Luca Carmignani

University of Milan | UNIMI · Department of Human Morphology and Biomedical Sciences "Cittá Studi"

To the Editor, The aim of this "position paper" is to describe the discipline of Pediatric Urology with its clinical and cultural competencies, represent the reasons for legitimizing its existence, and reinforce its importance in the "scenario" of the National Italian Healthcare System. The requisites and the educational requirements were defined b...

Aim: To assess the effect of antegrade and retrograde common iliac artery (CIA) revascularization on erectile dysfunction (ED) using the validated International Index of Erectile Function (IIEF) questionnaire, on patients treated for chronic occlusions of the CIA. Materials and methods: Clinical data of patients who were submitted either to endo...

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...

Purpose To demonstrate safety of a new internal protocol for patients and health workers adopted for elective urologic surgical activity during COVID-19 pandemic. Methods From March 9 to April 24, 2020 we have retrospectively evaluated 62 patients who underwent elective surgery in the urology department of IRCCS Policlinico San Donato which became...

Objectives To analyze the potential survival benefit of perioperative chemotherapy (CHT) in patients treated with nephroureterectomy (NU) for non-metastatic locally advanced upper tract urothelial carcinoma. Methods Within the Surveillance, Epidemiology, and End Results database (2004–2014), we identified 1286 patients with T3 or T4, N 0–3 M0 UTUC...

Background Enhanced recovery after surgery (ERAS) protocols have been developed and implemented as of 2001 and may have significantly reduced several complication types including paralytic ileus. However, no formal analyses targeted paralytic ileus rates after contemporary major surgical oncology procedures. We examined temporal trends of paralytic...

Background: Few data examined the potential survival benefit of nephroureterectomy (NU) in the setting of metastatic upper urinary tract urothelial carcinoma (mUTUC). We hypothesized that a survival benefit might be associated with the use of NU in that setting and tested this hypothesis within a large population-based cohort. Patients and method...

Objectives To examine intraoperative and postoperative morbidity and mortality, as well as the impact on length of stay and total hospital charges of minimally invasive nephroureterectomy compared with open nephroureterectomy in patients with upper tract urothelial carcinoma. Methods Within the National Inpatient Sample (2008–2013), we identified...

Purpose: To analyze lymph node invasion (LNI) rates according to tumor characteristics and to test the impact of LNI and its extent on cancer specific mortality (CSM) in surgically-treated non metastatic urothelial upper urinary tract carcinoma (UTUC) patients. Materials and methods: Within the SEER database (2004-2014), we identified 2098 patie...

Background: Few studies examined the rates of guideline implementation and the survival effect of bladder cuff excision (BCE) at nephroureterectomy (NU). Objective: To assess the rates of guideline implementation regarding NU with BCE relative to NU without BCE in patients with upper tract urothelial carcinoma (UTUC) and to test the effect of BC...

Background: Few data examined the potential survival benefit of chemotherapy (CHT) in the setting of metastatic upper urinary tract urothelial carcinoma (mUTUC). We hypothesized that a survival benefit might be associated with the use of CHT in nonsurgically treated primary mUTUC and tested this hypothesis within a large population-based cohort....

Background: Data regarding the relationship between non-disease-specific (NDSM) and disease-specific mortality (DSM) in patients with surgically treated nonmetastatic retroperitoneal sarcoma (nmRPS) are lacking. Objective: To examine the rates of NDSM and DSM among patients with surgically treated nmRPS. Design, setting and participants: We us...

Introduction: Radical cystectomy represents the standard of care for muscle invasive bladder cancer (MIBC). Due to its novelty the use of robotic radical cystectomy (RARC) is still under debate. We examined intraoperative and postoperative morbidity and mortality as well as impact on length of stay (LOS) and total hospital charges (THCGs) of RARC...

Objectives: To test rates over time of robotic partial and radical nephrectomy (RPN and RRN) at teaching vs. non-teaching institutions and to examine associated complication rates and length of stay. Material and methods: Within the Nationwide Inpatient Sample (2008-2013), after stratification according to institutional teaching status, we exami...

Background and objectives: Enhanced recovery after surgery protocols (ERAS) have been developed and implemented as of 2001. However, no previous analyses targeted length of stay (LOS) changes over time after major surgical oncological procedures (MSOPs). Methods: Between 2003 and 2013, we retrospectively identified patients, who underwent prosta...

Objective: We aimed to determine safety and feasibility of thulium laser transurethral vapoenucleation of prostate (ThuVEP) for treatment of obese patients affected by benign prostatic hyperplasia (BPH). Methods: We retrospectively analysed data of 452 patients with BPH who underwent ThuVEP from February 2012 to March 2016 in a single center. Pa...

Background and purpose: Contemporary data regarding the benefit of radiotherapy in surgically treated retroperitoneal sarcoma are scarce. The aim of the study was to evaluate the effect of radiotherapy on cancer specific mortality in surgically treated patients according to tumor size, histological subtype and grade. Material and methods: Within...

Introduction: To evaluate the efficacy and safety of ureteroscopic thulium laser (TL) treatment of upper urinary tract carcinoma (UTUC). Materials and methods: Forty-two consecutive patients underwent conservative TL treatment for UTUC at two referral institutions. All patients underwent preliminary biopsy and then laser vaporization. A 272 μm a...

Introduction The gold standard for Leydig cell tumors (LCTs) is still considered radical orchidectomy, but testis sparing surgery (TSS) in conjunction with intraoperative frozen section (FSE) has been recently attempted with promising results. Acquisition of evidence Studies were identified by searching electronic databases. A bibliographic search...

Background and study aims The thulium laser system (TLS) is an emerging surgical tool. The 2-μm wavelength provides a confined coagulation depth (0.2 – 0.4 mm) to reduce the potential for inadvertent injuries. For the first time ever, we assessed TLS feasibility for endoscopic hemostasis ex vivo in pigs. In addition, we performed the first in vivo...

Introduction: The gold standard for Leydig cell tumours (LCTs) is still considered radical orchidectomy, but testis sparing surgery (TSS) in conjunction with intraoperative frozen section (FSE) has been recently attempted with promising results. Acquisition of evidence: Studies were identified by searching electronic databases. A bibliographic s...

Objectives: To evaluate the functional and operative results of thulium laser prostate enucleation (ThuLEP) in patients with indwelling catheters for refractory urinary retention (RUR). Methods: Patients with indwelling catheter, undergoing ThuLEP for benign prostate hyperplasia were prospectively enrolled. Every episode of urinary retention was...

Various articles have previously addressed the introduction of new surgical laser therapies for an enlarged prostate gland causing obstructive symptoms. The objective of this study was to report the feasibility of performing the thulium laser vapo-enucleation of the prostate (ThuVEP) procedure for benign prostatic obstruction in a 1-day surgery. Fr...

Treatment of patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) may affect the quality of sexual function and ejaculation. The effect of new surgical procedures, which are currently available to treat BPH, on erection and ejaculation, has been poorly studied. This study aimed to assess the effect of th...

Purpose: To assess the validity of frozen section examination (FSE) on testis nodules. Materials and methods: A series of 86 preselected patients with testicular nodules were recruited in this study. Nodules smaller than 2 cm had been surgically removed and biopsies of the margins performed. Larger nodules were just biopsied. Orchiectomy was the...

Aim Ureteral double J stent placement is a common urological procedure. A stent placement is performed for multiple conditions but some of them are contraindicated, mainly in pregnant female patients, because of X-rays. This work aims to suggest a mathematical model to predict female ureteral length by finding a link among different physical data....

Introduction: We investigated the possibility that patients could carry out a urine flow assessment at home by themselves, in comfort, without expense and without the use of equipment. We compared this strategy of "Do-It-Yourself" (DIY) uroflowmetry with traditional, hospital uroflowmetry. Materials and methods: One hundred and twenty patients w...

The purpose of this article is to contribute information to the interpretation of the feasibility and outcomes regarding open, laparoscopic and robotic strategies of radical prostatectomy in patients with previous synthetic mesh inguinal hernia repair. A bibliographic search covering the period from January 1980 to September 2012 was conducted in P...

Recently, many articles reported increased incidence of urinary tract infection (UTI) due to Extended-Spectrum Beta-Lactamase (ESBL)-producing E. coli. No data are available to date regarding patients presenting with complicated upper ESBL-positive E. coli UTI and sepsis. We report the clinical presentation, management, and outcomes in seven cases....

Objective: We performed a long-term evaluation of testicular conservative surgical treatment of benign conditions. Material and methods: Between January 2001 and January 2005, a single center perspective clinical study was performed at our Academic Department of Urology. Case files of all patients diagnosed with small testicular mass (less than 1.5...

Urologists have not reached a consensus regarding the pre-, intra-, and postoperative management of patients taking antiplatelet agents. This study aimed to evaluate the clinical course of patients receiving antithrombotic monotherapy with acetylsalicylic acid (ASA) 100 mg who underwent transurethral resection of bladder cancer. This study was desi...

The objective was to evaluate the utility of the “pocket ultrasound” in making clinical decisions in urologic emergencies. From May to September 2011, 105 patients were assessed for urologic emergencies: acute flank pain, macroscopic hematuria, urinary retention, and lower urinary tract symptoms. All patients underwent an ultrasonographic examinati...

We investigated if an adequate histological diagnosis can be made from tissue after Thulium laser vapo-enucleation of the prostate (ThuVEP) and whether it is comparable to transurethral prostate resection (TURP) tissue findings in patients with symptomatic benign prostatic hyperplasia. We analyzed 350 ThuLEP and 100 matched TURP tissue specimens fr...

Introduction: A number of randomized trials and meta-analysis in patients who underwent ureteroscopic stone removal investigated the effects of placing a ureteral stent at the end of the procedure on complication rates. However, none of these investigates the stone diameter and its possible influence on complication rates and, as such, if it shoul...

Introduction: The purpose of this work was to evaluate the prevalence of the Quinolones resistant Escherichia coli and/or ESBL producers in the population of our catchment area and hospital component. Materials and Methods: From January 2008 to December 2010, all data concerning urine cultures in patients with suspected urinary tract infection and...

Objective: To evaluate the pre- and postoperative aspects of sexual life (SL) in patients with bulbar urethral stricture who underwent ventral oral graft urethroplasty. Methods: Between 2009 and 2010, 52 men (mean age 36 years) were enrolled in our prospective study to ascertain sexual disorders before and after surgery. The validated Male Sexua...

Background: Our objective was to perform a long-term evaluation of conservative surgical treatment of Leydig cell tumors. Patients and methods: A multicenter retrospective clinical study was performed at 6 European centers. Case files of all patients diagnosed with Leydig cell tumor and treated with conservative surgery were examined. Patients u...

A review of the literature was performed to summarize current evidence regarding the efficacy of topical immunotherapy and chemotherapy for upper urinary tract urothelial cell carcinoma (UUT-UCC) in terms of post-treatment recurrence rates. A Medline database literature search was performed in March 2012 using the terms upper urinary tract, urothel...

Objective: To assess the current etiology, features, and natural history of urethral stricture disease in the developed world. Materials and methods: We analyzed the data from 1439 male patients with urethral stricture, who had undergone surgical treatment in our referral urethral center from 2000 to 2010. The preoperative evaluation included a...

Microlithiasis of the epididymis is a rare ultrasound finding in the general population, but the incidence of calcifications in various organs of patients with end-stage renal disease (ESRD) is extremely high. The aim of this study was to describe epididymal microlithiasis in 22 previously dialysed patients who received kidney transplantations at a...

Purpose: Patients who undergo radical cystectomy for urothelial cancer are at risk for upper urinary tract disease in the remnant transitional tissue. Previous studies have identified several risk factors for upper urinary tract recurrence but the predictive value of each factor remains controversial. Furthermore, the schedule for surveillance of...

It is not unusual to encounter the clinical scenario of a male patient undergoing endoscopic treatment for bladder cancer (TURBT) who also needs transurethral resection of prostate (TURP). The aims of this meta-analysis were to understand whether it is oncologically safe or advantageous to combine the two procedures in terms of subsequent overall r...

The rationale for the use of immediate shock wave lithotripsy (SWL) after a renal colic episode is to obtain maximum stone clearance in the shortest possible time with associated early detection of lithotripsy failures which can be treated with auxiliary procedures. The aim of this meta-analysis is to understand the role of this treatment option in...

Until the 1970s, inverted urothelial papilloma (IUP) of the bladder was generally regarded as a benign neoplasm. However, in the 1980s, several reported cases suggested the malignant potential of these papillomas, including cases with features indicative of malignancy, recurrent cases, and cases of IUP synchronous or metachronous with transitional...

To compare the antibiotic prophylaxis based on quinolone administered orally with a combination of cephalosporin administered periprostatically and a fluoroquinolone orally, in terms of post-prostate bioptic infectious complication rates in those men undergoing transrectal ultrasound-guided prostate biopsy (TRUS gpb). In a prospective, randomized,...

To report a case of successful testicular sperm extraction performed during an emergency scrotal exploration for trauma in a patient with a history of previous contralateral cryptorchidism. Case report. Clinica Urologica I, Università degli Studi di Milano, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico Ca' Granda, Ospedale Maggiore...

Despite the recent innovations, complications of prostate biopsy can occur. The aim of this study was a prospective monitoring of major septic complications occurring after transrectal prostate biopsy, to describe their causing agents, to report the clinical course of these patients, and to give guidelines based on our personal experience. This pro...

There are various recent studies on the use of ureteroscopy and debate on whether this should be the first-line treatment for patients with ureteral stones. The aim of this meta-analysis was to understand the role of this surgical procedure in the emergency setting as first-line treatment and to compare the immediate procedure with a delayed one in...