Angelo Peroni - Academia.edu (original) (raw)

Papers by Angelo Peroni

Research paper thumbnail of Evidence for the Presence of α<sub>1</sub> Adrenoceptor Subtypes in the Human Ureter

Rivista Urologia, 2005

Several studies proposed a role for α1 adrenoceptors (α1 ARs) in the ureteral physiology, indicat... more Several studies proposed a role for α1 adrenoceptors (α1 ARs) in the ureteral physiology, indicating that they are present in the ureter; however, few studies have been made to identify α1 AR subtypes present in this area. Thus, this study was carried out to characterize the α1 AR subtype gene and protein expression in proximal, medial and distal region of the human ureter. Methods Molecular characterization of α1 AR subtypes was done by semi-quantitative RT-PCR. The α1 AR protein expression was studied by saturation binding curves using the α1 AR antagonist 125I-HEAT. Analysis of data was performed using the GraphPad PRISM 4 software. Results Analysis of saturation binding curves revealed an heterogeneous distribution of α1 AR binding sites; the Bmax for the distal ureter was indeed 52.5 ±5.4 fmol/mg prot, while a lower similar density of α1 ARs was demonstrated in the medial (25.2 ±1.7 fmol/mg prot) and proximal (23.4 ±0.4 fmol/mg prot) ureters. Molecular characterization of α1 AR subtypes indicated that each receptor was present, although with differences in term of the amount expressed. Conclusions Human ureter was endowed with each α1 AR subtype, although α1D and α1A ARs were prevalent over α1B ARs. Radioligand binding results revealed that there were no significant differences in the Kd between ureteral regions, while an heterogeneous distribution of α1 AR binding sites was detected, with the highest density of α1 ARs in the distal ureter and a lower similar density in the medial and proximal ureter.

Research paper thumbnail of Alpha1 adrenoceptors in human urinary tract:expression, distribution and clinical implications

Rivista Urologia, 2007

Adrenergic receptors (ARs) are a class of proteins belonging to the G proteincoupled receptor fam... more Adrenergic receptors (ARs) are a class of proteins belonging to the G proteincoupled receptor family. Pharmacological and molecular studies allowed dividing ARs into three different categories: α1, α2 and β. In this review, we focused on α1 ARs and α1 AR antagonists, since α1 ARs play an important role in the pathophysiology of a number of urinary tract (UT) dysfunctions. α1 ARs are widely expressed in human UT; in particular, the three ureter areas (distal, medial and proximal) show different patterns of receptor expression (i.e. distal > medial = proximal), giving the molecular basis for the use of α1 ARs antagonist in the expulsive therapy of distal ureter calculi. Bladder areas are characterized by important differences among trigone, detrusor and neck, the first showing a different pattern of expression compared to the other parts. Further, there are evidences of both density and subtype gender-dependent expressions. α1 ARs expression in prostate and detrusor is a widely investigated area of research, mainly due to the clinical impact of benign prostatic hyperplasia (BPH). Urethra has not been well studied in human, although it plays a role in the control of continence. Studies carried out on α1 AR subtype expression in the UT indicate that, although the presence of each subtype is observed, α1A firstly and then α1D ARs seem to be more expressed than α1B ARs. Thus, drugs that demonstrate high α1A/D AR selectivity have drawn the researchers' attention. As it relates specifically to the α1 AR antagonists used in the treatment of lower UT symptoms, the concept of uroselectivity has been operationally defined; indeed, in a number of recent publications uroselectivity has been defined as the degree to which a given compound inhibits norepinephrine-induced increase in urinary muscle contractions and/or its propensity to generate unwanted cardiovascular effects, such as decreases in blood pressure.

Research paper thumbnail of Microwave ablation to treat a urinary fistula after robot-assisted radical nephrectomy of a horseshoe kidney

Journal of vascular and interventional radiology, Mar 1, 2024

Research paper thumbnail of Identification and characterization of muscarinic receptors in human male detrusor and in primary cell culture of detrusor leiomyocytes

Research paper thumbnail of Stimulation of muscarinic receptors induces cell proliferation of human detrusor muscle cell

Research paper thumbnail of 180° Kidney lateral rotation: A rare cause of Ureteropelvic junction obstruction

European Urology Supplements, Sep 1, 2018

Research paper thumbnail of Risultati oncologici a breve-medio termine della prostatectomia radicale robot-assistita: studio comparativo prospettico non randomizzato

Rivista Urologia, Dec 5, 2012

Research paper thumbnail of Muscarinic receptor sub-types in the human urothelium: Gender- and age-dependent modifications

Research paper thumbnail of The effect of COVID-19 outbreak on endourological activities: a multicentric retrospective study

European Urology Open Science, 2021

Research paper thumbnail of Can robotic approach become the gold standard to perform ureteral re-implantation for deep infiltrating endometriosis involving the ureter? A retrospective comparative study from a single institution

European Urology Supplements, 2016

Research paper thumbnail of Robot-assisted simple prostatectomy and diverticulectomy

European Urology Supplements, 2016

Research paper thumbnail of Robot-assisted surgical management of complex renal cysts

European Urology Supplements, 2016

Research paper thumbnail of Muscarinic receptor messenger RNAS are differentially expressed in male and female normal human bladder

European Urology Supplements, 2003

Research paper thumbnail of Holographic reconstructions can aid surgical planning before partial nephrectomy: A head-to-head comparison with standard ct scan

European Urology Supplements, 2018

Research paper thumbnail of Ralp Can Reduce the Rate of Positive Surgical Margin: Comparison with Open Prostatectomy in a Medium Volume Center

Anticancer Research, 2015

Research paper thumbnail of Robot-assisted ureteral re-implantation with psoas hitching

European Urology Supplements, 2016

Research paper thumbnail of Outcomes of primary ureteroscopic lithotripsy: The role of maximum ureteral wall thickness at the site of stone impaction

Urologia Journal

Objectives: To verify if the maximum thickness of the ureteral wall at the stone site (m-UWT) can... more Objectives: To verify if the maximum thickness of the ureteral wall at the stone site (m-UWT) can affect the outcomes of primary retrograde ureteroscopic lithotripsy (P-URSL) within a single-center dataset. Material and methods: We retrospectively reviewed data on 354 consecutive URSL performed from January 2020 to May 2022 at “Fondazione Poliambulanza” in Brescia (Italy). We included patients older than 18 years who underwent URSL for a single ureteral stone with a maximum diameter ranging from 5 to 10 mm. Patients with anatomical abnormalities, a positive preoperative urinary culture, or without a NCCT performed during the acute event were excluded. Patients were treated in an emergency setting (P-URSL within 48 h from the diagnosis of acute ureteral colic) or in a delayed one (D-URSL after a period of maximum 90 days of ureteral double-j stenting). For the resulting 139 patients we recorded demographic, clinical and stone-related features and perioperative data. We processed thes...

Research paper thumbnail of 509: Evidence for the Presence of α1 Adrenoceptor Subtypes in the Human Ureter

Research paper thumbnail of V04-12 Robot-Assisted Partial Nephrectomy and Bilateral Pyelolythotomy of Ectopic Pelvic Kidneys

The Journal of Urology

pyeloplasty as a modified technique during which the alignment of ureter and renal pelvis remains... more pyeloplasty as a modified technique during which the alignment of ureter and renal pelvis remains intact during ureteropelvic junction (UPJ) anastomosis. We also assessed intraoperative and postoperative outcomes of this modification in comparison to standard laparoscopic dismembered pyeloplasty. METHODS: Patients with significant primary UPJ obstruction without any previous history of abdominal surgery, high ureter insertion or renal anomalies were considered. The patients were consecutively enrolled one after another into one of two study groups: classic laparoscopic dismembered pyeloplasty (Group I) or laparoscopic in situ dismembered pyeloplasty (Group II), however, those with aberrant vessels crossing the UPJ were allocated specifically to Group I because UPJ anastomosis should be done anterior to the aberrant vessels. Demographic data, intraoperative timings, postoperative and follow-up outcomes were compared. RESULTS: Patients in Group I (n¼23) and Group II (n¼14) had similar demographic characteristics. Mean operative time was significantly longer in Group I (103.8AE19.95 min versus 89.5AE18.90 min, P¼0.038). Total duration of UPJ repair and anastomosis was also significantly longer in Group I (92.7AE15.82 versus 78.4AE 14.76 min, P¼0.021). The method of pyeloplasty significantly affected the time required to prepare ureter and renal pelvis (P¼0.017) and the duration of UPJ anastomosis (P¼0.014) (Figure 1). Both were shorter in Group II. Mean follow-up period was 14.4AE7.42 months in Group I and 14.05AE7.93 months in Group II (P¼0.88). Success rate was 95.6% in Group I and 100% in Group II (P¼0.42). CONCLUSIONS: Laparoscopic in situ pyeloplasty is a safe and effective approach to simplify laparoscopic pyeloplasty, especially at teaching centers where surgeons with variable levels of experience perform laparoscopic procedures.

Research paper thumbnail of Standard vs delayed ligature of the dorsal vascular complex during robot-assisted radical prostatectomy: results from a randomized controlled trial

Journal of Robotic Surgery

Purpose Prospective randomized trial to compare standard vs delayed approach to dorsal vascular c... more Purpose Prospective randomized trial to compare standard vs delayed approach to dorsal vascular complex (s-DVC vs d-DVC) in robot-assisted radical prostatectomy (RARP). Methods Patients scheduled for RARP were randomized into a 1:1 ratio to receive either s-DVC or d-DVC by two experienced surgeons. In s-DVC arm an eight-shaped single stitch was given at the beginning of the procedure and the DVC was subsequently cut at time of apical dissection; in d-DVC arm the plexus was transected at the end of prostatectomy, prior to apex dissection and then sutured. Primary endpoint was difference in estimated blood loss (EBL) and a sample size of 226 cases was calculated; ad interim analysis was planned after 2/3 of recruitment. Results Endpoint was reached at ad interim analysis after 162 cases (81 s-DVC, 81 d-DVC) and recruitment was, therefore, interrupted. Baseline and tumor characteristics were overlapping. EBL was significantly higher in d-DVC arm (mean EBL 107 vs 65 ml, p = 0.003), but without differences in post-operative hemoglobin, transfusions and complications. Overall PSM rate was higher in d-DVC arm (21.0 vs 14.8%, p = 0.323), with statistical significance relatively to organ-confined disease (15.5 vs 3.6%, p = 0.031). Apical involvement was instead significantly higher in s-DVC arm (prevalence in PSM patients 66.7 vs 23.5%, p = 0.020). Post-operative PSA, continence and potency rates were similar between groups. Conclusions Standard and delayed approaches to DVC are safe and lead to similar functional outcomes. A delayed approach exposes to a higher risk of PSM in organ-confined disease but with a lower risk of apical involvement.

Research paper thumbnail of Evidence for the Presence of α<sub>1</sub> Adrenoceptor Subtypes in the Human Ureter

Rivista Urologia, 2005

Several studies proposed a role for α1 adrenoceptors (α1 ARs) in the ureteral physiology, indicat... more Several studies proposed a role for α1 adrenoceptors (α1 ARs) in the ureteral physiology, indicating that they are present in the ureter; however, few studies have been made to identify α1 AR subtypes present in this area. Thus, this study was carried out to characterize the α1 AR subtype gene and protein expression in proximal, medial and distal region of the human ureter. Methods Molecular characterization of α1 AR subtypes was done by semi-quantitative RT-PCR. The α1 AR protein expression was studied by saturation binding curves using the α1 AR antagonist 125I-HEAT. Analysis of data was performed using the GraphPad PRISM 4 software. Results Analysis of saturation binding curves revealed an heterogeneous distribution of α1 AR binding sites; the Bmax for the distal ureter was indeed 52.5 ±5.4 fmol/mg prot, while a lower similar density of α1 ARs was demonstrated in the medial (25.2 ±1.7 fmol/mg prot) and proximal (23.4 ±0.4 fmol/mg prot) ureters. Molecular characterization of α1 AR subtypes indicated that each receptor was present, although with differences in term of the amount expressed. Conclusions Human ureter was endowed with each α1 AR subtype, although α1D and α1A ARs were prevalent over α1B ARs. Radioligand binding results revealed that there were no significant differences in the Kd between ureteral regions, while an heterogeneous distribution of α1 AR binding sites was detected, with the highest density of α1 ARs in the distal ureter and a lower similar density in the medial and proximal ureter.

Research paper thumbnail of Alpha1 adrenoceptors in human urinary tract:expression, distribution and clinical implications

Rivista Urologia, 2007

Adrenergic receptors (ARs) are a class of proteins belonging to the G proteincoupled receptor fam... more Adrenergic receptors (ARs) are a class of proteins belonging to the G proteincoupled receptor family. Pharmacological and molecular studies allowed dividing ARs into three different categories: α1, α2 and β. In this review, we focused on α1 ARs and α1 AR antagonists, since α1 ARs play an important role in the pathophysiology of a number of urinary tract (UT) dysfunctions. α1 ARs are widely expressed in human UT; in particular, the three ureter areas (distal, medial and proximal) show different patterns of receptor expression (i.e. distal > medial = proximal), giving the molecular basis for the use of α1 ARs antagonist in the expulsive therapy of distal ureter calculi. Bladder areas are characterized by important differences among trigone, detrusor and neck, the first showing a different pattern of expression compared to the other parts. Further, there are evidences of both density and subtype gender-dependent expressions. α1 ARs expression in prostate and detrusor is a widely investigated area of research, mainly due to the clinical impact of benign prostatic hyperplasia (BPH). Urethra has not been well studied in human, although it plays a role in the control of continence. Studies carried out on α1 AR subtype expression in the UT indicate that, although the presence of each subtype is observed, α1A firstly and then α1D ARs seem to be more expressed than α1B ARs. Thus, drugs that demonstrate high α1A/D AR selectivity have drawn the researchers' attention. As it relates specifically to the α1 AR antagonists used in the treatment of lower UT symptoms, the concept of uroselectivity has been operationally defined; indeed, in a number of recent publications uroselectivity has been defined as the degree to which a given compound inhibits norepinephrine-induced increase in urinary muscle contractions and/or its propensity to generate unwanted cardiovascular effects, such as decreases in blood pressure.

Research paper thumbnail of Microwave ablation to treat a urinary fistula after robot-assisted radical nephrectomy of a horseshoe kidney

Journal of vascular and interventional radiology, Mar 1, 2024

Research paper thumbnail of Identification and characterization of muscarinic receptors in human male detrusor and in primary cell culture of detrusor leiomyocytes

Research paper thumbnail of Stimulation of muscarinic receptors induces cell proliferation of human detrusor muscle cell

Research paper thumbnail of 180° Kidney lateral rotation: A rare cause of Ureteropelvic junction obstruction

European Urology Supplements, Sep 1, 2018

Research paper thumbnail of Risultati oncologici a breve-medio termine della prostatectomia radicale robot-assistita: studio comparativo prospettico non randomizzato

Rivista Urologia, Dec 5, 2012

Research paper thumbnail of Muscarinic receptor sub-types in the human urothelium: Gender- and age-dependent modifications

Research paper thumbnail of The effect of COVID-19 outbreak on endourological activities: a multicentric retrospective study

European Urology Open Science, 2021

Research paper thumbnail of Can robotic approach become the gold standard to perform ureteral re-implantation for deep infiltrating endometriosis involving the ureter? A retrospective comparative study from a single institution

European Urology Supplements, 2016

Research paper thumbnail of Robot-assisted simple prostatectomy and diverticulectomy

European Urology Supplements, 2016

Research paper thumbnail of Robot-assisted surgical management of complex renal cysts

European Urology Supplements, 2016

Research paper thumbnail of Muscarinic receptor messenger RNAS are differentially expressed in male and female normal human bladder

European Urology Supplements, 2003

Research paper thumbnail of Holographic reconstructions can aid surgical planning before partial nephrectomy: A head-to-head comparison with standard ct scan

European Urology Supplements, 2018

Research paper thumbnail of Ralp Can Reduce the Rate of Positive Surgical Margin: Comparison with Open Prostatectomy in a Medium Volume Center

Anticancer Research, 2015

Research paper thumbnail of Robot-assisted ureteral re-implantation with psoas hitching

European Urology Supplements, 2016

Research paper thumbnail of Outcomes of primary ureteroscopic lithotripsy: The role of maximum ureteral wall thickness at the site of stone impaction

Urologia Journal

Objectives: To verify if the maximum thickness of the ureteral wall at the stone site (m-UWT) can... more Objectives: To verify if the maximum thickness of the ureteral wall at the stone site (m-UWT) can affect the outcomes of primary retrograde ureteroscopic lithotripsy (P-URSL) within a single-center dataset. Material and methods: We retrospectively reviewed data on 354 consecutive URSL performed from January 2020 to May 2022 at “Fondazione Poliambulanza” in Brescia (Italy). We included patients older than 18 years who underwent URSL for a single ureteral stone with a maximum diameter ranging from 5 to 10 mm. Patients with anatomical abnormalities, a positive preoperative urinary culture, or without a NCCT performed during the acute event were excluded. Patients were treated in an emergency setting (P-URSL within 48 h from the diagnosis of acute ureteral colic) or in a delayed one (D-URSL after a period of maximum 90 days of ureteral double-j stenting). For the resulting 139 patients we recorded demographic, clinical and stone-related features and perioperative data. We processed thes...

Research paper thumbnail of 509: Evidence for the Presence of α1 Adrenoceptor Subtypes in the Human Ureter

Research paper thumbnail of V04-12 Robot-Assisted Partial Nephrectomy and Bilateral Pyelolythotomy of Ectopic Pelvic Kidneys

The Journal of Urology

pyeloplasty as a modified technique during which the alignment of ureter and renal pelvis remains... more pyeloplasty as a modified technique during which the alignment of ureter and renal pelvis remains intact during ureteropelvic junction (UPJ) anastomosis. We also assessed intraoperative and postoperative outcomes of this modification in comparison to standard laparoscopic dismembered pyeloplasty. METHODS: Patients with significant primary UPJ obstruction without any previous history of abdominal surgery, high ureter insertion or renal anomalies were considered. The patients were consecutively enrolled one after another into one of two study groups: classic laparoscopic dismembered pyeloplasty (Group I) or laparoscopic in situ dismembered pyeloplasty (Group II), however, those with aberrant vessels crossing the UPJ were allocated specifically to Group I because UPJ anastomosis should be done anterior to the aberrant vessels. Demographic data, intraoperative timings, postoperative and follow-up outcomes were compared. RESULTS: Patients in Group I (n¼23) and Group II (n¼14) had similar demographic characteristics. Mean operative time was significantly longer in Group I (103.8AE19.95 min versus 89.5AE18.90 min, P¼0.038). Total duration of UPJ repair and anastomosis was also significantly longer in Group I (92.7AE15.82 versus 78.4AE 14.76 min, P¼0.021). The method of pyeloplasty significantly affected the time required to prepare ureter and renal pelvis (P¼0.017) and the duration of UPJ anastomosis (P¼0.014) (Figure 1). Both were shorter in Group II. Mean follow-up period was 14.4AE7.42 months in Group I and 14.05AE7.93 months in Group II (P¼0.88). Success rate was 95.6% in Group I and 100% in Group II (P¼0.42). CONCLUSIONS: Laparoscopic in situ pyeloplasty is a safe and effective approach to simplify laparoscopic pyeloplasty, especially at teaching centers where surgeons with variable levels of experience perform laparoscopic procedures.

Research paper thumbnail of Standard vs delayed ligature of the dorsal vascular complex during robot-assisted radical prostatectomy: results from a randomized controlled trial

Journal of Robotic Surgery

Purpose Prospective randomized trial to compare standard vs delayed approach to dorsal vascular c... more Purpose Prospective randomized trial to compare standard vs delayed approach to dorsal vascular complex (s-DVC vs d-DVC) in robot-assisted radical prostatectomy (RARP). Methods Patients scheduled for RARP were randomized into a 1:1 ratio to receive either s-DVC or d-DVC by two experienced surgeons. In s-DVC arm an eight-shaped single stitch was given at the beginning of the procedure and the DVC was subsequently cut at time of apical dissection; in d-DVC arm the plexus was transected at the end of prostatectomy, prior to apex dissection and then sutured. Primary endpoint was difference in estimated blood loss (EBL) and a sample size of 226 cases was calculated; ad interim analysis was planned after 2/3 of recruitment. Results Endpoint was reached at ad interim analysis after 162 cases (81 s-DVC, 81 d-DVC) and recruitment was, therefore, interrupted. Baseline and tumor characteristics were overlapping. EBL was significantly higher in d-DVC arm (mean EBL 107 vs 65 ml, p = 0.003), but without differences in post-operative hemoglobin, transfusions and complications. Overall PSM rate was higher in d-DVC arm (21.0 vs 14.8%, p = 0.323), with statistical significance relatively to organ-confined disease (15.5 vs 3.6%, p = 0.031). Apical involvement was instead significantly higher in s-DVC arm (prevalence in PSM patients 66.7 vs 23.5%, p = 0.020). Post-operative PSA, continence and potency rates were similar between groups. Conclusions Standard and delayed approaches to DVC are safe and lead to similar functional outcomes. A delayed approach exposes to a higher risk of PSM in organ-confined disease but with a lower risk of apical involvement.