The aim of this study was to evaluate efficacy and safety of the ATOMS system for the treatment of postoperative stress urinary incontinence (SUI).
We included all consecutive male patients referring ...for postoperative SUI and treated with ATOMS system from June 2013 to July 2017. Patients received anamnesis, 24 h Pad Test, Pad count, physical examination, urodynamic evaluation, ICIQ-UI SF questionnaire. We excluded patients with low bladder capacity and compliance, uncontrolled detrusor overactivity.
We treated 98 patients with median age of 70.21±10.02 years. The most common cause of SUI was open radical prostatectomy in 79 patients. Ten patients had undergone urethrotomy, 7 bladder neck incision, 14 adjuvant radiotherapy. Thirty-nine patients suffered of mild incontinence (24 h Pad Test <200 g), 49 moderate incontinence (200-400 g), 10 severe incontinence (≥400 g). Thirty-one patients underwent previous incontinence surgery: 29 ProACT, 3 artificial urinary sphincters (in 2 cases both devices), 1 bulking agents and subsequent male sling. Median follow-up was 21.5 months. We had a significant reduction of mean 24 h Pads Test, pad count and ICIQ-UI SF questionnaire (P<0.01). At last follow-up 47.96% of patients were dry and 79.59% reached social continence. A high incontinence grade, adjuvant radiotherapy, previous urethral surgery and incontinence surgery have been associated with lower continence results. We had complications in 33 patients (33.7%). The device was removed in 4 cases due to scrotal port erosion and in one case due to persistent pain.
The ATOMS system seems to be an effective and safe surgical treatment for postoperative male SUI.
Aim of the study is to verify if a stress reaction due to G8 meeting, held in Genoa on July 2001, can produce a mass stress reaction and influence negatively people sexuality and so the birth rate.
...402 citizens (221 men and 181 women ranging in age from 25 to 52 years, mean 39) have been invited to answer two questionnaires concerning their sexual activity and their feelings before, during and after the G8 meeting. After 9,10 and 11 months we have valued the birth rate in Genoa.
30 people (7%) did not answer the two questionnaires. 12 people (3%) answered the questionnaire wrongly and were excluded from the study. 228 people (63%) didn't report changes about their sexual activity, during G8 meeting. 120 people (33%) reported a decrease of sexual intercourses and of sexual desire; 12 people (4%) reported an increase of these parameters. 54% of our population reported a definite anxiety. We want to emphasize the high number of people that had anxiety even in the group that didn't report changes in sexual activity (105/228 = 46%). After 9, 10 and 11 months we have recorded a significant decrease of the birth rate respectively of 29%, 23%, 20%. (P < 0.05).
Violent demonstrations during G8 meeting have negatively influenced people sexual activity and people behaviour. Besides, we have recorded a decrease of birth rate in Genoa, nine, ten and eleven months after G8. This decrease rate was respectively 29%-23%-20% as regards the same months during the three years before (P < 0.05). We cannot determine the real cause of this decrease. Violent G8 demonstrations could be responsible for a stress reaction with negative consequences on human reproductive functions.
The therapeutic choice in patients with clinically localized prostate cancer depends on preoperative clinical stage. Diagnostic instruments currently available for such an evaluation--considered ...separately--have not shown enough efficacy. Roach has recently introduced three simple mathematical equations that--on the basis of prostate-specific antigen and the biopsy Gleason score--are aimed at calculating the definitive pathological stage. We retrospectively analyzed our radical prostatectomy data base to assess the accuracy of the equations in predicting the final stage in patients with clinically localized prostate cancer. METHODS STUDY DESIGN: The study included 173 patients who had undergone radical retropubic prostatectomy at our Institution. Patients were divided into 25 groups, depending on preoperative PSA and the biopsy Gleason score. The risk of extracapsular neoplastic growth, seminal vesicle involvement and lymph node involvement was calculated for each group by means of Roach's equations. On the basis of definitive histological examinations, we compared the expected risk to the observed risk.
The observed risk fell within the interval of expected risk in 16 of 17 groups (94%) regarding the evaluation of extracapsular growth, in 15 of 17 (88%) regarding the analysis of seminal vesicle involvement, and in 14 of 17 (82%) regarding the evaluation of lymph node involvement. Therefore, the observed event was in agreement with the expected event in 45 of 51 groups (88%).
The equations represent a practical and effective instrument for preoperative clinical staging in patients with localized prostate cancer. By means of these mathematical formulas, one can assess the correct prognosis and--above all--plan the best therapeutic approach.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
We report our experience-based approach in transperineal ultrasound guided biopsy to detect early prostate cancer. We selected patients on the basis of clinical characteristics. We tried to determine ...correct number and sites of biopsy to reduce patient discomfort and complications without loosing sensibility. Routine TZ biopsy increases detection rate of prostate cancer in T1 patients. Lateral peripheral biopsy resulted in a loss of sensibility of 5% and thus we considered it useless. Literature reported gain of sensibility with lateral peripheral biopsy referred to transrectal technique. Needle angle of incidence is different and therefore the area biopsied differs. Thus, results are not comparable.
The transport sector plays a crucial role in the social and economic development of our society. Nevertheless, it is responsible for one quarter of the global CO2 emission worldwide. Although ...sustainable mobility could drastically reduce transport-related emissions, its adoption is still underdeveloped. In this paper, an impact innovation methodology has been used to generate a solution that could boost sustainable mobility development by creating an efficient offline tracking method that combines transactions and GPS data. The results suggest that incentive-based solutions could increase the adoption of sustainable mobility. This study generates the basis for the development of a sophisticated algorithms, able to track mobility and to incentivize people’s sustainable habits.
