects
- Male, Humans, Margins of Excision, Prostate-Specific Antigen, Neoplasm Grading, Prostatectomy adverse effects, Neoplasm Recurrence, Local pathology, Robotics, Robotic Surgical Procedures
- Abstract
Objective: To study and analyze any correlations between positive surgical margins after RARP and biochemical recurrence., Methods: We enrolled 105 patients who underwent robot-assisted radical prostatectomy (RARP) from 2016-2020 with PSMs on final pathology, all performed or supervised by a senior surgeon in two tertiary referral center. Pathology has been described indicating also the area (apical, base, mediolateral, anterior, or multiple) and the extent of PSMs: focal (≤3 mm) or extensive (>3 mm). Cox univariable and multi-variable regression models were used to find the correlation between clinico-pathologic factors: age, local staging, PSA, grading, area, and size of PSMs)., Results: We found a good correlation between PSA and grading and between PSA and local staging (T) ( p < 0.001). There was no clear correlation between the PSM area with grading nor with T staging. There is a statistically significant correlation between extensive PSM and the worsening of grading and local staging ( p < 0.001). BCR rate also has a strong correlation with the worsening of grading and local staging (T) ( p < 0.001). A relevant fact is the difference between the BCR rate in the apical and base PSM (34.88%vs 62.5%; p < 0.001) which are the most frequent locations of PSMs., Discussion: PSMs remain a predictor of BCR but which may have controversial significance. The likelihood of BCR increases as grading or local staging gets worse. However, apical PSM is a relatively less powerful predictor of postoperative BCR. This can help to better select patients for subsequent RT, which still causes important side effects., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Published
- 2023
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12. Treatment of 2-4 cm kidney stones: multicentre experience. Comparison of safety, efficacy, and costs of percutaneous nephrolithotomy and retrograde intrarenal surgery.
- Author
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Fiorello N, Di Benedetto A, Mogorovich A, Summonti D, Aquilini M, Silvestri G, Gilli C, Romei G, Santarsieri M, Manassero F, Pomara G, Benvenuti S, and Sepich CA
- Abstract
Introduction: The objective of this study is to compare the safety and efficacy, through the stone-free rate (SFR), as well as the costs, between retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL), for 2-4 cm kidney stones., Material and Methods: We analysed the data relating to RIRS and PCNL performed in 3 reference centres for kidney stones, in the period between 1/2019 and 12/2021. The total number of procedures was 130 (63 RIRS and 67 PCNL). We defined SFR as the absence of lithiasic fragments or stones <3 mm. Results were compared between 2 groups depending on the stone size: 2-3 cm stones (group 1) and >3 cm stones (group 2)., Results: The duration of RIRS was 90 minutes for group 1 and 115 minutes for group 2, and for PCNL it was 135 minutes for group 1 and 145 minutes for group 2. RIRS had shorter duration with a significant difference in group 1 (p = 0.000014). SFR for RIRS was 78% for group 1 and 21% for group 2, and for PCNL it was 92% for group 1 and 81% for group 2. Therefore, there is a statistically significant difference, which is more evident for 3 cm and multiple stones (p = 0.0057 for group 1, p = 0.000146 for group 2). The difference in costs was estimated by calculating the expected costs for a single surgical procedure and the estimated cost per day for ordinary hospitalization., Conclusions: 2-4 cm stones can be safely treated with both RIRS and PCNL, but RIRS should not be chosen as an option for stones >3 cm, except in selected cases. PCNL remains the gold standard for the treatment of complex stones, especially for stones >3 cm. Risk of postoperative complications is higher in PCNL, even if this difference is not great. The costs associated with RIRS, even when recalculating with the need for new treatments, remain cheaper., Competing Interests: The authors declare no conflicts of interest., (Copyright by Polish Urological Association.)
- Published
- 2023
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13. Learning curve in robot-assisted partial nephrectomy: comparison between an expert surgeon and a team in training in single-center experiences.
- Author
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Fiorello N, Di Benedetto A, Summonti D, Mogorovich A, and Sepich CA
- Abstract
Introduction: An important issue in robotic surgery is the training of urologists and the learning curve to perform a robot-assisted partial nephrectomy (RAPN), especially for those procedures that require vascular clamping., Material and Methods: We retrospectively enrolled 333 patients, undergoing RAPN in the period between 01/2014 and 12/2020. Surgical complexity, surgery duration, perioperative complications, and clamping were evaluated for each patient. Comparisons were made between an experienced surgeon and 3 urologists with initial experience in robotic surgery., Results: Total number of RAPN was 333, of wich 172 were performed by the chief and 142 by the team. Analyzing the data, after an initial training in robotic surgery, it's possible to perform surgery of medium complexity (RENAL score 6-7) after 15 procedures performed in total independence. To proceed to high complexity tumors (RENAL score 8-9) with possible vascular clamping and warm ischemia time <25 minutes at least 25 completely independent procedures are required. There were no significant differences in the comparisons regarding the duration of the procedures (p = 0.19), complications (p = 0.44) and positive margins (p = 0.96)., Conclusions: Robotic training for complex procedures, with low intra and postoperative complication rates, acceptable positive margin rates and sustainable cost-effective durations, requires a minimum number of medium complexity procedures, which in our study we have identified as 25 procedures, considering the initial ability in simple procedures of our 3 surgeons in training., Competing Interests: The authors declare no conflicts of interest., (Copyright by Polish Urological Association.)
- Published
- 2021
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14. Molecular characterization of low grade and high grade bladder cancer.
- Author
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Apollo A, Ortenzi V, Scatena C, Zavaglia K, Aretini P, Lessi F, Franceschi S, Tomei S, Sepich CA, Viacava P, Mazzanti CM, and Naccarato AG
- Subjects
- Aged, Cadherins genetics, DNA Mutational Analysis methods, Female, Humans, Hyaluronan Receptors genetics, Keratin-20 genetics, Male, Mutation genetics, Neoplasm Grading, Receptor, Fibroblast Growth Factor, Type 3 genetics, Survivin genetics, Tumor Suppressor Protein p53 genetics, Urinary Bladder metabolism, Urinary Bladder pathology, Urinary Bladder Neoplasms genetics, Urinary Bladder Neoplasms pathology
- Abstract
Background: Bladder cancer (BC) is the 9th most common cancer diagnosis worldwide. Low grade (LG) represents 70% of all BCs, characterized by recurrence and rare ability (10-15%) to progress to high grade (HG) and invade. The remaining 30% is high grade (HG), fast invasive BC, which is resistant to therapy. Identifying biomarkers for predicting those tumors able to progress is a key goal for patient outcome improvement. This study focuses on the most promising prognostic markers., Materials and Methods: TP53 and FGFR3 mutational status, Survivin, CK19, CK20, E-cadherin and CD44 gene expression analysis were performed on 66 BCs., Results: Survivin was found associated to tumor grade (p<0.05). Moreover, Survivin correlated with CD44 in TP53 wild type (p = 0.0242) and FGFR3 wild type (p = 0.0036) tumors. In particular the Survivin-CD44 correlation was associated to HG FGFR3 wild type BCs (p = 0.0045). Unsupervised hierarchical clustering based on gene expression data identified four distinct molecular groups reflecting the patient histology (p = 0.038)., Conclusion: We suggest Survivin, both as a biomarker associated to G3 BCs but negatively related to TP53 mutational status, and as a potential novel therapeutic target., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2019
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15. Loss of nuclear p27(kip1) and α-dystroglycan is a frequent event and is a strong predictor of poor outcome in renal cell carcinoma.
- Author
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Sgambato A, Camerini A, Genovese G, De Luca F, Viacava P, Migaldi M, Boninsegna A, Cecchi M, Sepich CA, Rossi G, Arena V, Cittadini A, and Amoroso D
- Subjects
- Adult, Aged, Aged, 80 and over, Blotting, Western, Carcinoma, Renal Cell pathology, Cell Nucleus metabolism, Female, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Kidney Neoplasms pathology, Male, Middle Aged, Neoplasm Staging, Outcome Assessment, Health Care, Predictive Value of Tests, Prognosis, Young Adult, Carcinoma, Renal Cell metabolism, Cyclin-Dependent Kinase Inhibitor p27 metabolism, Dystroglycans metabolism, Kidney Neoplasms metabolism
- Abstract
Expression levels of p27(kip1) , a negative regulator of the G1 phase of the cell cycle, and 8-hydroxydeoxyguanosine (8-OHdG), a marker of oxidative DNA damage, were assessed by immunostaining in a series of renal cell carcinomas (RCCs) and their prognostic significance was evaluated. Expression of p27(kip1) as well as of the α-subunit of the dystroglycan (DG) complex, previously reported to be altered in RCC, was also evaluated by western blot analysis. Nuclear expression of p27(kip1) was reduced in a significant fraction of tumors and low p27(kip1) staining correlated with higher tumor grade (P < 0.01). Recurrence and death from clear cell RCCs were significantly more frequent in p27(kip1) -low expressing tumors and Kaplan-Meier curves showed a significant separation between high vs low expressor groups for both disease-free (P = 0.011) and overall (P = 0.002) survival. Low nuclear expression of p27(kip1) as well as loss of α-DG were confirmed to be independent prognostic parameters at a multivariate analysis and the simultaneous loss of both molecules defined a "high-risk" group of patients with increased risk of recurrence (RR = 28.7; P = 0.01) and death (RR = 12.9; P = 0.03). No significant correlation with clinical or pathological parameters was found for 8-OHdG staining. Western blot analyses suggested a post-translational mechanism for the loss of α-DG expression and demonstrated that cytoplasmic dislocation of the protein contributes to the loss of active nuclear p27(kip1) . Loss of nuclear p27(kip1) is a frequent event in human RCCs and is a powerful predictor of poor outcome which, in combination with low DG expression, could help to identify high-risk patients with clear cell RCC., (© 2010 Japanese Cancer Association.)
- Published
- 2010
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16. [Adenoid cystic carcinoma of the prostate. Clinical case].
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Cecchi M, Sepich CA, Bertolini L, Catastini M, Di Benedetto A, Ippolito C, Pazzagli I, Summonti D, Bonadio AG, and Fiorentini L
- Subjects
- Adenocarcinoma diagnosis, Antineoplastic Agents, Hormonal therapeutic use, Biomarkers, Tumor blood, Biopsy, Carcinoma, Adenoid Cystic diagnosis, Carcinoma, Adenoid Cystic drug therapy, Diagnosis, Differential, Flutamide therapeutic use, Gonadotropin-Releasing Hormone antagonists & inhibitors, Humans, Lymph Node Excision, Lymphatic Metastasis diagnosis, Male, Middle Aged, Prostate-Specific Antigen blood, Prostatic Neoplasms diagnosis, Prostatic Neoplasms drug therapy, Triptorelin Pamoate therapeutic use, Carcinoma, Adenoid Cystic pathology, Lymph Nodes pathology, Prostatic Neoplasms pathology
- Abstract
The authors report an extremely rare case of adenoid cystic carcinoma of the prostate. No satisfactory clinical and pathological classification exists for this tumour, creating particular difficulties for therapeutic decisions and prognosis. Descriptions of cases with excellent survival rates are reported in the literature, to the extent that this is sometimes regarded as a low-malignancy tumour, but other reports also exist of massive diffusion of the pathology with fatal consequences. Advances in the knowledge of this tumour have enabled a number of earlier pathogenetic hypotheses to be ruled out, namely its possible derivation from ectopic salivary cells, ectopic periurethral glands or metaplastic urethral mucosa, but the origin of this carcinoma is still not certain. It is also difficult to differentiate this form from the typical adenocarcinoma and to make a prognosis for survival. In the case reported here, the final diagnosis was made on the lymph node biopsy obtained during surgery, given that a preoperative biopsy was not feasible owing to the scarcity of material available. The patient received standard hormonal therapy for prostate carcinoma.
- Published
- 2000
17. [Fibrous pseudotumors of the tunica vaginalis testis. A clinical case].
- Author
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Cecchi M, Sepich CA, Pagni GL, Ippolito C, Summonti D, Di Benedetto A, Bertolini L, Esposito I, Pazzagli I, and Catastini M
- Subjects
- Adult, Fibroma diagnostic imaging, Humans, Male, Testicular Neoplasms diagnostic imaging, Ultrasonography, Fibroma pathology, Testicular Neoplasms pathology
- Abstract
A case of multiple fibrous pseudotumors of the tunica vaginalis is reported. Ultrasonography led to diagnosis 10 years previously and the patient underwent surgical exploration when the lesions were up to 6 cm in diameter.
- Published
- 1999
18. [Prostatic endoprosthesis in the treatment of prostatic obstruction: preliminary experience with the new Trestle model].
- Author
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Cecchi M, Sepich CA, Pagni GL, Summonti D, Ippolito C, Di Benedetto A, Bertolini L, Minervini R, and Fiorentini L
- Subjects
- Catheterization, Evaluation Studies as Topic, Humans, Male, Stents, Prostatic Hyperplasia therapy, Prostheses and Implants
- Abstract
The urethral stent is a relatively new treatment modality for benign prostatic hypertrophy ostruction. Although the ultimate prostatic endoprosthesis has yet to be developed, various stents have been produced and investigated with good results. We review the several currently available stents and we report the preliminary clinical experience with a new device (Trestle).
- Published
- 1998
19. Correlation between Gleason score of needle biopsy and radical prostatectomy tissue.
- Author
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Cecchi M, Minervini R, Sepich CA, Ippolito C, Pagni GL, Summonti D, Di Benedetto A, and Fiorentini L
- Subjects
- Aged, Humans, Lymphatic Metastasis pathology, Male, Middle Aged, Predictive Value of Tests, Prostate-Specific Antigen blood, Prostatic Neoplasms blood, Biopsy, Needle, Neoplasm Staging, Prostatectomy, Prostatic Neoplasms pathology
- Abstract
Gleason score has been identified as an important variable to predict disease extent and biologic behaviour of prostate cancer. However, the correlation between Gleason score of needle biopsy and surgical specimen is often poor. We studied 72 patients who underwent needle biopsy and radical prostatectomy to correlate Gleason score with PSA, clinical and pathological tumour stage. Only 47.2% of Gleason scores were identical in the biopsy and specimens, 37.5% were undergraded and 15.2% were overgraded. Correlations between clinical and pathological stage were identical in 30.5% of patients, 61.1% of patients were understaged and 8.3% overstaged. In conclusion, accuracy of clinical staging and grading of prostate cancer is low. Although the Gleason score on needle biopsy might be useful to predict the final stage and grade, correlation with surgical specimen is poor.
- Published
- 1998
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20. [Unusual development of urothelioma of the upper urinary tract].
- Author
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Cecchi M, Sepich CA, Ippolito C, Pagni GL, Summonti D, Bertolini L, Di Benedetto A, and Fiorentini L
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- Aged, Humans, Male, Ureter pathology, Carcinoma, Transitional Cell pathology, Urinary Tract pathology, Urogenital Neoplasms pathology
- Abstract
A case of extrarenal spreading of transitional cell carcinoma caused by rupture of ureterohydronephrosis by ureteral transitional cell carcinoma is reported. Ultrasonography and CT revealed the presence of a severe right ureterohydronephrosis with large septa and a 2 cm diameter exophytic neoplasia of the middle ureter. Nephroureterectomy was performed with excision of a perirenal mass. Histologic examination revealed the presence of transitional cell carcinoma in the perirenal mass, caused by dissemination after renal rupture. CT and ultrasonography were not able to differentiate hydronephrosis from pericapsular spreading because of the extreme disruption of the renal parenchyma.
- Published
- 1997
21. [Fracture of the penis: description of a case].
- Author
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Cecchi M, Pagni GL, Ippolito C, Summonti D, Sepich CA, and Fiorentini L
- Subjects
- Adult, Humans, Male, Penis surgery, Penis injuries
- Abstract
Fracture of the penis is not a frequent event and it consists of a rupture of the tunica albuginea of the corpora cavernosa and sometimes of the urethra; the lesion occurs when the penis is erect because during erection the tunica albuginea is very thin and not flexible and it can be easily damaged by a trauma; most lesions occur during intercourse for impact of the erect penis against the female perineum or the pubic synphisis, but lesions during masturbation, fightings or falling off the bed are also described [1-2-3]. Clinically there are pain, detumescence, hematoma and recurvatum of the penis toward the opposite side of the lesion and hematuria if also the urethra is damaged. Usually diagnosis is quite easy with a good anamnesis, clinical examination and echotomography which can reveal presence of hematoma and hypoechogenic areas along the tunica albuginea or the urethra that appears irregular. Nowadays, fractures of the penis need a surgical approach to obtain good results avoiding consequences such as recurvatum or fibrotic areas [3-4-7-8]. We describe two cases of fracture of the penis occurred in two young men during masturbation and treated surgically with excellent results: twelve and eighteen months respectively after surgery patients are well and can enjoy a normal sexual activity with no problems at all.
- Published
- 1997
22. Painless treatment of hydrocele: EMLA cream anaesthesia and fibrin adhesive sclerotherapy.
- Author
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Cecchi M, Sepich CA, Pagni G, Ippolito C, Minervini R, and Fiorentini L
- Subjects
- Aged, Anesthetics, Combined therapeutic use, Humans, Lidocaine, Prilocaine Drug Combination, Male, Middle Aged, Anesthetics, Local therapeutic use, Fibrin Tissue Adhesive therapeutic use, Lidocaine therapeutic use, Prilocaine therapeutic use, Sclerotherapy methods, Testicular Hydrocele therapy, Tissue Adhesives therapeutic use
- Abstract
Sclerotherapy for hydroceles was performed in 18 patients. Cutaneous anaesthesia was induced with an anaesthetic cream (lidocaine and prilocaine, EMLA cream) and a fibrin sealant (Tissucol) was injected into the sac after fluid aspiration. Patients experienced no pain during needle insertion and sclerosant procedure; 2 recurrences were observed during follow-up. EMLA cream anaesthesia and fibrin adhesive sclerotherapy represent a useful alternative to surgical treatment of hydroceles.
- Published
- 1997
- Full Text
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23. Urinary tract endometriosis: report of 2 cases and a review of the literature.
- Author
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Sepich CA, Cecchi M, Pampaloni S, Notaro M, Ippolito C, Pagni GL, and Fiorentini L
- Subjects
- Adult, Endometriosis diagnostic imaging, Endometriosis therapy, Female, Humans, Magnetic Resonance Imaging, Tomography, X-Ray Computed, Urography, Urologic Diseases diagnostic imaging, Urologic Diseases therapy, Endometriosis diagnosis, Urologic Diseases diagnosis
- Abstract
Endometriosis of the urinary tract is a relatively rare condition. Since clinical signs are not specific the diagnosis is difficult and the therapy is not well defined. Two cases and a review of the literature are presented.
- Published
- 1997
- Full Text
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24. Bladder replacement with modified Studer pouch using absorbable staples.
- Author
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Cecchi M, Sepich CA, Pagni G, and Fiorentini L
- Subjects
- Absorption, Aged, Humans, Male, Middle Aged, Postoperative Complications, Urinary Bladder Neoplasms surgery, Surgical Stapling, Urinary Reservoirs, Continent methods
- Abstract
The use of absorbable staples may allow to reduce the operating time of orthotopic bladder replacement. We report our experience in 14 patients with a modification of the Studer technique using absorbable PolyGIA instruments. The technique has been shown to be simple and quick to perform (time for pouch creation 15-40 minutes, mean 16 minutes) with no significant intraoperative difficulties. Urodynamic data and continence are satisfactory and seem comparable to different procedures and not related to staples' use. The main question remains if the reduced operating time equalizes the high cost of staple devices.
- Published
- 1997
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25. [Electrovaporization of the prostate].
- Author
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Cecchi M, Sepich CA, Pagni G, Ippolito C, Summonti D, and Fiorentini L
- Subjects
- Aged, Aged, 80 and over, Electrosurgery instrumentation, Follow-Up Studies, Humans, Male, Middle Aged, Time Factors, Electrosurgery methods, Prostate surgery, Prostatic Hyperplasia surgery
- Abstract
Electrovaporization is a new and potentially useful modification of transurethral resection of the prostate which is rapidly becoming a treatment of choice for symptomatic benign prostatic hyperplasia. We report our experience with 22 patients treated using the Circon Acmi Grooved Vaportrode vaporization electrode. Procedures were carried out using the standard technique of electrovaporization with general or regional anaesthesia. Mean operative time was 40 minutes (range 25-65 minutes) and all patients were discharged without catheter after 1 or 2 days. Symptom score, peak uroflow and postvoid residual urine showed statistically significant improvement at 3 months (p < 0.01). There were no significant complications. Transurethral electrovaporization of the prostate seems to be a easy and safe procedure with significantly lower costs and excellent results. However, long-term efficacy and complications need to be evaluated in multicentre clinical trials.
- Published
- 1996
26. Vacuum constriction device and topical minoxidil for management of impotence.
- Author
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Cecchi M, Sepich CA, Felipetto R, Vigano L, Pagni G, Minervini R, and Fiorentini L
- Subjects
- Administration, Topical, Adult, Aged, Constriction, Humans, Male, Middle Aged, Vacuum, Erectile Dysfunction therapy, Minoxidil administration & dosage, Vasodilator Agents administration & dosage
- Abstract
Objective: We report our preliminary experience with a vacuum constriction device and topical minoxidil for the management of impotence., Methods: We evaluated 18 patients, 8 with neurogenic and 10 with psychogenic impotence with a vacuum constriction device and topical minoxidil (1 ml 2% solution)., Results and Conclusions: All patients responded to treatment but 100 cases refused home use because of psychological impact. Twelve patients did not need the application of the constrictive ring because of the erection facilitation effect of minoxidil. No side effects were observed. In our opinion the association of the vacuum constriction device with topical minoxidil might be useful in the treatment of impotence; however, several factors must be evaluated in selecting patients. Application of minoxidil before vacuum constriction device might be useful to reduce the time of device application, to increase the efficacy of the device and in some cases to avoid the use of the constrictive ring.
- Published
- 1995
27. [Role of color-Doppler in the assessment of erectile impotence: personal experience].
- Author
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Minervini R, Felipetto R, Cecchi M, Sepich CA, Viganò L, Pagni GL, Perri G, and Fiorentini L
- Subjects
- Aged, Alprostadil therapeutic use, Erectile Dysfunction drug therapy, Humans, Male, Middle Aged, Erectile Dysfunction diagnostic imaging, Ultrasonography, Doppler, Color
- Abstract
We present our experience with colour duplex sonography in the assessment of 38 impotent men, whose ten underwent radical prostatectomy, following intracavernous pharmacological stimulation with PGE1. All patients with a clinical good response following PGE1 injection had peak cavernosal artery velocities > 30 cm/sec. The remaining suboptimal responders who presented an elevated end-diastolic velocity (> 5 cm/sec) showed a venous leakage demonstrated with cavernosography. Colour duplex sonography is a valuable and non-invasive tool in the assessment of impotence and can provide valuable information in the diagnosis of vasculogenic erectile dysfunction.
- Published
- 1994
28. [Intrinsic endometriosis of the ureter. Clinical case].
- Author
-
Gastaldi E, De Maria M, Sepich CA, Caviglione M, Mennini B, Iacoviello M, Anselmi L, Chiaro S, and Traverso GB
- Subjects
- Adult, Endometriosis complications, Endometriosis surgery, Female, Humans, Hydronephrosis diagnosis, Hydronephrosis etiology, Ureteral Neoplasms complications, Ureteral Neoplasms surgery, Endometriosis diagnosis, Ureteral Neoplasms diagnosis
- Abstract
Endometriosis is defined as the presence of endometrial tissue outside the cavity of the uterus. The urinary tract is rarely affected, only 1 to 11%. Bladder is the most frequent urinary localization while the ureteral involvement is rare. We report a case of intrinsic ureteral endometriosis in a woman with left hydronephrosis, lumbar pain and septic fever. Instrumental and laboratory investigations can hardly lead to a reliable diagnosis of ureteral endometriosis. A final diagnosis is feasible only by histologic examination, which obviously implies surgery.
- Published
- 1992
29. Leiomyosarcoma of the spermatic cord: report of a case.
- Author
-
Minervini R, Morelli G, Benvenuti S, Sepich CA, and Cecchi M
- Subjects
- Genital Neoplasms, Male diagnosis, Genital Neoplasms, Male pathology, Humans, Leiomyosarcoma diagnosis, Leiomyosarcoma pathology, Male, Middle Aged, Neoplasm Invasiveness, Orchiectomy, Genital Neoplasms, Male surgery, Leiomyosarcoma surgery, Spermatic Cord
- Published
- 1992
30. [Echography in scrotal trauma].
- Author
-
Sepich CA, Cuttano MG, Benvenuti S, Cecchi M, De Maria M, Morelli G, and Giannotti P
- Subjects
- Biopsy, Needle, Epididymis diagnostic imaging, Epididymis injuries, Humans, Incidence, Male, Retrospective Studies, Testis diagnostic imaging, Testis injuries, Testis pathology, Testis surgery, Ultrasonography, Scrotum diagnostic imaging, Scrotum injuries
- Abstract
The Authors report 28 cases of scrotal traumas evaluated during a period of 5 years on an amount of 1.100 scrotal echography: 5 patients with severe scrotal trauma are investigated with echography within 2 hours while the others between 1 and 6 days. Some cases of overlooked trauma were studied some months later. In their experience the authors underline the importance of echography in early diagnosis of scrotal contents lesions which need a surgical exploration and those which allow a medical treatment. Also ultrasound investigation is important in evaluating and in the follow-up the scrotal content lesions caused by trauma.
- Published
- 1991
31. [Echography of injuries of the penis].
- Author
-
Morelli G, Sepich CA, Cecchi M, Benvenuti S, Cuttano MG, Fiorentini L, and Giannotti P
- Subjects
- Evaluation Studies as Topic, Hematoma diagnostic imaging, Humans, Male, Radiography, Rupture, Ultrasonography, Penis diagnostic imaging, Penis injuries
- Abstract
The Authors report 3 cases of penile trauma observed in a period of 6 months. The patients were studied by penile echography and cavernosography. In this series+ echotomography resulted more accurate than cavernosography which gave always negative results.
- Published
- 1991
32. [Peri-deferential ectopic adrenal gland. Apropos of a case].
- Author
-
Benvenuti S, Sepich CA, Cecchi M, Castagna M, Viacava P, and Fiorentini L
- Subjects
- Adrenal Glands abnormalities, Adult, Carcinoma complications, Dysgerminoma complications, Humans, Male, Testicular Neoplasms complications, Adrenal Glands embryology, Carcinoma surgery, Choristoma surgery, Dysgerminoma surgery, Testicular Neoplasms surgery
- Published
- 1991
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