Francesco Claps

• MD
• Fellow at Netherlands Cancer Institute

Introduction Up to 22% of pediatric patients with testicular torsion (TT) present initially with lower abdominal pain, which progresses to scrotal pain over time. Misdiagnosis can lead to testicular loss. This study examines the frequency of this presentation in adults and its clinical implications. Materials and Methods We retrospectively analyze...

Objectives To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy. Patients Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy....

Background: Approximately 70% of bladder cancer is diagnosed as non-muscle invasive (NMIBC) and inflammation is known to impact the oncological outcomes. Adjuvant intravesical BCG in intermediate/high risk can lower recurrence and progression. The efficacy of intravesical BCG can be impacted by smoking effects on systemic inflammation. Methods:...

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...

Objective: To assess the effectiveness of Platelet Concentrates (PCs) in the contest of Hemorrhagic, Actinic, and Radiation Cystitis, plus Urethral Obstruction or Stenosis. Eligibility criteria: Open article in English or Italian regarding in situ applications of PCs for the selected pathologies. Information sources: MEDLINE, Cochrane Library, and...

Objective: Prostate cancer, the second most diagnosed cancer among men, requires precise diagnostic techniques to ensure effective treatment. This review explores the technological advancements, optimal application conditions, and benefits of targeted prostate biopsies facilitated by multiparametric magnetic resonance imaging (mpMRI). Methods: A sy...

Bladder cancer (BC) is the tenth most commonly diagnosed malignancy worldwide. In approximately 25% of cases, it presents as a muscle-invasive disease, requiring a radical treatment. Traditionally, the mainstay of treatment has been radical cystectomy (RC), but in the last decade, bladder-sparing treatments have been gaining growing interest. In pa...

Objectives To assess the risk of venous thromboembolic events (VTEs) and bleeding with or without thromboprophylaxis during neoadjuvant chemotherapy in bladder cancer patients scheduled for radical cystectomy. Materials and Methods We conducted a retrospective cohort study in 4886 patients with non‐metastatic bladder cancer undergoing cystectomy a...

Background: The IDENTIFY study developed a model to predict urinary tract cancer using patient characteristics from a large multicentre, international cohort of patients referred with haematuria. In addition to calculating an individual's cancer risk, it proposes thresholds to stratify them into very-low-risk (<1%), low-risk (1-<5%), intermediate-r...

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...

Background and objective: The role of cytoreductive nephrectomy (CN) in the treatment of metastatic renal cell carcinoma (mRCC) has been called into question on the basis of clinical trial data from the tyrosine kinase inhibitor (TKI) era. Comparative analyses of CN for patients treated with immuno-oncology (IO) versus TKI agents are sparse. Our ob...

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...

598 Background: Patients undergoing radical cystectomy are at risk of developing venous thromboembolic events (VTE), with most VTEs occurring during neoadjuvant chemotherapy. The ASCO Clinical Practice Guideline Update recommends thromboprophylaxis in cancer patients with a high risk of VTE and a low risk of bleeding. However, the risks of VTE and...

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....

A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons: repeat-TURB is recommended for a macroscopically incomplete initial resection, restaging-TURB is required if the first resection was macroscopically complete but contained no detrusor muscl...

Introduction: Intestinal anastomosis can be performed by hand suturing (single layer or double layer) or by a mechanical suturing machine. The aim of the study was to compare complications, operative time, and costs of the intestinal anastomosis techniques. Methods: A retrospective comparative study was conducted including patients who underwent...

In this study, we explored the incidence of double J (JJ) contamination of patients who underwent an endourological procedure for urinary stones and ureteral stenosis. We developed a prospective study between January 2019 and December 2021. Ninety-seven patients, 54 male and 43 female, were enrolled. Urine culture was taken during four steps: befor...

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...

Aim Risk-stratification for patients referred with haematuria is important in diagnosing cancer early and for health resource efficiency. A recent prediction model developed from the IDENTIFY study created a cancer risk calculator that aimed to help clinicians with their decision-making in the investigation of patients with haematuria. We aimed to...

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...

Citation: Rossin, G.; Zorzi, F.; De Pablos-Rodríguez, P.; Biasatti, A.; Marenco, J.; Ongaro, L.; Perotti, A.; Tulone, G.; Traunero, F.; Piasentin, A.; et al. Sentinel Lymph Node Biopsy in Prostate Cancer: An Overview of Diagnostic Performance, Oncological Outcomes, Safety, and Feasibility. Diagnostics 2023, 13, 2543. Abstract: Sentinel node biopsy...

Objectives To study the safety and efficacy of a personalised indocyanine‐guided pelvic lymph node dissection (PLND) against extended PLND (ePLND) during radical prostatectomy (RP). Patients and Methods Patients who were candidates for RP and lymphadenectomy, with intermediate‐ or high‐risk prostate cancer (PCa) according to the National Comprehen...

Background: Since 2014, a new residency program selection process has been established with a national examination. The aim of this study was to assess characteristics, career goals, and practice preferences of current Italian urology residents. Methods: A web-based survey of 25 items performed from May 2021 to September 2021 was sent to 585 Ita...

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...

Introduction: Mutations in the TP53 gene are indicative of worse outcome in bladder cancer and are usually assessed by immunohistochemistry. To define p53-overexpression, a threshold of >10% is most commonly used (cut-off1). Recently, a novel cut-off (aberrant = 0% or ≥50%) (cut-off2) showed better correlation to clinical outcome. In this study, we...

Purpose We hypothesized that two-tier re-classification of the “M” (metastasis) domain of the Tumor-Node-Metastasis (TNM) staging of Renal Cell Carcinoma (RCC) may improve staging accuracy than the current monolithic classification, as advancements in the understanding of tumor biology have led to increased recognition of the heterogeneous potentia...

Bladder cancer is the most common tumor of the urinary system, with a high incidence in the male population. Surgery and intravesical instillations can eradicate it, although recurrences are very common, with possible progression. For this reason, adjuvant therapy should be considered in all patients. Resveratrol displays a biphasic dose response b...

Introduction: The aim of the study was to provide data related to endoscopic combined intra-renal surgery learning curve using minimally invasive techniques with vacuum-assisted devices. Minimal data exist on the learning curve for these techniques. Methods: We conducted a prospective study monitoring the training of a mentored surgeon learning...

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...

From challenges presented in everyday clinical practice to the complex cases without simple answers, Challenging Cases in Urological Surgery is an effective reference and revision aid for trainees and consultants alike. Cases are examined from a multidisciplinary approach considering all aspects of diagnostic, practical, and evidence-based skills t...

From challenges presented in everyday clinical practice to the complex cases without simple answers, Challenging Cases in Urological Surgery is an effective reference and revision aid for trainees and consultants alike. Cases are examined from a multidisciplinary approach considering all aspects of diagnostic, practical, and evidence-based skills t...

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...

Objective: To externally validate Yonsei nomogram. Methods: From 2000 through 2018, 3526 consecutive patients underwent on-clamp PN for cT1 renal masses at 23 centers were included. All patients had two kidneys, preoperative eGFR ≥60 ml/min/1.73 m2, and a minimum follow-up of 12 months. New-onset CKD was defined as upgrading from CKD stage I or...

Urolithiasis is a worldwide spread condition that affects patients’ Health-Related Quality of Life (HRQOL), which measurement is an important tool for routine clinical and research practice. Disease-specific HRQOL measures demonstrated to perform better in assessing the effects of specific conditions. A disease-specific questionnaire for kidney sto...

Background: The aim of this study was to investigate the long-term effects of ureteral stenting and the exact timing of stent removal in favor of surgery in patients with idiopathic retroperitoneal fibrosis (IRF). Summary: Medline research terms of "idiopathic retroperitoneal fibrosis" AND " medical therapy" OR "ureteral stenting" OR "surgical t...

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-...

PURPOSE Urolithiasis is a worldwide spread condition that affect patients’ Health Related Quality of Life (HRQOL), which measurement is an important tool for routinary clinical and research practice. Disease-specific HRQOL measures demonstrated to perform better in assessing effects of specific conditions. A disease-specific questionnaire for kidne...

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...

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...

Purpose To investigate the effects of different antibiotic prophylaxis regimens in patients with diabetes mellitus (DM) candidates to trans-rectal ultrasound-guided prostate biopsy (TRUSPB). Methods 143 outpatients with DM who underwent TRUSPB during the period 2018–2020 were selected from a cohort of 1150 patients in 3 different institutions. Exc...

Objectives The study aimed to evaluate quality of nephrolithometric nomograms to predict stone-free rates (SFRs) and complication rates (CRs) in case of minimally invasive percutaneous nephrolithotomy (PNL). In the last decade, nomograms have been introduced to estimate the SFRs and CR of PNL. However, no data are available regarding their reliabil...

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...

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...

Our study aimed to compare the incidence of infective complications after transrectal ultrasound-guided prostate biopsy (TRUSBx) when adopting different antimicrobial prophylaxis regimens. A multi-institutional cohort of 1150 patients who underwent TRUSBx was retrospectively analyzed. Procedures were performed between 2017 and 2019 (before and afte...

Predicting response to definitive treatmentsis a fascinating challenge which develops throughthe evolution of a panel of convincing molecularbiomarkers capable of adding in clinical decissionsdespite interpatient and intratumoral heterogenicity.Muscle-invasive bladder cancer (MIBC) can be locallytreated either with radical cystectomy (RC) with or w...

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...

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....

Objectives To determine the association between the FGFR3 mutation status and immuno-histochemistry (IHC) markers (p53 and Ki-67) in invasive bladder cancer (BC), and to analyze their prognostic value in a multicenter, multi-laboratory radical cystectomy (RC) cohort. Patients and methods We included 1058 cN0M0, chemotherapy-naive BC patients who u...

Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective ob...

Background: The impact of warm ischemia time (WIT) on renal functional recovery remains controversial. We examined the length of WIT >30 min. on the long-term renal function following on-clamp partial nephrectomy (PN). Methods: Data from 23 centers for patients undergoing on-clamp PN between 2000 and 2018 were analyzed. We included patients with...

Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer (UTUC) and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective obs...

Introduction Diagnostic haematuria services have been reduced due to the COVID-19 pandemic, compromising patient care, and necessitating a more pragmatic pathway. Method The IDENTIFY study was an international, prospective, multicentre cohort study of over 11,000 patients referred to secondary care for investigation of haematuria. Using this data,...

Identification of reliable molecular biomarkers that can complement clinical practice represents a fascinating challenge in any cancer field. Urothelial carcinoma is a very heterogeneous disease and responses to systemic therapies, and outcomes after radical cystectomy are difficult to predict. Advances in molecular biology such as next generation...

Introduction and objectives To evaluate the prognostic role of albumin-to-fibrinogen ratio (AFR) for the prediction of oncological outcomes in a multi-institutional cohort of bladder cancer (BC) patients treated with radical cystectomy (RC). Materials and methods We retrospectively analyzed a multicenter cohort of patients treated with upfront RC...

Objectives To evaluate whether indocyanine green guidance can improve the quality of extended pelvic lymph node dissection in patients undergoing radical prostatectomy. Methods A total of 214 patients underwent laparoscopic radical prostatectomy with indocyanine green‐guided lymph node dissection plus extended pelvic lymph node dissection. These p...

BACKGROUND: Abdominopelvic computer tomography (CT) is widely used in the follow up of seminoma patients after radical orchidectomy. The aim of this study is to evaluate the clinical utility of abdominopelvic computer tomography in the follow-up of patients with Stage I seminoma. METHODS: The pathological reports of all patients that have undergone...

Identification of reliable molecular biomarkers that can complement clinical practice represents a fascinating challenge in any cancer field. Renal tumors are usually asymptomatic and incidentally identified during imaging studies undertaken for unrelated causes. However, in 25% to 30% of patients the first diagnosis is accompanied by symptoms and...

Renal cell carcinoma (RCC) incidence has been increasing in recent years, and it now represents the sixth most common cancer diagnosis in men and the tenth in women. Although this is partly due to in-creased detection of incidental small renal masses on unrelated imaging, advanced RCC continues to be diagnosed in a significant portion of patients,...

Purpose The COVID-19 outbreak has substantially altered residents’ training activities. While several new virtual learning programs have been recently implemented, the perspective of urology trainees regarding their usefulness still needs to be investigated. Methods A cross-sectional, 30-item, web-based Survey was conducted through Twitter from Ap...

Background Selection of patients for upfront cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) has to be improved. Objective To evaluate a new scoring system for the prediction of overall mortality (OM) in mRCC patients undergoing CN. Design, setting, and participants We identified a total of 519 patients with synchronous m...