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Uretroplastia femenina con injerto de mucosa oral en una etapa: resultados comunicados por las pacientes y tasas de éxito funcional a largo plazo 采用口腔黏膜移植的一段式女性尿道成形术:患者报告的结果和长期功能成功率
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.acuro.2024.04.002
J. Klemm, P. Marks, R.J. Schulz, D.K. Filipas, D.R. Stelzl, R. Dahlem, M. Fisch, M.W. Vetterlein, en representación del Grupo de Trabajo de Urología Reconstructiva y Trauma Urológico de la Sección de Jóvenes Urólogos Académicos - Asociación Europea de Urología

Introduction and objectives

Female urethral strictures are a rare condition that significantly impacts patients’ quality of life. Patient-reported outcomes are crucial, yet data regarding sexual function and treatment satisfaction are scarce. We aimed to provide insights from a reconstructive referral center.

Patients and methods

We conducted a retrospective analysis of women treated with ventral onlay one-stage buccal mucosa graft urethroplasty for urethral strictures between 2009–2023. We assessed objective (retreatment-free survival, improvement in maximum flow rate) and subjective outcomes (validated patient-reported outcomes).

Results

Of 12 women, 83 and 17% had iatrogenic and idiopathic strictures, respectively. Median number of prior interventions was 6. Strictures were located meatal and mid-urethral in 25 and 75%, respectively, 22% had the bladder neck involved. Median graft length was 2 cm At median follow-up of 66 months, 33% of patients underwent stricture retreatment, but only one case occurred within the first 2 years postoperatively. The median improvement in maximum flow rate was 10 ml/s. Median International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ-FLUTS) scores were 8 for filling symptoms, 6 for voiding symptoms, and 3 for incontinence symptoms. Median ICIQ-FLUTSsex score was 4. Higher scores indicate a higher symptom burden. Median ICIQ-Satisfaction outcome and satisfaction scores were 18 and 7, respectively, reflecting high treatment satisfaction.

Conclusions

Buccal mucosal graft urethroplasty by ventral onlay for female urethral strictures yields effective, durable, and positively received outcomes. However, larger studies across multiple institutions are necessary to further assess its efficacy, especially regarding patient-reported experiences and sexual function.
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引用次数: 0
Vías clínicas para el cuidado oral en pacientes sometidos a extracción de injerto de mucosa oral: una revisión sistemática
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.acuro.2024.10.004
M. Frankiewicz , J. Adamowicz , L. Białek , F. Campos-Juanatey , F. Chierigo , A. Cocci , F.X. Madec , G. Mantica , M. Oszczudłowski , E.J. Redmond , C.M. Rosenbaum , W. Verla , M. Waterloos , M. Jobczyk , A. Kałużny , M.W. Vetterlein , M. Matuszewski , en representación del Grupo de Trabajo de Urología Reconstructiva y Trauma Urológico de la Sección de Jóvenes Urólogos Académicos - Asociación Europea de Urología

Introduction

Oral mucosal grafts are essential in reconstructive urology, particularly for urethral and genital defects. Advances in harvesting and implantation techniques have been made, yet perioperative care remains crucial for optimal outcomes. This systematic review explores postoperative care pathways following oral mucosal graft harvesting to consolidate knowledge, identify best practices, and highlight research gaps.

Objective

The review aims to identify optimal care pathways, compare different oral care approaches, and address research gaps.

Methods

A systematic literature search was conducted using PubMed, Scopus, and Web of Science databases without time constraints. Key search terms included «oral mucosal graft», «oral care pathways», «OMG post-operative care», «BMG», «LMG», and «OMG graft harvesting». Selection followed PRISMA guidelines. Inclusion criteria focused on studies addressing oral mucosal grafts in reconstructive urology and associated perioperative care, excluding non-English articles, case reports, and editorials.

Results

The review underscores the suitability of oral mucosa for grafting due to properties like excellent vascularization and minimal immunogenicity. Comparisons among graft harvesting sites reveal differences in tissue quality, ease of harvest, and donor site morbidity. Non-closure techniques generally result in less postoperative pain and quicker healing, though closure might better control bleeding and infection. Despite common complications such as mild trismus and altered chewing efficiency, patient satisfaction remains high.

Conclusions

Effective management of oral mucosal grafts harvesting emphasizes tailored perioperative care to minimize complications and enhance recovery. Further research should focus on long-term oral morbidity, standardized care protocols, and patient-reported outcomes to improve care pathways and surgical results.
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引用次数: 0
Complicaciones estéticas de la cirugía de uretra anterior: revisión exploratoria y galería de imágenes
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.acuro.2024.11.002
F. Chierigo , G. Mantica , G. Drocchi , F.X. Madec , W. Verla , Ł. Białek , J. Adamowicz , A. Cocci , M. Frankiewicz , J. Klemm , P. Neuville , M. Oszczudłowski , E.J. Redmond , C.M. Rosenbaum , M. Waterloos , M.W. Vetterlein , F. Campos-Juanatey , en representación del Grupo de Trabajo de Urología Reconstructiva y Trauma Urológico de la Sección de Jóvenes Urólogos Académicos (YAU) - Asociación Europea de Urología (EAU)

Introduction

Anterior urethroplasty is the gold standard for treating complex urethral strictures, primarily focusing on restoring urinary function. However, aesthetic complications, including penile curvature, scarring, and meatal deformities, can impact patient satisfaction, self-image, and quality of life. Despite their significance, cosmetic outcomes are underreported in the literature, affecting patient counseling and surgical planning.

Objective

This scoping review aims to assess the prevalence, types, and contributing factors of cosmetic complications after anterior urethroplasty. A photographic collection of these complications is also presented to aid in clinical education.

Materials and methods

A systematic search of PubMed, Scopus, and Web of Science databases was performed, including studies from 2000 onward that report cosmetic outcomes in male adult patients post-urethroplasty. Following PRISMA guidelines, studies focusing on pediatric cases, case reports with fewer than 10 patients, and those lacking specific cosmetic data were excluded.

Results

Of the 493 studies screened, 97 met the inclusion criteria, with only a minority (8 studies) explicitly discussing cosmetic complications. Reported issues varied widely, including penile curvature, skin tethering, hypertrophic scarring, meatal deformities, and penile shortening, underscoring the diversity of aesthetic challenges in urethral reconstruction.

Conclusion

This review highlights the need for incorporating aesthetic considerations into surgical planning and patient counseling for anterior urethroplasty. Standardized metrics for evaluating cosmetic outcomes could improve patient satisfaction and the quality of care in urethral reconstruction.
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引用次数: 0
Historia de la cirugía uretral: lecciones aprendidas del pasado
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.acuro.2024.12.001
F.X. Madec , P. Neuville , F. Chierigo , J. Adamowicz , Ł. Białek , A. Cocci , M. Frankiewicz , G. Mantica , M. Oszczudłowski , E.J. Redmond , C.M. Rosenbaum , W. Verla , M. Waterloos , F. Campos-Juanatey , J. Klemm , M. Vetterlein , en representación del Grupo de Trabajo de Urología Reconstructiva y Trauma Urológico de la Sección de Jóvenes Urólogos Académicos - Asociación Europea de Urología

Introduction

Although failures are undesirable, they offer valuable learning opportunities that drive progress through necessary changes. This concept holds particularly true in the history of urethral reconstruction.

Methods

A comprehensive literature review was conducted using PubMed, focusing on the history of the urethral stricture and current trends based on national and international guidelines for urethral stricture management.

Results

Urethral strictures are among the oldest known urological conditions, with initial treatments centred around dilatation. These palliative measures proved disappointing. The advent of reconstructive urology has transformed this pathology into a treatable condition, notably through Excision and Primary Anastomosis (EPA) and one-stage augmentation urethroplasty using buccal grafts.

Conclusion

Urethroplasty is the gold standard treatment for urethral strictures, and ongoing refinements aim to further reduce morbidity.
{"title":"Historia de la cirugía uretral: lecciones aprendidas del pasado","authors":"F.X. Madec ,&nbsp;P. Neuville ,&nbsp;F. Chierigo ,&nbsp;J. Adamowicz ,&nbsp;Ł. Białek ,&nbsp;A. Cocci ,&nbsp;M. Frankiewicz ,&nbsp;G. Mantica ,&nbsp;M. Oszczudłowski ,&nbsp;E.J. Redmond ,&nbsp;C.M. Rosenbaum ,&nbsp;W. Verla ,&nbsp;M. Waterloos ,&nbsp;F. Campos-Juanatey ,&nbsp;J. Klemm ,&nbsp;M. Vetterlein ,&nbsp;en representación del Grupo de Trabajo de Urología Reconstructiva y Trauma Urológico de la Sección de Jóvenes Urólogos Académicos - Asociación Europea de Urología","doi":"10.1016/j.acuro.2024.12.001","DOIUrl":"10.1016/j.acuro.2024.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Although failures are undesirable, they offer valuable learning opportunities that drive progress through necessary changes. This concept holds particularly true in the history of urethral reconstruction.</div></div><div><h3>Methods</h3><div>A comprehensive literature review was conducted using PubMed, focusing on the history of the urethral stricture and current trends based on national and international guidelines for urethral stricture management.</div></div><div><h3>Results</h3><div>Urethral strictures are among the oldest known urological conditions, with initial treatments centred around dilatation. These palliative measures proved disappointing. The advent of reconstructive urology has transformed this pathology into a treatable condition, notably through Excision and Primary Anastomosis (EPA) and one-stage augmentation urethroplasty using buccal grafts.</div></div><div><h3>Conclusion</h3><div>Urethroplasty is the gold standard treatment for urethral strictures, and ongoing refinements aim to further reduce morbidity.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 63-71"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156139","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}
引用次数: 0
Eficacia y seguridad del balón de dilatación uretral Optilume® en la práctica clínica real: análisis multicéntrico en España
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.acuro.2024.07.002
C. Ballesteros Ruiz , F. Campos-Juanatey , I. Povo Martín , S. Mitjana Biosca , Ó. Gorría Cardesa , J.F. Aguilar Guevara , N. García Formoso , E. Fernández Pascual , J.I. Martínez Salamanca , S. Martínez Pérez , J.M. Alonso Dorrego , E. Ríos González , S. San Cayetano Talegón , A.M. Araujo Suarez , E. Moran Pascual , M.Á. Bonillo García , J. Medina Polo , L. Viver Clotet , A.J. Vicens Morton , J. Arce Gil , L. Martínez-Piñeiro Lorenzo

Introduction

The Optilume® paclitaxel-coated urethral dilatation balloon is an alternative to conventional endoscopic treatments that combines mechanical dilatation with local delivery of paclitaxel.

Objective

To describe the success rate and analyze the safety of the device in real clinical practice. To evaluate possible predictors of treatment failure.

Material and methods

Retrospective multicenter study in patients diagnosed with urethral stricture and treated with an Optilume® balloon in routine clinical practice. Data were collected from flowmetry, questionnaires (PROM and IPSS) and cystoscopy before surgery, and 3, 6 and 12 months after the procedure, according to standard practice. Surgical success was defined as the absence of subsequent urethral manipulation and a Qmax > 10 ml/s.

Results

238 patients treated with Optilume® in 12 Spanish hospitals between May 2021 and April 2024 were included in the study. Of these, 156 who had a minimum follow-up of 3 months, were analyzed. Median stricture length: 1.5 cm (0.5 - 5.3), mainly in bulbar urethra (87.7%). Of the total, 12.8% of patients had a history of pelvic radiotherapy, and 81.4% had undergone prior urethral manipulation. Postoperative complications were reported in 14.2% of the total. The treatment success rate was 73.8%, with a median follow-up of 8 months (5-12). No predictors of stricture recurrence were identified. Recurrence rates were higher in strictures located in the posterior versus anterior urethra (42.9% vs. 24.6%, p = 0.126). No significant differences were observed between patients with and without prior urethral manipulation.

Conclusion

Treatment with Optilume® has been shown to be safe and effective in short-term routine clinical practice.
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引用次数: 0
Controversias en el abordaje del cáncer de próstata: consenso de recomendaciones de expertos del norte de España 处理前列腺癌的争议:西班牙北部专家建议的共识
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-12-01 DOI: 10.1016/j.acuro.2024.06.001
D. Pérez Fentes , P. Willisch , S. Martínez Breijoo , M. Domínguez , U. Anido , C. Álvarez , A. Gómez Caamaño
In recent years, various aspects of prostate cancer (PC) management have undergone significant changes, including the implementation of therapeutic strategies such as the use of new hormonal agents like abiraterone, apalutamide, enzalutamide or darolutamide and the incorporation of next generation imaging techniques. However, the evidence regarding the role of next generation imaging techniques and the therapeutic decision-making based on their findings is not solid. Following the methodology of the Advanced Prostate Cancer Consensus Conference, a multidisciplinary expert consensus was developed to address controversial questions concerning the use of next generation imaging techniques and clinical management in 4 priority scenarios: localized PC, PC after radical prostatectomy, PC after radiotherapy with curative intent, and metastatic hormone-sensitive PC. This consensus represents the opinions of medical oncology, radiation oncology and urology physicians, and provides useful recommendations for clinical practice.
近年来,前列腺癌(PC)治疗的各个方面都发生了重大变化,包括治疗策略的实施,如使用新的激素药物,如阿比特龙、阿帕鲁胺、恩杂鲁胺或darolutamide,以及新一代成像技术的结合。然而,关于下一代成像技术的作用和基于其发现的治疗决策的证据并不可靠。根据晚期前列腺癌共识会议的方法,制定了多学科专家共识,以解决有关在4种优先情况下使用下一代成像技术和临床管理的争议问题:局限性前列腺癌、根治性前列腺癌后的前列腺癌、放射治疗后的前列腺癌和转移性激素敏感的前列腺癌。这一共识代表了内科肿瘤学、放射肿瘤学和泌尿外科医生的意见,并为临床实践提供了有益的建议。
{"title":"Controversias en el abordaje del cáncer de próstata: consenso de recomendaciones de expertos del norte de España","authors":"D. Pérez Fentes ,&nbsp;P. Willisch ,&nbsp;S. Martínez Breijoo ,&nbsp;M. Domínguez ,&nbsp;U. Anido ,&nbsp;C. Álvarez ,&nbsp;A. Gómez Caamaño","doi":"10.1016/j.acuro.2024.06.001","DOIUrl":"10.1016/j.acuro.2024.06.001","url":null,"abstract":"<div><div>In recent years, various aspects of prostate cancer (PC) management have undergone significant changes, including the implementation of therapeutic strategies such as the use of new hormonal agents like abiraterone, apalutamide, enzalutamide or darolutamide and the incorporation of next generation imaging techniques. However, the evidence regarding the role of next generation imaging techniques and the therapeutic decision-making based on their findings is not solid. Following the methodology of the Advanced Prostate Cancer Consensus Conference, a multidisciplinary expert consensus was developed to address controversial questions concerning the use of next generation imaging techniques and clinical management in 4 priority scenarios: localized PC, PC after radical prostatectomy, PC after radiotherapy with curative intent, and metastatic hormone-sensitive PC. This consensus represents the opinions of medical oncology, radiation oncology and urology physicians, and provides useful recommendations for clinical practice.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 739-750"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relación entre varicocele e hipogonadismo o disfunción eréctil: revisión sistemática y metaanálisis 静脉曲张与性腺功能减退或勃起功能障碍的关系:系统综述和荟萃分析
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-12-01 DOI: 10.1016/j.acuro.2024.05.002
S.J. Gonzalez-Daza , A.M. Díaz-Hung , H.A. García-Perdomo

Objective

To assess the association between varicocele and hypogonadism, or erectile dysfunction.

Methods

We searched MEDLINE, EMBASE, LILACS, CENTRAL, and other sources. We included cohort, case-control, and cross-sectional studies. The primary outcome was the association between varicocele and hypogonadism, or erectile dysfunction, and the secondary outcome included semen analysis. We assessed the risk of bias with the Newcastle-Ottawa Scale. We performed statistical analysis in Review Manager® 5.3 and reported information about the odds ratio (OR) with a 95% confidence interval. We produced a forest plot for the primary outcome.

Results

We included ten studies in qualitative analysis and six studies in quantitative analysis. Most of the cross-sectional studies showed a low risk of bias, not so for the two case-control studies, which represented a high risk of bias. Most of the reports described a correlation between having varicocele and presenting low testosterone levels: the meta-analysis showed that there is a significant association between varicocele and hypogonadism (OR: 3.27; 95% CI: 1.23-8.68). Regarding varicocele and erectile, only one study showed a significant difference in erectile function in comparison to varicocele patients and men without varicocele.

Conclusion

There is an association between varicocele presence and hypogonadism, although more studies are needed. Besides, not much is reported about an association between varicocele and erectile dysfunction, but impairment can occur through hormone disturbances.
目的探讨精索静脉曲张与性腺功能减退或勃起功能障碍的关系。方法检索MEDLINE、EMBASE、LILACS、CENTRAL等数据库。我们纳入了队列研究、病例对照研究和横断面研究。主要结果是精索静脉曲张与性腺功能减退或勃起功能障碍之间的关系,次要结果包括精液分析。我们用纽卡斯尔-渥太华量表评估偏倚风险。我们在Review Manager®5.3中进行了统计分析,并以95%的置信区间报告了优势比(OR)的信息。我们制作了一张森林图作为主要结果。结果定性分析纳入10项研究,定量分析纳入6项研究。大多数横断面研究显示低偏倚风险,但两项病例对照研究并非如此,它们代表高偏倚风险。大多数报告描述了精索静脉曲张与低睾酮水平之间的相关性:荟萃分析显示精索静脉曲张与性腺功能减退之间存在显著关联(OR: 3.27;95% ci: 1.23-8.68)。关于精索静脉曲张和勃起,只有一项研究显示,与精索静脉曲张患者和无精索静脉曲张的男性相比,勃起功能有显著差异。结论精索静脉曲张与性腺功能减退之间存在相关性,但仍需进一步研究。此外,关于精索静脉曲张和勃起功能障碍之间的联系的报道不多,但损伤可能通过激素紊乱发生。
{"title":"Relación entre varicocele e hipogonadismo o disfunción eréctil: revisión sistemática y metaanálisis","authors":"S.J. Gonzalez-Daza ,&nbsp;A.M. Díaz-Hung ,&nbsp;H.A. García-Perdomo","doi":"10.1016/j.acuro.2024.05.002","DOIUrl":"10.1016/j.acuro.2024.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the association between varicocele and hypogonadism, or erectile dysfunction.</div></div><div><h3>Methods</h3><div>We searched MEDLINE, EMBASE, LILACS, CENTRAL, and other sources. We included cohort, case-control, and cross-sectional studies. The primary outcome was the association between varicocele and hypogonadism, or erectile dysfunction, and the secondary outcome included semen analysis. We assessed the risk of bias with the Newcastle-Ottawa Scale. We performed statistical analysis in Review Manager® 5.3 and reported information about the odds ratio (OR) with a 95% confidence interval. We produced a forest plot for the primary outcome.</div></div><div><h3>Results</h3><div>We included ten studies in qualitative analysis and six studies in quantitative analysis. Most of the cross-sectional studies showed a low risk of bias, not so for the two case-control studies, which represented a high risk of bias. Most of the reports described a correlation between having varicocele and presenting low testosterone levels: the meta-analysis showed that there is a significant association between varicocele and hypogonadism (OR: 3.27; 95% CI: 1.23-8.68). Regarding varicocele and erectile, only one study showed a significant difference in erectile function in comparison to varicocele patients and men without varicocele.</div></div><div><h3>Conclusion</h3><div>There is an association between varicocele presence and hypogonadism, although more studies are needed. Besides, not much is reported about an association between varicocele and erectile dysfunction, but impairment can occur through hormone disturbances.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 751-759"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimización de la triple terapia en el tratamiento del cáncer de próstata hormonosensible metastásico 优化激素敏感转移性前列腺癌的三联疗法
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-12-01 DOI: 10.1016/j.acuro.2024.07.003
A. Borque-Fernando , D.A. Pérez-Fentes , M. Rodrigo-Aliaga , J. Puente-Vázquez , A. Gómez-Iturriaga , M. Unda , M.A. Calleja-Hernández , J.M. Cózar-Olmo , J.L. Álvarez-Ossorio
Triple therapy with docetaxel, androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) has demonstrated survival benefits in patients with metastatic hormone-sensitive prostate cancer (mHSPC), especially in those with high-risk disease. However, once the use of ADT and docetaxel is established, guidelines do not clearly specify which ARPI is most appropriate. In this work, a literature review to identify phase III clinical trials, systematic reviews, meta-analyses, and clinical practice guidelines on triple therapy in mHSPC was carried out. Evidence and recommendations were qualitatively reviewed to provide guidelines on the most suitable ARPI based on patient risk, disease volume, and nature of metastases (synchronous or metachronous). This review aims to update the previously published consensus on the optimal pharmacological treatment for mHSPC and to expose the opinions of hospital pharmacy, urology and medical and radiation oncology experts.
多西紫杉醇、雄激素剥夺疗法(ADT)和雄激素受体途径抑制剂(arpi)的三联疗法已证明可改善转移性激素敏感前列腺癌(mHSPC)患者的生存,尤其是那些高风险疾病患者。然而,一旦确定了ADT和多西他赛的使用,指南并没有明确规定哪种ARPI是最合适的。在这项工作中,进行了文献综述,以确定mHSPC三联疗法的III期临床试验、系统评价、荟萃分析和临床实践指南。对证据和建议进行定性审查,以根据患者风险、疾病体积和转移性质(同步或异时性)提供最合适的ARPI指南。本综述旨在更新先前发表的关于mHSPC最佳药物治疗的共识,并揭示医院药学、泌尿科、医学和放射肿瘤学专家的意见。
{"title":"Optimización de la triple terapia en el tratamiento del cáncer de próstata hormonosensible metastásico","authors":"A. Borque-Fernando ,&nbsp;D.A. Pérez-Fentes ,&nbsp;M. Rodrigo-Aliaga ,&nbsp;J. Puente-Vázquez ,&nbsp;A. Gómez-Iturriaga ,&nbsp;M. Unda ,&nbsp;M.A. Calleja-Hernández ,&nbsp;J.M. Cózar-Olmo ,&nbsp;J.L. Álvarez-Ossorio","doi":"10.1016/j.acuro.2024.07.003","DOIUrl":"10.1016/j.acuro.2024.07.003","url":null,"abstract":"<div><div>Triple therapy with docetaxel, androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) has demonstrated survival benefits in patients with metastatic hormone-sensitive prostate cancer (mHSPC), especially in those with high-risk disease. However, once the use of ADT and docetaxel is established, guidelines do not clearly specify which ARPI is most appropriate. In this work, a literature review to identify phase III clinical trials, systematic reviews, meta-analyses, and clinical practice guidelines on triple therapy in mHSPC was carried out. Evidence and recommendations were qualitatively reviewed to provide guidelines on the most suitable ARPI based on patient risk, disease volume, and nature of metastases (synchronous or metachronous). This review aims to update the previously published consensus on the optimal pharmacological treatment for mHSPC and to expose the opinions of hospital pharmacy, urology and medical and radiation oncology experts.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 703-717"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hacia un cambio de modelo en el manejo de la hiperplasia benigna de próstata: importancia de un enfoque individualizado 改变良性前列腺增生管理模式:个体化方法的重要性
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-12-01 DOI: 10.1016/j.acuro.2024.09.001
A. Alcántara Montero
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引用次数: 0
Evaluación de los cambios en la función sexual en pacientes sometidos a cirugía endoscópica de la litiasis del tracto urinario superior 评价上尿路碎石症内镜手术患者的性功能变化
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-12-01 DOI: 10.1016/j.acuro.2024.06.002
J. Tabares Jiménez, G. Bueno Serrano, M.P. Alcoba García, R. González López, B. Gómez Jordana, I. Mahillo Fernández, C. González Enguita

Objective

To evaluate the effect of endoscopic surgery on sexual function in patients with upper urinary tract (UUT) lithiasis.

Material and methods

We conducted an observational, prospective, longitudinal study with a single cohort of cases undergoing ureteroscopy (URS), retrograde intrarenal surgery (RIRS), or endoscopic combined intrarenal surgery (ECIRS). Patients’ sexual response was assessed with questionnaires in the 30 days prior to surgery, and at one and three months after surgery. The International Index of Erectile Function (IIEF-t) was used in male patients, and the Female Sexual Function Index (FSFI) was used in female patients.

Results

Seventy patients -34 men and 36 women- completed the study. Among men, the IIEF-t did not show significant difference between baseline scores (64.1 ± 7.50) and those obtained at 3 months (63.8 ± 9.51), with a non-significant decrease (p = 0.054) at the first month (61.4 ± 10.4). Subdomains did not worsen at 3 months, and desire (IIEF-SD) improved from 7.3 ± 1.9 to 8.0 ± 1.8. Among women, the FSFI-t did not change significantly after surgery: baseline score (27.3 ± 4.1), 1-month score (26.8 ± 3.7) and 3-month score (27.5 ± 4.2). No subdomain worsened at the third month.

Conclusion

Endoscopic surgery for UUT is a safe technique in both sexes with no negative effect on sexual function. There are no differences between the baseline IIEF-t and FSFI-t scores and those obtained at 3 months.
目的探讨内镜下手术对上尿路结石患者性功能的影响。材料和方法我们对接受输尿管镜(URS)、逆行肾内手术(RIRS)或内窥镜联合肾内手术(ECIRS)的病例进行了一项观察性、前瞻性、纵向研究。在手术前30天、手术后1个月和3个月用问卷评估患者的性反应。男性患者采用国际勃起功能指数(IIEF-t),女性患者采用女性性功能指数(FSFI)。结果70名患者(34名男性,36名女性)完成了研究。在男性中,IIEF-t在基线得分(64.1±7.50)与3个月时的得分(63.8±9.51)之间无显著差异,在第一个月时的得分(61.4±10.4)无显著下降(p = 0.054)。子域在3个月时没有恶化,desire (IIEF-SD)从7.3±1.9改善到8.0±1.8。在女性中,术后FSFI-t无明显变化:基线评分(27.3±4.1),1个月评分(26.8±3.7)和3个月评分(27.5±4.2)。第三个月没有子域名恶化。结论内镜下手术治疗UUT是一种安全的技术,对两性均无不良影响。基线IIEF-t和FSFI-t评分与3个月时的评分没有差异。
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引用次数: 0
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Actas urologicas espanolas
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