Pub Date : 2025-01-01DOI: 10.1016/j.acuro.2024.07.002
C. Ballesteros Ruiz , F. Campos-Juanatey , I. Povo Martín , S. Mitjana Biosca , Ó. Gorría Cardesa , J.F. Aguilar Guevara , N. García Formoso , E. Fernández Pascual , J.I. Martínez Salamanca , S. Martínez Pérez , J.M. Alonso Dorrego , E. Ríos González , S. San Cayetano Talegón , A.M. Araujo Suarez , E. Moran Pascual , M.Á. Bonillo García , J. Medina Polo , L. Viver Clotet , A.J. Vicens Morton , J. Arce Gil , L. Martínez-Piñeiro Lorenzo
Introduction
The Optilume® paclitaxel-coated urethral dilatation balloon is an alternative to conventional endoscopic treatments that combines mechanical dilatation with local delivery of paclitaxel.
Objective
To describe the success rate and analyze the safety of the device in real clinical practice. To evaluate possible predictors of treatment failure.
Material and methods
Retrospective multicenter study in patients diagnosed with urethral stricture and treated with an Optilume® balloon in routine clinical practice. Data were collected from flowmetry, questionnaires (PROM and IPSS) and cystoscopy before surgery, and 3, 6 and 12 months after the procedure, according to standard practice. Surgical success was defined as the absence of subsequent urethral manipulation and a Qmax > 10 ml/s.
Results
238 patients treated with Optilume® in 12 Spanish hospitals between May 2021 and April 2024 were included in the study. Of these, 156 who had a minimum follow-up of 3 months, were analyzed. Median stricture length: 1.5 cm (0.5 - 5.3), mainly in bulbar urethra (87.7%). Of the total, 12.8% of patients had a history of pelvic radiotherapy, and 81.4% had undergone prior urethral manipulation. Postoperative complications were reported in 14.2% of the total. The treatment success rate was 73.8%, with a median follow-up of 8 months (5-12). No predictors of stricture recurrence were identified. Recurrence rates were higher in strictures located in the posterior versus anterior urethra (42.9% vs. 24.6%, p = 0.126). No significant differences were observed between patients with and without prior urethral manipulation.
Conclusion
Treatment with Optilume® has been shown to be safe and effective in short-term routine clinical practice.
{"title":"Eficacia y seguridad del balón de dilatación uretral Optilume® en la práctica clínica real: análisis multicéntrico en España","authors":"C. Ballesteros Ruiz , F. Campos-Juanatey , I. Povo Martín , S. Mitjana Biosca , Ó. Gorría Cardesa , J.F. Aguilar Guevara , N. García Formoso , E. Fernández Pascual , J.I. Martínez Salamanca , S. Martínez Pérez , J.M. Alonso Dorrego , E. Ríos González , S. San Cayetano Talegón , A.M. Araujo Suarez , E. Moran Pascual , M.Á. Bonillo García , J. Medina Polo , L. Viver Clotet , A.J. Vicens Morton , J. Arce Gil , L. Martínez-Piñeiro Lorenzo","doi":"10.1016/j.acuro.2024.07.002","DOIUrl":"10.1016/j.acuro.2024.07.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The Optilume® paclitaxel-coated urethral dilatation balloon is an alternative to conventional endoscopic treatments that combines mechanical dilatation with local delivery of paclitaxel.</div></div><div><h3>Objective</h3><div>To describe the success rate and analyze the safety of the device in real clinical practice. To evaluate possible predictors of treatment failure.</div></div><div><h3>Material and methods</h3><div>Retrospective multicenter study in patients diagnosed with urethral stricture and treated with an Optilume® balloon in routine clinical practice. Data were collected from flowmetry, questionnaires (PROM and IPSS) and cystoscopy before surgery, and 3, 6 and 12 months after the procedure, according to standard practice. Surgical success was defined as the absence of subsequent urethral manipulation and a Qmax<!--> <!-->><!--> <!-->10<!--> <!-->ml/s.</div></div><div><h3>Results</h3><div>238 patients treated with Optilume® in 12 Spanish hospitals between May 2021 and April 2024 were included in the study. Of these, 156 who had a minimum follow-up of 3 months, were analyzed. Median stricture length: 1.5<!--> <!-->cm (0.5 - 5.3), mainly in bulbar urethra (87.7%). Of the total, 12.8% of patients had a history of pelvic radiotherapy, and 81.4% had undergone prior urethral manipulation. Postoperative complications were reported in 14.2% of the total. The treatment success rate was 73.8%, with a median follow-up of 8 months (5-12). No predictors of stricture recurrence were identified. Recurrence rates were higher in strictures located in the posterior versus anterior urethra (42.9% vs. 24.6%, p<!--> <!-->=<!--> <!-->0.126). No significant differences were observed between patients with and without prior urethral manipulation.</div></div><div><h3>Conclusion</h3><div>Treatment with Optilume® has been shown to be safe and effective in short-term routine clinical practice.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 80-85"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.acuro.2024.06.001
D. Pérez Fentes , P. Willisch , S. Martínez Breijoo , M. Domínguez , U. Anido , C. Álvarez , A. Gómez Caamaño
In recent years, various aspects of prostate cancer (PC) management have undergone significant changes, including the implementation of therapeutic strategies such as the use of new hormonal agents like abiraterone, apalutamide, enzalutamide or darolutamide and the incorporation of next generation imaging techniques. However, the evidence regarding the role of next generation imaging techniques and the therapeutic decision-making based on their findings is not solid. Following the methodology of the Advanced Prostate Cancer Consensus Conference, a multidisciplinary expert consensus was developed to address controversial questions concerning the use of next generation imaging techniques and clinical management in 4 priority scenarios: localized PC, PC after radical prostatectomy, PC after radiotherapy with curative intent, and metastatic hormone-sensitive PC. This consensus represents the opinions of medical oncology, radiation oncology and urology physicians, and provides useful recommendations for clinical practice.
{"title":"Controversias en el abordaje del cáncer de próstata: consenso de recomendaciones de expertos del norte de España","authors":"D. Pérez Fentes , P. Willisch , S. Martínez Breijoo , M. Domínguez , U. Anido , C. Álvarez , A. Gómez Caamaño","doi":"10.1016/j.acuro.2024.06.001","DOIUrl":"10.1016/j.acuro.2024.06.001","url":null,"abstract":"<div><div>In recent years, various aspects of prostate cancer (PC) management have undergone significant changes, including the implementation of therapeutic strategies such as the use of new hormonal agents like abiraterone, apalutamide, enzalutamide or darolutamide and the incorporation of next generation imaging techniques. However, the evidence regarding the role of next generation imaging techniques and the therapeutic decision-making based on their findings is not solid. Following the methodology of the Advanced Prostate Cancer Consensus Conference, a multidisciplinary expert consensus was developed to address controversial questions concerning the use of next generation imaging techniques and clinical management in 4 priority scenarios: localized PC, PC after radical prostatectomy, PC after radiotherapy with curative intent, and metastatic hormone-sensitive PC. This consensus represents the opinions of medical oncology, radiation oncology and urology physicians, and provides useful recommendations for clinical practice.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 739-750"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To assess the association between varicocele and hypogonadism, or erectile dysfunction.
Methods
We searched MEDLINE, EMBASE, LILACS, CENTRAL, and other sources. We included cohort, case-control, and cross-sectional studies. The primary outcome was the association between varicocele and hypogonadism, or erectile dysfunction, and the secondary outcome included semen analysis. We assessed the risk of bias with the Newcastle-Ottawa Scale. We performed statistical analysis in Review Manager® 5.3 and reported information about the odds ratio (OR) with a 95% confidence interval. We produced a forest plot for the primary outcome.
Results
We included ten studies in qualitative analysis and six studies in quantitative analysis. Most of the cross-sectional studies showed a low risk of bias, not so for the two case-control studies, which represented a high risk of bias. Most of the reports described a correlation between having varicocele and presenting low testosterone levels: the meta-analysis showed that there is a significant association between varicocele and hypogonadism (OR: 3.27; 95% CI: 1.23-8.68). Regarding varicocele and erectile, only one study showed a significant difference in erectile function in comparison to varicocele patients and men without varicocele.
Conclusion
There is an association between varicocele presence and hypogonadism, although more studies are needed. Besides, not much is reported about an association between varicocele and erectile dysfunction, but impairment can occur through hormone disturbances.
{"title":"Relación entre varicocele e hipogonadismo o disfunción eréctil: revisión sistemática y metaanálisis","authors":"S.J. Gonzalez-Daza , A.M. Díaz-Hung , H.A. García-Perdomo","doi":"10.1016/j.acuro.2024.05.002","DOIUrl":"10.1016/j.acuro.2024.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the association between varicocele and hypogonadism, or erectile dysfunction.</div></div><div><h3>Methods</h3><div>We searched MEDLINE, EMBASE, LILACS, CENTRAL, and other sources. We included cohort, case-control, and cross-sectional studies. The primary outcome was the association between varicocele and hypogonadism, or erectile dysfunction, and the secondary outcome included semen analysis. We assessed the risk of bias with the Newcastle-Ottawa Scale. We performed statistical analysis in Review Manager® 5.3 and reported information about the odds ratio (OR) with a 95% confidence interval. We produced a forest plot for the primary outcome.</div></div><div><h3>Results</h3><div>We included ten studies in qualitative analysis and six studies in quantitative analysis. Most of the cross-sectional studies showed a low risk of bias, not so for the two case-control studies, which represented a high risk of bias. Most of the reports described a correlation between having varicocele and presenting low testosterone levels: the meta-analysis showed that there is a significant association between varicocele and hypogonadism (OR: 3.27; 95% CI: 1.23-8.68). Regarding varicocele and erectile, only one study showed a significant difference in erectile function in comparison to varicocele patients and men without varicocele.</div></div><div><h3>Conclusion</h3><div>There is an association between varicocele presence and hypogonadism, although more studies are needed. Besides, not much is reported about an association between varicocele and erectile dysfunction, but impairment can occur through hormone disturbances.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 751-759"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.acuro.2024.07.003
A. Borque-Fernando , D.A. Pérez-Fentes , M. Rodrigo-Aliaga , J. Puente-Vázquez , A. Gómez-Iturriaga , M. Unda , M.A. Calleja-Hernández , J.M. Cózar-Olmo , J.L. Álvarez-Ossorio
Triple therapy with docetaxel, androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) has demonstrated survival benefits in patients with metastatic hormone-sensitive prostate cancer (mHSPC), especially in those with high-risk disease. However, once the use of ADT and docetaxel is established, guidelines do not clearly specify which ARPI is most appropriate. In this work, a literature review to identify phase III clinical trials, systematic reviews, meta-analyses, and clinical practice guidelines on triple therapy in mHSPC was carried out. Evidence and recommendations were qualitatively reviewed to provide guidelines on the most suitable ARPI based on patient risk, disease volume, and nature of metastases (synchronous or metachronous). This review aims to update the previously published consensus on the optimal pharmacological treatment for mHSPC and to expose the opinions of hospital pharmacy, urology and medical and radiation oncology experts.
{"title":"Optimización de la triple terapia en el tratamiento del cáncer de próstata hormonosensible metastásico","authors":"A. Borque-Fernando , D.A. Pérez-Fentes , M. Rodrigo-Aliaga , J. Puente-Vázquez , A. Gómez-Iturriaga , M. Unda , M.A. Calleja-Hernández , J.M. Cózar-Olmo , J.L. Álvarez-Ossorio","doi":"10.1016/j.acuro.2024.07.003","DOIUrl":"10.1016/j.acuro.2024.07.003","url":null,"abstract":"<div><div>Triple therapy with docetaxel, androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) has demonstrated survival benefits in patients with metastatic hormone-sensitive prostate cancer (mHSPC), especially in those with high-risk disease. However, once the use of ADT and docetaxel is established, guidelines do not clearly specify which ARPI is most appropriate. In this work, a literature review to identify phase III clinical trials, systematic reviews, meta-analyses, and clinical practice guidelines on triple therapy in mHSPC was carried out. Evidence and recommendations were qualitatively reviewed to provide guidelines on the most suitable ARPI based on patient risk, disease volume, and nature of metastases (synchronous or metachronous). This review aims to update the previously published consensus on the optimal pharmacological treatment for mHSPC and to expose the opinions of hospital pharmacy, urology and medical and radiation oncology experts.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 703-717"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.acuro.2024.09.001
A. Alcántara Montero
{"title":"Hacia un cambio de modelo en el manejo de la hiperplasia benigna de próstata: importancia de un enfoque individualizado","authors":"A. Alcántara Montero","doi":"10.1016/j.acuro.2024.09.001","DOIUrl":"10.1016/j.acuro.2024.09.001","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 761-762"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.acuro.2024.06.002
J. Tabares Jiménez, G. Bueno Serrano, M.P. Alcoba García, R. González López, B. Gómez Jordana, I. Mahillo Fernández, C. González Enguita
Objective
To evaluate the effect of endoscopic surgery on sexual function in patients with upper urinary tract (UUT) lithiasis.
Material and methods
We conducted an observational, prospective, longitudinal study with a single cohort of cases undergoing ureteroscopy (URS), retrograde intrarenal surgery (RIRS), or endoscopic combined intrarenal surgery (ECIRS). Patients’ sexual response was assessed with questionnaires in the 30 days prior to surgery, and at one and three months after surgery. The International Index of Erectile Function (IIEF-t) was used in male patients, and the Female Sexual Function Index (FSFI) was used in female patients.
Results
Seventy patients -34 men and 36 women- completed the study. Among men, the IIEF-t did not show significant difference between baseline scores (64.1 ± 7.50) and those obtained at 3 months (63.8 ± 9.51), with a non-significant decrease (p = 0.054) at the first month (61.4 ± 10.4). Subdomains did not worsen at 3 months, and desire (IIEF-SD) improved from 7.3 ± 1.9 to 8.0 ± 1.8. Among women, the FSFI-t did not change significantly after surgery: baseline score (27.3 ± 4.1), 1-month score (26.8 ± 3.7) and 3-month score (27.5 ± 4.2). No subdomain worsened at the third month.
Conclusion
Endoscopic surgery for UUT is a safe technique in both sexes with no negative effect on sexual function. There are no differences between the baseline IIEF-t and FSFI-t scores and those obtained at 3 months.
{"title":"Evaluación de los cambios en la función sexual en pacientes sometidos a cirugía endoscópica de la litiasis del tracto urinario superior","authors":"J. Tabares Jiménez, G. Bueno Serrano, M.P. Alcoba García, R. González López, B. Gómez Jordana, I. Mahillo Fernández, C. González Enguita","doi":"10.1016/j.acuro.2024.06.002","DOIUrl":"10.1016/j.acuro.2024.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of endoscopic surgery on sexual function in patients with upper urinary tract (UUT) lithiasis.</div></div><div><h3>Material and methods</h3><div>We conducted an observational, prospective, longitudinal study with a single cohort of cases undergoing ureteroscopy (URS), retrograde intrarenal surgery (RIRS), or endoscopic combined intrarenal surgery (ECIRS). Patients’ sexual response was assessed with questionnaires in the 30 days prior to surgery, and at one and three months after surgery. The International Index of Erectile Function (IIEF-t) was used in male patients, and the Female Sexual Function Index (FSFI) was used in female patients.</div></div><div><h3>Results</h3><div>Seventy patients -34 men and 36 women- completed the study. Among men, the IIEF-t did not show significant difference between baseline scores (64.1<!--> <!-->±<!--> <!-->7.50) and those obtained at 3 months (63.8<!--> <!-->±<!--> <!-->9.51), with a non-significant decrease (p<!--> <!-->=<!--> <!-->0.054) at the first month (61.4<!--> <!-->±<!--> <!-->10.4). Subdomains did not worsen at 3 months, and desire (IIEF-SD) improved from 7.3<!--> <!-->±<!--> <!-->1.9 to 8.0<!--> <!-->±<!--> <!-->1.8. Among women, the FSFI-t did not change significantly after surgery: baseline score (27.3<!--> <!-->±<!--> <!-->4.1), 1-month score (26.8<!--> <!-->±<!--> <!-->3.7) and 3-month score (27.5<!--> <!-->±<!--> <!-->4.2). No subdomain worsened at the third month.</div></div><div><h3>Conclusion</h3><div>Endoscopic surgery for UUT is a safe technique in both sexes with no negative effect on sexual function. There are no differences between the baseline IIEF-t and FSFI-t scores and those obtained at 3 months.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 688-694"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.acuro.2024.05.001
A. Medina Gamero
{"title":"El leaking pipeline y las brechas de género en Urología","authors":"A. Medina Gamero","doi":"10.1016/j.acuro.2024.05.001","DOIUrl":"10.1016/j.acuro.2024.05.001","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Page 760"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141134343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.acuro.2024.10.001
J. Morote Robles
{"title":"Hacia el cribado poblacional del cáncer de próstata en España","authors":"J. Morote Robles","doi":"10.1016/j.acuro.2024.10.001","DOIUrl":"10.1016/j.acuro.2024.10.001","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 685-687"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.acuro.2024.06.003
M. Fernández Arjona , L. López Martín , L.M. Herranz Fernández , B. Sinues Ojas , J.M. Campá Bortoló , J. Extramiana Cameno , E. López Alcina , I. Povo Martín , A. Budía Alba , G. Ordaz Jurado , J.M. Osca García , M. Perán Teruel , V. Gimeno Argente , A. Navarro Beltrán , J. Benejam Gual , Y.E. Hernández Martínez , C. González Enguita
Benign prostatic hyperplasia is an increasingly common pathology in the adult male, especially after the age of 40-45 years, and its management consumes an enormous amount of resources. The UroLift® system is an approved technology designed to treat lower urinary tract symptoms secondary to benign prostatic hyperplasia and is used to perform the prostatic urethral lift procedure. Various urology specialists in Spain with experience in prostatic urethral lift have prepared this consensus document. Endorsed by the Spanish Urology Association, its information is based on the most recent findings. The main objective of this document is to disseminate the consensus recommendations among all professionals treating patients with lower urinary tract symptoms/benign prostatic hyperplasia. Both primary care physicians and urologists can assess and offer prostatic urethral lift as an effective, minimally invasive treatment.
{"title":"Aplicación clínica del sistema de liberación uretral UroLift® en España: consenso sobre el tratamiento de los síntomas del tracto urinario inferior asociados a la obstrucción del flujo urinario por hiperplasia benigna de próstata","authors":"M. Fernández Arjona , L. López Martín , L.M. Herranz Fernández , B. Sinues Ojas , J.M. Campá Bortoló , J. Extramiana Cameno , E. López Alcina , I. Povo Martín , A. Budía Alba , G. Ordaz Jurado , J.M. Osca García , M. Perán Teruel , V. Gimeno Argente , A. Navarro Beltrán , J. Benejam Gual , Y.E. Hernández Martínez , C. González Enguita","doi":"10.1016/j.acuro.2024.06.003","DOIUrl":"10.1016/j.acuro.2024.06.003","url":null,"abstract":"<div><div>Benign prostatic hyperplasia is an increasingly common pathology in the adult male, especially after the age of 40-45 years, and its management consumes an enormous amount of resources. The UroLift® system is an approved technology designed to treat lower urinary tract symptoms secondary to benign prostatic hyperplasia and is used to perform the prostatic urethral lift procedure. Various urology specialists in Spain with experience in prostatic urethral lift have prepared this consensus document. Endorsed by the Spanish Urology Association, its information is based on the most recent findings. The main objective of this document is to disseminate the consensus recommendations among all professionals treating patients with lower urinary tract symptoms/benign prostatic hyperplasia. Both primary care physicians and urologists can assess and offer prostatic urethral lift as an effective, minimally invasive treatment.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 732-738"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.acuro.2024.06.004
Ó. Rodríguez Faba , J.M. Fernández Gómez , F. Guerrero-Ramos , M. Álvarez-Maestro , M.J. Ledo Cepero , M. Unda Urzaiz , L. Martínez-Piñeiro , J.M. Cózar Olmo , J. Palou Redorta , J.L. Álvarez-Ossorio
Patients with non-muscle-invasive bladder cancer (NMIBC) in the intermediate and high-risk groups must receive adjuvant treatment with intravesical Bacillus Calmette-Guerin (BCG) following transurethral resection (TUR), as it reduces the risk of recurrence and presumably the risk of progression as well. Optimization of BCG efficacy is achieved by administering maintenance therapy. However, since many immunological aspects of the mechanism of action of BCG in the bladder remain unknown, the implementation of the optimal dose, number of instillations, strains and adequate maintenance regimen over the last decades has been heterogeneous. Additionally, this has hindered the interpretation of efficacy in terms of oncologic outcomes. This, together with the shortages of BCG in recent years, have forced scientific societies to adapt their clinical practice guidelines and modify their protocols of adjuvant treatment with BCG. This includes changes to strains, doses, and maintenance during this period of time. This consensus document evaluates the current status of adjuvant BCG treatment and the implications of BCG supply availability in the treatment of patients with NMIBC. It also addresses the implementation of novel therapies that will improve cancer prognosis and the quality of life of patients with NMIBC in the future.
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