1,721,384 research outputs found
PROSTATE CANCER IN 2010 GSU: misclassification or biological progression?
No full textGleason sum upgrading (GSU) is common in patients with organ-confined prostate cancer. Studies in 2010 have identified GSU predictors and examined the role of GSU in patients with prostate cancer, but several clinical applications for GSU have been suggested-has its clinical importance in daily practice been inflated
Re: Acute Kidney Injury After Partial Nephrectomy in Solitary Kidneys: Impact on Long-term Stability of Renal Function
No full textN.A
Is Erectile Dysfunction a Reliable Proxy of General Male Health Status? The Case for the International Index of Erectile Function-Erectile Function Domain
No full textIntroduction. Erectile dysfunction (ED) has emerged progressively as a sentinel marker of cardiovascular disease (CVD). The correlation between ED and the burden arising from multiple comorbid conditions has been incompletely analyzed. Aim. Assess whether erectile function, defined with the International Index of Erectile FunctionErectile Function (IIEF-EF) domain score, is associated with health-significant comorbidities scored with the Charlson comorbidity index (CCI). Methods. Clinical and hemodynamic variables of the last 140 consecutive patients who underwent penile color Doppler ultrasonography for new-onset ED were considered. Patients were assessed with a thorough medical and sexual history. Health-significant comorbidities were scored with the CCI. Main Outcome Measure. Descriptive statistics and either linear or logistic regression models tested the association among IIEF-EF, hemodynamic parameters, and CCI, which was included in the model both as continuous and categorized variable (0 vs. =1). Results. Complete data were available for 138 patients (98.6%) (mean age 46.6 years [standard deviation 13.0]; range 2175 years). CCI was 0, 1, and =2 in 94 (68.1%), 23 (16.7%), and 21 (15.25%) patients, respectively. Of all, 35 patients (79.5%) did not have a CVD comorbidity. Mean IIEF-EF was 13.7 (9.3). ED severity was no ED, mild, mild to moderate, moderate, and severe in 12 (9.1%), 28 (20.2%), 12 (9.1%), 23 (16.2%), and 63 (45.5%) patients, respectively. At multivariable linear regression analysis, CCI significantly worsened with increased age (beta = 0.33; P = 0.001) and decreased IIEF-EF values (beta = -0.25; P = 0.01). At logistic regression analysis, age (odds ratio [OR]: 1.05; P = 0.004) and IIEF-EF (OR: 0.95; P = 0.04) emerged as significant predictors of categorized CCI. Conclusions. Severity of ED, as objectively interpreted with IIEF-EF, accounts for a higher CCI, which may be considered a reliable proxy of a lower general male health status regardless of the etiology of ED. Salonia A, Castagna G, Sacca A, Ferrari M, Capitanio U, Castiglione F, Rocchini L, Briganti A, Rigatti P, and Montorsi F. Is erectile dysfunction a reliable proxy of general male health status? The case for the International Index of Erectile FunctionErectile function domain. J Sex Med **;**:****
Reply to Kazutaka Saito's Words of Wisdom re: Nephron-sparing Techniques Independently Decrease the Risk of Cardiovascular Events Relative to Radical Nephrectomy in Patients with a T1a-T1b Renal Mass and Normal Preoperative Renal Function. Eur Urol. 2016;69:538
No full textHOW CAN WE PREDICT LYMPHORRHOEA AND CLINICALLY SIGNIFICANT LYMPHOCELES AFTER RADICAL PROSTATECTOMY AND PELVIC LYMPHADENECTOMY? CLINICAL IMPLICATIONS REPLY
No full textReply to Giovanni Lughezzani, Paolo Casale, and Laura Evangelista's Letter to the Editor re: Giuseppe Basile, Giuseppe Fallara, Paolo Verri, et al. The Role of 99mTc-Sestamibi Single-photon Emission Computed Tomography/Computed Tomography in the Diagnostic Pathway for Renal Masses: A Systematic Review and Meta-analysis. Eur Urol. 2024;85:63–71
No full textReply to Angela Estevez, Phillip Kim, Peter Chang, and Andrew A. Wagner's Letter to the Editor re: Giuseppe Basile, Giuseppe Fallara, Paolo Verri, et al. The Role of 99mTc-Sestamibi Single-photon Emission Computed Tomography/Computed Tomography in the Diagnostic Pathway for Renal Masses: A Systematic Review and Meta-analysis. Eur Urol 2024;85:63–71
No full textErectile Function Outcome after Bilateral Nerve Sparing Radical Prostatectomy: Which Patients May Be Left Untreated?
No full textIntroduction. Several studies have shown that erectile function (EF) recovery in patients undergoing bilateral nerve sparing radical prostatectomy (BNSRP) improves significantly when phosphodiesterase type 5 inhibitors (PDE5) are administered following surgery. Methods. We included 293 patients treated with BNSRRP at a single center. Postoperative EF recovery was defined as an EF domain score of the International Index of Erectile Function (IIEF) >= 22. No patient received any treatment for postoperative erectile dysfunction (ED). Kaplan-Meier curves assessed time to EF recovery according to patient age, preoperative EF, and Charlson comorbidity index (CCI). Univariable and multivariable Cox regression models tested the association between predictors and EF recovery. Finally, the rate of EF recovery of untreated patients after BNSRP was compared with a subset of patients with similar preoperative characteristics but receiving PDE5. Main Outcome Measure. The main outcome measure of this article was the IIEF-EF domain score. Results. Overall, 105/293 (35.8%) reached an IIEF-EF >= 22 after a mean follow-up of 26.8 months. At multivariable analyses, age, preoperative IIEF-EF, and CCI achieved independent predictor status (all P 70 years (P = 26) had a 56.6% chance of recovering EF after surgery compared with 18% of patients with severe ED before surgery (P = 22 was higher but did not differ significantly from comparable patients receiving PDE5 (P = 0.11). Conclusions. Overall, the rate of EF postoperative recovery in patients left untreated after surgery is modest (35.8%). Although younger patients with a good preoperative EF may experience good EF recovery rates even without any treatment, use of PDE5 after surgery further improved their functional outcomes. Therefore, a therapy for ED should be offered to all patients treated with BNSRP. Gallina A, Ferrari M, Suardi N, Capitanio U, Abdollah F, Tutolo M, Bianchi M, Sacca A, Salonia A, Rigatti P, Montorsi F, and Briganti A. Erectile function outcome after bilateral nerve sparing radical prostatectomy: Which patients may be left untreated? J Sex Med 2012; 9: 903-908
Extended Pelvic Lymph Node Dissection Does Not Affect Erectile Function Recovery in Patients Treated with Bilateral Nerve-Sparing Radical Prostatectomy
No full textIntroduction. Extended pelvic lymph node dissection (ePLND) might be associated with damages to the pelvic plexus, potentially affecting erectile function (EF) recovery after radical prostatectomy (RP). However, the impact of the extent of pelvic lymph node dissection (PLND) on EF has never been addressed. Aim. The aim of this study is to evaluate the impact of ePLND on potency recovery in patients who underwent bilateral nerve-sparing RP (BNSRP). Methods. The study included 396 patients with prostate cancer treated with BNSRP by two high-volume surgeons. Patients were retrospectively divided into two groups based on PLND status: no PLND (N = 161; 40.9%) and ePLND (N = 235; 59.1%) at the time of BNSRP. All patients had preoperative functional and oncological data. Univariable and multivariable Cox regression models tested the association between ePLND and EF recovery after surgery, after accounting for confounders. Main Outcome Measure. The International Index of Erectile Function (IIEF) was used to evaluate EF after BNSRP. Postoperative EF recovery was defined as an IIEF-EF domain score =22. Results. At a mean follow up of 33.2 months after surgery (median 30), 183 patients (46.2%) recovered EF. Overall, postoperative EF recovery rate at 2 years was 48.4%. No significant differences were recorded when patients were stratified according to the extent of PLND (EF recovery rates at 2-year: 46.6% vs. 49.7% for patients who did not undergo PLND vs. those treated with ePLND; P = 0.33). These results were confirmed at multivariable analyses, where only age at surgery and preoperative IIEF-EF (all P = 0.03), but not ePLND (P = 0.8), represented independent predictors of EF recovery. Conclusions. The extent of PLND is not associated with potency after BNSRP. Conversely, other factors such as age at surgery and preoperative EF represent the major predictors of postoperative potency recovery. Therefore, when indicated, ePLND can be safely performed without compromising EF outcomes. Gandaglia G, Suardi N, Gallina A, Abdollah F, Capitanio U, Salonia A, Colombo R, Bianchi M, Chun FK, Hansen J, Rigatti P, Montorsi F, and Briganti A. Extended pelvic lymph node dissection does not affect erectile function recovery in patients treated with bilateral nerve-sparing radical prostatectomy. J Sex Med 2012;9:21872194
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