Papers by Salvatore Privitera
International Journal of Andrology, May 6, 2016
This review explores the role of carnitine in male infertility. The structure of this review is o... more This review explores the role of carnitine in male infertility. The structure of this review is organized into short paragraphs that address the following aspects: antiapoptotic effect of L-carnitine on germ cells, effects of L-carnitine on conventional sperm parameters, in vitro effects of L-carnitine on sperm function, and the role of L-carnitine on erectile function.
International Journal of Urology, Jul 20, 2015
We carried out a systematic review in order to determine the connection between lower urinary tra... more We carried out a systematic review in order to determine the connection between lower urinary tract symptoms secondary to bladder outlet obstruction and metabolic syndrome with its components. We searched the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, the Cochrane Database of Systematic Review and Web of Science from their inception until January 2015 to identify all eligible studies on the effect of metabolic syndrome (or component factors) on the presence or severity of lower urinary tract symptoms/bladder outlet obstruction in men. This analysis was carried out according to the STrengthening the Reporting of OBservational studies in Epidemiology guidelines. In total, 19 studies were identified as eligible for this systematic review. The quality assessment score was ≥50% in more than half of the studies (11/19). The evidence synthesis showed a positive association between metabolic syndrome, number of components and lower urinary tract symptoms/bladder outlet obstruction. In particular, the major endocrine aberrations of this connection are central obesity and hypertriglyceridemia. The links between insulin resistance and lower urinary tract symptoms/bladder outlet obstruction should be better investigated. Ethnic disparities in all examined studies showed a different impact of metabolic syndrome on lower urinary tract symptoms/bladder outlet obstruction severity and such influence still remain unclear. The relationship between metabolic syndrome and lower urinary tract symptoms/bladder outlet obstruction open the way for introducing physical activity and diet as recognized first-line interventions for treating lower urinary tract symptoms. However, this connection should be investigated in two different ethnic cohorts (i.e. Asian vs Caucasian) in order to better understand the impact of ethnic disparities on metabolic syndrome and lower urinary tract symptoms/bladder outlet obstruction severity.
Scandinavian journal of urology, Jun 23, 2017
Objective: The aim of this study was to analyze the discriminative capabilities of Briganti, Part... more Objective: The aim of this study was to analyze the discriminative capabilities of Briganti, Partin and Memorial Sloan Kettering Cancer Center (MSKCC) nomograms in predicting lymph-node invasion (LNI) and to perform a meta-analysis to yield pooled area under the receiver operating characteristics curves (AUCs) for model comparison. Materials and methods: An electronic search of the MEDLINE and Embase databases up to October 2016 was undertaken. The AUC value, total number of patients and rate of LNI were extracted from the included references. After excluding redundant literature, 19 studies were identified including 86,338 patients. The Briganti, Partin and MSKCC nomograms were validated in 6629, 69,681 and 10,028 patients, respectively. Results: The pooled AUCs for Briganti, Partin, and MSKCC nomograms were 0.793, 0.778 and 0.780, respectively. The Mantel-Haenszel-derived comparison of AUC values revealed no statistical differences of predictive capabilities for Briganti vs Partin (p ¼ 0.23), Briganti vs MSKCC (p ¼ 0.83) and Partin vs MSKCC (p ¼ 0.26). The accuracy of Briganti, Partin and MSKCC models is statistically similar in predicting the presence of LNI. International guidelines could consider these findings by reporting similarities in the accuracy of these models. Conclusions: The accuracy of Briganti, Partin and MSKCC was similar in predicting the presence of LNI. Based on these results, patients and clinicians may use any of these nomograms without significant advantages.
Clinical Genitourinary Cancer, Aug 1, 2017
Markers for prostate cancer (PCa) have progressed over recent years. In particular, the prostate ... more Markers for prostate cancer (PCa) have progressed over recent years. In particular, the prostate health index (PHI) and the 4-kallikrein (4K) panel have been demonstrated to improve the diagnosis of PCa. We aimed to review the diagnostic accuracy of PHI and the 4K panel for PCa detection. We performed a systematic literature search of PubMed, EMBASE, Cochrane, and Academic One File databases until July 2016. We included diagnostic accuracy studies that used PHI or 4K panel for the diagnosis of PCa or high-grade PCa. The methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Twenty-eight studies including 16,762 patients have been included for the analysis. The pooled data showed a sensitivity of 0.89 and 0.74 for PHI and 4K panel, respectively, for PCa detection and a pooled specificity of 0.34 and 0.60 for PHI and 4K panel, respectively. The derived area under the curve (AUC) from the hierarchical summary receiver operating characteristic (HSROC) showed an accuracy of 0.76 and 0.72 for PHI and 4K panel respectively. For high-grade PCa detection, the pooled sensitivity was 0.93 and 0.87 for PHI and 4K panel, respectively, whereas the pooled specificity was 0.34 and 0.61 for PHI and 4K panel, respectively. The derived AUC from the HSROC showed an accuracy of 0.82 and 0.81 for PHI and 4K panel, respectively. Both PHI and the 4K panel provided good diagnostic accuracy in detecting overall and high-grade PCa.
BJUI, Mar 25, 2015
To determine the relationship between lower urinary tract symptoms (LUTS)/benign prostatic hyperp... more To determine the relationship between lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and 10-year risk of cardiovascular disease (CVD) assessed by the Framingham CVD risk score in a cohort of patients without previous episodes of stroke and/or acute myocardial infarction. From September 2010 to September 2014, 336 consecutive patients with BPH-related LUTS were prospectively enrolled. The general 10-year Framingham CVD risk score, expressed as percentage and assessing the risk of atherosclerotic CVD events, was calculated for each patient. Individuals with low risk had ≤10% CVD risk at 10 years, with intermediate risk 10-20% and with high risk ≥20%. Logistic regression analyses were used to identify variables for predicting a Framingham CVD risk score of ≥10% and moderate-severe LUTS (International Prostate Symptom Score [IPSS] ≥8), adjusted for confounding factors. As category of Framingham CVD risk score increased, we observed higher IPSS (18.0 vs 18.50 vs 19.0; P < 0.05), high IPSS-voiding (6.0 vs 9.0 vs 9.5; P < 0.05) and worse sexual function. Prostate volume significantly increased in those with intermediate- vs low-risk scores (54.5 vs 44.1 mL; P < 0.05). Multivariate logistic regression analysis showed that intermediate- [odds ratio (OR) 8.65; P < 0.01) and high-risk scores (OR 1.79; P < 0.05) were independently associated with moderate-severe LUTS. At age-adjusted logistic regression analysis, moderate-severe LUTS was independently associated with Framingham CVD risk score of ≥10% (OR 5.91; P < 0.05). Our cross-sectional study in a cohort of patients with LUTS-BPH showed an increase of more than five-fold of having a Framingham CVD risk score of ≥10% in men with moderate-severe LUTS.
Journal of Personalized Medicine, Oct 5, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
The Journal of Urology, Apr 1, 2014
the subjects. Then, the study investigates the correlation by performing the correlation analysis... more the subjects. Then, the study investigates the correlation by performing the correlation analysis among each factor. The cases of being diagnosed either higher 10 PSA or prostate cancer and the prostate operation are excluded. RESULTS: The study analyzes a total of 4,736 males. The average age is 68.4AE8.4 years old and the subjects consist of 89 in their 40s, 651 in their 50s, 1699 in their 60s, 1868 in their 70s and 429 in their 80s. The average PSA is 1.47AE1.52pmol/ml and the average TURS is 27.9AE12.60g. The total average of the IPSS is 15.92AE8.55 points and the quality of life is 3.41AE1.27. The BMI shows negative correlation with the age, IPSS and quality of life (Pearson:-0.228,-0.077 and-0.40, respectively, p<0.01). And the BMI shows the positive correlation with the size of the prostate (Pearson correlation coefficient: 0.109, p<0.01). However, it has no significant relation with the PSA (p>0.01). The size of the prostate shows significant relation with the IPSS, quality of life, PSA, BMI and age (Pearson: 0.146, 0.138, 0.548 and 0.198, respectively, p<0.01). The study performs the regression analysis under the assumption that the BMI and the prostate size affect each other. The analysis shows the tendency that the higher BMI means the bigger prostate (t¼7.523, p<0.01). CONCLUSIONS: It shows that the higher obesity level tends to have larger size of the prostate. That is, it may be said that increasing the prostate size means more possibility for the lower urinary track symptoms. Therefore, it may be thought that it is required to maintain proper weight to prevent the lower urinary track symptoms and there shall be more studies.
Elsevier eBooks, 2018
Abstract Benign prostatic hyperplasia (BPH) is one of the most common urologic conditions affecti... more Abstract Benign prostatic hyperplasia (BPH) is one of the most common urologic conditions affecting the elderly male. Current management options for BPH and for lower urinary tract symptoms (LUTS) related to BPH include lifestyle changes, drugs, and surgical treatment. A comprehensive spectrum of drugs for the treatment of LUTS is available, ranging from adrenoceptor antagonists (alpha-blockers), 5-alpha-Reductase inhibitors (5-ARIs), phosphodiesterase type 5 inhibitor (PDE5-i), antimuscarinics, beta-3-adrenoceptor agonist, vasopressin analogs, and phytotherapeutic agents. Phytotherapy is commonly used as one form of treatment. Our concern is that it should be used in patients with mild-to-moderate grade of disease. The agent most widely used nowadays is the Serenoa repens while the other compounds are less used worldwide. Experimental and clinical studies suggest a crucial role for SeR as an alternative therapy (or as a complementary therapy) for the treatment of LUTS due to BPH.
International Neurourology Journal, Dec 28, 2015
To determine the relationship between the neurogenic bladder symptoms score (NBSS) and urodynamic... more To determine the relationship between the neurogenic bladder symptoms score (NBSS) and urodynamic examination in patients affected by multiple sclerosis (MS) and related lower urinary tract dysfunction (LUTD). Methods: We recruited 122 consecutive patients with MS in remission and LUTD from January 2011 to September 2013 who underwent their first urodynamic examination. Neurological impairment was assessed using the Expanded Disability Status Scale (EDSS) and bladder symptoms were studied with the NBSS. Results: Median NBSS was 20.0 (interquartile range, 12.75-31.0). Neurogenic detrusor overactivity (NDO) was discovered in 69 patients (56.6%). The concordance between patients with NDO and maximum detrusor pressure during involuntary detrusor contraction (PdetmaxIDC) ≥ 20.0 cm H2O was 0.89 (κ-Cohen; P < 0.05). Patients with EDSS scores of ≥ 4.5 had a greater NBSS (25.41 vs. 20.19, P < 0.05), NBSS-incontinence (8.73 vs. 4.71, P < 0.05), NBSS-consequence (4.51 vs. 3.13, P < 0.05) and NBSS-quality of life (2.14 vs. 1.65, P < 0.05). The NBSS was not associated with PdetmaxIDC ≥ 20 cm H2O (P = 0.77) but with maximum cystometric capacity < 212 mL (odds ratio, 0.95; P < 0.05). Conclusions: The NBSS cannot give adequate information the way urodynamic studies can, in patients with MS and LUTD.
International Braz J Urol, Jun 1, 2016
Benign prostatic hyperplasia and prostate cancer are two common urological diseases of the elderl... more Benign prostatic hyperplasia and prostate cancer are two common urological diseases of the elderly. Scientific community has always looked for a link that could explain the correlation between the two diseases and the role of chronic inflammation in the pathogenesis of BPH and PCa. As shown by the reports of the two diseases relationship with oxidative stress and metabolic syndrome, the use of compounds with antioxidant action could therefore affect both the symptoms and their onset. Polyphenols appear to act not only against oxidative stress but also at different levels. The aim of this review is to evaluate the role of the most important polyphenols on these two urological diseases. As antioxidants these compounds seems to have a direct action on the cell cycle and hormone function, important for both prostate cancer and BPH. Despite a large number of articles about the relationship of the polyphenols with prostate cancer, very little evidence exists for BPH. Additional clinical trials or meta-analysis are necessary on this topic.
European Medical Journal Urology, Jan 20, 2015
Testis-sparing surgery (TSS) represents a therapeutic choice for testicular cancer (TC). However,... more Testis-sparing surgery (TSS) represents a therapeutic choice for testicular cancer (TC). However, international guidelines are very cautious about the use of the testis-sparing technique, namely due to the lack of certain indications and long-term oncological outcomes. The aim of this systematic-review is to illustrate current trends of what may today be the uses of organ-sparing surgery in TC, to evaluate the relationship between the organ-sparing safety and oncological features such as definitive histology, tumour size, and post-surgery oncological outcomes. This analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. An electronic search of the Medline and Embase was undertaken until September 2014. The search was limited to English-Language articles. Current indications of TSS are synchronous bilateral testicular tumours, metachronous contralateral tumours, or tumour in a solitary testis with normal preoperative testosterone levels. Moreover, histological characteristics should not be taken into account when performing a TSS approach. TSS outcomes for germ cell tumours are encouraging and we reported high rates of disease-free survival and a few cases of patients receiving neoadjuvant chemotherapy or radiotherapy. In light of the examined, TSS could be considered a viable alternative to radical surgery of the testis but it should be performed in specialised centres with competence.
The Journal of Urology, Apr 1, 2017
The Journal of Urology, Apr 1, 2015
The Journal of Urology, Apr 1, 2014
in each group was 9.05%, 7.49 %, and 5.40%. The difference between all these three groups were si... more in each group was 9.05%, 7.49 %, and 5.40%. The difference between all these three groups were significant (P<0.001, odds ratio 1.27 (A to B) and 1.89 (A to C)). Age is also a significant predictor of AUR after TURP (P<0.001, odds ratio 1.024). Patient who had previous AUR episodes within 2 months before TURP have higher post-TURP AUR rate (9.46%) than those without AUR before TURP (7.04%), with odds ratio of 1.352 (P<0.001). About co-morbidities, DM and CVA were significant risk factors for AUR after TURP, with odds ratio of 1.107 (P¼0.047) and 1.241 (P<0.001) respectively, while SS and HIVD were not significant (P¼0.212 and 0.277 respectively). CONCLUSIONS: By the NHI database, we may take a glance of AUR after TURP in Taiwan. The mean age was significantly older for the heavier resection weight group of TURP. The most AUR occurred within the group A (TURP 5w15g), followed by group B (15w50g), and group C (50g). Besides, age, pre-TURP Foley indwelling, DM, and CVA were also significant predictors for post TURP AUR possibility, while SS and HIVD were not.
The Journal of Urology, Apr 1, 2015
Urologic Oncology-seminars and Original Investigations, May 1, 2018
Introduction and objectives: To evaluate the association between metabolic syndrome (MetS) and pr... more Introduction and objectives: To evaluate the association between metabolic syndrome (MetS) and proliferative inflammatory atrophy (PIA) in patients with suspected prostate cancer (PCa). Patients and methods: From June 2015 to July 2016, we conducted the FIERY (Flogosis Increased Events of pRostatic biopsY) study at the Urology section, Department of Surgery of the University of Catania (Local registration number: #131/2015). A total of 205 patients with elevated prostate-specific antigen (≥ 4 ng/ml) or clinical suspicion of PCa who underwent primary transperineal prostate biopsy were included in this cross-sectional study. The assessment of PIA, HGPIN, and PCa were performed by 2 experienced pathologists and samples were investigated for the presence of an inflammatory infiltrate, according to the Irani score. Primary and secondary Gleason grade of tumor in positive biopsies were evaluated according to the 2016 ISUP Modified Gleason System. Results: In the entire cohort, median age was 68.0 (interquartile range: 62.0-74.5), median prostate-specific antigen was 6.5 (interquartile range: 5.51-9.57). The prevalence of MetS was 34.1%, the detection rate of PCa was 32.7%, the rate of PIA was 28.3%, the rate of HGPIN was 32.2%, whereas the rate of severe intraprostatic inflammation (Irani-score ≥4) was 28.8%. When comparing clinical and histological variables in patients without and with PIA, metabolic aberrations where not significantly different in both groups. We did not find statistical association in detection rate of PCa (29.3% vs. 34.0%; P ¼ 0.07) and HGPIN (27.6% vs. 34.0%; P ¼ 0.37) in patients with and without PIA, respectively. When considering metabolic aberrations, MetS was not associated with Irani-score ≥4 (28.6% vs. 28.4%; P ¼ 0.96) and none of each component was statistically predictive of severe inflammation. At the multivariable logistic regression analysis, PIA, HGPIN, and MetS were not associated with greater risk of PCa. Conclusion: In this study, we did not show an association between MetS and PIA and PCa. Although the small sample size and the cross-sectional nature of the study, we do not suppose that MetS could be associated with greater evidence of PIA. Further studies should be conducted to evaluate the exact nature of this pathological lesion.
The Aging Male, Sep 16, 2015
We aimed to investigate the predictive factor of erectile dysfunction (ED) in prostate cancer (PC... more We aimed to investigate the predictive factor of erectile dysfunction (ED) in prostate cancer (PCa) patients who underwent low-dose permanent I(125) seed implant brachytherapy and to investigate if ED could represent a patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s reported outcome measures (PROMs) of efficacy of BT and indirectly associated with biochemical recurrence free survival (BRFS). From 2000 to 2012, 176 consecutive patients with low-risk PCa underwent BT. ED was evaluated with the International Index of Erectile Function (IIEF-5). Cox regression analysis was performed to assess significant predictors of mild-to-severe ED and BRFS after BT, including covariates. The 10-year actuarial rate of ED was 66%. Subjects with severe ED had higher values of D90 (183.0 versus 177.0; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) and V100% (40.1 versus 31.4; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) compared with normal. At the multivariate logistic regression analysis, D90 (OR: 1.10; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) was an independent predictor of ED. Multivariate Cox-regression analysis did not demonstrate significant association between erectile preservation and biochemical recurrence (BCR) after 10 years of follow up (HR: 2.15; p = 0.20), while D90 ≤ 180 Gy independently predicted BCR (HR: 4.65; [95%CI: 1.25-17.34]; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Erectile preservation should be addressed as valuable PROMs after permanent seed I(125) implant, but it is not associated with better BRFS.
Anti-cancer Agents in Medicinal Chemistry, Oct 31, 2013
European Urology Supplements, 2018
Archivio Italiano di Urologia e Andrologia, 2020
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the coronavirus that causes an in... more Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the coronavirus that causes an infectious disease, called COVID-19, first detected in patients with pneumonia in Wuhan (People's Republic of China) on December 2019. Italy was the first European country to state the outbreak of the infection and its Council of Ministers declared the state of health emergency on 31.01.2020, then the World Health Organization ruled a global pandemic on 11.03.2020. The nasopharyngeal swab is based on the detection of virus RNA and is the only reliable one for declaring COVID-19 infection. The most common symptoms observed in COVID-19 patients before hospitalization may be fever, chills, cough, dyspnea, asthenia, myalgia and/or arthralgia. This symptomatology can be often complicated in a dramatically increasing manner such as to require hospitalization starting from the third-fourth week. COVID-19 outbreak has dramatically affected the quality of life by changing inter-personal relatio...
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Papers by Salvatore Privitera