Carlo Trombetta

• Professor
• University of Trieste

Scrotal masses are often identified by the patient as an abnormal lump during self-palpation. Scrotal lumps can be caused by cystic lesions or solid tumors of the testis or paratesticular structures, trauma, inflammations or testicular torsion, varicocele, fluid collections, inguinoscrotal hernia, or tumors of the scrotal wall. When a patient prese...

Defining the site of recurrent disease shortly after the completion of definitive treatment for localized prostate cancer constitutes a crucial concern as it can significantly impact subsequent therapeutic decisions and patient care. While the diagnosis of biochemical recurrence primarily relies on monitoring PSA levels and their trends, localizati...

Background: This study aims to evaluate the safety and efficacy of prostatic artery embolization (PAE) in elderly, multimorbid patients with benign prostatic hyperplasia (BPH). Additionally, it seeks to identify technical and clinical factors that predict clinical failure at the mid-term follow-up. Methods: We analyzed the clinical records of 175 c...

Background: Scoring metrics are important to compare outcomes of different percutaneous treatments for small renal masses (RMs). The concept of trifecta (no complications, kidney function preservation, and absence of local recurrence) has been recently introduced in percutaneous thermal ablation of RM. In this context, previous studies have shown t...

Simple Summary Renal Cell Carcinoma is a common cancer in Western countries. To date, the gold standard treatment for localized non-metastatic disease is partial or radical nephrectomy. When surgical treatment is feasible, the prediction of postoperative renal function might influence the treatment algorithm. On the other hand, there is growing evi...

Background: Sexual difficulties are a recognized consequence of prostate cancer (PCa) treatments. An estimated one in three men who have sex with men (MSM) receive PCa a diagnosis during their lifetime. MSM may experience all types of sexual dysfunction as reported in men who have sex with women (MSW), along with a number of more specific botherso...

Prostheses are widely used in urogenital surgery for many decades and have gained a fundamental role in the management of multiple diseases with good results in terms of functionality, aesthetic outcomes, and patients’ satisfaction. It is remarkable that prosthetic devices vary in terms of mechanical sophistication, costs, and surgical implantation...

BACKGROUND Prognostic tools in pathological-node (pN) patients after radical cystectomy (RC) are needed. OBJECTIVES To evaluate the prognostic impact of lymph node (LN)-density on disease-specific survival (DSS) in patients with bladder cancer (BC) undergoing RC with pelvic lymph node dissection. METHODS We analyzed a multi-institutional cohort o...

Background The coronavirus disease (COVID-19) pandemic has posed challenges to the global health care community, affecting the management of upper urinary tract stones. Materials and methods This retrospective study involved 9 Italian centers. We compared the 12-month period prior to COVID-19 (March 1, 2019, to February 28, 2020; Period A) with th...

Nesbit’s procedure remains a cornerstone in surgical management of Peyronie’s disease, despite the subjective loss of penile length. This retrospective study demonstrates that the perceived length loss has already occurred prior to surgery and that the Nesbit’s procedure does not produce additional loss of length. Ninety-one patients who had underg...

Fluorescence confocal microscopy (FCM) represents a novel diagnostic technique able to provide real-time histological images from non-fixed specimens. As a consequence of its recent developments, FCM is gaining growing popularity in urological practice. Nevertheless, evidence is still sparse, and, at the moment, its applications are heterogeneous....

Peyronie’s disease (PD) is a connective tissue disorder characterized by the formation of fibrous plaques in the tunica albuginea of the penis which can result in pain, deformity and erectile dysfunction (ED). The Peyronie’s Disease Questionnaire (PDQ) assesses the severity of symptoms, including pain, penile curvature and ED, as well as the impact...

Genital manifestations of Crohn's disease, though rare and often referred to as Metastatic Crohn's disease, can present as lymphedema of the external genitalia with granulomatous lesions (Genital Granulomatosis). While extraintestinal skin involvement is reported in 22–75% of Crohn’s cases, severe manifestations may require surgical intervention wh...

LUTS BPH REZUM

Purpose The primary aim of this study was to evaluate if exposure to 5-alpha-reductase inhibitors (5-ARIs) modifies the effect of MRI for the diagnosis of clinically significant Prostate Cancer (csPCa) (ISUP Gleason grade ≥ 2). Methods This study is a multicenter cohort study including patients undergoing prostate biopsy and MRI at 24 institutions...

Urothelial carcinoma (UC), the sixth most common cancer in Western countries, includes upper tract urothelial carcinoma (UTUC) and bladder carcinoma (BC) as the most common cancers among UCs (90–95%). BC is the most common cancer and can be a highly heterogeneous disease, including both non-muscle-invasive (NMIBC) and muscle-invasive (MIBC) forms w...

Sentinel node biopsy (SNB) for prostate cancer (PCa) represents an innovative technique aimed at improving nodal staging accuracy. The routinary adoption of this procedure in patients undergoing radical prostatectomy (RP) might be crucial to identify candidates who could effectively benefit from extensive pelvic lymph nodal dissection (ePLND). Desp...

Background/objectives: Peyronie's disease (PD) is a connective tissue disorder characterized by the formation of fibrous plaques in the tunica albuginea of the penis, resulting in pain, deformity, and erectile dysfunction. The Peyronie's Disease Questionnaire (PDQ) assesses the severity of symptoms, including pain, penile curvature, and erectile dy...

Assigned female at birth with anorgasmia possess a smaller clitoral glans and clitoral components farther from the vagina lumen than women with normal orgasmic function. There are no studies evaluating this correlation in operated transgender women. We evaluated whether differences in MRI measurements of neoclitoris volume and distance between the...

Background and Objectives: To date, sparse evidence exists about the impact of inflammatory serum markers in predicting perioperative complications after radical cystectomy (RC) for bladder cancer (BC). Here, we evaluated the role of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), sy...

Objectives To evaluate variant histologies (VHs) for disease‐specific survival (DSS) in patients with invasive urothelial bladder cancer (BCa) undergoing radical cystectomy (RC). Materials and Methods We analysed a multi‐institutional cohort of 1082 patients treated with upfront RC for cT1‐4aN0M0 urothelial BCa at eight centres. Univariable and mu...

Bladder cancer (BCa) is one of the most diagnosed urological malignancies. A timely and accurate diagnosis is crucial at the first assessment as well as at the follow up after curative treatments. Moreover, in the era of precision medicine, proper molecular characterization and pathological evaluation are key drivers of a patient-tailored managemen...

Genital manifestations of Crohn's disease, though rare and often referred to as Metastatic Crohn's disease, can present as lymphedema of the external genitalia with granulomatous lesions (Genital Granulomatosis). While extraintestinal skin involvement is reported in 22–75% of Crohn’s cases, severe manifestations may require surgical intervention wh...

Background: The vanishing testis syndrome (VTS), is a 46, XY disorder of sex development (46, XY DSD) and is characterized by the absence of testis in a 46, XY subject with male genitalia, gonadal dysgenesis and consequent hypergonadotropic hypogonadism. Case presentation: A young man affected by VTS has been followed up for more than 15-year in...

Introduction Fournier’s Gangrene (FG) has still a mortality rate up to 45%. Several studies identified prognostic factors but there is a knowledge gap concerning procalcitonin (PCT) levels and mortality risk in FG. This study is aimed to assess the role of PCT as prognostic factor in FG. Materials and methods The medical records of 20 male FG pati...

Robot assisted radical prostatectomy is a procedure linked to different grades of erectile dysfunction due to the anatomical position of the cavernous nerves. In this chapter we will go through different types of surgical approach, focusing on the nerve sparing technique and what’s the current scenario for the functional recovery after surgery. We...

Gender affirming surgery should provide satisfying results in terms of aesthetic and functional outcomes, therefore, no standard procedure could fit for every subject. Penoscrotal flap technique with neoclitoral-neourethral complex confreres acceptable outcomes, is reproducible in different anatomical scenarios and not involves major abdominal surg...

Purpose To investigate prevalence and predictors of renal function variation in a multicenter cohort treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Methods Patients from 17 tertiary centers were included. Renal function variation was evaluated at postoperative day (POD)—1, 6 and 12 months. Timepoints dif...

Introduction and objectives To evaluate the impact of the Controlling Nutritional Status (CONUT) score on perioperative morbidity and oncological outcomes of bladder cancer (BC) patients treated with radical cystectomy (RC). Materials and Methods We retrospectively analyzed a multi-institutional cohort of 347 patients treated with RC for clinical-...

Pathological conditions such as infections, cancer, inflammation, or iatrogenic lesions, can hinder the correct functionality of the ureter and its structural integrity. Several strategies for the regeneration of the ureter and the restoration of its functionality are available but the best strategy has not been reached yet. Among the proposed stra...

The Rezūm procedure is an emerging minimally invasive treatment for LUTS-BPH in poor surgical candidates and patients that wish to preserve ejaculatory function. The study aims to report outcomes of patients that underwent Rezūm in a provincial hospital.

Introduction and objectives Extended Pelvic Lymph Node Dissection (ePLND) remains the most accurate technique for the detection of occult lymph node metastases (LNMs) in prostate cancer (CaP) patients. Here we aim to examine whether free-Indocyanine Green (F-ICG) could accurately assess the pathological nodal (pN) status in CaP patients during real...

Introduction and objectives Impending erosion is an unusual complication of inflatable penile prosthesis that can strongly impact on patient’s morbidity and quality of life. In this case report we present a salvage surgery technique for impending erosion performed in a 57-year-old man. Materials and methods We present our surgical technique for cy...

Background and Objectives: To assess efficacy and safety of Percutaneous Cryoablation (PCA) of small renal masses (SRMs) using Trifecta outcomes in a large cohort of patients who were not eligible for surgery. Materials and methods: All PCAs performed in four different centers between September 2009 and September 2019 were retrospectively evaluated...

Introduction : Percutaneous microwave ablation (MWA) of renal masses (RM) is still considered experimental as opposed to established procedures such as cryoablation (CA). We aimed to compare perioperative, functional and oncological outcomes of patients with RM treated with CA and MWA. Methods : Data from 116 (69.9%) and 50 (30.1%) patients treate...

In the last years the incidence of renal neoplasms has been steadily increasing, along with the average age of patients at the time of diagnosis. Surgical management for localized disease is becoming more challenging because of patients’ frailty. We conducted a multi-center prospective study to evaluate the role of the G8 as a screening tool in the...

Natal women with anorgasmia possess a smaller clitoral glans and clitoral components farther from the vagina lumen than women with normal orgasmic function. There are no studies evaluating this correlation in operated transgender women. We evaluated whether differences in magnetic resonance imaging (MRI) measurements of neoclitoris volume and dista...

Background: Patient factors associated with urinary tract cancer can be used to risk stratify patients referred with haematuria, prioritising those with a higher risk of cancer for prompt investigation. Objective: To develop a prediction model for urinary tract cancer in patients referred with haematuria. Design, setting, and participants: A p...

Background Several trials have reported on the impact of social restrictions due to SARS-CoV-2 (COVID-19) pandemic on sexual function and psycho-physical well-being. However, data showing modifications of these outcomes over time and at the end of lock-down are scant. Aim We investigated the longitudinal changes in sexual function during social re...

Yuichiro Oishi et al [...]

Although the eukaryotic elongation factor eEF1A1 plays a role in various tumours, there is little information on its prognosis/therapeutic value in prostate carcinoma. In high-grade and castration-resistant prostate carcinoma (CRPC), the identification of novel therapeutic markers/targets remains a priority. The expression of eEF1A1 protein was det...

The treatment of urological cancers has been significantly improved in recent years. However, for the advanced stages of these cancers and/or for those developing resistance, novel therapeutic options need to be developed. Among the innovative strategies, the use of small interfering RNA (siRNA) seems to be of great therapeutic interest. siRNAs are...

Introduction Despite the introduction of robot-assisted surgery in daily clinical practice, complex renal masses are still challenging even for expert surgeon. In this scenario 3D anatomical models and augmented reality represent valuable tools for the surgeon. Materials and Methods We present a challenging case where PN was mandatory to preserve...

Introduction: The world population is ageing and surgical procedures for older patients are associated with higher perioperative morbidity and mortality rates than in younger patients. Segmental ureterectomy (SU) has been proposed as an alternative to radical nephroureterectomy (RNU) for selected upper tract urothelial carcinomas (UTUC), to reduce...

Purpose To evaluate the risk factors associated with positive surgical margins' (PSMs) location and their impact on disease-specific survival (DSS) in patients with bladder cancer (BCa) undergoing radical cystectomy (RC). Methods We analyzed a large multi-institutional cohort of patients treated with upfront RC for non-metastatic (cT1-4aN0M0) BCa....

Background: To investigate the impact of COVID-19 outbreak on the diagnosis and treatment of non-muscle invasive bladder cancer (NMIBC). Methods: A retrospective analysis was performed using an Italian multi-institutional database of TURBT patients with high-risk urothelial NMIBC between January 2019 and February 2021, followed by Re-TURBT and/or a...