Actas urologicas espanolas最新文献_第3页

Prevalencia de mutaciones en genes de reparación en hombres mexicanos con cáncer de próstata 墨西哥男性前列腺癌患者中修复基因突变的发生率

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuro.2024.03.003

Introduction and objective

Mexico reported 26,742 new cases of prostate cancer in 2020. Different risk factors have been identified in the pathogenesis of prostate cancer. Among them, genetic factors and alterations or mutations in specific genes have been described in different ethnic groups worldwide. The aim of our study is to report the prevalence of germline DNA-repair gene mutations in Mexican patients with prostate cancer.

Material and method

We performed germline genetic testing in 50 patients with localized prostate cancer and 50 patients with metastatic prostate cancer. Demographic, clinical, and histopathological data were collected.

Results

Thirty-seven germline mutations were identified in 32 patients. The most commonly affected genes were ATM in 6%, followed by FANCA (5%), and ATR (4%). BRCA2 mutations were identified in 3%. The frequency of mutations was higher in the metastatic group.

Discussion and Conclusion

The results of our study show different mutations from those reported in different populations or regions. The use of PARP inhibitors is indicated in patients with germline mutations, specifically BRCA2, showing improvement in overall survival and progression free survival. To our knowledge, this is the first study reporting the prevalence of mutations in DNA-repair genes in Mexican patients with prostate cancer.

导言和目标据报告，2020 年墨西哥新增前列腺癌病例 26 742 例。在前列腺癌的发病机制中发现了不同的风险因素。其中，遗传因素和特定基因的改变或突变已在全球不同种族群体中得到描述。我们的研究旨在报告墨西哥前列腺癌患者种系 DNA 修复基因突变的发生率。材料和方法我们对 50 名局部前列腺癌患者和 50 名转移性前列腺癌患者进行了种系基因检测。结果在 32 名患者中发现了 37 个基因突变。最常受影响的基因是ATM，占6%，其次是FANCA（5%）和ATR（4%）。BRCA2基因突变占3%。我们的研究结果显示了与不同人群或地区报告的基因突变不同的突变。PARP抑制剂适用于有基因突变（尤其是BRCA2）的患者，可改善总生存期和无进展生存期。据我们所知，这是第一项报告墨西哥前列腺癌患者 DNA 修复基因突变发生率的研究。

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引用次数: 0

Los últimos avances en prostatectomía robótica: ¿cómo lo hacemos en Cataluña, España? 机器人前列腺切除术的最新进展：我们如何在西班牙加泰罗尼亚地区开展这项工作？

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuro.2024.02.006

Introduction and objective

Robotic-assisted laparoscopic prostatectomy (RALP) seems to improve functional outcomes, however there is not a consensus of a standard procedure. The aim of this study was to identify the RALP “state of art” in Catalonia, Spain.

Material and methods

This was a cross-sectional survey-based study conducted among urologists across Catalonia. The survey was distributed through online platforms and the professional urology society. All statistical analyses were performed using Stata software, v. 20.

Results

Fifty-nine urologists completed the survey, revealing RALP as the most commonly used technique (79.7%). Most urologist (70%) create the pneumoperitoneum using a controlled incision with direct access and 78.3% use the AirSeal® technology. The intraperitoneal approach is performed in more than 90% of cases. Endopelvic fascia preservation is not routinely performed. A percentage of 34.5 of the survey not perform the dorsal vein complex suture. All preserves the bladder neck when oncologically safe. Nerve-vascular bundles bleeding control is performed using standard coagulation or suturing. Thirty-four percent performed posterior reconstruction. Only use hemostatic devices when evident bleeding and 70% does not routinely left a drainage. Multivariable analysis showed that center volume had a significant independent association with dorsal venous complex suturing (OR 0.073, 95% CI 0.07-0.826), nerve-vascular bundles suturing hemostasis (OR 11.67, 95% CI 1.07-127.60) and endopelvic fascia preservation (OR 13.64, 95% CI 1.087-201.27), but there was no correlation with time the bladder catheter or days hospitalized.

Conclusions

The study provides an overview of the state of RALP in Catalonia, Spain, showing significant variability and reflecting a commitment to advancing surgical technology and patient care.

导言和目的机器人辅助腹腔镜前列腺切除术（RALP）似乎可以改善功能性结果，但目前尚未就标准手术达成共识。本研究旨在确定西班牙加泰罗尼亚地区的 RALP "技术水平"。调查通过在线平台和专业泌尿外科学会进行。结果59 名泌尿科医生完成了调查，结果显示 RALP 是最常用的技术（79.7%）。大多数泌尿科医生（70%）使用直接进入的可控切口创建腹腔积气，78.3%的医生使用 AirSeal® 技术。90%以上的病例采用腹腔内方法。骨盆内筋膜保留不是常规做法。34.5%的调查未进行背静脉复合缝合。在肿瘤学安全的情况下，均保留膀胱颈。使用标准凝固或缝合术控制神经血管束出血。34%进行了后方重建。只有在明显出血时才使用止血装置，70%的人不会常规留置引流管。多变量分析显示，中心体积与背静脉复合体缝合（OR 0.073，95% CI 0.07-0.826）、神经血管束缝合止血（OR 11.67，95% CI 1.07-127.60）和骨盆内筋膜保留（OR 13.64，95% CI 1.结论该研究概述了西班牙加泰罗尼亚地区 RALP 的发展状况，显示出显著的差异性，并反映了该地区致力于推进手术技术和患者护理的决心。

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引用次数: 0

Aumento de la incidencia del cáncer testicular en España a pesar del descenso de la mortalidad: un análisis edad-periodo-cohorte 死亡率下降但西班牙睾丸癌发病率上升：年龄、时期和队列分析

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuro.2024.03.004

Background

Testicular cancer, primarily affecting young men, has seen an alarming rise globally. This study delves into incidence and mortality trends in Spain from 1990 to 2019 using the Global Burden of Disease (GBD) database and the Age-Period-Cohort (A-P-C) model.

Methods

We analyzed GBD data on testicular cancer cases and deaths in Spain, calculating age-standardized rates (ASIR and ASMR) and employing Joinpoint regression to identify significant shifts. The A-P-C model further dissected the effects of age, period, and birth cohort on these trends.

Results

A striking doubling in testicular cancer incidence was observed, from 3.09 to 5.40 per 100,000 men (1.9% annual increase), while mortality rates remained stable and even decreased in younger age groups (0.34 to 0.26 per 100,000, 0.8% annual decrease). Joinpoint analysis revealed four distinct periods of increasing incidence, with a recent slowdown. The A-P-C model highlighted a consistent rise in incidence risk with each successive generation born after 1935, contrasting with a progressive decline in mortality risk across cohorts, particularly marked for those born since the 1960s.

Conclusion

While mortality rates are encouraging, Spain reflects the global trend of escalating testicular cancer incidence. The A-P-C analysis suggests a generational influence, but the underlying causes remain elusive. Further research is crucial to understand these trends and implement effective prevention strategies to combat this growing health concern.

背景睾丸癌主要影响年轻男性，其发病率在全球范围内呈惊人上升趋势。本研究利用全球疾病负担（GBD）数据库和年龄-时期-队列（A-P-C）模型，对1990年至2019年西班牙的发病率和死亡率趋势进行了深入研究。方法我们分析了西班牙睾丸癌病例和死亡的GBD数据，计算了年龄标准化比率（ASIR和ASMR），并采用Joinpoint回归法确定了显著的变化。结果观察到睾丸癌发病率翻了一番，从每 10 万名男性中 3.09 例增加到 5.40 例（每年增加 1.9%），而死亡率保持稳定，甚至在较年轻的年龄组中有所下降（每 10 万名男性中 0.34 例下降到 0.26 例，每年下降 0.8%）。结合点分析显示，发病率有四个不同的上升期，最近有所放缓。A-P-C模型显示，1935年后出生的每一代人的发病风险都在持续上升，与此形成鲜明对比的是，各年龄组的死亡风险在逐步下降，20世纪60年代后出生的人尤其明显。A-P-C分析表明，睾丸癌的发生与世代因素有关，但其根本原因仍难以捉摸。要了解这些趋势并实施有效的预防策略来应对这一日益严重的健康问题，进一步的研究至关重要。

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引用次数: 0

Coinfección de viruela del mono, COVID-19 y sífilis en un HSH usuario de PrEP: informe de un caso en Barcelona 一名使用 PrEP 的男男性行为者同时感染猴痘、COVID-19 和梅毒：来自巴塞罗那的病例报告。

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuro.2024.04.001

引用次数: 0

Tendencias de género en el Congreso Anual de la Asociación Española de Urología (AEU): revisión de los programas de la AEU en un periodo de 10 años (2012-2022) 西班牙泌尿外科协会（AEU）年会的性别趋势：对西班牙泌尿外科协会 10 年间（2012-2022 年）计划的回顾。

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuro.2024.02.005

Introduction

Gender equity in urological meetings is pivotal for fostering diversity and inclusivity in the field. This study aims to evaluate the representation of Spanish urologist and regional disparities, and to assess its alignment with the demographic composition of the urological community.

Materials and methods

All urology meetings organized by the AEU between January 2012 and December 2022 were reviewed, including meeting information and details of the faculty. Additionally, we analysed geographic distribution of speakers across 17 different regions. Gender demographics were obtained disaggregating data by sex and year from the Organización Médica Colegial de España (OMC) and from those urologists affiliated to the AEU.

Results

Analysing 52 AEU congresses held from 2012 to 2022, encompassing 3,407 speakers, the study found that 95.25% of speakers were from Spain and 89.6% were male speakers. Over the years, there was a positive trend in female speaker representation, increasing by 1.1% annually, slightly lagging the 1.8% annual rise in the number of female urologists in Spain. In specific subfields like functional, transplantation, and oncology sessions, the study revealed a higher representation of women, indicating focused efforts in these areas. Geographically, Madrid, Catalonia and Andalusia exhibited the highest representation.

Conclusions

Although there was a positive trend towards an increased participation of female urologists in Spanish urological meetings, it fails to accurately reflect the proportional increase in the number of women entering the urology profession in recent years. This study underscores the importance of ongoing efforts to ensure diverse and balanced representation in urological forum.

导言泌尿外科会议中的性别平等对于促进该领域的多样性和包容性至关重要。本研究旨在评估西班牙泌尿外科医生的代表性和地区差异，并评估其与泌尿外科社区人口构成的一致性。材料和方法回顾了 2012 年 1 月至 2022 年 12 月期间由 AEU 组织的所有泌尿外科会议，包括会议信息和教师详情。此外，我们还分析了发言人在 17 个不同地区的地理分布情况。结果分析了2012年至2022年期间举行的52次AEU大会，共有3407名发言人，研究发现95.25%的发言人来自西班牙，89.6%的发言人为男性。多年来，女性发言人的比例呈上升趋势，每年增加1.1%，略低于西班牙泌尿科女医生人数每年1.8%的增幅。研究显示，在功能、移植和肿瘤等特定子领域的会议上，女性代表的比例较高，这表明这些领域的工作重点是女性。结论虽然女性泌尿科医师在西班牙泌尿外科会议中的参与率呈上升趋势，但这并不能准确反映近年来进入泌尿外科行业的女性人数的增长比例。这项研究强调了持续努力确保泌尿外科论坛的多元化和均衡代表性的重要性。

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引用次数: 0

Elaboración de un modelo experimental en conejos con diferentes grados de torsión testicular 在兔子身上建立不同程度睾丸扭转的实验模型。

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuro.2024.04.007

X. Zhu , C. Peng , Z. Wu , X. Zhang , S. Liu , Y. Luo , L. Yang

Introduction and objectives

Different degrees of testicular torsion result in varying degrees of testicular damage, which influences treatment options and outcomes. Therefore, establishing a testicular torsion model with different degrees is necessary for clinical diagnosis.

Materials and methods

Rabbits were randomly divided into 4 groups and their spermatic cords were twisted at 0°, 180°, 360°, and 720°, respectively. Color Doppler flow imaging (CDFI) were performed to evaluate the blood supply in testicles. The twisted testicles were surgically removed at 6 hours post-operation and were evaluated by morphological observation and Hematoxylin and Eosin staining.

Results

CDFI signals were gradually decreased as the degree of testicular torsion increased, and scores of CDFI in the 360° and 720° groups were significantly decreased at postoperative 6 hours compared to pre-surgery. Compared to the sham, the testicle in the 180° group exhibited slight congestion, whereas the testicles in the 360° and 720° groups were dark red in color and had severe congestion and unrecognizable vessels. Hematoxylin and Eosin staining showed mild spermatogenic cell reduction and testicular interstitial hemorrhage in the 180° group. In the 360° and 720° groups, disordered seminiferous tubules, shed spermatogenic cells in tubules, inflammatory cell infiltration, and severe hemorrhage were found. In comparison with the sham, interstitial hemorrhage scores in the 360° and 720° groups were significantly higher, and scores of germinal epithelial cell thickness in the 3 testicular torsion groups were significantly decreased.

Conclusion

Collectively, we successfully constructed a testicular torsion model with different degrees in rabbits.

简介和目的不同程度的睾丸扭转会导致不同程度的睾丸损伤，从而影响治疗方案和效果。因此，建立不同程度的睾丸扭转模型对临床诊断非常必要。材料和方法将兔子随机分为 4 组，分别将其精索扭转 0°、180°、360° 和 720°。进行彩色多普勒血流成像（CDFI）以评估睾丸的血液供应情况。结果随着睾丸扭转程度的增加，CDFI信号逐渐减弱，360°和720°组术后6小时的CDFI评分与术前相比明显降低。与假体相比，180°组的睾丸表现出轻微充血，而360°和720°组的睾丸呈暗红色，充血严重，血管无法辨认。血红素和伊红染色显示 180°组有轻微的生精细胞减少和睾丸间质出血。在 360° 和 720° 组中，发现曲细精管紊乱、精管内生精细胞脱落、炎性细胞浸润和严重出血。与假体相比，360°组和 720°组间质出血评分明显升高，3 个睾丸扭转组的生精上皮细胞厚度评分明显降低。

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引用次数: 0

Colposacropexia robótica para el tratamiento del prolapso de órganos pélvicos en mujeres de edad avanzada: análisis comparativo de la seguridad y eficacia frente a mujeres jóvenes 机器人阴道环切术治疗老年妇女盆腔器官脱垂：安全性和有效性与年轻妇女的比较分析

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuro.2024.04.005

Introduction

Pelvic organ prolapse is a condition with high prevalence in elderly women. With increasing life expectancy and a desire for improved quality of life, a rise in the frequency of surgical treatments for these women is anticipated. The aim is to compare complication, success, and satisfaction rates among elderly patients (aged >70 years) in comparison to younger women undergoing robotic sacrocolpopexy, thereby assessing the safety and efficacy of this surgery in this group of patients.

Method

A prospective observational comparative study of 123 robotic sacrocolpopexies conducted between December 2016 and June 2022. Patients were stratified by age (cutoff point: 70 years). Baseline characteristics, type, and grade of prolapse, intra and postoperative data, complications, functional and anatomical outcomes, and satisfaction levels were collected.

Results

Among the 123 patients, 62.6% were under 70 years old, while 37.4% were 70 years or older, exhibiting similar baseline characteristics, prolapse grade, and type. The percentages of intraoperative (6.5%) and postoperative complications (4.4-9%) were comparable in both age groups. Furthermore, success and satisfaction rates exceeded 90%, with no significant differences between women under and over 70 years during a two-year follow-up.

Conclusion

Robotic sacrocolpopexy is at least as effective and safe in women aged 70 years or older as in younger individuals, with no higher rates of intra and postoperative complications and similar rates of anatomical and subjective success.

引言盆腔脏器脱垂是老年妇女的高发病。随着预期寿命的延长和对提高生活质量的渴望，预计对这些妇女进行手术治疗的频率将会增加。本研究旨在比较老年患者（70 岁）与年轻女性接受机器人骶尾部结扎术的并发症发生率、成功率和满意度，从而评估该手术在这类患者中的安全性和有效性。患者按年龄分层（分界点：70 岁）。研究收集了患者的基线特征、脱垂类型和等级、术中和术后数据、并发症、功能和解剖结果以及满意度。两个年龄组的术中（6.5%）和术后并发症（4.4%-9%）发生率相当。此外，成功率和满意度均超过 90%，在为期两年的随访中，70 岁以下和 70 岁以上妇女的成功率和满意度无明显差异。结论机器人骶尾部结扎术对 70 岁或以上妇女的有效性和安全性至少与年轻人相同，术中和术后并发症发生率不高，解剖学成功率和主观成功率相似。

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引用次数: 0

El periplo de la determinación de la expresión de PD-L1 en el carcinoma urotelial infiltrante 确定浸润性尿路上皮癌中 PD-L1 的表达：西班牙病理解剖学会的建议。

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuro.2024.04.006

引用次数: 0

Utilidad de Bladder Epicheck® en el seguimiento del tumor de vejiga no músculo infiltrante: revisión sistemática de la literatura 膀胱Epicheck®在非肌浸润性膀胱肿瘤随访中的作用：文献系统回顾

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuro.2024.02.004

Introduction

In recent years, different urinary markers such as the Bladder Epicheck® have been developed in an attempt to reduce the number of cystoscopies in the follow-up of non-muscle invasive bladder cancer (NMIBC).

Aim

To provide a systematic review of Bladder Epicheck® and its current clinical utility in the follow-up and detection of recurrence of NMIBC.

Material and methods

Systematic review based on a literature search of PubMed, Web of Science and Scopus databases until October 2023, according to PRISMA and Quadas-2 criteria. Sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the marker were calculated. Diagnostic performance was evaluated by the area under the curve (AUC).

Results

Fifteen studies were analyzed (n = 3761) including 86.7% prospective studies. Of the patient series, 53.2% had received previous intravesical instillations. The mean Se of the biomarker in the detection of recurrence varied according to tumor grade (87.9%-high grade/HG vs. 44.9%-low grade/LG, respectively). Their weighted mean Se and Sp were 71.6% and 84.5%, respectively. The mean recurrence rate was 29.1%. The weighted mean PPV and NPV were 56.4% and 92.8% (97.7% non-LG), respectively. The mean AUC was 85.63%.

Conclusion

Bladder Epicheck® is a useful urinary marker in the follow-up of NMIBC, with significantly high Se and NPV in the detection of recurrences, especially in cases of HG disease. Its use can reduce the number of cystoscopies required in the follow-up of NMIBC, improving the quality of life of patients and potentially increasing health economic savings.

导言近年来，为了减少非肌层浸润性膀胱癌（NMIBC）随访中的膀胱镜检查次数，人们开发了膀胱Epicheck®等不同的尿液标记物。材料与方法根据 PRISMA 和 Quadas-2 标准，在 2023 年 10 月之前对 PubMed、Web of Science 和 Scopus 数据库进行文献检索的基础上进行系统综述。计算了标记物的敏感性（Se）、特异性（Sp）、阳性预测值（PPV）和阴性预测值（NPV）。结果分析了 15 项研究（n = 3761），包括 86.7% 的前瞻性研究。53.2%的患者曾接受过膀胱内注射。生物标记物检测复发的平均Se因肿瘤级别而异（高级别/HG为87.9%，低级别/LG为44.9%）。它们的加权平均 Se 和 Sp 分别为 71.6% 和 84.5%。平均复发率为 29.1%。加权平均PPV和NPV分别为56.4%和92.8%（非LG为97.7%）。结论膀胱Epicheck®是一种用于NMIBC随访的有用尿液标记物，在检测复发方面具有显著的高Se和NPV，尤其是在HG病例中。使用它可以减少 NMIBC 随访中所需的膀胱镜检查次数，提高患者的生活质量，并有可能节省更多的医疗经济成本。

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引用次数: 0

Impacto del tamaño de la lesión en las tasas de detección del cáncer de próstata clínicamente significativo en lesiones PI-RADS 3-5 病变大小对 PI-RADS 病变中具有临床意义的前列腺癌检出率的影响 3-5

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2024-09-01 DOI: 10.1016/j.acuro.2024.01.003

A. Ayranci, U. Caglar, A. Meric, M. Gelmis, O. Sarilar, F. Ozgor

Introduction

Prostate cancer (PCa) ranks second among prevalent cancers in men, necessitating effective screening tools such as multiparametric magnetic resonance imaging (mpMRI) with the prostate imaging reporting and data system (PI-RADS) classification. This study explores the impact of lesion volume on clinically significant prostate cancer (csPCa) detection rates in PI-RADS 3–5 lesions, aiming to contribute insights into the underexplored relationship between lesion size and csPCa detection.

Materials and methods

A retrospective analysis was conducted on data from 754 patients undergoing mpMRI-guided transrectal ultrasound (TRUS) prostate biopsy between January 2016 and 2023. Patients with PI-RADS 3, 4, and 5 lesions were included. Lesion size and PI-RADS categories were assessed through mpMRI, followed by MR fusion biopsy.

Results

Of the patients, 33.7%, 52.3%, and 14.1% had PI-RADS 3, 4, and 5 lesions, respectively. Lesion sizes correlated significantly with csPCa detection in PI-RADS 4 and 5 categories. For PI-RADS 3 lesions, no significant differences in csPCa rates were observed based on lesion size. However, in PI-RADS 4 and 5 groups, larger lesions showed higher csPCa rates.

Conclusions

This study suggests that subgroup categorizations based on lesion volume could predict clinically significant PCa with high accuracy, potentially reducing unnecessary biopsies and associated overtreatment. Future research should further explore the relationship between lesion size and csPCa, clarifying discussions regarding the inclusion of systematic biopsies in diagnostic protocols.

导言：前列腺癌（PCa）在男性癌症发病率中排名第二，因此需要有效的筛查工具，如采用前列腺成像报告和数据系统（PI-RADS）分类的多参数磁共振成像（mpMRI）。本研究探讨了PI-RADS 3-5病变中病变体积对有临床意义的前列腺癌（csPCa）检出率的影响，旨在深入探讨病变大小与csPCa检出率之间尚未充分探索的关系。材料与方法对2016年1月至2023年期间接受mpMRI引导下经直肠超声（TRUS）前列腺活检的754名患者的数据进行了回顾性分析。纳入了 PI-RADS 3、4 和 5 病变患者。通过 mpMRI 评估病变大小和 PI-RADS 类别，然后进行 MR 融合活检。在 PI-RADS 4 和 5 类病变中，病变大小与 csPCa 检出率明显相关。对于 PI-RADS 3 病变，病变大小与 csPCa 检出率无明显差异。结论这项研究表明，基于病变体积的亚组分类可以高度准确地预测有临床意义的 PCa，从而减少不必要的活检和相关的过度治疗。未来的研究应进一步探讨病变大小与 csPCa 之间的关系，并澄清有关在诊断方案中纳入系统活检的讨论。

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引用次数: 0