40. Krege S, Souchon R, Schmoll HJ: Interdisciplinary consensus on diagnosis and treatment of testiculargerm cell tumours: result of an updated conference on evidence-based medicine. Eur Urol, 40: 373-391, 2001.41. Domont J, Laplanche A, de Crevoisier R, Theodore, P. Wibault, K. Fizazi: A risk-adapted strategy ofradiotherapy and cisplatin-based chemotherapy in stage II seminoma: results of a 20-year experience.Proc Am Soc Clin Oncol, 2005; 4571 (abstr)42. Albers P, Siener R, Kliesch S, Weissbach L, Krege S, Sparwasser C, Schulze H, Heidenreich A, de RieseW, Loy V, Bierhoff E, W<strong>it</strong>tekind C, Fimmers R, Hartmann M: Risk factors for relapse in clinical stagenonseminomatous testicular germ cell tumors: results of the German Testicular Cancer Study Grouptrial. J Clin Oncol, 21: 1505-1512, 2003.43. Madej G, Pawinski A: Risk-related adjuvant chemotherapy for stage I non-seminoma of the testis. ClinOncol, 3: 270-272, 1991.44. Freedman LS, Parkinson MC, Jones WG, Oliver RT, Peckham MJ, Read G, Newlands ES, Williams CJ:Histopathology in the prediction of relapse of patients w<strong>it</strong>h stage I testicular teratoma treated byorchiectomy alone. Lancet, 2: 294-298, 1987.45. Read G, Stenning SP, Cullen MH, Parkinson MC, Horwich A, Kaye SB, Cook PA: Medical ResearchCouncil prospective study of surveillance for stage I testicular teratoma. Medical Research CouncilTesticular Tumors Working Party. J Clin Oncol, 10: 1762, 1992.46. Nicolai N, Miceli R, Artusi R, Piva L, Pizzocaro G: A simple model for predicting nodal metastasis inpatients w<strong>it</strong>h clinical stage I nonseminomatous germ cell testicular tumors undergoing retroper<strong>it</strong>oneallymph node dissection. J Urol, 171: 172-176, 2004.47. Pont J, Holtl W, Kosak D, Machacek E, Kienzer H, Julcher H, Honetz N: Risk-adapted treatment choicein stage I nonseminomatous testicular germ cell cancer by regarding vascular invasion in the primarytumor: a prospective trial. J Clin Oncol, 8: 16-19, 1990.48. Cullen MH, Stenning SP, Parkinson MC, Fossa SD, Kaye SB, Horwich AH, Harland SJ, Williams MV,Jakes R: Short-course adjuvant chemotherapy in high-risk stage I nonseminomatous germ cell tumorsof the testis: a Medical Research Council report. J Clin Oncol, 14: 1106, 1996.49. Nicolai N, Pizzocaro G: A surveillance study of clinical stage I nonseminomatous germ cell tumors ofthe testis: 10-year follow-up. J Urol, 154: 1045, 1995.50. Langstroer P, Rosen MA, Griebling TL, Thrasher B: Ejaculatory function in stage T1 nonseminomatousgerm cell tumors: retroper<strong>it</strong>oneal lymph node dissection versus surveillance-a decision analysis. J Urol,168: 1396-1401, 2002.51. Donohue JP, Thornhill JA, Foster RS, Rowland RG, Bihrle R: Retroper<strong>it</strong>oneal lymphadenectomy for clinicalstage A testis cancer (1965 to 1989): modifications of technique and impact on ejaculation. JUrol, 149: 237, 1993.52. Travis LB, Fosså SD, Schonfeld SJ, McMaster ML, Lynch CF, Storm H, Hall P, Holowaty E, Andersen A,Pukkala E, Andersson M, Kaijser M, Gospodarowicz M, Joensuu T, Cohen RJ, Boice JD Jr, Dores GM,Gilbert ES: Second Cancers Among 40,576 Testicular Cancer Patients: Focus on Long-term Survivors.J Natl Cancer Inst, 97: 1354-1365, 2005.53. Culine S, Theodore C, Terrier-Lacombe MJ, Droz JP: Primary chemotherapy in patients w<strong>it</strong>h nonseminomatousgerm cell tumors of the testis and biological disease only after orchiectomy. J Urol, 155:1296-1298, 1996.54. Davis BE, Herr HW, Fair WR, Bosl GJ: The management of patients w<strong>it</strong>h nonseminomatous germ celltumors of the testis w<strong>it</strong>h serologic disease only after orchiectomy. J Urol, 152: 111-113, 1994.55. Weissbach L, Bussar-Maatz R, Flechtner H, Pichlmeier U, Hartmann M, Keller L: RPLND or primary chemotherapyin clinical stage IIA/B nonseminomatous germ cell tumors? Results of a prospective multicentertrial including qual<strong>it</strong>y of life assessment. Eur Urol, 37: 582-594, 2000.56. Neyer M, Peschel R, Akkad T, Springer-Stöhr B, Berger A, Bartsch G, Steiner H: Long-term results oflaparoscopic retroper<strong>it</strong>oneal lymph-node dissection for clinical stage I non seminomatous germ-celltesticular cancer. J Endourol, 21: 180-183, 2007.57. Pizzocaro G, Monfardini S: No adjuvant chemotherapy in selected patients w<strong>it</strong>h pathologic stage IInonseminomatous germ cell tumors of the testis. J Urol, 131: 677-680, 1984.58. Williams SD, Stablein DM, Einhorn LH, Muggia FM, Weiss RB, Donohue JP, Paulson DF, Brunner KW,Jacobs EM, Spaulding JT: Immediate adjuvant chemotherapy versus observation w<strong>it</strong>h treatment atrelapse in pathological stage II testicular cancer patients. N Engl J Med, 317: 1433-1438, 1987.214
59. Weissbach L, Hartlapp JH: Adjuvant chemotherapy of metastatic stage II nonseminomatous testis tumor. JUrol, 146: 1295-1298, 1991.60. Kondagunta GV, Sheinfeld J, Mazumdar M, Mariani TV, Bajorin D, Bacik J, Bosl GJ, Motzer RJ: Relapse-freeand overall survival in patients w<strong>it</strong>h pathologic stage II nonseminomatous germ cell cancer treated w<strong>it</strong>hetoposide and cisplatin adjuvant chemotherapy. J Clin Oncol, 22: 464-467, 2004.61. Gregory C, Peckham MJ: Results of radiotherapy for stage II testicular seminoma. Radiother Oncol, 6: 285-292, 1986.62. Willan BD, McGowan DG: Seminoma of the testis: a 22-year experience w<strong>it</strong>h radiation therapy. Int J RadiatOncol Biol Phys, 11: 1769-1775, 1985.63. de W<strong>it</strong> R, Roberts JT, Wilkinson PM, de Mulder PH, Mead GM, Fossa SD, Cook P, de Prijck L, Stenning S,Collette L: Equivalence of three or four cycles of bleomycin, etoposide, and cisplatin chemotherapy and ofa 3- or 5-day schedule in good-prognosis germ cell cancer: a randomized study of the EuropeanOrganization for Research and Treatment of Cancer Gen<strong>it</strong>ourinary Tract Cancer Cooperative Group and theMedical Research Council. J Clin Oncol, 19: 1629-1640, 2001.64. Fossa SD, de W<strong>it</strong> R, Roberts JT, Wilkinson PM, de Mulder PH, Mead GM, Cook P, de Prijck L, Stenning S,Aaronson NK, Bottomley A, Collette L: Qual<strong>it</strong>y of life in good prognosis patients w<strong>it</strong>h metastatic germ cellcancer: a prospective study of the European Organization for Research and Treatment of CancerGen<strong>it</strong>ourinary Group/Medical Research Council Testicular Cancer Study Group (30941/TE20). J ClinOncol, 21: 1107-1118, 2003.65. Sm<strong>it</strong>h TJ, Khatcheressian J, Lyman GH, Ozer H, Arm<strong>it</strong>age JO, Balducci L, Bennett CL, Cantor SB, CrawfordJ, Cross SJ, Demetri G, Desch CE, Pizzo PA, Schiffer CA, Schwartzberg L, Somerfield MR, Somlo G, WadeJC, Wade JL, Winn RJ, Wozniak AJ, Wolff AC: 2006 update of recommendations for the use of wh<strong>it</strong>e bloodcell growth factors: an evidence-based clinical practice guideline. J Clin Oncol, 24: 3187-3205, 2006.66. De Santis M, Becherer A, Bokemeyer C, Stoiber F, Oechsle K, Sellner F, Lang A, Kletter K, Dohmen BM,D<strong>it</strong>trich C, Pont J: 2-18fluoro-deoxy-D-glucose pos<strong>it</strong>ron emission tomography is a reliable predictor for viabletumor in postchemotherapy seminoma: an update of the prospective multicentric SEMPET trial. J ClinOncol, 22: 1034-1039, 2004.67. De Giorgi U, Pupi A, Fiorentini G, Rosti G, Marangolo M: FDG-PET in the management of germ cell tumor.Ann Oncol, 16(Suppl 4): iv90-iv94, 2005.68. Lewis DA, Tann M, Kesler K, McCool A, Foster RS, Einhorn LH: Pos<strong>it</strong>ron Emission Tomography Scans inPostchemotherapy Seminoma Patients W<strong>it</strong>h Residual Masses: A Retrospective Review From IndianaUnivers<strong>it</strong>y Hosp<strong>it</strong>al. J Clin Oncol, 24: e54 - e55, 2006.69. Hendry WF, A'Hern RP, Hetherington JW, Peckham MJ, Dearnaley DP, Horwich A: Para-aortic lymphadenectomyafter chemotherapy for metastatic non-seminomatous germ cell tumors: prognostic value and therapeuticbenef<strong>it</strong>, Br J Urol, 71: 208-213, 1993.70. Tekgul S, Özen HA, Celebi I, Ozgu I, Ergen A, Demircin M, Remzi D: Postchemotherapeutic surgery formetastatic testicular germ cell tumors: results of extended primary chemotherapy and lim<strong>it</strong>ed surgery.Urology, 43: 349-354, 1994.71. Fizazi K, Tjulandin S, Salvioni R, Germà-Lluch JR, Bouzy J, Ragan D, Bokemeyer C, Gerl A, Fléchon A, de BonoJS, Stenning S, Horwich A, Pont J, Albers P, De Giorgi U, Bower M, Bulanov A, Pizzocaro G, Aparicio J, NicholsCR, Théodore C, Hartmann JT, Schmoll HJ, Kaye SB, Culine S, Droz JP, Mahé C: Viable malignant cells afterprimary chemotherapy for disseminated nonseminomatous germ cell tumors: prognostic factors and role ofpostsurgery chemotherapy-results from an international study group, J Clin Oncol, 19: 2647-2657, 2001.72. Fizazi K, Oldenburg J, Dunant A, Chen I, Salvioni R, Hartmann JT, De Santis M, Daugaard G, Flechon A, DeGiorgi U, Tjulandin S, Schmoll HJ, Bouzy J, Fossa SD, Fromont G: Assessing prognosis and optimizing treatmentin patients w<strong>it</strong>h post-chemotherapy viable non-seminomatous germ-cell tumors (NSGCT): results ofthe sCR2 International study. Ann Oncol, (in press)73. Loehrer PJ, Gonin R, Nichols CR, Weathers T, Einhorn LH: Vinblastine plus iofosfamide plus cisplatin as in<strong>it</strong>ialsalvage therapy in recurrent germ cell tumor, J Clin Oncol 16: 2500-2504, 1998.74. Beyer J, Rick O, Siegert W, Bokemeyer C: Salvage chemotherapy in relapsed germ cell tumor. Word J Urol,19: 90-93, 2001.75. Kondagunta GV, Motzer RJ: Chemotherapy for advanced germ cell tumors. J Clin Oncol, 24: 5493-5502, 2006.76. Fossa SD, Stenning SP, Gerl A, Horwich A, Clark PI, Wilkinson PM, Jones WG, Williams MV, Oliver RT,Newlands ES, Mead GM, Cullen MH, Kaye SB, Rustin GJ, Cook PA: Prognostic factors in patients progressingafter cisplatin-based chemotherapy for malignant non-seminomatous germ cell tumours. Br J Cancer,80: 1392-1399, 1999.215
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Linee GuidaComitato SIU Linee Guida
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• Roberto SalvioniUrologia, Fonda
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NEOPLASIA DELLA VESCICA INFILTRANTE
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INDICELINEE GUIDA 20091. INFERTILIT
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INDICE1. EPIDEMIOLOGIA E FATTORI DI
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La definizione d'infertilità da fa
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gli ormoni prodotti dalle cellule d
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11. Gandini L, Lombardo F, Lenzi A,
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2. Approccioclinico-diagnosticoal m
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L’esame del liquido seminale comp
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La viscosità può essere sia norma
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Una motilità normale è definita d
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Nel caso in cui la percentuale di f
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Accanto ai fattori appena descritti
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integrare le indicazioni derivate d
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I mitocondri sono organelli richies
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Il Dna dello spermatozoo è organiz
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24. Sakkas D, Manicardi G, Bianchi
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Fig. 1Altri tipi di sonde sono quel
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Bibliografia1. Egozcue S, Blanco J,
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tropo). In quest'ultimo caso è nec
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tumore testicolare. Lo studio compl
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2.5 DIAGNOSTICA IMMUNOLOGICADai dat
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Bibliografia1. Coulam CB and Stern
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EFFETTO DELL’INFEZIONE SULLA QUAL
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tengono a 5 diversi generi: Alpha,
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Bibliografia1. Dinarello CA. Biolog
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2.7 DIAGNOSTICA ECOGRAFICANel perco
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cografia testicolare è particolarm
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Le dimensioni della prostata varian
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La misura meno soggetta a variazion
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2.8 DIAGNOSTICA CITOLOGICA ED AGOAS
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Fig. 3- spermatidi. Classicamente s
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Fig. 7- Quadri citologici nelle azo
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Tabella 2: Principali quadri citolo
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Come conseguenza diretta dell’alt
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Tutte le anomalie genetiche vengono
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Traslocazioni che coinvolgono i cro
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l’eiaculato o testicolari) per su
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cazione assoluta dal momento che la
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4. Quadri seminali4.1 AZOOSPERMIAL
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secretorie l’FSH è aumentato 2-8
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Fig. 3Pur essendo una rara causa di
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4.2 OLIGOZOOSPERMIA SEVERACon il te
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Studi geneticiL’esame del carioti
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Bibliografia1. Westlander G, Ekerho
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4.4 ASTENOZOOSPERMIANell’ambito d
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FLOW-CHART DIAGNOSTICA103
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5. Principali quadri cliniciassocia
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eflusso viene considerato patologic
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Attualmente una precisa indicazione
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5.2 CRIPTORCHIDISMODefinizione e cl
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Cenni di embriologiaLa discesa del
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- FG syndrome- del 22q11.2- del 1p3
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gressivi danni all’epitelio semin
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Ostruzioni epididimaliLe ostruzioni
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o acquisite (cisti) a carico dei va
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5.4 INFEZIONI DELLE GHIANDOLE SESSU
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disturbi disurici (6%) 4 . Nelle fo
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EpididimitiL’infiammazione dell
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6. L’approccio terapeuticoal masc
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Bibliografia1. Matsumoto AM. Hormon
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Terapia androgenicaL’induzione ed
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Terapia con antiestrogeniIl raziona
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specificamente il perossido di idro
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6.3 TERAPIA CHIRURGICALa terapia ch
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7. Metodichedi crioconservazione7.1
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Nel congelamento lento, invece, il
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Le tecniche più utilizzate per il
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7.6 CONCLUSIONILa crioconservazione
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32. Desai N, Glavan D, Goldfarb J.
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8.Parametri seminalie tecniche di p
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Nei casi di bassa concentrazione sp
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Infertilità di eziologia sconosciu
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8.2 FECONDAZIONE IN VITRO CON EMBRI
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Condizioni non chiaramente legate a
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8.4 INIEZIONE INTRACITOPLASMATICA D
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- Page 167 and 168: Capitolo 2I DISTURBI DELL'EIACULAZI
- Page 169 and 170: IntroduzioneLe disfunzioni eiaculat
- Page 171 and 172: 1. Eiaculazione PrecoceLa mancanza
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- Page 177 and 178: Figura 1. Modificata da: CG. McMaho
- Page 179 and 180: 2. AneiaculazioneAlcune patologie p
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- Page 185 and 186: Figura 2. Modificata da: CG. McMaho
- Page 187 and 188: 4. Eiaculazione RetrogradaDEFINIZIO
- Page 189 and 190: Bibliografia1. CG. McMahon. Disorde
- Page 191 and 192: 51. GM Colpi, G. Piediferro. Ritard
- Page 193 and 194: Capitolo 3NEOPLASIA DEL TESTICOLOR.
- Page 195 and 196: IntroduzioneI tumori a cellule germ
- Page 197 and 198: Linee guidapratiche IGG per pazient
- Page 199 and 200: orchiectomia (nel seminoma puro dev
- Page 201 and 202: stazioni linfonodali para-aortiche
- Page 203 and 204: NON-SEMINOMA STADIO ILa prognosi de
- Page 205 and 206: Se la RPLND è eseguita senza la st
- Page 207 and 208: Non-seminoma stadio clinico IIA mar
- Page 209 and 210: Anche il trattamento di prima linea
- Page 211 and 212: te investigata nei GCT 77,78 . Dopo
- Page 213 and 214: filattica nei casi a basso potenzia
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- Page 219 and 220: Capitolo 4NEOPLASIA DELLA VESCICAIN
- Page 221 and 222: IntroduzioneAl momento della diagno
- Page 223 and 224: Diagnosi e stadiazioneL'imaging gio
- Page 225 and 226: • In previsione di un trattamento
- Page 227 and 228: Opzioni terapeuticheLa cistectomia
- Page 229 and 230: ne nei tessuti e nell'urina anche d
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- Page 233 and 234: l'uretra prostatica) (Cresswell, 20
- Page 235 and 236: ti variabili, come l'età del pazie
- Page 237 and 238: BibliografiaAbol-Enein H, Ghoneim M
- Page 239 and 240: Hardt J, Filipas D, Hohenfellner R,
- Page 241 and 242: Rosenberg JE, Carroll PR, Small EJ.
- Page 243 and 244: Tumore vescicale metastaticoe Chemi
- Page 245 and 246: CATEGORIE PECULIARI DI PAZIENTIPazi
- Page 247 and 248: BibliografiaBamias A, Efstathiou E,
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- Page 251 and 252: Capitolo 5CALCOLOSI DELL’URETEREC
- Page 253 and 254: Fattori da considerarenella scelta
- Page 255 and 256: Opzioni terapeuticheper il paziente
- Page 257 and 258: • Rivalutazione clinica ematochim
- Page 259 and 260: C3. URETEROLITOTOMIA A CIELO APERTO
- Page 261 and 262: BibliografiaQueste linee guida sono
- Page 263 and 264: Capitolo 6CALCOLOSI RENALEF. Zatton
- Page 265 and 266: 1. Criteri di utilizzoLe presenti l
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2. IntroduzioneL’urolitiasi occup
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3. Classificazionee fattori di risc
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4. Diagnostica strumentalee di labo
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Bibliografia1. Smith RC, Rosenfield
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5. Ricerca di fattori rischioper ur
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sovrasaturazione con ossalato di ca
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Bibliografia1. Tiselius HG, Alken P
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6. Massa litiasicaLa “massa litia
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7.Trattamentodella colica renaleLe
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8. Indicazioni perla rimozione diun
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9. Procedure perla rimozione deical
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I fattori che influenzano l’esito
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of stones from the urinary tract. J
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9.2 LITOTRISSIA PERCUTANEA (PNL)La
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Bibliografia1. Kim SC, Kuo RL, Ling
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Per il trattamento di calcoli renal
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20. Grasso M, Chalik Y. Principles
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9.4 CHIRURGIA “A CIELO APERTO”I
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9.5 LAPAROSCOPIACon l’acquisizion
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9.6 CHEMIOLISI PERCUTANEALa chemiol
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9.7 GESTIONE DI PROBLEMI “PARTICO
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10. Inquadramentometabolico dellane
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A. Acidosi tubulare distale complet
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CALCOLOSI CALCICA (continua Tabella
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TRATTAMENTO PREVENTIVO NELLA CALCOL
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CALCOLOSI CALCICA (continua tabella
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11. Sinossi delle principaliraccoma
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Nel caso in cui pazienti con calcol
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11.5 DIAGNOSI DELL’UROLITIASI IN
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Tabella 28. Raccomandazioni per il
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11.11 GESTIONE DEI PAZIENTI CON CAL
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AbbreviazioniCKD:CY:ESWL:GR:INF:KDO
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Capitolo 7STENOSI DELL’URETRA:DIA
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AnatomiaL’uretra maschile non è
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Il suo scopo è fornire informazion
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dono al collassamento sono cadute i
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TESSUTI DI SOSTITUZIONE URETRALELa
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Bibliografia1 Jordan GH.Gestione de
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341
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Capitolo 8CARCINOMA DEL PENEG. Pizz
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INDICE1. FONTI UTILIZZATE pag 3472.
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1. Fonti utilizzateLa struttura por
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2. Epidemiologia ed EziologiaIl car
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3. Classificazione e Patologia3.1 C
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4. Diagnosi e StadiazioneUna stadia
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Tuttavia, tutti questi metodi non r
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5. Trattamento5.1 TUMORE PRIMITIVO5
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60 Gy 46 . La brachiterapia (BRT) h
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5.2.4 Trattamento dei pazienti con
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6. Follow-upLo scopo del follow-up
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7. Qualità della vita7.1 SESSUALIT
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ConclusioniAllo stato attuale, circ
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TabelleTabella 1. Livelli di eviden
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Tabella 4. Classificazione TNM del
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Tabella 8. Classificazione anatomo-
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Bibliografia1 Pizzocaro G, Algaba F
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51 Culkin DJ, Beer TM. Advanced pen
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APPENDICECARCINOMA DELLA PROSTATAag
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Screening nel tumoredella prostataL
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Bibliografia1. Oliver SE, May MT, G
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Prevenzione deltumore prostaticoLe
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INDICE LINEE GUIDA • EDIZIONE SET