1.The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease
Antonio BRILLANTINO ; Adolfo RENZI ; Pasquale TALENTO ; Luigi BRUSCIANO ; Luigi MARANO ; Maurizio GRILLO ; Mauro Natale MAGLIO ; Fabrizio FORONI ; Alessio PALUMBO ; Maria Laura Sandoval SOTELO ; Luciano VICENZO ; Michele LANZA ; Giovanna FREZZA ; Massimo ANTROPOLI ; Claudio GAMBARDELLA ; Luigi MONACO ; Ilaria FERRANTE ; Domenico IZZO ; Alfredo GIORDANO ; Michele PINTO ; Corrado FANTINI ; Marcello GASPARRINI ; Michele Schiano DI VISCONTE ; Francesca MILAZZO ; Giovanni FERRERI ; Andrea BRAINI ; Umberto COCOZZA ; Massimo PEZZATINI ; Valeria GIANFREDA ; Alberto DI LEO ; Vincenzo LANDOLFI ; Umberto FAVETTA ; Sergio AGRADI ; Giovanni MARINO ; Massimiliano VARRIALE ; Massimo MONGARDINI ; Claudio Eduardo Fernando Antonio PAGANO ; Riccardo Brachet CONTUL ; Nando GALLESE ; Giampiero UCCHINO ; Michele D’AMBRA ; Roberto RIZZATO ; Giacomo SARZO ; Bruno MASCI ; Francesca DA POZZO ; Simona ASCANELLI ; Patrizia LIGUORI ; Angela PEZZOLLA ; Francesca IACOBELLIS ; Erika BORIANI ; Eugenio CUDAZZO ; Francesca BABIC ; Carmelo GEREMIA ; Alessandro BUSSOTTI ; Mario CICCONI ; Antonia Di SARNO ; Federico Maria MONGARDINI ; Antonio BRESCIA ; Leonardo LENISA ; Massimiliano MISTRANGELO ; Matteo ZUIN ; Marta MOZZON ; Alessandro Paolo CHIRIATTI ; Vincenzo BOTTINO ; Antonio FERRONETTI ; Corrado RISPOLI ; Ludovico CARBONE ; Giuseppe CALABRÒ ; Antonino TIRRÒ ; Domenico DE VITO ; Giovanna IOIA ; Giovanni Luca LAMANNA ; Lorenzo ASCIORE ; Ettore GRECO ; Pierluigi BIANCHI ; Giuseppe D’ORIANO ; Alessandro STAZI ; Nicola ANTONACCI ; Raffaella Marina Di RENZO ; Gianmario Edoardo POTO ; Giuseppe Paolo FERULANO ; Antonio LONGO ; Ludovico DOCIMO
Annals of Coloproctology 2024;40(4):287-320
The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to PICO (patients, intervention, comparison, and outcomes) criteria, and the statements were developed adopting the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. In cases of grade 1 hemorrhoidal prolapse, outpatient procedures including hemorrhoidal laser procedure and sclerotherapy may be considered the preferred surgical options. For grade 2 prolapse, nonexcisional procedures including outpatient treatments, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, the Rafaelo procedure, and stapled hemorrhoidopexy may represent the first-line treatment options, whereas excisional surgery may be considered in selected cases. In cases of grades 3 and 4, stapled hemorrhoidopexy and hemorrhoidectomy may represent the most effective procedures, even if, in the expert panel opinion, stapled hemorrhoidopexy represents the gold-standard treatment for grade 3 hemorrhoidal prolapse.
2.The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease
Antonio BRILLANTINO ; Adolfo RENZI ; Pasquale TALENTO ; Luigi BRUSCIANO ; Luigi MARANO ; Maurizio GRILLO ; Mauro Natale MAGLIO ; Fabrizio FORONI ; Alessio PALUMBO ; Maria Laura Sandoval SOTELO ; Luciano VICENZO ; Michele LANZA ; Giovanna FREZZA ; Massimo ANTROPOLI ; Claudio GAMBARDELLA ; Luigi MONACO ; Ilaria FERRANTE ; Domenico IZZO ; Alfredo GIORDANO ; Michele PINTO ; Corrado FANTINI ; Marcello GASPARRINI ; Michele Schiano DI VISCONTE ; Francesca MILAZZO ; Giovanni FERRERI ; Andrea BRAINI ; Umberto COCOZZA ; Massimo PEZZATINI ; Valeria GIANFREDA ; Alberto DI LEO ; Vincenzo LANDOLFI ; Umberto FAVETTA ; Sergio AGRADI ; Giovanni MARINO ; Massimiliano VARRIALE ; Massimo MONGARDINI ; Claudio Eduardo Fernando Antonio PAGANO ; Riccardo Brachet CONTUL ; Nando GALLESE ; Giampiero UCCHINO ; Michele D’AMBRA ; Roberto RIZZATO ; Giacomo SARZO ; Bruno MASCI ; Francesca DA POZZO ; Simona ASCANELLI ; Patrizia LIGUORI ; Angela PEZZOLLA ; Francesca IACOBELLIS ; Erika BORIANI ; Eugenio CUDAZZO ; Francesca BABIC ; Carmelo GEREMIA ; Alessandro BUSSOTTI ; Mario CICCONI ; Antonia Di SARNO ; Federico Maria MONGARDINI ; Antonio BRESCIA ; Leonardo LENISA ; Massimiliano MISTRANGELO ; Matteo ZUIN ; Marta MOZZON ; Alessandro Paolo CHIRIATTI ; Vincenzo BOTTINO ; Antonio FERRONETTI ; Corrado RISPOLI ; Ludovico CARBONE ; Giuseppe CALABRÒ ; Antonino TIRRÒ ; Domenico DE VITO ; Giovanna IOIA ; Giovanni Luca LAMANNA ; Lorenzo ASCIORE ; Ettore GRECO ; Pierluigi BIANCHI ; Giuseppe D’ORIANO ; Alessandro STAZI ; Nicola ANTONACCI ; Raffaella Marina Di RENZO ; Gianmario Edoardo POTO ; Giuseppe Paolo FERULANO ; Antonio LONGO ; Ludovico DOCIMO
Annals of Coloproctology 2024;40(4):287-320
The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to PICO (patients, intervention, comparison, and outcomes) criteria, and the statements were developed adopting the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. In cases of grade 1 hemorrhoidal prolapse, outpatient procedures including hemorrhoidal laser procedure and sclerotherapy may be considered the preferred surgical options. For grade 2 prolapse, nonexcisional procedures including outpatient treatments, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, the Rafaelo procedure, and stapled hemorrhoidopexy may represent the first-line treatment options, whereas excisional surgery may be considered in selected cases. In cases of grades 3 and 4, stapled hemorrhoidopexy and hemorrhoidectomy may represent the most effective procedures, even if, in the expert panel opinion, stapled hemorrhoidopexy represents the gold-standard treatment for grade 3 hemorrhoidal prolapse.
3.The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease
Antonio BRILLANTINO ; Adolfo RENZI ; Pasquale TALENTO ; Luigi BRUSCIANO ; Luigi MARANO ; Maurizio GRILLO ; Mauro Natale MAGLIO ; Fabrizio FORONI ; Alessio PALUMBO ; Maria Laura Sandoval SOTELO ; Luciano VICENZO ; Michele LANZA ; Giovanna FREZZA ; Massimo ANTROPOLI ; Claudio GAMBARDELLA ; Luigi MONACO ; Ilaria FERRANTE ; Domenico IZZO ; Alfredo GIORDANO ; Michele PINTO ; Corrado FANTINI ; Marcello GASPARRINI ; Michele Schiano DI VISCONTE ; Francesca MILAZZO ; Giovanni FERRERI ; Andrea BRAINI ; Umberto COCOZZA ; Massimo PEZZATINI ; Valeria GIANFREDA ; Alberto DI LEO ; Vincenzo LANDOLFI ; Umberto FAVETTA ; Sergio AGRADI ; Giovanni MARINO ; Massimiliano VARRIALE ; Massimo MONGARDINI ; Claudio Eduardo Fernando Antonio PAGANO ; Riccardo Brachet CONTUL ; Nando GALLESE ; Giampiero UCCHINO ; Michele D’AMBRA ; Roberto RIZZATO ; Giacomo SARZO ; Bruno MASCI ; Francesca DA POZZO ; Simona ASCANELLI ; Patrizia LIGUORI ; Angela PEZZOLLA ; Francesca IACOBELLIS ; Erika BORIANI ; Eugenio CUDAZZO ; Francesca BABIC ; Carmelo GEREMIA ; Alessandro BUSSOTTI ; Mario CICCONI ; Antonia Di SARNO ; Federico Maria MONGARDINI ; Antonio BRESCIA ; Leonardo LENISA ; Massimiliano MISTRANGELO ; Matteo ZUIN ; Marta MOZZON ; Alessandro Paolo CHIRIATTI ; Vincenzo BOTTINO ; Antonio FERRONETTI ; Corrado RISPOLI ; Ludovico CARBONE ; Giuseppe CALABRÒ ; Antonino TIRRÒ ; Domenico DE VITO ; Giovanna IOIA ; Giovanni Luca LAMANNA ; Lorenzo ASCIORE ; Ettore GRECO ; Pierluigi BIANCHI ; Giuseppe D’ORIANO ; Alessandro STAZI ; Nicola ANTONACCI ; Raffaella Marina Di RENZO ; Gianmario Edoardo POTO ; Giuseppe Paolo FERULANO ; Antonio LONGO ; Ludovico DOCIMO
Annals of Coloproctology 2024;40(4):287-320
The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to PICO (patients, intervention, comparison, and outcomes) criteria, and the statements were developed adopting the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. In cases of grade 1 hemorrhoidal prolapse, outpatient procedures including hemorrhoidal laser procedure and sclerotherapy may be considered the preferred surgical options. For grade 2 prolapse, nonexcisional procedures including outpatient treatments, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, the Rafaelo procedure, and stapled hemorrhoidopexy may represent the first-line treatment options, whereas excisional surgery may be considered in selected cases. In cases of grades 3 and 4, stapled hemorrhoidopexy and hemorrhoidectomy may represent the most effective procedures, even if, in the expert panel opinion, stapled hemorrhoidopexy represents the gold-standard treatment for grade 3 hemorrhoidal prolapse.
4.The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease
Antonio BRILLANTINO ; Adolfo RENZI ; Pasquale TALENTO ; Luigi BRUSCIANO ; Luigi MARANO ; Maurizio GRILLO ; Mauro Natale MAGLIO ; Fabrizio FORONI ; Alessio PALUMBO ; Maria Laura Sandoval SOTELO ; Luciano VICENZO ; Michele LANZA ; Giovanna FREZZA ; Massimo ANTROPOLI ; Claudio GAMBARDELLA ; Luigi MONACO ; Ilaria FERRANTE ; Domenico IZZO ; Alfredo GIORDANO ; Michele PINTO ; Corrado FANTINI ; Marcello GASPARRINI ; Michele Schiano DI VISCONTE ; Francesca MILAZZO ; Giovanni FERRERI ; Andrea BRAINI ; Umberto COCOZZA ; Massimo PEZZATINI ; Valeria GIANFREDA ; Alberto DI LEO ; Vincenzo LANDOLFI ; Umberto FAVETTA ; Sergio AGRADI ; Giovanni MARINO ; Massimiliano VARRIALE ; Massimo MONGARDINI ; Claudio Eduardo Fernando Antonio PAGANO ; Riccardo Brachet CONTUL ; Nando GALLESE ; Giampiero UCCHINO ; Michele D’AMBRA ; Roberto RIZZATO ; Giacomo SARZO ; Bruno MASCI ; Francesca DA POZZO ; Simona ASCANELLI ; Patrizia LIGUORI ; Angela PEZZOLLA ; Francesca IACOBELLIS ; Erika BORIANI ; Eugenio CUDAZZO ; Francesca BABIC ; Carmelo GEREMIA ; Alessandro BUSSOTTI ; Mario CICCONI ; Antonia Di SARNO ; Federico Maria MONGARDINI ; Antonio BRESCIA ; Leonardo LENISA ; Massimiliano MISTRANGELO ; Matteo ZUIN ; Marta MOZZON ; Alessandro Paolo CHIRIATTI ; Vincenzo BOTTINO ; Antonio FERRONETTI ; Corrado RISPOLI ; Ludovico CARBONE ; Giuseppe CALABRÒ ; Antonino TIRRÒ ; Domenico DE VITO ; Giovanna IOIA ; Giovanni Luca LAMANNA ; Lorenzo ASCIORE ; Ettore GRECO ; Pierluigi BIANCHI ; Giuseppe D’ORIANO ; Alessandro STAZI ; Nicola ANTONACCI ; Raffaella Marina Di RENZO ; Gianmario Edoardo POTO ; Giuseppe Paolo FERULANO ; Antonio LONGO ; Ludovico DOCIMO
Annals of Coloproctology 2024;40(4):287-320
The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to PICO (patients, intervention, comparison, and outcomes) criteria, and the statements were developed adopting the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. In cases of grade 1 hemorrhoidal prolapse, outpatient procedures including hemorrhoidal laser procedure and sclerotherapy may be considered the preferred surgical options. For grade 2 prolapse, nonexcisional procedures including outpatient treatments, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, the Rafaelo procedure, and stapled hemorrhoidopexy may represent the first-line treatment options, whereas excisional surgery may be considered in selected cases. In cases of grades 3 and 4, stapled hemorrhoidopexy and hemorrhoidectomy may represent the most effective procedures, even if, in the expert panel opinion, stapled hemorrhoidopexy represents the gold-standard treatment for grade 3 hemorrhoidal prolapse.
5.Pelvic muscle floor rehabilitation as a therapeutic option in lifelong premature ejaculation: long-term outcomes.
Antonio Luigi PASTORE ; Giovanni PALLESCHI ; Andrea FUSCHI ; Yazan AL SALHI ; Alessandro ZUCCHI ; Giorgio BOZZINI ; Ester ILLIANO ; Elisabetta COSTANTINI ; Antonio CARBONE
Asian Journal of Andrology 2018;20(6):572-575
The aim of the study was to evaluate the long-term outcomes of pelvic floor muscle (PFM) rehabilitation in males with lifelong premature ejaculation (PE), using intravaginal ejaculatory latency time (IELT) and the self-report Premature Ejaculation Diagnostic Tool (PEDT) as primary outcomes. A total of 154 participants were retrospectively reviewed in this study, with 122 completing the training protocol. At baseline, all participants had an IELT ≤60 s and PEDT score >11. Participants completed a 12-week program of PFM rehabilitation, including physio-kinesiotherapy treatment, electrostimulation, and biofeedback, with three sessions per week, with 20 min for each component completed at each session. The effectiveness of intervention was evaluated by comparing the change in the geometric mean of IELT and PEDT values, from baseline, at 3, 6, and 12 months during the intervention, and at 24 and 36 months postintervention, using a paired sample 2-tailed t-test, including the associated 95% confidence intervals. Of the 122 participants who completed PFM rehabilitation, 111 gained control of their ejaculation reflex, with a mean IELT of 161.6 s and PEDT score of 2.3 at the 12-week endpoint of the intervention, representing an increase from baseline of 40.4 s and 17.0 scores, respectively, for IELT and PEDT (P < 0.0001). Of the 95 participants who completed the 36-month follow-up, 64% and 56% maintained satisfactory ejaculation control at 24 and 36 months postintervention, respectively.
Adolescent
;
Adult
;
Biofeedback, Psychology
;
Electric Stimulation
;
Follow-Up Studies
;
Humans
;
Male
;
Middle Aged
;
Muscle, Skeletal/physiology*
;
Pelvic Floor Disorders/rehabilitation*
;
Premature Ejaculation/rehabilitation*
;
Reflex/physiology*
;
Retrospective Studies
;
Treatment Outcome
;
Young Adult