Pub Date : 2025-11-01DOI: 10.1016/j.acuro.2025.501858
E. Vicente Palacio , P. Bosch Knape , S. Tarragón Gabarro , C. Centeno Álvarez , L. de Verdonces Román , A. Sanchez i Puy , B. Juaneda Castell , S. Cuadrench Solorzano , E. Sotelo Burillo , L.M. Marco Pérez , L. Sabiote Rubio , D. Salinas Duffo , J.A. Peña González
Objective
To assess whether chronic pelvic pain presents specific qualitative traits, as described by patients, that can guide identification of its underlying clinical phenotype.
Materials and methods
A retrospective study including 157 patients (81 men, 76 women), interviewed systematically by a single evaluator using a structured 10-item table aimed at identifying three possible phenotypes. The correlation between the predicted phenotype (based solely on anamnesis) and the final phenotype (established through physical examination, treatment response, and clinical evolution) was analyzed. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were calculated by phenotype and sex. The diagnostic relevance of each question was assessed, and statistical significance was tested using the Chi-square test.
Results
In women, the proportion of predicted phenotypes confirmed as final was: 64.5% bladder, 19.7% myofascial, 30.2% neuropathic. In men: 8.6% bladder, 81.5% myofascial, 23.5% neuropathic. Women-bladder: Se 0.92, Sp 0.74, PPV 0.90, NPV 0.72, AUC 0.82. Myofascial: Se 0.44, Sp 0.93, PPV 0.79, NPV 0.75, AUC 0.76. Neuropathic: Se 0.36, Sp 0.98, PPV 0.89, NPV 0.79, AUC 0.51. Men-bladder: Se 0.57, Sp 0.83, PPV 0.21, NPV 0.96, AUC 0.81. Myofascial: Se 0.75, Sp 0.75, PPV 0.93, NPV 0.41, AUC 0.75. Neuropathic: Se 0.29, Sp 1.00, PPV 1.00, NPV 0.80, AUC 0.64.
Conclusions
A structured anamnesis may help identify the clinical phenotype underlying chronic pelvic pain (bladder, myofascial, or neuropathic).
{"title":"Utilidad diagnóstica de la anamnesis estructurada para la identificación de fenotipos en el síndrome de dolor pélvico crónico: estudio retrospectivo orientado a la práctica clínica","authors":"E. Vicente Palacio , P. Bosch Knape , S. Tarragón Gabarro , C. Centeno Álvarez , L. de Verdonces Román , A. Sanchez i Puy , B. Juaneda Castell , S. Cuadrench Solorzano , E. Sotelo Burillo , L.M. Marco Pérez , L. Sabiote Rubio , D. Salinas Duffo , J.A. Peña González","doi":"10.1016/j.acuro.2025.501858","DOIUrl":"10.1016/j.acuro.2025.501858","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether chronic pelvic pain presents specific qualitative traits, as described by patients, that can guide identification of its underlying clinical phenotype.</div></div><div><h3>Materials and methods</h3><div>A retrospective study including 157 patients (81 men, 76 women), interviewed systematically by a single evaluator using a structured 10-item table aimed at identifying three possible phenotypes. The correlation between the predicted phenotype (based solely on anamnesis) and the final phenotype (established through physical examination, treatment response, and clinical evolution) was analyzed. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were calculated by phenotype and sex. The diagnostic relevance of each question was assessed, and statistical significance was tested using the Chi-square test.</div></div><div><h3>Results</h3><div>In women, the proportion of predicted phenotypes confirmed as final was: 64.5% bladder, 19.7% myofascial, 30.2% neuropathic. In men: 8.6% bladder, 81.5% myofascial, 23.5% neuropathic. Women-bladder: Se 0.92, Sp 0.74, PPV 0.90, NPV 0.72, AUC 0.82. Myofascial: Se 0.44, Sp 0.93, PPV 0.79, NPV 0.75, AUC 0.76. Neuropathic: Se 0.36, Sp 0.98, PPV 0.89, NPV 0.79, AUC 0.51. Men-bladder: Se 0.57, Sp 0.83, PPV 0.21, NPV 0.96, AUC 0.81. Myofascial: Se 0.75, Sp 0.75, PPV 0.93, NPV 0.41, AUC 0.75. Neuropathic: Se 0.29, Sp 1.00, PPV 1.00, NPV 0.80, AUC 0.64.</div></div><div><h3>Conclusions</h3><div>A structured anamnesis may help identify the clinical phenotype underlying chronic pelvic pain (bladder, myofascial, or neuropathic).</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 9","pages":"Article 501858"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425552","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 determine the effectiveness and safety of pharmacological therapy in men older than 18 years with primary or secondary anorgasmia in terms of induced orgasm, improvement of the International Index of Erectile Function (IIEF), or Arizona Sexual Experience Scale (ASEX).
Methods
we conducted this systematic review according to the recommendations of the Cochrane Collaboration and following the PRISMA Statement. We designed a search strategy in MEDLINE (OVID), EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to the present. We assessed the risk of bias based on the STROBE statement for observational studies and the Rob 2.0 tool for clinical trials.
Results
234 patients were included, and 232 were treated with pharmacological therapy in 7 studies. Some pathologies reported were a history of prostatectomy, hypogonadism, psychiatric disorders, and use of antidepressants.
Cabergoline was the most frequently administered treatment, followed by yohimbine and bupropion. The cabergoline improved orgasm in 66% of the population and yohimbine in 55%. The change in IIEF orgasmic function improved significantly with cabergoline and bupropion (P=<.001 and P=.002). The ASEX improved with pycnogenol and was maintained in months 2,3 and 4 (P≤.05). The side effects reported were mild in 3 studies. Amantadine required discontinuation due to depression.
Conclusion
Pharmacological therapy with cabergoline, yohimbine, bupropion, and pycnogenol can have a positive effect on the orgasmic function of patients with primary or secondary anorgasmia.
目的从诱导性高潮、改善国际勃起功能指数（IIEF）或亚利桑那性体验量表（ASEX）的角度，确定药物治疗对18岁以上原发性或继发性性高潮障碍的有效性和安全性。方法根据Cochrane Collaboration的建议，遵循PRISMA声明进行系统评价。我们在MEDLINE （OVID）、EMBASE、LILACS和Cochrane Central Register of Controlled Trials （Central）中设计了一个从开始到现在的搜索策略。我们根据观察性研究的STROBE声明和临床试验的Rob 2.0工具评估偏倚风险。结果共纳入234例患者，7项研究中有232例患者接受了药物治疗。一些病理报告是前列腺切除术，性腺功能减退，精神疾病和使用抗抑郁药的历史。卡麦角林是最常用的治疗方法，其次是育亨宾和安非他酮。卡麦角林提高了66%的人的性高潮，育亨宾提高了55%。卡麦角林和安非他酮组IIEF性高潮功能的改变明显改善（P=<； 0.001和P=.002）。碧萝芷酚改善了ASEX，并在第2、3、4个月维持（P≤0.05）。在3项研究中报告的副作用是轻微的。金刚烷胺因抑郁症需要停药。结论卡麦角林、育亨宾、安非他酮、碧萝酚等药物治疗对原发性或继发性性高潮障碍患者的性高潮功能均有积极影响。
{"title":"Intervenciones farmacológicas en la anorgasmia masculina primaria o secundaria: una revisión sistemática","authors":"M.P. Gómez-Bueno , A.M. Diaz-Hung , H.A. García-Perdomo","doi":"10.1016/j.acuro.2025.501835","DOIUrl":"10.1016/j.acuro.2025.501835","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the effectiveness and safety of pharmacological therapy in men older than 18 years with primary or secondary anorgasmia in terms of induced orgasm, improvement of the International Index of Erectile Function (IIEF), or Arizona Sexual Experience Scale (ASEX).</div></div><div><h3>Methods</h3><div>we conducted this systematic review according to the recommendations of the Cochrane Collaboration and following the PRISMA Statement. We designed a search strategy in MEDLINE (OVID), EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to the present. We assessed the risk of bias based on the STROBE statement for observational studies and the Rob 2.0 tool for clinical trials.</div></div><div><h3>Results</h3><div>234 patients were included, and 232 were treated with pharmacological therapy in 7<!--> <!-->studies. Some pathologies reported were a history of prostatectomy, hypogonadism, psychiatric disorders, and use of antidepressants.</div><div>Cabergoline was the most frequently administered treatment, followed by yohimbine and bupropion. The cabergoline improved orgasm in 66% of the population and yohimbine in 55%. The change in IIEF orgasmic function improved significantly with cabergoline and bupropion <em>(P</em>=<.001 and <em>P</em>=.002). The ASEX improved with pycnogenol and was maintained in months 2,3 and 4 (<em>P</em>≤.05). The side effects reported were mild in 3<!--> <!-->studies. Amantadine required discontinuation due to depression.</div></div><div><h3>Conclusion</h3><div>Pharmacological therapy with cabergoline, yohimbine, bupropion, and pycnogenol can have a positive effect on the orgasmic function of patients with primary or secondary anorgasmia.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 9","pages":"Article 501835"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425421","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 : 2025-11-01DOI: 10.1016/j.acuro.2025.501866
D. Carracedo , P. Moscatiello , I. Hernández , T. Jerez , C. Grañen , M. Toledo , M.A. Sanchez-Encinas
Introduction
Limited evidence has been reported on the results of robot-assisted sacrocolpopexy (RASC) related to the type of sutures used.
Objective
The objective of this study is to analyze the results comparing absorbable with non-absorbable sutures. The primary outcome was mesh related complications and secondary outcomes were anatomical success, early complications and patient satisfaction.
Methods
A prospective, comparative study for the first 123 RASC surgeries performed between December 2016 and June 2022. All patients who underwent robotic sacrocolpopexy were included. No exclusion criteria were established. The procedures were performed by surgeon A who used non-absorbable sutures and surgeon B who used absorbable sutures. Patient data was collected at baseline, intraoperatively, as well as reporting early complications and mesh-related complications. Anatomic recurrence was defined as patients with POP ≥ 2 on the Baden-Walker scale while the sensation of vaginal bulge determined subjective failure.
Results
Non-absorbable sutures were used in 55.3% of the patients while absorbable sutures were used in 44.7% of the patients. The mean follow-up was longer in the absorbable suture group (21.5 vs. 35.3 P < .01).
No statistically significant differences were found in mesh-complication rate (4.4% vs. 0%, P = .16) and in anatomical recurrence and subjective (4.4% vs. 9.1%, P = .24).
The main limitation of our study was the absence of randomization.
Conclusions
The type of suture used for mesh fixation in RASC does not influence the anatomical outcomes, early complications or mesh-related complications.
机器人辅助骶colpop固定术（RASC）的结果与所使用的缝合线类型相关的证据有限。目的分析可吸收缝线与不可吸收缝线的临床效果。主要结果是补片相关并发症，次要结果是解剖成功、早期并发症和患者满意度。方法对2016年12月至2022年6月进行的首批123例RASC手术进行前瞻性比较研究。所有接受机器人骶骶固定术的患者均被纳入研究。未建立排除标准。术者A采用不可吸收缝线，术者B采用可吸收缝线。在基线、术中收集患者数据，并报告早期并发症和网状物相关并发症。解剖性复发定义为巴登-沃克评分（Baden-Walker scale）的POP≥2，阴道隆起感为主观失败。结果55.3%的患者使用不可吸收缝线，44.7%的患者使用可吸收缝线。可吸收缝线组的平均随访时间较长（21.5比35.3 P < 01）。网片并发症发生率（4.4%比0%，P = 0.16）、解剖复发率和主观复发率（4.4%比9.1%,P = 0.24）差异无统计学意义。本研究的主要局限性是缺乏随机化。结论RASC补片固定使用的缝线类型不影响解剖结果、早期并发症及补片相关并发症。
{"title":"El dilema de la fijación de la malla en la sacrocolpopexia robótica: ¿sutura absorbible o no absorbible? Datos de una cohorte observacional de gran volumen","authors":"D. Carracedo , P. Moscatiello , I. Hernández , T. Jerez , C. Grañen , M. Toledo , M.A. Sanchez-Encinas","doi":"10.1016/j.acuro.2025.501866","DOIUrl":"10.1016/j.acuro.2025.501866","url":null,"abstract":"<div><h3>Introduction</h3><div>Limited evidence has been reported on the results of robot-assisted sacrocolpopexy (RASC) related to the type of sutures used.</div></div><div><h3>Objective</h3><div>The objective of this study is to analyze the results comparing absorbable with non-absorbable sutures. The primary outcome was mesh related complications and secondary outcomes were anatomical success, early complications and patient satisfaction.</div></div><div><h3>Methods</h3><div>A prospective, comparative study for the first 123 RASC surgeries performed between December 2016 and June 2022. All patients who underwent robotic sacrocolpopexy were included. No exclusion criteria were established. The procedures were performed by surgeon A who used non-absorbable sutures and surgeon B who used absorbable sutures. Patient data was collected at baseline, intraoperatively, as well as reporting early complications and mesh-related complications. Anatomic recurrence was defined as patients with POP ≥<!--> <!-->2 on the Baden-Walker scale while the sensation of vaginal bulge determined subjective failure.</div></div><div><h3>Results</h3><div>Non-absorbable sutures were used in 55.3% of the patients while absorbable sutures were used in 44.7% of the patients. The mean follow-up was longer in the absorbable suture group (21.5 vs. 35.3 <em>P</em> <!--><<!--> <!-->.01).</div><div>No statistically significant differences were found in mesh-complication rate (4.4% vs. 0%, <em>P</em> <!-->=<!--> <!-->.16) and in anatomical recurrence and subjective (4.4% vs. 9.1%, <em>P</em> <!-->=<!--> <!-->.24).</div><div>The main limitation of our study was the absence of randomization.</div></div><div><h3>Conclusions</h3><div>The type of suture used for mesh fixation in RASC does not influence the anatomical outcomes, early complications or mesh-related complications.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 9","pages":"Article 501866"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425422","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 : 2025-10-01DOI: 10.1016/j.acuro.2025.501826
P. Vázquez Carral
Introduction
Calcium oxalate kidney stones—the most common type of renal calculi—are closely associated with dietary and metabolic factors. An appropriate dietary approach can help prevent their formation and reduce the risk of recurrence.
Objective
To evaluate the efficacy of dietary interventions involving adequate calcium intake combined with oxalate control in preventing the formation of calcium oxalate kidney stones.
Evidence acquisition
An integrative review was conducted in PubMed®, Scopus®, Medline®, and Dialnet® (2014-2024), following PRISMA guidelines, focusing on calcium and oxalate dietary management in kidney stone disease.
Evidence synthesis and conclusions
The reviewed evidence indicates that an adequate calcium intake (800-1,200 mg/day) reduces intestinal oxalate absorption and, consequently, urinary oxalate excretion. Additionally, hydration, sodium restriction, and urine alkalinization with citrate are complementary dietary strategies. Recent studies also suggest that urinary microbiota and genetic predisposition may influence individual responses to dietary interventions. Overall, a personalized dietary approach may constitute an effective and accessible strategy for the prevention of calcium oxalate kidney stones. However, the current body of evidence is limited by methodological constraints and heterogeneity across studies.
{"title":"Eficacia de la intervención dietética con calcio y control de oxalato en la prevención de los cálculos de oxalato cálcico: revisión integrativa","authors":"P. Vázquez Carral","doi":"10.1016/j.acuro.2025.501826","DOIUrl":"10.1016/j.acuro.2025.501826","url":null,"abstract":"<div><h3>Introduction</h3><div>Calcium oxalate kidney stones—the most common type of renal calculi—are closely associated with dietary and metabolic factors. An appropriate dietary approach can help prevent their formation and reduce the risk of recurrence.</div></div><div><h3>Objective</h3><div>To evaluate the efficacy of dietary interventions involving adequate calcium intake combined with oxalate control in preventing the formation of calcium oxalate kidney stones.</div></div><div><h3>Evidence acquisition</h3><div>An integrative review was conducted in PubMed®, Scopus®, Medline®, and Dialnet® (2014-2024), following PRISMA guidelines, focusing on calcium and oxalate dietary management in kidney stone disease.</div></div><div><h3>Evidence synthesis and conclusions</h3><div>The reviewed evidence indicates that an adequate calcium intake (800-1,200<!--> <!-->mg/day) reduces intestinal oxalate absorption and, consequently, urinary oxalate excretion. Additionally, hydration, sodium restriction, and urine alkalinization with citrate are complementary dietary strategies. Recent studies also suggest that urinary microbiota and genetic predisposition may influence individual responses to dietary interventions. Overall, a personalized dietary approach may constitute an effective and accessible strategy for the prevention of calcium oxalate kidney stones. However, the current body of evidence is limited by methodological constraints and heterogeneity across studies.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 8","pages":"Article 501826"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195948","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}
Renal cell carcinoma (RCC) invades the inferior vena cava (IVC) in 4% to 10% of cases, increasing the risk of surgical complications that affect oncological outcomes.
Materials and methods
The research question was defined using the PICOST acronym. An exhaustive search, material selection, and data extraction were conducted in duplicate and independently. Original articles were included on patients with metastatic RCC (mRCC) with thrombus in the IVC, treated with immune checkpoint inhibitors with or without tyrosine kinase inhibitors (TKIs) and cytoreductive nephrectomy (CN). Studies involving patients with thrombi localized solely to the renal artery or atrium were excluded.
Results
A total of 17 articles were included: one retrospective cohort, five retrospective case series, and 11 retrospective case reports. In total, 32 patients were analyzed; 10 were excluded due to the absence of metastases. In most cases, the size of the primary tumor decreased. Regarding the thrombus in the IVC, based on the level, out of 22 patients, 7 remained unchanged, 13 showed a reduction (9 by one level, 3 by two levels, and 1 by three levels), and one showed an increase. In another case, the magnitude of the reduction in thrombus size or level was not specified. Tumor thrombus size decreased even in cases where the level remained unchanged.
Conclusions
Patients with mRCC and thrombus in the IVC may benefit from neoadjuvant treatment with immune checkpoint inhibitors, with or without TKIs, and delayed cytoreductive nephrectomy.
{"title":"Nefrectomía citorreductora diferida en adultos con carcinoma de células renales metastásico y trombo tumoral en vena cava tratados con neoadyuvancia basada en inmunoterapia: revisión sistemática","authors":"E.S. Cruz Peralta , M. González Domínguez , R.J. Salgueiro Ergueta , M.L. Peralta Pedrero","doi":"10.1016/j.acuro.2025.501799","DOIUrl":"10.1016/j.acuro.2025.501799","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal cell carcinoma (RCC) invades the inferior vena cava (IVC) in 4% to 10% of cases, increasing the risk of surgical complications that affect oncological outcomes.</div></div><div><h3>Materials and methods</h3><div>The research question was defined using the PICOST acronym. An exhaustive search, material selection, and data extraction were conducted in duplicate and independently. Original articles were included on patients with metastatic RCC (mRCC) with thrombus in the IVC, treated with immune checkpoint inhibitors with or without tyrosine kinase inhibitors (TKIs) and cytoreductive nephrectomy (CN). Studies involving patients with thrombi localized solely to the renal artery or atrium were excluded.</div></div><div><h3>Results</h3><div>A total of 17 articles were included: one retrospective cohort, five retrospective case series, and 11 retrospective case reports. In total, 32 patients were analyzed; 10 were excluded due to the absence of metastases. In most cases, the size of the primary tumor decreased. Regarding the thrombus in the IVC, based on the level, out of 22 patients, 7 remained unchanged, 13 showed a reduction (9 by one level, 3 by two levels, and 1 by three levels), and one showed an increase. In another case, the magnitude of the reduction in thrombus size or level was not specified. Tumor thrombus size decreased even in cases where the level remained unchanged.</div></div><div><h3>Conclusions</h3><div>Patients with mRCC and thrombus in the IVC may benefit from neoadjuvant treatment with immune checkpoint inhibitors, with or without TKIs, and delayed cytoreductive nephrectomy.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 8","pages":"Article 501799"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195986","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 : 2025-10-01DOI: 10.1016/j.acuro.2025.501825
I.B. de Angst , M. Reichert , M.I. Dönmez , Y. Quiroz , F. O’Kelly , S. Sforza , W.M. Bramer , B. Bañuelos , E. Bindi , I. Selvi , F. Brandt , E. Starink , J. Stufken , A. Territo , A. López-Abad , R.J.M. Lammers , L.A. ‘t Hoen
Introduction and objectives
Urological complications are common after kidney transplantation (KTx), mostly in the form of ureterovesical obstruction or leakage. Routine ureteral stenting was previously shown to reduce these complications on the expense of other complications such as urinary tract infections. There is no consensus on optimal duration of stents, and relevant literature on this topic is lacking. The aim of this systematic review is to summarize and compare the incidences of stent-related complications using short (< 2 weeks) and long (≥ 2 weeks) stent duration after pediatric KTx.
Material and methods
A systematic search in Embase, MEDLINE, Cochrane, and ClinicalTrial.gov was performed. Studies reporting on children (0-18 years) undergoing KTx with intraoperative ureteral stenting with at least one month follow up were included. Data on surgical and outcome characteristics were extracted.
Results
From a total of 322 articles, 14 studies were included, reporting on 971 pediatric KTx of whom 411 were female (42%). Sample sizes ranged from 32 to 146 patients. Mean or median age at time of transplantation ranged from 3.36 to 14.7 years. A systematic synthesis approach was used to summarize results. Of the 4 comparative studies, only one showed significantly more post-transplant urinary tract infections in the long duration group, without a significant difference in other urological complications.
Conclusions
Due to lack of good quality studies, it remains uncertain whether a short stent duration is safer and more feasible for reducing the incidence of stent-related complications in pediatric KTx, while also preventing stenosis or leakage at the ureterovesical anastomosis.
{"title":"Comparación de los resultados del trasplante renal pediátrico según la duración del catéter ureteral: una revisión sistemática de los Grupos de Trabajo de Urología Pediátrica y Trasplante Renal de la Sección de Jóvenes Urólogos Académicos","authors":"I.B. de Angst , M. Reichert , M.I. Dönmez , Y. Quiroz , F. O’Kelly , S. Sforza , W.M. Bramer , B. Bañuelos , E. Bindi , I. Selvi , F. Brandt , E. Starink , J. Stufken , A. Territo , A. López-Abad , R.J.M. Lammers , L.A. ‘t Hoen","doi":"10.1016/j.acuro.2025.501825","DOIUrl":"10.1016/j.acuro.2025.501825","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Urological complications are common after kidney transplantation (KTx), mostly in the form of ureterovesical obstruction or leakage. Routine ureteral stenting was previously shown to reduce these complications on the expense of other complications such as urinary tract infections. There is no consensus on optimal duration of stents, and relevant literature on this topic is lacking. The aim of this systematic review is to summarize and compare the incidences of stent-related complications using short (<<!--> <!-->2 weeks) and long (≥<!--> <!-->2 weeks) stent duration after pediatric KTx.</div></div><div><h3>Material and methods</h3><div>A systematic search in Embase, MEDLINE, Cochrane, and ClinicalTrial.gov was performed. Studies reporting on children (0-18 years) undergoing KTx with intraoperative ureteral stenting with at least one month follow up were included. Data on surgical and outcome characteristics were extracted.</div></div><div><h3>Results</h3><div>From a total of 322 articles, 14 studies were included, reporting on 971 pediatric KTx of whom 411 were female (42%). Sample sizes ranged from 32 to 146 patients. Mean or median age at time of transplantation ranged from 3.36 to 14.7 years. A systematic synthesis approach was used to summarize results. Of the 4 comparative studies, only one showed significantly more post-transplant urinary tract infections in the long duration group, without a significant difference in other urological complications.</div></div><div><h3>Conclusions</h3><div>Due to lack of good quality studies, it remains uncertain whether a short stent duration is safer and more feasible for reducing the incidence of stent-related complications in pediatric KTx, while also preventing stenosis or leakage at the ureterovesical anastomosis.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 8","pages":"Article 501825"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195947","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 : 2025-10-01DOI: 10.1016/j.acuro.2025.501819
J.A. Mainez , J.A. Galán , J.M. López , B. Isern-Amengual , P. Sanchís-Cortés
Introduction and objectives
Urolithiasis is a prevalent urological condition that requires continuous monitoring and management to prevent recurrence. The myLit-Control® App is a digital health tool designed to support self-management by tracking urinary pH, water intake, and medication adherence. This study aimed to describe the demographic and clinical characteristics of myLit-Control® App users in Spain, analyze their engagement patterns, and evaluate adherence to health goals.
Patients and methods
This retrospective observational study included users who downloaded the app between May 2022 and June 2024. Data on demographics, urinary pH tracking, water intake, and medication adherence were extracted and analyzed to explore correlations, group comparisons, and identify factors influencing adherence and outcomes.
Results
The study included 699 users, with a median age of 50 years (IQR: 40-59) and 57.1% male. A total of 217 users (31.0%) were taking urolithiasis-specific treatment. Urine pH monitoring was used by 52.9% of participants, with a rate of 53% (± 37) within target pH levels. Water intake tracking was the most frequently used feature, yet adherence to hydration goals remained low (15 ± 30%). A negative correlation was observed between age and treatment adherence (r = −0.456, p < 0.001).
Conclusions
The myLit-Control® App facilitates urinary pH monitoring and medication adherence, supporting self-management in urolithiasis patients. However, engagement with key features, particularly water intake tracking, remains suboptimal. Future research should explore long-term outcomes and strategies to enhance patient adherence, ensuring effective integration of mHealth tools in routine clinical practice.
前言和目的尿石症是一种常见的泌尿系统疾病，需要持续监测和管理以防止复发。myLit-Control®App是一款数字健康工具，旨在通过跟踪尿液pH值、饮水量和药物依从性来支持自我管理。本研究旨在描述西班牙myLit-Control®App用户的人口统计学和临床特征，分析他们的参与模式，并评估对健康目标的依从性。患者和方法这项回顾性观察研究包括在2022年5月至2024年6月期间下载该应用程序的用户。提取和分析人口统计学、尿pH值跟踪、饮水量和药物依从性的数据，以探索相关性、组比较，并确定影响依从性和结果的因素。结果本研究纳入699名用户，中位年龄50岁（IQR: 40-59），男性占57.1%。共有217名使用者（31.0%）正在接受尿石症特异性治疗。52.9%的参与者使用尿液pH监测，在目标pH水平内的比例为53%（±37）。水摄入量跟踪是最常用的功能，但坚持补水目标仍然很低（15±30%）。年龄与治疗依从性呈负相关（r = - 0.456, p < 0.001）。结论myLit-Control®应用程序促进尿pH监测和药物依从性，支持尿石症患者的自我管理。然而，与关键功能的互动，特别是水摄入跟踪，仍然不是最理想的。未来的研究应探索长期结果和策略，以提高患者的依从性，确保在常规临床实践中有效整合移动医疗工具。
{"title":"Perfil e interacción de los usuarios con una app de salud digital para urolitiasis: estudio descriptivo de los primeros 699 usuarios","authors":"J.A. Mainez , J.A. Galán , J.M. López , B. Isern-Amengual , P. Sanchís-Cortés","doi":"10.1016/j.acuro.2025.501819","DOIUrl":"10.1016/j.acuro.2025.501819","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Urolithiasis is a prevalent urological condition that requires continuous monitoring and management to prevent recurrence. The myLit-Control® App is a digital health tool designed to support self-management by tracking urinary pH, water intake, and medication adherence. This study aimed to describe the demographic and clinical characteristics of myLit-Control® App users in Spain, analyze their engagement patterns, and evaluate adherence to health goals.</div></div><div><h3>Patients and methods</h3><div>This retrospective observational study included users who downloaded the app between May 2022 and June 2024. Data on demographics, urinary pH tracking, water intake, and medication adherence were extracted and analyzed to explore correlations, group comparisons, and identify factors influencing adherence and outcomes.</div></div><div><h3>Results</h3><div>The study included 699 users, with a median age of 50 years (IQR: 40-59) and 57.1% male. A total of 217 users (31.0%) were taking urolithiasis-specific treatment. Urine pH monitoring was used by 52.9% of participants, with a rate of 53% (±<!--> <!-->37) within target pH levels. Water intake tracking was the most frequently used feature, yet adherence to hydration goals remained low (15<!--> <!-->±<!--> <!-->30%). A negative correlation was observed between age and treatment adherence (r<!--> <!-->=<!--> <!-->−0.456, p < 0.001).</div></div><div><h3>Conclusions</h3><div>The myLit-Control® App facilitates urinary pH monitoring and medication adherence, supporting self-management in urolithiasis patients. However, engagement with key features, particularly water intake tracking, remains suboptimal. Future research should explore long-term outcomes and strategies to enhance patient adherence, ensuring effective integration of mHealth tools in routine clinical practice.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 8","pages":"Article 501819"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195950","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 : 2025-10-01DOI: 10.1016/j.acuro.2025.501808
B. Kozubaev , S. Oguz Demirdogen , T. Aksakalli , F. Ozkaya , S. Adanur
Objective
This study compares the clinical outcomes of Holmium:YAG (Ho:YAG) laser lithotripsy and Thulium Fiber Laser (TFL) lithotripsy in retrograde intrarenal surgery (RIRS) for kidney stones < 20 mm.
Materials and Methods
Patients who underwent RIRS for renal stones < 20 mm between September 2022 and November 2023 were prospectively analyzed. They were randomly assigned to either the TFL or Ho:YAG laser group using a sealed-envelope method. Preoperative demographics, stone characteristics, kidney-ureter-bladder x-ray (KUB), ultrasound and noncontrast computer tomography (NCCT) scan findings were recorded. Operative time, laser usage time, postoperative stone-free rate (SFR), and complications were assessed and statistically analyzed.
Results
A total of 126 patients (mean age: 49.16 ± 15.18 years; 64.3% male, 35.7% female) were included. The TFL group (n = 64, 50.8%) had significantly shorter operative and laser usage times than the Ho:YAG laser group (n = 62, 49.2%) (operative time: 45.77 ± 15.67 min vs. 52.79 ± 18.11 min, p = 0.031; laser usage: 29.84 ± 13.32 min vs. 36.39 ± 15.75 min, p = 0.024). No significant SFR difference was found between groups (TFL group: n = 57, 91.8% vs. Ho:YAG laser group: n = 60, 93.8%; p = 0.488).
Conclusion
In the treatment of kidney stones smaller than 20 mm using laser lithotripsy, both TFL and Ho:YAG laser are effective, safe, and associated with low complication rates. However, the use of TFL significantly reduces operative time and lithotripsy time, potentially improving surgical efficiency. Further studies with larger patient cohorts are necessary to validate these findings and provide additional insights into the advantages and limitations of each laser type.
目的比较钬激光碎石（Ho:YAG）和铥光纤激光碎石（TFL）在肾结石（20mm）逆行肾内手术（RIRS）中的临床效果。材料与方法对2022年9月至2023年11月行RIRS治疗肾结石（20mm）的患者进行前瞻性分析。他们被随机分配到TFL或Ho:YAG激光组，采用密封包膜法。记录术前人口统计学、结石特征、肾-输尿管-膀胱x线（KUB）、超声和非对比计算机断层扫描（NCCT）扫描结果。对手术时间、激光使用时间、术后结石游离率（SFR）、并发症进行统计分析。结果共纳入126例患者，平均年龄49.16±15.18岁，男性64.3%，女性35.7%。TFL组（n = 64, 50.8%）的手术时间和激光使用时间明显短于Ho:YAG激光组（n = 62, 49.2%）（手术时间：45.77±15.67 min vs. 52.79±18.11 min, p = 0.031；激光使用时间：29.84±13.32 min vs. 36.39±15.75 min, p = 0.024）。两组间SFR差异无统计学意义（TFL组：n = 57, 91.8%； Ho:YAG激光组：n = 60, 93.8%; p = 0.488）。结论激光碎石治疗小于20mm肾结石，TFL和Ho:YAG激光均有效、安全，并发症发生率低。然而，TFL的使用显著减少了手术时间和碎石时间，潜在地提高了手术效率。有必要对更大的患者群体进行进一步的研究，以验证这些发现，并进一步了解每种激光类型的优点和局限性。
{"title":"Comparación de la litotricia con láser de fibra de tulio y láser Holmium:YAG en la cirugía retrógrada intrarrenal para el tratamiento de cálculos renales: estudio prospectivo aleatorizado","authors":"B. Kozubaev , S. Oguz Demirdogen , T. Aksakalli , F. Ozkaya , S. Adanur","doi":"10.1016/j.acuro.2025.501808","DOIUrl":"10.1016/j.acuro.2025.501808","url":null,"abstract":"<div><h3>Objective</h3><div>This study compares the clinical outcomes of Holmium:YAG (Ho:YAG) laser lithotripsy and Thulium Fiber Laser (TFL) lithotripsy in retrograde intrarenal surgery (RIRS) for kidney stones <<!--> <!-->20<!--> <!-->mm.</div></div><div><h3>Materials and Methods</h3><div>Patients who underwent RIRS for renal stones <<!--> <!-->20<!--> <!-->mm between September 2022 and November 2023 were prospectively analyzed. They were randomly assigned to either the TFL or Ho:YAG laser group using a sealed-envelope method. Preoperative demographics, stone characteristics, kidney-ureter-bladder x-ray (KUB), ultrasound and noncontrast computer tomography (NCCT) scan findings were recorded. Operative time, laser usage time, postoperative stone-free rate (SFR), and complications were assessed and statistically analyzed.</div></div><div><h3>Results</h3><div>A total of 126 patients (mean age: 49.16<!--> <!-->±<!--> <!-->15.18 years; 64.3% male, 35.7% female) were included. The TFL group (n<!--> <!-->=<!--> <!-->64, 50.8%) had significantly shorter operative and laser usage times than the Ho:YAG laser group (n<!--> <!-->=<!--> <!-->62, 49.2%) (operative time: 45.77<!--> <!-->±<!--> <!-->15.67<!--> <!-->min vs. 52.79<!--> <!-->±<!--> <!-->18.11<!--> <!-->min, p<!--> <!-->=<!--> <!-->0.031; laser usage: 29.84<!--> <!-->±<!--> <!-->13.32<!--> <!-->min vs. 36.39<!--> <!-->±<!--> <!-->15.75<!--> <!-->min, p<!--> <!-->=<!--> <!-->0.024). No significant SFR difference was found between groups (TFL group: n<!--> <!-->=<!--> <!-->57, 91.8% vs. Ho:YAG laser group: n<!--> <!-->=<!--> <!-->60, 93.8%; p<!--> <!-->=<!--> <!-->0.488).</div></div><div><h3>Conclusion</h3><div>In the treatment of kidney stones smaller than 20<!--> <!-->mm using laser lithotripsy, both TFL and Ho:YAG laser are effective, safe, and associated with low complication rates. However, the use of TFL significantly reduces operative time and lithotripsy time, potentially improving surgical efficiency. Further studies with larger patient cohorts are necessary to validate these findings and provide additional insights into the advantages and limitations of each laser type.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 8","pages":"Article 501808"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195935","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 : 2025-10-01DOI: 10.1016/j.acuro.2025.501815
S. Juste-Álvarez, C. García-Rayo Encina, C. Gómez del Cañizo, M. Hernández-Arroyo, N.R. Miranda Utrera, A. Rodríguez-Antolín, F. Guerrero-Ramos
Introduction
Up to 15% of muscle-invasive bladder cancers (MIBC) arise from the progression of a non-muscle-invasive neoplasm. Despite sharing similar treatment strategies, the literature reports differences in survival rates between these 2 groups. This study aims to identify differences in recurrence and survival that may influence individualized treatment approaches.
Material and methods
Prospective study of cystectomies performed for MIBC between 2011 and 2023, collecting demographic, diagnostic, treatment, and recurrence data (local, urothelial, or distant). A comparative and multivariate analysis was conducted.
Results
We did not observe significant differences in recurrence rates between primary and progressive MIBC. However, the group with progression showed better overall survival (OS) rates at 2, 5 and 10 years (100%, 90%, 55%) compared to the primary (80%, 55%, 35%; P = 0.012), as well as better cancer-specific survival (CSS) (100%, 100%, 95% vs. 85%, 77%, 65%; P = 0.033). Independent risk factors for recurrence include pN + (OR: 3.72) and lymphovascular invasion (LVI) (OR: 5.53). Predictors of lower OS include age, nodal involvement, LVI and relapse at any level. For CSS, predictors include nodal involvement, LVI and relapse at any level.
Conclusions
In our series, patients with progressive MIBC have better OS and CSS. For both groups, pN + and LVI are independent risk factors for recurrence. Nodal involvement, LVI and relapse at any level are predictors of poorer OS and CSS.
{"title":"Comparación del pronóstico entre carcinoma vesical musculoinvasivo primario y progresivo: análisis prospectivo de resultados a largo plazo tras cistectomía radical","authors":"S. Juste-Álvarez, C. García-Rayo Encina, C. Gómez del Cañizo, M. Hernández-Arroyo, N.R. Miranda Utrera, A. Rodríguez-Antolín, F. Guerrero-Ramos","doi":"10.1016/j.acuro.2025.501815","DOIUrl":"10.1016/j.acuro.2025.501815","url":null,"abstract":"<div><h3>Introduction</h3><div>Up to 15% of muscle-invasive bladder cancers (MIBC) arise from the progression of a non-muscle-invasive neoplasm. Despite sharing similar treatment strategies, the literature reports differences in survival rates between these 2<!--> <!-->groups. This study aims to identify differences in recurrence and survival that may influence individualized treatment approaches.</div></div><div><h3>Material and methods</h3><div>Prospective study of cystectomies performed for MIBC between 2011 and 2023, collecting demographic, diagnostic, treatment, and recurrence data (local, urothelial, or distant). A comparative and multivariate analysis was conducted.</div></div><div><h3>Results</h3><div>We did not observe significant differences in recurrence rates between primary and progressive MIBC. However, the group with progression showed better overall survival (OS) rates at 2, 5 and 10 years (100%, 90%, 55%) compared to the primary (80%, 55%, 35%; <em>P</em> = 0.012), as well as better cancer-specific survival (CSS) (100%, 100%, 95% vs. 85%, 77%, 65%; <em>P</em> = 0.033). Independent risk factors for recurrence include pN<!--> <!-->+<!--> <!-->(OR: 3.72) and lymphovascular invasion (LVI) (OR: 5.53). Predictors of lower OS include age, nodal involvement, LVI and relapse at any level. For CSS, predictors include nodal involvement, LVI and relapse at any level.</div></div><div><h3>Conclusions</h3><div>In our series, patients with progressive MIBC have better OS and CSS. For both groups, pN<!--> <!-->+<!--> <!-->and LVI are independent risk factors for recurrence. Nodal involvement, LVI and relapse at any level are predictors of poorer OS and CSS.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 8","pages":"Article 501815"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195936","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 : 2025-10-01DOI: 10.1016/j.acuro.2025.501821
I. Selvi , M.İ. Dönmez , N. Baydilli , Y. Quirroz Madarriaga , R. Lammers , E. Bindi , S. Sforza , F. O’Kelly , B. Haid , B. Banuelos Marco , L.A. t’Hoen
Introduction
Vesicoureteral reflux (VUR) may have long lasting effects on affected individuals, especially in females. Its intertwined relationship with urinary tract infection (UTI) has been well documented and there is a further risk during pregnancy where UTIs are more problematic.
Objective
To analyze existing data within the literature to identify factors associated with pregnancy-related complications in women with a history of VUR in childhood.
Methods
PubMed, MEDLINE, Embase, and the Cochrane Library databases were searched to identify all published reports of pregnancy outcomes in women with a history of VUR in childhood up to January 2024 (PROSPERO Registration ID: CRD42024550470). Selection criteria included all English-language original articles reporting pregnancy outcomes (maternal and fetal morbidities) in pregnant patients with a history of VUR in childhood. After screening and eligibility assessment, 17 articles met the PICO inclusion criteria.
Results
The search yielded 1060 papers, of which 17 remained after exclusions, and assessed 2349 women with a history of VUR in childhood, 1167 pregnant women and a total of 2206 pregnancies. Compared with the general obstetric population, the results showed an increased rate of pregnancy-related complications (particularly febrile urinary tract infection, gestational hypertension, pre-eclampsia) in the presence of renal scarring, even if the women had undergone anti-reflux surgery in childhood, but not persistent low-grade VUR.
Conclusion
Despite the lack of larger prospective randomized controlled trials with long-term follow-up, based on the findings of this systematic review, we conclude that close monitoring during pregnancy should be recommended in the presence of persistent high-grade VUR or in women with renal scarring, even if VUR has resolved.
{"title":"Factores asociados con complicaciones en el embarazo de mujeres con antecedente de reflujo vesicoureteral: una revisión sistemática del Grupo de Trabajo de Urología Pediátrica de la Sección de Jóvenes Urólogos Académicos (YAU) - Asociación Europea de Urología (EAU)","authors":"I. Selvi , M.İ. Dönmez , N. Baydilli , Y. Quirroz Madarriaga , R. Lammers , E. Bindi , S. Sforza , F. O’Kelly , B. Haid , B. Banuelos Marco , L.A. t’Hoen","doi":"10.1016/j.acuro.2025.501821","DOIUrl":"10.1016/j.acuro.2025.501821","url":null,"abstract":"<div><h3>Introduction</h3><div>Vesicoureteral reflux (VUR) may have long lasting effects on affected individuals, especially in females. Its intertwined relationship with urinary tract infection (UTI) has been well documented and there is a further risk during pregnancy where UTIs are more problematic.</div></div><div><h3>Objective</h3><div>To analyze existing data within the literature to identify factors associated with pregnancy-related complications in women with a history of VUR in childhood.</div></div><div><h3>Methods</h3><div>PubMed, MEDLINE, Embase, and the Cochrane Library databases were searched to identify all published reports of pregnancy outcomes in women with a history of VUR in childhood up to January 2024 (PROSPERO Registration ID: CRD42024550470). Selection criteria included all English-language original articles reporting pregnancy outcomes (maternal and fetal morbidities) in pregnant patients with a history of VUR in childhood. After screening and eligibility assessment, 17 articles met the PICO inclusion criteria.</div></div><div><h3>Results</h3><div>The search yielded 1060 papers, of which 17 remained after exclusions, and assessed 2349 women with a history of VUR in childhood, 1167 pregnant women and a total of 2206 pregnancies. Compared with the general obstetric population, the results showed an increased rate of pregnancy-related complications (particularly febrile urinary tract infection, gestational hypertension, pre-eclampsia) in the presence of renal scarring, even if the women had undergone anti-reflux surgery in childhood, but not persistent low-grade VUR.</div></div><div><h3>Conclusion</h3><div>Despite the lack of larger prospective randomized controlled trials with long-term follow-up, based on the findings of this systematic review, we conclude that close monitoring during pregnancy should be recommended in the presence of persistent high-grade VUR or in women with renal scarring, even if VUR has resolved.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 8","pages":"Article 501821"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195946","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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