Publications by authors named "Ficarra V"

Background: Voluntary PCa screening frequently results in excessive use of unnecessary diagnostic tests and an increasing risk of detection of indolent PCa and unaffordable costs for the various national health systems. In this scenario, the Italian Society of Urology (Società Italiana di Urologia, SIU) proposes an organized flow chart guiding physicians to improve early diagnosis of significant PCa avoiding unnecessary diagnostic tests and prostate biopsy.

Methods: According to available evidence and international guidelines [i.

View Article and Find Full Text PDF

To contrast opportunistic PCa screening, the European Union Council suggested extending screening programs to PCa by recommending the implementation of a stepwise approach in the EU Countries to evaluate the feasibility and effectiveness of an organized program based on PSA testing in combination with additional MRI as a follow-up test. The objective of this expert-based document is to propose an organized PCa screening program according to the EU Council recommendations. The Italian Society of Urology (SIU) developed a team of experts with the aim to report 1) the most recent epidemiologic data about incidence, prevalence, and mortality of PCa; 2) the most important risk factors to identify categories of men with an increased risk to eventually develop the disease; 3) the most relevant studies presenting data on population-based screening; and 4) the current recommendations of the leading International Guidelines.

View Article and Find Full Text PDF

Background: Prostate cancer is the second most common cancer in males worldwide, and its incidence is rising. Early detection is crucial for improving the outcomes, but the current screening methods have limitations. While prostate-specific antigen (PSA) testing is the most widely used screening tool, it has poor specificity, leading to a high rate of false positives and unnecessary biopsies.

View Article and Find Full Text PDF
Article Synopsis
  • The systematic review evaluated the status of new robotic systems approved for urological surgery, focusing on their evolution based on the IDEAL framework.
  • It found 74 studies, with 90.5% being noncomparative, while only one randomized trial compared the KangDuo system with the da Vinci system.
  • Results showed that the new robotic platforms had similar outcomes to the da Vinci system, but the review highlighted limitations like small sample sizes and the lack of robust comparative studies.
View Article and Find Full Text PDF

Background: Sexual difficulties are a recognized consequence of prostate cancer (PCa) treatments. An estimated one in three men who have sex with men (MSM) receive PCa a diagnosis during their lifetime. MSM may experience all types of sexual dysfunction as reported in men who have sex with women (MSW), along with a number of more specific bothersome problems.

View Article and Find Full Text PDF

Background: Radical cystectomy (RC) shows an important impact on quality of life (QoL), for various clinical aspects. The aim of our study was to evaluate the short-term bowel function in patients that underwent RC.

Methods: Two hundred and six patients with MIBC underwent RC with ONB or IC urinary diversion.

View Article and Find Full Text PDF
Article Synopsis
  • The objective of the study was to create performance metrics for a standard transurethral resection of bladder tumors (TURBT) procedure and gain consensus from international experts on these metrics.
  • The methodology involved defining the TURBT procedure through detailed phases, steps, and types of errors, followed by evaluation and refinement through a modified Delphi process with a panel of experienced urologists.
  • The results showed that the Delphi panel reached a unanimous 100% consensus on the performance metrics, confirming their validity and paving the way for their use in training programs for TURBT.
View Article and Find Full Text PDF
Article Synopsis
  • - This study analyzes outcomes of laparoscopic (LPN), robot-assisted (RAPN), and laparoscopic radical nephrectomy (LRN) in obese patients with renal cell carcinoma to assess their perioperative and long-term effectiveness.
  • - Data from 388 patients were evaluated, showing that LRN resulted in a significantly higher incidence of acute kidney injury and greater decline in renal function compared to LPN and RAPN.
  • - The research suggests that LPN and RAPN are associated with similar complication rates and better kidney function preservation than LRN, emphasizing the advantages of these minimally invasive techniques for obese patients.
View Article and Find Full Text PDF
Article Synopsis
  • - Partial nephrectomy (PN) is a surgical approach to remove kidney tumors while maintaining kidney function, with this paper focusing on its indications, techniques, management, and follow-up care within the Italian healthcare system.
  • - Research shows that PN provides similar survival rates to radical nephrectomy while better preserving renal function, influenced by factors like preoperative health and the technique used by the surgeon.
  • - The paper emphasizes the importance of individualized surgical plans, the role of innovative technologies in improving surgery, and the necessity of thorough postoperative monitoring for ensuring patient outcomes.
View Article and Find Full Text PDF

Objective: In this single-blinded randomized controlled trial, we compared the "Test in-Train Out" structured home-based exercise program (TiTo-SHB) with the traditional "go home and walk" exercise intervention in people with peripheral artery disease (PAD).

Methods: Peripheral artery disease patients at Leriche-Fontaine's stage II were randomized to receive TiTo-SHB or walking advice (C-WA). The TiTo-SHB group performed two daily 8-min sessions of pain-free interval walking at progressive low-to-moderate speed maintained with a metronome.

View Article and Find Full Text PDF
Article Synopsis
  • This study used the Delphi method to gather expert opinions on unresolved issues in lower urinary tract infections (UTIs), focusing on recurrent UTIs, asymptomatic bacteriuria in pregnant women, and catheter-associated UTIs in adults.
  • A panel of 37 experts participated in multiple consensus phases, achieving agreement on 12 out of 13 key topics related to the diagnosis and prevention of these UTIs.
  • The findings highlight the need for more research on non-antibiotic preventive measures for UTIs, as antibiotic resistance continues to be a significant concern in treatment strategies.
View Article and Find Full Text PDF

Objectives: To evaluate the feasibility of loco-regional anaesthesia and to compare perioperative outcomes between loco-regional and standard general anaesthesia in patients with bladder cancer undergoing open radical cystectomy (ORC).

Patients And Methods: A single-surgeon cohort of 60 consecutive patients with bladder cancer undergoing ORC with an enhanced recovery after surgery protocol between May 2020 and December 2021 was analysed. A study group of 15 patients operated on under combined spinal and epidural anaesthesia was compared with a control group of 45 patients receiving standard general anaesthesia.

View Article and Find Full Text PDF

Objective: In the following years after the United States Preventive Service Task Force (USPSTF) recommendation against prostate cancer screening with PSA in 2012, several authors worldwide described an increase in higher grades and aggressive prostate tumors. In this scenario, we aim to evaluate the potential impacts of USPSTF recommendations on the functional and oncological outcomes in patients undergoing robotic-assisted radical prostatectomy (RARP) in a referral center.

Material And Methods: We included 11396 patients who underwent RARP between 2008 and 2021.

View Article and Find Full Text PDF

Objectives: The aim of this study is to assess the aetiology, perioperative outcomes and treatment failure of contemporary patients undergoing open or robot-assisted ureteral reconstruction for iatrogenic injuries.

Patients And Methods: We retrospectively analysed consecutive patients who underwent ureteral reconstruction for iatrogenic injuries at two academic centres 07/2013 and 06/2022. A variety of open or robot-assisted procedures were performed, including uretero-cystoneostomy, Boari bladder flap, uretero-ureterostomy, ileal replacement and pyelo-ureteroplasty.

View Article and Find Full Text PDF

Introduction: Intestinal anastomosis can be performed by hand suturing (single layer or double layer) or by a mechanical suturing machine. The aim of the study was to compare complications, operative time, and costs of the intestinal anastomosis techniques.

Methods: A retrospective comparative study was conducted including patients who underwent radical cystectomy and uretero-ileo-cutaneostomy or vescica ileale Padovana orthotopic neobladder.

View Article and Find Full Text PDF

Purpose: The primary aim of this study was to evaluate if exposure to 5-alpha-reductase inhibitors (5-ARIs) modifies the effect of MRI for the diagnosis of clinically significant Prostate Cancer (csPCa) (ISUP Gleason grade ≥ 2).

Methods: This study is a multicenter cohort study including patients undergoing prostate biopsy and MRI at 24 institutions between 2013 and 2022. Multivariable analysis predicting csPCa with an interaction term between 5-ARIs and PIRADS score was performed.

View Article and Find Full Text PDF

The nature of alpha-D-mannose-natural aldohexose sugar, C-2 glucose epimer, whose intended use is for preventing urinary tract infections-in the interaction with E. coli is addressed in order to drive the issue of its regulatory classification as a medicinal product or medical device. PRISMA systematic review approach was applied; Delphi Panel method was used to target consensus on statements retrieved from evidence.

View Article and Find Full Text PDF
Article Synopsis
  • Rectal injury (RI) is a serious complication that can occur after radical prostatectomy (RP), leading to both immediate and long-term health issues like bleeding and rectourethral fistulas (RUF).
  • A systematic review of literature identified an overall RI incidence of 0.58%, with higher rates found in open and laparoscopic RP compared to other surgical methods, and associated factors include age (≥60 years) and prior radiation therapy.
  • The study suggests that RI, although rare, is more likely in certain patient groups and emphasizes the importance of timely detection to reduce the risk of severe complications, urging the development of a management algorithm for better outcomes.
View Article and Find Full Text PDF

Background: On March 11 2019, European Medicines Agency (EMA) issues a warning after a review of serious, disabling and potentially permanent adverse events (AEs), particularly on musculoskeletal and nervous system, with quinolone (QN) and fluoroquinolone (FQ) antibiotics. Aim of this study was to evaluate the effect of the EMA warning on the rate of AEs after QN and FQ treatments, reported in the EudraVigilance (EV) database.

Methods: EV database is the system for managing and analyzing information on suspected AEs to medicines which have been authorized or being studied in clinical trials in the European Economic Area (EEA).

View Article and Find Full Text PDF

The hexanic extract of (HESr) has been in use for decades as an effective, safe and well-tolerated therapy for relieving bothersome lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia (BPH). This manuscript gives an overview of HESr as monotherapy for LUTS/BPH treatment and focuses on the currently available literature investigating the possible clinical benefits of HESr combination therapy with α-blockers. Combination therapy of HESr with α-blockers has been gaining significant interest in recent years, as an increasing body of evidence shows the beneficial pharmacological effects that HESr treatment can add to standard first-line treatment with α-blockers.

View Article and Find Full Text PDF

Background: Retzius-sparing robot-assisted radical prostatectomy (RARP) is not yet universally accepted due to still limited functional data and some concerns on oncological safety compared to the standard one. We assessed perioperative, pathological and early functional outcomes in patients with clinically localised prostate cancer treated with Retzius-sparing versus standard RARP.

Methods: A single-surgeon cohort of 207 consecutive patients undergoing RARP was analysed.

View Article and Find Full Text PDF

Purpose: The COVID-19 pandemic has led to competing strains on hospital resources and healthcare personnel. Patients with newly diagnosed invasive urothelial carcinomas of bladder (UCB) upper tract (UTUC) may experience delays to definitive radical cystectomy (RC) or radical nephro-ureterectomy (RNU) respectively. We evaluate the impact of delaying definitive surgery on survival outcomes for invasive UCB and UTUC.

View Article and Find Full Text PDF

Background and Objectives: The aim was to compare the intra and postoperative outcomes between the Enhanced Recovery After Surgery (ERAS) protocol versus the standard of care protocol (SCP) in patients who underwent radical cystectomy performed by a single surgeon. Materials and Methods: A retrospective comparative study was conducted including patients who underwent radical cystectomy from 2017 to 2020. Length of stay (LOS), incidence of ileus, early postoperative complications, and number of re-hospitalizations within 30 days were considered as primary comparative outcomes of the study.

View Article and Find Full Text PDF