Mauro Ragonese

Policlinico Universitario Agostino Gemelli · Urology

Objectives: The aim of this study is to investi-gate the association between the urinary metabolic milieu and kidney stone recurrence with a validated papillary evaluation score (PPLA). Materials and methods: We prospectively enrolled 30 stone for-mers who underwent retrograde intrarenal surgery procedures. Visual inspection of the accessible re...

Background: Hem-o-lok clips (HOLCs) are a useful tool in mini-invasive surgery, especially for renal surgery. However, in rare cases they could migrate into the collecting system and be calculogenic. Case presentation: we present a case of a 53 years old man with an incidental CT finding of a left renal stone increasing its size in the last 2 year...

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....

Prostate cancer therapy for locally advanced and metastatic diseases includes androgen deprivation therapy (ADT). Second-generation antiandrogens have a role in castration-resistant prostate cancer. Nevertheless, some patients do not respond to this therapy, and eventually all the patients became resistant. This is due to modifications to intracell...

Laser technology has been used in Urology since the 80s with a lot of different applications in endoscopic and open surgery. With the developments of the technology and the introduction of new active medium and source of laser energy, this technology have become the gold standard not only in stone surgery but even in benign prostate enlargement (BP...

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...

Purposes Little research exists on potential learning curve for male sling procedures. We aimed to perform a learning curve analysis of a single surgeon’s experience of sling placement evaluating multiple outcomes and using the cumulative sum failure methodology. Methods The study included 65 consecutive patients that underwent implantation of a f...

Background The management of non-muscle invasive bladder carcinoma (NMIBC) after transurethral resection of a bladder tumor consists of adjuvant intravesical therapy and strict and long surveillance with urine cytology and cystoscopy. The Bladder EpiCheck test (Nucleix Ltd) (BE) is a newly developed urinary markers based on DNA methylation changes...

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...

Objective Radical cystectomy with permanent urinary diversion is the gold standard treatment for invasive muscle bladder cancer. Hydronephrosis is common in these patients, but Ultrasound (US) or Computed Tomography Urography (CTU) scan are unable to discriminate obstructive from non-obstructive hydronephrosis. We used Diuresis Renography (DR) with...

Prostate cancer still represents the most common urinary malignancies and the second most common cancer in adult men after skin cancer. Prostate specific antigen (PSA) represents a milestone in the diagnosis and screening of prostate cancer since its introduction even considering its limitations in term of sensitivity and specificity. The widesprea...

Objectives To assess if the lockdown period (March–April 2020) during the coronavirus disease-19 outbreak in Italy influenced the number, presentation, and treatment of urgent admissions to the emergency department for ureteral lithiasis, and to evaluate the same variables during the reopening phase (May–June 2020). Methods We performed a retrospe...

The treatment of renal cancer has changed in the last decades with an increase in application of conservative surgery such as partial nephrectomy (PN) in order to achieve an optimal oncological outcome with the maximum preservation of renal function. The indication for PN is mandatory in case of bilateral tumors or in case of impaired renal functio...

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...

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 and objectives We aimed to evaluate how the corona virus disease of 2019 (COVID-19) outbreak influenced emergency department (ED) admissions for urolithiasis, hospitalizations and clinical management of the hospitalized Patients. Patients and methods We conducted a multicentric retrospective analysis of ED admissions in three high vol...

Introduction Complete ureteral avulsion represents a rare and fearsome complication of ureteroscopy, reported in less than 1% of cases. In literature there are few reports and different options are presented for its treatment. We present a case of a ureteral avulsion managed with ileal ureter replacement. Case presentation A 67‐year‐old man with a...

Resumen Introducción Y Objetivos: Nuestro objetivo fue evaluar el impacto de la enfermedad del coronavirus de 2019 (COVID-19)* en los ingresos en los servicios de urgencias (SU)**, las hospitalizaciones y el manejo clínico de los pacientes con urolitiasis. Pacientes Y Métodos: Realizamos un análisis retrospectivo multicéntrico de las admisiones en...

Background and Aims Nephrolithiasis is a medical condition characterized by high prevalence among the general population both in Europe and in the U.S. and it is responsible for high costs reaching up to $10 billion per year. It is associated with specific comorbidities such as obesity, arterial hypertension, diabetes mellitus, metabolic syndrome a...

Introduction: Psychological aptitude for surgery includes all the non-technical abilities that are necessary for the surgeons. However, differently from the other careers, these skills are not considered in the selection process and their role is definitively underestimated in the field of surgery. We perform a literature review of non-technical s...

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...

Abstract 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-lin...

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...

When a sudden death occurs during a minor surgical intervention, it may require a careful and extensive postmortem investigation. One such case concerns a 61-year-old male patient affected by Peyronie's disease, who died suddenly during a corporoplasty procedure. Autopsy and histologic examinations showed a massive bilateral pulmonary micro-embolis...

Mitomycin C (MMC) as an intravesical chemotherapeutic agent is a well-known option for treatment of nonmuscle invasive bladder cancer (NMIBC) recurrence; it is probably the most commonly used agent given its low rate of side effects and its efficacy. Both the American Urologic Association (AUA) and European Association of Urology (EAU) consider MMC...

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...

The narrow band imaging (NBI) is a new technology introduced to complement the traditional endoscopy in order to enhance the detection of nonmuscle-invasive bladder cancer and, consequently, to improve the management of the disease. In this review, we considered the most important studies about the use of NBI in the diagnosis and treatment of bladd...

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...

Introduction: To optimize the functional and esthetic result of cranioplasty, it is necessary to choose appropriate materials and take steps to preserve and support tissue vitality. As far as materials are concerned, custom-made porous hydroxyapatite implants are biomimetic, and therefore, provide good biological interaction and biointegration. Ho...

Bladder cancer represents the second most common neoplasm of the urinary tract and the fourth in general among all the neoplastic pathologies for the male gender; in females, it is the eighth most frequent among all cancers. At the initial diagnosis, 70% of bladder tumors are non-muscle invasive. Treatment of this stage is multimodal, both surgical...