1,721,011 research outputs found
Recent advances in managing and understanding nephrolithiasis/nephrocalcinosis
No full textUrinary stone disease is a very common disease whose prevalence is still increasing. Stone formation is frequently associated with other diseases of affluence such as hypertension, osteoporosis, cardiovascular disease, metabolic syndrome, and insulin resistance. The increasing concentration of lithogenic solutes along the different segments of the nephron involves supersaturation conditions leading to the formation, growth, and aggregation of crystals. Crystalline aggregates can grow free in the tubular lumen or coated on the wall of the renal tubule. Plugs of crystalline material have been highlighted in the tubular lumen in some patients, but crystalline growth starting from plaques of calcium phosphate within the renal papillae has been demonstrated in others. Urinary supersaturation is the result of a complex interaction between predisposing genetic features and environmental factors. Dietary intake is certainly the most important environmental risk factor. In particular, an insufficient intake of dietary calcium (<600 mg/day) can increase the intestinal absorption of oxalate and the risk of calcium oxalate stone formation. Other possible risk factors that have been identified include excessive intake of salt and proteins. The potential role of dietary acid load seems to play an important role in causing a state of subclinical chronic acidosis; therefore, the intake of vegetables is encouraged in stone-forming patients. Consumption of sugar-sweetened soda and punch is associated with a higher risk of stone formation, whereas consumption of coffee, tea, beer, wine, and orange juice is associated with a lower risk. A high fluid intake is widely recognized as the cornerstone of prevention of all forms of stones. The effectiveness of protein and salt restriction has been evaluated in some studies that still do not allow definitive conclusions to be made. Calcium stone formation can be prevented by the use of different drugs with different mechanisms of action (thiazide diuretics, allopurinol, and potassium citrate), but there is no ideal drug that is both risk free and well tolerated
Psychological and sexological assessment of patients with chronic prostatitis
No full textPurpose: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by a multiform clinical presentation requiring a differentiated treatment based on different phenotypes including the psychosocial and sexual domains. The aim of this study was assessing the complex correlations between somatic, psychological, and sexual symptoms of CP/CPPS patients. Materials and methods: We performed a cross-sectional study on patients attending a Prostatitis Clinic. Patients were administered the following questionnaires: National Institutes of HealthChronic Prostatitis Symptom Index (NIH-CPSI), International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF), Premature Ejaculation Diagnostic Tool (PEDT), Patient Health Questionnaire -9 (PHQ-9), Generalized Anxiety Disorder 7 -item (GAD -7), Oxford Happiness Questionnaire (OHQ), and Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS -A). Results: Linear regression analyses show highly significant correlations between scores of the NIH-CPSI and the scores of the GAD -7, PHQ-9 and OHQ psychometric questionnaires. IPSS scores correlate significantly with the psychometric scores only when a non -parametric analysis is performed. IIEF and PEDT sexual function scores did not correlate with any of the psychometric tests. NIH-CPSI scores correlate positively with most of the TEMPS -A profiles but the hyperthymic profile correlated negatively with the total and QoL NIH-CPSI and with PEDT scores. Conclusions: Scores measuring anxiety, depression, and psychological well-being in patients with CP/CPPS are strictly correlated with prostatitis-like symptoms although they are poorly correlated with symptoms of prostatism, as measured by IPSS, and not correlated with scores of sexual dysfunctions, as measured by IIEF and PEDT. A hyperthymic temperament may temperament may increase resilience against the disease
SARS-CoV-2 and clinical urology: there is no dragon in this story
No full textCovid-19 disease is caused by the coronavirus of severe acute respiratory syndrome 2. The disease has evolved into a global pandemic that continues to this day. Coronavirus basically causes acute respiratory illness, the symptoms of which may remain milder even three months after the onset of this acute infection. Many patients also experience cardiological, gastrointestinal, and neurological symptoms that last for at least two months. Some patients report worsening of certain urinary symptoms. In this paper, we review the current knowledge about the relationship between SARS-CoV-2 and urinary system. A database and a manual search were conducted in the MEDLINE database of the National Library of Medicine, PubMed, Embase, the Cochrane Library, and other libraries using the keywords “SARS-CoV-2,” “COVID-19,” and “pandemic,” in various combinations with the terms “kidney,” “bladder” “prostate,” “testicles,” “LUTS,” “pain,” and “infection.” A considerable number of articles investigate the possible interaction between SARS-CoV-2 and the urinary system. In addition, to the well-documented involvement of the kidneys, testicle, and penile involvement seems to be possible. There are also studies investigating the development of benign prostatic hypertrophy (BPH) as a complication of SARS-CoV-2 infection and some studies examining the impact of COVID-19 disease on LUTS. In conclusion, the studies published so far do not provide conclusive evidence about a strong association between SARS-CoV-2 and the genitourinary system. Further investigation is warranted to better understand the nature of COVID-19 disease
Lithogenic Potential of Ureaplasma in Chronic Prostatitis
No full textIntroduction: The role of Ureaplasma spp. (UPs) in the pathogenesis of chronic prostatitis is debated. The lithogenic potential of UPs could be a risk factor for the development of chronic prostatitis.
Methods: A total of 143 patients with identification of UPs were retrospectively selected from a database including patients with prostatitis-like symptoms who were studied according to the same protocol including clinical, microbiological and microscopic evaluation, and transrectal prostate ultrasound. A control group of patients with negative UPs was considered including 393 with chronic bacterial prostatitis (CBP), 42 patients with Chlamydia trachomatis (CT), and 781 patients with chronic pelvic pain syndrome. UPs and Mycoplasma hominis (MH) were identified using a semiquantitative assay.
Results: Calcifications were observed more frequently in patients with UPs (64%) than in patients with CBP without UPs (39%), CT infection (37%), and chronic pelvic pain syndrome (29%) (p < 0.0001). UPs were isolated in VB1 alone in 35 patients (urethral UPs), in expressed prostatic secretion (EPS) or post-massage urine (VB3) or sperm in 77 patients (prostatic UPs) and associated with other pathogens in 31 patients (associated UPs). Calcifications were more frequent in prostatic UPs (71%) and associated UPs (73%) than in urethral UPs (34%). Mean NIH-CPSI scores were not significantly different between groups, although mean WBC counts of sperm of patients with urethral UPs were significantly lower than in patients with prostatic UPs (p = 0.000) and associated UPs (p = 0.002).
Conclusions: UPs identification in the urogenital fluids is related to higher rates of prostate calcifications. The ability of UPs to promote the formation of calcifications could be related to the chronicization of prostate infection. In particular, the presence of UPs in VB3/EPS/sperm is associated with higher rates of calcifications and high WBC sperm counts, suggesting a partial or full causative role of UPs in the pathogenesis of this disease
Assessment of Sexual Function in Relation to Microbiological Findings in Patients with Chronic Bacterial Prostatitis
No full textBackground/Objectives: Patients with chronic bacterial prostatitis (CBP) often present symptoms of sexual dysfunction. We aimed to evaluate the impact of the infection location and etiology on sexual dysfunction in patients with CBP. Methods: Male patients with CBP diagnosed by microbiological tests underwent a complete clinical assessment and were administered questionnaires for prostatitis (NIH-CPSI), voiding (IPSS), and sexual function (IIEF-15, PEDT). Results: Out of 614 patients, erectile dysfunction (ED) was present in 49.8%, and premature ejaculation (PE) in 40.7%. At least one sexual disorder was present in 86.3% when other disorders of ejaculation, orgasm, and sexual desire were considered. Patients with Gram-negative infections in expressed prostatic secretion (EPS) or voided urine after prostatic massage (VB3) had higher odds of moderate to severe erectile dysfunction compared to patients with infection by atypical pathogens (OR 3.31, CI 1.43–7.63, p = 0.0039). Rates of orgasmic dysfunction were also higher in Gram-negative and Gram-positive with respect to atypicals (OR 3.2, CI 1.36–7.90, p = 0.006 and OR 3.78, CI 1.64–8.71, p = 0.001). Hemospermia was more frequent in patients with semen infection by Gram-positive than in patients with infection by atypical pathogens (OR 2.2984, CI 1.3239–3.9901, p = 0.002). Prostatic calcifications at transrectal ultrasound were less frequent in patients with semen infection by Gram-negative compared to Gram-positive (OR 0.471, CI 0.3029–0.7322, p = 0.000). The addition of an “S” (sexual) domain to the UPOINT classification achieves a more significant correlation between the number of positive domains in each patient and the NIH-CPSI score. Conclusions: Infections by Gram-negative are associated with more sexual morbidity in patients with CBP. The use of a questionnaire investigating all the main domains of sexual dysfunction could be very useful for the phenotyping of patients with chronic prostatitis
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Genetic determinants of prostate cancer predisposition in Ashkenazi Jews
No full textBackground: Prostate cancer (PCa) is the most prevalent cancer among men in the European Union, the USA and Israel, with heritability being a key risk factor. Endogamy and kinship are known to increase the likelihood of transmitting genetic mutations associated with various cancers, as seen in populations with high levels of consanguinity, such as Ashkenazi Jews. The Ashkenazi Jewish population, with a history of genetic bottlenecks and selective migrations, has a higher prevalence of inherited mutations that predispose individuals to various diseases including cancer. This article reviews the literature examining the potential effects of founder mutations specific to Ashkenazi Jews, in enhancing the genetic risk of prostate cancer in this population. Methods: We searched for English-language articles on DNA mutations in Ashkenazi Jewish patients of any age with prostate cancer of any grade, including various study types, using PubMed and other databases with relevant keywords, and confirmed the search was up-to-date as of January 31st, 2025. Results: While the overall burden of PCa may not be higher than in European non-Jews, certain founder mutations in Ashkenazi Jews, especially 6174delT in BRCA2, are linked to increased risk and aggressive forms of PCa. Further research is needed to ascertain unequivocally the potential predisposing role of mutations such as 185delAG in BRCA1 or 471delAAAG in RNASEL. Conclusions: Overall, genetic screening for PCa risk in Ashkenazi Jewish men, particularly within high-endogamy subgroups (Haredim), may be beneficial. Increasing awareness of familial hereditary prostate cancer among Ashkenazi men and healthcare providers is also crucial for early detection and better management of the condition. The complexity of PCa genetics in Ashkenazim, including the influence of multiple low-penetrance mutations, the possible confounding factor of phenocopies, and the need for larger, more diverse studies, underscores the challenges in identifying definitive genetic risk factors. Further studies are awaited investigating in-depth the aggressiveness and response to treatment of PC among Ashkenazi Jews
Herbal medicines for urinary stone treatment. A systematic review
No full textTo analyze the clinical evidence on the efficacy of phytotherapy in the treatment of calculi in the urinary tract
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