Epidemiological Features and Resistance Pattern in Uropathogens Isolated from Chronic Bacterial Prostatitis

Tommaso Cai,Sandra Mazzoli,Francesca Meacci,Vieri Boddi,Nicola Mondaini,Gianni Malossini,Riccardo Bartoletti 한국미생물학회 2011 The journal of microbiology Vol.49 No.3

Chronic bacterial prostatitis (CBP) is, usually, caused by uropathogens, especially gram-negative bacilli,although infection is sometimes due to Gram-positive and atypical microorganisms. A recent increasing in prevalence of Gram-positive strains has been reported. The aim of this study was to explore the epidemiological features and resistance rates in uropathogens isolated from CBP outpatients in last 10 years. All consecutive outpatients with demonstrated CBP attending a single Sexually Transmitted Disease centre from January 1997 and December 2008, were enrolled and underwent microbiological cultures in first void early morning urine, midstream urine, expressed prostatic secretion, and post prostate massage urine. Prevalence of different bacterial strains was stratified in four different periods: 1997-1999, 2000-2002, 2003-2005, 2006-2008. Any changes observed in epidemiological features and resistance rates in uropathogens over the whole study period have been analyzed. The present study has been planned, thus, as in vitro study. From 6,221patients, 4,601 Gram-positive and 1,620 Gram-negative bacterial strains have been isolated. Enterococcus faecalis and Escherichia coli strains are the first and second frequent pathogens found, respectively. Significant differences between E. faecalis prevalence in the 1997-1999 and 2006-2008 periods were found. E. coli showed a significant difference between prevalence in 1997-1999 and 2006-2008 periods. Gram-positive organisms showed a decreasing of susceptibility to ciprofloxacin as well as Gram-negative strains, while a good susceptibility to the levofloxacin was evidenced. E. faecalis prevalence seemed to be raised in 2006-2008periods. Moreover, a decreasing of activity of ciprofloxacin and a good activity profile of levofloxacin have been reported.

Oral Administration and Intralesional Injection of Hyaluronic Acid Versus Intralesional Injection Alone in Peyronie’s Disease: Results from a Phase III Study

Cai Tommaso,Tiscione Daniele,Favilla Vincenzo,Puglisi Marco,Palumbo Fabrizio,Zucchi Alessandro,Malossini Gianni,Palmieri Alessandro,Bjerklund Johansen Truls E. 대한남성과학회 2021 The World Journal of Men's Health Vol.39 No.3

Purpose: The aim of this study was to compare the effect of combined oral administration and intralesional injection of hyaluronic acid (HA) with intralesional injections alone, in patients with early onset of Peyronie’s disease (PD). Materials and Methods: For this prospective, randomized phase III clinical trial we included patients with recent diagnosis of PD. Eighty-one patients were randomized into two groups. Group A consisted of 41 patients receiving oral administration of HA in combination with weekly intralesional injection of HA for 6 weeks. Group B consisted of 40 patients group B who received weekly intralesional injections of HA for 6 weeks, only. The main outcome measures were the changes from baseline to the end of therapy after three months in penile curvature (°) and changes in the international index of erectile function (IIEF-5) score and patient’s global impressions of improvement (PGI-I) score. Results: Group A had a significantly larger reduction in penile curvature as compared with group B (Group A: -7.8°, Group B: -4.1° [p<0.001]). Group A also showed a higher improvement in IIEF-5 and PGI-I scores in comparison with Group B (Group A: +4 IIEF-5, Group B: +2 IIEF-5 [p<0.001]; Group A: 3 PGI-I, Group B: 1 PGI-I, [p<0.001]). At three months both groups had a significant reduction of penile curvature from baseline (p<0.001). Conclusions: Oral administration combined with intralesional treatment with HA shows greater efficacy to improve penile curvature and overall sexual satisfaction in comparison with intralesional HA treatment alone.

Chlamydia trachomatis versus common uropathogens as a cause of chronic bacterial prostatitis: Is there any difference? Results of a prospective parallel-cohort study

Tommaso Cai,Francesca Pisano,Gabriella Nesi,Vittorio Magri,Paolo Verze,Gianpaolo Perletti,Paolo Gontero,Vincenzo Mirone,Riccardo Bartoletti 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.6

Purpose: The role of Chlamydia trachomatis (CT) infection in chronic bacterial prostatitis (CBP) is well known. What is unclear is whether there are any differences in the course or clinical outcome of the disease when the cause is CT or other uropathogens. Materials and Methods: A series of 311 patients affected by CBP due to CT (cohort A) was compared with a group of 524 patients affected by CBP caused by common uropathogen bacteria (cohort B). All participants completed the following questionnaires: National Institutes of Health Chronic Prostatitis Symptom Index, International Prostate Symptom Score, International Index of Erectile Function-15 erectile function domain (IIEF-15-EFD), Premature Ejaculation Diagnostic Tool (PEDT), and the Short Form 36 (SF-36) Health Survey. All patients were followed with clinical and microbiological evaluations. Results: After a mean follow-up time of 42.3 months, the number of symptomatic episodes was significantly higher in patients in cohort A than in cohort B (4.1±1.1 vs. 2.8±0.8, p<0.001), and the mean time to first symptomatic recurrence was shorter in cohort A than in cohort B (3.3±2.3 months vs. 5.7±1.9 months, p<0.001). Moreover, scores on the SF-36 tool were significantly lower in cohort A (96.5±1.0 vs. 99.7±1.9, p<0.001) at the first symptomatic recurrence. Cohort A also showed significantly lower scores on the IIEF-15-EFD and PEDT questionnaires at the end of the follow-up period (26.8±2.9 vs. 27.3±3.3, p=0.02 and 11.5±2.3 vs. 4.5±2.8, p<0.001, respectively). Conclusions: Patients affected by CBP due to CT infection have a higher number of symptomatic recurrences with a more severe impact on quality of life.

Prostate calcifications: A case series supporting the microbial biofilm theory

Tommaso Cai,Francesco Tessarolo,Iole Caola,Federico Piccoli,Giandomenico Nollo,Patrizio Caciagli,Sandra Mazzoli,Alessandro Palmieri,Paolo Verze,Gianni Malossini,Vincenzo Mirone,Truls E. Bjerklund Joha 대한비뇨의학회 2018 Investigative and Clinical Urology Vol.59 No.3

Purpose: Prostate calcifications are a common finding during transrectal prostate ultrasound in both healthy subjects and patients, but their etiopathogenesis and clinical significance are not fully understood. We aimed to establish a new methodology for evaluating the role of microbial biofilms in the genesis of prostate calcifications. Materials and Methods: Ten consecutive patients who had undergone radical prostatectomy were enrolled in this study. All of the patients presented with prostate calcifications during transrectal ultrasound evaluation before surgery and underwent Meares-Stamey tests and clinical evaluation with the National Institutes of Health Chronic Prostatitis Symptom Index and the International Prostate Symptom Score. At the time of radical prostatectomy, the prostate specimen, after removal, was analyzed with ultrasonography under sterile conditions in the operating room. Core biopsy specimens were taken from the site of prostate calcification and subjected to ultrastructural and microbiological analysis. Results: The results of the Meares-Stamey test showed only 1 of 10 patients (10%) with positive cultures for Escherichia coli. Two of five patients (40%) had positive cultures from prostate biopsy specimens. Enterococcus faecalis, Enterococcus raffinosus, and Citrobacter freundii were isolated. Ultrastructural analysis of the prostate biopsy specimens showed prostate calcifications in 6 of 10 patients (60%), and a structured microbial biofilm in 1 patient who had positive cultures for E. faecalis and E. raffinosus. Conclusions: Although the findings are supported by a low number of patients, this study highlights the validity of the proposed methodology for investigating the role of bacterial biofilms in the genesis of prostate calcification.

A Case Series of Patients Who Underwent Laparoscopic Extraperitoneal Radical Prostatectomy with the Simultaneous Implant of a Penile Prosthesis: Focus on Penile Length Preservation

Nicola Mondaini,Tommaso Cai,Enrico Sarti,Gaia Polloni,Andrea Gavazzi,Duccio Conti,Andrea Cocci,Maarten Albersen,Gianmartin Cito,Riccardo Bartoletti 대한남성과학회 2018 The World Journal of Men's Health Vol.36 No.2

Purpose: There are many grey areas in the field of penile rehabilitation after radical prostatectomy (RP). The preservation ofthe full dimensions of the penis is an important consideration for improving patients’ compliance for the treatment. We presentthe first case series of patients treated by laparoscopic extraperitoneal RP and simultaneous penile prosthesis implantation(PPI) in order to preserve the full length of the penis and to improve patients’ satisfaction. Materials and Methods: From June 2013 to June 2014, 10 patients underwent simultaneous PPI (with an AMS InhibiZoneprosthesis) and RP. Patients were evaluated by means of urological visits, questionnaires, and objective measurements beforesurgery, at discharge from the hospital, on postoperative days 21 to 28, each 3 months for the first year, and each 6 monthsthereafter. The main outcome measures were biochemical recurrence-free rate, penile length, and quality of life. Results: Ten patients (mean age of 61 years; completed the study follow-up period (median, 32.2 months). No difference wasfound between the time of surgery and the 2-year follow-up evaluation in terms of penile length. The pre-surgery 36-ItemShort Form Health Survey (SF-36) median score was 97. Patients were satisfied with their penile implants, and couples’ levelof sexual satisfaction was rated median 8. The median postoperative SF-36 score was 99 at 3 months follow-up. Conclusions: Laparoscopic extraperitoneal RP surgery with simultaneous PPI placement seems to be an interesting possibilityto propose to motivated patients for preserving the length of the penis and improving their satisfaction.

Male Inflammatory Parameters Are not Useful to Predict the Outcomes of Intracytoplasmic Sperm Injection: Results from a Cross-Sectional Study

Gianmartin Cito,Maria Elisabetta Coccia,Rita Picone,Andrea Cocci,Giorgio Ivan Russo,Tommaso Cai,Giulia Bencini,Rossella Fucci,Elisabetta Micelli,Luciana Criscuoli,Francesco Bertocci,Elena Borrani,Serg 대한남성과학회 2019 The World Journal of Men's Health Vol.37 No.3

Purpose: The relationship between male systemic inflammation and fertility seems intriguing, but no data about its impact on the assisted reproductive technology outcomes has been reported. Here, we aimed to evaluate the prognostic role of male systemic inflammatory parameters in intracytoplasmic sperm injection (ICSI) outcomes prediction, in couples undergoing an ovum donation program.Materials and Methods: From January 2016 to December 2017, one hundred-ten couples were considered for this cross-sectional study. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-eosinophil ratio (MER), platelet-to-lymphocyte ratio (PLR), seminal parameters, fertilization rate (FR), cleavage rate (CR), pregnancy rate (PR) were evaluated. Male patients were divided into Group A with FR ≤70%, Group B with FR >70%.Results: Overall, FR was 74.5%, CR 90.9%, PR 41.8%. Group A included 43 patients, Group B 67 men. Group A showed a median NLR of 1.55, PLR of 106.09, MER of 2.33. Group B reported a median NLR of 1.64, PLR 109.0, MER 2.76. We found no statistically differences between two groups with respect to NLR, PLR, MER (p=0.90, p=0.70, p=0.96, respectively). The age-adjusted linear regression analysis demonstrated only a relationship between NLR and sperm motility count (r=-0.02; p<0.05). Using the univariate logistic regression analysis, we found no significant associations. Conclusions: We did not find any relationship between ICSI outcomes and male inflammation parameters.