Giuseppe Palermo

Catholic University of the Sacred Heart | UNICATT · School of Urology

Background: Recently, it was reported that the Bladder EpiCheck test is likely to represent a valid tool in the diagnostic process of patients who have suspected bladder carcinoma, with some controversial management decisions because of the technical limitations of cytology. Methods: Two hundred ninety patients with a diagnosis of nonmuscle-inva...

Background: Severe functional impairment is often considered a contraindication to intravesical therapy for nonmuscle-invasive bladder cancer (NMIBC). A tailored intravesical bacillus Calmette-Guérin (BCG) procedure was evaluated in high-risk (HR)-NMIBC patients with severe functional impairment. Materials and methods: Patients with a Katz Index...

Despite several efforts in the search for noninvasive biomarkers to provide prognostic information for noninvasive muscle bladder cancer, none have shown significant potential. In this context, standard urinalysis is still necessary to provide many data. This method is an inexpensive, simple, and easy-to-repeat tool to follow-up patients over time....

Background: To date, robotic surgery in urology is well established all over the world. The newest platform on the market is the HUGO™ RAS system, developed by Medtronic. In this paper we provide a brief description of the system and describe our system set-up and surgical approach with this new platform in our initial experience of robotic radica...

Background/aim: Recent evidence suggests potential synergistic antitumor effects of the combination of programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) immune checkpoint inhibitors with the oral hypoglycemic agent metformin. The aim of this study was to investigate the safety and activity of metformin combined with nivolumab in diabetic...

Introduction EpiCheck is a new urinary test that analyses DNA methylation biomarkers in order to identify high-risk urothelial cancer Materials and methods A prospective single centre study was performed. We analysed Epicheck results in a population of 231 patients in follow-up for non-muscle invasive bladder cancer. The primary endpoint was to ev...

Background: Bladder cancer (BCa) emits specific volatile organic compounds (VOCs) in the urine headspace that can be detected by an electronic nose. The diagnostic performance of an electronic nose in detecting BCa was investigated in a pilot study. Methods: A prospective, single-center, controlled, non-randomized, phase 2 study was carried out...

Background: The 2021 American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium represents an unmissable event for oncologists who deal with renal cell carcinoma (RCC). Aim and results: This article describes the main acquisitions of RCC management, including the advent of a new combo (pembrolizumab+lenvatinib) as first-line th...

Prostate cancer is the second most commonly diagnosed cancer in man. Since the first MRI was performed, enormous progress has been made in diagnosis, treatment, and follow up of PCa, mainly due to multiparametric prostatic MRI (mpMRI). Although mpMRI has become the best imaging tool for identifying PCa, some limitations still exist. Prostate imagin...

Background Atypical small acinar proliferation (ASAP) occurs in approximately 5% of prostate biopsies. Approximately 30%–40% of these patients may develop prostate cancer (PCa) within a 5-year period, often not clinically significant. Current guidelines recommend a repeat biopsy within 3–6 months after the initial diagnosis, but it seem not to be t...

Background: A common limit for the widely used risk scores for preoperative assessment is the lack of information about aspects linked to frailty that may affect outcome, especially in the setting of elderly patients undergoing urologic surgery. Frailty has been recently introduced as an additional characteristic to be assessed for better identify...

Metanephric adenoma (MA) is an uncommon benign renal tumor whose histomorphological aspect resembles that of Wilms' tumor and papillary renal cell carcinoma. From a diagnostic and therapeutic perspective, recognition of this entity is important as it has a more favorable clinical outcome compared with Wilms' tumor and papillary renal cell carcinoma...

Introduction In cases of recurrent high-risk non–muscle-invasive bladder cancer, radical cystectomy (RC) is recommended. We compared oncologic and treatment-related outcomes of second-line conservative device-assisted therapy to RC. Patients and Methods In a retrospective cohort study, we analyzed 209 consecutive patients with recurrent bacillus C...

Introduction: To compare the efficacy of artificial urinary sphincter (AUS) versus retrourethral transobturator sling (RTS) in men with moderate postprostatectomy urinary incontinence (PPI) using the propensity score-matching (PSM) to enhance the validity of the comparison (Canadian Task Force classification II-2). Patients and methods: Consecut...

Background: Bladder leiomyosarcoma is the most frequent mesenchymal neoplasm of the bladder. However, the rarity of the disease and some morphological aspects could give serious problems to differential diagnosis. Case presentation: A 86-year-old male patient was referred to our institution to undergo endoscopic low-urinary-tract re-evaluation 2...

BACKGROUND: Circulating tumor cells (CTCs) represent a prerequisite for the formation of metastases. The aim of the study was to identify the role of CTCs as a biological marker of aggressiveness of prostate cancer and verify the expression of molecular markers predictive of response to different therapeutic approaches. METHODS: Prospective, single...

Objectives: To evaluate the neutrophil-to-lymphocyte ratio (NLR) as a prognostic factor for response of high risk non muscle invasive bladder cancer (HRNMIBC) treated with BCG therapy. Materials and methods: Between March 2010 and February 2014 in a tertiary center 100 consecutive patients with newly diagnosed HRNMIBC were retrospectively analyz...

Background In case of high grade non-muscle invasive bladder cancer (HG-NMIBC), intravesical BCG represents the first-line treatment; despite the “gold” standard therapy, up to 50% of patients relapse, needing radical cystectomy. Hence, alternative therapeutic strategies have been developed. The aim of the study was to evaluate a first-line salvage...

Background Mitomycin C (MMC) is widely used, but the optimal dose and schedule have not been established. Objective To evaluate the ablative power and patient safety of a short-term intensive schedule of intravesical MMC in patients with recurrent non–muscle-invasive bladder cancer (NMIBC). Design, setting, and participants This was a prospective,...

Objectives: To evaluate the efficacy and safety of a tailored endovesical immunotherapy protocol with biweekly BCG for elderly Patients with high risk non muscle invasive bladder cancer (HG-NMIBC). Materials and methods: We retrospectively evaluated data from 200 patients older than 80 years newly diagnosed with HG-NMIBC: 100 (group 1) with mult...

Objective: To evaluate prospectively midterm outcomes of a new titanium-coated fixed polypropylene sling for male stress urinary incontinence. Materials and methods: From 01/2013 to 06/2016, 44 consecutive patients with incontinence caused by radical prostatectomy (39) or TURP (5) underwent transobturator two-arm titanium-coated sling (TiLOOP Ma...

Aims: To objectively assess and enhance the appropriateness of continence products provision to sufferers from urinary incontinence (UI) managed with containment strategies. Methods: Incontinent patients of five Italian continence care services were included in this industry-supported study from 01/2012 to 03/2016. All patients/carers have been inv...

Bladder metastases from lung cancer are extremely rare; in some previously reported cases in with the primitive tumor was a lung adenocarcinoma, the finding of an intact epithelium overlying the bladder tumour was considered suggestive of a secondary lesion. Differentiating primary bladder non-urothelial cancers from metastatic lesions can be diffi...

Background: Prostate cancer (PCa) is the most commonly diagnosed malignancy in men and the second leading cause of cancer death in developed countries. Despite the primary treatments, 20-30% of patients experience a recurrence. The main objective of this study was to evaluate the clinical efficacy of salvage HIFU after radical prostatectomy in ter...

Background: To evaluate the difference at different steps of follow-up of the postoperative quality of life (QoL) in patients who had undergone radical cystectomy and ileal orthotopic neobladder derivation. Patients and methods: A multicentric, cross-qualitative study was performed in 5 Italian centers of reference for the treatment of bladder c...

Prostate cancer is the most common urologic neoplasm and the second leading cause of cancer-related death among men in many developed countries. Given the highly heterogeneous behaviour of the disease, there is a great need for prognostic factors, in order to stratify the clinical risk and give the best treatment options to the patient. Clinical fa...

The occult urothelial cancerTransitional cell carcinoma (TCC) is the tumor that most frequently affects the urinary tract. The most common location is at the level of the bladder; the diagnosis is based, as per the follow-up, on urine cytology, endoscopic, and radiological examinations. Urine cytologic study is an important noninvasive tool used in...

Transitional cell carcinoma (TCC) is the tumor that most frequently affects the urinary tract. The most common location is at the level of the bladder; the diagnosis is based, as per the follow-up, on urine cytology, endoscopic, and radiological examinations. Urine cytologic study is an important noninvasive tool used in the diagnosis and follow-up...

Hypothesis - Aim of study. To evaluate safety, tolerability and efficacy on urinary continence and quality-of-life of a new titanized sling for male post-surgical stress incontinence Study design, materials and methods: Interventional single-armed prospective study. From 11/2012 to 12/2014, 25 patients with stress urinary incontinence after radical...

Materials and methods: The study was conducted from December 2011 to December 2012 on 95 patients between the ages of 20 and 65 years: 44 of which had been undergoing dialysis for over a year and 51 of whom had undergone kidney transplants more than 6 months before. Comorbidities were carefully recorded, erectile function was evaluated the with II...

Introduction: Prostate cancer (PCa) is the most commonly diagnosed malignancy in men and the second leading cause of cancer-related death in industrialized countries. Even if the healing chances are very high after definitive treatment of localized disease, 20-30% of patients experience recurrence. Evidence acquisition: A review of the literatur...

Aim. To evaluate safety, tolerability and efficacy on urinary continence and quality-of-life of a new titanized sling for male post-surgical stress incontinence. Matherials and methods: Interventional single-armed prospective study. From 11/2012 to 10/2014, 23 patients with stress urinary incontinence after radical prostatectomy (19) or TURP (4) u...

Aim. To evaluate safety, tolerability and efficacy on urinary continence and quality-of-life of a new titanized sling for male post-surgical stress incontinence. Matherials and methods: Interventional single-armed prospective study. From 11/2012 to 10/2014, 23 patients with stress urinary incontinence after radical prostatectomy (19) or TURP (4) un...

The ongoing research on pioneering drug candidates for the overactive bladder (OAB) aimed to overcome the limitations of currently licensed pharmacotherapies, such as antimuscarinics, β3-adrenergic agents, and botulinum neurotoxin, has been reviewed performing a systematic literature review and web search. The review covers the exploratory agents a...

Statistical tests in medical research: traditional methods vs. multivariate npc permutation testsWithin medical research, a useful statistical tool is based on hypotheses testing in terms of the so-called null, that is the treatment has no effect, and alternative hypotheses, that is the treatment has some effects. By controlling the risks of wrong...

Male stress urinary incontinence, which has radical prostatectomy as the main aetiology, affects about 39% of the adult male population and is one of the complications of radical prostatectomy with the greatest impact on the quality of life of patients. There are a wide range of treatments for stress urinary incontinence available to the urologist,...

Urinary tract infectionsUrinary tract infections (UTI) are amongst the most frequent bacterial infections and therefore are responsible for a significant fraction of antibiotic use, thus carrying a relevant social and economic burden. UTI may present as benign, uncomplicated cystitis or severe, life-threatening urosepsis. Due to the heterogeneity o...

Positive surgical margins in nephron sparing surgery for renal cell carcinoma Nephron sparing surgery (NSS) with a minimal tumor-free margin is considered the cornerstone in the contemporary management of renal cell carcinoma (RCC) stage T1. The aim of this study is to review incidence, predictive risk factors, clinical significance and oncologic...

Radical orchiectomy is the standard treatment of testicular neoplasia causing androgen insufficiency, infertility and psychological stress. Focal surgery allows the preservation of fertility, endocrine function and integrity of the genital anatomy, with preservation of the image of the male body. The EAU guidelines suggest focal surgery in case of...

A systematic review of the current treatment options and of the outcomes of penile carcinoma has been performed with special focus on controversial issues. A MedLine search using specified search terms was done during the period 1988 - January 2013. Demolitive surgery is considered as the "gold standard" treatment of invasive penile carcinoma stag...

Radical surgery is the "gold standard" for treatment of invasive penile carcinoma but very poor aesthetic, functional and psychological outcomes have been reported. Our purpose was to assess the impact of organ potency-sparing surgery in locally confined carcinoma of the penis. We evaluated retrospectively 42 patients with early penile cancer (Ta,T...

Abstract High-intensity focused ultrasound (HIFU) is a minimally invasive therapy applied for prostate cancer that capitalizes on the coagulation necrosis that occurs at temperatures greater than 60°C. Owing to a lack of long-term follow-up data the procedure is still considered experimental treatment. As primary therapy, HIFU is indicated in patie...

Objectives: Non-muscle-invasive bladder cancer is characterized by a high recurrence rate after primary transurethral resection. In case of bacillus Calmette-Guérin-refractory neoplasms, cystectomy is the gold standard. In this study the effects of thermochemotherapy with mitomycin C were evaluated in high-risk bladder cancer nonresponders to prev...