Urology, Medicine, Pediatrics, Perinatology and Child Health, Oncology
26
Scopus Publications
Scopus Publications
Double blind-ending ureter: diagnostic challenges and robotic-assisted surgical management—case report Marco Di Mitri, Edoardo Collautti, Cristian Bisanti, Andrea Zulli, Alberto Mantovani, Annalisa Di Carmine, Michelangelo Baldazzi, Roberto Lo Piccolo, Riccardo Coletta, Lorenzo Masieri, Mario Lima Canadian Journal of Urology, 2026 BACKGROUND: Double blind-ending ureter (DBU) is an extremely rare congenital anomaly involving a duplicated ureter with no connection to the renal pelvis or bladder, making diagnosis difficult. CASE DESCRIPTION: A 10-year-old girl presented with recurrent abdominal pain and ultrasound evidence of left hydroureteronephrosis. Magnetic resonance imaging (MRI) and three-dimensional (3D) reconstruction revealed a 30 cm blind-ending ureter. Robotic-assisted excision (Da Vinci Xi) was performed safely, preserving adjacent structures. Histology confirmed a nonfunctional ureteral remnant. CONCLUSIONS: DBU is a rare duplication variant. Advanced imaging and robotic surgery are essential for accurate diagnosis and effective, minimally invasive treatment.
Impact of second-layer coverages on complication rates in primary tubularized incised plate urethroplasty (TIPU) for distal and midpenile hypospadias repair: a systematic review Marta Pezzoli, Mattia Lo Re, Virginia Carletti, Lorenzo Masieri, Alberto Mantovani Pediatric Surgery International, 2025 This systematic review assesses the impact of different second-layer coverage techniques on complication rates following primary tubularized incised plate urethroplasty (TIPU) for distal and midpenile hypospadias. A systematic search of PubMed, EMBASE, Cochrane Central, and Scopus was conducted in August 2024. Studies were included if they reported outcomes of single- or double-layer neourethral coverage in primary TIPU for distal or midpenile hypospadias. A narrative synthesis was performed due to study heterogeneity. Forty studies met inclusion criteria. In distal hypospadias, single-layer coverage yielded urethrocutaneous fistula (UCF) rates below 10% in most cases. Meatal stenosis reached 33.3% but was uncommon with dorsal dartos (DD) flaps. Double-layer coverage, especially with double DD flaps, showed lower UCF rates (0–12)% and minimal stenosis. For midpenile hypospadias, single-layer coverage showed higher UCF rates (0–36.4%), with DD flaps performing worse (12.5–36.4%) than tunica vaginalis (TV) flaps (0–3.1%). Double-layer techniques consistently reduced UCF to < 5%, with double DD flaps showing no fistula or stenosis. In conclusion, second-layer coverage, particularly double layer, reduces complications in TIPU. The DD flap remains most commonly used due to its accessibility, while the technically demanding TV flap shows promising results. Further high-quality data are needed to identify the optimal technique.
Intravesical Botulin Toxin-A Injections for Neurogenic Bladder Dysfunction in Children: Summary Update on Last 10 Years of Research Andrea Zulli, Virginia Carletti, Alberto Mantovani, Maria Angela Cerruto, Luca Giacomello Toxins, 2024 Neurogenic bladder dysfunction (NB) represents a challenge in pediatric urology. Intravesical botulin toxin-A (BTX-A) bladder injection is part of the armamentarium for the treatment of this condition, usually after failed first-line medical strategies and before the escalation to more invasive options such as neuromodulation or augmented cystoplasty in severe cases. However, there is still a lack of consensus about the appropriate treatment modality for the pediatric population. A review of the last 10 years’ research was performed on the PubMed database by two authors. Articles doubly selected and meeting the inclusion criteria were collected and analyzed for their study type, demographics, neurological disease(s) at diagnosis, BTX-A treatment modality and duration, previous treatment, clinical and urodynamic parameters, adverse events, outcomes, and follow-ups. A total of 285 studies were initially selected, 16 of which matched the inclusion criteria. A cohort of 630 patients was treated with BTX-A at a median age of 9.7 years, 40% of which had a diagnosis of myelomeningocele. The results of the selected publications show the overall efficacy and safety of BTX-A injections in children and confirmed BTX-A as a valuable strategy for NB treatment in pediatric population. Nevertheless, up to now, the literature on this topic offers scarce uniformity among the published series and poor protocol standardization.
Long-term Functional, Sexual, and Cosmetic Outcomes in Adult Patients Who Underwent Hypospadias Repair During Childhood at a Highly Specialized Italian Pediatric Hospital , Alessia Celeste Bocchino, Andrea Cocci, , Mart Pezzoli, , Antonio Elia, , Luca Landi, , Alberto Mantovani, , Chiara Cini, , Lorenzo Masieri, and Urology Research and Practice, 2024 OBJECTIVE: This study aims to evaluate long-term functional, sexual, and cosmetic outcomes in adult patients who underwent hypospadias repair during childhood at a national highly specialized pediatric hospital. METHODS: Medical records of pediatric patients who had undergone surgical repair of hypospadias between 1993 and 2004 at Meyer Children Hospital of Florence were reviewed. Adult patients were contacted by telephone between July and August 2021 and invited to participate. Long-term surgical outcomes were assessed focusing on complications and reinterventions, and 3 validated questionnaires on urinary function, erectile function, and penile cosmetic appearance were administered. RESULTS: From January 1993 to December 2004, a total of 799 patients with hypospadias underwent repair surgery. Two hundred thirty-nine patients gave consent to be included in the study. Follow-ups occurred between 17 and 28 years after the first surgery. Most patients had anterior localization of hypospadias (210/239) and associated penile curvature (132/239). The most frequent surgery for hypospadias repair was meatal advancement and glanduloplasty incorporated (MAGPI) (88/239), and the most used surgical treatment for penile curvature was the Nesbit technique (49/132). The complication rate was 27% (65/239) in an average time of 4.7 years, and 48 surgical procedures have been performed to treat them. At follow-up, the mean IPSS was 0.96 ± 1.97, the mean IIEF-5 score was 24.10 ± 1.02, and the mean HOSE score was 15.47 ± 0.45. Patients who underwent reintervention reported a lower IPSS than those who underwent only 1 surgery (0.29 vs. 1.16). CONCLUSION: Hypospadias repair during childhood leads to rather normal urinary and sexual function and penile cosmetic appearance in adolescence and adulthood.
Editorial: Update in pediatric gynecology Federica Perelli, Chiara Grimaldi, Massimo Candiani, Lorenzo Masieri, Alberto Mantovani Frontiers in Surgery, 2024 Pediatric patients and young women affected by diseases that directly or indirectly affect the genital system deserve a multidisciplinary approach, to encompass every aspect of their global health and to ensure the most effective treatment and follow-up.
Robotic approach with neoadjuvant chemotherapy in adult Wilms’ tumor: A feasibility study report and a systematic review of the literature Simone Sforza, Valeria Emma Palmieri, Maria Rosaria Raspollini, Giandomenico Roviello, Alberto Mantovani, Umberto Basso, Maria Carmen Affinita, Alberto D'Angelo, Lorenzo Antonuzzo, Marco Carini, Andrea Minervini, Lorenzo Masieri Asian Journal of Urology, 2023 Objective: The incidence of Wilms' tumor (WT) among adult individuals accounts for less than 1% of kidney cancer cases, with a prognosis usually less favorable when compared to younger individuals and an overall survival rate of 70% for the adult patients versus 90% for the pediatric cases. The diagnosis and treatment of WT are complex in the preoperative setting; neoadjuvant chemotherapy (NAC) or robotic surgery has rarely been described. This study aimed to review the literature of robotic surgery in WT and report the first adult WT management using both NAC and robotic strategy. Methods: We reported a case of WT managed in a multidisciplinary setting. Furthermore, according to Preferred Reporting Items for Systematic reviews and Meta-Analyses recommendations, a systematic review of the literature until August 2020 of WT treated with a robotic approach was carried out. Results: A 33-year-old female had a diagnosis of WT. She was scheduled to NAC, and according to the clinical and radiological response to a robotic radical nephrectomy with aortic lymph nodes dissection, she was managed with no intraoperative rupture, a favorable surgical outcome, and a follow-up of 25 months, which did not show any recurrence. The systematic review identified a total number of 230 cases of minimally invasive surgery reported in the literature for WT. Of these, approximately 15 patients were carried out using robotic surgery in adolescents while none in adults. Moreover, NAC has not been administered before minimally invasive surgery in adults up until now. Conclusion: WT is a rare condition in adults with only a few cases treated with either NAC or minimally invasive approach so far. The advantage of NAC followed by the robotic approach could lead to favorable outcomes in this complex scenario. Notwithstanding, additional cases of adult WT need to be identified and investigated to improve the oncological outcome.
Single port surgery in pediatric age: report of first 300 cases Nicola ZAMPIERI, Elettra VESTRI, Federica BIANCHI, Marta PERETTI, Simone PATANÈ, Mariangela CECCHETTO, Alberto MANTOVANI, Annamaria GIAMBANCO, Fabiana FARINA, Gabriella SCIRÈ, Francesco S. CAMOGLIO Minerva Surgery, 2023
Management of Kidney Stones Using RIRS Lorenzo Masieri, Alfonso Crisci, Alberto Mantovani, Chiara Cini, Simone Sforza Minimally Invasive Techniques in Pediatric Urology Endourology Laparoscopy and Robotics, 2022
robot-assisted laparoscopic pyeloplasty in children: A systematic review Lorenzo Masieri, Simone Sforza, Antonio A. Grosso, Francesca Valastro, Riccardo Tellini, Chiara Cini, Luca Landi, Maria Taverna, Antonio Elia, Alberto Mantovani, Andrea Minervini, Marco Carini Minerva Urologica E Nefrologica, 2020
Paediatric urology practice during COVID-19 pandemic Chiara Cini, Giulia Bortot, Simone Sforza, Alberto Mantovani, Luca Landi, Ciro Esposito, Maria Escolino, Lorenzo Masieri Journal of Pediatric Urology, 2020
