To evaluate the patterns of prescription of androgen deprivation therapy (ADT) in patients with p... more To evaluate the patterns of prescription of androgen deprivation therapy (ADT) in patients with prostate cancer (PCa) and the adherence to European Association Urology (EAU) guidelines for ADT prescription. The CHOsIng treatment for prostate canCEr (CHOICE) study was an Italian multicenter cross-sectional study conducted from December 2010 to January 2012. A total of 1386 patients treated with ADT for PCa (first prescription or renewal of ADT) were selected. According to EAU guidelines, the cohort was categorized in discordant ADT (Group A) and concordant ADT (Group B). The final cohort included 1075 patients with a geographical distribution including North-Italy in 627 (58.3%), Center-Italy in 233 (21.7%) and South-Italy in 215 (20.0%). In the category of patients treated with primary ADT, a total of 125 (56.3%) were classified as low-risk according to D'Amico Classification. According to EAU guidelines, 285 (26.51%) and 790 (73.49%) were classified as discordant (Group A) and concordant (Group B) respectively. In Group A, patients were more likely to receive primary ADT (57.5%; 164/285) than RP (30.9%; 88/285), RT (6.7%; 19/285) or RP + RT (17.7%; 14/285) (p<0.01). Multivariate logistic regression analysis, adjusted for clinical and pathological variables, demonstrated that patients from Center-Italy (OR: 2.86; p<0.05) and South-Italy (OR: 2.65; p<0.05) were more likely to receive discordant ADT. EAU guideline adherence for ADT was low in the Italian country and it is influenced by geographic areas. Health makers and urologists should consider these results in order to verify the inadequate use of ADT and to set policy strategies to overcome this risk. This article is protected by copyright. All rights reserved.
International journal of urology : official journal of the Japanese Urological Association, Jan 25, 2015
To evaluate the outcome in patients undergoing photoselective vaporization of the prostate for be... more To evaluate the outcome in patients undergoing photoselective vaporization of the prostate for benign prostatic obstruction as part of the Clinical Research Office of the Endourological Society Global GreenLight Laser Study. Data were collected on 713 patients with lower urinary tract symptoms suggestive of benign prostatic obstruction undergoing photoselective vaporization of the prostate at 25 centers worldwide, between April 2010 and April 2012. Three types of GreenLight laser powers were used: 80 W, 120 W or 180 W. Intraoperative and postoperative complications were recorded. Outcome parameters measured at baseline, 6-12 weeks, 6 months and 12 months were: uroflow measurements, International Prostate Symptom Score; prostate-specific antigen and International Index of Erectile Function. Operating time was shortest with the 180-W laser at 53.8 min. Intraoperatively, bleeding occurred in 3.1% of patients. Statistically significant changes were reported in maximum flow rate, postvoi...
To externally validate the Young Academic Urologist (YAU) nomogram for the prediction of benign p... more To externally validate the Young Academic Urologist (YAU) nomogram for the prediction of benign prostatic obstruction (BPO) in patients with lower urinary tract symptoms and benign prostatic enlargement. Between January 2013 and September 2014, a consecutive series of patients with lower urinary tract symptoms and benign prostatic enlargement underwent standardized pressure flow studies (PFSs) in 2 tertiary Italian centers. Variables assessed were International Prostatic Symptom Score, Prostate Specific Antigen (PSA), prostate size, transitional zone volume, maximal urinary flow rate (Qmax), postvoid residual urine. BPO was defined as a Schäfer grade ≥3 at PFSs. Qmax and transitional zone volume were plotted on the YAU nomogram to predict the presence of BPO. Receiver operating characteristic curve analysis was used to evaluate predictive properties of the nomogram for the final diagnosis of BPO. A total of 449 patients were consecutively enrolled. In those, 310 patients (69%) presented a BPO (Schäfer ≥3) at PFSs. The novel YAU nomogram presented an area under the curve of 0.76; 95% confidence interval: 0.72-0.82 for the diagnosis of BPO. At the best cutoff value of 80% (nomogram probability), the sensitivity was 74% and specificity was 79%, the positive predictive value was 89%, and the negative predictive value was 56%. Although further studies are needed to confirm our results, the YAU nomogram was, in our experience, an excellent tool to predict the presence of BPO.
The GOLIATH study is a 2-yr trial comparing transurethral resection of prostate (TURP) to photose... more The GOLIATH study is a 2-yr trial comparing transurethral resection of prostate (TURP) to photoselective vaporization with the GreenLight XPS Laser System (GL-XPS) for the treatment of benign prostatic obstruction (BPO). Noninferiority of GL-XPS to TURP was demonstrated based on a 6-mo follow-up from the study. To determine whether treatment effects observed at 6 mo between GL-XPS and TURP was maintained at the 2-yr follow-up. Prospective randomized controlled trial at 29 centers in nine European countries involving 281 patients with BPO. Photoselective vaporization using the 180-W GreenLight GL-XPS or conventional (monopolar or bipolar) TURP. The primary outcome was the International Prostate Symptom Score for which a margin of three was used to evaluate the noninferiority of GL-XPS. Secondary outcomes included Qmax, prostate volume, prostate specific antigen, Overactive Bladder Questionnaire Short Form, International Consultation on Incontinence Questionnaire Short Form, occurrenc...
Breast carcinoma has a metastatic potential to any organ system. However, breast carcinoma metast... more Breast carcinoma has a metastatic potential to any organ system. However, breast carcinoma metastases to the urinary tract have very rarely been described. The authors present the case of a patient with a synchronous right ureteral and vesical metastasis of a breast cancer. This is the unique case reported in Literature of synchronous urinary metastatic localization from breast invasive lobular carcinoma.
Medical science monitor: international medical journal of experimental and clinical research
Benign prostatic enlargement (BPE) is one of the most common diseases in ageing men; it is associ... more Benign prostatic enlargement (BPE) is one of the most common diseases in ageing men; it is associated with bothersome lower urinary tract symptoms that affect the individual's quality of life. This review focuses on the different available options for treating benign prostatic hyperplasia (BPH) in older men and on how to choose the right treatment. A literature search was done to review relevant papers. Relatively recent papers, as well as those in a series or papers from expert centers, are included in the reference list. Treatment options for BPE in older men include medical therapy, transurethral resection of the prostate (TURP), minimally invasive treatments (ie, transurethral microwave thermotherapy, transurethral needle ablation, and laser surgery) and prostatic stenting. Age, individual anesthesiologic risk, grade of obstruction, prostate volume, serum prostate specific antigen (PSA) value, treatment-related complication rate, presence of an indwelling catheter, and neuro...
We have reviewed the evidence published on botulinum toxin A (BoNT/A), percutaneous tibial nerve ... more We have reviewed the evidence published on botulinum toxin A (BoNT/A), percutaneous tibial nerve stimulation (PTNS), and sacral nerve stimulation (SNS) in the management of overactive bladder (OAB). BoNT/A is effective irrespectively of the number of previous anticholinergic treatments and of the reason for failure. Doses up to 360U 3-monthly are well tolerated. BoNT/A is well tolerated and effective also in the pediatric population. Bladder instillation of liposome encapsulated BoNT/A is a new approach, deserving further research. When using PTNS, motor response from the electrical stimulus is not required, a sensory response suffices. PTNS has a lasting effect compared to oxybutynin alone. SNS is superior to standard medical treatment but the combination of SNS and anticholinergics is more effective than anticholinergic alone. The evidence published in the last 18 months has increased the level of evidence on safety and effectiveness of BoNT/A, PTNS, and SNS in the management of OAB. BoNT/A is now recommended as standard third-line treatment for OAB (in the USA) and urgency incontinence (in the USA and in Europe) in selected patients refractory to pharmacological therapy. All available third-line treatment options for OAB/urgency urinary incontinence should be offered before surgery is contemplated. http://links.lww.com/COU/A7.
ABSTRACT PURPOSE To evaluate the diagnostic accuracy of a new diagnostic imaging technique called... more ABSTRACT PURPOSE To evaluate the diagnostic accuracy of a new diagnostic imaging technique called voiding MR- cystourethrography that allows the visualization of the male urethra. METHOD AND MATERIALS 10 normal volunteers and 86 male patients with bladder outlet obstruction (evaluated with urine-flow velocity recording) underwent voiding MR-cystourethrography, performed with an 1.5 T magnet with the patient placed in supine position. The filling of the urinary bladder with paramagnetic contrast agent was obtainded by the i.v administration 20 mg of furosemide followed by the i.v. administration of ¾ of the normal dose of a paramagnetic contrast agent. When the bladder was filled of contrast-material-enhanced urine, the patient was asked to urinate. During the micturition T1-weighted spoiled 3D gradient-echo acquisitions on sagittal plane were performed. Two consecutive MR acquisitions were performed and the 3D row images were post-processed with MIP algorithm. 25 patients performed retrograde and micturating conventional cystourethrography in the month preceding MRI. In 10 patient we also performed urethral virtual endoscopy using volume rendering technique. RESULTS Homogeneous opacification of the bladder lumen was always obtained. 10 patients were unable to perform the MR examination. In all the volunteers and in all the patients studied (76 pts) we obtained a perfect evaluation of the male urethra with voiding MR-cystourethrography. The visualization of the urethra with MIP reconstructed images was considered comparable to that obtained with conventional cystourethrography. We detected 24 cases of bladder neck obstruction, 36 cases of urethral stricture, 10 cases following TURP and TUIP procedures, 2 urethral papillomatosis and 4 cases of benign prostatic hypertrophy. The site, length and the number of urethral strictures were accurately determined by MRI. The analysis of 3D sagittal scans and urethral virtual endoscopy allowed a better evaluation of the morphology of the urethral strictures in comparison with conventional cystourethrography. CONCLUSION Voiding MR-cystourethrography demonstrates the morfology of the bladder neck and urethra during the micturition and can substitute standard retrograde and micturating cystourethrogram. This novel technique avoids radiation exposure to the gonads and urinary catheterization. CLINICAL RELEVANCE/APPLICATION This modality can substitute standard retrograde and micturating cystourethrogram.
There are various forms of treatment for prostate cancer. In addition to oncologic outcomes, phys... more There are various forms of treatment for prostate cancer. In addition to oncologic outcomes, physicians and increasingly patients are focusing on functional and adverse outcomes. Symptoms of overactive bladder (OAB), including urinary frequency, urgency, and incontinence, can occur regardless of treatment modality. This article examines the prevalence, pathophysiology, and options for treatment of OAB after radical prostate cancer treatment. OAB seems to be more common and severe after radiation therapy than surgical therapy and even persisted longer with complications, suggesting an advantage for surgery over radiotherapy. Because OAB that occurs after radical prostate surgery or radiotherapy can be difficult to treat, it is important that patients are made aware of the potential development of OAB during counselling before decisions regarding treatment choice are made. To ensure a successful outcome of both treatments, it is imperative that clinicians and non-specialists enquire a...
ABSTRACT INTRODUCTION & OBJECTIVES: The objective of this study was to evaluate the diagn... more ABSTRACT INTRODUCTION & OBJECTIVES: The objective of this study was to evaluate the diagnostic accuracy of bladder cancer detection using the TRIMprob, a nonlinear tuneable oscillator generating extremely low energy multiple electromagnetic fields. MATERIAL & METHODS: 200 consecutive patients referred to Sant’Andrea’s outpatients clinic for urethrocystoscopy were enrolled in the study. All patients were investigated by history, physical examination, urinalysis, urine colture and urine cytology, urethrocystoscopy and TRIMprob test. Transurethral resection of the bladder was performed in case of any suspicious lesion. Main indications for cystoscopy were gross haematuria and follow-up of patients after TURB. Patients affected by pelvic tumors, urinary tract infection, cardiac pacemakers or other electromagnetic devices were excluded from the study. The TRIMprob was moved over the surface of the patient’s pubic region while standing in front of the system receiver in two different positions, with a bladder filling of 150 ml after endoscopic examination. Two operators blinded to the patient status independently conducted the test from January 2008 to October 2010. Nonlinear resonance was analyzed at 465, 930 and 1395 MHz. RESULTS: Analysis of resonance values at 465MHz showed a statistically significant difference between patients with and without bladder cancer (p=0 Mann Whitney test). No statistically significant difference was observed in the values at 930 and 1395 MHz. The following accuracy values were observed for the diagnosis of bladder cancer: sensitivity:86%,specificity:94%, positive and negative  e439a predictive value of 86% and 94% overall, diagnostic accuracy was 92%. No significant difference was found between the two different positions and operators. CONCLUSIONS: In our experience the TRIMprob has a high diagnostic accuracy for the diagnosis of bladder cancer and has a great potential clinical value in Urology.
This is a systematic review on the treatment of lower urinary tract symptoms (LUTS) in patients w... more This is a systematic review on the treatment of lower urinary tract symptoms (LUTS) in patients with multiple sclerosis (MS). The heterogeneity of the outcome criteria did not allow a meta-analysis of the published evidence. In the last few decades, the therapeutic options for neurogenic bladder dysfunction have broadened. Despite this, no consensus has been reached as to the management of LUTD and LUTS in patients with MS, and the subject remains controversial. Bladder dysfunction is common in MS, affecting 80 %-100 % of patients during the course of the disease. Several studies have shown that urinary incontinence has a severe effect on patients' quality of life, with 70 % of patients classifying the impact bladder symptoms had on their life as "high" or "moderate." Moreover, the progressive feature of MS makes its treatment complex, since any achieved therapeutic result may be short-lived, with the possibility that symptoms will recur or develop de novo.
To evaluate the patterns of prescription of androgen deprivation therapy (ADT) in patients with p... more To evaluate the patterns of prescription of androgen deprivation therapy (ADT) in patients with prostate cancer (PCa) and the adherence to European Association Urology (EAU) guidelines for ADT prescription. The CHOsIng treatment for prostate canCEr (CHOICE) study was an Italian multicenter cross-sectional study conducted from December 2010 to January 2012. A total of 1386 patients treated with ADT for PCa (first prescription or renewal of ADT) were selected. According to EAU guidelines, the cohort was categorized in discordant ADT (Group A) and concordant ADT (Group B). The final cohort included 1075 patients with a geographical distribution including North-Italy in 627 (58.3%), Center-Italy in 233 (21.7%) and South-Italy in 215 (20.0%). In the category of patients treated with primary ADT, a total of 125 (56.3%) were classified as low-risk according to D'Amico Classification. According to EAU guidelines, 285 (26.51%) and 790 (73.49%) were classified as discordant (Group A) and concordant (Group B) respectively. In Group A, patients were more likely to receive primary ADT (57.5%; 164/285) than RP (30.9%; 88/285), RT (6.7%; 19/285) or RP + RT (17.7%; 14/285) (p<0.01). Multivariate logistic regression analysis, adjusted for clinical and pathological variables, demonstrated that patients from Center-Italy (OR: 2.86; p<0.05) and South-Italy (OR: 2.65; p<0.05) were more likely to receive discordant ADT. EAU guideline adherence for ADT was low in the Italian country and it is influenced by geographic areas. Health makers and urologists should consider these results in order to verify the inadequate use of ADT and to set policy strategies to overcome this risk. This article is protected by copyright. All rights reserved.
International journal of urology : official journal of the Japanese Urological Association, Jan 25, 2015
To evaluate the outcome in patients undergoing photoselective vaporization of the prostate for be... more To evaluate the outcome in patients undergoing photoselective vaporization of the prostate for benign prostatic obstruction as part of the Clinical Research Office of the Endourological Society Global GreenLight Laser Study. Data were collected on 713 patients with lower urinary tract symptoms suggestive of benign prostatic obstruction undergoing photoselective vaporization of the prostate at 25 centers worldwide, between April 2010 and April 2012. Three types of GreenLight laser powers were used: 80 W, 120 W or 180 W. Intraoperative and postoperative complications were recorded. Outcome parameters measured at baseline, 6-12 weeks, 6 months and 12 months were: uroflow measurements, International Prostate Symptom Score; prostate-specific antigen and International Index of Erectile Function. Operating time was shortest with the 180-W laser at 53.8 min. Intraoperatively, bleeding occurred in 3.1% of patients. Statistically significant changes were reported in maximum flow rate, postvoi...
To externally validate the Young Academic Urologist (YAU) nomogram for the prediction of benign p... more To externally validate the Young Academic Urologist (YAU) nomogram for the prediction of benign prostatic obstruction (BPO) in patients with lower urinary tract symptoms and benign prostatic enlargement. Between January 2013 and September 2014, a consecutive series of patients with lower urinary tract symptoms and benign prostatic enlargement underwent standardized pressure flow studies (PFSs) in 2 tertiary Italian centers. Variables assessed were International Prostatic Symptom Score, Prostate Specific Antigen (PSA), prostate size, transitional zone volume, maximal urinary flow rate (Qmax), postvoid residual urine. BPO was defined as a Schäfer grade ≥3 at PFSs. Qmax and transitional zone volume were plotted on the YAU nomogram to predict the presence of BPO. Receiver operating characteristic curve analysis was used to evaluate predictive properties of the nomogram for the final diagnosis of BPO. A total of 449 patients were consecutively enrolled. In those, 310 patients (69%) presented a BPO (Schäfer ≥3) at PFSs. The novel YAU nomogram presented an area under the curve of 0.76; 95% confidence interval: 0.72-0.82 for the diagnosis of BPO. At the best cutoff value of 80% (nomogram probability), the sensitivity was 74% and specificity was 79%, the positive predictive value was 89%, and the negative predictive value was 56%. Although further studies are needed to confirm our results, the YAU nomogram was, in our experience, an excellent tool to predict the presence of BPO.
The GOLIATH study is a 2-yr trial comparing transurethral resection of prostate (TURP) to photose... more The GOLIATH study is a 2-yr trial comparing transurethral resection of prostate (TURP) to photoselective vaporization with the GreenLight XPS Laser System (GL-XPS) for the treatment of benign prostatic obstruction (BPO). Noninferiority of GL-XPS to TURP was demonstrated based on a 6-mo follow-up from the study. To determine whether treatment effects observed at 6 mo between GL-XPS and TURP was maintained at the 2-yr follow-up. Prospective randomized controlled trial at 29 centers in nine European countries involving 281 patients with BPO. Photoselective vaporization using the 180-W GreenLight GL-XPS or conventional (monopolar or bipolar) TURP. The primary outcome was the International Prostate Symptom Score for which a margin of three was used to evaluate the noninferiority of GL-XPS. Secondary outcomes included Qmax, prostate volume, prostate specific antigen, Overactive Bladder Questionnaire Short Form, International Consultation on Incontinence Questionnaire Short Form, occurrenc...
Breast carcinoma has a metastatic potential to any organ system. However, breast carcinoma metast... more Breast carcinoma has a metastatic potential to any organ system. However, breast carcinoma metastases to the urinary tract have very rarely been described. The authors present the case of a patient with a synchronous right ureteral and vesical metastasis of a breast cancer. This is the unique case reported in Literature of synchronous urinary metastatic localization from breast invasive lobular carcinoma.
Medical science monitor: international medical journal of experimental and clinical research
Benign prostatic enlargement (BPE) is one of the most common diseases in ageing men; it is associ... more Benign prostatic enlargement (BPE) is one of the most common diseases in ageing men; it is associated with bothersome lower urinary tract symptoms that affect the individual's quality of life. This review focuses on the different available options for treating benign prostatic hyperplasia (BPH) in older men and on how to choose the right treatment. A literature search was done to review relevant papers. Relatively recent papers, as well as those in a series or papers from expert centers, are included in the reference list. Treatment options for BPE in older men include medical therapy, transurethral resection of the prostate (TURP), minimally invasive treatments (ie, transurethral microwave thermotherapy, transurethral needle ablation, and laser surgery) and prostatic stenting. Age, individual anesthesiologic risk, grade of obstruction, prostate volume, serum prostate specific antigen (PSA) value, treatment-related complication rate, presence of an indwelling catheter, and neuro...
We have reviewed the evidence published on botulinum toxin A (BoNT/A), percutaneous tibial nerve ... more We have reviewed the evidence published on botulinum toxin A (BoNT/A), percutaneous tibial nerve stimulation (PTNS), and sacral nerve stimulation (SNS) in the management of overactive bladder (OAB). BoNT/A is effective irrespectively of the number of previous anticholinergic treatments and of the reason for failure. Doses up to 360U 3-monthly are well tolerated. BoNT/A is well tolerated and effective also in the pediatric population. Bladder instillation of liposome encapsulated BoNT/A is a new approach, deserving further research. When using PTNS, motor response from the electrical stimulus is not required, a sensory response suffices. PTNS has a lasting effect compared to oxybutynin alone. SNS is superior to standard medical treatment but the combination of SNS and anticholinergics is more effective than anticholinergic alone. The evidence published in the last 18 months has increased the level of evidence on safety and effectiveness of BoNT/A, PTNS, and SNS in the management of OAB. BoNT/A is now recommended as standard third-line treatment for OAB (in the USA) and urgency incontinence (in the USA and in Europe) in selected patients refractory to pharmacological therapy. All available third-line treatment options for OAB/urgency urinary incontinence should be offered before surgery is contemplated. http://links.lww.com/COU/A7.
ABSTRACT PURPOSE To evaluate the diagnostic accuracy of a new diagnostic imaging technique called... more ABSTRACT PURPOSE To evaluate the diagnostic accuracy of a new diagnostic imaging technique called voiding MR- cystourethrography that allows the visualization of the male urethra. METHOD AND MATERIALS 10 normal volunteers and 86 male patients with bladder outlet obstruction (evaluated with urine-flow velocity recording) underwent voiding MR-cystourethrography, performed with an 1.5 T magnet with the patient placed in supine position. The filling of the urinary bladder with paramagnetic contrast agent was obtainded by the i.v administration 20 mg of furosemide followed by the i.v. administration of ¾ of the normal dose of a paramagnetic contrast agent. When the bladder was filled of contrast-material-enhanced urine, the patient was asked to urinate. During the micturition T1-weighted spoiled 3D gradient-echo acquisitions on sagittal plane were performed. Two consecutive MR acquisitions were performed and the 3D row images were post-processed with MIP algorithm. 25 patients performed retrograde and micturating conventional cystourethrography in the month preceding MRI. In 10 patient we also performed urethral virtual endoscopy using volume rendering technique. RESULTS Homogeneous opacification of the bladder lumen was always obtained. 10 patients were unable to perform the MR examination. In all the volunteers and in all the patients studied (76 pts) we obtained a perfect evaluation of the male urethra with voiding MR-cystourethrography. The visualization of the urethra with MIP reconstructed images was considered comparable to that obtained with conventional cystourethrography. We detected 24 cases of bladder neck obstruction, 36 cases of urethral stricture, 10 cases following TURP and TUIP procedures, 2 urethral papillomatosis and 4 cases of benign prostatic hypertrophy. The site, length and the number of urethral strictures were accurately determined by MRI. The analysis of 3D sagittal scans and urethral virtual endoscopy allowed a better evaluation of the morphology of the urethral strictures in comparison with conventional cystourethrography. CONCLUSION Voiding MR-cystourethrography demonstrates the morfology of the bladder neck and urethra during the micturition and can substitute standard retrograde and micturating cystourethrogram. This novel technique avoids radiation exposure to the gonads and urinary catheterization. CLINICAL RELEVANCE/APPLICATION This modality can substitute standard retrograde and micturating cystourethrogram.
There are various forms of treatment for prostate cancer. In addition to oncologic outcomes, phys... more There are various forms of treatment for prostate cancer. In addition to oncologic outcomes, physicians and increasingly patients are focusing on functional and adverse outcomes. Symptoms of overactive bladder (OAB), including urinary frequency, urgency, and incontinence, can occur regardless of treatment modality. This article examines the prevalence, pathophysiology, and options for treatment of OAB after radical prostate cancer treatment. OAB seems to be more common and severe after radiation therapy than surgical therapy and even persisted longer with complications, suggesting an advantage for surgery over radiotherapy. Because OAB that occurs after radical prostate surgery or radiotherapy can be difficult to treat, it is important that patients are made aware of the potential development of OAB during counselling before decisions regarding treatment choice are made. To ensure a successful outcome of both treatments, it is imperative that clinicians and non-specialists enquire a...
ABSTRACT INTRODUCTION & OBJECTIVES: The objective of this study was to evaluate the diagn... more ABSTRACT INTRODUCTION & OBJECTIVES: The objective of this study was to evaluate the diagnostic accuracy of bladder cancer detection using the TRIMprob, a nonlinear tuneable oscillator generating extremely low energy multiple electromagnetic fields. MATERIAL & METHODS: 200 consecutive patients referred to Sant’Andrea’s outpatients clinic for urethrocystoscopy were enrolled in the study. All patients were investigated by history, physical examination, urinalysis, urine colture and urine cytology, urethrocystoscopy and TRIMprob test. Transurethral resection of the bladder was performed in case of any suspicious lesion. Main indications for cystoscopy were gross haematuria and follow-up of patients after TURB. Patients affected by pelvic tumors, urinary tract infection, cardiac pacemakers or other electromagnetic devices were excluded from the study. The TRIMprob was moved over the surface of the patient’s pubic region while standing in front of the system receiver in two different positions, with a bladder filling of 150 ml after endoscopic examination. Two operators blinded to the patient status independently conducted the test from January 2008 to October 2010. Nonlinear resonance was analyzed at 465, 930 and 1395 MHz. RESULTS: Analysis of resonance values at 465MHz showed a statistically significant difference between patients with and without bladder cancer (p=0 Mann Whitney test). No statistically significant difference was observed in the values at 930 and 1395 MHz. The following accuracy values were observed for the diagnosis of bladder cancer: sensitivity:86%,specificity:94%, positive and negative  e439a predictive value of 86% and 94% overall, diagnostic accuracy was 92%. No significant difference was found between the two different positions and operators. CONCLUSIONS: In our experience the TRIMprob has a high diagnostic accuracy for the diagnosis of bladder cancer and has a great potential clinical value in Urology.
This is a systematic review on the treatment of lower urinary tract symptoms (LUTS) in patients w... more This is a systematic review on the treatment of lower urinary tract symptoms (LUTS) in patients with multiple sclerosis (MS). The heterogeneity of the outcome criteria did not allow a meta-analysis of the published evidence. In the last few decades, the therapeutic options for neurogenic bladder dysfunction have broadened. Despite this, no consensus has been reached as to the management of LUTD and LUTS in patients with MS, and the subject remains controversial. Bladder dysfunction is common in MS, affecting 80 %-100 % of patients during the course of the disease. Several studies have shown that urinary incontinence has a severe effect on patients' quality of life, with 70 % of patients classifying the impact bladder symptoms had on their life as "high" or "moderate." Moreover, the progressive feature of MS makes its treatment complex, since any achieved therapeutic result may be short-lived, with the possibility that symptoms will recur or develop de novo.
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Papers by Andrea Tubaro