Konstantinos Skriapas

Publications (9)35.28 Total impact

• Article: Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia: Combined Treatment with Fesoterodine Fumarate Extended-Release and Tamsulosin - A Prospective Study.

  Charalampos Konstantinidis, Michael Samarinas, Sotirios Andreadakis, Stylianos Xanthis, Konstantinos Skriapas
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  ABSTRACT: Objective: To evaluate the efficacy and safety of fesoterodine extended-release (ER) plus tamsulosin in men with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Patients and Methods: Men aged ≥50 years, with LUTS, prostate volume ≤60 ml and International Prostate Symptom Score (IPSS) ≥13 were enrolled in this study. 173 consecutive patients were treated initially with tamsulosin (0.4 mg) for 1 week. At the second visit, 47 patients out of the sample of 173 who were still experiencing inconvenient LUTS were randomized into two groups. The first group received a therapy with tamsulosin and fesoterodine combination (group 1, n = 24) while the second continued the therapy with the single administration of tamsulosin (group 2, n = 23) for an additional 4-week period. Results: There was no statistically significant difference in age, prostate volume, Q(max), and postvoid residual urine between the two groups. A statistical significance appeared in the combination group regarding the storage and the total IPSS values among the second and third visits (10.5 ± 1.4 to 8.5 ± 1.3 and 16.1 ± 1.8 to 13.7 ± 1.5 respectively). Conclusion: Regarding bothersome LUTS and storage symptoms, fesoterodine ER and tamsulosin combination was significantly more effective than the single administration of tamsulosin.
  Urologia Internationalis 12/2012; · 0.99 Impact Factor
• Source

  Available from: Elpiniki I Papageorgiou

  Article: ARTICLE IN PRESS Application of evolutionary fuzzy cognitive maps to the long-term prediction of prostate cancer

  Wojciech Froelich, Elpiniki I Papageorgiou, Michael Samarinas, Konstantinos Skriapas
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  ABSTRACT: a b s t r a c t The prediction of multivariate time series is one of the targeted applications of evolutionary fuzzy cogni-tive maps (FCM). The objective of the research presented in this paper was to construct the FCM model of prostate cancer using real clinical data and then to apply this model to the prediction of patient's health state. Due to the requirements of the problem state, an improved evolutionary approach for learning of FCM model was proposed. The focus point of the new method was to improve the effectiveness of long-term prediction. The evolutionary approach was verified experimentally using real clinical data acquired during a period of two years. A preliminary pilot-evaluation study with 40 men patient cases suffering with prostate cancer was accomplished. The in-sample and out-of-sample prediction errors were cal-culated and their decreased values showed the justification of the proposed approach for the cases of long-term prediction. The obtained results were approved by physicians emerging the functionality of the proposed methodology in medical decision making.
  Applied Soft Computing. 01/2012; 8.
• Article: Comparison between lidocaine and glyceryl trinitrate ointment for perianal-intrarectal local anesthesia before transrectal ultrasonography-guided prostate biopsy: a placebo-controlled trial.

  Konstantinos Skriapas, Charalampos Konstantinidis, Michael Samarinas, Stylianos Xanthis, Aristomenis Gekas
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  ABSTRACT: To evaluate the use of topical lidocaine gel and glyceryl trinitrate ointment (GTN) vs placebo, in reducing anal pain and discomfort as an adjunct to periprostatic anesthesia because of probe insertion, during the use of transrectal ultrasonography (TRUS) prostate-guided biopsy in young patients. Two-hundred twenty-three men who underwent prostate biopsy were divided into 3 groups. Seventy-four patients (first group) and 76 patients (second group) received perianal local anesthesia with lidocaine gel 2%, and 1 g of 0.4% GTN ointment, respectively, whereas 73 patients (third group) received lubricant gel as perianal local anesthesia. All patients also underwent periprostatic nerve block (PPNB). Visual analogue scales (VAS 1 and VAS 2) were used to estimate the pain and discomfort during probe insertion and biopsy. Men in the first and second groups reported significantly less pain score (mean, 1.7 and 1.6, respectively) vs men from the third group (mean, 5.7) during probe insertion. Comparing the 3 different groups subsequently with the periprostatic anesthesia, no significant difference in VAS scores between the first and the third groups (mean, 1.9 and 2.1, respectively) was found; in addition, patients from the second group reported significantly less pain score (mean, 1.3) during biopsy. Lidocaine gel and GTN ointment is safe and effective in reducing anal pain associated with the insertion of an ultrasound probe. Furthermore, men with GTN ointment also reported less pain during biopsy. We suggest that analgesia before PPNB could significantly reduce anal pain and improve tolerance during TRUS prostate-guided biopsy.
  Urology 02/2011; 77(4):905-8. · 2.43 Impact Factor
• Article: Vesicourethral anastomosis during endoscopic extraperitoneal radical prostatectomy: a prospective comparison between the single-knot running and interrupted technique.

  Vassilis Poulakis, Konstantinos Skriapas, Rachelle de Vries, Wolfgang Dillenburg, Ulrich Witzsch, Eduard Becht
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  ABSTRACT: To determine the safety and efficacy of the single-knot running versus interrupted technique for urethrovesical anastomosis during endoscopic extraperitoneal radical prostatectomy. A total of 250 consecutive patients who underwent endoscopic extraperitoneal radical prostatectomy were prospectively divided into two groups of 125 patients each who underwent urethrovesical anastomosis using the single-knot running technique (group 1) or the interrupted suture technique (group 2). Surgical data, operative time, difficulty scores, extravasation rate, catheterization time, occurrence of anastomotic strictures, and the early and late continence rates were analyzed statistically. Regarding the clinical and pathologic findings, extravasation rate, catheterization time, and occurrence of anastomotic strictures, no significant differences were found between the two groups (P >0.05). The strongest independent predictors for extravasation were the integrity of the dorsal wall of the anastomosis and the degree of bladder neck opening (P <0.001). Overall, the continence rate at 3 and 6 months was 76% and 91.5% for group 1 and 77.6% and 93% for group 2, respectively (all P >0.05). The anastomosis technique had no impact on extravasation or continence status (all P >0.05). The only significant differences (P <0.001) in favor of the single-knot technique were the mean operative time and difficulty score (16 versus 24 minutes and 1 versus 3, respectively). Both techniques provide satisfactory and similar functional results. However, because of its simplicity and shorter operative time, the single-knot running technique appears preferable.
  Urology 01/2007; 68(6):1284-9. · 2.43 Impact Factor
• Article: Quality of life after laparoscopic and open retroperitoneal lymph node dissection in clinical Stage I nonseminomatous germ cell tumor: a comparison study.

  Vassilis Poulakis, Konstantinos Skriapas, Rachelle de Vries, Wolfgang Dillenburg, Nikolaos Ferakis, Ulrich Witzsch, Edward Becht
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  ABSTRACT: To compare the postoperative quality of life (QOL) and reconvalescence in patients with clinical Stage I nonseminomatous germ cell tumor (NSGCT) after laparoscopic retroperitoneal lymph node dissection (L-RPLND) and the open procedure (O-RPLND). Twenty-one patients with NSGCT who underwent transperitoneal L-RPLND were matched and compared with 29 patients who underwent O-RPLND. The operative, QOL, and recovery data and complications and cure rates were analyzed for both groups. The mean follow-up time for the L-RPLND and O-RPLND groups was 14 months (range 6 to 20) and 26 months (range 8 to 38), respectively. No major complication requiring open surgical revision or prolongation of hospitalization was observed intraoperatively or postoperatively in either group. However, the early and late minor postoperative complications were significantly greater in the O-RPLND group than in the L-RPLND group (P <0.001). The L-RPLND patients had a significantly shorter hospitalization, greater QOL scores, and a faster return to normal activities than did the O-RPLND patients (all P <0.001). L-RPLND for patients with clinical Stage I NSGCT is a safe and efficacious procedure, with a faster reconvalescence and greater postoperative QOL than after O-RPLND.
  Urology 08/2006; 68(1):154-60. · 2.43 Impact Factor
• Article: Extracorporeal shockwave therapy for Peyronie's disease: an alternative treatment?

  Vassilis Poulakis, Konstantinos Skriapas, Rachelle de Vries, Wolfgang Dillenburg, Nikolaos Ferakis, Ulrich Witzsch, Michael Melekos, Edward Becht
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  ABSTRACT: To determine retrospectively the safety and efficacy of extracorporeal shock wave therapy (ESWT) in patients with Peyronie's disease. Fifty-three patients with stable Peyronie's disease underwent ESWT (group 1). Fifteen patients matched with the baseline characteristic of the patients in group 1, who received no treatment, were used as the control (group 2). The patients' erectile function (International Index of Erectile Function [IIEF-5] score), pain severity (visual analog scale), plaque size and degree of penile angulation were assessed before and after the treatment in group 1 and during the follow-up in group 2. The mean follow-up time was 32 months (range: 6-64 months) in group 1 and 35 months (range: 9-48 months) in group 2. All the patients were available for the follow-up. Considering erectile function and plaque size, no significant changes (P > 0.05) were observed in group 1 before or after the ESWT. A total of 39 patients (74%) reported a significant effect in pain relief in group 1 after ESWT. However, regarding improvement in pain, IIEF-5 score and plaque size, no significant differences were observed between the two groups. In 21 patients (40%) of group 1, the deviation angle was decreased more than 10 degrees with a mean reduction in all patients of 11 degrees (range: 6-20 degrees). No serious complications were noted considering ESWT procedure. ESWT is a minimally invasive and safe alternative procedure for the treatment of Peyronie's disease. However, the effect of ESWT on penile pain, sexual function and plaque size remains questionable.
  Asian Journal of Andrology 06/2006; 8(3):361-6. · 1.52 Impact Factor
• Article: Tension-free vaginal tape (TVT) in morbidly obese patients with severe urodynamic stress incontinence as last option treatment.

  Konstantinos Skriapas, Vassilis Poulakis, Wolfgang Dillenburg, Rachelle de Vries, Ulrich Witzsch, Michael Melekos, Eduard Becht
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  ABSTRACT: To determine the safety and efficacy of tension-free vaginal tape (TVT) in morbidly obese women with severe urodynamic stress incontinence (USI) as last option treatment. Thirty-one patients with body mass index (BMI) >40 kg/m2, who had undergone the TVT procedure for urodynamically-confirmed USI were matched with 52 patients with BMI <30 kg/m2 who underwent the same procedure. BMI was calculated at the time of the surgery. Patients' characteristics and surgical data, complications and cure rates were analyzed for both groups. After a mean follow-up of 18.5 (range: 12-24) months the continence rates were 87% and 92% for morbidly obese women and control group, respectively (p = 0.103). No serious intraoperative complications were noted in both groups. However, the early postoperative complications were significantly higher (p < 0.05) in morbidly obese patients. In 4 patients from both group long term postoperative catheterization was necessary for 4 weeks. In one patient (2%) from the control group dilatation of urethra took place. No defect in healing or rejection of the tape occurred. TVT is a minimal invasive and safe procedure for morbidly obese patients suffering from severe USI with good outcome. Preoperative morbid obesity does not seem to be a risk factor for failure of this procedure.
  European Urology 03/2006; 49(3):544-50. · 8.49 Impact Factor
• Source

  Available from: urosource.com

  Article: Retroperitoneoscopic versus open surgical radical nephrectomy for large renal cell carcinoma in clinical stage cT2 or cT3a: quality of life, pain and reconvalescence.

  Wolfgang Dillenburg, Vassilis Poulakis, Konstantinos Skriapas, Rachelle de Vries, Nikolaos Ferakis, Ulrich Witzsch, Michael Melekos, Edward Becht
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  ABSTRACT: To determine whether retroperitoneoscopic radical nephrectomy for large renal cell carcinoma in stage cT2 or cT3a is a feasible, safe and effective therapy option and if it shows any advantage regarding quality of life in comparison to open procedure. 23 patients who underwent RPNx for tumor size greater than 7 cm (group 1) were matched and compared with 25 patients, who underwent ONx (group 2) for tumor with similar size characteristics. Patient and surgical data, QoL variables and complications were statistically analyzed. The median followup was 12 (range: 6-18) months for both groups. Group 1 had significantly (p < 0.001) less blood loss, shorter hospital stay, and shorter postoperative analgesic requirements. No conversion to open surgery was necessary, and no major complications requiring an invasive intervention occurred. Retroperitoneoscopic patients had significantly better QoL and pain scores postoperatively to 6 months (p < 0.001) and they return to baseline QoL status faster (p < 0.001). RPNx for large RCC in stage cT2 or cT3a is a safe and efficacious procedure with good short-term outcome results and significantly shorter recovery of QoL variables.
  European Urology 03/2006; 49(2):314-22; discussion 322-3. · 8.49 Impact Factor
• Article: Laparoscopic radical prostatectomy: the value of intraoperative frozen sections.

  Wolfgang Dillenburg, Vasileios Poulakis, Ulrich Witzsch, Rachelle de Vries, Konstantinos Skriapas, Hans-Michael Altmansberger, Eduard Becht
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  ABSTRACT: To examine the clinical and pathological value of intraoperative frozen section (IFS) in patients undergoing laparoscopic radical prostatectomy (L-RPE) for clinically localized prostate cancer. The study includes 198 consecutive cases of L-RPE. After removal of the prostate, a 2-3mm circumferential specimen was obtained from the apical and bladder neck soft-tissue margin and submitted for IFS examination. In cases suspicious for capsular incision (n=57), IFS were taken from the neurovascular bundle/lateral pedicle. The IFS diagnosis from the apical, bladder neck, and neurovascular bundle/lateral pedicle soft-tissue margins was adenocarcinoma in 12 (6%), 1 (0.5%), and 2 (1%) cases, respectively. Patient age, clinical stage, and mean specimen weight were not associated with cancer at the apical IFS. The accuracy, sensitivity, specificity, positive and negative predictive value of the apical IFS to predict cancer in the permanent section of the apical soft-tissue margin was 96%, 70%, 97%, 58%, and 98%, respectively. All the patients (n=15) with cancer at IFS had wide resections of additional tissue in the area of positive soft-tissue margin and all had no cancer in the additional resected tissue. Especially at the apex, IFS decreases the overall PSM status on surgical specimen by 5.1% (apical PSM from 8.6% to 3.5%). Because of the low predictive value of IFS of bladder neck and neurovascular bundle/lateral pedicle their use is not recommended. IFS of the apex should be performed to reduce the PSM rate.
  European Urology 11/2005; 48(4):614-21. · 8.49 Impact Factor