Elisabetta Costantini - Academia.edu (original) (raw)
Papers by Elisabetta Costantini
European Urology Supplements, 2018
Urinary tract infection still a challenge to figth: A real setting study P35 Do we really need sy... more Urinary tract infection still a challenge to figth: A real setting study P35 Do we really need systematic use of antimicrobial prophylaxis before transurethral resection of bladder tumor? P36 Urine culture, asymptomatic bacteriuria and diabetic patients. Is antibiotic prophylaxis always indicated? P37 Concordance of preoperative bladder urine, renal pelvic urine and stone cultures after endourological procedures and risk of systemic inflammatory response syndrome: Results from a cross-sectional study P38 Characterization of the novaginal microflora after surgical gender reassignment in HIV, HBV and HCV Seronegative transsexual women P39 Evaluation of insight into the diagnosis and management of tropical diseases among european urologists: Are we prepared to deal with mass migration? Results of an international survey P40 Effectiveness of Vacuum-Assisted Closure Therapy (VAC) in the management of disseminated fournier's gangrene: A multicentre study P41 L-Metionina associated with ibiscus sabdariffa and boswellia serrata (ACIDIF PLUS ®) extracts in patients affected by recurrent uncomplicated urinary tract infections: Is it a feasible alternative to antibiotic treatment? P42 Epidemiological features of resistance patterns among uropathogens: Focus on fosfomycin trometamol P43 Rate of complications and urinary infection after antibiotic prophylaxis with fosfomycin vs. standard of care in patients undergoing prostate biopsy: A randomized, single-blinded, clinical study P34 Urinary tract infection still a challenge to figth: A real setting study
The Journal of Urology, 2012
the three groups when compared to the 239 patients who were dry pre-operatively as well. Addition... more the three groups when compared to the 239 patients who were dry pre-operatively as well. Additionally, ALPP did not correlate with postoperative SUI based on sling type. CONCLUSIONS: Despite suburethral sling placement at the time of cystocele repair, some patients experience post-operative SUI which is usually reported as mild. There is no evidence for a direct correlation between ALPP on pre-operative urodynamics and the likelihood of continued SUI after cystocele repair with sling placement.
Costantini E, Natale F, Vittori G, Salvini E, Pastore A L, Di Biase M, Cervigni M 1. Department o... more Costantini E, Natale F, Vittori G, Salvini E, Pastore A L, Di Biase M, Cervigni M 1. Department of Medical-Surgical Specialties and Public Health, Urology and Andrology Section, University of Perugia, Italy, 2. Department of Gynecology, Urogynecology Section, S. Carlo-IDI Hospital, Rome, Italy, 3. Sapienza University of Rome, Faculty of Pharmacy and Medicine; Department of Medico-Surgical Sciences and Biotechnologies, Urology Unit
Life
Catheter-associated infections in bladder cancer patients, following radical cystectomy or ureter... more Catheter-associated infections in bladder cancer patients, following radical cystectomy or ureterocutaneostomy, are very frequent, and the development of antibiotic resistance poses great challenges for treating biofilm-based infections. Here, we characterized bacterial communities from catheters of patients who had undergone radical cystectomy for muscle-invasive bladder cancer. We evaluated the efficacy of conventional antibiotics, alone or combined with the human ApoB-derived antimicrobial peptide r(P)ApoBLAla, to treat ureteral catheter-colonizing bacterial communities on clinically isolated bacteria. Microbial communities adhering to indwelling catheters were collected during the patients’ regular catheter change schedules (28 days) and extracted within 48 h. Living bacteria were characterized using selective media and biochemical assays. Biofilm growth and novel antimicrobial strategies were analyzed using confocal laser scanning microscopy. Statistical analyses confirmed the ...
The Journal of Sexual Medicine, 2018
Introduction Coital urinary incontinence (CUI) is not much explored during clinical history, and ... more Introduction Coital urinary incontinence (CUI) is not much explored during clinical history, and this could lead to an underestimation of the problem. Aim To evaluate the prevalence and clinical risk factors of CUI in women with urinary incontinence (UI), and to measure the impact of CUI on women’s sexuality and quality of life. Methods This was a multicenter international study, conducted in Italy, Greece, the United States, and Egypt. Inclusion criteria were: sexually active women with UI and in a stable relationship for at least 6 months. Exclusion criteria were: age <18 years and unstable relationship. The UI was classified as stress UI (SUI), urgency UI (UUI), and mixed UI (MUI). Women completed a questionnaire on demographics and medical history, in particular on UI and possible CUI and the timing of its occurrence, and the impact of CUI on quality and frequency of their sexual life. Main Outcome Measures To evaluate the CUI and its impact on sexual life we used the open qu...
European Urology Supplements, 2012
The Journal of Urology, 2016
European Urology Supplements, 2004
European Urology Supplements, 2004
European Urology Supplements, 2002
European Urology Supplements, 2002
The Journal of Urology, 2009
®19 (21.3%) had grade 4 cystoceles. In addition to the CaPS procedure, 50 (57%) underwent additio... more ®19 (21.3%) had grade 4 cystoceles. In addition to the CaPS procedure, 50 (57%) underwent additional prolapse surgery. Nine patients (10%) had recurrence of cystocele with a mean time to recurrence of 29.7 months (range 12-50). Of the 9 patients with cystocele recurrence, 3 patients (33%) had grade 4 cystocele, 5 patients (56%) had grade 3, and 1 patient (11%) had grade 2 cystocele. The mean SEAPI scores were 6.75 preoperatively and 2.22 postoperatively, representing a significant improvement (p <0.001). Of the 62 patients with preoperative stress urinary incontinence, 26 (42%) reported being completely dry (no incontinence episodes of any type). Fifty-three of the 65 (85%) reported at least 50% improvement in their incontinence. Of the 87 patients 61 (70%) were greater than 80% satisfied and 77 (86%) stated that they would undergo the CaPS procedure again. CONCLUSIONS: With a maximum follow-up of over 9 years in patients undergoing CaPS, results are excellent and durable with the use of cadaveric fascia lata for cystocele repair
Journal of Surgical Oncology, 2000
Background and Objectives: We present the long-term functional results of a new technique for bla... more Background and Objectives: We present the long-term functional results of a new technique for bladder substitution after cystectomy for bladder cancer in women. Methods: Between 1991 and 1995, 10 women underwent radical cystectomy for bladder cancer with a new technique. We created a detubularized rectosigmoid neobladder associated with either a terminal colostomy or intrasphincteric perineal colostomy section (Heitz-Boyer-Hovelacque). We evaluated neobladder functioning over almost 5 years by means of urodynamic studies, ultrasound scans, urograms and pouchgrams, and renal function tests. Results: Neobladder function was excellent in all patients, with good diurnal and nocturnal urinary continence, voiding patterns, and preservation of the upper urinary tract. Conclusions: This new technique, which is a modification of the standard rectal or rectosigmoid neobladder technique, is a valid alternative to the ortothopic neobladder in women, with good functional results.
European Urology, 2011
Referring to the article published on pp. 253-260 of this issue
The Journal of Urology, 2012
impact that ‘never events’ had on mortality, length of stay (LOS), and total hospital charges was... more impact that ‘never events’ had on mortality, length of stay (LOS), and total hospital charges was determined. RESULTS: The overall rate for ‘never event’ was 8.2%. Most common were SSI (3.7%), DVT/PE (2.7%), and vascular-catheter infection (1.3%). Demographics that predicted ‘never events’ included black race (OR 1.5, 95% CI 1.3 – 1.8), increasing age (OR 1.01, 95% CI 1.00 – 1.01), comorbidities (OR 1.3, 95% CI 1.1 – 1.5), Medicare insurance (OR 1.3, 95% CI 1.2 – 1.4). ‘Never event’ rate was decreased in females (OR 0.8, 95% CI 0.7 – 0.9), urban nonteaching hospitals (OR 0.7, 95% CI 0.6 – 0.8) and high cystectomy volume hospitals (OR 0.8, 95% CI 0.7 – 0.9). ‘Never events’ increased average LOS (by 13 days), total charges (by $80,000), and odds of in-hospital mortality (9.7% vs. 1.8%). CONCLUSIONS: ‘Never events’ are more likely in older patients with more comorbidities. Developing a ‘never event’ strongly predicts negative patient outcomes including higher LOS, charges, in-hospital mortality. High-risk populations may benefit from a case risk adjustment process prior to implementing a significant alteration in hospital or physician reimbursement policies.
European Urology, 2007
Objectives: To compare transurethral resection of prostate (TURP) using monopolar and bipolar tra... more Objectives: To compare transurethral resection of prostate (TURP) using monopolar and bipolar transurethral resection in saline (TURIS) system. Materials and methods: A prospectively randomized study was conducted between January 2004 and January 2005. Patient demographics and indications for surgery were recorded. The safety end points studied were occurrence of complications and decline in postoperative serum sodium (Na +) and hemoglobin (Hb) levels. Efficacy end points were resection time, weight of resected prostate tissue, and improvement in International Prostate Symptoms Score (IPSS) and maximum flow rate (Q max) in patients' uroflow over 12 mo. Results: One hundred consecutive patients were randomized and completed the study, with 52 patients in the monopolar TURP group and 48 in the TURIS group. At baseline, the two groups were comparable; they had at least 12 mo of follow-up. Mean resection time and mean weight of resected prostate tissue were comparable for both groups. Declines in the mean postoperative serum Na + for TURIS and monopolar TURP groups were 3.2 and 10.7 mmol/l, respectively (p < 0.01). However, there was no statistical difference in the decline in postoperative Hb between the two groups. There were two cases of clinically significant transurethral resection syndrome in the monopolar group. Urethral strictures were observed in three cases of TURIS and one patient in the monopolar group. The IPSS and Q max improvements were comparable between the two groups at 12 mo of follow-up. Conclusions: Bipolar TURP using the TURIS system is clinically comparable to monopolar TURP at 1 yr with an improved safety profile.
Journal of Clinical Medicine, 2022
The aim of the present study is to analyze the outcomes of urethral bulking in the treatment of n... more The aim of the present study is to analyze the outcomes of urethral bulking in the treatment of non-neurogenic female stress and mixed urinary incontinence and to assess predictors of clinical outcomes. We retrospectively included all consecutive patients affected by stress or mixed urinary incontinence and treated with urethral bulking. Outcomes were evaluated via the PGI-I questionnaire and the 24-h pad test. Between January 2010 and January 2020, we treated 216 patients (Bulkamid n = 206; Macro-plastique n = 10). The median age at surgery was 66 years (IQR 55–73.75). The median follow-up was 12 months (IQR 12–24). In total, 23.8% of patients were subjected to prior incontinence surgery, 63.8% of patients were affected by genuine stress urinary incontinence, 36.2% reported mixed urinary incontinence, whereas detrusor overactivity was confirmed in only 24.9%. The dry rate was 32.9%; nevertheless, 69.9% of patients declared themselves “very improved” or “improved” (PGI-I1-2). Low co...
Journal of Clinical Medicine, 2021
Background: the aim of this study was to perform an Italian telematics survey analysis on the cha... more Background: the aim of this study was to perform an Italian telematics survey analysis on the changes in couples’ sex lives during the coronavirus disease 2019 (COVID-19) lockdown. Methods: a multicenter cross sectional study was conducted on people sexually active and in stable relationships for at least 6 months. To evaluate male and female sexual dysfunctions, we used the international index of erectile function (IIEF-15) and the female sexual function index (FSFI), respectively; marital quality and stability were evaluated by the marital adjustment test (items 10–15); to evaluate the severity of anxiety symptoms, we used the Hamilton Anxiety Rating Scale. The effects of the quarantine on couples’ relationships was assessed with questions created in-house. Results: we included 2149 participants. The sex lives improved for 49% of participants, particularly those in cohabitation; for 29% it deteriorated, while for 22% of participants it did not change. Women who responded that thei...
European Urology Supplements, 2018
Urinary tract infection still a challenge to figth: A real setting study P35 Do we really need sy... more Urinary tract infection still a challenge to figth: A real setting study P35 Do we really need systematic use of antimicrobial prophylaxis before transurethral resection of bladder tumor? P36 Urine culture, asymptomatic bacteriuria and diabetic patients. Is antibiotic prophylaxis always indicated? P37 Concordance of preoperative bladder urine, renal pelvic urine and stone cultures after endourological procedures and risk of systemic inflammatory response syndrome: Results from a cross-sectional study P38 Characterization of the novaginal microflora after surgical gender reassignment in HIV, HBV and HCV Seronegative transsexual women P39 Evaluation of insight into the diagnosis and management of tropical diseases among european urologists: Are we prepared to deal with mass migration? Results of an international survey P40 Effectiveness of Vacuum-Assisted Closure Therapy (VAC) in the management of disseminated fournier's gangrene: A multicentre study P41 L-Metionina associated with ibiscus sabdariffa and boswellia serrata (ACIDIF PLUS ®) extracts in patients affected by recurrent uncomplicated urinary tract infections: Is it a feasible alternative to antibiotic treatment? P42 Epidemiological features of resistance patterns among uropathogens: Focus on fosfomycin trometamol P43 Rate of complications and urinary infection after antibiotic prophylaxis with fosfomycin vs. standard of care in patients undergoing prostate biopsy: A randomized, single-blinded, clinical study P34 Urinary tract infection still a challenge to figth: A real setting study
The Journal of Urology, 2012
the three groups when compared to the 239 patients who were dry pre-operatively as well. Addition... more the three groups when compared to the 239 patients who were dry pre-operatively as well. Additionally, ALPP did not correlate with postoperative SUI based on sling type. CONCLUSIONS: Despite suburethral sling placement at the time of cystocele repair, some patients experience post-operative SUI which is usually reported as mild. There is no evidence for a direct correlation between ALPP on pre-operative urodynamics and the likelihood of continued SUI after cystocele repair with sling placement.
Costantini E, Natale F, Vittori G, Salvini E, Pastore A L, Di Biase M, Cervigni M 1. Department o... more Costantini E, Natale F, Vittori G, Salvini E, Pastore A L, Di Biase M, Cervigni M 1. Department of Medical-Surgical Specialties and Public Health, Urology and Andrology Section, University of Perugia, Italy, 2. Department of Gynecology, Urogynecology Section, S. Carlo-IDI Hospital, Rome, Italy, 3. Sapienza University of Rome, Faculty of Pharmacy and Medicine; Department of Medico-Surgical Sciences and Biotechnologies, Urology Unit
Life
Catheter-associated infections in bladder cancer patients, following radical cystectomy or ureter... more Catheter-associated infections in bladder cancer patients, following radical cystectomy or ureterocutaneostomy, are very frequent, and the development of antibiotic resistance poses great challenges for treating biofilm-based infections. Here, we characterized bacterial communities from catheters of patients who had undergone radical cystectomy for muscle-invasive bladder cancer. We evaluated the efficacy of conventional antibiotics, alone or combined with the human ApoB-derived antimicrobial peptide r(P)ApoBLAla, to treat ureteral catheter-colonizing bacterial communities on clinically isolated bacteria. Microbial communities adhering to indwelling catheters were collected during the patients’ regular catheter change schedules (28 days) and extracted within 48 h. Living bacteria were characterized using selective media and biochemical assays. Biofilm growth and novel antimicrobial strategies were analyzed using confocal laser scanning microscopy. Statistical analyses confirmed the ...
The Journal of Sexual Medicine, 2018
Introduction Coital urinary incontinence (CUI) is not much explored during clinical history, and ... more Introduction Coital urinary incontinence (CUI) is not much explored during clinical history, and this could lead to an underestimation of the problem. Aim To evaluate the prevalence and clinical risk factors of CUI in women with urinary incontinence (UI), and to measure the impact of CUI on women’s sexuality and quality of life. Methods This was a multicenter international study, conducted in Italy, Greece, the United States, and Egypt. Inclusion criteria were: sexually active women with UI and in a stable relationship for at least 6 months. Exclusion criteria were: age <18 years and unstable relationship. The UI was classified as stress UI (SUI), urgency UI (UUI), and mixed UI (MUI). Women completed a questionnaire on demographics and medical history, in particular on UI and possible CUI and the timing of its occurrence, and the impact of CUI on quality and frequency of their sexual life. Main Outcome Measures To evaluate the CUI and its impact on sexual life we used the open qu...
European Urology Supplements, 2012
The Journal of Urology, 2016
European Urology Supplements, 2004
European Urology Supplements, 2004
European Urology Supplements, 2002
European Urology Supplements, 2002
The Journal of Urology, 2009
®19 (21.3%) had grade 4 cystoceles. In addition to the CaPS procedure, 50 (57%) underwent additio... more ®19 (21.3%) had grade 4 cystoceles. In addition to the CaPS procedure, 50 (57%) underwent additional prolapse surgery. Nine patients (10%) had recurrence of cystocele with a mean time to recurrence of 29.7 months (range 12-50). Of the 9 patients with cystocele recurrence, 3 patients (33%) had grade 4 cystocele, 5 patients (56%) had grade 3, and 1 patient (11%) had grade 2 cystocele. The mean SEAPI scores were 6.75 preoperatively and 2.22 postoperatively, representing a significant improvement (p <0.001). Of the 62 patients with preoperative stress urinary incontinence, 26 (42%) reported being completely dry (no incontinence episodes of any type). Fifty-three of the 65 (85%) reported at least 50% improvement in their incontinence. Of the 87 patients 61 (70%) were greater than 80% satisfied and 77 (86%) stated that they would undergo the CaPS procedure again. CONCLUSIONS: With a maximum follow-up of over 9 years in patients undergoing CaPS, results are excellent and durable with the use of cadaveric fascia lata for cystocele repair
Journal of Surgical Oncology, 2000
Background and Objectives: We present the long-term functional results of a new technique for bla... more Background and Objectives: We present the long-term functional results of a new technique for bladder substitution after cystectomy for bladder cancer in women. Methods: Between 1991 and 1995, 10 women underwent radical cystectomy for bladder cancer with a new technique. We created a detubularized rectosigmoid neobladder associated with either a terminal colostomy or intrasphincteric perineal colostomy section (Heitz-Boyer-Hovelacque). We evaluated neobladder functioning over almost 5 years by means of urodynamic studies, ultrasound scans, urograms and pouchgrams, and renal function tests. Results: Neobladder function was excellent in all patients, with good diurnal and nocturnal urinary continence, voiding patterns, and preservation of the upper urinary tract. Conclusions: This new technique, which is a modification of the standard rectal or rectosigmoid neobladder technique, is a valid alternative to the ortothopic neobladder in women, with good functional results.
European Urology, 2011
Referring to the article published on pp. 253-260 of this issue
The Journal of Urology, 2012
impact that ‘never events’ had on mortality, length of stay (LOS), and total hospital charges was... more impact that ‘never events’ had on mortality, length of stay (LOS), and total hospital charges was determined. RESULTS: The overall rate for ‘never event’ was 8.2%. Most common were SSI (3.7%), DVT/PE (2.7%), and vascular-catheter infection (1.3%). Demographics that predicted ‘never events’ included black race (OR 1.5, 95% CI 1.3 – 1.8), increasing age (OR 1.01, 95% CI 1.00 – 1.01), comorbidities (OR 1.3, 95% CI 1.1 – 1.5), Medicare insurance (OR 1.3, 95% CI 1.2 – 1.4). ‘Never event’ rate was decreased in females (OR 0.8, 95% CI 0.7 – 0.9), urban nonteaching hospitals (OR 0.7, 95% CI 0.6 – 0.8) and high cystectomy volume hospitals (OR 0.8, 95% CI 0.7 – 0.9). ‘Never events’ increased average LOS (by 13 days), total charges (by $80,000), and odds of in-hospital mortality (9.7% vs. 1.8%). CONCLUSIONS: ‘Never events’ are more likely in older patients with more comorbidities. Developing a ‘never event’ strongly predicts negative patient outcomes including higher LOS, charges, in-hospital mortality. High-risk populations may benefit from a case risk adjustment process prior to implementing a significant alteration in hospital or physician reimbursement policies.
European Urology, 2007
Objectives: To compare transurethral resection of prostate (TURP) using monopolar and bipolar tra... more Objectives: To compare transurethral resection of prostate (TURP) using monopolar and bipolar transurethral resection in saline (TURIS) system. Materials and methods: A prospectively randomized study was conducted between January 2004 and January 2005. Patient demographics and indications for surgery were recorded. The safety end points studied were occurrence of complications and decline in postoperative serum sodium (Na +) and hemoglobin (Hb) levels. Efficacy end points were resection time, weight of resected prostate tissue, and improvement in International Prostate Symptoms Score (IPSS) and maximum flow rate (Q max) in patients' uroflow over 12 mo. Results: One hundred consecutive patients were randomized and completed the study, with 52 patients in the monopolar TURP group and 48 in the TURIS group. At baseline, the two groups were comparable; they had at least 12 mo of follow-up. Mean resection time and mean weight of resected prostate tissue were comparable for both groups. Declines in the mean postoperative serum Na + for TURIS and monopolar TURP groups were 3.2 and 10.7 mmol/l, respectively (p < 0.01). However, there was no statistical difference in the decline in postoperative Hb between the two groups. There were two cases of clinically significant transurethral resection syndrome in the monopolar group. Urethral strictures were observed in three cases of TURIS and one patient in the monopolar group. The IPSS and Q max improvements were comparable between the two groups at 12 mo of follow-up. Conclusions: Bipolar TURP using the TURIS system is clinically comparable to monopolar TURP at 1 yr with an improved safety profile.
Journal of Clinical Medicine, 2022
The aim of the present study is to analyze the outcomes of urethral bulking in the treatment of n... more The aim of the present study is to analyze the outcomes of urethral bulking in the treatment of non-neurogenic female stress and mixed urinary incontinence and to assess predictors of clinical outcomes. We retrospectively included all consecutive patients affected by stress or mixed urinary incontinence and treated with urethral bulking. Outcomes were evaluated via the PGI-I questionnaire and the 24-h pad test. Between January 2010 and January 2020, we treated 216 patients (Bulkamid n = 206; Macro-plastique n = 10). The median age at surgery was 66 years (IQR 55–73.75). The median follow-up was 12 months (IQR 12–24). In total, 23.8% of patients were subjected to prior incontinence surgery, 63.8% of patients were affected by genuine stress urinary incontinence, 36.2% reported mixed urinary incontinence, whereas detrusor overactivity was confirmed in only 24.9%. The dry rate was 32.9%; nevertheless, 69.9% of patients declared themselves “very improved” or “improved” (PGI-I1-2). Low co...
Journal of Clinical Medicine, 2021
Background: the aim of this study was to perform an Italian telematics survey analysis on the cha... more Background: the aim of this study was to perform an Italian telematics survey analysis on the changes in couples’ sex lives during the coronavirus disease 2019 (COVID-19) lockdown. Methods: a multicenter cross sectional study was conducted on people sexually active and in stable relationships for at least 6 months. To evaluate male and female sexual dysfunctions, we used the international index of erectile function (IIEF-15) and the female sexual function index (FSFI), respectively; marital quality and stability were evaluated by the marital adjustment test (items 10–15); to evaluate the severity of anxiety symptoms, we used the Hamilton Anxiety Rating Scale. The effects of the quarantine on couples’ relationships was assessed with questions created in-house. Results: we included 2149 participants. The sex lives improved for 49% of participants, particularly those in cohabitation; for 29% it deteriorated, while for 22% of participants it did not change. Women who responded that thei...