Simone Cilio

IRCCS Ospedale San Raffaele

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Andrea Salonia

IRCCS Ospedale San Raffaele

Federico Belladelli

IRCCS Ospedale San Raffaele

Edoardo Pozzi

Vita-Salute San Raffaele University

Luca Boeri

Ospedale Maggiore

Paolo Capogrosso

Ospedale di Circolo e Fondazione Macchi

Francesco Montorsi

IRCCS Ospedale San Raffaele

Christian Corsini

Vita-Salute San Raffaele University

Giuseppe Fallara

European Institute of Oncology

Massimiliano Raffo

IRCCS Ospedale San Raffaele

Luigi Candela

Sorbonne Université

Cooperative Institutions

University of Naples Federico II

Federico II University Hospital

Istituti di Ricovero e Cura a Carattere Scientifico

IRCCS Ospedale San Raffaele

Vita-Salute San Raffaele University

University of Campania "Luigi Vanvitelli"

Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele

Sapienza University of Rome

Institute of Experimental Endocrinology of the Slovak Academy of Sciences

Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"

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One out of two idiopathic infertile men has pathologic sperm DNA fragmentation values: Potential implications for clinical practice

Clinical Endocrinology (2024)

Luca Boeri Edoardo Pozzi Federico Belladelli Christian Corsini Simone Cilio

Abstract Objectives To investigate the distribution of sperm DNA fragmentation (SDF) values and their association with clinical and seminal parameters in idiopathic infertile men. Design, Patients, Measurements Data from 3224 primary infertile men (belonging to couples having failed to conceive a pregnancy within 12 months) who underwent a thorough diagnostic work‐up were analysed. A SDF value ≥ 30% (according to Sperm Chromatin Structure Assay) was considered pathologic. We excluded: (1) men with genetic abnormalities; (2) men with history of cryptorchidism; (3) men with biochemical hypogonadism; (4) men with clinical varicocele; and (5) men with other possible known aetiological factors. Descriptive statistics and logistic regression analyses were used to describe the whole cohort. Results Of all, 792 (23%) men with at least one abnormal WHO semen parameter but without any identified aetiologic factor for infertility, were considered as idiopathic infertile men. Of 792, 418 (52.7%) men had SDF ≥30%. Men with pathologic SDF were older ( p = .02), had higher Follicle‐stimulating hormone (FSH) ( p = .04) but lower total testosterone ( p = .03) values than those with SDF <30%. The homoeostatic model assessment index for insulin resistance (HOMA‐IR) was higher in men with SDF ≥30% ( p = .01). Idiopathic infertile men with SDF ≥30% presented with lower sperm concentration ( p < .001) and lower progressive sperm motility ( p < .01) than those with SDF < 30%. Logistic regression analysis revealed that older age (OR: 1.1, p = .02) and higher HOMA‐IR score (OR: 1.8, p = .03) were associated with SDF ≥ 30%, after accounting for FSH and sperm concentration values. Conclusions Approximately half of infertile men categorized as idiopathic had pathologic SDF values. Idiopathic infertile men with pathologic SDF showed worse clinical, hormonal and semen parameters than those with normal SDF values. These results suggest that including SDF testing could be clinically relevant over the real‐life management work‐up of infertile men.

Clinical Practice

Fragmentation

10.1111/cen.15093

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Citations (2)

Comparing cardiovascular adverse events in cancer patients: A meta-analysis of combination therapy with angiogenesis inhibitors and immune checkpoint inhibitors versus angiogenesis inhibitors alone

Critical Reviews in Oncology/Hematology (2023)

Felice Crocetto Matteo Ferro Carlo Buonerba Luca Bardi Pasquale Dolce

Cardiotoxicity

10.1016/j.critrevonc.2023.104059

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Citations (17)

A Novel Low-Cost Uroflowmetry for Patient Telemonitoring

International Journal of Environmental Research and Public Health (2023)

Savio Domenico Pandolfo Federica Crauso Achille Aveta Simone Cilio Biagio Barone

Uroflowmetry (UF) is a crucial guideline-recommended tool for men with benign prostatic obstruction (BPO). Moreover, UF is a helpful decision-making tool for the management of patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). In the last few years, telemedicine and telehealth have increased exponentially as cost-effective treatment options for both patients and physicians. Telemedicine and telehealth have been well positioned during the COVID-19 pandemic to prevent healthcare system overload and to ensure adequate management of patients through screening, diagnosis, and follow-up at home. In the present manuscript, the main characteristics and performance of a novel and low-cost device for home-based UF have been analyzed. The simple weight-transducer method has been applied to perform UF. An inexpensive load cell connected to a 24 bit analogic digital converter (ADC) sends data to a cloud server via SIM card or home Wi-Fi. Data are processed and shown in graphics with both volume and flow rate as a function of time, allowing for measurement of average flow rate, maximum flow rate, voided volume, and voiding time. A numerical algorithm allows for filtering of the dynamic effect due to the urine gravity acceleration and for removing the funnel to simplify the home measurement procedure. Through an online platform, the physician can see and compare each UF data. The device’s reliability has been validated in a first laboratory setting and showed excellent performance. This approach based on domiciliary tests and an online platform can revolutionize the urologic clinic landscape by offering a constant patient cost-effective follow-up, eliminating the time wasted waiting in the office setting.

Telehealth

10.3390/ijerph20043287

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Unrecognised orgasmic phase disorders in men presenting with new‐onset erectile dysfunction—Findings from a real‐life, cross‐sectional study

Andrology (2023)

Simone Cilio Edoardo Pozzi Giuseppe Fallara Federico Belladelli Massimiliano Raffo

Abstract Background Orgasmic phase disorders in men worsen the burden of erectile dysfunction on sexual satisfaction. Objectives To investigate the prevalence of and predictors of unreported orgasmic phase disorder in a cohort of men looking for their first urological assessment for new‐onset erectile dysfunction in a real‐life setting. Materials and methods Data from 1107 heterosexual, sexually active men consecutively assessed for new‐onset erectile dysfunction were analysed. Throughout a comprehensive medical and sexual history, all patients were asked to self‐report any orgasmic phase disorder and to complete the International Index of Erectile Function and the Beck's Inventory for Depression (depressive symptoms scored as Beck's Inventory for Depression ≥11). Men self‐reporting orgasmic phase disorder during the interview were excluded from further analyses. The median value of the International Index of Erectile Function‐orgasmic function domain was arbitrarily used to categorise men with (International Index of Erectile Function‐orgasmic function ≤5) and without unreported orgasmic phase disorder (International Index of Erectile Function‐orgasmic function >5). Circulating hormones were measured in every patient. Descriptive statistics and logistic regression models were used to test the association between clinical variables and unreported orgasmic phase disorder. Results Of 1098 patients with non‐self‐reporting orgasmic phase disorder, 314 (28.6%) had International Index of Erectile Function‐orgasmic function ≤5. Patients with erectile dysfunction + unreported orgasmic phase disorder were older (median [interquartile range]: 58 [44–66] years vs. 51 [40–60] years), had higher body mass index [25.8 (23.7–28.1) kg/m 2 vs. 25.2 (23.3–27.4) kg/m 2 ], higher prevalence of type 2 diabetes (36 [11.5%] vs. 45 [5.7%]) and lower International Index of Erectile Function‐erectile function scores (6 [2–10] vs. 18 [11–24]) than men with erectile dysfunction‐only (all p < 0.05). Patients with erectile dysfunction + unreported orgasmic phase disorder depicted higher rates of severe erectile dysfunction (75.5% vs. 25%) and Beck's Inventory for Depression ≥11 (22.6% vs. 17.9%) (all p < 0.05). In the multivariable logistic regression analysis, older age (odds ratio: 1.02) and lower International Index of Erectile Function‐erectile function scores (odds ratio: 0.83) were independently associated with unreported orgasmic phase disorder (all p < 0.05). Conclusions Almost one in three men seeking first medical help for erectile dysfunction depicted criteria suggestive of unreported orgasmic phase disorder. Men with unreported orgasmic phase disorder were older and had higher rates of severe erectile dysfunction and concomitant depressive symptoms. These real‐life findings outline the clinical relevance of a comprehensive investigation of concomitant sexual dysfunction in men only complaining of erectile dysfunction to more effectively tailor patient management.

Orgasm

Depression

10.1111/andr.13506

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Citations (2)

Testicular pain and youtube™: are uploaded videos a reliable source to get information?

International Journal of Impotence Research (2022)

Alberto Melchionna Claudia Collà Ruvolo Marco Capece Roberto La Rocca Giuseppe Celentano

Misinformation

Interquartile range

Scrotal Pain

10.1038/s41443-022-00536-w

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Citations (23)

Urinary MicroRNAs as Biomarkers of Urological Cancers: A Systematic Review

International Journal of Molecular Sciences (2023)

Achille Aveta Simone Cilio Roberto Contieri Gianluca Spena Luigi Napolitano

MicroRNAs (miRNAs) are emerging as biomarkers for the detection and prognosis of cancers due to their inherent stability and resilience. To summarize the evidence regarding the role of urinary miRNAs (umiRNAs) in the detection, prognosis, and therapy of genitourinary cancers, we performed a systematic review of the most important scientific databases using the following keywords: (urinary miRNA) AND (prostate cancer); (urinary miRNA) AND (bladder cancer); (urinary miRNA) AND (renal cancer); (urinary miRNA) AND (testicular cancer); (urinary miRNA) AND (urothelial cancer). Of all, 1364 articles were screened. Only original studies in the English language on human specimens were considered for inclusion in our systematic review. Thus, a convenient sample of 60 original articles was identified. UmiRNAs are up- or downregulated in prostate cancer and may serve as potential non-invasive molecular biomarkers. Several umiRNAs have been identified as diagnostic biomarkers of urothelial carcinoma and bladder cancer (BC), allowing us to discriminate malignant from nonmalignant forms of hematuria. UmiRNAs could serve as therapeutic targets or recurrence markers of non-muscle-invasive BC and could predict the aggressivity and prognosis of muscle-invasive BC. In renal cell carcinoma, miRNAs have been identified as predictors of tumor detection, aggressiveness, and progression to metastasis. UmiRNAs could play an important role in the diagnosis, prognosis, and therapy of urological cancers.

Kidney cancer

10.3390/ijms241310846

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Citations (52)

Reply to a letter to the editor regarding the published article: “YouTube™ as a source of information on bladder pain syndrome: A contemporary analysis”

Neurourology and Urodynamics (2022)

Simone Morra Claudia Collà Ruvolo Luigi Napolitano Roberto La Rocca Giuseppe Celentano

10.1002/nau.24945

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Citations (3)

Hyperestrogenism is associated with sexual function impairment in men—findings from a cross‐sectional, real‐life study

Andrology (2023)

Federico Belladelli Luca Boeri Giuseppe Fallara Edoardo Pozzi Christian Corsini

Abstract Background Hyperestrogenism is believed to be harmful to male sexuality. We aimed to investigate the prevalence of and the impact of hyperestrogenism on sexual functioning in a cohort of men seeking medical attention for new‐onset erectile dysfunction. Materials and methods Data from 547 men seeking first medical help for new‐onset erectile dysfunction at a single andrology center were analyzed. Patients were assessed with a thorough medical and sexual history. Comorbidities were scored with the Charlson comorbidity index. All patients completed the International index of erectile function; the International index of erectile function‐erectile function domain was categorized according to Cappelleri's criteria. Circulating hormones were measured in every patient. Hyperestrogenism was defined as estradiol levels >42.6 pg/mL (Tan et al., 2015). Descriptive statistics and logistic/linear regression models tested the association between hyperestrogenism and International index of erectile function domains score. Results Overall, 96 (17.6%) participants had serum estrogen levels suggestive of hyperestrogenism. Men with hyperestrogenism were older (median [interquartile range]: 46 [35–59] vs. 44 [31–56] years; p < 0.001), had a higher rate of comorbidities (Charlson comorbidity index ≥1: 26.0% vs. 7.4%; p < 0.001), and higher serum total testosterone values (5.4 [5.2–8.0] vs. 4.3 [4.1–5.7] ng/mL; p = 0.01) than those with normal estradiol values. A higher prevalence of severe erectile dysfunction (135 [29.9%] vs. 47 [48.9%] men; p = 0.01) and of hypogonadism (22 [4.8%] vs. 6 [6.3%] men; p = 0.004) were found in men with hyperestrogenism. Serum estradiol levels were positively correlated with total testosterone levels ( β = 0.26, p < 0.001) but negatively correlated with International index of erectile function‐orgasmic function ( β = –0.24, p = 0.002) and International index of erectile function‐erectile function scores ( β = –0.03, p < 0.001). When International index of erectile function scores was used to stratify erectile dysfunction patients, hyperestrogenism (odds ratio 2.44, p = 0.02) was associated with severe erectile dysfunction. Conclusions One out of five men seeking first medical help for erectile dysfunction showed elevated serum estradiol values suggestive of hyperestrogenism. Hyperestrogenism was associated with health‐significant comorbidities, orgasmic function impairment, and erectile dysfunction severity.

Interquartile range

Cross-sectional study

Charlson comorbidity index

10.1111/andr.13470

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Citations (3)

Urinary Micro-RNAs As Biomarkers of Urological Cancers: A Systematic Review

Achille Aveta Simone Cilio Roberto Contieri Gianluca Spena Luigi Napolitano

Background: Micro-RNAs (miRNA) are emerging as biomarkers in the detection and prognosis of cancers due to their inherent stability and resilience. Methods: To summarize evidence regarding urinary miRNA (umiRNAs) role in the detection, prognosis and therapeutic management of urological cancers, we performed a systematic review of the most important scientific databases using the following keywords: (urinary mir-na)AND(prostate cancer); (urinary mirna)AND(bladder cancer); (urinary mirna)AND(renal cancer); (urinary mirna)AND(testicular cancer); (urinary mirna)AND(urothelial cancer). Results: Of all, 1364 articles were initially selected. Only original studies in the English language on human specimens were considered for inclusion in our systematic review. Thus, a convenient sample of 60 original articles was identified. Urinary miRNA (UmiRNAs) are downregulated in prostate cancers and may serve as potential non-invasive molecular biomarkers. Several umiR-NAs have been identified as diagnostic biomarkers of urothelial carcinoma and bladder cancer (BCa), allowing to discriminate malignant from non-malignant forms of haematuria. UmiRNAs could serve as therapeutic targets or recurrence markers of non-muscle invasive BCa and could predict the aggressivity and prognosis of muscle-invasive BCa. In renal cell carcinoma, miRNAs have been identified as predictors of tumour detection, aggressiveness, and progression to metastasis. Conclusion: umiRNAs could play an important role in the diagnosis, prognosis, and therapy of urological cancers.

10.20944/preprints202305.1974.v1

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Citations (29)

Looking for cystoscopy on YouTube: Are videos a reliable information tool for internet users?

Archivio Italiano di Urologia e Andrologia (2022)

Carmine Turco Claudia Collà Ruvolo Simone Cilio Giuseppe Celentano Gianluigi Califano

The Internet is an important and easily accessible source of information. The aim of the current study was to investigate the quality of YouTube videos on cystoscopy and to establish if they can be used as a reliable information tool for internet users.The search term "cystoscopy" was used on YouTube platform and the first 120 YouTube videos were analyzed. To assess the video quality Patient Education Materials Assessment Tool (PEMAT) for Audiovisual (A/V) Materials (Understandability and Actionability sections), Misinformation score and Global Quality Score (GQS) were used.Of all 120 videos, 72 were included in the analyses. Of all videos, 59.7% (n = 43), and 40.3% (n = 29) were targeted to General Public and Healthcare Workers. Moreover, "technical aspects" was the main topic addressed (n = 29, 40.3%). The median PEMAT A/V Understandability and Actionability scores were 50.0% (IQR: 39.1-70.0) and 66.7% (IQR: 33.3- 100.0), respectively. The median Misinformation score ranged from 1.0 to 3.0. According to GQS, 22 (30.6%), 26 (36.1%), 16 (22.2%), 8 (11.1%) videos were poor, generally poor, moderate, and good, respectively. No video was evaluated as excellent.Today, YouTube videos on cystoscopy are more frequently uploaded by healthcare workers, who share information about specific aspects of this procedure. However, the quality of YouTube contents on cystoscopy is still poor. Therefore, currently users interested in cystoscopy cannot rely on YouTube to get good informative material on this topic. In consequence, future authors should focus on improving the quality of video contents on cystoscopy.

Misinformation

Upload

Quality Score

10.4081/aiua.2022.1.57

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Citations (22)