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Book ; Audio / Video: Complete periprostatic anatomy preservation during robot assisted laparoscopic radical prostatectomy (RALP)

Asimakopoulos, Anastasios D.

the new pubovesical complex-sparing technique

(European urology ; 58,3, DVD iss. : Surgery in motion)

2010

Title variant	Complete periprostatic anatomy preservation during robot-assisted laparoscopic radical prostatectomy (RALP)
Author's details	A. D. Asimakopoulos
Series title	European urology ; 58,3, DVD iss. : Surgery in motion
Collection
Language	English
Size	1 DVD, 12 cm
Publishing place	S.l.
Publishing country	Great Britain
Document type	Book ; Audio / Video
HBZ-ID	HT016584977
ISBN	978-9-0797-5440-3 ; 9-0797-5440-4
Database	Catalogue ZB MED Medicine, Health

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Article: Phimosis in Adults: Narrative Review of the New Available Devices and the Standard Treatments.

Rosato, Eleonora / Miano, Roberto / Germani, Stefano / Asimakopoulos, Anastasios D

Clinics and practice

2024 Volume 14, Issue 1, Page(s) 361–376

Abstract: Background: Phimosis is the inability to completely retract the foreskin and expose the glans. The treatment of phimosis varies depending on the age of the patient and the severity of the disease; a great number of conservative or surgical treatments ... ...

Abstract	Background: Phimosis is the inability to completely retract the foreskin and expose the glans. The treatment of phimosis varies depending on the age of the patient and the severity of the disease; a great number of conservative or surgical treatments are currently available. Aim: To provide the first review summarizing the available options for the treatment of adult phimosis. Methods: A PubMed, Cochrane and Embase search for peer-reviewed studies, published between January 2001 and December 2022 was performed using the search terms "phimosis AND treatment". Results: A total of 288 publications were initially identified through database searching. Thirty manuscripts were ultimately eligible for inclusion in this review. Conservative treatment is an option. and it includes topical steroid application and the new medical silicon tubes (Phimostop™) application for gentle prepuce dilation. Concerning the surgical approach, the gold-standard treatment is represented by circumcision in which tissue synthesis after prepuce removal can be also obtained with barbed sutures, fibrin glues or staples. Laser circumcision seems to be providing superior outcomes in terms of operative time and postoperative complication rate when compared to the traditional one. Several techniques of preputioplasty and use of in situ devices (which crush the foreskin and simultaneously create haemostasis) have been also described. These in situ devices seem feasible, safe and effective in treating phimosis while they also reduce the operative time when compared to traditional circumcision. Patient satisfaction rates, complications and impact on sexual function of the main surgical treatments are presented. Conclusion: Many conservative and surgical treatments are available for the treatment of adult phimosis. The choice of the right treatment depends on the grade of phimosis, results, complications, and cost-effectiveness.
Language	English
Publishing date	2024-02-18
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2605724-4
ISSN	2039-7283 ; 2039-7275
ISSN (online)	2039-7283
ISSN	2039-7275
DOI	10.3390/clinpract14010028
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Article: Urodynamic Parameters and Continence Outcomes in Asymptomatic Patients with Ileal Orthotopic Neobladder: A Systematic Review and Metanalysis.

Asimakopoulos, Anastasios D / Finazzi Agrò, Enrico / Piechaud, Thierry / Gakis, Georgios / Gaston, Richard / Rosato, Eleonora

Cancers

2024 Volume 16, Issue 7

Abstract: Introduction: The orthotopic neobladder is the type of urinary diversion (UD) that most closely resembles the original bladder. However, in the literature the urodynamic aspects are scarcely analysed.: Objective: To provide the first systematic ... ...

Abstract	Introduction: The orthotopic neobladder is the type of urinary diversion (UD) that most closely resembles the original bladder. However, in the literature the urodynamic aspects are scarcely analysed. Objective: To provide the first systematic review (SR) on the urodynamic (UDS) outcomes of the ileal orthotopic neobladders (ONB). Continence outcomes are also presented. Methods: A PubMed, Embase and Cochrane CENTRAL search for peer-reviewed studies on ONB published between January 2001-December 2022 was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Results and conclusion: Fifty-nine manuscripts were eligible for inclusion in this SR. A great heterogeneity of data was encountered. Concerning UDS parameters, the pooled mean was 406.2 mL (95% CI: 378.9-433.4 mL) for maximal (entero)cystometric capacity (MCC) and 21.4 cmH
Language	English
Publishing date	2024-03-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16071253
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Article ; Online: Traumatic testicular dislocation in the abdomen: diagnosis and management.

Colalillo, Gaia / Pletto, Simone / Laudazi, Mario / Asimakopoulos, Anastasios D

BMJ case reports

2023 Volume 16, Issue 9

Abstract: Testicular dislocation in the abdomen after scrotal trauma is a rare and sometimes unrecognised event.Early detection and timely management reduce possible complications which include the risk of fertility loss, endocrine dysfunction, and future ... ...

Abstract	Testicular dislocation in the abdomen after scrotal trauma is a rare and sometimes unrecognised event.Early detection and timely management reduce possible complications which include the risk of fertility loss, endocrine dysfunction, and future malignancy.We present the case of a man who suffered a traumatic dislocation of the right testis in the abdomen after a motorcycle crash. The large scrotal haematoma did not permit adequate physical examination. Furthermore, during the clinical management of the polytrauma, the main focus was on active arterial bleeding, multiple pelvic fractures and clinical investigation of the integrity of the lower urinary tract. Therefore, the diagnosis and surgical management of the testicular dislocation were delayed.The patient underwent abdominal-inguinal surgical exploration, haematoma evacuation, identification of the right testis and right orchidopexy.After 6 months, the right testis of the patient is of regular volume, consistency and physiologic echogenicity on ultrasound evaluation.Hormonal evaluation and semen analysis were normal after 3 months.
MeSH term(s)	Male ; Humans ; Testis/diagnostic imaging ; Testis/surgery ; Testis/injuries ; Scrotum/diagnostic imaging ; Scrotum/surgery ; Orchiopexy ; Abdominal Cavity ; Groin ; Joint Dislocations/surgery
Language	English
Publishing date	2023-09-26
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2022-254530
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Article ; Online: Role of inguinal and pelvic lymph node dissection for primary urethral carcinoma: a systematic review.

Kochergin, Maxim / Fahmy, Omar / Asimakopoulos, Anastasios D / Gakis, Georgios

Current opinion in urology

2023 Volume 33, Issue 4, Page(s) 288–293

Abstract: Purpose of review: Primary urethral carcinoma (PUC) is a rare urologic tumor. There is limited evidence on this entity. This review summarizes the existing evidence on lymph node dissection (LND) in patients with PUC.: Recent findings: We performed a ...

Abstract	Purpose of review: Primary urethral carcinoma (PUC) is a rare urologic tumor. There is limited evidence on this entity. This review summarizes the existing evidence on lymph node dissection (LND) in patients with PUC. Recent findings: We performed a systematic search of the PubMed, EMBASE, and Web of Science databases to evaluate the impact of inguinal and pelvic LND on the oncological outcomes of PUC and to identify indications for this procedure. Results: Three studies met the inclusion criteria. The cancer detection rate in clinically nonpalpable inguinal lymph node (cN0) was 9% in men and 25% in women. In clinically palpable lymph node (cN+), the malignancy rate was 84% and 50% in men and women, respectively. Overall cancer detection rate in pelvic lymph nodes in patients with cN0 was 29%. Based on tumor stage, the detection rate was 11% in cT1-2 N0 and 37% in cT3-4 N0. Nodal disease was associated with higher recurrence and worse survival. Pelvic LND seems to improve overall survival for patients with LND regardless of the location or stage of lymph nodes. Inguinal LND improved overall survival only in patients with palpable lymph nodes. Inguinal LND had no survival benefit in patients with nonpalpable lymph nodes. Summary: The available, albeit scarce, data suggest that inguinal LND derives the highest benefit in women and in patients with palpable inguinal nodes, whereas the benefit of pelvic LND seems to be more pronounced across all stages of invasive PUC. Prospective studies are urgently needed to further address the prognostic benefit of locoregional LND in PUC.
MeSH term(s)	Male ; Humans ; Female ; Prospective Studies ; Lymph Node Excision/methods ; Lymph Nodes/surgery ; Lymph Nodes/pathology ; Urologic Neoplasms/pathology ; Carcinoma/pathology ; Neoplasm Staging ; Retrospective Studies
Language	English
Publishing date	2023-05-09
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	1091792-5
ISSN	1473-6586 ; 0963-0643
ISSN (online)	1473-6586
ISSN	0963-0643
DOI	10.1097/MOU.0000000000001101
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Article ; Online: Practice change: No benefit of extended lymphadenectomy at radical cystectomy in patients with muscle invasive bladder cancer.

Fahmy, Omar / Kochergin, Maxim / Asimakopoulos, Anastasios D / Gakis, Georgios

Seminars in oncology

2023 Volume 50, Issue 3-5, Page(s) 102–104

Abstract: For many decades, extended pelvic lymph node dissection has been an integral part during radical cystectomy for patients with muscle invasive bladder cancer. This practice was based on large retrospective meta-analyses suggesting an oncologic benefit to ... ...

Abstract	For many decades, extended pelvic lymph node dissection has been an integral part during radical cystectomy for patients with muscle invasive bladder cancer. This practice was based on large retrospective meta-analyses suggesting an oncologic benefit to an extended dissection. This mini review and meta-analysis includes the two available randomized trials in the current literature. Therefore, it can be considered as the strongest level of evidence regarding the prognostic benefit of an extended pelvic lymphadenectomy. Based on current randomized data, standard pelvic lymph node dissection up to the level of iliac bifurcation is sufficient, and extension of the dissection above this level does not provide any additional oncologic benefit.
Language	English
Publishing date	2023-09-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	189220-4
ISSN	1532-8708 ; 0093-7754
ISSN (online)	1532-8708
ISSN	0093-7754
DOI	10.1053/j.seminoncol.2023.09.001
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Article ; Online: Fournier's gangrene with prostatic and bladder trigone colliquation: a suggested treatment algorithm.

Asimakopoulos, Anastasios D / Colalillo, Gaia / Miano, Roberto / Germani, Stefano

BMJ case reports

2022 Volume 15, Issue 9

Abstract: Fournier's gangrene (FG) is an infectious necrotising fasciitis of the perineum and genital regions with a high mortality rate. We report the case of a man in his 70s with FG who presented with bladder trigone and prostate colliquation. Bulbar and penile ...

Abstract	Fournier's gangrene (FG) is an infectious necrotising fasciitis of the perineum and genital regions with a high mortality rate. We report the case of a man in his 70s with FG who presented with bladder trigone and prostate colliquation. Bulbar and penile urethra were also injured with multiple fenestrations. Bilateral percutaneous nephrostomy positioning followed by the placement of occluding ureteral catheters preceded the surgical debridement of the necrotic tissues and protective colostomy. There followed periodic sessions of surgical debridement and VAC therapy. The persistent perineal urinary leak required the crafting of a suprapubic surgical cystostomy with bladder neck obliteration through double-layer raphy. The cystostomy maintained the healing tissues free from the constant and damaging urine action. This report describes the successful multistep approach of an FG with deep involvement and colliquation of the bladder neck and prostate reaching the Denonvilliers fascia that ensured the correct healing of tissues.
MeSH term(s)	Algorithms ; Debridement ; Fournier Gangrene/surgery ; Humans ; Male ; Necrosis ; Perineum ; Prostate ; Urinary Bladder/surgery
Language	English
Publishing date	2022-09-26
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2022-251448
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Article ; Online: Antegrade left ureterolithotripsy in a patient with previous psoas-hitch ureteral reimplantation.

Colalillo, Gaia / Annino, Filippo / Khorrami, Saba / Asimakopoulos, Anastasios D

BMJ case reports

2022 Volume 15, Issue 10

Abstract: A standard surgical treatment of distal ureteric defects is represented by the ureteroneocystostomy-ureteric reimplantation. However, the procedure involves an anatomical alteration of the ureterovesical (neo)junction that often hinders the retrograde ... ...

Abstract	A standard surgical treatment of distal ureteric defects is represented by the ureteroneocystostomy-ureteric reimplantation. However, the procedure involves an anatomical alteration of the ureterovesical (neo)junction that often hinders the retrograde catheterisation of the reimplanted ureter.We describe a case of antegrade ureterolithotripsy (AULT) in a psoas-hitch reimplanted ureter. A woman with severe left hydronephrosis supported by a subcentimetric proximal ureteral stone in a psoas-hitch reimplanted ureter was referred to our unit. Retrograde ureteroscopy was unsuccessful due to impossibility in incannulating the ureteral neo-orifice. Following the placement of a percutaneous nephrostomy, percutaneous AULT through ureteral sheath was successfully performed with complete treatment of the stone.AULT may represent a viable alternative in the management of ureteral stones when the upper urinary tract is not amenable to retrograde ureteroscopy. In experienced hands, the procedure is straightforward and may avoid the adoption of transabdominal approaches.
MeSH term(s)	Female ; Humans ; Ureter/surgery ; Replantation ; Ureteral Calculi/surgery ; Ureteroscopy ; Hydronephrosis
Language	English
Publishing date	2022-10-31
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2022-250635
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Article ; Online: Not Only Length Matters! Impact of the Ileal Width on the Capacity of the Orthotopic Neobladder: The AADAPT Formula Tested on the Animal Model.

Annino, Filippo / Piechaud, Thierry / Ghattas, Robert / Gaston, Richard / Asimakopoulos, Anastasios D

European urology open science

2023 Volume 58, Page(s) 55–63

Abstract: Background: The capacity of a given shape of an orthotopic ileal neobladder (ONB) varies significantly, although the same length of preterminal ileum is utilised.: Objective: To investigate the variability of the human ileal width and to create a ... ...

Abstract	Background: The capacity of a given shape of an orthotopic ileal neobladder (ONB) varies significantly, although the same length of preterminal ileum is utilised. Objective: To investigate the variability of the human ileal width and to create a mathematical formula that calculates its impact on the neobladder capacity. Design setting and participants: During 50 consecutive cases of robotic pelvic surgery, a segment of preterminal ileum was identified and the width was measured. A mathematical formula was created to calculate, for a given ileal length and width, the neobladder capacity and, for a given ileal width and neobladder capacity, the length of the (pre)terminal ileum to harvest. The accuracy of our model was tested on 28 pouches created by swine ileum. Outcome measurements and statistical analysis: The interindividual variability of the ileal width and its impact on the ileal neobladder capacity was investigated. Results and limitations: The mean hemicircumference of the human distal ileum is 2.43 ± 0.39 cm (range 2-3.5 cm). According to our geometric model and as confirmed in the swine model, an increase of 1 cm in ileal width increases the neobladder capacity by 85%. The Pearson correlation coefficient reported a strong positive relationship between the formula-calculated and effective volumes of the pouch ( Conclusions: The ileal width impacts the capacity of the ONB. For a given type of ONB, no standard length of ileum should be harvested; instead, the length should be tailored to the width of the ileum for a given patient. Clinical studies are required to confirm our model. Patient summary: We demonstrated the variability of the ileal width among humans, and we provided a mathematical formula tested on swine that evaluates the impact of the ileal width on the capacity of the orthotopic ileal neobladder.
Language	English
Publishing date	2023-11-08
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	3040546-4
ISSN	2666-1683 ; 2058-4881
ISSN (online)	2666-1683
ISSN	2058-4881
DOI	10.1016/j.euros.2023.10.003
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Article ; Online: Free-hand, transrectal ultrasound-guided hydrodissection of the retroprostatic space during robot-assisted radical prostatectomy: Impact on the learning curve.

Asimakopoulos, Anastasios D / Annino, Filippo / Pastore, Antonio L / Carbone, Antonio / Fuschi, Andrea

Urologic oncology

2022 Volume 40, Issue 9, Page(s) 408.e1–408.e8

Abstract: Background: Aim of the current study is to describe our technique of hydrodissection (HD) of the retroprostatic space (RPS) performed between the Denonvillier's fascia (DF) and prostatic capsule (PC) and to evaluate its impact on the outcomes of nerve- ... ...

Abstract	Background: Aim of the current study is to describe our technique of hydrodissection (HD) of the retroprostatic space (RPS) performed between the Denonvillier's fascia (DF) and prostatic capsule (PC) and to evaluate its impact on the outcomes of nerve-sparing robot-assisted radical prostatectomy (nsRALP) during the learning-curve period. Methods: This randomized study enrolled 25 consecutive male patients with indication of nsRALP. The HD and the subsequent dissection of the seminal vesicles (SVs) and RPS was performed by a resident in learning curve for RALP; the residual portion of RALP was performed by an expert. The perioperative, oncologic and functional outcomes of 2 groups of patients (Group A: nsRALP after HD of the RPS and Group B: standard nsRALP without HD) were compared. Two analyses were performed, considering a per-protocol (PP) population regarding only randomized patients with correct HD and an Intention-To-Treat (ITT) population regarding all randomized patients. Results: In 4/14 (29%) of patients of Group A the injected fluid was not intraoperatively identified in the expected plane. The groups were statistically homogeneous in relation to the baseline variables. A statistically significant difference was observed between the SVs/RPS dissection time and the SVs-related estimated blood loss in both analyses. A significantly higher rate of dry patients was observed in group A at 1 month after nsRALP. A statistically significant correlation was observed between the effective time of dissection of the SVs and the postoperative IIEF-5 drop. Conclusions: The transrectal ultrasound-guided transperineal HD seems useful for the preliminary development of the RPS during the learning curve period of nsRALP. It seems associated with less time and blood loss for the dissection of the SVs and RPS. Studies on larger cohorts are needed to draw more robust conclusions.
MeSH term(s)	Humans ; Laparoscopy ; Learning Curve ; Male ; Prostatectomy ; Prostatic Neoplasms ; Robotic Surgical Procedures ; Robotics ; Seminal Vesicles ; Treatment Outcome ; Ultrasonography, Interventional
Language	English
Publishing date	2022-07-16
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1336505-8
ISSN	1873-2496 ; 1078-1439
ISSN (online)	1873-2496
ISSN	1078-1439
DOI	10.1016/j.urolonc.2022.06.012
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