Biomedical subjects

F Catanzaro

Publications and source records attributed to F Catanzaro.

At least 19 recordsLinked to original sources

PubMed2001

Long-term effectiveness of sacral nerve stimulation for refractory urge incontinence.

OBJECTIVES: To evaluate the long-term efficacy of sacral nerve stimulation for refractory urinary urge incontinence. STUDY DESIGN AND METHODS: Urge incontinent patients qualified for surgical implantation of a neurostimulator system after trial screening with percutaneous test stimulation. Surgical implantation of the InterStim System (Medtronic Inc., Minneapolis, Minn., USA) was performed in cases where a >50% reduction in incontinence symptoms was documented during the 3- to 7-day test stimulation period. The InterStim System consists of an implantable pulse generator, a transforamenally placed quadripolar lead, and an extension that connects these two devices for unilateral stimulation of the S3 or S4 sacral nerve. Efficacy for 96 implanted patients was based on urinary symptom changes as quantified in voiding diaries collected at baseline and annually after surgical implantation. RESULTS: As compared to baseline, the group of 96 implanted patients demonstrated significant reductions in urge incontinent symptoms at an average of 30.8+/-14.8 (range 12-60) months with respect to the number of urge incontinent episodes per day, severity of leaking, and the number of absorbent pads/diapers replaced per day due to incontinence (all p<0.0001, respectively). Gender, pretreatment variables, and age were not found to be relevant factors that affected these results. 11 of the 96 patients underwent device explant due to lack of efficacy, pain or bowel dysfunction. These data were conservatively included in the efficacy results. No permanent injuries associated with the devices or therapy were reported. CONCLUSION: Sacral nerve stimulation is an effective treatment for refractory urge incontinence with sustained long-term benefit through an average of 30.8 months.

Adult↗

PubMed2001

High-dose epirubicin in the prophylactic treatment of T1G2 superficial bladder tumors.

OBJECTIVES: To evaluate the activity and safety of intravesical instillations of 80 mg epirubicin in a selected patient population with T1G2 primary and multiple superficial bladder tumors. To assess the completeness of the transurethral resection (TUR) at 4 weeks (second look) and to compare the histology of local and review pathology. METHODS: One hundred and sixty-nine patients have been histologically assessed both locally and extramurally for T1G2 superficial bladder tumors. Epirubicin (80 mg/instillation) started within 20 days after TUR was administered weekly during the first month and then monthly for another 11 months. Assessments for relapse were carried out according to the standard methods. RESULTS: Histological consistency for T1G2 between local and extramural assessments was found in 85.2% of cases. At the median follow-up time of 38 months, the overall relapse rate was 43.3%. Treatment was very well tolerated: no systemic adverse events were reported and local adverse events were confined to chemical cystitis which in 3% required treatment discontinuation. CONCLUSIONS: Epirubicin (80 mg/instillation) appeared effective in the prophylaxis of relapse in primary and multiple T1G2 superficial bladder tumors. A second TUR at 3-4 weeks is necessary in T1 tumors. Excellent concordance between local and review pathology was found.

Adult↗

PubMed2001

Chronic sacral neuromodulation in patients with lower urinary tract symptoms: results from a national register.

PURPOSE: The Italian Register was created in February 1997 to collect the national results of sacral neuromodulation. All Italian centers at which sacral neuromodulation is performed were invited to participate in our study. We present the results from retrospective and prospective registers. MATERIALS AND METHODS: A total of 196 patients underwent permanent implantation of sacral neuromodulation and were enrolled in the Italian register. There were 18 males and 75 females in the retrospective, and 28 males and 75 females in the prospective studies. Student's t test was used to compare paired values, and the Wilcoxon rank sum and nonparametric tests were used when necessary. RESULTS: Mean incontinent episodes daily plus or minus standard deviation for patients with detrusor instability went from 5.4 +/- 3.9 to 1.1 +/- 1.6 (median 5 and 0, respectively) at 12-month followup (p <0.001). For idiopathic retention average residual volume decreased from 277 to 108 cc (median 287 and 80, respectively), and 50% of patients stopped catheterization and another 13% catheterized once daily at 1-year after implantation. With neurogenic voiding disturbances, the results fluctuated with time from a minimum of 33% to a maximum 66% of patients who did not catheterize at 6-month followup and 12 months after implantation, respectively. At 12-month followup, 50% of patients with hyperreflexia had less than 1 incontinent episode daily. The problem was completely solved in 66% of patients in the retention group. Of patients in the urge incontinent population 39% were completely dry and 23% had less than 1 incontinent episode daily. CONCLUSIONS: Sacral neuromodulation is effective therapy for treating lower urinary tract symptoms resistant to less invasive therapy.

Adolescent↗

PubMed2000

Long-term results of a multicenter study on sacral nerve stimulation for treatment of urinary urge incontinence, urgency-frequency, and retention.

Many patients have chronic, debilitating symptoms of voiding dysfunction that are refractory to conventional medical or surgical therapies. This multicenter, prospective study evaluated the long-term effectiveness of sacral nerve stimulation using the implantable Medtronic InterStim therapy for urinary control in patients with otherwise intractable complaints of urinary urge incontinence, urgency-frequency, or retention. Each patient first underwent temporary, percutaneous sacral nerve test stimulation. If at least a 50% reduction in target symptoms was documented for at least 3 days, patients received a permanent Medtronic InterStim sacral nerve stimulation system that includes a surgically implanted lead and neurostimulator. Regular follow-up was conducted with outcome data. We report here on patients who have been observed from 1.5 to 3 years postimplantation. The results demonstrate that after 3 years, 59% of 41 urinary urge incontinent patients showed greater than 50% reduction in leaking episodes per day with 46% of patients being completely dry. After 2 years, 56% of the urgency-frequency patients showed greater than 50% reduction in voids per day. After 1. 5 years, 70% of 42 retention patients showed greater than 50% reduction in catheter volume per catheterization. We conclude that the Medtronic InterStim therapy for urinary control system is an effective therapy with sustained clinical benefit for patients with intractable symptoms of urinary urge incontinence, urgency-frequency, or retention.

Adolescent↗

PubMed1999

Modified expression of plasma glutathione peroxidase and manganese superoxide dismutase in human renal cell carcinoma.

Two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) is a powerful tool to separate thousands of polypeptides and to highlight the modification of protein expression in malignant diseases. By applying 2-D PAGE to ten normal human kidney and ten homologous renal cell carcinoma (RCC) tissues, we found two peptides in all ten normal tissues but not in RCCs and, conversely, two peptides were detected in all RCCs but not in normal tissues. Using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and internal sequence analysis, the two first peptides were identified as two isoforms of plasma glutathione peroxidase (GPxP). The two other peptides isolated in all RCCs but not in normal tissues were identified by N-terminal sequence analysis as multimeric forms of manganese superoxide dismutase (Mn-SOD). No multimeric Mn-SODs and only two monomeric forms were detected in normal tissues. GPxP and Mn-SOD are metallo-enzymes encoded on chromosome 5q32 and on chromosome 6p25, respectively. Their regions are within the locus 5q21-->qter and 6q21-6q27 on which deletions and translocations are described in some cytogenetic studies of RCC transformation. Therefore, our results might suggest a correlation between the modified expression of GPxP and Mn-SOD in tumor tissues and chromosomal modifications, and that the two proteins may be putative markers for diagnosis of RCC.

Carcinoma, Renal Cell↗

PubMed1998

[Ethical aspects].

The relation is considered between ethical choices, morals and deontology in plastic surgery of the male external genitals. Ethics dictates the behavioural model applied by an individual or group in their actions. Professional ethics--deontology--is the collection of duties governing the exercise of a certain profession. Morals are the set of rules governing an individual's life in society. Ethics, deontology and morals do not always convey the same message, since environmental, racial and religious situations, custom, and even fashion can influence a patient's demands, reflecting his desire to improve his quality of life, even only from the purely hedonistic viewpoint, and the specialist's attitude. Surgeons are increasingly tending to bend to these demands or--much worse--even encourage and foster them, with a view to financial considerations. The attitude and ethical choices available are examined in relation to surgery to lengthen or enlarge the penis.

Esthetics↗

PubMed1997

Management of recurrent stricture of appendicostomy in continent neobladder (Indiana pouch) with Memotherm ureteral stent: case report.

The authors report their experience in the treatment of recurrent stricture of the appendiceal stump in continent diversion (Indiana pouch) after cystectomy by means of the Memotherm ureteral stent. The patient presented was treated successfully with this device after failure of repeat cold-knife incisions of the stricture. At 9-months' follow-up from positioning, the stent is in place, covered by mucosa. Self-catheterization of the pouch is easily performed five or six times a day with a 12F catheter.

Aged↗

PubMed1996

[Conservative treatment of high-risk (T1G3) transitional carcinoma].

OBJECTIVE: This study evaluates the outcome of patients (pts) with primary T1G3 bladder cancer treated by transurethral resection (TUR) alone or followed by intravesical prophylaxis (BCG/Doxorubicin). Cistectomy was considered at disease progression. METHODS: Between 1/89 and 5/95 thirty-one pts with primary T1G3 bladder cancer were treated by TUR, in 24 followed by intravesical prophylaxis (13 with BCG, 11 with Doxorubicin). 7 pts had only TUR. RESULTS: At 42 months median follow up 45.2% pts (14/31) are disease free. The recurrence rate was 25.8% (8/31) and progression of disease was seen in 29.0% (9/31); mortality rate was 22.6% (7/31). In 13/31 pts treated by TUR + BCG 53.8% pts (7/13) are disease free. The recurrance rate was 23.1% (3/13) and progression of disease was seen in 23.1% (3/13) of cases; mortality rate was 23.1% (3/13). In 11/31 pts treated by TUR+Doxorubicin 54.5% pts (6/11) are disease free. The recurrance rate was 18.2% (2/11), progression of disease was seen in 27.3% (3/11) of cases of mortality rate of 9.1% (1/11). In 7/31 pts treated by TUR alone 14.3% pts (1/7) are disease free. The recurrance rate was 42.9% (3/7) and progression of disease was seen in 42.9% (3/7) of cases and mortality rate of 42.9% (3/7). Cistectomy was considered in 4 pts (3 for disease progression and 1 because of no disease free interval). The other pts with progression were not treated surgically because of their poor performance status. CONCLUSION: At a 42 months median follow up 77.4% pts (24/31) are alive (83.3% pts treated by TUR+intravesical prophylaxis). 64.5% pts (20/31) still have their bladder (66.6% pts treated by TUR+intravesical prophylaxis (16/24). We did not find a significative difference between prophylaxis with immunotherapy or chemotherapy. In conclusion we believe that the conservative management of high risk bladder transitional cell carcinoma T1G3 is feasible and allow us to plan cistectomy only in pts with progression or recurrance with no free interval without losing survival.

Administration, Intravesical↗

PubMed1996

[Stents in the treatment of stenosis of the entero-urethral junction in continent diversion: case reports].

Strictures of entero-urethral anastomosis in orthotopic neobladder and of the catheterizable conduit in continent diversion after cystectomy are seldom encountered; they are usually treated with dilation, TUR or cold incision. 3 cases that came to our observation are presented. The first was treated with TUR after neo-bladder neck stricture in orthotopic neobladder; total incontinence occurred after this procedure. The patient at present is waiting for AS800 artificial sphincter implant. The second patient had similar features. After repeat TUR a prostacoil removable stent was placed through the stricture and removed after 5 months. At 12 months from removal the patient is continent and doesn't present clinical evidence of restriction. The third patient underwent cystectomy with Indiana continent pouch. After 4 months increasing problems in self catheterization occurred due to stricture of the catheterization conduit (appendix). He was treated twice with cold incision with early recurrence of the stricture. A permanent Memotherm stent (indicated for urethral strictures) was placed inside the appendix. After one month self catheterization was started again. At a 2 months follow up there is no evidence of stricture. In our experience, even if anecdotal, we have verified that treatment of this kind of strictures with TUR can cause incontinence or expose to further recurrences. 2 of the cases presented were treated with different kind of stents; the outcome is good even if the follow up is still short. We believe that this kind of treatment can be considered in selected cases.

Aged↗

PubMed1996

[Role and current significance of EDVG (epididymography plus vasography) in obstructive azoospermia].

The Authors present their 20 years experience about 612 EDVG (epididymography plus vasography). We will here discuss indications, complications and future prospects of EDVG and refer data arising from 55 andrology units: we can appreciate as this methodic is up to date in selected cases, i.e. obstructive azoospermia associated with normal FSH levels and lower or absent fructose, in presence of clearly pathological TRUS.EDVG is also indicated when on obstructive pathology is suspected to be the cause of an oligospermia or before vaso-vasostomy.

Diagnosis, Differential↗

PubMed1995

[Prostatic prosthesis in the treatment of prostatic hypertrophy: our experience].

Prostatic stenting is a therapeutic option in the management of obstruction in patients unfit for surgical treatment. At present different devices are available, permanent or temporary, the former being covered by epithelium. The Authors report their experience on 40 patients, 27 of which treated with Fabian spiral. They conclude considering that permanent stenting is likely to be a better solution; temporary spirals, however, give good results and can be the first choice in some situations.

Evaluation Studies as Topic↗

PubMed1995

[Impotence: non-hormonal drug therapy. Old and new drugs].

The treatment for male impotence has undergone a radical change during these last years. This change is due mainly to the use of vasoactive drugs and more and more sophisticated prosthesis. The Authors discuss old and new drugs used, considering that often pharmacotherapy for impotence doesn't require the giving of a drug, but its suspension. The Authors mention, among the most active drugs, trazodone, yohimbine, pentoxifylline and L-arginine hydrochloride. However these pharmacological agents found only application to well defined and unfortunately limited cases. To day the ideal therapeutic agent is still not available. There is a need for continued research in this field; the initial results, like the ones on the erective mechanisms NO-dependents, give hope for the future.

Erectile Dysfunction↗

PubMed1994

[Current role of echography, of PSA and of PSAD in the diagnosis of prostatic carcinoma].

The Authors report their experience in the diagnosis of prostatic carcinoma by means of DRE, TRUS and PSA. They emphasize the improvement of diagnosis given by these exams when used in association, despite a high rate of false positives. In the years 92-93, 182 patients underwent ecoguided prostatic biopsy after DRE and PSA evaluation. PSA density value was calculated as proposed by Benson (PSAD = PSA/V); this parameter should screen between PSA elevation due to BPH and those due to prostatic carcinoma. After their experience, even if limited, they conclude that TRUS should not be used as a "first-line test" but only in patients with abnormal findings in DRE and/or PSA. PSAD may be useful to improve specificity of PSA even if a precise cut-off can not be determined.

Aged↗

PubMed1993

[Induction of puberty and maintenance of secondary sexual characteristics in males with thalassemia major].

18 males with beta-thalassaemia major were studied; mean age was 17.6 flAF 4.3, 8 of 18 males evaluated were prepubertal (Tanner 1), 5 were early and mid pubertal (Tanner 2-3) and 5 were full pubertal (Tanner 5). All patients (pts) underwent GnRH test and 61% showed positive response. 8 pts. were treated with hCG; 2 were azoospermic, 6 were aspermic. The starting dose was 1000 IU twice weekly; dose adjustments were made basing on testosterone levels and clinical features. Clinical examination, testosterone assays, semen analysis were performed every 3 months during the treatment period. Therapy was started 18-48 months ago and it is still in progress. Within 12 months of treatment 4 pts progressed to Tanner stage 4, 3 pts to Tanner stage 5, 1 showed no response. Semen analysis showed an improvement in 6 pts: after 12 months of therapy 1 pts was aspermic, 5 were azoospermic, 1 was oligozoospermic. Our data showed that hCG administration is effective in inducing and maintaining secondary sexual character.

Adolescent↗

PubMed1993

[Spontaneous pregnancy in "sterile couples"].

The aim of the study is to evaluate the results of tests performed in "infertile" couples that have obtained spontaneous pregnancy. 953 couples were studied from 1986 to 1991; 108 spontaneous pregnancies occurred (11.1%). All patients were evaluated according to standard procedures recommended by literature. "Female factor" as cause of infertility was present in 41.5%; "cervical factor" was present in 19.4%; "male factor" was present in 48.1% while in 14.8% of the couples evaluated no pathology was showed. In this series, spontaneous pregnancy occurred within 4 year of infertility in more than 90%; no significant difference was present between primary and secondary infertility. A considerable incidence of pathologies was observed in couples that obtained spontaneous pregnancy. Our data suggest that common investigation for infertility may have not a real prognostic value.

Adult↗

PubMed1992

HER-2/neu oncogene expression and DNA ploidy in normal human kidney and renal cell carcinoma.

Using flow cytometry (FCM), we have investigated both the DNA content (stained with propidium iodide) and HER-2/neu oncogene expression (revealed by means of an anti-HER-2/neu monoclonal antibody) in neoplastic and non-neoplastic kidney samples from 20 patients with renal cell carcinoma. All the non-neoplastic samples and 15/20 (75%) renal cell cancers showed diploid modal DNA content while the remaining 5 neoplastic sample (25%) showed both diploid and hyperdiploid cell populations. In normal kidney the level of HER-2/neu oncoprotein was low (median fluorescence values in arbitrary units = 7.5 AU, range: 4-10 AU). In diploid renal cancers the level of HER-2/neu was slightly increased (median fluorescence values = 20 AU, range: 9.5-30 AU) (p < .005). The relationship of HER-2/neu expression to the cell cycle in these tumor samples is not clear since most of the cells express the antigen in all phases of the cell cycle. On the other hand, there is an association between HER-2/neu expression and abnormal DNA content suggesting that aneuploid pattern may be biologically related to overexpression of the HER-2/neu gene.

Aneuploidy↗

PubMed1988

The neuropathic bladder in children with spinal cord injury.

The occurrence of spinal cord lesions in children has been reported to be rare. In the literature, there is little information about the management of the neurovesical dysfunction. We report our experience in the treatment of the neuropathic bladder in 18 children with spinal cord injury. The long-term follow-up shows that there is a good recovery and the complication rate is low.

Catheterization↗

PubMed1980

Urodynamic response of unstable bladder to flavoxate.

Bladder instability provokes frequency, urgency, urge incontinence and enuresis in a great percentage of patients of both sexes, who undergo urodynamic examination when other clinical elements are not in evidence. The presence of bladder contractions of variable entity, even capable of inducing emptying, during filling are accompanied by a strong desire to micturate. Our study includes daily recordings of rhythm and quantity of micturitions and leaks, evaluation of urethral pressure, transurethral cystometry and uroflowmetry. The urethral pressure profile was performed with the technique of Brown and Wickham by infusing at 2 ml/min with 10-Ch catheter, withdrawn at a speed of 15 cm/min. Transurethral cystometry was performed by a continuous infusion at moderate speed (50 ml/min) of an isotonic solution at room temperature in a recumbent patient with two catheters in the bladder. When the contractions of the detrusor appear, we evaluate the pharmacological response to the filling with a myolitic agent (flavoxate) first, and with synthetic anticholinergic (emepronium bromide) after, with the purpose of discriminating the myogenic or neurogenic nature of the alteration and to propose suitable therapy.

Adult↗