Background: The use of organ sparing strategies to treat penile cancer (PC) is currently supported by evidence that has indicated the safety, efficacy and benefit of this surgery. However, radical penectomy still represents up to 15-20% of primary tumor treatments in PC patients. The aim of the study was to evaluate efficacy in terms of overall survival (OS) and disease-free survival (DFS) of radical penectomy in PC patients.Methods: Data from a retrospective multicenter study (PEnile Cancer ADherence study, PECAD Study) on PC patients treated at 13 European and American urological centers (Hospital "
Purpose
Few tools are available to predict uretero-lithotripsy outcomes in patients with ureteral stones. Aim of our study was to develop a nomogram predicting the probability of stone free rate in patients undergoing semi-rigid uretero-lithotripsy (ULT) for ureteral stones.
Methods
From January 2014 onwards, patients undergoing semi-rigid Ho: YAG laser uretero-lithotripsy for ureteral stones were prospectively enrolled in two centers. Patients were preoperatively evaluated with accurate clinical history, urinalysis and renal function. Non-contrast CT was used to define number, location and length of the stones and eventually the presence of hydronephrosis. A nomogram was generated based on the logistic regression model used to predict ULT success.
Results
Overall, 356 patients with mean age of 54 years (IQR 44/65) were enrolled. 285/356 (80%) patients were stone free at 1 month. On multivariate analysis single stone (OR 1.93, 95% CI 1.05–3.53, p = 0.034), stone size (OR 0.92, 95% CI 0.87–0.97, p = 0.005), distal position (OR 2.12, 95% CI 1.29–3.48, p = 0.003) and the absence of hydronephrosis (OR 2.02, 95% CI 1.08–3.78, p = 0.029) were predictors of success and these were used to develop a nomogram. The nomogram based on the model presented good discrimination (area under the curve [AUC]: 0.75), good calibration (Hosmer–Lemeshow test, p > 0.5) and a net benefit in the range of probabilities between 15 and 65%. Internal validation resulted in an AUC of 0.74.
Conclusions
The implementation of our nomogram could better council patients before treatment and could be used to identify patients at risk of failure. External validation is warranted before its clinical implementation.
ObjectiveIn this study, we evaluate the short- and mid-term results of water vapor thermal therapy (WVTT) for LUTS (lower urinary tract symptoms) due to benign prostatic hyperplasia (BPH).MethodsPatients with LUTS due to BPH who underwent WVTT from September 2019 to April 2022 were included in this prospective, single-center study. Data regarding functional and sexual outcomes were evaluated by validated questionnaires as well as uroflowmetry, urinalysis and cultures, digital rectal examination, serum prostate-specific antigen, and transrectal ultrasound. The patients were followed-up with 3, 6, 12, and 18 months after the procedure.ResultsEighty-four men were treated. Mean ± SD prostate volume, operative time, and hospital stay were 76.9 ± 26.3 ml, 14 ± 18.5 min, and 0.9 ± 0.7 days, respectively. The catheter was removed after 7 ± 4.4 days. A significant (p < 0.05) improvement in Qmax, IPSS, QoL, OAB-q SF, ICIQ-SF, and IIEF- 5 from the baseline at the last follow-up (18 months) was recorded. Seventy-six (90%) patients reported a significant improvement in ejaculatory function (de novo dry ejaculation in 4 patients). Early (≤30 days) postoperative complications were reported in 70% of patients, all grade 1 according to Clavien–Dindo. No late (>30 days) Clavien–Dindo >1 procedure-related complications occurred. Three patients required reoperation (6–12 months after surgery).ConclusionWVTT is an effective and safe treatment for the management of LUTS due to BPH in the short- and mid-term follow-up, and it provides negligible sequelae with respect to ejaculation.
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