[A variant of the classic technique of ultrasound guided percutaneous renal biopsy: the perpendicular entry by longitudinal viewing planes with a perforated probe].

The percutaneous biopsy of native kidneys according to the classic methodology, takes place with the introduction of the needle and its guide with ultrasound sagittal viewing planes, with a 30-degree angle, up to the lower pole of the kidney. Since the longitudinal axis of the kidneys converges towards the spine with a sharp angle, we observed that starting from a longitudinal scan of the kidney (conducted along the posterior axillary line with the patient prone) you can drive the needle by a perforated probe through a shorter path perpendicular to the end section of the lower pole of the kidney where the front and rear rims of the cortex bearings without the renal sinus interposed so increasing the chance to obtain, even with a single pass, a good sample of cortical tissue while limiting the possibility to damage the lower chalices that may cause hematuria. We biopsied in that manner 26 patients and we compared the data with those reported in the literature performed with the same needle gauge and post-biopsy monitoring period.

Renal extracapsular hypoechoic rim and kidney cortical thickness.

Objectives: A renal extracapsular hypoechoic rim was previously recognized and interpreted as a typical sonographic finding of renal failure. Subsequently it was hypothesized that the hypoechoic rim could be produced by a state of sodium retention and oedema caused by nephropathy but not necessarily associated with renal failure. In order to get this cleared we performed a retrospective analysis of 80 renal ultrasound examinations, carried out at our center, in 41 of which it was found a renal extracapsular hypoechoic rim.

[Nephrolithiasis associated with normocalcemic or hypercalcemic primary hyperparathyroidism: focus on calciomimetics].

Primary hyperparathyroidism (PHPT) is a disease involving a broad range of alterations of calcium homeostasis, sustained by parathyroid hormone (PTH) levels that are clearly abnormal. The anomalies directly associated with hyperparathyroidism are nephrolithiasis and fibrocystic bone disease. Since PHPT resolves when abnormal parathyroid tissue is removed, surgery is clearly the only definitive approach to this type of hyperparathyroidism.

Molecular Dissection Using Array Comparative Genomic Hybridization and Clinical Evaluation of An Infertile Male Carrier of An Unbalanced Y;21 Translocation: A Case Report and Review of The Literature.

Chromosomal defects are relatively frequent in infertile men however, translocations between the Y chromosome and autosomes are rare and less than 40 cases of Y-autosome translocation have been reported. In particular, only three individuals has been described with a Y;21 translocation, up to now. We report on an additional case of an infertile man in whom a Y;21 translocation was associated with the deletion of a large part of the Y chromosome long arm.

Erectile dysfunction and diabetes: Association with the impairment of lipid metabolism and oxidative stress.

Objectives: To test the hypothesis that exists an association of non-diabetic and diabetic patients suffering from erectile dysfunction (ED) with lipid metabolism and oxidative stress.

Design And Methods: Clinical and laboratory characteristics in non-diabetic (n = 30, middle age range: 41–55.5 years; n = 25, old age range: 55.

Role of chemotherapy in the treatment of metastatic castration-resistant prostate cancer patients who have progressed after abiraterone acetate.

Abiraterone acetate is a novel irreversible inhibitor of CYP17 that was recently approved for men with post-chemotherapy or chemo-naive castration-resistant prostate cancer. Unfortunately, this agent is not curative, and patients often ultimately develop resistance. However, men who progress after treatment with this new hormonal agent may be considered for another line of chemotherapy-based treatment.

Tolerability of cabazitaxel in patients with metastatic castration-resistant prostate cancer progressing after docetaxel and abiraterone acetate: a single-institution experience.

Both abiraterone acetate (AA) and cabazitaxel (Cbz) have been shown to prolong survival in patients with metastatic castration-resistant prostate cancer (mCRPC) progressing during or after docetaxel (D). Although no standard sequencing has been established as yet, Cbz has recently been proven to be active after AA. However, to date, few data are available on its safety in this setting.

Low-Dose Estramustine Phosphate and Concomitant Low-Dose Acetylsalicylic Acid in Heavily Pretreated Patients With Advanced Castration-Resistant Prostate Cancer.

Background: The aim of this phase 2 study was to evaluate the activity and tolerability of low-dose estramustine phosphate (EMP) with concomitant low-dose acetylsalicylic acid (ASA) as a thromboprophylactic agent in heavily pretreated patients with advanced castration-resistant prostate cancer.

Methods: Patients received 420 mg of oral EMP twice daily and oral ASA 100 mg once daily. The primary endpoint was prostate-specific antigen response.

Use of cinacalcet in nephrolithiasis associated with normocalcemic or hypercalcemic primary hyperparathyroidism: results of a prospective randomized pilot study.

Objectives: To evaluate, by means of a prospective randomized study, the efficacy of cinacalcet in the forms of nephrolithiasis associated with primary hyperparathyroidism in both the hypercalcemic and normocalcemic variant.

Materials And Methods: Ten patients suffering from active nephrolithiasis associated with primary hyperparathyroidism (4 hypercalcemics and 6 normocalcemics), equally divided between males and females, were randomly but not blindly addressed to treatment with potassium citrate and allopurinol, or to the same therapeutic regimen in combination with cinacalcet. The dosage of cinacalcet was optimized for each patient in order to obtain a reduction of parathyroid hormone (PTH) within normal limits while enabling the maintenance of adequate calcemic values.

Triorchidism: genetic and imaging evaluation in an adult male.

We report the results of imaging and cytogenetic studies in a case of triorchidism in a 54 years old male without any associated anomaly. A scrotal ultrasonography revealed the presence of two testes within the left hemiscrotum with complete septation and echotexture and vascular flow pattern similar to the vascular flow of the normal right testis. There was no focal abnormal echogenicity suggesting malignancy.

[Light therapy as a treatment for sexual dysfunctions--beyond a pilot study].

Objectives: Seasonal trends were demonstrated in reproduction and sexual activity. Through the secretion ofmelatonin the pineal gland plays an important role in the neuroendocrine control of sexual function and reproductive physiology. We hypothesized that inhibition of the pineal gland activity through a light treatment may favorably affect sexual function.

Realtime-elastosonography of the penis in patients with Peyronie's disease.

Objective: To evaluate the performance of real time elastosonography (RTE) in the identification of different types of penile lesions in patients with Peyronie's disease.

Materials And Methods: Seventy four consecutive patients with complaints of Peyronie's disease underwent B-Mode ultrasonography (US) and RTE of the penis in the same sitting. In each patient all sequences of elastosonography and B-Mode US were recorded and compared to evaluate the diagnostic performance of the new imaging technique.

Effects of the association of potassium citrate and agropyrum repens in renal stone treatment: results of a prospective randomized comparison with potassium citrate.

Objectives: To evaluate by a prospective randomized controlled study the efficacy of the association of potassium citrate and dry extract of couch grass (Agropyrum repens) (CalcoMEV) in renal stone treatment.

Materials And Methods: 50 patients with nephrolithiasis associated with one or more active metabolic alterations that constitute an indication to the use of potassium citrate were randomly divided in two equal unblinded treatment groups. A group of patients was assigned to treatment with the association of potassium citrate and couch grass (at the dose of 24 mEq of potassium citrate and 100 mg of dry extract of Agropyrum repens bis in die) and the other group to potassium citrate (at a dose of 20 mEq ter in die).

Is prostate-specific antigen percentage decrease predictive of clinical outcome after permanent iodine-125 interstitial brachytherapy for prostate cancer?

Objective: To determine the usefulness of prostate-specific antigen (PSA) percentage (vs. pretreatment value assumed as 100%) in prediction of biochemical relapse, after iodine-125 ((125)I) permanent brachytherapy for prostate cancer, to employ a parameter independent by the initial PSA amount and by the individual prostatic volume.

Methods And Materials: Our study included 133 patients, 102 still disease free (Group A) and 31 who experienced proven biochemical recurrence (Group B).

Bevacizumab and weekly docetaxel in patients with metastatic castrate-resistant prostate cancer previously exposed to docetaxel.

Background. The aim of this paper was to evaluate the activity and tolerability of docetaxel (D) and bevacizumab (Bev) in patients with metastatic castrate-resistant prostate cancer (CRPC) previously exposed to D. Methods.

Docetaxel and epirubicin compared with docetaxel and prednisone in advanced castrate-resistant prostate cancer: a randomised phase II study.

Background: This randomised phase II study compared the activity and safety of the combination docetaxel (D)/epirubicin (EPI) with the conventional treatment D/prednisone (P) in advanced castrate-resistant prostate cancer (CRPC) patients.

Materials And Methods: Patients were randomly assigned to D 30 mg m(-2) as intravenous infusion (i.v.

Real-time elastography in the diagnosis of prostate tumor.

Aim: To assess the diagnostic gain of transrectal real-time elastography (RTE) compared to transrectal B-mode ultrasonography (US) in the detection of tumors in patients suspected of having prostate cancer.

Materials And Methods: Eighty-four patients suspected of having prostate cancer on the basis of clinical and biochemical evaluation underwent transrectal US, RTE and transperineal prostate biopsy.

Results: Biopsy was considered the gold standard.

An open-label, randomized, flexible-dose, crossover study to assess the comparative efficacy and safety of sildenafil citrate and apomorphine hydrochloride in men with erectile dysfunction.

Introduction: We report the methodology and results of a study that compared a dopaminergic agonist, apomorphine, with a phosphodiesterase type-5 inhibitor, sildenafil, in terms of efficacy, tolerability, satisfaction and patient preference.

Patients And Methods: This was a 20-week open- label, randomized, flexible-dose, crossover study to assess the comparative efficacy and safety of sildenafil and apomorphine. One sequence group received treatment with sildenafil followed by apomorphine and the other sequence group received treatment with apomorphine followed by sildenafil.

[Extratesticular intraescrotal neurofibroma: case report].

Objectives: We report a rare case of intrascrotal neurofibroma in an adult patient not affected by neurofibromatosis (NF1).

Methods: Clinical diagnosis of asymptomatic right scrotal lipoma and left symptomatic inguinal hernia carried the patient to the surgical treatment. After the first surgical step of left hernia repair, we proceeded to the excision by an inguinoscrotal approach of a voluminous whitish neoplastic mass occupying the whole left scrotum and not involving homolateral testis.

Accuracy of prostate volume measurements using transrectal multiplanar three-dimensional sonography.

The aim of this study is to evaluate the accuracy of three-dimensional (3D) ultrasound in comparison with conventional bidimensional (2D) sonography in prostatic calculations. The study was performed using a Kretztechnik Voluson 530D machine with a 7.5 MHz endocavitary transducer.

Carcinoma of the breast metastatic to the ureter seven years later.

We present a case of ureteral metastasis from a primary breast cancer where the disease recurred with an episode of renal colic 7 years after diagnosis. A surgical operation was performed to remove the terminal ureter and the perimeatal area of the urinary bladder. Urological and radiological outcome was satisfactory after a 2-year follow up.

Aneurysmal dilatation of the right renal vein for arterovenous fistula as a late consequence of open renal surgery.

We report a case of right renal arterial-venous (A-V) fistula, probably related to injury of renal blood vessels during open surgery for renal stones performed eight years ago, presenting with symptoms of congestive heart failure and chronic renal failure. On physical examination a palpable abdominal pulsatile mass in the right upper quadrant, associated with a continuous thrill was appreciated. The computed tomographic (CT) scan and the selective renal angiography showed the shunt between the renal vessels and the subsequent aneurysmal dilatation of right renal vein.

Genitourinary cancer: psychological assessment and gender differences.

Introduction: The study of the psychological impact in patients diagnosed with cancer is an important topic. Cancer diagnosis can induce feelings of anxiety, depression, fear of recurrence and produce treatment side effects. Men and women tend to differ in their way of dealing with emotional distress and physical illness.