Francesco Cappellano | Multimedica IRCCS (original) (raw)

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Papers by Francesco Cappellano

Research paper thumbnail of Prevalence of Positive Trigger Points for Pelvic Pain Suggestive of Pudendal Nevralgiain 100 Women with Pelvic Floor Dysfunctions

Research paper thumbnail of Percutaneous Tibial Nerve Stimulation (PTNS): Results at long term follow-up

Research paper thumbnail of Percutaneous tibial nerve stimulation (PTNS) in the treatment of LUTS secondary to Parkinson's disease

Hypothesis / aims of study It is well known that lower urinary tract symptoms (LUTS) such as urge... more Hypothesis / aims of study It is well known that lower urinary tract symptoms (LUTS) such as urgency, increased urinary frequency and urinary incontinence are present in as much as two thirds of parkinsonian patients (1). It is often difficult to treat PD patients with LUTS of both filling and voiding phase, because drugs as antimuscarinic could be contraindicated. Thus, alternative treatments must be found. Few data have been published on the role of percutaneous tibial nerve stimulation (PTNS) in the treatment of LUTS secondary to Parkinson’s disease (PD). Amarenco showed an acute positive effect of PTNS on detrusor overactivity in a population of neurogenic patients, some affected by PD (2). Aim of this study was to investigate effects of PTNS on PD patients with LUTS of the filling phase, but presenting significant post-void residual urine.

Research paper thumbnail of Results of rehabilitation therapy in the treatment of urinary stress incontinence

Urologia Journal, 1995

Risultati della terapia riabilitativa nel trattamento della incontinenza urinaria da sforzo Resul... more Risultati della terapia riabilitativa nel trattamento della incontinenza urinaria da sforzo Results of rehabilitation therapy in the treatment of urinary stress incontinence

Research paper thumbnail of Sacral root neuromodulation in chronic lower urinary tract dysfunction: Preliminary reports on our clinical experience

Urologia Journal, 1995

— Chronic lower urinary tract dysfunction not responsive to conventional therapies can be treated... more — Chronic lower urinary tract dysfunction not responsive to conventional therapies can be treated by sacral root neuromodulation. Before implantation of a permanent stimulator, the effect is tested by temporary implantation of a wire electrode connected to an external stimulator (PNE). We report our experience with 19 PNE and 2 permanent implants with a follow-up of 12 and 6 months, very good results and no serious side effects. A short excursus follows about PNE and the permanent implant technique and above all indications of this technique and patient selection. From our clinical experience and data, patients with excellent response to PNE, who have urethral or detrusorial instability, would appear to respond best after permanent implant.

Research paper thumbnail of Pudendal Nerve Brain Mapping in Healthy Subjects Proposal of a New Neurophysiological Tool for the Functional Evaluation of CNS

Associato All'USPI - Unione Stampa Periodica Italia, 2005

Research paper thumbnail of Vaginal Collagen Remodelling After Fractional Carbon Dioxide Laser Surgery

Neurourology and Urodynamics, 2011

Hypothesis / aims of study The process of becoming older is genetically determined and environmen... more Hypothesis / aims of study The process of becoming older is genetically determined and environmentally modulated. The process of vaginal ageing itself can contribute to the loss of vaginal trophism, tone, support and function with a consequent increased risk of lower urinary tract symptoms and pelvic floor dysfunction. Connective tissues and collagen constituents and architecture play an important role in this ageing process. With age, in fact, collagen fibrils loose their reticular spatial disposition and, the Type I/III ratio is altered compared to premenopausal state. The aim of this study is to assess if CO2 laser at the level of vaginal mucosa can determine new collagen formation or modification as shown in the skin [1] .

Research paper thumbnail of Effectiveness of Sacral Neuromodulation in the Management of Refractory Bladder Pain Syndrome

Research paper thumbnail of Intermittent sacral root neuromodulation (ISRN): a novel therapy for the treatment of chronic pelvic pain syndrome (CPPS)

Research paper thumbnail of Pudendal nerve brain mapping in healthy subjects: Proposal of a new neurophysiological tool for the functional evaluation of CNS

Hypothesis / aims of study The precise identification of the anatomical cerebral structures invol... more Hypothesis / aims of study The precise identification of the anatomical cerebral structures involved in micturition can contribute to a better understanding of the control of urine storage and micturition and the development of therapeutic models. Functional brain evaluation of central nervous system (CNS) using PET and fMRI offers a powerful but expensive tool for the non-invasive localization of sensorimotor areas involved in micturition. It’s well known that the general principle for neuromodulation in the urogenital area is to activate artificially normal detrusor inibitory reflexes. The inhibitory effect on the urinary bladder is mediated by the activation of pudendal afferents, resulting in direct inhibition of the pelvic nerve outflow via the Onuf’s nucleus and also by cortical inhibition as shown recently by Jianget al. State-of-art literature doesn’t provide any information about cortical representation of pudendal nerve afferents using non invasive functional brain imaging...

Research paper thumbnail of Sacral neuromodulation and previous pelvic surgery: Long-term results of a prospective multi-centre study

Research paper thumbnail of Pudendal nerve block under neurophysiologic guidance for the treatment of chronic pelvic pain (CPP): Technical notes and clinical results

Research paper thumbnail of Comment on: Results of Sacral Neuromodulation Therapy for Urinary Voiding Dysfunction : Outcomes of a Prospective, Worldwide Clinical Study. Authors' reply

The Journal of Urology, 2008

Research paper thumbnail of Sacral Neuromodulation in Children

Stimulation of the parasympathetic nerves via the sacral micturition centre travels in the pelvic... more Stimulation of the parasympathetic nerves via the sacral micturition centre travels in the pelvic nerve, resulting in contraction of the detrusor muscle and relaxation of the sphincter facilitating micturition. Different modalities of neuromodulation have been used in children, and the level of interest for treating bladder-bowel dysfunction is high with SNM over time. In adult patients invasive SNM using electrode in third sacral foramina is largely utilized while is limited in paediatrics. Indications still controversial, and the third sacral (S3) nerve root remains the main access point used for neuromodulation. Nowadays this treatment is considered as a second- or third-line treatment for patients when conservative or less-invasive treatment has failed. Moreover some studies in literature have demonstrated their safety and effectiveness in well-selected cases as a reversible and mini-invasive treatment for neurogenic bladder, demonstrating an improvement on urodynamic parameters...

Research paper thumbnail of Considerazioni sull'utilizzo degli stent temporanei nel trattamento delle stenosi uretrali

Research paper thumbnail of Vaginal repair of vesico-vaginal fistulas: our experience

Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica, 2005

Vesico-vaginal fistula repair is feasible both with abdominal and vaginal approach. We report our... more Vesico-vaginal fistula repair is feasible both with abdominal and vaginal approach. We report our experience in vaginal repair of 34 vesico vaginal fistulas. Twenty-eight out of 34 fistulas have been treated by vaginal repair (82.3%) (in 2 cases after an attempt of endoscopic repair), 4/34 (11.8%) by abdominal repair and 4/34 (11.8%) by endoscopic repair with good outcome in 2 cases. In 96% of fistulas treated by vaginal repair (27/28) we obtained a complete recovery; in one patient we observed fistula recurrence after 2 months from the operation. Four patients were treated by abdominal approach: in two complex patients with vesico-uretero-vaginal fistula, the repair was associated with entero-cystoplasty and ureteral reimplantation; in one case of huge fistula following cesarean section (7 cm) a vesical flap was used; in one case we repaired a recurrent fistula in orthotopic ileal neobladder: A good outcome was achieved in all cases. Vaginal approach is less aggressive, well accept...

Research paper thumbnail of Impianto uretrale di gax collagene nell'incontinenza urinaria da stress: Studio ecografico a breve e lungo follow-up

Research paper thumbnail of La neuromodulazione delle radici sacrali nel trattamento dell'incontinenza urinaria femminile da urgenza e mista

Research paper thumbnail of Is hyperpathic urethra the main target of percutaneous tibialis nerve neuromodulation (PTNM)? Our 6 years experience

Research paper thumbnail of Incontinenza urinaria iatrogena maschile: opzioni terapeutiche proponibili. Gli iniettabili

Iatrogenic urinary incontinence in male is increasing due to surgical (radiotherapic) treatment o... more Iatrogenic urinary incontinence in male is increasing due to surgical (radiotherapic) treatment of prostatic cancer. Surgery is responsable of intrinsic urethral deficency with the loss of the urethral sealing effect. Bulking agents work recreating the urethral sealing effect without bladder outlet obstruction. Since 1938 many different materials have been proposed but "the ideal" substance has not yet been found. This tecnique is interesting because of the mininvasivity: different authors proposed different sites of injection and the patient's selection has different criteria, thus there is a large variability in the results. The authors report success (dry) between 10% and 40%, and improvement beetwen 20% and 60%. The positive effect is not stable over the time and repeted procedures are often needed.

Research paper thumbnail of Prevalence of Positive Trigger Points for Pelvic Pain Suggestive of Pudendal Nevralgiain 100 Women with Pelvic Floor Dysfunctions

Research paper thumbnail of Percutaneous Tibial Nerve Stimulation (PTNS): Results at long term follow-up

Research paper thumbnail of Percutaneous tibial nerve stimulation (PTNS) in the treatment of LUTS secondary to Parkinson's disease

Hypothesis / aims of study It is well known that lower urinary tract symptoms (LUTS) such as urge... more Hypothesis / aims of study It is well known that lower urinary tract symptoms (LUTS) such as urgency, increased urinary frequency and urinary incontinence are present in as much as two thirds of parkinsonian patients (1). It is often difficult to treat PD patients with LUTS of both filling and voiding phase, because drugs as antimuscarinic could be contraindicated. Thus, alternative treatments must be found. Few data have been published on the role of percutaneous tibial nerve stimulation (PTNS) in the treatment of LUTS secondary to Parkinson’s disease (PD). Amarenco showed an acute positive effect of PTNS on detrusor overactivity in a population of neurogenic patients, some affected by PD (2). Aim of this study was to investigate effects of PTNS on PD patients with LUTS of the filling phase, but presenting significant post-void residual urine.

Research paper thumbnail of Results of rehabilitation therapy in the treatment of urinary stress incontinence

Urologia Journal, 1995

Risultati della terapia riabilitativa nel trattamento della incontinenza urinaria da sforzo Resul... more Risultati della terapia riabilitativa nel trattamento della incontinenza urinaria da sforzo Results of rehabilitation therapy in the treatment of urinary stress incontinence

Research paper thumbnail of Sacral root neuromodulation in chronic lower urinary tract dysfunction: Preliminary reports on our clinical experience

Urologia Journal, 1995

— Chronic lower urinary tract dysfunction not responsive to conventional therapies can be treated... more — Chronic lower urinary tract dysfunction not responsive to conventional therapies can be treated by sacral root neuromodulation. Before implantation of a permanent stimulator, the effect is tested by temporary implantation of a wire electrode connected to an external stimulator (PNE). We report our experience with 19 PNE and 2 permanent implants with a follow-up of 12 and 6 months, very good results and no serious side effects. A short excursus follows about PNE and the permanent implant technique and above all indications of this technique and patient selection. From our clinical experience and data, patients with excellent response to PNE, who have urethral or detrusorial instability, would appear to respond best after permanent implant.

Research paper thumbnail of Pudendal Nerve Brain Mapping in Healthy Subjects Proposal of a New Neurophysiological Tool for the Functional Evaluation of CNS

Associato All'USPI - Unione Stampa Periodica Italia, 2005

Research paper thumbnail of Vaginal Collagen Remodelling After Fractional Carbon Dioxide Laser Surgery

Neurourology and Urodynamics, 2011

Hypothesis / aims of study The process of becoming older is genetically determined and environmen... more Hypothesis / aims of study The process of becoming older is genetically determined and environmentally modulated. The process of vaginal ageing itself can contribute to the loss of vaginal trophism, tone, support and function with a consequent increased risk of lower urinary tract symptoms and pelvic floor dysfunction. Connective tissues and collagen constituents and architecture play an important role in this ageing process. With age, in fact, collagen fibrils loose their reticular spatial disposition and, the Type I/III ratio is altered compared to premenopausal state. The aim of this study is to assess if CO2 laser at the level of vaginal mucosa can determine new collagen formation or modification as shown in the skin [1] .

Research paper thumbnail of Effectiveness of Sacral Neuromodulation in the Management of Refractory Bladder Pain Syndrome

Research paper thumbnail of Intermittent sacral root neuromodulation (ISRN): a novel therapy for the treatment of chronic pelvic pain syndrome (CPPS)

Research paper thumbnail of Pudendal nerve brain mapping in healthy subjects: Proposal of a new neurophysiological tool for the functional evaluation of CNS

Hypothesis / aims of study The precise identification of the anatomical cerebral structures invol... more Hypothesis / aims of study The precise identification of the anatomical cerebral structures involved in micturition can contribute to a better understanding of the control of urine storage and micturition and the development of therapeutic models. Functional brain evaluation of central nervous system (CNS) using PET and fMRI offers a powerful but expensive tool for the non-invasive localization of sensorimotor areas involved in micturition. It’s well known that the general principle for neuromodulation in the urogenital area is to activate artificially normal detrusor inibitory reflexes. The inhibitory effect on the urinary bladder is mediated by the activation of pudendal afferents, resulting in direct inhibition of the pelvic nerve outflow via the Onuf’s nucleus and also by cortical inhibition as shown recently by Jianget al. State-of-art literature doesn’t provide any information about cortical representation of pudendal nerve afferents using non invasive functional brain imaging...

Research paper thumbnail of Sacral neuromodulation and previous pelvic surgery: Long-term results of a prospective multi-centre study

Research paper thumbnail of Pudendal nerve block under neurophysiologic guidance for the treatment of chronic pelvic pain (CPP): Technical notes and clinical results

Research paper thumbnail of Comment on: Results of Sacral Neuromodulation Therapy for Urinary Voiding Dysfunction : Outcomes of a Prospective, Worldwide Clinical Study. Authors' reply

The Journal of Urology, 2008

Research paper thumbnail of Sacral Neuromodulation in Children

Stimulation of the parasympathetic nerves via the sacral micturition centre travels in the pelvic... more Stimulation of the parasympathetic nerves via the sacral micturition centre travels in the pelvic nerve, resulting in contraction of the detrusor muscle and relaxation of the sphincter facilitating micturition. Different modalities of neuromodulation have been used in children, and the level of interest for treating bladder-bowel dysfunction is high with SNM over time. In adult patients invasive SNM using electrode in third sacral foramina is largely utilized while is limited in paediatrics. Indications still controversial, and the third sacral (S3) nerve root remains the main access point used for neuromodulation. Nowadays this treatment is considered as a second- or third-line treatment for patients when conservative or less-invasive treatment has failed. Moreover some studies in literature have demonstrated their safety and effectiveness in well-selected cases as a reversible and mini-invasive treatment for neurogenic bladder, demonstrating an improvement on urodynamic parameters...

Research paper thumbnail of Considerazioni sull'utilizzo degli stent temporanei nel trattamento delle stenosi uretrali

Research paper thumbnail of Vaginal repair of vesico-vaginal fistulas: our experience

Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica, 2005

Vesico-vaginal fistula repair is feasible both with abdominal and vaginal approach. We report our... more Vesico-vaginal fistula repair is feasible both with abdominal and vaginal approach. We report our experience in vaginal repair of 34 vesico vaginal fistulas. Twenty-eight out of 34 fistulas have been treated by vaginal repair (82.3%) (in 2 cases after an attempt of endoscopic repair), 4/34 (11.8%) by abdominal repair and 4/34 (11.8%) by endoscopic repair with good outcome in 2 cases. In 96% of fistulas treated by vaginal repair (27/28) we obtained a complete recovery; in one patient we observed fistula recurrence after 2 months from the operation. Four patients were treated by abdominal approach: in two complex patients with vesico-uretero-vaginal fistula, the repair was associated with entero-cystoplasty and ureteral reimplantation; in one case of huge fistula following cesarean section (7 cm) a vesical flap was used; in one case we repaired a recurrent fistula in orthotopic ileal neobladder: A good outcome was achieved in all cases. Vaginal approach is less aggressive, well accept...

Research paper thumbnail of Impianto uretrale di gax collagene nell'incontinenza urinaria da stress: Studio ecografico a breve e lungo follow-up

Research paper thumbnail of La neuromodulazione delle radici sacrali nel trattamento dell'incontinenza urinaria femminile da urgenza e mista

Research paper thumbnail of Is hyperpathic urethra the main target of percutaneous tibialis nerve neuromodulation (PTNM)? Our 6 years experience

Research paper thumbnail of Incontinenza urinaria iatrogena maschile: opzioni terapeutiche proponibili. Gli iniettabili

Iatrogenic urinary incontinence in male is increasing due to surgical (radiotherapic) treatment o... more Iatrogenic urinary incontinence in male is increasing due to surgical (radiotherapic) treatment of prostatic cancer. Surgery is responsable of intrinsic urethral deficency with the loss of the urethral sealing effect. Bulking agents work recreating the urethral sealing effect without bladder outlet obstruction. Since 1938 many different materials have been proposed but "the ideal" substance has not yet been found. This tecnique is interesting because of the mininvasivity: different authors proposed different sites of injection and the patient's selection has different criteria, thus there is a large variability in the results. The authors report success (dry) between 10% and 40%, and improvement beetwen 20% and 60%. The positive effect is not stable over the time and repeted procedures are often needed.