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Article: Pharmacological Management of Urinary Incontinence: Current and Emerging Treatment.

Gandi, Carlo / Sacco, Emilio

Clinical pharmacology : advances and applications

2021 Volume 13, Page(s) 209–223

Abstract: Pharmacological management of urinary incontinence (UI) is currently based on antimuscarinic and beta-3-agonist drugs. Botulinum toxin A detrusor injections represent an effective but more invasive alternative. This review covers the latest developments ... ...

Abstract	Pharmacological management of urinary incontinence (UI) is currently based on antimuscarinic and beta-3-agonist drugs. Botulinum toxin A detrusor injections represent an effective but more invasive alternative. This review covers the latest developments of the currently available drugs and the emerging compounds for the treatment of UI. Evidence shows that new antimuscarinics and beta-3-agonists with improved safety profiles may offer unique options to patients intolerant to currently available drugs. Combination therapy proved to be a non-invasive alternative for patients refractory to first-line monotherapy. Exciting advances are ongoing in the research to improve the efficacy/tolerability profile of botulinum toxin, through innovative routes of administration. Several new agents emerged from preclinical studies, some of which have now entered the clinical phase of development and could represent, in the coming years, a new way for the treatment of UI. Recent evidence on the existence of different overactive bladder phenotypes could be the key to tailored treatment. Rather than discovering new molecules, reaching the ability to identify the right drug for the right patient could be the real gamechanger of the future.
Language	English
Publishing date	2021-11-25
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2520726-X
ISSN	1179-1438
ISSN	1179-1438
DOI	10.2147/CPAA.S289323
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Article ; Online: Lifestyle in urology: Benign diseases.

Bientinesi, Riccardo / Gandi, Carlo / Vaccarella, Luigi / Sacco, Emilio

Urologia

2021 Volume 88, Issue 3, Page(s) 163–174

Abstract: Modifiable lifestyle-related risk factors are the object of increasing attention, with a view to primary and tertiary prevention, to limit the onset and development of diseases.Also in the urological field there is accumulating evidence of the ... ...

Abstract	Modifiable lifestyle-related risk factors are the object of increasing attention, with a view to primary and tertiary prevention, to limit the onset and development of diseases.Also in the urological field there is accumulating evidence of the relationship between urological diseases and lifestyle-related risk factors that can influence their incidence and prognosis. Risk factors such as nutrition, physical activity, sexual habits, tobacco smoking, or alcohol consumption can be modified to limit morbidity and reduce the social impact and the burdensome costs associated with diagnosis and treatment.This review synthesizes the current clinical evidence available on this topic, trying to satisfy the need for a summary on the relationships between the most important lifestyle factors and the main benign urological diseases, focusing on benign prostatic hyperplasia (BPH), infections urinary tract (UTI), urinary incontinence (UI), stones, erectile dysfunction, and male infertility.
MeSH term(s)	Erectile Dysfunction/epidemiology ; Erectile Dysfunction/etiology ; Humans ; Life Style ; Lower Urinary Tract Symptoms/epidemiology ; Lower Urinary Tract Symptoms/etiology ; Male ; Prostatic Hyperplasia/epidemiology ; Prostatic Hyperplasia/therapy ; Urinary Incontinence ; Urology
Language	English
Publishing date	2021-02-12
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	204043-8
ISSN	1724-6075 ; 0376-0057 ; 0391-5603
ISSN (online)	1724-6075
ISSN	0376-0057 ; 0391-5603
DOI	10.1177/0391560321994386
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Article ; Online: Comments on a case of ureteropelvic junction obstruction with late progression in an adult female.

Gandi, Carlo / Totaro, Angelo / Bientinesi, Riccardo / Sacco, Emilio

Urologia

2021 Volume 88, Issue 3, Page(s) 247–250

Abstract: Introduction: Ureteropelvic junction obstruction is a pathology typically diagnosed in childhood. Nevertheless, some clinically silent cases may be unnoticed until adulthood.: Case description: We report the case of a 53-year-old female with ... ...

Abstract	Introduction: Ureteropelvic junction obstruction is a pathology typically diagnosed in childhood. Nevertheless, some clinically silent cases may be unnoticed until adulthood. Case description: We report the case of a 53-year-old female with hydronephrosis due to ureteropelvic junction stenosis diagnosed in the adulthood, who subsequently developed obstruction with progressive worsening of renal function without symptoms. Conclusion: The natural history of ureteropelvic junction obstruction is still obscure. Diuretic renogram is the gold standard for diagnosis and follow-up of ureteropelvic junction obstruction, but is weak in predicting the evolution of the disease, especially in patients with vague symptoms. Conservative treatment of adult patient with equivocal ureteropelvic junction obstruction seems reasonable, but requires a close clinical follow-up and strict patient compliance in order to promptly identify significant obstruction.
MeSH term(s)	Adult ; Conservative Treatment ; Diuretics ; Female ; Humans ; Hydronephrosis/etiology ; Kidney Pelvis/diagnostic imaging ; Middle Aged ; Ureteral Obstruction/etiology
Chemical Substances	Diuretics
Language	English
Publishing date	2021-08-13
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	204043-8
ISSN	1724-6075 ; 0376-0057 ; 0391-5603
ISSN (online)	1724-6075
ISSN	0376-0057 ; 0391-5603
DOI	10.1177/0391560320945833
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Article ; Online: Efficacy of transurethral botulinum toxin A injections for bladder outlet obstruction: A systematic review and meta-analysis.

Gavi, Filippo / Ragonese, Mauro / Fettucciari, Daniele / Bientinesi, Riccardo / Gandi, Carlo / Campetella, Marco / Marino, Filippo / Racioppi, Marco / Sacco, Emilio / Foschi, Nazario

Urologia

2024 , Page(s) 3915603241228166

Abstract: Introduction: Botulinum toxin A (BoNT-A) injections in the prostate gland have been used as a minimally invasive option for treating bladder outlet obstruction (BOO). However, the efficacy of transurethral BoNT-A injections for BOO is not well ... ...

Abstract	Introduction: Botulinum toxin A (BoNT-A) injections in the prostate gland have been used as a minimally invasive option for treating bladder outlet obstruction (BOO). However, the efficacy of transurethral BoNT-A injections for BOO is not well established in the literature. The aim of this study is to collect evidence on the efficacy of transurethral BoNT-A injections for the treatment of BOO. Materials and methods: This systematic review and meta-analyses was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. A systematic literature search was performed till December 2022. The study population consisted of adult patients diagnosed with BOO, who underwent transurethral injections of BoNT-A for the treatment of BOO. Evidence synthesis: Out of 883 records, we identified seven studies enrolling 232 participants, of which only one nonrandomized controlled trial was found. Four prospective studies and two retrospective studies. Three studies included patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) and were included in the meta-analysis. Three studies included patients with urethral sphincter hyperactivity. One study included patients with primary bladder neck disease (PBND). All studies showed significant improvements from baseline in maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and postvoid residual (PVR) at 3 and 6 months. The adverse events were mild in all studies. Hematuria, UTI, and urinary retention were reported across all studies. Conclusion: In conclusion, transurethral BoNT-A injections have been shown to improve LUTS, QoL, and urodynamic parameters of individuals with BOO at 3 and 6 months after injections, and no serious adverse effects have been reported. However, data on the long-term benefits of this treatment are scarce, and more prospective, randomized studies with larger samples examining various injection techniques, dosages, and extended follow-up of recurrent injections are needed.
Language	English
Publishing date	2024-02-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	204043-8
ISSN	1724-6075 ; 0376-0057 ; 0391-5603
ISSN (online)	1724-6075
ISSN	0376-0057 ; 0391-5603
DOI	10.1177/03915603241228166
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Article: Managing Urological Disorders in Multiple Sclerosis Patients: A Review of Available and Emerging Therapies.

Bientinesi, Riccardo / Gandi, Carlo / Bassi, PierFrancesco

International neurourology journal

2020 Volume 24, Issue 2, Page(s) 118–126

Abstract: Multiple sclerosis (MS) is a progressive neurological autoimmune disease with a diverse range of urological symptomatology, and most MS patients experience 1 or more moderate to severe urinary symptoms, as well as bladder and/or sexual disorders. ... ...

Abstract	Multiple sclerosis (MS) is a progressive neurological autoimmune disease with a diverse range of urological symptomatology, and most MS patients experience 1 or more moderate to severe urinary symptoms, as well as bladder and/or sexual disorders. Urologists play the director's role in evaluating and treating these patients. Therefore, identifying the proper evaluation tools and the most suitable therapeutic options for specific patients requires a thorough understanding of this disease process.
Language	English
Publishing date	2020-06-30
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2584447-7
ISSN	2093-6931 ; 2093-4777
ISSN (online)	2093-6931
ISSN	2093-4777
DOI	10.5213/inj.2040028.014
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Article: Transalbugineal Artificial Urinary Sphincter: A Refined Implantation Technique to Improve Surgical Outcomes.

Sacco, Emilio / Marino, Filippo / Gandi, Carlo / Bientinesi, Riccardo / Totaro, Angelo / Moretto, Stefano / Gavi, Filippo / Campetella, Marco / Racioppi, Marco

Journal of clinical medicine

2023 Volume 12, Issue 8

Abstract: The artificial urinary sphincter (AUS) implantation is an effective treatment of post-prostatectomy urinary incontinence (PPI). Still, it may result in troublesome complications such as intraoperative urethral lesion and postoperative erosion. Based on ... ...

Abstract	The artificial urinary sphincter (AUS) implantation is an effective treatment of post-prostatectomy urinary incontinence (PPI). Still, it may result in troublesome complications such as intraoperative urethral lesion and postoperative erosion. Based on the multilayered structure of the tunica albuginea of the corpora cavernosa, we evaluated an alternative transalbugineal surgical technique of AUS cuff placement with the aim to decrease perioperative morbidity while preserving the integrity of the corpora cavernosa. A retrospective study was conducted in a tertiary referral center from September 2012 to October 2021, including 47 consecutive patients undergoing AUS (AMS800
Language	English
Publishing date	2023-04-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12083021
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Article ; Online: Classification and management of sexual dysfunctions in multiple sclerosis patients: A review of current literature.

Campetella, Marco / Marino, Filippo / Gavi, Filippo / Gandi, Carlo / Ragonese, Mauro / Coluzzi, Simone / Racioppi, Marco / Sacco, Emilio / Bientinesi, Riccardo

Urologia

2023 Volume 90, Issue 4, Page(s) 605–610

Abstract: Multiple sclerosis (MS) is the most frequent neurological disease in young adults, with the greatest incidence between age of 30 and 35 years. Sexual dysfunctions (SDs) are frequent, but are often underestimated in patients with MS, and can have a ... ...

Abstract	Multiple sclerosis (MS) is the most frequent neurological disease in young adults, with the greatest incidence between age of 30 and 35 years. Sexual dysfunctions (SDs) are frequent, but are often underestimated in patients with MS, and can have a significantly high impact on patient's quality of life. Aim of this review is to summarize sexual dysfunctions in male and female MS patients and to illustrate current and emerging therapeutic options for treatment.
MeSH term(s)	Young Adult ; Humans ; Male ; Female ; Adult ; Quality of Life ; Multiple Sclerosis/complications ; Multiple Sclerosis/epidemiology ; Multiple Sclerosis/therapy ; Sexual Dysfunction, Physiological/etiology ; Sexual Dysfunction, Physiological/therapy ; Sexual Dysfunction, Physiological/epidemiology ; Incidence ; Surveys and Questionnaires
Language	English
Publishing date	2023-06-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	204043-8
ISSN	1724-6075 ; 0376-0057 ; 0391-5603
ISSN (online)	1724-6075
ISSN	0376-0057 ; 0391-5603
DOI	10.1177/03915603231183751
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Article ; Online: What can the metaverse do for urology?

Gandi, Carlo / Cosenza, Luigi / Campetella, Marco / Marino, Filippo / Ragonese, Mauro / Bientinesi, Riccardo / Totaro, Angelo / Racioppi, Marco / Sacco, Emilio

Urologia

2023 Volume 90, Issue 3, Page(s) 454–458

Abstract: Everyone talks about the metaverse but few know what it really is. Augmented reality, virtual reality, internet of things (IoT), 5G, blockchain: these are just some of the technologies underlying the structure of the metaverse, a sort of parallel ... ...

Abstract	Everyone talks about the metaverse but few know what it really is. Augmented reality, virtual reality, internet of things (IoT), 5G, blockchain: these are just some of the technologies underlying the structure of the metaverse, a sort of parallel dimension in which the physical and virtual worlds merge together enabling users to interact by emerging technologies in order to enhance their actions and decisions. The healthcare scientific community is already looking at the metaverse as a new research frontier, a tool to improve medical knowledge and patient care. We reviewed the metaverse applications and services, looking for those that could best be developed in the urological field. Urology, due to its technological nature, is a privileged laboratory for experimenting and exploiting the applications of the metaverse both inside and outside the operating room. The revolution of the metaverse is already happening, which is why it is necessary that urologists face it as protagonists in order to lead it in the right direction.
MeSH term(s)	Humans ; Urology/trends ; Augmented Reality ; Virtual Reality ; Internet of Things ; Blockchain
Language	English
Publishing date	2023-06-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	204043-8
ISSN	1724-6075 ; 0376-0057 ; 0391-5603
ISSN (online)	1724-6075
ISSN	0376-0057 ; 0391-5603
DOI	10.1177/03915603231175940
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Article ; Online: Elderly and bladder cancer: The role of radical cystectomy and orthotopic urinary diversion.

Bizzarri, Francesco Pio / Scarciglia, Eros / Russo, Pierluigi / Marino, Filippo / Presutti, Simona / Moosavi, Seyed Koosha / Ragonese, Mauro / Campetella, Marco / Gandi, Carlo / Totaro, Angelo / Palermo, Giuseppe / Sacco, Emilio / Racioppi, Marco

Urologia

2024 , Page(s) 3915603241240644

Abstract: The incidence of bladder cancer (BC) depends on advancing age and other risk factors, significantly impacting on surgical, functional and oncological outcomes. Radical cystectomy (RC) with urinary diversion is the gold standard therapy for muscle ... ...

Abstract	The incidence of bladder cancer (BC) depends on advancing age and other risk factors, significantly impacting on surgical, functional and oncological outcomes. Radical cystectomy (RC) with urinary diversion is the gold standard therapy for muscle invasive bladder cancer; however, it remains a complex surgery and requires careful analysis of risk factors in order to potentially decrease post-surgical complication rates. Age in surgery is a limiting factor that can modify surgical and oncological outcomes, and is correlated with a high rate of post-dimssion hospital readmissions. The reconstruction of the bladder with the intestine represents a crucial point of radical cystectomy and the urinary derivation (UD) is at the center of many debates. A non-continent UD seems to be the best choice in elderly patients (>75 years old), while orthotopic neobladder (ON) is poorly practiced. We reviewed the literature to identify studies reporting outcomes, complications, patient- selection criteria, and quality-of-life data on elderly patients, who underwent ON following radical cystectomy. Reviewing the literature there is no clear evidence on the use of age as an exclusion criterion. Certainly, the elderly patient with multiple comorbidities is not eligible for ON, preferring other UD or rescue therapies. A careful preoperative selection of elderly patients could greatly improve clinical, surgical and oncological outcomes, giving the chance to selected patients to receive an ON.
Language	English
Publishing date	2024-03-29
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	204043-8
ISSN	1724-6075 ; 0376-0057 ; 0391-5603
ISSN (online)	1724-6075
ISSN	0376-0057 ; 0391-5603
DOI	10.1177/03915603241240644
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Article ; Online: Risk factors for hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation in a letermovir-exposed CMV-free population receiving PTCy.

Galli, Eugenio / Metafuni, Elisabetta / Gandi, Carlo / Limongiello, Maria Assunta / Giammarco, Sabrina / Mattozzi, Andrea / Santangelo, Rosaria / Bacigalupo, Andrea / Sorà, Federica / Chiusolo, Patrizia / Sica, Simona

European journal of haematology

2024 Volume 112, Issue 4, Page(s) 577–584

Abstract: Hemorrhagic cystitis (HC) is a highly impacting complication in allogeneic hematopoietic stem cell transplantation (HSCT), occurring in 12%-37% of patients. The impact of transplant- and patient-specific variables has been described, with a possible role ...

Abstract	Hemorrhagic cystitis (HC) is a highly impacting complication in allogeneic hematopoietic stem cell transplantation (HSCT), occurring in 12%-37% of patients. The impact of transplant- and patient-specific variables has been described, with a possible role for JCV and BKV, which may be cooperating with cytomegalovirus (CMV). Here, we analyze 134 letermovir-exposed, CMV-free patients, treated with the same cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis, describing risk factors for HC. The overall incidence of HC was 23%. Patients with HLA mismatched transplant, higher comorbidity score, and receiving three alkylating agents with TBF (thiotepa, busulfan, and fludarabine) conditioning regimen had a higher risk of HC in multivariate analysis (OR: 4.48, 6.32, and 1.32, respectively). A HC-score including male gender, TBF conditioning, and HLA-mismatch stratifies the risk of HC in the first 100 days after HSCT. The role of BKV and JCV was not highly impacting in those patients, suggesting a possible synergistic effect between CMV and JCV in causing HC. HC can be interpreted as the combination of patient-related factors, chemotherapy-related toxicities-especially due to alkylating agents-and immunological elements.
MeSH term(s)	Humans ; Male ; Cystitis, Hemorrhagic ; Cytomegalovirus ; Cystitis/diagnosis ; Cystitis/epidemiology ; Cystitis/etiology ; Hematopoietic Stem Cell Transplantation/adverse effects ; Risk Factors ; Cytomegalovirus Infections/diagnosis ; Cytomegalovirus Infections/epidemiology ; Cytomegalovirus Infections/etiology ; Alkylating Agents ; Graft vs Host Disease/etiology ; Retrospective Studies ; Acetates ; Quinazolines
Chemical Substances	letermovir (1H09Y5WO1F) ; Alkylating Agents ; Acetates ; Quinazolines
Language	English
Publishing date	2024-01-06
Publishing country	England
Document type	Journal Article
ZDB-ID	392482-8
ISSN	1600-0609 ; 0902-4441
ISSN (online)	1600-0609
ISSN	0902-4441
DOI	10.1111/ejh.14147
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