Change in Postoperative Storage Symptoms and De Novo Urge Incontinence After Thulium:YAG Laser Enucleation of the Prostate: Results from a Prospective Multicenter Study.

Objectives: To assess the change of storage symptoms (SS) and their impact on quality of life in men undergoing thulium:YAG laser enucleation of the prostate (ThuLEP) for benign prostatic hyperplasia (BPH). Materials and Methods: BPH patients requiring surgery were prospectively evaluated (April 2019-October 2020). Inclusion criteria: International Prostate Symptom Score (IPSS) ≥8, maximum urinary flow rate ≤15 mL/s, and urinary retention. Exclusion criteria: previous urethral/prostatic surgery, pelvic irradiation, bladder/prostate cancer, neurogenic bladder, concomitant transurethral surgery, and active urinary tract infection. IPSS, International Continence Society-Overactive Bladder (ICIQ-OAB) and International Continence Society-Overactive Bladder Quality of Life (ICIQ-OABq) scores were gathered before surgery and 1, 3, 6, and 12 months after surgery. Results: In total, 117 men were included. Mean age was 68.0 ± 7.7 years. Mean prostate volume was 86.6 ± 34 cc. Mean IPSS subscore was 8.7 ± 3.1 and 11.7 ± 4.7 for storage and voiding symptoms, respectively. Mean ICIQ-OAB was 29.1 ± 16.8. Mean ICIQ-OABq was 80.3 ± 30.6. Voiding IPSS decreased 72.8% at 1 month, whereas the reduction of storage IPSS was 38.0%. ICIQ-OAB decreased 49.6% at 1 month. ICIQ-OABq showed a 30.0% reduction. One year after surgery, the reduction of voiding IPSS was 94.8%, ICIQ-OAB 85.5%, storage IPSS 76.7%, and ICIQ-OABq 60.5%. Urge incontinence was present in 26.5% of men at 1 month, 15.4% at 3 months, and 4.3% at 6 months. Four (3.4%) patients complained of urge incontinence 12 months after surgery. Conclusion: Both storage and voiding lower urinary tract symptoms significantly decreased after ThuLEP, but storage symptoms showed less reduction with a significant impact on patients' quality of life, particularly during the first 3 months.

Prepuce-sparing corporoplasty as a safe alternative for patients with acquired penile curvature.

OBJECTIVES: penile curvature is a rare condition, classified as congenital or acquired (Peyronie's disease) (PD). Surgical correction is the standard treatment. It's common practice to associate circumcision with penile de-gloving to prevent complications. In this paper we evaluate the feasibility of penile surgery avoiding circumcision. MATERIALS AND METHODS: patients presenting with penile curvature were treated using a modified Nesbit procedure. Patients were divided into group A if they opted for a prepuce-sparing surgery and the others into group B. Patients were evaluated pre and postoperatively and postoperative complications were assessed. The 5-item International Index of Erectile Function (IIEF-5) was administered before and 6 months after surgery and we compared the difference of mean value using T-Test. RESULTS: Group A and B were made of 53 and 16 patients respectively. Median age was 59 years [interquartile range (IQR) 12] in A and 62 (IQR 9) in B (p = 0.2). Median curvature was 40° (IQR 40°) in A and 40 ° (IQR 30°) in B (p = 0.62). Mean difference between pre- and post-operative IEFF was 1.9 ± 2 in A and 2.6 ± 2.1 in B (p = 0.36). CONCLUSIONS: According to our experience, surgical correction of penile curvature without performing circumcision could be a safe and feasible strategy. We recommend performing circumcision only in patients who present with pre-operative phimosis.

Urinary bladder xanthoma: Two case reports and a review of the literature.

OBJECTIVE: We present two rare cases ofbladder xanthomata associated with transitional cell carcinoma. METHOD AND RESULTS: Cases description and selectionof related pictures. Review of the existing literature. CONCLUSIONS: Xanthomata are non-neoplastic lesionsconsisting of group of foamy lipidstoring histiocytes in thedermis of skin or in the lamina propria of mucosa. Urinarybladder is an uncommon localization for these lesions andtheir etiology isn't still well understood, being variably associatedwith abnormalities of lipid metabolism. Althoughsometimes they are described in association with urothelialneoplasms, they were not believed to have any biologicalneoplastic potential and so they are treated consequently.

OBJETIVO: Presentamos dos raros casos de Xantoma vesical asociado con carcinoma de células transicionales.MÉTODOS Y RESULTADOS: Descripción de los casos y selección de imágenes relacionadas. Revisión de la bibliografía existente. CONCLUSIONES: Los xantomas son lesiones no neoplásicas constituidas por grupos de histiocitos espumosos almacenadores de lípidos en la dermis cutánea o en la lámina propia de la mucosa. La vejiga urinaria es una localización rara de estas lesiones y su etiología no se entiende bien todavía, asociándose variablemente con anomalías del metabolismo lipídico. Aunque a veces se describen en asociación con neoplasias uroteliales, no se piensa que tengan ningún potencial neoplásico y consecuentemente así se tratan.

Urinary bladder xanthoma: two case reports and a review of the literature / Xantoma vesical: Presentación de dos casos y revisión bibliográfica

OBJECTIVE: We present two rare cases of bladder xanthomata associated with transitional cell carcinoma. Method and results: Cases description and selection of related pictures. Review of the existing literature. CONCLUSIONS: Xanthomata are non-neoplastic lesions consisting of group of foamy lipidstoring histiocytes in the dermis of skin or in the lamina propria of mucosa. Urinary bladder is an uncommon localization for these lesions and their etiology isn't still well understood, being variably associated with abnormalities of lipid metabolism. Although sometimes they are described in association with urothelial neoplasms, they were not believed to have any biological neoplastic potential and so they are treated consequently

OBJETIVO: Presentamos dos raros casos de Xantoma vesical asociado con carcinoma de células transicionales. MÉTODOS Y RESULTADOS: Descripción de los casos y selección de imágenes relacionadas. Revisión de la bibliografía existente. CONCLUSIONES: Los xantomas son lesiones no neoplásicas constituidas por grupos de histiocitos espumosos almacenadores de lípidos en la dermis cutánea o en la lámina propia de la mucosa. La vejiga urinaria es una localización rara de estas lesiones y su etiología no se entiende bien todavía, asociándose variablemente con anomalías del metabolismo lipídico. Aunque a veces se describen en asociación con neoplasias uroteliales, no se piensa que tengan ningún potencial neoplásico y consecuentemente así se tratan

Prevalence of fasting hypercalciuria associated with increased citraturia in the ambulatory evaluation of nephrolithiasis.

BACKGROUND: Nephrolithiasis is a common, high costing pathology of the urinary tract. The most common urinary abnormalities are fasting hypercalciuria, hypercalciuria and hypocitraturia. This study aimed to identify the principal urinary abnormalities in our patients. METHODS: Ninety-eight patients (pts) (43 females, 55 males) with recurrent calcium nephrolithiasis underwent metabolic evaluation. In two 24-hr urine collections the following parameters were evaluated: calcium, phosphate, sodium, potassium, chloride, magnesium, citrate, oxalate, uric acid, creatinine (Cr), urea, ammonium and pH; blood measurement of calcium, phosphate, sodium, potassium, chloride, magnesium, uric acid, Cr, urea, acid-base balance ionized calcium and intact parathyroid hormone (iPTH) were also performed. A first morning voided urine sample was collected for measuring the urinary cross-links and fasting calciuria. The tubular threshold of phosphate (TmP) was calculated according to Walton and Bijovet. Metabolic evaluation was repeated in 63/98 pts after 7 days on a low calcium diet. RESULTS: The most common urinary abnormalities were fasting hypercalciuria in 51/96 pts (53.1%), hypercalciuria in 33/97 pts (34%) and hypocitraturia in 29/98 pts (29%); 24/33 pts (73%) with hypercalciuria had fasting hypercalciuria. Hypercalciuria was partially corrected on the calcium-restricted diet, while fasting hypercalciuria was not. Urine citrate levels were significantly higher in patients with fasting hypercalciuria. CONCLUSIONS: Fasting hypercalciuria was the most frequent urinary abnormality and it was not corrected with a calcium-restricted diet. In fasting hypercalciuric patients, increased bone resorption activity could be responsible for higher citraturia levels.