Subjects -> MEDICAL SCIENCES (Total: 8821 journals)
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UROLOGY, NEPHROLOGY AND ANDROLOGY (159 journals)                     

Showing 1 - 159 of 159 Journals sorted alphabetically
Acta Urológica Portuguesa     Open Access   (Followers: 1)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 11)
Advances in Urology     Open Access   (Followers: 13)
African Journal of Nephrology     Open Access  
African Journal of Urology     Open Access   (Followers: 7)
AJP Renal Physiology     Hybrid Journal   (Followers: 8)
Aktuelle Urologie     Hybrid Journal   (Followers: 4)
American Journal of Kidney Diseases     Hybrid Journal   (Followers: 42)
American Journal of Men's Health     Open Access   (Followers: 9)
American Journal of Nephrology     Full-text available via subscription   (Followers: 38)
Andrologia     Hybrid Journal   (Followers: 2)
Andrology     Hybrid Journal   (Followers: 4)
Andrology & Gynecology : Current Research     Hybrid Journal   (Followers: 4)
Andrology and Genital Surgery     Open Access   (Followers: 7)
Andrology-Open Access     Open Access  
Annales d'Urologie     Full-text available via subscription  
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Arab Journal of Urology     Open Access   (Followers: 7)
Archives of Clinical Nephrology     Open Access   (Followers: 2)
Archivio Italiano di Urologia e Andrologia     Open Access   (Followers: 1)
Archivos Españoles de Urología     Open Access  
Asian Journal of Andrology     Open Access   (Followers: 1)
Asian Journal of Urology     Open Access   (Followers: 3)
Bangladesh Journal of Urology     Open Access   (Followers: 5)
BANTAO Journal     Open Access  
Basic and Clinical Andrology     Open Access  
BJU International     Hybrid Journal   (Followers: 34)
BJUI Compass     Open Access   (Followers: 2)
BMC Nephrology     Open Access   (Followers: 11)
BMC Urology     Open Access   (Followers: 14)
Canadian Journal of Kidney Health and Disease     Open Access   (Followers: 8)
Canadian Urological Association Journal     Open Access   (Followers: 2)
Cancer Urology     Open Access   (Followers: 2)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Case Reports in Nephrology     Open Access   (Followers: 5)
Case Reports in Nephrology and Dialysis     Open Access   (Followers: 9)
Case Reports in Urology     Open Access   (Followers: 12)
Clinical and Experimental Nephrology     Hybrid Journal   (Followers: 4)
Clinical Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 22)
Clinical Kidney Journal     Open Access   (Followers: 4)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Nephrology     Full-text available via subscription   (Followers: 8)
Clinical Nephrology and Urology Science     Open Access   (Followers: 6)
Clinical Queries: Nephrology     Hybrid Journal   (Followers: 1)
Cuadernos de Cirugía     Open Access   (Followers: 3)
Current Opinion in Nephrology & Hypertension     Hybrid Journal   (Followers: 10)
Current Opinion in Urology     Hybrid Journal   (Followers: 12)
Current Urology     Open Access   (Followers: 10)
Current Urology Reports     Hybrid Journal   (Followers: 5)
Der Nephrologe     Hybrid Journal  
Der Urologe     Hybrid Journal   (Followers: 1)
Diabetic Nephropathy     Open Access   (Followers: 1)
EMC - Urología     Full-text available via subscription  
Enfermería Nefrológica     Open Access   (Followers: 1)
European Urology     Full-text available via subscription   (Followers: 33)
European Urology Focus     Hybrid Journal   (Followers: 5)
European Urology Oncology     Hybrid Journal   (Followers: 1)
European Urology Open Science     Open Access   (Followers: 10)
Forum Nefrologiczne     Full-text available via subscription  
Geriatric Nephrology and Urology     Hybrid Journal   (Followers: 7)
Giornale di Clinica Nefrologica e Dialisi     Open Access  
Herald Urology     Open Access   (Followers: 2)
Hong Kong Journal of Nephrology     Open Access   (Followers: 3)
Human Andrology     Partially Free   (Followers: 2)
IJU Case Reports     Open Access  
Indian Journal of Nephrology     Open Access   (Followers: 2)
Indian Journal of Urology     Open Access   (Followers: 5)
International Brazilian Journal of Urology     Open Access   (Followers: 5)
International Journal of Nephrology     Open Access   (Followers: 2)
International Journal of Nephrology and Renovascular Disease     Open Access   (Followers: 2)
International Journal of Urology     Hybrid Journal   (Followers: 12)
International Urology and Nephrology     Hybrid Journal   (Followers: 7)
Jornal Brasileiro de Nefrologia     Open Access  
Journal für Urologie und Urogynäkologie/Österreich     Hybrid Journal  
Journal of Clinical Nephrology     Open Access   (Followers: 2)
Journal of Clinical Urology     Hybrid Journal   (Followers: 14)
Journal of Endoluminal Endourology     Open Access  
Journal of Endourology     Hybrid Journal   (Followers: 2)
Journal of Endourology Case Reports     Hybrid Journal  
Journal of Genital System & Disorders     Hybrid Journal   (Followers: 3)
Journal of Integrative Nephrology and Andrology     Open Access   (Followers: 2)
Journal of Kidney Cancer and VHL     Open Access  
Journal of Lower Genital Tract Disease     Hybrid Journal  
Journal of Nephrology     Hybrid Journal   (Followers: 4)
Journal of Nephrology Research     Open Access   (Followers: 3)
Journal of Pediatric Nephrology     Open Access   (Followers: 5)
Journal of Renal Care     Hybrid Journal   (Followers: 8)
Journal of Renal Nursing     Full-text available via subscription   (Followers: 12)
Journal of Renal Nutrition     Hybrid Journal   (Followers: 28)
Journal of Renal Nutrition and Metabolism     Open Access   (Followers: 1)
Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 31)
Journal of The Egyptian Society of Nephrology and Transplantation     Open Access  
Journal of Translational Neurosciences     Open Access  
Journal of Urology     Full-text available via subscription   (Followers: 46)
Journal of Urology & Nephrology     Open Access   (Followers: 2)
Kidney Disease and Transplantation     Open Access   (Followers: 4)
Kidney Diseases     Open Access   (Followers: 3)
Kidney International     Hybrid Journal   (Followers: 46)
Kidney International Reports     Open Access   (Followers: 3)
Kidney Medicine     Open Access  
Kidney Research Journal     Open Access   (Followers: 6)
Kidneys (Počki)     Open Access   (Followers: 1)
Nature Reviews Nephrology     Full-text available via subscription   (Followers: 22)
Nature Reviews Urology     Full-text available via subscription   (Followers: 13)
Nefrología (English Edition)     Open Access  
Nefrología (Madrid)     Open Access  
Nephro-Urology Monthly     Open Access   (Followers: 1)
Nephrology     Hybrid Journal   (Followers: 13)
Nephrology Dialysis Transplantation     Hybrid Journal   (Followers: 27)
Nephron     Hybrid Journal   (Followers: 4)
Nephron Clinical Practice     Full-text available via subscription   (Followers: 4)
Nephron Experimental Nephrology     Full-text available via subscription   (Followers: 4)
Nephron Extra     Open Access   (Followers: 1)
Nephron Physiology     Full-text available via subscription   (Followers: 4)
Neurourology and Urodynamics     Hybrid Journal   (Followers: 1)
OA Nephrology     Open Access   (Followers: 2)
Open Access Journal of Urology     Open Access   (Followers: 6)
Open Journal of Nephrology     Open Access   (Followers: 5)
Open Journal of Urology     Open Access   (Followers: 6)
Open Urology & Nephrology Journal     Open Access  
Pediatric Urology Case Reports     Open Access   (Followers: 7)
Portuguese Journal of Nephrology & Hypertension     Open Access   (Followers: 1)
Progrès en Urologie     Full-text available via subscription  
Progrès en Urologie - FMC     Full-text available via subscription  
Prostate Cancer and Prostatic Diseases     Hybrid Journal   (Followers: 6)
Renal Failure     Open Access   (Followers: 12)
Renal Replacement Therapy     Open Access   (Followers: 4)
Research and Reports in Urology     Open Access   (Followers: 4)
Revista de Nefrología, Diálisis y Trasplante     Open Access   (Followers: 1)
Revista Mexicana de Urología     Open Access   (Followers: 1)
Revista Urologia Colombiana     Open Access  
Saudi Journal of Kidney Diseases and Transplantation     Open Access   (Followers: 2)
Scandinavian Journal of Urology     Hybrid Journal   (Followers: 7)
Seminars in Nephrology     Hybrid Journal   (Followers: 11)
The Prostate     Hybrid Journal   (Followers: 8)
Therapeutic Advances in Urology     Open Access   (Followers: 4)
Trends in Urology & Men's Health     Partially Free   (Followers: 1)
Ukrainian Journal of Nephrology and Dialysis     Open Access   (Followers: 1)
Uro-News     Hybrid Journal   (Followers: 1)
Urolithiasis     Hybrid Journal   (Followers: 2)
Urologia Internationalis     Full-text available via subscription   (Followers: 2)
Urologia Journal     Hybrid Journal  
Urologic Clinics of North America     Full-text available via subscription   (Followers: 4)
Urologic Nursing     Full-text available via subscription   (Followers: 4)
Urologic Radiology     Hybrid Journal  
Urological Science     Open Access  
Urologicheskie Vedomosti     Open Access  
Urologie in der Praxis     Hybrid Journal  
Urologie Scan     Hybrid Journal  
Urology     Hybrid Journal   (Followers: 33)
Urology Annals     Open Access   (Followers: 4)
Urology Case Reports     Open Access   (Followers: 3)
Urology Practice     Full-text available via subscription   (Followers: 2)
Urology Times     Free   (Followers: 3)
Urology Video Journal     Open Access   (Followers: 1)
World Journal of Nephrology and Urology     Open Access   (Followers: 15)
World Journal of Urology     Hybrid Journal   (Followers: 11)


Similar Journals
Journal Cover
Urologia Journal
Journal Prestige (SJR): 0.189
Number of Followers: 0  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0391-5603 - ISSN (Online) 1724-6075
Published by Sage Publications Homepage  [1143 journals]
  • The evolution in the surgical management of Peyronie’s disease
    • Authors: Fulvio Colombo, Alessandro Franceschelli, Giorgio Gentile, Matteo Droghetti, Alessandro Fiorillo, Franco Palmisano
      Pages: 79 - 89
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 79-89, May 2021.
      Peyronie’s disease (PD) is due to a fibrotic alteration of the tunica albuginea of the penis. It is responsible of penile pain, angulation, and possible erectile dysfunction (ED). Despite almost three centuries have passed since the first description of the disease, etiology still remains uncertain. This fact has led to the lack of a truly effective medical therapy and to date the surgical treatment, although not yet standardized, is the only one that offers acceptable outcomes in terms of function and overall patient’s satisfaction. Since the beginning of the surgical experience in this field, two different currents of thought have developed: the first, involved the proposal of a number of different plication techniques, applied on the healthy side of the penis, opposite to the sick side, with the sole purpose of correcting the curvature; on the other side, efforts have focused on treating the “focus” of the disease, thus developing the so called “plaque surgery.” If with the passing of the decades neither of the two “philosophical” currents has prevailed, this probably depends on the fact that is still not clear which is the lesser of evils: the frequent onset of ED which may follows the plaque surgery or rather the penis shortening that inevitably occurs if any technique of plication has been applied. Our contribution aims to offer an historical retrospective of the surgical treatment of this disease as well as to discuss the latest international guidelines on this topic. The reader will also find some notes about our personal experience in this field.
      Citation: Urologia Journal
      PubDate: 2021-03-30T07:00:06Z
      DOI: 10.1177/03915603211005326
      Issue No: Vol. 88, No. 2 (2021)
  • Bladder cancer in the time of machine learning: Intelligent tools for
           diagnosis and management
    • Authors: Carlo Gandi, Luigi Vaccarella, Riccardo Bientinesi, Marco Racioppi, Francesco Pierconti, Emilio Sacco
      Pages: 94 - 102
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 94-102, May 2021.
      Machine learning (ML) is the subfield of artificial intelligence (AI), born from the marriage between statistics and computer science, with the unique purpose of building prediction algorithms able to improve their performances by automatically learning from massive data sets. The availability of ever-growing computational power and highly evolved pattern recognition software has led to the spread of ML-based systems able to perform complex tasks in bioinformatics, medical imaging, and diagnostics. These intelligent tools could be the answer to the unmet need for non-invasive and patient-tailored instruments for the diagnosis and management of bladder cancer (BC), which are still based on old technologies and unchanged nomograms. We reviewed the most significant evidence on ML in the diagnosis, prognosis, and management of bladder cancer, to find out if these intelligent technologies are ready to be introduced into the daily clinical practice of the urologist.
      Citation: Urologia Journal
      PubDate: 2021-01-06T06:48:54Z
      DOI: 10.1177/0391560320987169
      Issue No: Vol. 88, No. 2 (2021)
  • Functional and aesthetic outcome after ventral spatulation of urethra in
           partial penectomy
    • Authors: Gupta Prateek, Pandey Himanshu, Singh Mahendra, Goyal Suresh, Madduri Vijay Kumar Sarma, Choudhary Gautam Ram, Jain Pritesh, Jain Aaron
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Partial penectomy is one of the common organ preserving procedures for penile malignancies and certain benign conditions. Partial penectomy causes psychosexual morbidity to the patient. Dorsal spatulation of urethra is classically done while performing the procedure, it carries risk of meatal stenosis along with compromised cosmesis. Several complex neoglans reconstructive techniques exist to prevent stenosis and improve cosmetic outcomes. We hereby describe outcomes of a simple and reproducible modification of the procedure by ventral spatulation of the urethra.Materials and method:An analysis of 31 partial penectomies from May 2016 to June 2019 using a ventral spatulation technique was done. Patients were followed up for an average of 1 year to look for meatal stenosis, the morphological appearance of residual stump and psychosexual well-being.Results:None of the patient had meatal stenosis on follow up. All patients had a satisfactory cosmetic outcome, scoring 6 or more on ANA scale. Seventeen patients reported “satisfied”, six scored “highly satisfied “and eight were “harmonic” with the outcome. Out of 31, significant patients (20) were sexually active with most of them “equally satisfied or dissatisfied” or “very much satisfied.”Conclusion:Used uncommonly, ventral spatulation of urethra is a simple, reproducible and less time consuming alternative, which avoids the chances of meatal stenosis and gives goodcosmetic results with psychological benefits to patients.
      Citation: Urologia Journal
      PubDate: 2021-05-03T09:28:31Z
      DOI: 10.1177/03915603211013170
  • Response to “Evaluation of transverse dorsal lumbotomy in management of
           PUJ obstruction in patients younger than 6 months”
    • Authors: Jorge Panach-Navarrete, Lorena Valls-González, José María Martínez-Jabaloyas
      Abstract: Urologia Journal, Ahead of Print.

      Citation: Urologia Journal
      PubDate: 2021-04-28T12:35:10Z
      DOI: 10.1177/03915603211014017
  • Renal effect of severe hypoxia evaluated By NGAL measurements: An in vivo
           and in vitro study
    • Authors: Emilio Sacco, Matteo Vittori, Pietro Manuel Ferraro, Paola Verde, Alessandro Scagliusi, Silvia Baroni, Valentina Masola, Maurizio Onisto, Maria Nicosia, PierFrancesco Bassi
      Abstract: Urologia Journal, Ahead of Print.
      Purpose:To investigate possible renal damage in healthy men exposed to extreme hypobaric hypoxia, using urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) concentration as biomarker. The value of NGAL as a biomarker of proximal tubular cell damage under hypoxic conditions was also tested in vitro experiments.Methods:NGAL was assayed in a cohort of air cadets (n = 16) exposed to hypobaric hypoxia in a hypobaric chamber during their training program. In all subjects, urine creatinine (Cr) and urinary NGAL levels were measured immediately before, 3, and 24 h after hypobaric environment exposure. Three in vitro experiments using proximal tubular cell cultures were also performed to measure NGAL gene expression, NGAL secretion in the culture medium and to evaluate apoptosis under two cycles of hypoxia and reoxygenation.Results:In the in vivo study, geometric means of urinary NGAL/Cr ratio measured 24 h after hypobaric hypoxia in the hypobaric chamber were significantly lower than baseline values (13.4 vs 25.9 ng/mg, p = 0.01). In cell cultures, hypoxia down-regulated NGAL gene expression without significantly changing NGAL secretion in the culture medium. Hypoxia significantly increased the percentage of apoptotic/necrotic cells, especially after the second hypoxia-reoxygenation cycle.Conclusions:Exposure to hypobaric-hypoxic environments does not cause significant and irreversible renal tubular injury in vivo and in vitro, except than in a late stage. The hypoxic insult does not seem to be mirrored by an increase of urinary NGAL in healthy men nor of NGAL gene expression in HK-2 cell culture or secretion in the culture medium in the in vitro conditions reported in the present study.
      Citation: Urologia Journal
      PubDate: 2021-04-20T11:14:59Z
      DOI: 10.1177/03915603211009117
  • A rare cause of hydronephrosis: Leiomyoma of the ureter and a literature
    • Authors: Furkan Umut Kilic, Uygar Micoogullari, Serkan Altinova
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Leiomyomas of the genitourinary tract are rare and their manifestation in the ureter is even rarer. To our knowledge, only 14 cases of leiomyoma of the ureter have been reported worldwide since 1955, therefore this case will be 15th.Case presentation:We present a rare case of primary leiomyoma of the right ureter. Ureteroscopy did not show any abnormal findings in the ureteral mucosa. The primary leiomyoma was resected with distal ureterectomy and partial cystectomy that was followed with ureteroneocystostomy due to extraluminal mass that caused hydronephrosis and back pain.Conclusion:Although rare, we believe that leiomyoma should be considered in the differential diagnoses of well-circumscribed ureteral masses and kidney-sparing surgery should be performed.
      Citation: Urologia Journal
      PubDate: 2021-04-19T09:47:14Z
      DOI: 10.1177/03915603211010463
  • Hematuria and its repetition after initial control in patients receiving
           anti-coagulant: A prospective observational study
    • Authors: Ehsan Hajikhani, Seyyed Mohammad Ghahestani, Hamed Akhavizadegan, Mojgan Karbakhsh
      Abstract: Urologia Journal, Ahead of Print.
      Objectives:Although Gross hematuria in patients receiving anticoagulants is not very common, it is one of the most common reasons of consulting with urologists. It is recommended to investigate urinary tract malignancies but simultaneous approach to anticoagulation and hematuria so as the optimum balance could be attained, is not clearly defined in the literature yet. We aim to answer pitfalls of hematuria management in anticoagulant receiving patients in this manuscript.Materials and methods:In a prospective case control study during 2017–2019, we observed and collected the data of patients receiving anticoagulant therapy and suffered from gross hematuria with coagulation parameters in prophylactic or therapeutic range in an academic hospital affiliated to Tehran University of Medical Sciences. SPSS 24th version was used for descriptive analysis of collected data.Results:Sixty-six patients encountered hematuria while receiving anticoagulant therapy. Although hematuria was more common in male patients, its recurrence was higher in female patients. It started mostly in first 72 h of therapy and was anticoagulant-dose dependent. Degree of hematuria was mostly mild or moderate by visual estimation and controlled easily by holding the anticoagulant therapy for less than 2 days. Anti-platelet therapy, urinary catheterization and patient’s activity did not have any effect on re-bleeding rate.Conclusion:Considering the fact that ruling out the urinary tract malignancy is mandatory in these patients, moderate and severe hematuria can be controlled simply by short term holding the anticoagulant therapy while continuing antiplatelet therapy albeit there is possibility to continue them in mild cases. Removing urinary catheters and decreasing the patient’s mobility are not recommended. In order to decrease the recurrence of hematuria, re-establishing anticoagulation with LMWH and non-Vitamin D dependent oral agents rather than continuing Heparin and Warfarin might be helpful.
      Citation: Urologia Journal
      PubDate: 2021-04-17T06:52:19Z
      DOI: 10.1177/0391560321999965
  • Gossypiboma: An uncommon but avoidable dreadful complication
    • Authors: Amit Sharma, Deepak Biswal, Satyadeo Sharma, Siddhant Roy
      Abstract: Urologia Journal, Ahead of Print.
      Gossypiboma or retained surgical sponge in abdominal cavity is an avoidable complication which has wide variety of clinical presentations and associated medico-legal issues as well. The incidence is under-reported. Pre-operative diagnosis is difficult and management is surgical. We present a case of gossypiboma in a male with multiple vesico-cutaneous and colo-vesical fistulae.
      Citation: Urologia Journal
      PubDate: 2021-04-13T06:41:18Z
      DOI: 10.1177/03915603211010636
  • Prostate cancer testicular metastasis: Are they underestimated' Case
           report and analysis of the literature
    • Authors: Salvatore Smelzo, Guglielmo Mantica, Roberta Lucianò, Nazario Pio Tenace, Davide De Marchi, Giovannalberto Pini, Giovanni Passaretti, Andrea Losa, Franco Gaboardi
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:We aim to present a rare case of a patient who developed a late testicular metastasis of PCa after radical prostatectomy.Case description:A 78 years old man presenting for left testicular swelling slowly increasing of size over the last 2 months. He underwent a retropubic radical prostatectomy and extended bilateral lymphadenectomy in 2007 for prostatic adenocarcinoma. At the time of the presentation the last PSA was 0.91 ng/mL. The patient underwent a standard left orchifunicolectomy in April 2019 without intra- or perioperative complications. The pathological analysis showed a testicular metastasis of acinar adenocarcinoma.Conclusions:In conclusion, testicular metastasis from PCa are uncommon conditions. PSA evaluation and physical examination of all sites of metastasis and accurate evaluation of all signs/symptoms during the clinical visit remains crucial to the diagnosis of recurrence.
      Citation: Urologia Journal
      PubDate: 2021-04-09T06:58:31Z
      DOI: 10.1177/03915603211009118
  • Risk factors associated with urethral stricture recurrence after
           end-to-end urethroplasty and buccal mucosal graft urethroplasty
    • Authors: Rigoberto Pallares-Méndez, Jesús Arturo Cota-Agüero, Adrian Gutierrez-Gonzalez, Daniel Eduardo Cervantes-Miranda, Katherine Lyn Hernández-Aranda, Mario Ochoa-Arvizo, Luis Gerardo Aguilar-Rivera
      Abstract: Urologia Journal, Ahead of Print.
      Objectives:(1) Assess risk factors associated with urethral stricture recurrence (USR). (2) Assess urethral stricture recurrence after end-to-end urethroplasty (EE) and buccal mucosal graft urethroplasty (BMG).Subjects and methods:A total of 29 males with urethral stricture who underwent either an end-to-end urethroplasty or a buccal mucosal graft urethroplasty were included in this study and followed for 18 months. The association between risk factors and stricture recurrence was assessed.Results:Overall mean patient age was 51.69 ± 14.22 years, time to recurrence was 3 months (IQR: 1–6.25), and stricture length was 2.57 ± 1.30 cm. Important risk factors for USR were stricture length ⩾ 2 cm (p = 0.024), older age (p = 0.042), BMI > 25 kg/m2 (p = 0.021), Qmax after catheter removal
      Citation: Urologia Journal
      PubDate: 2021-04-09T06:57:08Z
      DOI: 10.1177/03915603211008739
  • The feasibility of multimodal fiber optic spectroscopy analysis in bladder
           cancer detection, grading, and staging
    • Authors: Simone Morselli, Enrico Baria, Riccardo Cicchi, Andrea Liaci, Arcangelo Sebastianelli, Gabriella Nesi, Sergio Serni, Francesco Saverio Pavone, Mauro Gacci
      Abstract: Urologia Journal, Ahead of Print.
      Objective:To prove the feasibility of Multimodal Fiber Optic Spectroscopy (MFOS) analysis in bladder cancer (BCa) detection, grading, and staging.Materials and methods:Bladder specimens from patients underwent TURBT or TURP were recorded and analyzed with MFOS within 30 min from excision. In detail, our MFOS combined fluorescence, Raman spectroscopy, and diffuse reflectance. We used these optical techniques to collect spectra from bladder biopsies, then we compared the obtained results to gold standard pathological analysis. Finally, we developed a classification algorithm based on principal component analysis-linear discriminant analysis.Results:A total of 169 specimens were collected and analyzed from 114 patients, 40 (23.7%) healthy (from TURP), and 129 (76.3%) with BCa. BCa specimens were divided according to their grade—34 (26.4%) low grade (LG) and 95 (73.6%) high grade (HG) BCa—and stage—64 (49.6%) Ta, 45 (34.9%) T1, and 20 (15.5%) T2. MFOS-based classification algorithm correctly discriminated healthy versus BCa with 90% accuracy, HG versus LG with 83% accuracy. Furthermore, it assessed tumor stage with 75% accuracy for Ta versus T1, 85% for T1 versus T2, and 86% for Ta versus T2.Conclusions:Our preliminary results suggest that MFOS could be a reliable, fast, and label-free tool for BCa assessment, providing also grading and staging information. This technique could be applied in future for in vivo inspection as well as of ex vivo tissue biopsies. Thus, MFOS might improve urothelial cancer management. Further studies are required.
      Citation: Urologia Journal
      PubDate: 2021-04-01T06:41:36Z
      DOI: 10.1177/03915603211007018
  • Bipolar transurethral enucleation of the prostate combined with open
           cystolithotomy in the treatment of large and giant prostate with bladder
           stones: Case series
    • Authors: Rami Walid Abdullah Alshayyah, Yang Yu, Hang Lv, Wengtong Liu, Bo Yang
      Abstract: Urologia Journal, Ahead of Print.
      The surgical management of large or giant prostate still has challenges to urologists, especially if combined with bladder stones, and the traditional techniques by open prostatectomy and cystolithotomy have significant morbidity rates. The endoscopic procedure might not be feasible to treat both conditions in a single procedure, despite advances in surgical techniques and instrumentation, we present a one-session procedure by a combined endoscopic and open approach for treating benign prostatic hyperplasia (BPH) larger than 100 g combined with bladder stones in the elderly patient with other comorbidities. Between May 2017 and January 2020, bipolar transurethral plasma kinetic enucleation of the prostate (TUEP) followed by open cystolithotomy was performed to six patients at our institution, three of them combined with a big bladder stone(s). All the patients have other chronic chest and heart diseases; we retrospectively collected the data. All the patients diagnosed as BPH of big size or giant prostate over 100 g, with bladder stone, and all the patients treated with the same procedure. We founded that the combination methods showed a significant effect in terms of surgery time, patient outcomes and recovery, hospital discharge. The mean age of patients was 78.16 ± 4.2 (73–84) years, and the mean prostate-specific antigen (PSA) value was 16.27 ± 10.01 (8.32–32.17) ng/mL. The mean size of the prostate measured by MRI/US was 266.16 ± 89.1 (169–405) mL. The mean total operation time was 70.5 ± 10.9 (60–90) min, while the mean enucleation time was 28.38 ± 6.61 (23–40) min. The mean intraoperative blood loss was 193.33 ± 19.66 (170–220) mL. The mean resected prostate weight was 217.166 ± 94.67 (117–365) g. The mean post-operative hospital stay was 2.6 ± 0.81 (2–4) days. One patient was readmitted 2 months later due to urinary tract infection, and one patient complains of urine incontinence who spontaneously subsided in 4 months after surgery, other that no severe postoperative complications observed, a significant reduction of serum PSA and IPSS recorded at 3 months, postoperatively. Although simple open prostatectomy remains the reference standard for the treatment. Of excessively large or giant prostatic hyperplasia, the combination procedure not only facilitates the management of selected cases of hyperplasia but further imparts significant benefits to patients and surgeons alike. This treatment plan is safe, time-consuming, and could revolutionize future treatment approaches to giant prostate.
      Citation: Urologia Journal
      PubDate: 2021-03-31T06:37:57Z
      DOI: 10.1177/03915603211001686
  • Erectile dysfunction pattern in patients with end stage renal disease on
           regular dialysis
    • Authors: Mohamed A Abdelaal, Tamer Ali Abouelgreed, Amal H Ibrahim, Ahmed I Elshater, Khalid M Sabry
      Abstract: Urologia Journal, Ahead of Print.
      Introductions:Evaluating the epidemiology, pattern, and contributing factors of sexual dysfunction in end-stage renal disease (ESRD) patients is the cornerstone in understanding and enhancing these patients’ quality of life. In this study, we aimed to identify the different patterns of erectile dysfunction (ED) among 100 patients undergoing hemodialysis.Materials and methods:A single-center, cross-sectional, study was conducted on 100 patients with ESRD on hemodialysis. Patients were assessed using the International index of erectile dysfunction (IIEF) and Doppler assessment of the penis.Results:A total of 100 patients were included in this study with a mean age of 48.77 ± 9.66 years old. The mean erectile index was 7.10 ± 4.62; while the mean free and total testosterone were 10.07 ± 7.69 and 2.93 ± 1.4 ng/dL, respectively. Overall, 67% of the patients had abnormal hormonal levels. Concerning the penile vasculature, 71% of the patients had arterogenic importance and 19% had venous impotence. The comparative analysis demonstrated that hypertensive patients had lower erectile index (p = 0.002). In addition, smokers had lower erectile index (p 
      Citation: Urologia Journal
      PubDate: 2021-03-30T09:29:50Z
      DOI: 10.1177/03915603211007056
  • Very low risk T1a renal cell carcinoma presenting with pathological
           fracture caused by a solitary metastases to the contralateral arm
    • Authors: Petros Sountoulides, Linda Metaxa, Irene Asouhidou, Marios Stavropoulos, John Calleary
      Abstract: Urologia Journal, Ahead of Print.
      Background:Renal Cell Carcinomas are notorious for asynchronous metastases, atypical metastatic sites and late relapses even decades after nephrectomy. It is quite rare though for RCCs to present as metastatic, solitary and symptomatic bone lesions. Even more uncommon is a solitary bone metastasis much larger that the primary tumour caused by a low risk primary T1a RCC which would have otherwise been eligible for active surveillance.Case presentation:An otherwise healthy 68-year-old female was seen by the orthopaedics for right shoulder and upper arm worsening pain. Imaging showed a pathological fracture caused by a 5.5 cm lytic lesion involving the coracoid process and proximal humerus. She underwent proximal humeral replacement and histology of the lesion showed metastatic RCC. Whole body CT scan revealed a primary tumour of the left kidney less than 4cm in diameter. The patient underwent laparoscopic radical nephrectomy and diagnosis of a T1a, clear cell RCC without adverse pathological features was confirmed. She has been on systematic therapy with oral TKIs since and is free from recurrence at 12-months follow up.Conclusions:Even T1a RCCs without adverse pathological features can give rise to distant metastases following unpredictable patterns of spread thereby questioning the safety of active surveillance in healthy and fit patients.
      Citation: Urologia Journal
      PubDate: 2021-03-30T06:58:25Z
      DOI: 10.1177/03915603211007059
  • Effect of a novel technique of posterior reconstruction of pubourethralis
           on ‘early’ return of continence after robot assisted radical
           prostatectomy (RARP): A comparative study
    • Authors: Malik Abdul Rouf, Venkatesh Kumar, Anshuman Agarwal, Mahender Sharma, Suresh Kumar Rawat, Rajesh Taneja
      Abstract: Urologia Journal, Ahead of Print.
      Objective:To study the effect of a novel technique of posterior reconstruction of pubourethralis on early return of continence after robot assisted radical prostatectomy (RARP).Materials and methods:The study included 206 patients of organ confined prostate cancer managed at our centre between March 2014 and December 2018.The patients were randomly distributed into two comparable groups with respect to age, height, weight and BMI, with 100 patients in control and 106 patients in study group. After standard excision of the specimen, the posterior reconstruction in the form of Rocco stitch was done in control group while in addition to Rocco stitch pubourethralis was approximated posteriorly in midline at the proposed site of vesicourethral anastomosis in study group. Continence was defined as the need to use 0–1 pad in 24 h. The data was collected on day 0, 3, 7, 15, 30, 90 and 180 after removal of catheter.Results:At day zero, 3,7, 15, 30, 90 and 180 days after catheter removal continence rates (⩽1 pad usage per day) were observed to be 18.8% versus 0%, 22.6% versus 0%, 50.9% versus 5%, 72.6% versus 20%, 84.9 versus 32%, 97.1% versus 83%, and 97.1% versus 91% in the study and control group respectively.Conclusion:Despite small number of patients in this study the results with respect to early return of continence are encouraging in the reconstruction group and there by in favour of this technique .Furthermore the technique is easily reproducible and may be seen as one more additional step to be applied in order to enhance the recovery of continence after RARP. However it is necessary to further validate the efficacy of this procedure through multicenteric controlled trials.
      Citation: Urologia Journal
      PubDate: 2021-03-30T06:55:05Z
      DOI: 10.1177/03915603211007052
  • Perioperative and oncological outcomes of renal cell carcinoma with venous
           tumour thrombus
    • Authors: Sriharsha Bokka, Ramanitharan Manikandan, Lalgudi Narayanan Dorairajan, K Srivathsa, Kodakkattil Sreenivasan Sreerag, Sidhartha Kalra, Biju Pottakat
      Abstract: Urologia Journal, Ahead of Print.
      Aim:The aim of the present study is to report the perioperative and long-term surgical outcomes of renal cell carcinoma (RCC) with venous tumour thrombus (VTT).Materials and methods:Data of 34 patients (males = 23, females = 11) from 2009 to 2020 who underwent radical nephrectomy with thrombectomy for RCC and VTT was retrospectively analysed. The parameters recorded include tumour laterality, size, level of thrombus, surgical approach, blood loss, transfusion rates, operative time, hospital stay, Clavien complications, tumour histology, follow-up duration, local recurrence, distant metastasis, overall and cancer-specific survival rates.Results:The extent of thrombus was level I in thirteen, level II in twelve, level III (a-1, b-2, c-1, d-2) in six and level IV in three patients respectively. Mean operative time was 320 (±145) min, mean blood loss was 1371.15 (±1020.8) ml and mean hospital stay was 9.6 (±7.4) days. Mean transfusion rate was 6.4 (±3.2) units. Three patients died within the first 30 days of surgery. Cardiopulmonary bypass (CPB) was utilized in three patients. Median follow-up period was 58 (Range: 4–101) months. A statistically significant correlation was found between operative time (p = 0.014) and median survival (p = 0.003) respectively and tumour thrombosis level. Nine patients died due to metastasis, and ten due to unrelated causes. The estimated actuarial survival rates at a median of 58 months were 35.3%.Conclusion:An accurate preoperative assessment of the thrombus extent with the involvement of a multidisciplinary team approach is crucial in achieving optimal surgical outcomes in patients of RCC with VTT, particularly with level III and IV thrombus.
      Citation: Urologia Journal
      PubDate: 2021-03-30T06:53:25Z
      DOI: 10.1177/03915603211007030
  • Correlation between testicular volume and histological findings in
           children with unilateral cryptorchidism: Potential impact on future
    • Authors: Claudio Spinelli, Girolamo Morelli, Gianmartin Cito, Alessia Bertocchini, Marco Ghionzoli, Angela Pucci, Andrea Cocci, Riccardo Morganti, Silvia Strambi
      Abstract: Urologia Journal, Ahead of Print.
      Objectives:Our aim is to assess the correlation between testicular volume and histological findings in children with unilateral cryptorchidism.Methods:From September 2016 to August 2018, from 60 patients surgically treated for cryptorchidism, 45 children were enrolled in this single-center prospective study. Depending on the degree of testicular volume reduction, patients were divided into Group 1 with
      Citation: Urologia Journal
      PubDate: 2021-03-30T06:51:45Z
      DOI: 10.1177/03915603211004732
  • Spontaneous urinary bladder perforation: An unusual presentation of
           well-differentiated papillary peritoneum mesothelioma
    • Authors: Armando Serao, Francesca Ambrosini, Barbara Cavallone, Tiziana Borra, Andrea Di Stasio
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Well-differentiated papillary mesothelioma (WDPM) is a very rare neoplasm. Most of WDPM are asymptomatic and are often incidentally detected during surgery. This report describes a case of WDPM of the peritoneum unexpectedly diagnosed in a male with a spontaneous intraperitoneal bladder rupture.Case presentation:A 65-year-old male presented to our Emergency Department in November 2019 with a two-day history of anuria, abdominal pain, distention, and sepsis. The CT scan reported a large amount of extra and intraperitoneal free fluid. The CT cystogram showed bladder perforations on the dome and on the left lateral wall which was repaired through exploratory laparotomy. Intraoperatively, we encountered extensive suppurative peritonitis with large fibrino-purulent exudation. The purulent perivesical peritoneum was dissected and sent for histopathological examination which unexpectedly resulted in WDPM of the peritoneum.Conclusion:Although we can’t affirm with certainty, this case would seem to suggest that WDPM had played a role in patient’s clinical presentation. However, further research is necessary to draw stronger conclusion.
      Citation: Urologia Journal
      PubDate: 2021-03-29T11:08:28Z
      DOI: 10.1177/03915603211001181
  • Interposing layer of fibrin glue: A new horizon in vesico-vaginal fistula
    • Authors: Sunirmal Choudhury, Avisek Dutta, Naveen Gupta, Dilip Kumar Pal
      Abstract: Urologia Journal, Ahead of Print.
      Aim:In this study our idea is to compare the effectiveness of using interposing layer of fibrin glue to omental flap in reducing the failure of laparoscopic vesicovaginal fistula repair.Methods:Forty patients with fairly large vesicovaginal fistula were enrolled and divided in two groups of 20 each. We have used fibrin glue in one group and omental flap in the other group.Result:Of 20 patients in fibrin glue group no failure was seen, while 5 patients out of 20 in omental flap group had failure.Conclusion:This result is statistically significant and hence use of fibrin glue to be considered during laparoscopic repair of vesicovaginal fistulas.
      Citation: Urologia Journal
      PubDate: 2021-03-26T10:44:47Z
      DOI: 10.1177/03915603211004748
  • Laparoscopic surgery experience does not influence oncological and
           functional results of robotic-assisted laparoscopic prostatectomy
    • Authors: Taha Cetin, Mehmet Yigit Yalcin, Erkin Karaca, Mert Hamza Ozbilen, Batuhan Ergani, Gokhan Koc, Hayal Boyacioglu, Yusuf Ozlem Ilbey
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Surgery is one of the treatment alternatives for prostate cancer, and robotic-assisted laparoscopic prostatectomy (RALP) has become the new trend in the past decade. There is no consensus yet for surgeons who will perform RALP whether they need to be trained or experienced in laparoscopy. In this study, it was aimed to investigate the effectiveness of the surgeon’s laparoscopy experience in the perioperative and postoperative results of RALP patients.Material and method:Patients who underwent RALP were retrospectively screened. The first 20 cases done by surgeons in both groups and 40 cases in total were included in the study. Surgeons with laparoscopy training were designated as group 1, and surgeons without laparoscopy training were designated as group 2. Patient’s age, preoperative prostate-specific antigen (PSA) value, prostate biopsy pathology, radical prostatectomy pathology, surgical margin positivity, extracapsular extension, and seminal vesicle invasion status, blood transfusion rate, operation time, length of hospital stay, and 1-year follow-up potency and urinary incontinence rates were compared.Results:There was no difference between the two groups in terms of age, preoperative PSA, preoperative biopsy results, blood transfusion rates, operation times, and the length of hospital stay of the patients. When the postoperative oncological and functional results of the patients were examined, there was no difference between the two groups in the prostatectomy pathology (p = 0.895), extracapsular extension (pT3a) (p = 0.519), positive surgical margin (pSM) (p = 0.723), and seminal vesicle invasion (pT3b) (p = 0.756). Potency and urinary incontinence rates were similar in both groups at the end of one year follow-up (p = 0.327, 0.500 respectively).Conclusions:Based on our study, it is clearly seen that regardless of the surgeon’s experience of laparoscopy, it can be safely preferred when looking at the oncological and functional results of RALP.
      Citation: Urologia Journal
      PubDate: 2021-03-25T09:42:05Z
      DOI: 10.1177/03915603211004781
  • Lichen sclerosis–induced long segment anterior urethral stricture: The
           early outcome of one-stage repair using dorsolateral onlay buccal mucosa
    • Authors: Atef Fathi, Omar Mohamed, Osama Mahmoud, Gamal A Alsagheer, Ahmed M Reyad, Ahmed M Hasan, Mostafa Abdelrazek, Mohammed Saber-Khalaf
      Abstract: Urologia Journal, Ahead of Print.
      Background:Substitution urethroplasty using buccal mucosal grafts can be performed by several approaches including ventral onlay graft, dorsal onlay graft, or ventral urethrotomy with dorsal inlay graft. Our study aims to evaluate the surgical outcome of dorsolateral buccal mucosal graft for long segment anterior urethral stricture >6 cm in patients with Lichen sclerosus (LS).Methods:A retrospective study included patients who underwent repair for long segment anterior urethral stricture >6 cm due to LS between January 2013 and April 2019. All patients were followed-up at 3, 6, 9, and 12 months postoperatively and then yearly by clinical symptoms, uroflowmetry, and calculation of post-void residual urine volume. Retrograde urethrogram was requested for patients with voiding symptoms or decreased maximum flow rate. Stricture recurrence that required subsequent urethrotomy or urethroplasty was considered failure. The success rate and surgical complications were collected and analyzed.Results:Thirty patients were identified. The median age (range) was 39 (25–61) years and a median (range) stricture length was 8 (6–14) cm. Most of postoperative complications were of minor degree. The success rate at median follow-up of 15 (12–24) months was 86.5%. The median maximum flow rate increased significantly from 6 (2–11) ml/s preoperatively to 18 (range: 6–23) ml/s at the 6th month (p value 
      Citation: Urologia Journal
      PubDate: 2021-03-25T09:40:25Z
      DOI: 10.1177/03915603211003396
  • Association between hyperlipidemia and prostatic enlargement: A
           case-control study
    • Authors: Güven Erbay, Gökhan Ceyhun
      Abstract: Urologia Journal, Ahead of Print.
      Objective:A high-fat diet is associated with the development of benign prostatic enlargement (BPE), but whether hyperlipidemia is associated with BPE remains unclear. This study aimed to evaluate whether hyperlipidemia is a risk factor for the development of BPE.Material and methods:This study included 265 BPE patients with lower urinary tract symptoms (LUTS) and 248 age-matched healthy individuals without LUTS. The patient and control groups included in the study were compared in terms of fasting serum glucose, serum lipid values, prostate specific antigen (PSA), and prostate size measured by abdominal ultrasonography.Results:The prostate sizes of the patient and healthy control group were 59.4 ± 12.6 and 41.8 ± 11.1 ml, respectively (p = 0.007). It was observed that the mean PSA value of the patient group (2.33 ± 1.69) was statistically higher than that of the control group (1.21 ± 1.05) (p = 0.002). Total cholesterol and LDL-cholesterol were significantly higher and HDL-cholesterol was significantly lower among the patients compared to the controls. Prostate size had a negative correlation with HDL-cholesterol and a positive correlation with LDL-cholesterol and total cholesterol. Additionally, LDL-cholesterol and total cholesterol were independent risk factors for prostate enlargement.Conclusion:This study indicates that increased levels of LDL-cholesterol and total cholesterol are significantly associated with the enlargement of the prostate. Hyperlipidemia may be one of the risk factors in the processes of prostatic growth and progression.
      Citation: Urologia Journal
      PubDate: 2021-03-22T06:08:25Z
      DOI: 10.1177/03915603211003401
  • COVID-19 and slowdown of residents’ activity: Feedback from a novel
           e-learning event and overview of the literature
    • Authors: Tommaso Calcagnile, Maria Chiara Sighinolfi, Luca Sarchi, Simone Assumma, Beatrice Filippi, Giulia Bonfante, Alessandra Cassani, Valentina Spandri, Filippo Turri, Stefano Puliatti, Giorgio Bozzini, Marcio Moschovas, Giampaolo Bianchi, Salvatore Micali, Bernardo Rocco
      Abstract: Urologia Journal, Ahead of Print.
      Objective:To evaluate the impact of an e-learning online event, created for supporting resident’s training during the slowdown of surgical and clinical activities caused by COVID-19 pandemic. An overview of PubMed literature depicting the state of the art of urology residency in the COVID-19 era was performed as well, to contextualize the issue.Methods:An online learning event for residents was set up at the beginning of the pandemic; the faculty consisted of experts in urology who provided on-line lectures and videos on surgical anatomy, procedures, updates in guidelines, technology, training. The audience was composed of 30–500 attendees from Italy, USA, India and Belgium. A questionnaire to analyze relevance, satisfaction and popularity of the lessons was mailed to 30 local residents.Results and limitations:Almost all residents defined the web environment suitable to achieve the learning outcomes; the method, the number and the competence of the faculty were appropriate/excellent. Most of the younger residents (81.8%) stated their surgical knowledge would improve after the course; 72.7% declared they would take advantage into routine inpatients clinical activity. Nineteen more expert residents agreed that the course would improve their surgical knowledge and enhance their practical skills; almost all stated that the initiative would change their outpatients and inpatients practice. Overall, 44 articles available in PubMed have addressed the concern of urological learning and training during the pandemic from different standpoints; four of them considered residents’ general perception towards web-based learning programs.Conclusions:The paper confirms residents’ satisfaction with e-learning methods and, to our knowledge, is the first one focusing on a specific event promptly settled up at the beginning of the outbreak. Web-based educational experience developed during the pandemic may represent the very basis for the implementation of prospective on-site training and overall scientific update of future urologists.
      Citation: Urologia Journal
      PubDate: 2021-03-22T06:07:04Z
      DOI: 10.1177/03915603211001253
  • Idiopathic bilateral massive perirenal subcapsular effusion: The first
           case in the literature
    • Authors: Ibrahim Hacibey, Yusuf Sahin, Ismail Serifoglu, Ahmet Yaser Muslumanoglu
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Bilateral perirenal subcapsular effusion is a rare clinical condition and is associated with several underlying etiologies. We present a 33 years old male patient with idiopathic bilateral massive subcapsular effusion.Case presentation:A 33-year-old male patient presented to our outpatient clinic with bilateral flank pain and fever for 2 weeks. Bilateral perirenal subcapsular effusion was detected in intravenous contrast-enhanced CT and dynamic MRI.Treatment:Bilateral ultrasound-guided percutaneous drainage was performed by an expert uroradiologist to reduce the parenchymal pressure, Control CT imaging after 6 weeks demonstrate that bilateral normal kidneys.Discussion:It has been reported that subcapsular and perirenal effusion is a rare clinical condition that may develop secondary to causes such as Nephrotic syndrome, Eisenmenger Syndrome, Lymphangiomatosis, and Page Kidney Disease. In our case, the clinical symptoms of the patient regressed after the whole effusion fluid was drained. No underlying pathology was found in further examinations. Therefore, we present the first case of Idiopathic Bilateral Massive Perirenal Subcapsular Effusion in the literature.
      Citation: Urologia Journal
      PubDate: 2021-03-18T06:53:44Z
      DOI: 10.1177/03915603211001252
  • Did COVID-19 area change our urology practice: A retrospective analysis
    • Authors: Basri Cakiroglu, Cevdet Kaya, Hasan Huseyin KILIC, Suleyman Hilmi Aksoy, Ramazan Gözüküçük
      Abstract: Urologia Journal, Ahead of Print.
      Objective:This research aimed at evaluating the changing conditions and experiences of urological practice during the COVID-19 pandemic.Methods:The data of all patients who were admitted to outpatient clinics at Hisar Intercontinental Hospital or the hospital’s online patient portal system between March 11th and May 30th, 2020 were analyzed retrospectively. Of all patients, 545 in outpatient clinics and 25 in online portal system, (17%) were hospitalized for medical treatment, and 53 underwent surgery. There were 1032 patients admitted to Urology Clinics and 104 patients who underwent surgery in the same period of 2019. The pre-operative assessment of patients who were candidates of urological surgery included certain criteria for COVID-19.Results:Of patients included in this study, the median age was 41 years (18–90). The mean hospital stay was 1 day (1–12), and the mean duration of operation was 25 min (3–250). Thirty-seven patients (69.8%) underwent general anesthesia, while only 11(20.8%) underwent combined spinal epidural anesthesia. Four patients (7.5%) required local and only one patient (1.9%) underwent sedo-analgesia. Complications were encountered in six patients (11.4%), urosepsis in two, pneumonia in one, and urinary tract infection in three patients. Compared to last year’s numbers, the number of patients admitted to the hospital’s outpatient clinic and that of hospitalized patients decreased by 47.2% and 49.1%, respectively.Conclusion:Emergent surgeries in urological practices can be performed safely under routine preoperative testing for COVID-19 and with the use of adequate protective equipment for both the surgical team and the patient.
      Citation: Urologia Journal
      PubDate: 2021-03-18T06:52:04Z
      DOI: 10.1177/03915603211001681
  • Cosmetic results of circumcision and scar wrinkling: Do we exaggerate in
           terms of hemostasis and sutures'
    • Authors: Tuncay Taş, Basri Çakıroğlu, Uğur Ekici
      Abstract: Urologia Journal, Ahead of Print.
      Objective:To objective of this study was to investigate poor scar appearance of the circumcision line and scar wrinkling caused by the sutures placed during the circumcision in primary school age circumcised children.Methods:A total of 455 children aged between 6 and 9 years, circumcised by four different specialists in our hospital between 2009 and 2018 were evaluated. Circumcisions performed due to balanitis, phimosis, secondary phimosis, and paraphimosis were excluded from the study. Only routine religious circumcisions performed on request of the family were included in the study. Children underwent a second procedure and those receiving treatment after the circumcision due to infection were excluded from the study. About 363 patients included the study. Patients were evaluated according to the Fitzpatrick skin type classification, independent observer scale, Stony Brook Scar Evaluation Scale, and Dunn-Bonferroni test.Results:No statistically significant difference was found between distributions of scar wrinkling levels in children according to the circumcision (p > 0.05). There was a statistically significant difference between age of circumcision according to scare wrinkling levels (p = 0.001). According to the Dunn-Bonferroni test; the circumcision age was found to be significantly lower in children with severe scar wrinkling compared to the children with no or mild scar wrinkling (p = 0.001; p = 0.011).Conclusion:The tense, short-interval sutures placed away from the wound margin during circumcision in order to control subcutaneous bleeding lead to scar wrinkling and a poor cosmetic appearance. Knowing the risk factors leading to scar wrinkling and taking appropriate measures will provide acceptable cosmetic outcomes after the circumcision.
      Citation: Urologia Journal
      PubDate: 2021-03-17T09:44:26Z
      DOI: 10.1177/0391560320911526
  • 3D modeling in adherent perinephric fat prediction in nephron-sparing
           surgery planning in patients with localized renal neoplasms
    • Authors: Evgeny Sirota, Stanislav Vovdenko, Anastasia Sirota, Dmitrii Tsarichenko, Leonid Rapoport, Yuri Alyaev
      Abstract: Urologia Journal, Ahead of Print.
      Study objective:To develop a 3D-image based morphometry scoring system for Adherent Perinephric Fat (APF) prediction in nephron-sparing surgery in renal neoplasm patients.Materials and methods:The retrospective study involved 391 patients who underwent a laparoscopic partial nephrectomy performed by five surgeons from January 2014 till December 2018. The surgery involved the 3D virtual operation planning with «Amira» 3D modeling software. With the multivariate logistic regression models, we developed a scoring system based on 3D-models. We tested the significance and sensitivity of new scoring system in a comparative ROC analysis with Mayo Adhesive Probability Score (MAP).Results:We found APF in 111 patients (28.4%). The univariate analysis revealed that significant indicators included mean age 59.88 (55–67) (p 
      Citation: Urologia Journal
      PubDate: 2021-03-16T09:09:24Z
      DOI: 10.1177/03915603211001695
  • Laparoscopic versus open partial nephrectomy for the management of highly
           complex renal tumors with PADUA score ⩾10: A single center analysis.
    • Authors: Francesco Chiancone, Marco Fabiano, Clemente Meccariello, Maurizio Fedelini, Francesco Persico, Paolo Fedelini
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:The aim of this study was to compare laparoscopic and open partial nephrectomy (PN) for renal tumors of high surgical complexity (PADUA score ⩾10).Methods:We retrospectively evaluated 93 consecutive patients who underwent PN at our department from January 2015 to September 2019. 21 patients underwent open partial nephrectomy (OPN) (Group A) and 72 underwent laparoscopic partial nephrectomy (LPN) (Group B). All OPNs were performed with a retroperitoneal approach, while all LPNs were performed with a transperitoneal approach by a single surgical team. Post-operative complications were classified according to the Clavien-Dindo system.Results:The two groups showed no difference in terms of patients’ demographics as well as tumor characteristics in all variables. Group A was found to be similar to group B in terms of operation time (p = 0.781), conversion to radical nephrectomy (p = 0.3485), and positive surgical margins (p = 0.338) while estimated blood loss (p = 0.0205), intra-operative (p = 0.0104), and post-operative (p = 0.0081) transfusion rates, drainage time (p = 0.0012), pain score at post-operative day 1 (
      Citation: Urologia Journal
      PubDate: 2021-03-16T09:07:02Z
      DOI: 10.1177/03915603211001677
  • Trans-urethral bladder suture in female patients: Not a tour de force but
           a quick and realistic answer to complex situations
    • Authors: Fanourios Georgiades, Chryssanthos Kouriefs, Jonathan Makanjuola, Philippe Grange
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Trans-urethral bladder surgery has gained popularity in the fields of electro-resection and laser lithotripsy, with endoscopic suturing being overlooked. Bladder defect closure using a pure trans-urethral suturing technique can provide a quick and effective solution in situations where conventional management options are not feasible.Methods:Here we describe this innovative novel technique developed by our group that was used to treat two different cases with bladder perforation at two different institutions. We used a 5 mm laparoscopic port with gas insufflation and a laparoscopic needle holder trans-urethrally to achieve defect closure with a monofilament 2/0 monocryl mattress suture on a small 22 mm needle.Results:The defects were successfully closed without any intraoperative complications. Average operative time for the technique was 18 min with minimal blood loss. Bladder closure was sustained at a median follow-up of 2 years for one of these cases.Conclusions:We claim that transurethral bladder suturing is quick, safe in expert hands and provides an effective option where the clinical condition/situation of the patient warrants a minimally invasive surgery approach.
      Citation: Urologia Journal
      PubDate: 2021-03-16T09:05:42Z
      DOI: 10.1177/03915603211001168
  • Large spontaneous steinstrasse: Our experience and management issues in
           tertiary care centre
    • Authors: Kalpesh Parmar, Vignesh Manoharan, Santosh Kumar, Kumar Rajiv Ranjan, Abhishek Chandna, Kapil Chaudhary
      Abstract: Urologia Journal, Ahead of Print.
      Background:Steinstrasse, is described as array of stone pieces in the ureter following extracorporeal shock wave lithotripsy (SWL). It is well-recognized, transient event. Steinstrasse clears spontaneously, however about 6% require intervention. Spontaneous steinstrasse without prior history of SWL is a rare occurrence and only few case reports are published in literature. Objective of the study was to assess the aetiology and management issues of large spontaneous steinstrasse in our centre.Method:From February 2017 to March 2019, 684 patients underwent SWL for renal or ureteric stones. Twenty-eight patients presented with steinstrasse of which nine patients had no prior history of SWL. Detailed clinical profile and management issues have been discussed.Result:Among the nine patients of spontaneous steinstrasse, there were six males and three females. Mean age of the patients was 39 years (±13 years SD). Bilateral large spontaneous steinstrasse was seen in one out of nine patients. Seven patients had associated renal stones. Five patients presented with obstructive uropathy and three out of them had urosepsis as initial presentation. Ureterolithotomy and percutaneous nephrolithotomy were commonly performed procedures for stone clearance. Metabolic work was done in all cases in follow up period. Three patients had hypercalciuria and hypocitraturia suggestive of renal tubular acidosis.Conclusion:Large spontaneous steinstrasse is uncommon case scenario. It can be subtle in presentation and yet have significant patient consequence in terms of renal function and infection. Prompt management is essential to preclude permanent loss of renal function. Metabolic evaluation is indispensable in such cases.
      Citation: Urologia Journal
      PubDate: 2021-03-15T06:38:25Z
      DOI: 10.1177/03915603211001174
  • The role of perioperative ureteral stenting for urologic complications in
           radical surgery of cervical cancer
    • Authors: Stefan Miladinov Kovachev, Miladin Stefanov Kovachev
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:This study aimed to establish the urologic complications of radical type C2 hysterectomy in cervical cancer patients with or without ureteral stenting.Methods:This prospective randomized study included 76 (100%) patients with clinically and pathologically established cervical cancer stages I and II treated with radical type C2 hysterectomy with pelvic lymph node dissection for the last 5 years (2014–2019). Patients were randomized into two groups (2:1 ratio): group II received perioperative ureteral stenting (n = 24, 31.6%) and group I did not (n = 52, 68.4%). Urologic complications observed during follow-up include intraoperative ureter and urinary bladder lesions and postoperative ureterovaginal and vesicovaginal fistulas.Results:Of the 52 patients in group I who underwent surgery for cervical cancer, urologic complications were observed in 8 (10.5%) patients, 2 (2.6%) of whom underwent preoperative radiation therapy. In group II, urologic complications were observed in 2 (2.6%) patients, of which 1 (1.3%) received preoperative radiation therapy. Intraoperative urologic complications in group I (6.6%) included 3 (3.9%) ureteral lesions cases and 2 (2.6%) cases of urinary bladder lesions, wherein 1 patient received preoperative radiation therapy. One case of (1.3%) urinary bladder lesion was observed in group II. Postoperative complications were observed in 3 patients (3.9%) in group I, including 2 (2.6%) ureterovaginal fistula cases, wherein 1 (1.3%) patient received preoperative radiation therapy, and 1 (1.3%) case of vesicovaginal fistula. In group II, 1 (1.3%) patient who received perioperative radiotherapy developed postoperative vesicovaginal fistula.Discussion:Urologic complications are extremely common during and after radical surgery (hysterectomy type C2) for cervical cancer. The cervical cancer stage had a significant effect on intra- and postoperative urologic complication rates in this study; however, no such effect was observed for preoperative radiation therapy and ureteral stenting, and significant differences were observed between the two study groups.
      Citation: Urologia Journal
      PubDate: 2021-03-15T06:37:06Z
      DOI: 10.1177/03915603211001178
  • Collision kidney tumor with clear cell renal cell carcinoma and papillary
           type 1 renal cell carcinoma. A case report and review of the literature
    • Authors: Stavros Lamprou, Ioannis Glykas, Charalampos Fragkoulis, Georgia Theodoropoulou, Georgios Koutsonikas, Georgios Papadopoulos
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:The most common renal neoplasms include clear cell, papillary, and chromophobe renal cell carcinomas. The simultaneous occurrence of different histological types of adjacent neoplasms in the same organ is known as a collision tumor. Collision kidney tumors have already been described but only in rare cases.Case description:In this case report we present a 68-year-old man with chronic kidney insufficiency under dialysis who underwent an open right nephrectomy in our department with the histological diagnosis of a collision kidney tumor consisting of clear cell and papillary type 1 renal cell carcinoma.Conclusion:To the best of our knowledge, our case of a collision kidney tumor consisting of clear cell RCC and papillary type 1 RCC, is unique in literature.
      Citation: Urologia Journal
      PubDate: 2021-03-12T10:45:23Z
      DOI: 10.1177/03915603211001673
  • Disease management in a patient diagnosed with COVID-19 disease during
           induction intravesical BCG therapy: A case report and review of the
    • Authors: Fesih Ok, Emrullah Durmus
      Abstract: Urologia Journal, Ahead of Print.
      Objective:To discuss the patient diagnosed with COVID-19 disease while receiving intravesical induction bacillus Calmette-Guérin (BCG) treatment for non-muscle-invasive bladder cancer, its management in the light of the literature.Patient and methods:A 52-year-old male patient, who received intravesical BCG treatment for high-grade pT1 papillary urothelial carcinoma, presented 12 h after taking the fourth dose of induction therapy 38.2° fever and chills. The patient’s reverse transcriptase-polymerase chain reaction test was positive, and Thorax CT imaging showed a few ground-glass pneumonic infiltrations in bilateral lung bases consistent with COVID-19 disease.Results:Although international urology associations have current recommendations regarding the pandemic process, only one study has made specific recommendations regarding the patient group diagnosed with COVID-19 while receiving intravesical BCG treatment. According to this recommendation, we interrupted our patient’s BCG treatment for 3 weeks and then completed the treatment for 6 weeks. A maintenance treatment not exceeding 1 year was planned.Conclusion:This group of patients’ recommendation is to delay BCG therapy for at least 3 weeks after initial symptoms to allow for complete recovery. Although the administration schedule varies, maintenance therapy is recommended for no more than 1 year.
      Citation: Urologia Journal
      PubDate: 2021-03-12T10:43:50Z
      DOI: 10.1177/03915603211001670
  • Effects of severe hydronephrosis on the outcomes of percutaneous
           nephrolithotomy with one-shot dilation method
    • Authors: Uygar Micoogullari, Cem Yucel, Tufan Sueluzgen, Erdem Kisa, Mehmet Zeynel Keskin, Cemal Selcuk Isoglu, Yusuf Ozlem Ilbey
      Abstract: Urologia Journal, Ahead of Print.
      Objective:To investigate the effect of the presence of severe hydronephrosis on percutaneous nephrolithotomy (PNL) outcome in patients who underwent PNL operation with one-shot dilatation technique.Materials and methods:Medical data of 989 patients underwent PNL operation in our clinic between 2012 and 2018 were retrospectively reviewed. We included 373 of the patients underwent PNL operation due to renal pelvic stone, who were older than 18 years of age, who did not have any urinary tract abnormality, and had no previous history of open renal stone operation. Patients were divided into two groups according to the presence of severe hydronephrosis and absence of hydronephrosis. These two groups were compared in terms of age, gender, body mass index (BMI), number of stones, stone burden, operation duration, fluoroscopy time, hospitalization time, hemoglobin and creatinine change, complications, and stone free rate.Results:There was no statistically significant difference between the groups in terms of age, gender, BMI, stone number, stone size, stone density, operation duration, fluoroscopy time, and hospitalization duration. The mean change in hemoglobin was 1.5 g/dL in group 1 and 1.1 g/dL in group 2. This difference was statistically significant (p = 0.006). Postoperative blood transfusion was required for 3 patients (2.1%) in group 1 and 12 patients (5.1%) in group 2. This difference was statistically significant (p 
      Citation: Urologia Journal
      PubDate: 2021-03-12T10:41:09Z
      DOI: 10.1177/03915603211001175
  • Incidental discovery of endourethral clip migration 10 years after
           radical prostatectomy: A case report and review of the literature
    • Authors: Evangelos N Symeonidis, Dimitrios Memmos, Georgios Langas, Athanasios Bouchalakis, Panagiotis Baniotis, Eliophotos Savvides, Panagiotis Stefanidis, Wilbert F Mutomba, Georgios Dimitriadis
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Surgical clips (SCs) have been widely used for a variety of surgical procedures over the years. Despite their advantages and proven effectiveness, several clip-related complications have been reported, creating dilemmas as to their optimal use.Case description:Herein, we present a rare delayed and incidental discovery of two endourethral metallic SCs in a 77-year-old male seeking treatment for acute renal colic. The patient had undergone open radical retropubic prostatectomy 10 years ago, and had an uneventful postoperative recovery. Computed tomography scan revealed left-sided hydronephrosis secondary to proximal ureteral calculus, as well as SCs at the level of vesico-urethral (VUR) anastomosis. Flexible cystoscopy confirmed the imaging findings, showing two endourethral clips, partly obstructing the VUR. Firstly, a serial wire-guided dilation took place, followed by left ureteral double-J stent placement. Unfortunately, the clips could not be concurrently removed due to their firm attachment to the bladder neck. Hence, our patient was scheduled for transurethral resection of the bladder neck and simultaneous endoscopic clip removal.Conclusions:To the best of our knowledge, this is the first report to highlight such a delayed incidental finding, 10 years after open retropubic radical prostatectomy (RRP), during a JJ stent insertion for obstructive uropathy without previous clip-induced lower urinary tract symptoms. Although rare, physicians should be aware of the potential clip-related complications arising either in the short- or long-term postprostatectomy setting.
      Citation: Urologia Journal
      PubDate: 2021-03-10T09:16:31Z
      DOI: 10.1177/03915603211001177
  • Top 100 most influential manuscripts in erectile dysfunction
    • Authors: Thomas Minto, Nicholas Bullock, Gareth Brown
      Abstract: Urologia Journal, Ahead of Print.
      Erectile dysfunction (ED) is a common condition encountered by an array of subspecialists and is the most cited research topic within the field of andrology. This bibliometric analysis aims to identify the most influential papers that inform current clinical practice and likely shape future research. The Thompson Reuters Web of Science citation database was interrogated using search terms to cover the breadth of erectile dysfunction. Results were ranked according to citation number with country of origin, journal, topic, year of publication, author and institution also analysed. The search criteria matched 12,570 manuscripts. The top 100 highest citation ranged from 3013 to 161 (median 229.5). The most cited manuscript reports the prevalence and risk factors of ED within the Massachusetts Male Aging Study. The most manuscripts were published by the Journal of Urology (n = 15) with a total of 7913 citations. Institutions from the USA contributed the majority (n = 55) with the UK (n = 14) second. The most common theme represented was epidemiology (n = 46) followed by treatment (n = 27). This analysis provides a list of the most influential manuscripts within ED and illustrates what can be considered a ‘highly citable’ paper. The most influential papers in Erectile Dysfunction remain seminal works from the end of the last century. The most cited manuscript has been cited 194 times in the last 17 months showing its continued value. Only one paper published within the last decade has reached the top twenty exemplifying the relative lack of novel influential publications.
      Citation: Urologia Journal
      PubDate: 2021-02-26T05:40:56Z
      DOI: 10.1177/0391560321993559
  • Dual-phase 68Ga-PSMA-11 PET/CT may increase the rate of detected lesions
           in prostate cancer patients
    • Authors: Habibollah Dadgar, Manouchehr Seyedi Vafaee, Nasim Norouzbeigi, Esmail Jafari, Ali Gholamrezanezhad, Majid Assadi
      Abstract: Urologia Journal, Ahead of Print.
      Background:This study was conducted to compare the early static (3–6 min post-injection (p.i.)) and standard whole body (1 h, p.i.) 68Ga-PSMA-11 PET/CT imaging for detection of lesions in prostate cancer (PC) patients.Materials and methods:In this study, PC patients suspected of recurrence underwent 68Ga-PSMA-11 PET/CT. Early static images were acquired from the pelvis and the lower abdomen 3-5 minutes after radiotracer injection and, a routine whole body scan was performed from the skull to the mid-thigh 1 h after injection. Quantitative analysis (SUVmax) was evaluated in suspicious lesions.Results:Of 19 evaluated PC patients with a median age of 72 ± 1.66 years (range: 55–85 years) and prostate-specific antigen (PSA) of 1.72 ± 6.11 ng/ml (range: 0.1–100 ng/ml) (median ± SE), 16 showed positive in the whole body PET/CT. All of the patients with positive whole body scans due to pelvic involvement had positive early scan results. Totally, 22 lesions were detected in both early and delay scans in the pelvic which 16 were related to prostate involvement, 4 were related to lymph node involvement, and 2 were related to bone involvement. Moreover, in addition to the mentioned 22 lesions, early PET imaging successfully detected local recurrence in a patient who was negative on WB PET/ CT; this lesion was masked in the delay scan due to bladder activity. The median SUVmax values of the early and delay scans were 3.69 ± 1.07 (median ± SE) (range: 1.2–14.5) and 5.85 ± 1.69 (range: 3.1–23.4), respectively. (p = 0.005).Conclusion:Early static 68Ga-PSMA-11 PET/CT imaging might discriminate metastases from urinary bladder activity. Therefore, early static imaging in combination with whole body 60-min p.i. imaging can improve the detection of local involvement pelvic disease.
      Citation: Urologia Journal
      PubDate: 2021-02-25T07:06:41Z
      DOI: 10.1177/0391560321993544
  • Expression of aquaporins 3 in low grade risk of recurrence primary bladder
    • Authors: Marco Ticonosco, Simone Assumma, Andrea Iseppi, Mattia Benedetti, Luca Sarchi, Riccardo Ferrari, Tommaso Calcagnile, Bernardo Rocco, Maria Chiara Sighinolfi, Sulieman Alriyalat, Luca Reggiani Bonetti, Mario Migaldi, Salvatore Micali
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Bladder cancer (BC) is one of the most frequent malignancy of the urinary tract. Recent studies demonstrated the role of aquaporins urothelial tumor cells (AQPs) as potential prognostic factor for tumor progression and invasion. In this study we investigated the AQP3 expression levels inside primary superficial (pTa) low grade bladder cancer, correlating with pathological parameters and clinical outcomes.Materials and methods:We retrospectively analyzed tumor samples of 66 patients with diagnosis of superficial urothelial (pTa) bladder cancer between 1997 and 2007. All patients underwent transurethral bladder resection (TURB) and immediate single instillation of mitomycin C. All tumors samples were blindly reviewed by two expert anatomopathologists and only pTa low grade urothelial bladder cancer were included. Cancer recurrence was defined as the detection of bladder lesions during follow-up cystoscopy. AQP3-immunoreactive areas detected at immunohistochemical analysis were classified as AQP3 positive.Results:Of these 60.6% of patients was detected as negative for AQP3 expression. Forty-two patients develop cancer recurrence during follow-up with a mean progression free survival of 16.44 months. The absence of reaction for AQP3 was observed 56% (9/16) tumor grading G1 and 62% (31/50) tumor grading G2. No correlation was observed with sexual gender, grading of tumor differentiation, and recurrence of cancer disease. Kaplan-Meier curves of disease-free survival (DFS) showed a significant separation (p = 0.028) between patients AQP3-positive and AQP3-negative. It was observed a mean DFS of 23.83 and 14.43 months respectively in absence and presence of AQP3 expression.Conclusion:AQP3 expression is related to disease-free interval (DFI) and the absence of AQP3 expression correlates with a late relapse. The expression of AQP3 does not provide a reproducible quantitative aspect. AQP3 are not suitable to forecast tumor cell behavior but they perform a role as regulator for tumor cell homeostasis and for additional therapeutic developments.
      Citation: Urologia Journal
      PubDate: 2021-02-22T04:54:23Z
      DOI: 10.1177/0391560321993588
  • Living versus deceased kidney transplantation: Comparison of complications
    • Authors: Ali Mohammad Fakhr Yasseri, Farshad Namdari, Shahram Gooran, Ayat Ahmadi, Sanaz Dehghani, Mahboobeh Asadi, Abdolrasol Mehrsay, Gholamreza Pourmand, Hossein Dialameh
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:It is assumed that the outcome of kidney transplantation from living donors is more favorable than deceased donors. However, over the years there has been an overall improvement in transplant survival from both living and deceased donors. In this article we have evaluated and compared the most recent results in living and deceased donor kidney transplantations.Patients and Methods:Four hundred and forty six patients underwent kidney transplantation in our center from September 2009 to March 2014. The patients divided in two groups living (group A) and deceased (group B) donor transplantation groups. The patients were followed until September 2016. Acute rejection, graft survival, delayed graft function, renal artery thrombosis, graft nephrectomy, ureterocutaneous fistula, postoperative hypertension, mortality, hospital stay, hyperlipidemia, post transplantation diabetes and lymphocele rate measured and compared in two groups.Results:Most variables were not different between the two groups except lymphocele and delayed graft function. Lymphocele was more prevalent in group A (13.8% vs 3.1%, p-value = 0.02) and delayed graft function results were more desirable in living donor transplantation group (group B).Conclusion:Although, delayed graft function was less common in transplantation from living donors, short, and long term graft survival was not significantly different in this study.
      Citation: Urologia Journal
      PubDate: 2021-02-19T06:48:20Z
      DOI: 10.1177/0391560321993540
  • Evaluation of transverse dorsal lumbotomy in management of PUJ obstruction
           in patients younger than 6 months
    • Authors: Saeed Alhindi, Mohamed Mubarak, Husain Alaradi
      Abstract: Urologia Journal, Ahead of Print.
      Objective:The transverse dorsal lumbotomy approach provides excellent exposure to the PUJ and causes minimal tissue damage. In this study, we assess the efficacy of dorsal lumbotomy in PUJ obstruction in children younger than 6 months.Methods:All children less than 6 months who were managed with the dorsal lumbotomy approach between 2009 and 2017 were reviewed prospectively. Data included: demographic data, pre/post-operative renal ultrasound scan with SFU grading and RDS, operative time, post-operative complications, and follow up results.Results:A total of 42 children with a mean age of 4.4 ± 1 months were included. On pre-operative RDS, all patients had an obstructive pattern and a SRF of 30.3 ± 9.3. The mean operative duration was 49 min and analgesia was minimal. Post-operative ultrasound at 6 months showed an improvement in hydronephrosis (p 
      Citation: Urologia Journal
      PubDate: 2021-02-15T06:41:12Z
      DOI: 10.1177/0391560321993600
  • Do low dose CT-KUBs really expose patients to more radiation than plain
           abdominal radiographs'
    • Authors: Bob Yang, Noorunisa Suhail, Johan Marais, James Brewin
      Abstract: Urologia Journal, Ahead of Print.
      Background:Urolithiasis patients often require frequent urinary tract imaging, leading to high radiation exposure. CT Kidney-Ureter-Bladder (CT-KUB) is the gold standard in urolithiasis detection, however it is thought to harbour significant radiation load. Urologists have therefore utilised abdominal radiographs (XR-KUB) as an alternative, though with markedly lower sensitivity and specificity. We present the first contemporary UK study comparing the effective doses of XR-KUBs with low dose CT-KUBs.Method:Fifty-three patients were retrospectively identified in a single centre who underwent both a XR-KUB and a CT-KUB in 2018. Effective-Dose was measured by converting the recorded ‘Dose Area/Length Product’ via the International Commission on Radiological Protection formula.Results:The average effective dose of XR-KUBs and low dose CT-KUBs were 5.10 mSv and 5.31 mSv respectively. Thirty-four percent (18/53) of patients had a XR-KUBs with a higher effective dose than their low dose CT-KUB. Patients with higher Weight, BMI and AP diameter had higher effective doses for both their XR and low dose CT-KUBs. All patients in our study weighing over 92 kg or with a BMI greater than 32 had a XR-KUBs with a higher effective dose than their low dose CT-KUB.Conclusion:This data supports moving away from XR-KUBs for the investigation of urolithiasis, particularly in patients with a high BMI.
      Citation: Urologia Journal
      PubDate: 2021-02-13T09:09:50Z
      DOI: 10.1177/0391560321994443
  • Lifestyle in urology: Benign diseases
    • Authors: Riccardo Bientinesi, Carlo Gandi, Luigi Vaccarella, Emilio Sacco
      Abstract: Urologia Journal, Ahead of Print.
      Modifiable lifestyle-related risk factors are the object of increasing attention, with a view to primary and tertiary prevention, to limit the onset and development of diseases.Also in the urological field there is accumulating evidence of the relationship between urological diseases and lifestyle-related risk factors that can influence their incidence and prognosis. Risk factors such as nutrition, physical activity, sexual habits, tobacco smoking, or alcohol consumption can be modified to limit morbidity and reduce the social impact and the burdensome costs associated with diagnosis and treatment.This review synthesizes the current clinical evidence available on this topic, trying to satisfy the need for a summary on the relationships between the most important lifestyle factors and the main benign urological diseases, focusing on benign prostatic hyperplasia (BPH), infections urinary tract (UTI), urinary incontinence (UI), stones, erectile dysfunction, and male infertility.
      Citation: Urologia Journal
      PubDate: 2021-02-13T06:40:45Z
      DOI: 10.1177/0391560321994386
  • Unexpected hematologic malignancies after prostatectomy: Case report and
           literature review
    • Authors: Barış Karademir, Erdem Kısa, Mert Hamza Özbilen, Çağdaş Bildirici, Burak Karabacakoğlu, Tufan Süelözgen, Yusuf Özlem İlbey, Ülkü Küçük, Aybüke Olgun
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Voiding symptoms, storage symptoms and post-voiding symptoms together constitute lower urinary tract symptoms (LUTS). Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. The most common finding is lymphadenomegaly. Although infrequent, extranodal sites of involvement such as prostate can be detected. Mantle cell lymphoma (MCL) is a subtype of B cell non-Hodgkin lymphomas. Extranodal involvement findings such as prostate may be observed. In this case report, we will present a case in which we performed an open suprapubic prostatectomy (Freyer’s) and had CLL as a result of pathology, and a case whose pathology was MCL after transurethral resection of the prostate.Case 1:A 60-year-old male patient with LUTS for 6 years. Open suprapubic prostatectomy (Freyer’s) was performed on the patient. The pathology result of the prostatectomy material was compatible with CLL involvement.Case 2:A 62-year-old male patient with LUTS for 4 years. Transurethral resection of the prostate (TUR-P) was performed on the patient. The pathology result of the prostate was compatible with MCL involvement.Discussion and Conclusion:There are limited number of cases have been reported about CLL pathology after prostatectomy due to benign prostatic obstruction (BPO). There is no study indicating how often CLL pathology is seen after open prostatectomy or TUR-P due to BPO. In patients with CLL pathology after RRP, open prostatectomy, TUR-P, the need for additional surgery, the difference in prognosis or the difference between the treatment have not been shown in the studies. It should be kept in mind that patients with leukocytosis, lymphocytosis, cytopenias, and LUTS in their clinical presentation and who have not yet been diagnosed with CLL and other hematological malignancies such as mantle cell lymphoma may also have prostate gland involvement and can be diagnosed incidentally by any prostatic intervention.
      Citation: Urologia Journal
      PubDate: 2021-02-13T06:36:36Z
      DOI: 10.1177/0391560321993596
  • Rate of clinically significant prostate cancer on repeat saturation biopsy
           after a diagnosis of atypical small acinar proliferation
    • Authors: Angelo Totaro, Luca Di Gianfrancesco, Francesco Pinto, Marco Racioppi, Giuseppe Palermo, Marco Campetella, Agostino Antonio Santoro, Giuseppe Arbia, Emilio Sacco
      Abstract: Urologia Journal, Ahead of Print.
      Background:Atypical small acinar proliferation (ASAP) occurs in approximately 5% of prostate biopsies. Approximately 30%–40% of these patients may develop prostate cancer (PCa) within a 5-year period, often not clinically significant. Current guidelines recommend a repeat biopsy within 3–6 months after the initial diagnosis, but it seem not to be the best strategy.Methods:Objectives—evaluating the natural history of ASAP, stratifying the risk of csPCa after ASAP, identifying predictive factors of PCa after atypical diagnosis. Materials and methods—retrospective single-institutional study on patients undergoing prostate biopsy for suspicious PCa (2005–2016). We evaluated the incidence of overall PCa, intermediate-high risk of PCa and csPCa in case of ASAP, according to D’Amico classification and Epstein modified criteria.Results:Out of 4.567 patients undergoing prostate biopsy, ASAP was detected in 2.6% of cases. All patients with ASAP underwent repeat saturation biopsy within 6 months and PCa was diagnosed in 34.5%. According to D’Amico classification, 26%, 5.9%, and 2.5% had low, intermediate, and high-risk disease, respectively. According modified Epstein criteria, the incidence of csPCa was 12.6%. LRT showed that the overall probability to develop PCa doubled when PSA density (PSAD) moved from values lower than 0.13 ng/ml/cc to class 0.13–0.30 ng/ml/cc, and it tripled when PSAD was higher than 0.30 ng/ml/cc.Conclusions:The rate of csPCa in patients with an initial diagnosis of ASAP who had repeat biopsy was 12.6%. The overall PCa rate was 34.5%. Among patient undergoing RP, an upgrading from ncsPCa to csPCa was reported in 35% of cases. PSAD is the only predictive factor directly associated to the risk of developing PCa on repeat biopsy. These findings suggest that immediate repeat biopsy remains the correct strategy in absence of novel predictor factors and non-invasive diagnostic evaluations.
      Citation: Urologia Journal
      PubDate: 2021-02-13T06:34:17Z
      DOI: 10.1177/0391560321993595
  • Can the combined treatment of solifenacin and imipramine has a role in
           desmopressin refractory monosymptomatic nocturnal enuresis' A
           prospective double-blind randomized placebo-controlled study
    • Authors: Mohamed Samir, Mahmoud A Mahmoud, Hossam Elawady
      Abstract: Urologia Journal, Ahead of Print.
      Background:Nocturnal enuresis is a common disease of childhood. It can be classified into monosymptomatic nocturnal enuresis (MNE) or nonmonosymptomatic nocturnal enuresis (NMNE). Imipramine is a tricyclic antidepressant used to treat enuresis with initial success rates are high as 50% but some studies record a high relapse rate and it has a cardiotoxic effect when overdosed. Anticholinergics may be effective in the treatment of children with bladder storage dysfunction, including daytime incontinence. However, anticholinergics monotherapy is not effective in treating MNE. In our study, we used a low dose (25 mg) of imipramine in order to avoid its potential side effects and combined it with the synergistic anticholinergic action of solifenacin. Our objective was to evaluate the efficacy and safety of the combination of solifenacin and imipramine compared with placebo in the treatment of desmopressin refractory MNE.Methods:One hundred children aged 6 years or more with primary MNE unresponsive to desmopressin treatment were included. The children were randomly divided into two equal groups. Group A received imipramine 25 mg and solifenacin 5–10 mg oral tablets and group B received placebo once 1 h before bedtime for 3 months. The primary end point was to investigate the efficacy of the combined treatment of solifenacin and imipramine and the secondary end point was the safety of the drugs.Results:Our study showed that the mean post treatment wet nights per month was significantly lesser in the treatment group than placebo group (p 
      Citation: Urologia Journal
      PubDate: 2021-02-11T07:14:25Z
      DOI: 10.1177/0391560321993587
  • The prognostic importance of neutrophil-to-lymphocyte ratio in testicular
    • Authors: Ahmet Arıman, Erkan Merder
      Abstract: Urologia Journal, Ahead of Print.
      Purpose:Testicular cancer is mostly seen in young men. We planned this study that neutrophil-lymphocyte ratio (NLR) would help us predict the prognosis of the patients, except known markers such as AFP, hCG, and LDH.Patients and Method:Between 2015 and 2020, we conducted our study on 152 patients undergoing radical orchiectomy in our clinic. We divided our patients into good, moderate, and poor prognostic groups. We also created a control group of healthy patients of similar ages. We evaluated the NLR results in preoperative peripheral blood statistically among these groups.Results:We found a significant difference between the control group and the patient group, and between the good and moderate/poor prognostic groups for preoperative NLR.Conclusion:This study created the opinion that preoperative NLR will help us predict the prognosis of patients.
      Citation: Urologia Journal
      PubDate: 2021-02-11T07:08:44Z
      DOI: 10.1177/0391560321993584
  • Nephron sparing surgery for the treatment of renal masses: A single center
    • Authors: Michele Zazzara, Roberto Carando, Arjan Nazaraj, Marcello Scarcia, Michele Romano, Giuseppe Mario Ludovico
      Abstract: Urologia Journal, Ahead of Print.
      Background:Nowadays, the partial nephrectomy (PN) not only is considered oncological equivalent to radical nephrectomy as renal tumor’s treatment, but has also give benefits in quality of life and overall survival of patients.Objectives:The primary objective of the present study was to report our single center experience with NSS, predominantly performed by a robot assisted access, in a high-volume center with large experience with minimally invasive surgery.Methods:Between June 2018 and January 2020, a consecutive series of 109 patients (pts) with a renal mass suspicious of renal cell carcinoma, feasible of NSS, detected by ultrasound and abdominal computed tomography (CT), underwent NSS and they were included in a prospectively maintained institutional database. Baseline demographics and clinical characteristics, perioperative and postoperative parameters, pathological data were recorded.Results:The mean clinical maximum CT tumor diameter was 37.3 ± 19.6 mm (median 31.5 mm; interquartile range 25–45 mm). PADUA risk was low in 54 pts (49.5%), intermediate in 48 pts (44.0%), high in seven pts (6.4%). The clinical T stage was mostly pT1a (70.6%). NSS was performed by open surgery in nine pts (8.3%), laparoscopy in one pts (0.9%) and was robot assisted in 99 pts (90.8%). A simple enucleation was performed in 67 pts (61.5%), an enucleoresection was performed in 37 pts (33.9%) and a partial nephrectomy was performed in five pts (4.6%). Warm ischemia was performed in 41 pts (37.6%), with a mean warm ischemia time of 5.1 ± 7.1 min. The mean pathological maximum tumor diameter was 35.5 ± 21.7 mm (median 30 mm; interquartile range 22–40 mm). Overall PSM rate was 11.9% (13 pts). In 78% of cases no complication was recorded. No major complications (grade III-IV-V) were noted.Conclusion:Our findings suggest that NSS is a safe, reproducible and minimally invasive approach as treatment of small renal masses. NSS permits to achieve a fine oncological management without any worsening of renal function.
      Citation: Urologia Journal
      PubDate: 2021-02-10T11:04:54Z
      DOI: 10.1177/0391560321993557
  • Superselective prostatic artery embolization in the treatment of large
           benign prostatic hyperplasia
    • Authors: Alexander Izrailevich Neymark, Andrey Anatoljevich Karpenko, Boris Alexandrovich Neymark, Mikhail Alexandrovich Tachalov, Denis Dmitrievich Arzamastsev, Demid Vjacheslavovich Torbik, Elena Vladimirovn Gameeva, Boris Yuryevich Bobrov, Leonid Grigoryevich Spivak, Dmitry Olegovich Korolev, Dmitry Georgievich Tsarichenko, Leonid Moiseevich Rapoport
      Abstract: Urologia Journal, Ahead of Print.
      Purpose:To evaluate the use of prostatic artery embolization (PAE) as a treatment option for patients with symptomatic benign prostatic hyperplasia (BPH) with prostate volumes of 80 cc and more.Materials and Methods:The study included 75 patients with high anesthesia-related risks for conventional surgery (TURP). All patients were surveyed for symptom burden, using IPSS and quality of life score. The prostate volume was determined by transrectal ultrasonography (TRUS). At baseline, prostate-specific antigen (PSA) level was obtained in all patients. Urodynamics was evaluated using uroflowmetry. Clinical outcomes were assessed at follow-up 1, 3, 6, 12, and 24 months after PAE.Results:The prostate volume decreased significantly at months 1 and 3 post-treatment; the prostate continued shrinking until month 12, and the size was then stabilized. At month 24, prostate volume decreased by 40.82%, from 134.0 ± 8.3 mL at baseline to 79.3 ± 6.6 mL. Postvoid residual (PVR) urine volume was significantly decreased from 55.9 ± 5.3 mL to 22.0 ± 1.8 mL 1 month after PAE (p 
      Citation: Urologia Journal
      PubDate: 2021-02-08T05:17:23Z
      DOI: 10.1177/0391560321993598
  • The feasibility of one-day length of hospital stay after pediatric
           percutaneous nephrolithotomy
    • Authors: Mohammed Saber-Khalah, A.M. Reyad, Wael Gamal, Hazem Elmoghazy, Ahmed Mamdouh Abd Elhamed, Elnisr Rashed Mohamed, Abdelrahman M Abdellah, Abdelbasset A Badawy
      Abstract: Urologia Journal, Ahead of Print.
      Purpose:To evaluate the safety of one-day length of hospital stay (LOS) after pediatric percutaneous nephrolithotomy (PNL), and to study the predictors of LOS.Methods:A retrospective study included pediatric patients who PNL for renal calculi more than 1 cm between January 2016 and October 2019. PNL was performed in prone position. The nephrostomy tubes and ureteric catheters were removed on the second day and patients were discharged if there was no perforation or significant residual stones. The stone free rate, LOS and the surgical complications were reported. Bivariate and multivariate analysis were used to predict the LOS.Results:220 patients were identified. The median age (range) was eight (Range: 3–17) years. Stone free rate was achieved in 200 patients (91%) of patients, while residual fragments were detected in 20 patients (9%). Complications, they were reported in 50 (22.7%) patients. 184 (83.6%) of patients stayed at the hospital for only 1 day, while 36 (16. 4%) stayed more than 1 day. Of 36 patients who stayed more than one-day, 34 had complications (p value
      Citation: Urologia Journal
      PubDate: 2021-02-08T05:15:22Z
      DOI: 10.1177/0391560321993594
  • Laparoscopic single port radical prostatectomy in the 2020: Why not'
           Our experience
    • Authors: Giuseppe Sortino, Willy Giannubilo, Manuel Di Biase, Andrea Marconi, Maurizio Diambrini, Vincenzo Ferrara
      Abstract: Urologia Journal, Ahead of Print.
      Objectives:To analyze the feasibility, safety and advantages of Laparo-Endoscopic Single-site Surgery radical prostatectomy (LESS-RP) based on our personal experience.Patients and methods:Details of 520 patients were retrospectively analyzed, from 2009 to 2019. Extraperitoneal approach, with only two accesses (2.5 cm and 5 mm respectively) was used to perform radical prostatectomy. Perioperative characteristics and postoperative oncologic and functional outcomes are reported.Results:The mean age was 66.6 ± 5.6 years. Mean PSA level was 9 ± 3.5 ng/ml. According to D’Amico classification, the percentage of patients with low-, intermediate-, and high-risk disease cases were 116 (22.4%), 275 (52.8%), and 129 (24.8%) respectively. Mean operative time was 156 ± 43 min. Mean estimated blood loss was 214 ± 93 ml. Positive surgical margins (PSMs) were detected in 110 (21.2%) patients. PSM rates in pT2 and pT3 stages were 20.1% and 22.9%, respectively. The overall complication rate was 9.2%, based on the modified Clavien classification. The 12 months continence and potency rates were 90.9% and 49.1%, respectively. The biochemical recurrence rate was 6.8%, at the median follow-up time of 26.7 months (IQR 12–32).Conclusions:Our analyses show that LESS-RP is a safe procedure, if performed by surgeons with adequate experience and skills. Unlike the classic laparoscopic prostatectomy, this technique allows better aesthetic and psychological results, reduced postoperative pain, and a faster return to normal daily activity with the same functional and oncological results.
      Citation: Urologia Journal
      PubDate: 2021-02-08T05:10:22Z
      DOI: 10.1177/0391560321993555
  • Diagnostic bias during the COVID-19 era: COVID-19 or renal abscess'
    • Authors: Marco Amato, Ahmed Eissa, Giuseppe Rosiello, Rui Farinha, Pietro Piazza, Maria Chiara Sighinolfi, Bernardo Rocco, Giampaolo Bianchi, Salvatore Micali, Alexandre Mottrie, Stefano Puliatti
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:The Coronavirus disease-2019 (COVID-19) has been declared as a pandemic in March 2020 by the World Health Organization (WHO). Since then, this pandemic has dramatically affected the entire world, even radically influencing the way patients are framed at triage. Symptoms and tests in most cases lead to a correct diagnosis; however, error may be around the corner.Case report:A 60 years old patient was referred with weight loss, fatigue and mild fever for 3 weeks as he was working in a COVID-19 ward. After a positive swab and chest CT scan, he was admitted in the hospital and treated as mild COVID-19 patient. A CT scan performed after the patient was discharged revealed a renal lesion misidentified as a tumor then clarified to be an abscess which retrospectively appears to be the main cause of his symptoms.Conclusion:Clinicians should consider other life-threatening disease in the differential diagnosis of patients presenting with similar symptoms to minimize mistakes and avoid further unnecessary investigations.
      Citation: Urologia Journal
      PubDate: 2021-02-08T04:54:01Z
      DOI: 10.1177/0391560321993592
  • Primary renal non-Hodgkin’s lymphoma: A narrative review of
    • Authors: Bita Geramizadeh, Alireza Shojazadeh, Mahsa Marzban
      Abstract: Urologia Journal, Ahead of Print.
      Renal involvement by Non-Hodgkin’s lymphoma (NHL) is very rare, and involvement of the kidney as the primary site of NHL (PRNHL) is much more uncommon. Gold standard for the diagnosis of PRNHL is histology and imaging modalities although helpful are not specific. Nephrectomy has been mostly recommended for low grade lymphomas, and for high grade PRNHLs, chemotherapy without nephrectomy has been recommended as the treatment of choice. This tumor is aggressive with poor prognosis. This poor prognosis is partly because of delayed diagnosis and partly because of unnecessary surgeries, so it should be kept in mind, especially in bilateral renal tumors with unusual imaging characteristics, to take a tissue biopsy before nephrectomy. In this review, we will discuss all the detailed aspects of clinical, pathologic, and imaging characteristics of 83 cases of PRNHL reported in the last 20 years in the English literature so far. For this purpose, all the published cases of the primary non-Hodgkin’s lymphoma of kidney were reviewed via a search in PubMed, Scopus, and Google Scholar, (1999–2019), using the keywords of “Primary renal lymphoma” and “Non-Hodgkin’s lymphoma and kidney,” “renal Non-Hodgkin’s lymphoma,” “renal lymphoma,” and “lymphoma and kidney.” There were 83 cases in the published English literature which were reviewed for this article. There was some missing information in some cases which has been recorded as “not reported.”
      Citation: Urologia Journal
      PubDate: 2021-01-28T11:36:35Z
      DOI: 10.1177/0391560321990271
  • Emergency versus elective ureteroscopy for the management of ureteral
    • Authors: Nariman K Gadzhiev, Gagik N Akopyan, Farzona I Tursunova, Andrew S Afyouni, Dmitry O Korolev, Dmitry G Tsarichenko, Leonid M Rapoport, Zhamshid Okhunov, Somani Bhaskar, Vigen A Malkhasyan
      Abstract: Urologia Journal, Ahead of Print.
      Objective:To assess the safety and efficacy of emergency ureteroscopy (URS) compared with elective URS.Methods:We conducted a retrospective analysis of patients who underwent URS for isolated ureteral stones in a single center from October 2001 to February 2014. Our patient cohort was divided into two groups: an emergency URS group (Group A), which consisted of patients who underwent URS within the first 24 h of admission, and an elective or planned URS group (Group B). The URS success rate was defined as being the incidence of successful stone fragmentation and whether there was resolution of renal obstruction.Results:A total of 2957 patients’ medical records were available for analysis. Of these, 704 (21%) comprised of emergency cases and the remaining 2253 (79%) were elective cases. Patients in Group A were younger, had a smaller BMIs, and had smaller stone sizes (p 
      Citation: Urologia Journal
      PubDate: 2021-01-09T10:13:44Z
      DOI: 10.1177/0391560320987163
  • Can stone migration be predicted preoperatively in ureteroscopic
    • Authors: Ahmet Arıman, Erkan Merder, Mehmet ali Sezgin, Suzan Önol
      Abstract: Urologia Journal, Ahead of Print.
      Objective:In our study, we aimed to evaluate the parameters that are effective in predicting the possibility of stone migration during ureteroscopic lithotripsy.Patients and method:We divided our patients two group whom we applied ureteroscopic lithotripsy. Patients who migrated stones during ureteroscopic manipulation to the 1st group, and the patients who did not migrate stones to the second group were included. We measured the proximal ureter diameters of the patients in both groups on their computed tomography. We compared these values statistically. In addition, we determined a cut-off value for the ureter diameter to predict the possibility of stone migration.Result:Especially, ureter diameters of patients with middle and lower ureter stones showed significant differences between groups. Also, stone sizes differed significantly between groups.Conclusion:We concluded that the possibility of stone migration is high in patients with a ureter diameter higher than 7.45 mm in the middle and lower ureteric stones. Also, we believe that stone diameter and the surgeon’s experience are effective factors in stone migration.
      Citation: Urologia Journal
      PubDate: 2021-01-09T10:13:23Z
      DOI: 10.1177/0391560320988184
  • Functional, morphological and operative outcome after pyeloplasty in adult
           patients: Laparoscopic versus open
    • Authors: Erkan Merder, Ahmet Arıman, Kenan Sabuncu, Fatih Altunrende
      Abstract: Urologia Journal, Ahead of Print.
      Objective:The aim of this study is determine and compare improvement of hydronephrosis, renal function, and operative outcome between laparoscopıc and open pyeloplasty in adults.Material and methods:Sixty-five adult patients with primary ureteropelvic junction obstruction (UPJO) underwent pyeloplasty between January 2014 and September 2020. Thirty-four patients had laparoscopıc pyeloplasty (LP), 31 patients had open pyeloplasty (OP). In this retrospective study demographics, differential renal function (DRF), hydronephrosis, anteroposterior diameter of pelvis renalis (APD) and operative outcomes: operation time, blood loss, complications, hospital stay, etiology, analgesic requirement, complications, and success rates were compared between two groups.Results:Improvement of APD is higher in OP group (p: 0.001). Improvement of DRF (p: 0.713) and hydronephrosis (p = 1.000), success (p: 0.407) and complication rate (p: 0.661) are comparable between two groups. Median hospital stay, postoperative analgesia requirement and blood loss was less in LP group, mean operative time was shorter in OP group (p: 0.001).Conclusion:Pain complaints are greatly reduced after pyeloplasty in adult patients but the drainage of kidney, DRF and hydronephrosis does not improve as much as desired. Improvement of APD is better and median operative time is less in OP, intraoperative blood loss, hospital stay, and analgesic requirement is less in LP group in our study.
      Citation: Urologia Journal
      PubDate: 2021-01-08T07:07:28Z
      DOI: 10.1177/0391560320987921
  • Clinical assessment of stabilisation of renal function after nephrectomy
    • Authors: Debansu Sarkar, Akash Agrawal, Dilip Kumar Pal
      Abstract: Urologia Journal, Ahead of Print.
      Introduction and objective:Nephrectomy leads to derangement of renal function and various adaptive changes by the remaining kidney over a period of time. This study is performed to evaluate the amount of derangement of renal function in donor and radical nephrectomy, how much the remaining kidney adapts over a period of time and the time taken for stabilisation of renal function.Method:A total of 60 patients who underwent nephrectomy (Radical/Donor) were followed up for 12 months with serial estimation of renal function and was compared with preoperative renal function. Data was analysed with statistical analysis.Result:Patients who underwent radical nephrectomy had 37% initial decline in renal function which was later stabilised at 19% lower than baseline value. Patient who underwent donor nephrectomy had initially 39% decline in renal function which was later stabilised at 24% lower than normal.Conclusion:Removal of functional renal tissue led to reduction of renal function. This decline is more evident in the initial post-operative period and then begin to stabilise over months. The greater is the amount of normal tissue removed, the greater is the reduction of renal function and more time it will take to stabilise, increasing overall morbidity of the patient. This study suggests that even patients with normal GFRs should be followed up postoperatively to determine their ultimate renal functional outcomes.
      Citation: Urologia Journal
      PubDate: 2021-01-08T07:06:48Z
      DOI: 10.1177/0391560320987799
  • Changing in gender prevalence of nephrolithiasis
    • Authors: Elisa Cicerello, Mario S Mangano, Giandavide Cova, Matteo Ciaccia
      Pages: 90 - 93
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 90-93, May 2021.
      Although nephrolithiasis is a more common disease in men rather than women, several studies over the last decades show that the male to female ratio 3:1 is narrowing. These finding may be associated to modified risk factors for stone formation between females and males. Changes in lifestyle and increasing obesity in women may play a role in shifting of gender disparity. Furthermore, recent studies have demonstrated an increase of kidney stones in women which have necessitated emergency department visits (ED). Therefore, females show a greater percentage of mortality rate if compared to males, especially if stone disease is associated to urosepsis and requires the admission to the Intensive Care Unit (ICU). This article reviews recent insights into changing gender prevalence in urinary calculi and into identifying the relation between gender and risk factors for stone disease, that in case of severe urosepsis might also lead to mortality.
      Citation: Urologia Journal
      PubDate: 2020-10-21T11:12:38Z
      DOI: 10.1177/0391560320966206
      Issue No: Vol. 88, No. 2 (2020)
  • Urine and serum glycosaminoglycan levels in the diagnosis of urological
           diseases and conditions: A narrative review of the literature
    • Authors: Yasemin Ustundağ, Kağan Huysal, Muhammet Guzelsoy, Canan Erdem Genim, Ayca Yavuz
      Pages: 103 - 109
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 103-109, May 2021.
      Glycosaminoglycans (GAGs) are sulfated, negatively charged polysaccharides produced in almost every cell of the human body. As GAGs are extracellularly localized, the changes in body fluids such as blood and urine may reflect pathological changes in the urinary system as observed in other pathologies. In this review, we determined the potential of urinary and/or serum GAG levels as a marker for kidney and urothelial system diseases. We performed a search in the PubMed, MEDLINE, and ScienceDirect databases until September 30, 2019. A number of studies reported changes in the urinary and/or plasma GAG levels or composition in urological diseases and conditions, such as renal cell carcinoma, kidney stone, bladder carcinoma, and overactive bladder. GAGs were found to have a predictive biomarker potential that could be limited by generalizability concerns.
      Citation: Urologia Journal
      PubDate: 2020-10-11T06:17:24Z
      DOI: 10.1177/0391560320960003
      Issue No: Vol. 88, No. 2 (2020)
  • Does radical prostatectomy result in lower urinary tract symptom
           improvement in high-risk and locally advanced prostate cancer' A
           Single-center experience
    • Authors: Georgios Papadopoulos, Charalampos Fragkoulis, Konstantinos Stasinopoulos, Georgios Stathouros, Ioannis Glykas, Georgios Theocharis, Stavros Lamprou, Konstantinos Ntoumas
      Pages: 110 - 114
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 110-114, May 2021.
      Purpose:Radical prostatectomy represents the most popular method of prostate cancer treatment, including cases with high-risk and locally advanced cancer. Besides, men with this disease often experience lower urinary tract symptoms (LUTS) and report high International Prostate Symptom Scores (IPSS), pathological post-void residual (PVR) urine volumes and low levels of maximum urinary flow rates (Qmax). In this study we assessed the effect of radical prostatectomy on the above parameters in patients with high-risk and locally advanced disease.Methods:A number of 240 individuals were enrolled in the study. Patients that required any post-operative manipulation up to the completion of 12 months after surgery were excluded. All patients were assessed pre- and post-operatively at 3, 6 and 12 months. Evaluation included IPSS, Qmax and PVR.Results:Mean age was 66.8 years. Mean PSA value was 12.7 ng/ml and mean Gleason score was 7.9. At baseline 41.3% of the patients had Qmax ⩽10 and 42.5% had IPSS >8. There was a significant increase in Qmax during the follow-up (median value was 12 at baseline and increased to 21 at 12 months). Also, IPSS and PVR decreased significantly during the follow-up. IPSS median value decreased from 9 at baseline to 5 at 12 months. Improvement was observed in all grades of symptoms.
      Citation: Urologia Journal
      PubDate: 2020-10-10T10:38:55Z
      DOI: 10.1177/0391560320964611
      Issue No: Vol. 88, No. 2 (2020)
  • Relative position of bladder neck to pubic symphysis on cystogram is a
           strong and reproducible predictor of early urinary continence recovery
           following radical prostatectomy
    • Authors: Marta Rossanese, Simona Caloggero, Giuseppe Alario, Giuseppe Mucciardi, Giacomo Novara, Gianluca Giannarini, Vincenzo Ficarra
      Pages: 115 - 121
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 115-121, May 2021.
      Objectives:To assess whether bladder neck angle and position on cystogram predict early urinary continence in patients scheduled for early catheter removal after radical prostatectomy (RP).Methods:A total of 103 patients undergoing open or robot-assisted RP by one expert surgeon between January and December 2019 were retrospectively analyzed. A cystogram was performed on postoperative day 3 or 4 to evaluate anastomotic leakage, and, if none or minimal, the catheter was removed. Urinary continence was evaluated with a validated questionnaire at 1 week, 1 month, and 3 months after RP. Four investigators of different experience assigned bladder neck angle and relative position of bladder neck to pubic symphysis on archived cystogram images. Association between these two parameters and urinary continence rates at different follow-up times was assessed with logistic regression analysis adjusting for patient and tumor characteristics, and surgical technique. Interobserver agreement in assigning the two parameters was measured with k statistic.Results:Catheter was removed immediately after cystogram in 101 (98%) patients. On multivariable analysis, only relative position of bladder neck to pubic symphysis was an independent predictor of 1-week (odds ratio [OR] 30. 95% confidence intervals [CIs] 6-138, p 
      Citation: Urologia Journal
      PubDate: 2020-11-25T06:56:23Z
      DOI: 10.1177/0391560320974891
      Issue No: Vol. 88, No. 2 (2020)
  • Active surveillance for bilateral renal oncocytomas already resected on
           one side: a case report
    • Authors: Mangano Mario S, Cicerello Elisa, Cova Gian D, Ciaccia Matteo, Tomasi Biagio
      Pages: 122 - 124
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 122-124, May 2021.
      Introduction:To report our experience of active surveillance of new bilateral masses after left laparoscopic partial nephrectomy for oncocytoma.Method:A 67-year old man underwent left laparoscopic partial nephrectomy for a renal mass and histology confirmed oncocytoma. At follow-up magnetic resonance imaging (MRI) showed new renal bilateral masses: hence, sonogram-guided percutaneous core renal biopsies were performed confirming the presence of oncocytoma in both kidneys. A re-biopsy was required because of an increasing of the left mass while a histological was also consistent with oncocytoma.Result:At follow of 8 years the patient is well and shows a normal renal function.Conclusion:Oncocytomas show minimal growth rate or progression. MRI has an important role in the appropriate follow-up of renal oncocytomas. Patients with biopsy proven oncocytoma may be managed conservatively by active surveillance (AS).
      Citation: Urologia Journal
      PubDate: 2020-12-09T06:19:25Z
      DOI: 10.1177/0391560320978038
      Issue No: Vol. 88, No. 2 (2020)
  • Association of beta-catenin and CD44 in the development of renal cell
    • Authors: Akash Agrawal, Chhanda Datta, Chinmay Kumar Panda, Dilip Kumar Pal
      Pages: 125 - 129
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 125-129, May 2021.
      Introduction and objective:Renal cell carcinoma (RCC) accounts for approximately 3% of all cancers. Approximately 25%–30% of patients present with metastatic disease at the time of diagnosis, and metastatic RCC is a treatment-resistant malignancy. Altered expression of cell adhesion molecules such as CD44 on tumor cells suggests a pathogenetic mechanism for tumor metastasis and may provide prognostic information for particular tumors. These cell matrix interactions of CD44 play a role in tumor cell invasion and metastasis. The Wnt/beta-catenin pathway turned out to be a promising target as it is involved in the regulation of cell proliferation, differentiation and apoptosis induction.Method:In this study, the expression of beta-catenin and CD44 was analyzed in primary renal cell carcinoma (RCC) samples to understand their association with development of the disease. For this purpose, immunohistochemical expression analysis of beta-catenin and CD44 was performed in 30 primary RCC histological samples and normal kidney tissues in different subtypes at different clinical stages of Indian patients (year: 2017–2019).Result:Most of the patients who presented were diagnosed as clear cell carcinoma and it was observed that expression of CD44 was high in patients with high stage tumors. Also beta-catenin was increased in advanced grade tumors, but there was insignificant correlation between high expression of molecules and survival or recurrence of disease.Conclusion:Both cd44 and beta-catenin activation was noted in patients with clear cell carcinoma, more in advanced tumors. Both can be promising targets for treatment in clear cell RCCs.
      Citation: Urologia Journal
      PubDate: 2020-12-10T10:13:34Z
      DOI: 10.1177/0391560320980672
      Issue No: Vol. 88, No. 2 (2020)
  • Flexible cystoscopy for ureteral stent removal without antimicrobial
           prophylaxis. A prospective observational study
    • Authors: Alberto Olivero, Niccolò Riccardi, Drilona Ndrevataj, Federica Balzarini, Mattia Cerasuolo, Paolo Bottino, Marco Borghesi, Ferdinando Dodi, Carlo Terrone
      Pages: 130 - 134
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 130-134, May 2021.
      Objective:Flexible cystoscopy for ureteral stent removal after ureteroscopy is widely performed. In this scenario, the real need for antimicrobial prophylaxis is still uncertain. Aim of this study is to determine the urinary tract infections rate after 4 weeks from outpatient flexible cystoscopies for ureteral stent removal without antimicrobial prophylaxis.Patients and methods:A prospective observational study was performed between November 2017 and August 2018 in a single, high-volume Institution.Risk factors for UTIs were recorded. Immediately before cystoscopy, each patient submitted a voided urine specimen. Antibiotics were not given before or after cystoscopy. About 7 and 28 days after cystoscopy all the patients underwent abdomen US, urine analysis and culture, and clinical evaluation to assess possible symptoms of UTI.Results:A total of 192 patients were enrolled in the study, 76 patients (39.2%) were female. Median age was 55 years [IQR 47- 68]. Median BMI was 24.2 [22.9-26.7]. Eighteen patients (9.4%) had asymptomatic bacteriuria before cystoscopy and 39 (20.3%) had positive culture at 7 days. About 21 patients (10.9%) were diagnosed with febrile UTI in the 28 days FU period. The 28.6 % of the Febrile patients had asymptomatic bacteriuria before the stent removal (p 
      Citation: Urologia Journal
      PubDate: 2020-12-16T12:16:07Z
      DOI: 10.1177/0391560320980897
      Issue No: Vol. 88, No. 2 (2020)
  • Robotic assisted laparoscopic radical prostatectomy following open
           trans-vesical adenomectomy: A single centre experience and review of the
    • Authors: Fanourios Georgiades, Kostas Konstantinou, Chryssanthos Kouriefs
      Pages: 135 - 139
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 135-139, May 2021.
      Introduction:Robotic assisted laparoscopic radical prostatectomy (RALRP) following endoscopic resection of the prostate is known to be feasible with good outcomes. However, the literature evidence is limited on the feasibility and outcomes of RALRP following open prostatic surgery. In this study, our aim was to report our experience with RALRP in patients who had undergone trans-vesical adenomectomy of the prostate in the past.Patients and methods:We reviewed our prospectively maintained database of men treated with RALRP at our institution to identify patients with previous history of open suprapubic trans-vesical adenomectomy, between 2016 and 2020. Data were collected on demographic information, interventions, oncological outcomes and follow-up.Results:Out of 362 patients, four individuals were identified that had previous open suprapubic trans-vesical adenomectomy. The mean age was 71 years with a mean pre-operative prostate specific antigen (PSA) of 11.35 ng/ml, and an average of 10 years after their trans-vesical adenomectomy. The mean console time was 119 min with an average estimated blood loss of 137.5 ml and 75% underwent lymphadenectomy. Post-operatively, all patients were discharged after 1 day with their urinary catheters removed at 7 days post-op. For one of the patients, a urine leak was identified, and his pelvic drain was removed at 5 days instead of 1 day as for the other three patients. No other complications were noted within 30 days. The average prostate weight was 54.7 g with all specimens being T3a R0. At 6 weeks follow-up, PSA was undetectable, three patients reported full continence and 1 was using two pads/day.Conclusion:RALRP following previous open trans-vesical prostatectomy is feasible and safe with excellent oncological outcomes. They are, however, more challenging and cumbersome with increased console time.
      Citation: Urologia Journal
      PubDate: 2020-12-10T10:12:44Z
      DOI: 10.1177/0391560320979858
      Issue No: Vol. 88, No. 2 (2020)
  • Urinary incontinence experiences of pregnant women: A qualitative study
    • Authors: Yasemin Erkal Aksoy, Bihter Akın, Sema Dereli Yılmaz
      Pages: 140 - 147
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 140-147, May 2021.
      Objective:The research was carried out to determine the life experiences of pregnant women who have urinary incontinence problems.Methods:The type of the research is of qualitative type. Views of pregnant women were coded according to repeating frequencies; then thematic grouping was done. Both common views and individual repetitions of the pregnant women were coded. During the study, 52 pregnant women stated that they had urinary incontinence problems. However, five pregnant women did not want to participate in the study and six pregnant women wanted to leave during the interview. Interviews ended with 41 pregnant women.Results:In the study, the mean age of the pregnant women was determined as 29.75 ± 4.83, and the mean gestational week was 27.85 ± 5.60. The views of pregnant women are divided into five main themes and 16 sub-themes. The main themes for the urinary incontinence life experiences of pregnant women were determined as “strategies to take precautions, psychological effects, pregnancy and baby-specific effects, physical effects and changes in their relationship with the spouse.”Conclusion:As a result, it was determined that urinary incontinence problem negatively affected the life experience of pregnant women.
      Citation: Urologia Journal
      PubDate: 2020-11-27T11:16:55Z
      DOI: 10.1177/0391560320974880
      Issue No: Vol. 88, No. 2 (2020)
  • Supine versus prone PCNL in lower calyceal stone: Comparative study in a
           tertiary care center
    • Authors: Sunirmal Choudhury, Paragmani Talukdar, Tapan Kumar Mandal, Tapas Kumar Majhi
      Pages: 148 - 152
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 148-152, May 2021.
      Introduction:Renal calculus disease is an age old disease of human being. PCNL (Percutaneous nephrolithotomy) stands as a gold standard treatment for large renal calculus which is traditionally being done in prone position.Objective:To evaluate the safety and efficacy of supine PCNL versus prone PCNL comparing intraoperative time, requirement of relook PCNL, post op hemoglobin drop, post operative hospital stay, post operative complication, SFR ( stone free rate).Methods and materials:It is a prospective study done in Urology department in a tertiary care center in Eastern India between October 2017 and October 2018. A total of 84 patients with lower calyceal renal stones underwent PCNL, 42 of them in supine and 42 in prone position. Lower calyceal stone, size measuring 1 to 2 cm were included in the study.Results:The mean intra operative time was 91.76 min in supine group and 85.43 min in prone group with a p value of 0.115. The mean hemoglobin drop was 1.11 g/dl and 1.18 g/dl in supine and prone position, respectively (p value 0.75). The mean post operative hospital stay was 4.1 and 3.86 days in supine and prone group (p value 0.58), respectively. Two patients in each group require relook PCNL. Stone free rate at 1 month was 95.23% and 90.47% (p value 0.9), respectively in case of supine and prone group.Conclusion:Supine PCNL is feasible, comparable to prone PCNL in respect to operative parameters with relatively higher stone free rate though statistically insignificant.
      Citation: Urologia Journal
      PubDate: 2020-10-08T04:57:24Z
      DOI: 10.1177/0391560320962404
      Issue No: Vol. 88, No. 2 (2020)
  • An atypical manifestation of idiopathic retroperitoneal fibrosis: A case
    • Authors: Diamond Ghieh, Charbel Saade, Fadi El-Merhi
      Pages: 153 - 156
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 153-156, May 2021.
      A 58-year-old male patient, previously healthy, presented with right flank pain of few hours duration. Initial workup showed an elevated creatinine and right hydroureteronephrosis. Computed tomography imaging revealed a retroperitoneal soft tissue mass encasing the right common iliac artery which is a first reported case in its anatomical distribution. Patient was referred to interventional radiology service where a percutaneous nephrostomy tube was placed followed by double J stenting. Subsequently, treatment with steroids was started. Follow up imaging a few months later revealed progressive resolution of the inflammatory process.
      Citation: Urologia Journal
      PubDate: 2020-02-05T01:00:29Z
      DOI: 10.1177/0391560319899302
      Issue No: Vol. 88, No. 2 (2020)
  • Renal pseudoaneurysm after blunt trauma in a 10-year-old girl: A case
    • Authors: Simone Sforza, Giorgio Persano, Chiara Cini, Idanna Sforzi, Antonio Andrea Grosso, Francesca Bronzini, Leonardo Bussolin, Manlio Acquafresca, Lorenzo Masieri
      Pages: 157 - 159
      Abstract: Urologia Journal, Volume 88, Issue 2, Page 157-159, May 2021.
      Introduction:Renal trauma is a relevant cause of morbidity in children older than 1 year. Most patients are currently managed conservatively, even in case of high-grade traumas; nevertheless, harmful complications may occur even in hemodynamically stable patients. We present a case of grade IV blunt renal trauma complicated by post-traumatic pseudoaneurysm.Case description:A 10-year-old girl was referred to our institution for grade IV trauma of the right kidney. During observation she had persistent hematuria that caused anemia. A second contrast-enhanced computed tomography scan revealed a posttraumatic pseudoaneurysm that was successfully treated by angiographic embolization.Conclusions:Although extremely rare after blunt renal trauma, post-traumatic renal pseudoaneurysm may cause severe blood loss and anemia, and angioembolization is therefore indicated. This condition should be suspected and move physicians to investigate further.
      Citation: Urologia Journal
      PubDate: 2020-01-23T09:50:47Z
      DOI: 10.1177/0391560319896155
      Issue No: Vol. 88, No. 2 (2020)
  • Impacts of the COVID-19 outbreak on visits and treatments for patients
           with ureteral stones in a general hospital emergency department
    • Authors: Zhenhua Liu, Libo Man
      Abstract: Urologia Journal, Ahead of Print.
      Background:The COVID-19 is a challenge for both patients and physicians in emergency department (ED). This study was aimed to report the impacts of the COVID-19 outbreak on visits and treatments for patients with ureteral stones in a general hospital ED.Methods:The patients with ureteral stones were collected from 24 January to 24 March 2020 during the COVID-19 outbreak in Beijing. Two periods were divided for study: 24 January to 24 February (Period 1) and 25 February to 24 March (Period 2). Data on patients’ characteristics, attendance, visual analog scale (VAS) scores, stone features, and final treatment choices were retrieved from the computer and compared with the data in the same periods in 2019.Results:The study included 376 patients with ureteral stones during the COVID-19 outbreak periods in 2020 and 343 patients during the same periods in 2019. Compared with the same periods in 2019, the number of patients with ureteral stones was less in Period 1 (137 vs 163) but had a rebound phenomenon in Period 2 (239 vs 180). The visit frequency was significantly reduced (2.6 ± 0.4 vs 3.6 ± 0.8, p 
      Citation: Urologia Journal
      PubDate: 2020-12-30T06:09:36Z
      DOI: 10.1177/0391560320985659
  • Letter to editor: One case of congenital dorsal penile cutaneous fistula
    • Authors: Xianqiang Yu, Yong Zhang
      Abstract: Urologia Journal, Ahead of Print.
      Congenital cutaneous fistula in the pubic area in infants and young children is a very rare congenital dysplasia disease, mainly manifested by abnormal punctiform opening near the midline of the area. What we are going to describe is a case of a 2-month-old boy with a congenital dorsal penile cutaneous fistula. At first, the main manifestation was pus at the opening of the fistula. The child recovered well after surgery without obvious complications.
      Citation: Urologia Journal
      PubDate: 2020-12-16T12:15:48Z
      DOI: 10.1177/0391560320980266
  • Epidemiological study of granulomatous prostatitis in a tertiary hospital:
           Associated risk factors and relationship with prostate cancer
    • Authors: Iris Coello Torà, Marta de la Cruz Ruiz, Paula Carrillo García, Enrique Carmelo Pieras Ayala
      Abstract: Urologia Journal, Ahead of Print.
      Objective:The primary objective was to estimate the incidence of granulomatous prostatitis (GP) in Son Espases University Hospital, a tertiary care hospital, in Palma de Mallorca (Spain). As secondary objectives, presence of concomitant PCa in the biopsy was analyzed, as well as the history of previous BCG instillations, biopsy origin, urinary symptoms, and cardiovascular risk (CV) factors.Methods:A descriptive retrospective study of GP and the aforedescribed variables were carried out from 2010 to 2017.Results:A total of 3651 histopathological prostate specimens were analyzed, 39 of which were diagnosed with GP (incidence of 1.06%). Lower urinary tract symptoms (LUTS) were present in a 48.7% and previous history of bladder tumor resection (TURBT) was present in 35.9% of the cases. Also, urinary tract infections were equally present. All cases with prior TURBT had intravesical instillations with BCG, although 5 (12.8%) and 4 (10.3%) cases had abnormal rectal examination and elevated PSA levels after instillations, respectively. Finally, in 14 cases (35.9%) there was also a diagnosis of concomitant PCa. The most common CV risk factor in these patients was smoking (79.5%) followed by hypertension (64.8%).Conclusions:The estimated incidence of GP in our center (1.06%)g is close to that described by other authors. About 14 cases were diagnosed with PCa (35.9%), a higher value than previously described in the literature, and most of these were found incidentally, especially in cystoprostatectomies. This high percentage of concomitant GP and PCa could be due to a rise in Transrectal Prostate biopsies (TRPB), as in recent years there has been a tendency to increase the use of PSA in routine clinical practice.
      Citation: Urologia Journal
      PubDate: 2020-12-10T10:13:04Z
      DOI: 10.1177/0391560320979859
  • A misdiagnosis of mesh extrusion treated as a psychiatric female pelvic
    • Authors: Ester Illiano, Vito Mancini, Francesco Trama, Larissa Maghlhàes Vasconcelos, Giuseppe Carrieri, Elisabetta Costantini
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Complications due to prosthetic surgery with mesh implantation may be misunderstood due to the insidious clinical presentation and inexperience of many surgeons if not adequately trained for the purpose.Case report:A 45-year-old female underwent a trans obturator tape procedure to correct severe stress urinary incontinence 3 months after surgery she developed urethral pain. The sling was partially removed, but the pain persisted. No residue sling was visualized by cystoscopies after surgery, and the pain was attributed to a psychiatric problem. She was treated with opioids, pregabalin without improvement of pain, until an extrusion of the sling into the urethra has been diagnosed by a careful urethrocystoscopy.Conclusion:It has been treated in our department by the removal of the residual sling, plus urethroplasty. The patient was followed up at 6 months with resolution of the painful symptoms.
      Citation: Urologia Journal
      PubDate: 2020-11-27T11:16:25Z
      DOI: 10.1177/0391560320974890
  • A rare case of spontaneous parenchymal kidney explosion in a patient with
           ureteral obstruction caused by a single stone
    • Authors: Francesco Chiancone, Clemente Meccariello, Maria Ferraiuolo, Giovanna Paola De Marco, Maurizio Fedelini, Nunzio Alberto Langella, Paolo Fedelini
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Spontaneous rupture of kidney may involve collecting system or parenchyma. Parenchymal rupture usually occurs in patients with renal cell carcinoma, angiomyolipoma, renal cysts, arteriovenous malformation or vascular diseases such as periarteritis nodosa. Collecting system rupture is usually a rare complication of obstructive urolithiasis. We describe the unusual cases of spontaneous kidney rupture in patients with acute urinary obstruction.Case presentation:The case report describes the left parenchymal kidney explosion related to ipsilateral ureteral obstruction caused by a single ureteral stone. The patient reached our emergency department with acute left flank pain and massive haematuria. At the moment of admission, the patient was in stage III hypovolemic shock and had a lower haematocrit (haemoglobin = 4.9 g/dL). Despite blood transfusions, emergency surgical exploration, extrafascial nephrectomy and intensive support care, the patient died twelve hours after surgery.Conclusions:Parenchymal renal rupture can be a life-threatening emergency. Despite its rarity, in the differential diagnosis of acute abdomen, parenchymal renal rupture should always be considered in patients with abdominal pain and an anamnesis or history of urinary stones, pointing out the need of early diagnosis also in benign urological conditions.
      Citation: Urologia Journal
      PubDate: 2020-11-27T11:13:40Z
      DOI: 10.1177/0391560320975881
  • Intra-peritoneal versus retropubic implantation of three-piece inflatable
           penile prosthesis: Patient-reported outcomes and complications
    • Authors: Alessandro Natali, Simone Grisanti Caroassai, Giovanni Tasso, Gianmartin Cito, Luca Gemma, Andrea Cocci, Francesco Sessa, Pierangelo Verrienti, Sergio Serni, Marco Carini, Augusto Delle Rose
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:The role of reservoir position was investigated in this series of patients treated with three-pieces penile prosthesis implantation (PPI). The outcomes and the patients’ reported quality of life after insertion of the balloon in the retropubic space, or the Retzius’s space (SOR), were compared with the outcomes of patients who received an intraperitoneal implantation (IP). The study aimed to analyze how the anatomy of the SOR influenced the long-term results of PPI, especially in patients who have been previously exposed to pelvic surgery or radiotherapy. The SOR has usually been identified as ideal for concealing and protecting the reservoir; nevertheless, an increasing rate of patients that ask for a PPI do not conserve the typical favorable characteristic of the SOR. In these cases, the tissue alteration can cause a higher rate of undesired events and can impair the satisfaction from device use. In the recent literature, few articles focus on the topic of reservoir position and very poor information is available about the results of the IP insertion.Materials:Our cohort of patients was retrospectively inspected; the two different subgroups, according to the reservoir position (SOR or IP) were evaluated considering the pre-operative condition, the post-operative complication, the development of undesired events or uncomfortable sensations during the follow-up. The quality of life after PPI was observed as well, with a questionnaire specifically developed for patients treated with PPI. The surgical technique adopted for the intraperitoneal implantation was described.Results:The results of penile prosthesis functionality and patients’ and partners’ reported quality of life (QoL) showed similar results between the two groups but greater satisfaction in the relational domain of the questionnaires adopted was described in the IP subgroup.Conclusion:According to our observations, the IP reservoir insertion guarantees good functionality and lower rates of undesired events after PPI.
      Citation: Urologia Journal
      PubDate: 2020-10-23T11:34:37Z
      DOI: 10.1177/0391560320967876
  • High-grade vesicoureteral reflux in infants: Our experience with
           endoscopic subureteric injections
    • Authors: Saeed Al Hindi, Mohamed Mubarak, Husain Al Aradi
      Abstract: Urologia Journal, Ahead of Print.
      Background:Vesicoureteral reflux (VUR) is the most common urological anomaly in pediatric patients. Management options for VUR vary from continuous antibiotic prophylaxis (CAP) to surgery via either endoscopic subureteric injection of a bulking agent or open anti-reflux surgery. In this study, we assess the efficacy of subureteric injections of Dextranomer/Hyaluronic acid Copolymer (Deflux) in managing primary VUR in infant patients with high-grade VUR.Methods:From 2010 to 2015, children less than 1-year-old with primary high-grade VUR were observed prospectively following the administration of endoscopic subureteric injections of Dextranomer/Hyaluronic Acid Copolymer (Deflux). The diagnosis of VUR was based on MCUG, and all patients underwent a holistic clinical, laboratory, and radiological assessment before and after the intervention. Complete success was defined as the resolution of VUR on follow up 1 year post-operatively.Results:A total of 30 infants (50 renal units) with high-grade VUR (grades IV and V) were included in the study. The mean age at surgery was 6.3 ± 2.5 months. Most of the patients presented with a urinary tract infection (90%). Complete symptomatic relief was achieved in 27 patients (90%) at the first post-operative follow-up. Forty-four renal units received one injection, while six required a second injection as they did not meet our treatment success criteria. No patients required a third injection or referral for open surgery.Conclusion:Endoscopic injection of Dextranomer/Hyaluronic acid Copolymer (Deflux) at the vesicoureteral junction is an effective minimally invasive intervention to treat high grades VUR (IV–V) infants.
      Citation: Urologia Journal
      PubDate: 2020-10-16T09:55:57Z
      DOI: 10.1177/0391560320966187
  • Multidisciplinary collaborative approach for management of adrenal tumors:
           Outcomes of minimally invasive adrenalectomy at a single center
    • Authors: Rahul Mahajan, Suman Kotwal, Arti Mahajan, Anjali, Amit Manhas
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Laparoscopy is currently the gold standard for the management of adrenal tumors as it is associated with less morbidity. Owing to technological advances, even large adrenal tumors are currently amenable to laparoscopic removal. In this work, we describe our multidisciplinary collaborative approach for management of adrenal tumors at a single center.Material and methods:Between January 2017 and January 2020, 18 patients with adrenal lesions were operated at our center. Five of these patients had incidentalomas. All patients were evaluated in coordination with endocrinologists and anesthetists. All patients underwent transperitoneal laparoscopic adrenalectomy. The surgical complications were classified as per Clavein-Dindo system. All patients with pheochromocytoma and Cushing syndrome were followed up by the endocrinologist for further evaluation and titration of glucocorticoids and antihypertensive medication.Results:Two out of the 18 patients had American Society of Anesthesiologists (ASA) physical status III. Out of the 18 patients, only one required conversion to open surgery. Five patients developed intraoperative hypertensive crisis while three patients developed hypotensive crisis. All patients were ambulated on the first postoperative day and were discharged on the third post operative day. None of the patients developed any major (Clavein-Dindo III–V) intra operative or post operative complications.Conclusion:Laparoscopic adrenalectomy is the procedure of choice for adrenal tumors. A multi-disciplinary approach involving the endocrinologist, anesthesiologist, and laparoscopic surgeon can help achieve favorable outcomes.
      Citation: Urologia Journal
      PubDate: 2020-10-10T10:37:54Z
      DOI: 10.1177/0391560320964617
  • Clinical significance of DJ stent culture in patients with indwelling
           ureteral stents prior to endourological intervention
    • Authors: Dilip Kumar Pal, Rajkumar Singha Mahapatra, Ankit Kumar
      Abstract: Urologia Journal, Ahead of Print.
      Background:Ureteral stents are placed to relieve ureteral obstruction in various endourological surgery. As soon as it is inserted it is rapidly colonized by host of microorganism. Culture and sensitivity pattern of these growing microorganism on the stent may provide us an insight to treat postoperative urosepsis in high risk patients with indwelling DJ stents.Materials and methods:Prospective study between September 2018 and August 2019 with enrollment of 100 patients to determine the ability of urine culture (UC) to predict stent culture (SC) status, to identify associated infectious pathogens with their antibiotic sensitivity patterns and to evaluate the association between SC and post-endourological intervention sepsis.Results:Colonization of bacteria on stent culture (SC) was identified in 53 out of 100 patients (53%). Most of the organism grown on SC were multidrug resistant and they were resistant to most commonly prescribed antibiotics like fluroquinolones, cephalosporins, and aminoglycosides .These organisms were only sensitive to newer antibiotics. Indwelling time of ureteral stent was directly proportional with SC positivity (p < 0.05). Association of Urine culture at DJ Removal and DJ stent culture was not statistically significant.Conclusion:Very low rates of colonization within 6 weeks after the insertion of stents. Sterile culture of urine does not rule out colonization of the stent. Most of the urinary pathogens as well as the organisms grown on DJ stent are resistant to fluroquinolones and cephalosporins.
      Citation: Urologia Journal
      PubDate: 2020-10-07T05:20:55Z
      DOI: 10.1177/0391560320962400
  • “Endourological closure of a malformative vascular source of bleeding
           using the VortX 0.018” coil®”
    • Authors: Alberto De Gobbi, Davide Barbisan, Matteo Ciaccia, Giandavide Cova, Fabrizio Farneti, Luigino Maccatrozzo, Mario Salvatore Mangano
      Abstract: Urologia Journal, Ahead of Print.
      Aims:Renal vascular malformations, congenital or acquired, are sometimes challenging for urologists and interventional radiologists to resolve. Arterovenous fistulas and pseudoaneuryms are usually embolized by interventional radiologists, with a low rate of complications. We propose a new endourological/interventional radiology technique to treat a source of arterovenous bleeding coming from a renal calyx in a minimally invasive way.Methods:A combined endourological and interventional radiology procedure is described, using a Flexible Fiberoptic Ureteroscopes to undertake a retrograde intrarenal surgery (RIRS) to identify the source of bleeding; subsequently the VortX Coil® is inserted through a microcatheter to stop the bleeding and the correct position of the VortX coil is evaluated. Furthermore, we made a literature research on Pubmed and Medline to look for similar procedures.Results:In case of a renal bleeding that could not be treated by endovascular way, a combined urological and interventional radiology procedure can be undertaken. We did not find similar endourological and interventional radiology procedure on Pubmed and Medline, so this is the first tecnique of endourological closure of a bleeding point using a coil.Conclusion:From our experience this could be a mininvasive technique to solve renal bleedings coming from a calyx that are not found by endovascular approach. Indeed, in our knowledge, the technique here described is the first that provides the use of an endovascular coil by endourological way in renal vascular malformations.
      Citation: Urologia Journal
      PubDate: 2020-10-05T06:03:31Z
      DOI: 10.1177/0391560320962883
  • Vaginocutaneous fistula: A rare long-term complication of transobturator
           tape procedure for stress urinary incontinence
    • Authors: Uygar Micoogullari, Cem Yucel, Volkan Ulker, Mehmet Zeynel Keskin, Orcun Celik
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:Synthetic mid-urethral slings are currently the most common performed surgical procedure for the treatment of female stress urinary incontinence. The transobturator mid-urethral sling technique has been widely accepted owing to its high success and low complication rates. Although complications are rarely seen, it may cause significant morbidity.Case presentation:We report a case of vaginocutaneous fistula following transobturator mid-urethral sling procedure and a successful reconstruction with transvaginal sling excision and fistula closure.Conclusion:Vaginocutaneous fistula is a known but rarely seen long-term complication of transobturator tape. With an increased use of mesh, various delayed complications can be seen in the long-term follow-up. This case showed us the need for longer and detailed studies that evaluate the effectiveness and safety of the transobturator tape procedure.
      Citation: Urologia Journal
      PubDate: 2020-08-03T09:44:24Z
      DOI: 10.1177/0391560320947260
  • Managing the unexpected: Carcinosarcoma of the kidney parenchyma A case
           with the longest follow-up
    • Authors: Drilona Ndrevataj, Guglielmo Mantica, Nataniele Piol, Alessia Cavo, Bruno Spina, Carlo Toncini, Francesco Boccardo, Carlo Terrone
      Abstract: Urologia Journal, Ahead of Print.
      Introduction:We present the management of the second reported case of carcinosarcoma of the kidney parenchyma with malignant degeneration of both epithelial and mesenchymal components.Case report:A 36-year-old woman came to our attention for an incidental sonographic finding of a lesion in the lower pole of the left kidney. A contrasted computed tomography scan confirmed the presence of a 50 × 52 mm2 contrasted lesion in the left lower kidney pole. The patient underwent a challenging laparoscopic left partial nephrectomy and para-aortic lymphadenectomy. The histological examination led to the diagnosis of a carcinosarcoma of the kidney parenchyma with malignant degeneration of both epithelial and mesenchymal components. The patient underwent adjuvant chemotherapy with paclitaxel at 175 mg/m2 plus carboplatin area under the curve 6 intravenously for six cycles. At a follow-up of 42 months, the patient is alive and does not show any local recurrences or distant metastases.Conclusion:A multi-disciplinary therapeutic approach, combined with an adequate doctor–patient relationship and a close and detailed follow-up, is of fundamental importance in obtaining good outcomes in such rare and challenging cases.
      Citation: Urologia Journal
      PubDate: 2020-06-20T09:06:22Z
      DOI: 10.1177/0391560320930439
  • Testing awareness of fertility and reproductive health among unmarried
           medical students at Cairo University
    • Authors: Sameh Fayek GamalEl Din, Wael Fayek Saleh
      Abstract: Urologia Journal, Ahead of Print.
      Aim:We aimed in this survey to assess fertility and reproductive health awareness among medical students.Methods:A total of 354 female and male final year medical students (193 females and 157 males) were recruited for this survey at the Kasr Al-Ainy Faculty of Medicine, who attended the lectures of the andrology and sexually transmitted disease department.Results:Our study demonstrated that the mean ages of the female and male medical students when they want to have their first child were 26.95 ± 2.924 and 28.7 ± 3.94, respectively, and and p = 0, while the mean ages of the female and male medical students when they want to have their last child were 32.5 ± 3.2 and 34.7 ± 5.1, respectively, and p = 0.001. Our study demonstrates that a majority of the female and male medical students moderately estimated the efficacy of the assisted reproductive technique to take a baby home, and the means of their estimation were 42.620% ± 12% and 43.5% ± 13.1% and p = 0.482. Moreover, our study showed that 75 (39.1%) females were convinced that vaginal delivery has a potential negative effect on the sexual functions. However, 99 (51.6%) females did not see any potential negative effect of vaginal delivery. In addition, 18 (9.4%) females responded in an indefinite way to this question. Finally, our study demonstrated that 145 (92.4%) males rejected the proposal of vasectomy.Conclusions:Interestingly, our study revealed increased estimation by the participants of the efficacy of the assisted reproductive technique to take a baby home, despite the fact that they were medical students who had already studied the subject of gynecology in their fifth year and should have estimated it properly.
      Citation: Urologia Journal
      PubDate: 2020-06-10T09:15:18Z
      DOI: 10.1177/0391560320928642
  • Denial and oncological pathology: Case report of a massive testicular
    • Authors: G Pizzuto, M Barale, O Sedigh, B Frea
      Abstract: Urologia Journal, Ahead of Print.
      Literature:The cancer of testicles represents 1% of male neoplasms and 5% of urological malignant neoplasm. Its incidence has been growing in Western societies. Cancer of testicles usually presents as an increase of consistence in one testicles and absence of pain, as a casual ultrasound scan finding, or it could be highlighted by a scrotal injury. The surgical treatment is either radical orchiectomy or radical orchiectomy plus retroperitoneal lymph node dissection.Case presentation:The case presented concerns a 48-year-old male with a history of left testicular trauma and subsequent hypotrophy. Over the next 4 years, the patient developed a testicle size increase up to 15 cm in diameter. At diagnosis, he had retroperitoneal lymphadenopathy. The patient was, after surgery, referred to the oncology department.Conclusion:The awareness of the male population respect to testicular cancer and its screening methods (e.g. self-examination) is essential to make the diagnosis at an early stage. It is also essential to psychologically support patients undergoing surgical and/or pharmacological therapy due to risk of determining anxiety or depression compared to the whole population.
      Citation: Urologia Journal
      PubDate: 2020-05-27T10:18:15Z
      DOI: 10.1177/0391560320921714
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