Roberta Scano
Vita-Salute San Raffaele University
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Featured researches published by Roberta Scano.
Fertility and Sterility | 2015
Eugenio Ventimiglia; Paolo Capogrosso; Luca Boeri; Alessandro Serino; Michele Colicchia; Silvia Ippolito; Roberta Scano; Enrico Papaleo; Rocco Damiano; Francesco Montorsi; Andrea Salonia
OBJECTIVE To evaluate the prevalence, and clinical and seminal impact of comorbidities in white European men presenting for couple infertility. DESIGN Cross-sectional study. SETTING Academic reproductive medicine outpatient clinic. PATIENT(S) Cohort of 2,100 consecutive infertile men (noninterracial infertile couples). INTERVENTION(S) Obtaining complete demographic, clinical, and laboratory data from 2,100 consecutive infertile men with health-significant comorbidities scored via the Charlson comorbidity index (CCI; categorized 0 vs. 1 vs. ≥2) and semen analysis values assessed based on 2010 World Health Organization reference criteria. MAIN OUTCOME MEASURE(S) Assessment of the rate of comorbidities by means of CCI scores and possible associations between CCI, semen and hormonal parameters. RESULT(S) Descriptive statistics and regression models tested the associations among semen parameters, clinical characteristics, and CCI. When assessing general comorbidity prevalence, CCI 0, CCI 1, and CCI ≥2 was found in 1,921 (91.5%), 102 (4.9%), and 77 (3.6%) patients, respectively. Patient age and follicle-stimulating hormone levels increased as the general health status decreased. Conversely, the total testosterone levels and sperm concentration decreased as CCI scores increased. A higher rate of oligozoospermia and nonobstructive azoospermia was observed in patients with CCI ≥1. No differences were observed among the considered comorbidity groups in terms of testicular volume or further hormonal or seminal parameters. Both continuously coded and categorized sperm concentrations were independent predictors of CCI ≥1. Patients with sperm concentration <45.6 million/mL (most informative cutoff value) had a 2.74-fold increased risk of having a CCI ≥1. CONCLUSION(S) Decreased general health status appears to be associated with impaired male reproductive health, including lower sperm concentration, lower total testosterone levels, and higher follicle-stimulating hormone values.
Journal of Andrology | 2017
Paolo Capogrosso; Eugenio Ventimiglia; L. Boeri; Umberto Capitanio; Giorgio Gandaglia; Federico Dehò; F. Pederzoli; W. Cazzaniga; Roberta Scano; F. Montorsi; Andrea Salonia
Erectile dysfunction has been described as a sentinel marker of co‐existing and undetected cardiovascular disease. Beside cardiovascular diseases, a correlation between erectile dysfunction and other major comorbidities has been also reported. The study was aimed to analyze the association between sexual functioning and overall mens health in sexually active, Caucasian‐European men with new‐onset sexual dysfunction. Data from the last 881 consecutive patients seeking first medical help for sexual dysfunction were cross‐sectionally analyzed. The International Classification of Diseases, 9th revision, Clinical Modification was used to classify health‐significant comorbidities, which were scored with the Charlson Comorbidity Index (CCI). A modified CCI score from which all potential cardiovascular risk factors (CCI‐CV) were subtracted was then calculated for every patient. Patients were requested to complete the International Index of Erectile Function (IIEF). The main outcome of the study was the association between the IIEF domain scores and CCI, which scored health‐significant comorbidities even irrespective of cardiovascular risk factors (CCI‐CV). The final sample included 757 patients (85.9%) (Median age: 48 years; IQ range: 37–59). Overall, erectile dysfunction was found in 540 (71.4%) patients. Of these, 164 (21.6%) had a CCI ≥ 1 and 138 (18.2%) had a CCI‐CV ≥ 1, respectively. At the analysis of variance, IIEF‐Erectile Function (EF) scores significantly decreased as a function of incremental CCI and CCI‐CV scores (all p < 0.01). At multivariable logistic regression analysis, both IIEF‐EF and IIEF‐total score achieved independent predictor status for either CCI ≥ 1 or CCI‐CV ≥ 1, after accounting for potential confounders (p < 0.01). We report novel findings of a significant association between erectile dysfunction severity and overall mens health, even irrespective of cardiovascular risk factors. Thereof, erectile dysfunction severity could serve as a proxy for general mens health, thus encouraging physicians to comprehensively assess patients complaining of sexual dysfunction in the real‐life everyday clinical practice.
European Urology | 2016
Eugenio Ventimiglia; Paolo Capogrosso; L. Boeri; F. Pederzoli; W. Cazzaniga; Roberta Scano; Silvia Ippolito; Nicola Fossati; Massimo Alfano; Francesco Montorsi; Andrea Salonia
Known genetic alterations play a major role in perturbing male reproductive health. We sought to retrospectively validate the European Association of Urology (EAU) guidelines for karyotype analysis (KA) in a homogenous cohort of 1168 White European men presenting for primary couples infertility (noninterracial infertile couples only) and to develop a novel nomogram capable of predicting karyotype alterations. Overall, 742 (63.5%) patients would have deserved KA according to the EAU guidelines. Of those, 48 (6.9% of the assessable patients according to EAU guidelines) displayed any kind of alteration at KA. Conversely, hypothetically relying on the EAU criteria, 12 (20%) out of 60 patients with karyotype abnormalities would not have been candidates for the same genetic assessment. Overall, 694 (62.6%) patients would have been candidates for genetic workup despite having a normal karyotype. As a whole, the EAU guideline sensitivity, specificity, and discrimination were 80%, 37%, and 59%, respectively. We developed a novel nomogram, with a 2% probability cut-off, which allows for a more careful detection of KA alterations. PATIENT SUMMARY The application of the European Association of Urology guidelines for karyotype analysis does not ensure an adequate diagnostic process. In this regard, we propose a novel diagnostic tool to improve detection of alterations at karyotype analysis.
Asian Journal of Andrology | 2017
Eugenio Ventimiglia; Paolo Capogrosso; Alessandro Serino; Luca Boeri; Michele Colicchia; Giovanni La Croce; Roberta Scano; Enrico Papaleo; Rocco Damiano; Francesco Montorsi; Andrea Salonia
We aimed to determine the impact of metabolic syndrome (MetS) on reproductive function in men with secondary infertility, a condition that has received relatively little attention from researchers. Complete demographic, clinical, and laboratory data from 167 consecutive secondary infertile men were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI; categorised 0 vs 1 vs 2 or higher). NCEP-ATP III criteria were used to define MetS. Semen analysis values were assessed based on the 2010 World Health Organization (WHO) reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and MetS. MetS was found in 20 (12%) of 167 men. Patients with MetS were older (P < 0.001) and had a greater BMI (P < 0.001) compared with those without MetS. MetS patients had lower levels of total testosterone (P = 0.001), sex hormone-binding globulin, inhibin B, and anti-Mόllerian hormone (all P ≤ 0.03), and they were hypogonadal at a higher prevalence (P = 0.01) than patients without MetS. Moreover, MetS patients presented lower values of semen volume, sperm concentration, and sperm normal morphology (all P ≤ 0.03). At multivariate logistic regression analysis, no parameters predicted sperm concentration, normal sperm morphology, and total progressive motility. Our data show that almost 1 of 8 White-European men presenting for secondary couple′s infertility is diagnosed with MetS. MetS was found to be associated with a higher prevalence of hypogonadism, decreased semen volume, decreased sperm concentration, and normal morphology in a specific cohort of White-European men.
PLOS ONE | 2016
Luca Boeri; Eugenio Ventimiglia; Paolo Capogrosso; Silvia Ippolito; Angela Pecoraro; Marco Paciotti; Roberta Scano; Alessandro Galdini; Luca Valsecchi; Enrico Papaleo; Francesco Montorsi; Andrea Salonia
Individuals born with low birth weight (LBW) risk cardiometabolic complications later in life. However the impact of LBW on general health status and male reproductive function has been scantly analysed. We investigated the clinical and seminal impact of different birth weights (BW) in white-European men presenting for primary couple’s infertility. Demographic, clinical, and laboratory data from 827 primary infertile men were compared with those of 373 consecutive fertile men. Patients with BW ≤2500, 2500–4200, and ≥4200gr were classified as having LBW, normal (NBW), and high BW (HBW), respectively. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Testicular volume was assessed with a Prader orchidometer. Semen analysis values were assessed based on 2010 WHO reference criteria. Descriptive statistics and regression models tested associations between semen parameters, clinical characteristics and BW categories. LBW, NBW and HBW were found in 71 (8.6%), 651 (78.7%) and 105 (12.7%) infertile men, respectively. LBW was more frequent in infertile patients than fertile men (p = 0.002). Infertile patients with LBW had a higher rate of comorbidities (p = 0.003), lower mean testicular volume (p = 0.007), higher FSH (p = 0.02) and lower tT levels (p = 0.04) compared to other BW groups. Higher rates of asthenozoospermia (p = 0.02) and teratozoospermia (p = 0.03) were also found in LBW men. At logistic regression models, LBW was univariably associated with pathologic progressive motility (p≤0.02) and pathologic sperm morphology (p<0.005). At multivariable logistic regression analysis, LBW achieved independent predictor status for both lower sperm motility and pathologic sperm morphology (all p≤0.04). Only LBW independently predicted higher CCI values (p<0.001). In conclusion, we found that LBW was more frequent in infertile than in fertile men. Infertile individuals with LBW showed a higher rate of comorbidities and significantly worse clinical, endocrine and semen parameters compared to other BW groups.
BMJ Open | 2018
Paolo Capogrosso; Luca Boeri; Eugenio Ventimiglia; Ilenya Camozzi; W. Cazzaniga; Francesco Chierigo; Roberta Scano; Alberto Briganti; Francesco Montorsi; Andrea Salonia
Objectives We looked at subjective attitude towards active surveillance (AS) as the first option for cancer management in a cohort of patients seeking first medical help for uroandrological disorders prior to a formal discussion with a caregiver. Design Cross-sectional observational study. Setting Uroandrological outpatient clinic of a European academic centre. Participants Data of 1059 patients at their first access for uroandrological purposes from January 2014 to December 2016 were analysed. Intervention Patients were invited to complete a survey with closed questions investigating their attitude towards AS, prior to any clinical evaluation. Likewise, patients were invited to score the importance given to different aspects of personal life in the case of a cancer diagnosis, using a 10-point Likert scale. Primary and secondary outcomes measures The reported opinion towards AS management for cancer was assessed. Logistic regression analyses tested participants’ sociodemographic characteristics associated with a positive opinion on AS. Results Positive, negative and doubtful attitudes towards AS were observed in 347 (33%), 331 (31%) and 381 (36%) patients, respectively. Female patients were more likely to report a negative attitude towards AS (38.7% vs 29.6%, p=0.04) while patients with previous parenthood more frequently reported a positive opinion on AS (37.2% vs 29.9%, p=0.005). Patient age emerged as the only predictor of a positive attitude towards AS (OR 1.03; 95% CI 1.01 to 1.04, p<0.001), with a 46% and 33% probability of being pro-AS for a patient aged 65 and 45 years, respectively. Conclusions One out of three patients would express positive feedbacks on AS in the unfortunate case of tumour diagnosis, only according to his/her baseline personal opinion and prior to any discussion with a cancer caregiver. The older the patient, the higher the probability of being compliant with a conservative management for cancer.
The Journal of Urology | 2017
W. Cazzaniga; Luca Boeri; Eugenio Ventimiglia; Paolo Capogrosso; Filippo Pederzoli; Roberta Scano; Rayan Matloob; Federico Dehò; E. Montanari; Franco Gaboardi; Francesco Montorsi; Andrea Salonia
INTRODUCTION AND OBJECTIVES: We previously reported that due to the inherent variability of SHBG, clinical hypogonadism is over/under-diagnosed in 20% of patients. We further analyzed the data between classically hypogonadal men (G1 total testosterone (TT) < 300) and those men who were “missed” but were hypogonadal using calculated bioavailable testosterone (cBT < 210) with the use of SHBG (G2). We analyzed the role of SHBG in the routine testing of male factor infertility by analyzing the relationship of TT and BT to common infertility parameters. METHODS: Retrospective review of 168 males seen in a fertility clinic from 2012-2014, to investigate the accuracy of TT in the biochemical diagnosis of hypogonadism using cBT as the reference value. The relationship between TT and other infertility parameters were calculated using nonparametric Spearman correlations. We compared semen parameters between G1 and G2 in men with and without azoospermia. We utilized a multivariable sub-analysis with linear regression with backward elimination of non-significant variables. The possible predictors in the model included age, TT, varicocele, FSH, and SHBG. RESULTS: Using Spearman correlations, SHBG independently predicted lower semen parameters by a similar magnitude as FSH for sperm concentration (r1⁄4 -0.24, p 1⁄4 0.0027) and motility (r1⁄4 -.16, p1⁄4.0447). Semen parameters were available for 76 men who met criteria for G1 and 46 for G2. Only SHBG levels differed significantly upon initial group comparision (p1⁄4.0001). After excluding men with azoospermia, G1 had 62 and G2 had 45 men respectively. SHBG remained significant (P1⁄4.0001) and sperm motility (p 1⁄4 .057) and sperm concentration (p1⁄4.09) approached significance. Using a more stringent cutoff for G2 (T<156) sperm motility was significantly different in G1 and G2 (p1⁄4.014). Linear regression to predict sperm motility and concentration eliminated age, TT, and varicocele from the model e leaving just FSH and SHBG. When predicting sperm motility, SHBG was no longer statistically significant (p1⁄4.0973) when FSH (p1⁄40.0231) was in the model. For sperm concentration, SHBG was significant (p1⁄40.0186) when FSH (p1⁄40.0079) was in the model. CONCLUSIONS: Our data demonstrates the utility of SHBG in the initial hormonal evaluation of males seen in a fertility clinic. The addition of SHBG to TT serum testing facilitates more accurate diagnosis with FT and cBT, as SHBG was the only significant parameter able to distinguish between true hypogonadal and eugonadal patients. In addition, elevated SHBG levels independently predicted decreased sperm motility and sperm concentration.
Scientific Reports | 2017
L. Boeri; Paolo Capogrosso; Eugenio Ventimiglia; Roberta Scano; Alessandra Graziottin; Federico Dehò; E. Montanari; Francesco Montorsi; Andrea Salonia
Uncomplicated recurrent urinary tract infections (rUTIs) are common among reproductive-aged women. We aimed to assess the prevalence and predictors of sexual dysfunction (FSD) in a cohort of women with rUTIs and compare their psychometric scores to those of matched controls. Data from 147 rUTIs women and 150 healthy controls were analysed. Participants completed the International Prostatic Symptoms Score (IPSS), the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (SDS). Descriptive statistics and logistic regression models tested prevalence and predictors of distressful FSD. Women with rUTIs had lower FSFI scores (p < 0.001) and a greater proportion of pathological FSFI (78.9% vs. 21.4%; p < 0.001) and SDS scores (77.8% vs. 21.4%; p < 0.001) than controls. Of rUTIs patients, 88 (60%), 77 (52.2%), and 75 (51.1%) reported pathological scores for FSFI-pain, lubrication and arousal, respectively; moreover, 64% had concomitant pathological FSFI and SDS scores. Age, IPSS severity, rUTIs, a history of ≥6 UTIs/year and a history of constipation were independent predictors of pathologic FSFI and SDS (all p ≤ 0.05). In conclusion, up to 80% of women with rUTIs showed pathologic FSFI and SDS scores, with 60% reporting scores suggestive of distressful FSD. Having ≥6 UTIs/year and a history of constipation independently predicted distressful FSD.
Prostate Cancer and Prostatic Diseases | 2015
Luca Boeri; Paolo Capogrosso; Eugenio Ventimiglia; Alessandro Serino; G. La Croce; Andrea Russo; Giulia Castagna; Roberta Scano; Alberto Briganti; Rocco Damiano; F. Montorsi; Andrea Salonia
BACKGROUND:Prevalence of and severity of lower urinary tract symptoms (LUTS) according to male sexual orientation have been scantly analysed. We aimed to assess the prevalence and severity of LUTS in a cohort of Caucasian-European men who have sex with men seeking medical help for uroandrologic reasons other than LUTS.METHODS:Data from 949 consecutive individuals in an outpatient setting were analysed. Severity of LUTS was measured with the International Prostate Symptom Score (IPSS). Men with storage symptoms scored 1–3 and ⩾4 (of 15), and voiding symptoms scored 1–4 and ⩾5 (of 20) were considered as having mild and moderate-to-severe symptoms, respectively. For individual symptoms, patients with scores ⩾1 were deemed symptomatic (according to Apostolidis et al.15). Descriptive statistics and logistic regression models tested the association between LUTS and sexual orientation.RESULTS:Complete data were available for 213 (22.4%) men who have sex with men (MSM) and 736 (77.6%) heterosexuals (mean age (s.d.): 41.0 (12.2) vs 39.9 (12.1) years). Compared with heterosexuals, MSM reported higher rates of total IPSS scores suggestive of moderate (21.6% vs 20%) and severe LUTS (3.8% vs 2.4%) (P=0.004). Similarly, MSM showed higher rates of mild (48.8% vs 45.2%) and moderate-to-severe (39.4% vs 30.4%) storage symptoms (all P<0.001), and of mild (45.1% vs 34.8%) and moderate-to-severe (20.2% vs 19.2%) voiding symptoms (all P<0.01). MSM status was an independent predictor of mild voiding symptoms (odds ratio (OR): 1.40; P=0.004), moderate-to-severe storage symptoms (OR: 1.40; P=0.04) and severe total IPSS (OR: 1.49; P=0.03), after adjusting for other variables.CONCLUSIONS:These findings suggest a higher prevalence and severity of LUTS in MSM compared with heterosexual men seeking medical help for uroandrologic reasons other than LUTS.
European Urology Supplements | 2015
Luca Boeri; Paolo Capogrosso; Eugenio Ventimiglia; G. La Croce; Alessandro Serino; Angela Pecoraro; Marco Paciotti; Silvia Ippolito; Giulia Castagna; Roberta Scano; Rocco Damiano; F. Montorsi; Andrea Salonia
INTRODUCTION AND OBJECTIVES: The raise of the developmental origins of adult disease has positioned low birth weight (LBW) as a significant health issue. We assessed prevalence of, and clinical and seminal impact of different categories of weight at birth in a cohort of white-European men presenting for primary couple’s infertility. METHODS: Complete data from 757 consecutive infertile men were analyzed. Patient with birth weight 2500, 2500 e 4200, and 4200 gr were considered as having LBW, normal birth weight (NBW) and high birth weight (HBW), respectively. Comorbidities were scored with the Charlson Comorbidity Index (CCI; categorized 0 vs 1 vs 2). Body mass index (BMI) was considered for each patient using NIH cut offs [normal weight (18.5e24.9), overweight (25.0e29.9), and class 1 obesity ( 30.0)]. Testicular volume (TV) was assessed with a Prader orchidometer. Semen analysis values were assessed based on 2010 WHO reference criteria. Descriptive statistics detailed the association between semen parameters and clinical characteristics and the defined birth weight categories. RESULTS: Of all, LBW, NBW and HBW were found in 52 (6.9%), 605 (79.9%) and 100 (13.2%) men, respectively. Normal BMI value and BMI suggestive for NIH class 1 obesity was more frequently reported in LBW and HBW (p<0.001), respectively. Of all, LBW reported a higher prevalence of comorbidities (p<0.001). Likewise, hypercholesterolemia (p1⁄40.04) and hypertriglyceridemia (p1⁄40.01) were more frequently reported in both LBW and HBW. LBW had a lower mean TV (p1⁄40.02). At semen analysis, LBW men showed a higher rate of both asthenozoospermia (p1⁄40.02) and teratozoospermia (p1⁄40.02). Overall, ejaculated volume (p1⁄40.006), sperm motility (p1⁄40.02) and normal morphology (p1⁄40.04) were significantly reduced in the LBW group. Likewise, LBW patients presented higher FSH levels (p1⁄40.04) but lower circulating testosterone levels (p1⁄40.03) as compared with the other groups. At MVA, LBW achieved independent predictor status for a higher CCI value (OR 3.7; p<0.001), lower sperm motility (OR 2.7; p<0.04), and lower normal sperm morphology (OR 2.3; p<0.04). CONCLUSIONS: Current findings in infertile patients showed that LBW was associated with a significant higher rate of adult diseases. Clinical, endocrine and semen parameters were significantly worse in the LBW group. These data confirmed the importance of the theory of LBW as a significant predictor of impaired health issue.