Patient and Context Factors in the Adoption of Active Surveillance for Low-Risk Prostate Cancer.

Importance: Although active surveillance for patients with low-risk prostate cancer (LRPC) has been recommended for years, its adoption at the population level is often limited.

Objective: To make active surveillance available for patients with LRPC using a research framework and to compare patient characteristics and clinical outcomes between those who receive active surveillance vs radical treatments at diagnosis.

Design, Setting, And Participants: This population-based, prospective cohort study was designed by a large multidisciplinary group of specialists and patients' representatives.

Efficacy and safety profile of GreenLight laser photoselective vaporization of the prostate in ≥ 75 years old patients: results from the Italian GreenLight Laser Study Group.

Background: Benign Prostatic Obstruction (BPO) is the most common non-malignant urological condition among men and its incidence rise with age. Among prostate treatments, GreenLight laser seems to reduce bleeding and would be safer in the aging population.

Aims: We aimed to compare the functional outcomes and safety profile of < 75 years old (Group A) and ≥ 75 years old (Group B) patients.

Post-Operative Acute Urinary Retention After Greenlight Laser. Analysis of Risk Factors from A Multicentric Database.

Purpose: Greenlight laser is a mini-invasive technique used to treat Benign Prostatic Obstruction (BPO). Some of the advantages of GreenLight photoselective vaporization (PVP) are shorter catheterization time and hospital stay compared to TURP. Post-operative acute urinary retention (pAUR) leads to patients' discomfort, prolonged hospital stay and increased health care costs.

Water vapor therapy (Rezūm) for lower urinary tract symptoms related to benign prostatic hyperplasia: early results from the first Italian multicentric study.

Purpose: Rezūm is the latest developed minimally invasive treatment for benign prostatic hyperplasia (BPH). We aimed to carefully assess the functional outcomes of patients treated with Rezūm for BPH.

Methods: We prospectively followed 135 consecutive patients treated by Rezūm at 5 institutions from June 2019 to August 2020.

How uro-oncology has been affected by COVID-19 emergency? Data from Piedmont/Valle d'Aosta Oncological Network, Italy.

Introduction: Coronavirus disease 2019 (COVID-19) pandemic has dramatically hit all Europe and Northern Italy in particular. The reallocation of medical resources has caused a sharp reduction in the activity of many medical disciplines, including urology. The restricted availability of resources is expected to cause a delay in the treatment of urological cancers and to negatively influence the clinical history of many cancer patients.

The safety and feasibility of the simultaneous use of 180-W GreenLight laser for prostate vaporization during concomitant surgery.

Objectives: To explore the safety and feasibility of photo-selective vaporization of the prostate (PVP) with GreenLight XPS 180 Watt laser (GL-180- W XPS) combined with other surgical procedures.

Material And Methods: Data on patients in whom GL-180-W XPS was performed to relieve lower urinary tract symptoms/ benign prostatic hyperplasia (LUTS/BPH) symptoms were extracted from a multi-institutional database (2011-2016). Patients were stratified into two groups.

Operative profile, safety and functional outcomes after GreenLight laser prostate surgery: results from a 12 months follow-up multicenter Italian cohort analyses.

Background: Over the two past decades, GreenLight laser therapy has been considered a valid alternative for the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia/benign prostatic obstruction (BPH/BPO). However, the debate on the effectiveness of laser therapy compared to conventional techniques is still open. The aim of our study is to analyze and describe the use of GreenLight laser prostate surgery in Italy, with regard to the surgical techniques performed and the surgical and functional outcomes at mid-term follow-up.

Three-year follow-up in patients with urinary stress incontinence treated with Altis® single-incision sling.

Background: The purpose of the study is to report three years follow-up of single incision slings for the treatment of stress urinary incontinence (SUI). The main outcomes are to evaluate the efficacy of the device and to assess safety, adverse events, quality of life, demographic features of treated women and prognostic factors for SUI.

Methods: We performed a retrospective, double-center, single-arm study.

GreenLight Photoselective Vaporization of the Prostate: One Laser for Different Prostate Sizes.

GreenLight laser vaporization of the prostate (photoselective vaporization of the prostate [PVP]) is a safe and effective procedure for Benign Prostatic Hyperplasia. Long-term results and advantages of PVP in patients with large and symptomatic prostate are still under evaluation. In a multicenter experience, patients who underwent standard or anatomical PVP were retrospectively reviewed.

Cost-effectiveness analysis of a single-use digital flexible cystoscope for double J removal.

Introduction And Objective: The novel single-use digital flexible cystoscope Isiris™ has been developed to perform in-office JJ stent removal, without the need of special equipment nor limitations linked to the disinfection of a reusable device. The aim of our study was to perform a cost-effectiveness analysis of Isiris™ in our institution.

Patients And Methods: A total of 127 consecutive patients undergoing in-office stent removal with Isiris™ were prospectively included in study.

Elastic fusion biopsy versus systematic biopsy for prostate cancer detection: Results of a multicentric study on 1,119 patients.

Objectives: To assess the accuracy of targeted and systematic biopsies for the detection of prostate cancer (PCa) and clinically significant PCa (csPCa) in the everyday practice, evaluating the need for additional systematic biopsies at the time of targeted biopsy.

Patients And Methods: From our multicentric database gathering data on 2,115 patients who underwent fusion biopsy with Koelis™ system between 2010 and 2017, we selected 1,119 patients who received targeted biopsies (a median of 3 for each target), followed by systematic sampling of the prostate (12 to 14 cores). Overall and clinically significant cancer detection rate (CDR) of Koelis™ fusion biopsies were assessed, comparing target and systematic biopsies.

A multicentric study on accurate grading of prostate cancer with systematic and MRI/US fusion targeted biopsies: comparison with final histopathology after radical prostatectomy.

Objective: To evaluate the accuracy in histologic grading of MRI/US image fusion biopsy by comparing histopathology between systematic biopsies (SB), targeted biopsies (TB) and the combination of both (SB + TB) with the final histopathologic outcomes of radical prostatectomy specimens.

Materials And Methods: Retrospective, multicentric study of 443 patients who underwent SB and TB using MRI/US fusion technique (Urostation and Trinity) prior to radical prostatectomy between 2010 and 2017. Cochran's Q test and McNemar test were conducted as a post hoc test.

Accuracy of elastic fusion biopsy in daily practice: Results of a multicenter study of 2115 patients.

Objectives: To assess the accuracy of Koelis fusion biopsy for the detection of prostate cancer and clinically significant prostate cancer in the everyday practice.

Methods: We retrospectively enrolled 2115 patients from 15 institutions in four European countries undergoing transrectal Koelis fusion biopsy from 2010 to 2017. A variable number of target (usually 2-4) and random cores (usually 10-14) were carried out, depending on the clinical case and institution habits.

Perioperative major acute cardiovascular events after 180-W GreenLight laser photoselective vaporization of the prostate.

Background: Major acute cardiovascular events (MACE) prevalence after 180-W GreenLight (180-W GL) laser photoselective vaporization (PVP) have never been explored. Aim of our study is to evaluate perioperative MACE that occurred concomitantly with 180-W GL PVP.

Materials And Methods: We relied on a multi-institutional database that included 14 centers.

Standard vs. anatomical 180-W GreenLight laser photoselective vaporization of the prostate: a propensity score analysis.

Purpose: To compare the efficacy, safety, Patient Global Impression of Improvement (PGI-I), and complications rates after 180-W GreenLight laser (180-W GL laser) standard and anatomical photoselective vaporization (sPVP and aPVP).

Methods: Within a multi-institutional database, we identified patients who underwent sPVP or aPVP to relief BPH symptoms. IPSS, Q , and prostate-specific antigen (PSA) were measured at baseline and during the follow-up.

Allium stent for the treatment of a malignant ureteral stenosis: A paradigmatic case.

Objective: The aim of this study was to present a paradigmatic case where the new-generation Allium URS stent was the optimal choice to treat a malignant ureteral stenosis.

Methods: We describe in detail all the steps of our surgery, performed on a 69-year-old patient with left hydronephrosis caused by lumbo-aortic nodal metastases compressing the ureter. The patient was intolerant to double-J stent due to strong irritative urinary symptoms.

Therapeutic ureteral occlusion with Ifabond cyanoacrylate glue: an interesting solution.

Objective: The aim of this study was to present a novel approach for complete and permanent ureteral occlusion using a percutaneous injection of Ifabond cyanoacrylate glue.

Methods: We describe in detail all the steps of our surgery, performed on a 79-year-old patient with urinary leakage from ureteral stump following radical cystectomy. N-hexyl-cyanoacrylate glue (Ifabond) was used to occlude the distal ureter and solve the leakage.

[Use of frozen sections to assess surgical margins during radical prostatectomy].

Introduction: At present there is no consensus on the use of frozen sections (FS) during radical prostatectomy. Several groups have proposed the benefit of FS although the studies differ widely in sampling methods and sites where FS were taken. This study aims to evaluate the usefulness and reliability of standard assessment of FS in multiple sites during radical prostatectomy.

Selective inhibition of carbonic anhydrase IX decreases cell proliferation and induces ceramide-mediated apoptosis in human cancer cells.

Recently, carbonic anhydrase (CA) inhibitors have been proposed as a potential new class of antitumor agents. The aim of this study was to evaluate the antitumor activity of three CA inhibitors, namely acetazolamide (AZ) and two newly synthesized aromatic sulfonamides with high affinity for CA IX, 2-(4-sulfamoylphenyl-amino)-4,6-dichloro-1,3,5-triazine (TR1) and 4-[3-(N,N-dimethylaminopropyl)thioreidophenylsulfonylaminoethyl]benzenesulfonamide (GA15), against human tumor cells. The effects of AZ, TR1, and GA15 on cell proliferation and apoptosis were evaluated in CA IX-positive HeLa and 786-O cells and CA IX-negative 786-O/von Hippel-Lindau (VHL) cells.

Periprostatic tissues intraoperative frozen section during retrograde radical retropubic prostatectomy.

Objective: To evaluate usefulness of periprostatic tissues intraoperative frozen sections (PTs IFSs) during RRP for prostate cancer, in order to find local extraprostatic neoplastic spreading and to eventually modify intervention and resection limits during surgery.

Material And Methods: From January 1998 to June 2004, 259 consecutive patients underwent RRP at our department for clinically organ-confined prostate cancer; PTs IFSs were prospectively performed in all cases at membranous urethra after removal of prostatic apex, at whole neurovascular bundle (NVB) or at fibroadipose tissue subtended between prostatic capsule and NVB during extrafascial or nerve sparing (NS) RRP respectively, at middle portion of Denonvillier's fascia, at detrusor ring after removal of the prostate. IFSs positivity was followed by further excision at the corresponding site during intervention.

Carbonic anhydrase inhibitors: inhibition of the tumor-associated isozymes IX and XII with a library of aromatic and heteroaromatic sulfonamides.

The inhibition of the two transmembrane, tumor-associated isozymes of carbonic anhydrase (CA, EC 4.2.1.

Skewing towards neuroendocrine phenotype in high grade or high stage androgen-responsive primary prostate cancer.

Objective: The prognostic influence of neuroendocrine (NE) differentiation in prostate cancer patients is not yet properly established. In a series of primary hormone-naive prostate cancers from a patient population that underwent radical prostatectomy, we wanted to determine the relationship between NE phenotype expression and Gleason sum, disease stage, and serum PSA concentration.

Methods: Chromogranin A (CgA) expression was scored and compared in 105 consecutive primary prostate cancers with their homologous preoperative tumor prostate biopsies.

Carbonic anhydrase inhibitors. Inhibition of cytosolic/tumor-associated carbonic anhydrase isozymes I, II, IX, and XII with Schiff's bases incorporating chromone and aromatic sulfonamide moieties, and their zinc complexes.

A series of Schiff's bases was prepared by reaction of 3-formyl-chromone or 6-methyl-3-formyl-chromone with aromatic sulfonamides, such as sulfanilamide, homosulfanilamide, 4-aminoethyl-benzenesulfonamide, a pyrimidinyl-substituted sulfanilamide derivative, sulfaguanidine and 4-amino-6-trifluoromethyl-benzene-1,3-disulfonamide. The zinc complexes of these sulfonamides have also been obtained. The new derivatives and their Zn(II) complexes were investigated for the inhibition of four physiologically relevant isozymes of carbonic anhydrase (CA, EC 4.

Color Doppler sonography in the intratesticular varicocele.

Objective: We describe and discuss clinical and color Doppler ultrasound findings of intratesticular varicocele.

Material And Methods: Since 1998 we evaluated 295 patients diagnosed with varicocele by scrotal color Doppler sonography Routine andrological assessment has entailed grading the varicocele (Dubin-Amelar scale and Dubin Doppler scale) and the assessment of testicular size. Intratesticular varicocele is defined as venous reflux detected into anechoic lesions of the testis with or without ypsilateral varicocele.

Carbonic anhydrase inhibitors: novel sulfonamides incorporating 1,3,5-triazine moieties as inhibitors of the cytosolic and tumour-associated carbonic anhydrase isozymes I, II and IX.

A new series of aromatic benzenesulfonamides incorporating 1,3,5-triazine moieties in their molecules is reported. This series was obtained by reaction of cyanuric chloride with sulfanilamide, homosulfanilamide or 4-aminoethylbenzenesulfonamide. The prepared dichlorotriazinyl-benzenesulfonamides were subsequently derivatized by reacting them with various nucleophiles, such as ammonia, hydrazine, primary and secondary amines, amino acid derivatives or phenol.