Pub Date : 2026-01-01Epub Date: 2025-03-13DOI: 10.1016/j.acuro.2025.501753
A. Bhosale , M. Gore
{"title":"Comentario sobre «Vías clínicas para el cuidado oral en pacientes sometidos a extracción de injerto de mucosa oral: una revisión sistemática»","authors":"A. Bhosale , M. Gore","doi":"10.1016/j.acuro.2025.501753","DOIUrl":"10.1016/j.acuro.2025.501753","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 1","pages":"Article 501753"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898170","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 : 2026-01-01Epub Date: 2025-07-18DOI: 10.1016/j.acuro.2025.501831
A. Bujons Tur
{"title":"Mirando al futuro: presente y perspectivas de la urología pediátrica","authors":"A. Bujons Tur","doi":"10.1016/j.acuro.2025.501831","DOIUrl":"10.1016/j.acuro.2025.501831","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 1","pages":"Article 501831"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898160","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 : 2026-01-01Epub Date: 2025-03-12DOI: 10.1016/j.acuro.2025.501750
A. Romero Crespo , R. España Navarro , E. Prieto Sanchez , E. Garcia Galisteo
{"title":"Masa renal secundaria a la enfermedad de Rosai-Dorfman: reporte de caso clínico","authors":"A. Romero Crespo , R. España Navarro , E. Prieto Sanchez , E. Garcia Galisteo","doi":"10.1016/j.acuro.2025.501750","DOIUrl":"10.1016/j.acuro.2025.501750","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 1","pages":"Article 501750"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898169","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 : 2026-01-01Epub Date: 2025-07-04DOI: 10.1016/j.acuro.2025.501822
N. Baydilli , M.İ. Dönmez , Y. Quiroz Madarriaga , B. Banuelos Marco , İ. Selvi , E. Bindi , R. Lammers , S. Sforza , L.A. ’tHoen , en representación del Grupo de Trabajo de Urología Pediátrica de la Sección de Jóvenes Urólogos Académicos – Asociación Europea de Urología (EAU-YAU)
Objective
This study assessed global diagnostic and therapeutic approaches to nocturnal enuresis (NE), highlighting current practices and variations.
Materials and methods
An 18-question survey by the European Association of Urology (EAU) Young Academic Urologist (YAU) Paediatric Urology Working Group targeted clinicians managing NE. Distributed online, it reached Urologists, Pediatric Urologists, Pediatricians, Nephrologists, and Urotherapists. The survey collected demographic data and details on diagnostic and treatment practices. Responses were analyzed using descriptive statistics.
Results
Most respondents worked in university or government hospitals, with pediatric urologists forming the largest group (43.6%). A significant portion had 11-20 years of NE management experience. Initial treatment favored behavioral strategies and urotherapy (84.5%), with desmopressin as a common first-line medication (23.8%). Most clinicians initiated treatment at ages 5-6. Bladder diaries were widely used (82.0%), while airway assessments were inconsistent (52.1%). Diagnostic test usage varied, with urinary tract ultrasonography (53.65%) and urinalysis (51.5%) employed to identify underlying abnormalities. Psychological referrals were common for secondary enuresis (58.9%).
Conclusion
NE management varies globally due to regional practices, clinician experience, and specialty focus. The findings emphasize the need for standardized guidelines and education on comprehensive assessments, including sleep-related factors. International collaboration and guideline development could enhance consistency and improve patient outcomes.
{"title":"Perspectiva internacional sobre el diagnóstico y tratamiento de la enuresis nocturna: estudio basado en una encuesta del Grupo de Trabajo de Urología Pediátrica de la Sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU)","authors":"N. Baydilli , M.İ. Dönmez , Y. Quiroz Madarriaga , B. Banuelos Marco , İ. Selvi , E. Bindi , R. Lammers , S. Sforza , L.A. ’tHoen , en representación del Grupo de Trabajo de Urología Pediátrica de la Sección de Jóvenes Urólogos Académicos – Asociación Europea de Urología (EAU-YAU)","doi":"10.1016/j.acuro.2025.501822","DOIUrl":"10.1016/j.acuro.2025.501822","url":null,"abstract":"<div><h3>Objective</h3><div>This study assessed global diagnostic and therapeutic approaches to nocturnal enuresis (NE), highlighting current practices and variations.</div></div><div><h3>Materials and methods</h3><div>An 18-question survey by the European Association of Urology (EAU) Young Academic Urologist (YAU) Paediatric Urology Working Group targeted clinicians managing NE. Distributed online, it reached Urologists, Pediatric Urologists, Pediatricians, Nephrologists, and Urotherapists. The survey collected demographic data and details on diagnostic and treatment practices. Responses were analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>Most respondents worked in university or government hospitals, with pediatric urologists forming the largest group (43.6%). A significant portion had 11-20 years of NE management experience. Initial treatment favored behavioral strategies and urotherapy (84.5%), with desmopressin as a common first-line medication (23.8%). Most clinicians initiated treatment at ages 5-6. Bladder diaries were widely used (82.0%), while airway assessments were inconsistent (52.1%). Diagnostic test usage varied, with urinary tract ultrasonography (53.65%) and urinalysis (51.5%) employed to identify underlying abnormalities. Psychological referrals were common for secondary enuresis (58.9%).</div></div><div><h3>Conclusion</h3><div>NE management varies globally due to regional practices, clinician experience, and specialty focus. The findings emphasize the need for standardized guidelines and education on comprehensive assessments, including sleep-related factors. International collaboration and guideline development could enhance consistency and improve patient outcomes.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 1","pages":"Article 501822"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898161","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 : 2026-01-01Epub Date: 2025-07-31DOI: 10.1016/j.acuro.2025.501837
I. Gulturk , C. Kapar , E. Arslan , M. Polat , G.B. Sonmezoz , D. Tural
Objective
To evaluate the relationship between treatment response and radiological progression-free survival (rPFS) in patients with metastatic castration-sensitive prostate cancer (mCSPC) assessed by PSMA-PET/CT using Response Evaluation Criteria on PSMA (RECIP 1.0) criteria.
Methods
In this study, 116 patients were analyzed retrospectively. At the beginning of the treatment and week 12 were PSMA PET/CT images evaluated for changes in total tumor volüme and new lesions. Patients were divided into four groups according to RECIP criteria; complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). The primary outcome was the correlation of RECIP criteria with rPFS.
Results
Mean age of the patients was 67 years (IQR: 62-72]). Total of 116 patients; 65 (56%) had PR, 17 (14,6%) SD, 19 (16,3%) PD, and 15 (12%) CR. rPFS was found to be statistically significantly different among these four groups (P<.001). RECIP PD was found to be significantly shorter rPFS compared with non-PD (P<.001), with an rPFS of 7 months (95% CI: 3.45-10.56). PSA values were measured at nadir in 40 patients and no patient in this group was evaluated as having PD.
Conclusion
RECIP criteria have been shown to have prognostic significance in terms of evaluating treatment response and rPFS in mCSPC patients.
{"title":"Evaluación de la eficacia del tratamiento según los criterios RECIP 1.0 en el cáncer de próstata sensible a la castración","authors":"I. Gulturk , C. Kapar , E. Arslan , M. Polat , G.B. Sonmezoz , D. Tural","doi":"10.1016/j.acuro.2025.501837","DOIUrl":"10.1016/j.acuro.2025.501837","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the relationship between treatment response and radiological progression-free survival (rPFS) in patients with metastatic castration-sensitive prostate cancer (mCSPC) assessed by PSMA-PET/CT using Response Evaluation Criteria on PSMA (RECIP 1.0) criteria.</div></div><div><h3>Methods</h3><div>In this study, 116 patients were analyzed retrospectively. At the beginning of the treatment and week 12 were PSMA PET/CT images evaluated for changes in total tumor volüme and new lesions. Patients were divided into four groups according to RECIP criteria; complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). The primary outcome was the correlation of RECIP criteria with rPFS.</div></div><div><h3>Results</h3><div>Mean age of the patients was 67 years (IQR: 62-72]). Total of 116 patients; 65 (56%) had PR, 17 (14,6%) SD, 19 (16,3%) PD, and 15 (12%) CR. rPFS was found to be statistically significantly different among these four groups (<em>P</em><.001). RECIP PD was found to be significantly shorter rPFS compared with non-PD (<em>P</em><.001), with an rPFS of 7 months (95% CI: 3.45-10.56). PSA values were measured at nadir in 40 patients and no patient in this group was evaluated as having PD.</div></div><div><h3>Conclusion</h3><div>RECIP criteria have been shown to have prognostic significance in terms of evaluating treatment response and rPFS in mCSPC patients.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 1","pages":"Article 501837"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898165","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 : 2026-01-01Epub Date: 2025-03-11DOI: 10.1016/j.acuro.2025.501747
A. Garcia-Segui, M. Ferrández-Jimenez, N. García-Cárceles, C. Soler-López
{"title":"Heminefroureterectomía laparoscópica en riñón en herradura con sospecha de carcinoma urotelial empleando un modelo virtual 3 D de hiperprecisión","authors":"A. Garcia-Segui, M. Ferrández-Jimenez, N. García-Cárceles, C. Soler-López","doi":"10.1016/j.acuro.2025.501747","DOIUrl":"10.1016/j.acuro.2025.501747","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 1","pages":"Article 501747"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898168","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 : 2025-12-01Epub Date: 2025-06-24DOI: 10.1016/j.acuro.2025.501818
K. Godlewski, M. Davis, D. Weiss, A. Shukla
Introduction
Classic bladder exstrophy presents a unique challenge for reconstructive surgeons given the significant alternations it has on normal pelvic anatomy. The ultimate goal of surgery, whether in one stage or more, is simple; close the bladder, reconstruct the bladder neck and urethra, and place the unit into a more orthotopic position deep in the pelvis, and establish normal genitalia. Despite significant improvements with the success of bladder exstrophy closure, a patient's ability to volitionally void and achieve urinary continence after initial closure remain an elusive «holy grail» for bladder exstrophy surgeons. After closure many patients will endure persistent urinary incontinence post exstrophy closure. In this review, we will discuss the conservative strategies and surgical options to facilitate continence in our bladder exstrophy patients. Regardless of surgical approach or initial outcome, all patients with bladder exstrophy require lifelong urologic follow-up.
Methods
A comprehensive search of electronic databases (Medline, PubMed, Embase, PsycINFO and CINAHL), and citation tracking platforms (Google Scholar and Web of Science) was performed. Keywords included classic bladder exstrophy, incontinence, behavioral therapy, urotherapy, biofeedback, bulking agents, artificial urinary sphincter, bladder neck reconstruction, bladder neck closure, urinary diversion.
Results
Conservative measures such as behavioral therapy, physical therapy and uropsychological counseling should be first line for the treatment of urinary incontinence after exstrophy closure. These interventions along with maturation of the child and bladder growth can improve incontinence without surgery. Patients should be counseled on the limited success of bulking agents and significant risk of erosion with sphincters. Although success after bladder neck reconstruction or bladder neck closure with or without augmentation and catheterizable channel can be variable, these surgical options can be offered to patients that have exhausted conservative treatment strategies.
Conclusions
A patient's ability to volitionally void and achieve urinary continence remain an elusive goal for bladder exstrophy surgeons with many experiencing persistent urinary incontinence following exstrophy closure. Behavioral therapy, physical therapy and pyschological support should be provided to all bladder exstrophy patients and families. Giving children time to grow and mature can potentially facilitate continence without surgical intervention. If surgical intervention is pursued lifelong follow-up and monitoring is critical.
经典膀胱外翻对重建外科医生提出了一个独特的挑战，因为它对正常骨盆解剖结构有重大的改变。手术的最终目的，无论是一个阶段还是多个阶段，都很简单；关闭膀胱，重建膀胱颈和尿道，并将单元置于骨盆深处更正位的位置，并建立正常的生殖器。尽管膀胱外翻闭合术的成功取得了显著的进步，但对于膀胱外翻外科医生来说，患者在初次闭合后自愿排空并实现尿失禁的能力仍然是一个难以实现的“圣杯”。闭锁后，许多患者在闭锁后会出现持续性尿失禁。在这篇综述中，我们将讨论保守策略和手术选择，以促进膀胱外翻患者的自制。无论采用何种手术方式或初始结果，所有膀胱外翻患者都需要终身泌尿外科随访。方法综合检索电子数据库（Medline、PubMed、Embase、PsycINFO和CINAHL）和引文跟踪平台（b谷歌Scholar和Web of Science）。关键词：经典膀胱外翻，尿失禁，行为治疗，泌尿治疗，生物反馈，膨胀剂，人工尿括约肌，膀胱颈重建，膀胱颈闭合，尿分流。结果行为治疗、物理治疗、泌尿心理咨询等保守措施是治疗外翻术后尿失禁的首选方法。随着儿童的成熟和膀胱的生长，这些干预措施可以改善失禁而无需手术。应告知患者膨胀剂的有限成功和括约肌糜烂的重大风险。尽管膀胱颈重建术或膀胱颈闭合术的成功与否有不同，但这些手术选择可以提供给已经用尽保守治疗策略的患者。结论膀胱外翻术后患者能否自主排尿并实现尿失禁一直是膀胱外翻外科医生难以实现的目标，许多患者在膀胱外翻术后出现了持续性尿失禁。对膀胱外翻患者及其家属应给予行为治疗、物理治疗和心理支持。给孩子时间成长和成熟可以潜在地促进失禁，而无需手术干预。如果进行手术干预，终身随访和监测是至关重要的。
{"title":"Manejo de la incontinencia tras el cierre de la extrofia vesical clásica","authors":"K. Godlewski, M. Davis, D. Weiss, A. Shukla","doi":"10.1016/j.acuro.2025.501818","DOIUrl":"10.1016/j.acuro.2025.501818","url":null,"abstract":"<div><h3>Introduction</h3><div>Classic bladder exstrophy presents a unique challenge for reconstructive surgeons given the significant alternations it has on normal pelvic anatomy. The ultimate goal of surgery, whether in one stage or more, is simple; close the bladder, reconstruct the bladder neck and urethra, and place the unit into a more orthotopic position deep in the pelvis, and establish normal genitalia. Despite significant improvements with the success of bladder exstrophy closure, a patient's ability to volitionally void and achieve urinary continence after initial closure remain an elusive «holy grail» for bladder exstrophy surgeons. After closure many patients will endure persistent urinary incontinence post exstrophy closure. In this review, we will discuss the conservative strategies and surgical options to facilitate continence in our bladder exstrophy patients. Regardless of surgical approach or initial outcome, all patients with bladder exstrophy require lifelong urologic follow-up.</div></div><div><h3>Methods</h3><div>A comprehensive search of electronic databases (Medline, PubMed, Embase, PsycINFO and CINAHL), and citation tracking platforms (Google Scholar and Web of Science) was performed. Keywords included classic bladder exstrophy, incontinence, behavioral therapy, urotherapy, biofeedback, bulking agents, artificial urinary sphincter, bladder neck reconstruction, bladder neck closure, urinary diversion.</div></div><div><h3>Results</h3><div>Conservative measures such as behavioral therapy, physical therapy and uropsychological counseling should be first line for the treatment of urinary incontinence after exstrophy closure. These interventions along with maturation of the child and bladder growth can improve incontinence without surgery. Patients should be counseled on the limited success of bulking agents and significant risk of erosion with sphincters. Although success after bladder neck reconstruction or bladder neck closure with or without augmentation and catheterizable channel can be variable, these surgical options can be offered to patients that have exhausted conservative treatment strategies.</div></div><div><h3>Conclusions</h3><div>A patient's ability to volitionally void and achieve urinary continence remain an elusive goal for bladder exstrophy surgeons with many experiencing persistent urinary incontinence following exstrophy closure. Behavioral therapy, physical therapy and pyschological support should be provided to all bladder exstrophy patients and families. Giving children time to grow and mature can potentially facilitate continence without surgical intervention. If surgical intervention is pursued lifelong follow-up and monitoring is critical.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 10","pages":"Article 501818"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623407","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 : 2025-12-01Epub Date: 2025-07-04DOI: 10.1016/j.acuro.2025.501820
R.J.M. Lammers , L.A.’t Hoen , F. O’Kelly , I. Selvi , Y. Quiroz Madarriaga , N. Baydilli , B. Bañuelos Marco , M.I. Dönmez , S. Sforza , E. Bindi , B. Haid , en representación del Grupo de Trabajo de Urología Pediátrica de la Sección de Jóvenes Urólogos Académicos (YAU) - Asociación Europea de Urología (EAU)
The objective of this study was to provide an overview of current practices on hormonal therapy (HT) in children with undescended testes (UDT).
An online questionnaire about HT, referral patterns, and orchidopexy was spread via several (social media) networks involved in pediatric urology.
A total of 283 individuals responded, with 54 countries sampled. The majority (84%) did not prescribe HT for UDT, predominantly due to a paucity of scientific evidence (76%). Among those who use HT, main reason was bilateral UDT (62%). There was no clear preference in administration type (50% intramuscular injection, 50% nasal spray). GnRH was slightly more favoured over HCG (50% vs. 32%). No standardized schedule was used. Most respondents (67%) felt all forms of UDT should be treated by either a pediatric urologist or -surgeon. Eighty-seven percent follow the current guidelines and perform orchidopexy between 6-18 months of age.
{"title":"Terapia hormonal para el testículo no descendido: resultados de un cuestionario internacional","authors":"R.J.M. Lammers , L.A.’t Hoen , F. O’Kelly , I. Selvi , Y. Quiroz Madarriaga , N. Baydilli , B. Bañuelos Marco , M.I. Dönmez , S. Sforza , E. Bindi , B. Haid , en representación del Grupo de Trabajo de Urología Pediátrica de la Sección de Jóvenes Urólogos Académicos (YAU) - Asociación Europea de Urología (EAU)","doi":"10.1016/j.acuro.2025.501820","DOIUrl":"10.1016/j.acuro.2025.501820","url":null,"abstract":"<div><div>The objective of this study was to provide an overview of current practices on hormonal therapy (HT) in children with undescended testes (UDT).</div><div>An online questionnaire about HT, referral patterns, and orchidopexy was spread via several (social media) networks involved in pediatric urology.</div><div>A total of 283 individuals responded, with 54 countries sampled. The majority (84%) did not prescribe HT for UDT, predominantly due to a paucity of scientific evidence (76%). Among those who use HT, main reason was bilateral UDT (62%). There was no clear preference in administration type (50% intramuscular injection, 50% nasal spray). GnRH was slightly more favoured over HCG (50% vs. 32%). No standardized schedule was used. Most respondents (67%) felt all forms of UDT should be treated by either a pediatric urologist or -surgeon. Eighty-seven percent follow the current guidelines and perform orchidopexy between 6-18 months of age.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 10","pages":"Article 501820"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623408","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 : 2025-12-01Epub Date: 2025-10-10DOI: 10.1016/j.acuro.2025.501869
K. Eskandar
Introduction
Focal therapy offers a middle-ground approach for localized prostate cancer, preserving the prostate while avoiding the morbidity of radical treatment. High-Intensity Focused Ultrasound (HIFU) is the most studied focal modality, with FocalONE representing the most widely adopted modern platform enabling precise image-guided ablation.
Objective
To systematically assess the oncologic control, functional outcomes, safety, and technological advancements of focal and hemiablation HIFU with an emphasis on the FocalONE platform.
Methodology
This systematic review followed PRISMA guidelines and was registered in PROSPERO. A comprehensive search of PubMed, Embase, and Cochrane databases identified prospective studies using FocalONE or earlier-generation transrectal HIFU devices for focal or hemiablation in localized prostate cancer. Key outcomes included biopsy negativity, salvage-free survival, urinary continence, erectile function, and complications. Study quality was appraised using the JBI tool.
Results
Five prospective studies involving 701 patients were included. Biopsy negativity ranged from 84% to 95%, with salvage-free survival reaching up to 92% at mid-term follow-up. Urinary continence was preserved in 96–100% of patients, and erectile function in 74–95%, with the most favorable functional outcomes consistently observed in FocalONE-based cohorts. Most adverse events were minor (grade I–II), with few serious complications. Compared to focal cryotherapy and irreversible electroporation, HIFU showed comparable cancer control and better or similar functional preservation. PSA density and MRI-visible lesions were strong predictors of success.
Conclusions
FocalONE-based focal HIFU provides effective cancer control with excellent functional preservation in selected patients. While evidence from earlier-generation devices supports these trends, generalizability across all HIFU platforms remains to be validated. Its precision and safety profile make it a promising alternative between active surveillance and radical therapies, especially in favorable intermediate-risk cases.
{"title":"Ultrasonido focalizado de alta intensidad con el dispositivo Focal One para el cáncer de próstata localizado: revisión sistemática de resultados oncológicos, preservación funcional y evolución de la tecnología","authors":"K. Eskandar","doi":"10.1016/j.acuro.2025.501869","DOIUrl":"10.1016/j.acuro.2025.501869","url":null,"abstract":"<div><h3>Introduction</h3><div>Focal therapy offers a middle-ground approach for localized prostate cancer, preserving the prostate while avoiding the morbidity of radical treatment. High-Intensity Focused Ultrasound (HIFU) is the most studied focal modality, with FocalONE representing the most widely adopted modern platform enabling precise image-guided ablation.</div></div><div><h3>Objective</h3><div>To systematically assess the oncologic control, functional outcomes, safety, and technological advancements of focal and hemiablation HIFU with an emphasis on the FocalONE platform.</div></div><div><h3>Methodology</h3><div>This systematic review followed PRISMA guidelines and was registered in PROSPERO. A comprehensive search of PubMed, Embase, and Cochrane databases identified prospective studies using FocalONE or earlier-generation transrectal HIFU devices for focal or hemiablation in localized prostate cancer. Key outcomes included biopsy negativity, salvage-free survival, urinary continence, erectile function, and complications. Study quality was appraised using the JBI tool.</div></div><div><h3>Results</h3><div>Five prospective studies involving 701 patients were included. Biopsy negativity ranged from 84% to 95%, with salvage-free survival reaching up to 92% at mid-term follow-up. Urinary continence was preserved in 96–100% of patients, and erectile function in 74–95%, with the most favorable functional outcomes consistently observed in FocalONE-based cohorts. Most adverse events were minor (grade I–II), with few serious complications. Compared to focal cryotherapy and irreversible electroporation, HIFU showed comparable cancer control and better or similar functional preservation. PSA density and MRI-visible lesions were strong predictors of success.</div></div><div><h3>Conclusions</h3><div>FocalONE-based focal HIFU provides effective cancer control with excellent functional preservation in selected patients. While evidence from earlier-generation devices supports these trends, generalizability across all HIFU platforms remains to be validated. Its precision and safety profile make it a promising alternative between active surveillance and radical therapies, especially in favorable intermediate-risk cases.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 10","pages":"Article 501869"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623410","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}
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