Andreas Skolarikos

General Hospital of Komotini "Sismanoglio", Komotina, East Macedonia and Thrace, Greece

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Publications (136)409.66 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: INTRODUCTION & OBJECTIVES: The aim of the current meta-analysis was to analyze the data of randomized and quasi- randomized studies on α-blockers implemented following ESWL for renal and ureteral stones. MATERIAL & METHODS: We first conducted a search of CENTRAL, WEB OF SCIENCE, PUBMED and SCOPUS using selected search terms. Subgroup analyses were a priori planned to be performed depending on the: type of α-blocker (i.e alfuzosin, terazosin, doxazosin, Urapidil), size and location of stones. All results were combined for meta-analysis with the Review Manager. RESULTS: 21 studies were analyzed including 1877 patients. Only 5 trials were placebo-controlled; the others compared α-blocker with a control group in which analgesics, NSAIDs or antispasmodics were allowed. Mean stone size ranged from 7.5 mm to 16.2 mm. Stones were located in the kidney/upper ureter, middle ureter and lower ureter in 1051, 6, 574 patients, respectively. Treatment duration ranged from 4.14 days to 12 weeks, or until stone passage if before than 12 weeks. Follow-up varied from 15 to 90 days. Mean time to passage ranged from 4.14 to 30.7 days. There was a benefit of a higher stone-free rate for those patients who have taken α-blockers at 2 weeks (OR=2.77, p<0.001), 1 month(OR=1.97, p<0.001), 2 months (OR=1.77, p<0.005) and 3 months (OR=1.71, p<0.0005) of follow-up. Τhe group receiving α-blockers had significantly decreased time to stone expulsion (WMD: -2.60 days, p<0.0001) in comparison to the control group. Furthermore, compared to patients who received placebo, the patients who received α-blockers experienced pain less frequently (OR=0.21, p<0.001) with less intensity (STD=-0.57, p=0.03). Steinstrasse formation was significantly less frequent in the α-blocker group at 2 weeks (OR=0.20, p=0.02) and 3 months (OR=0.45, p=0.008). Νo significant difference was detected regarding the stone-free rate between the various types of α-blockers at 2 weeks (p=0.51), 1 month (p=0.57) and 3 months after lithotripsy (p=0.54). In addition, no significant difference in the stone clearance rate at 2 weeks (p=0.81), 1 month (p=0.07) and 2 months (p=0.44) was detected between the different stone sizes (≤10 mm vs. > 10 mm). Similarly the stone-free rate was not altered by stone location at 2 weeks (p=0.81) and 1 month (p=0.50) after SWL. Overall, α-blockers were well tolerated in most patients and with just a few adverse effects. CONCLUSIONS: Evidence suggests that MET using α-blockers can be suggested as an adjuvant treatment after SWL owing to theirs expulsive efficacy, pain reduction, and safety profile. However, due to clinical heterogeneity among the included studies, conclusions drawn from our pooled results should be interpreted cautiously
    European Urology Supplements 04/2015; 14(2):e390. DOI:10.1016/S1569-9056(15)60385-2 · 3.37 Impact Factor
  • European Urology Supplements 04/2015; 14(2):e965. DOI:10.1016/S1569-9056(15)60953-8 · 3.37 Impact Factor
  • A. Dellis · A. Skolarikos · F. Keeley · A. Panagopoulos · A. Papatsoris
    European Urology Supplements 04/2015; 14(2):e1079. DOI:10.1016/S1569-9056(15)61067-3 · 3.37 Impact Factor
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    ABSTRACT: To determine the efficacy and safety of flexible ureterorenoscopy (fURS) for the treatment of single intrarenal calculi and further stratify the efficacy by stone burden. CROES collected prospective data on consecutive patients with urinary stones treated with URS at 114 centers worldwide for 1 year. Only patients who underwent fURS for a solitary renal stone where included in the present study. Pre- and intraoperative characteristics, and post- operative outcomes were evaluated. The relationships between stone size and stone-free rate (SFR), operative time, complications, hospital stay, and need for retreatment were explored. and limitations: A total of 1210 patients with solitary kidney stones <10mm (52.2%), 10-20mm (43.2%) and >20mm (4.6%) were treated with fURS. There was a negative correlation between SFR and stone size when adjusted for BMI. Operating time showed a positive correlation with stone size when adjusted for BMI. Single session SFR was 90% for stones <10mm and 80% for stones <15 mm. Patients with stones >20mm achieved a 30% SFR, more often needed retreatment and were more often readmitted. There were no differences in overall complication rates for different stone sizes. However, patients with a stone >20mm had a higher probability of developing fever after fURS as compared to patients with smaller stones. Our data indicate that fURS for a single intrarenal stone is a safe procedure. Best results after single session fURS were obtained for stones <15mm. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    The Journal of Urology 02/2015; 194(1). DOI:10.1016/j.juro.2015.01.112 · 3.75 Impact Factor
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    01/2015; 2(1). DOI:10.15586/jkcvhl.2015.22
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    ABSTRACT: The aim of the present review was to compare state‐of‐the‐art care and future perspectives for the detection and treatment of non‐muscle‐invasive transitional cell carcinoma (TCC) of the bladder. We provide a summary of the third expert meeting on ‘Optimising the management of non‐muscle‐invasive bladder cancer, organized by the European Association of Urology Section for Uro‐Technology (ESUT) in collaboration with the Section for Uro‐Oncology (ESOU), including a systematic literature review. The article includes a detailed discussion on the current and future perspectives for TCC, including photodynamic diagnosis, optical coherence tomography, narrow band imaging, the Storz Professional Image Enhancement system, magnification and high definition techniques. We also provide a detailed discussion of future surgical treatment options, including en bloc resection and tumour enucleation. Intensive research has been conducted to improve tumour detection and there are promising future perspectives, that require proven clinical efficacy. En bloc resection of bladder tumours may be advantageous, but is currently considered to be experimental.
    BJU International 01/2015; 115(1). DOI:10.1111/bju.12664 · 3.13 Impact Factor
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    ABSTRACT: An optimum metabolic evaluation strategy for urinary stone patients has not been clearly defined. To evaluate the optimum strategy for metabolic stone evaluation and management to prevent recurrent urinary stones. Several databases were searched to identify studies on the metabolic evaluation and prevention of stone recurrence in urolithiasis patients. Special interest was given to the level of evidence in the existing literature. Reliable stone analysis and basic metabolic evaluation are highly recommended in all patients after stone passage (grade A). Every patient should be assigned to a low- or high-risk group for stone formation. It is highly recommended that low-risk stone formers follow general fluid and nutritional intake guidelines, as well as lifestyle-related preventative measures to reduce stone recurrences (grade A). High-risk stone formers should undergo specific metabolic evaluation with 24-h urine collection (grade A). More specifically, there is strong evidence to recommend pharmacological treatment of calcium oxalate stones in patients with specific abnormalities in urine composition (grades A and B). Treatment of calcium phosphate stones using thiazides is only highly recommended when hypercalciuria is present (grade A). In the presence of renal tubular acidosis (RTA), potassium citrate and/or thiazide are highly recommended based on the relative urinary risk factor (grade A or B). Recommendations for therapeutic measures for the remaining stone types are based on low evidence (grade C or B following panel consensus). Diagnostic and therapeutic algorithms are presented for all stone types based on the best level of existing evidence. Metabolic stone evaluation is highly recommended to prevent stone recurrences. In this report, we looked at how patients with urolithiasis should be evaluated and treated in order to prevent new stone formation. Stone type determination and specific blood and urine analysis are needed to guide patient treatment. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.
    European Urology 11/2014; 67(4). DOI:10.1016/j.eururo.2014.10.029 · 12.48 Impact Factor
  • Andreas Skolarikos · Andreas Dellis · Thomas Knoll
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    ABSTRACT: The simultaneous surgical management of ureteropelvic junction obstruction (UPJO) with concomitant renal stones has evolved the last 20 years; hence, the ideal minimally invasive technique is still controversial. Laparoscopic and robot-assisted laparoscopic operations allow precise surgical maneuvers and were thought to simplify the reconstruction steps of the procedure, especially in the treatment of complex cases with large stones. The aim of this study was to summarize the available perioperative and functional outcomes of minimally invasive available techniques. A non-systematic review of the literature was performed using a free-text protocol in the MEDLINE database. The terms used were "ureteropelvic junction obstruction," "renal calculi" and "renal stones." Furthermore, other significant relevant studies cited in the reference lists of the selected papers were also evaluated in the structure of this review. Currently, available evidence suggests that both laparoscopic and robotic-assisted techniques offer excellent surgical solutions in the field of UPJO reconstruction and renal stones removal. In the hands of experienced surgeons, laparoscopic and robotic pyeloplasty with concomitant stone removal is a safe procedure with high stone-free rates and UPJ patency. Minimally invasive pyeloplasty should constitute the first choice of treatment for concomitant renal stones and ureteropelvic junction obstruction.
    11/2014; 43(1). DOI:10.1007/s00240-014-0736-2
  • European Urology Supplements 11/2014; 13(7):e1529-e1529a. DOI:10.1016/S1569-9056(14)61730-9 · 3.37 Impact Factor
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    ABSTRACT: Purpose: To examine the safety and efficacy of hyperbaric oxygen as the primary treatment for Grade IV radiation-induced haemorrhagic cystitis. Materials and Methods: Hyperbaric oxygen was prospectively applied as a primary treatment option in 11 patients with Grade IV radiation cystitis. Primary endpoint was the incidence of complete and partial response to treatment. Secondary endpoints included the duration of response, the correlation of treatment success-rate to the interval between the onset of haematuria and initiation of therapy, blood transfusion need and total radiation dose, the number of sessions to success, the avoidance of surgery and the overall survival. Results: All patients completed therapy without complications for a mean follow-up of 17.82 months (range 3 to 34). Mean number of sessions needed was 32.8 (range 27 to 44). Complete and partial response rate was 81.8% and 18.2%, respectively. However, in three patients the first treatment session was not either sufficient or durable giving a 72.7% rate of durable effect. Interestingly, all 9 patients with complete response received therapy within 6 months of the haematuria onset compared to the two patients with partial response who received therapy at 8 and 10 months from the haematuria onset, respectively (p = 0.018). The need for blood transfusion (p = 0.491) and the total radiation dose (p = 0.259) were not correlated to success-rate. One patient needed cystectomy, while all patients were alive at the end of follow-up. Conclusions: Early primary use of hyperbaric oxygen to treat radiation-induced grade IV cystitis is an effective and safe treatment option.
    International braz j urol: official journal of the Brazilian Society of Urology 05/2014; 40(3):296-305. DOI:10.1590/S1677-5538.IBJU.2014.03.02 · 0.96 Impact Factor
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    ABSTRACT: Objective: To report continence and urodynamic findings after radical cystectomy and urinary diversion with modified S-ileal neobladder between January 1993 and January 2013. Patients and Methods: 181 patients were enrolled. Continence status, reservoir sensation, compliance, capacity and activity were assessed. Results: Daytime continence was reported by 88.0, 98.4 and 99.2%, while nighttime continence was reported by 70.2, 94.0 and 95.8% of our patients at 6 months, 5 years and 20 years, respectively. Enterocystometric capacity and maximum reservoir pressure were 366 vs. 405 ml and 502 ml, and 29 vs. 18 and 11 cm H2O, at 6 months, 5 years and 20 years, respectively. Median post-void residual urine volume was 32 ml at 6 months, 50 ml at 5 years and 120 ml at 20 years. Conclusions: The modified S-ileal neobladder technique has a very good long-lasting functional outcome, with high day- and nighttime continence levels as well as high acceptability rates from our patients. © 2014 S. Karger AG, Basel.
    Urologia Internationalis 04/2014; 93(1). DOI:10.1159/000356283 · 1.15 Impact Factor
  • European Urology Supplements 04/2014; 13(1):e797. DOI:10.1016/S1569-9056(14)60785-5 · 3.37 Impact Factor
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    ABSTRACT: Objectives To compare state-of-the-art care and future perspectives of detection and treatment of non-muscle invasive transitional cancer of the bladder. Methods Summary of 3rd expert meeting on “Optimising the management of non-muscle invasive bladder cancer” organized by ESUT in collaboration with ESOU, including a systematic literature review. ResultsDetailed discussion on state-of-the-art and future perspectives of transitional cell cancer including PDD, OCT, NBI, SPIES, magnification and high definition.Detailed discussion of future surgical treatment options, including en-bloc resection and tumour enucleation Conclusions Intensive research has been conducted to improve tumour detection.Promising future perspectives, that require proven clinical efficacy.En-bloc resection of bladder tumours may be advantageous, however are currently considered to be experimental.
    BJU International 02/2014; · 3.13 Impact Factor
  • Article: Reply.
    Athanasios E Dellis · Francis X Keeley · Victor Manolas · Andreas A Skolarikos
    Urology 11/2013; DOI:10.1016/j.urology.2013.08.072 · 2.13 Impact Factor
  • Athanasios E Dellis · Francis X Keeley · Victor Manolas · Andreas A Skolarikos
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    ABSTRACT: To properly use the Ureteric Symptom Score Questionnaire (USSQ) to evaluate, in a randomized control study, the effect of 2 different α-blockers in improving symptoms and quality of life in patients with indwelling ureteral stents. After institutional review board approval, 150 consecutive patients with a double-J ureteral stent inserted after extracorporeal shockwave lithotripsy (ESWL) or ureteroscopic stone treatment were randomly assigned to receive tamsulosin 0.4 mg, alfuzosin 10 mg, or placebo. The validated USSQ was completed 1 and 4 weeks after stent insertion and 4 weeks after stent removal. The Kruskal-Wallis test for independent samples for non-normally distributed ordinal variables, chi-square to compare proportions or differences, and 1-way analysis of variance (ANOVA) for independent samples to compare for differences in case of continuous variables were used for statistical analysis of the results. Patients receiving α-blockers expressed an overall statistically significant lower urinary (P <.001), pain (P <.001 with stent in situ), and general health index (P <.002) scores. Sexual life and quality of life were also positively influenced. Quality of work was not influenced. No patients had to discontinue medication because of side effects or underwent stent removal before the due date. There was no difference in various outcomes between the 2 α-blockers. Stent-related morbidity is a reality in the majority of patients. Simple medication, such as α-blockers, reduce stent-related symptoms and the negative impact on quality of life. It seems that stent-related symptom improvement is independent to the type of α-blocker.
    Urology 11/2013; 83(1). DOI:10.1016/j.urology.2013.08.067 · 2.13 Impact Factor
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    ABSTRACT: CONTEXT: Controversy remains over whether adrenalectomy and lymph node dissection (LND) should be performed concomitantly with radical nephrectomy (RN) for locally advanced renal cell carcinoma (RCC) cT3-T4N0M0. OBJECTIVE: To systematically review all relevant literature comparing oncologic, perioperative, and quality-of-life (QoL) outcomes for locally advanced RCC managed with RN with or without concomitant adrenalectomy or LND. EVIDENCE ACQUISITION: Relevant databases were searched up to August 2012. Randomised controlled trials (RCTs) and comparative studies were included. Outcome measures were overall survival, QoL, and perioperative adverse effects. Risks of bias (RoB) were assessed using Cochrane RoB tools. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. EVIDENCE SYNTHESIS: A total of 3658 abstracts and 252 full-text articles were screened. Eight studies met the inclusion criteria: six LNDs (one RCT and five nonrandomised studies [NRSs]) and two adrenalectomies (two NRSs). RoB was high across the evidence base, and the quality of evidence from outcomes ranged from moderate to very low. Meta-analyses were not undertaken because of diverse study designs and data heterogeneity. There was no significant difference in survival between the groups, even though 5-yr overall survival appears better for the RN plus LND group compared with the no-LND group in one randomised study. There was no evidence of a difference in adverse events between the RN plus LND and no-LND groups. No studies reported QoL outcomes. There was no evidence of an oncologic difference between the RN with adrenalectomy and RN without adrenalectomy groups. No studies reported adverse events or QoL outcomes. CONCLUSIONS: There is insufficient evidence to draw any conclusions on oncologic outcomes for patients having concomitant LND or ipsilateral adrenalectomy compared with patients having RN alone for cT3-T4N0M0 RCC. The quality of evidence is generally low and the results potentially biased. Further research in adequately powered trials is needed to answer these questions.
    European Urology 04/2013; 64(5). DOI:10.1016/j.eururo.2013.04.033 · 12.48 Impact Factor
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    ABSTRACT: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: The effect of TURP on overall sexual function and particularly erectile function (EF) is controversial with conflicting results based on a low level of evidence. The effects of monopolar and bipolar TURP (M-TURP and B-TURP, respectively) on EF are similar, as has been shown in a few non-focused randomized control trials (RCTs). For the first time, the present study offers focused results of a comparative evaluation of the effects of B-TURP and M-TURP on overall sexual function, as quantified with the International Index of Erectile Function Questionnaire (IIEF-15) in an international, multicentre, double-blind RCT setting. OBJECTIVE: To compare monopolar and bipolar transurethral resection of the prostate (M-TURP and B-TURP, respectively) using a true bipolar system, for the first time in an international multicentre double-blind randomized controlled trial focusing on the overall sexual function quantified with the International Index of Erectile Function Questionnaire (IIEF-15). Other baseline/perioperative parameters potentially influencing erectile function (EF) after TURP were secondarily investigated. MATERIALS AND METHODS: From July 2006 to June 2009, consecutive TURP candidates with benign prostatic obstruction were prospectively recruited in four academic urological centres, randomized 1:1 into M-TURP/B-TURP arms and followed up at 6 weeks, 6 and 12 months after surgery. In all, 295 eligible patients were enrolled. Overall sexual function was quantified using self-administered IIEF-15 at baseline and at each subsequent visit. Total IIEF/domain scores were calculated and EF score classified erectile dysfunction severity. Differences in erectile dysfunction severity at each visit compared with baseline (EF evolution), classified patients into 'improved', 'stable' or 'deteriorated'. Pre-postoperative IIEF/domain scores and differences in the distribution of EF evolution were compared between arms throughout follow-up. RESULTS: In all, 279 patients received the allocated intervention; 218/279 patients (78.1%) provided complete IIEF-15 data at baseline and were considered in sexual function analysis. Complete IIEF-15 data were available from 193/218 (88.5%), 186/218 (85.3%) and 179/218 (82.1%) patients at 6 weeks, 6 months and 12 months, respectively. Sexual function did not differ significantly between arms during follow-up (scores: IIEF, P = 0.750; EF, P = 0.636; orgasmic function, P = 0.868; sexual desire, P = 0.735; intercourse satisfaction, P = 0.917; overall satisfaction, P = 0.927). Resection type was not a predictor of any sexual function changes observed. Distribution of EF evolution did not differ between arms at any time (M-TURP vs B-TURP at 12 months: improved, 23/87 [26.4%] vs 18/92 [19.6%]; stable, 53/87 [60.9%] vs 56/92 [60.8%]; deteriorated, 11/87 [12.7%] vs 18/92 [19.6%]; P = 0.323). CONCLUSION: There were no differences between M-TURP/B-TURP in any aspect of sexual function.
    BJU International 03/2013; 112(1). DOI:10.1111/j.1464-410X.2012.11662.x · 3.13 Impact Factor
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    ABSTRACT: Nowadays, rigid and flexible ureteroscopy is a precise, minimal invasive surgery that can assess the entire collecting system in order to treat a stone with intracorporeal lithotripsy. The implication of laser technology has revolutionized the intracorporeal lithotripsy. Currently, laser lithotripsy is advancing in two different directions: improvements of the existing Ho:YAG laser platform and the development of novel laser systems. Herein, we review the current literature upon intracorporeal lithotripsy.
    Minerva medica 02/2013; 104(1):55-60. · 1.20 Impact Factor
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    Athanasios Dellis · Andreas Skolarikos · Athanasios G. Papatsoris
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    ABSTRACT: Objectives To answer the questions ‘Why should I do research? Is it a waste of time?’ and present relevant issues. Methods Medline was used to identify relevant articles published from 2000 to 2013, using the following keywords ‘medicine’, ‘research’, ‘purpose’, ‘study’, ‘trial’, ‘urology’. Results Research is the most important activity to achieve scientific progress. Although it is an easy process on a theoretical basis, practically it is a laborious process, and full commitment and dedication are of paramount importance. Currently, given that the financial crisis has a key influence in daily practice, the need to stress the real purpose of research is crucial. Conclusion Research is necessary and not a waste of time. Efforts to improving medical knowledge should be continuous.
    01/2013; 12(1). DOI:10.1016/j.aju.2013.08.007
  • European Urology 12/2012; 63(4). DOI:10.1016/j.eururo.2012.11.054 · 12.48 Impact Factor

Publication Stats

1k Citations
409.66 Total Impact Points

Institutions

  • 1999–2015
    • General Hospital of Komotini "Sismanoglio"
      Komotina, East Macedonia and Thrace, Greece
  • 2007–2014
    • Harokopion University of Athens
      Athínai, Attica, Greece
  • 2013
    • University of Groningen
      Groningen, Groningen, Netherlands
  • 2009
    • Thriasio General Hospital of Elefsina
      Lepsina, Attica, Greece
  • 2008
    • Laiko Hospital
      • Department of Radiology
      Athínai, Attica, Greece
  • 2003
    • The Newcastle upon Tyne Hospitals NHS Foundation Trust
      Newcastle-on-Tyne, England, United Kingdom