Actas urologicas espanolas最新文献_第5页

Evaluación ecográfica prenatal y manejo de anomalías renales y urogenitales: una revisión exhaustiva basada en la experiencia en un centro de atención terciaria y análisis de la literatura 产前超声检查和肾脏和泌尿生殖系统异常的管理：基于三级护理中心经验的综合审查和文献分析

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-11-01 Epub Date: 2025-06-21 DOI: 10.1016/j.acuro.2025.501816

K. Weller , G.M. Eggenhuizen , K. Zandbergen , L.A. ’t Hoen , J. Mulder , A.T.J.I. Go

Introduction

Congenital renal and urogenital anomalies represent a major part of all congenital anomalies. These range from mild, transient conditions to severe forms leading to irreversible organ damage or perinatal mortality. Timely prenatal identification is crucial for expecting parents and their healthcare providers to decide about the continuation of a pregnancy or for careful planning of perinatal and postnatal care.

Objective

To describe the most common indications for referral of fetal renal and urogenital malformations, the process of narrowing the differential diagnosis based on prenatal ultrasonography and the coordination between prenatal and postnatal care in a tertiary care center in the Netherlands.

Results

The most common indications for referral of fetal renal and urogenital malformations are: (1) abnormal renal parenchyma; (2) urinary tract dilatation; (3) abnormal bladder appearance, and (4) atypical genitalia. In the differential diagnosis, ultrasonographic evaluation is crucial to determine the specific region of the urogenital system affected, its onset during pregnancy, and its progression throughout gestation. Integrated prenatal and postnatal care for these types of malformations relies on a multidisciplinary approach to guide parental decision-making in continuation of the pregnancy and optimize outcomes. Some cases only require routine perinatal care in secondary care centers, while complex malformations benefit from specialized planning at tertiary centers to improve outcomes.

Conclusion

Dedicated ultrasonographic evaluation of fetal renal and urogenital anomalies in a tertiary care center enables accurate diagnosis and individualized care planning, particularly in complex cases. This approach provides parents with timely information, supports decision-making, and guides individualized perinatal care.

先天性肾脏和泌尿生殖异常是所有先天性异常的主要组成部分。这些疾病的范围从轻微的、短暂的状况到导致不可逆器官损害或围产期死亡的严重形式。及时的产前鉴定对于准父母及其医疗保健提供者决定是否继续妊娠或仔细规划围产期和产后护理至关重要。目的介绍荷兰一家三级保健中心胎儿肾脏和泌尿生殖系统畸形转诊的最常见适应症、产前超声鉴别诊断的缩小过程以及产前和产后护理的协调情况。结果胎儿肾脏及泌尿生殖系统畸形转诊最常见的指征是：(1)肾实质异常；(2)尿路扩张；(3)膀胱外观异常；(4)生殖器不典型。在鉴别诊断中，超声评估对于确定泌尿生殖系统受影响的特定区域，其在妊娠期间的发病以及整个妊娠期间的进展至关重要。这些类型的畸形的综合产前和产后护理依赖于多学科的方法来指导父母在继续妊娠和优化结果的决策。有些病例只需要在二级护理中心进行常规围产期护理，而复杂的畸形则可以在三级护理中心进行专门规划，以改善结果。结论在三级医疗中心对胎儿肾脏和泌尿生殖器官异常进行专门的超声检查，可以准确诊断和制定个性化的护理计划，特别是在复杂的病例中。这种方法为父母提供及时的信息，支持决策，并指导个性化的围产期护理。

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引用次数: 0

Análisis de la atención al final de la vida y cuidados paliativos en los pacientes con cáncer renal metastásico 转移性肾癌患者临终关怀和姑息治疗分析

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-11-01 Epub Date: 2025-07-31 DOI: 10.1016/j.acuro.2025.501841

G. Lendínez-Cano , C. Roldán Cumbreras , C.B. Congregado Ruíz , R.A. Medina López

Introduction

Palliative care is a fundamental component of the comprehensive management of patients with advanced cancer, significantly improving quality of life. Since most patients with metastatic renal cell carcinoma (mRCC) ultimately die from disease progression, end-of-life care represents a key element of quality cancer care. This area can be assessed through specific indicators derived from administrative data.

Materials and methods

We conducted a retrospective analysis of patients diagnosed with mRCC who initiated treatment at our center between September 2012 and September 2019, evaluating quality indicators related to end-of-life care.

Results

Of the 71 patients identified, 57 had died at the time of analysis (81.6%).

A total of 59.6% (95% CI; 46.8-72.3) died in hospital, 64% of these in palliative care units. In the last 30 days of life, 22.8% (95% CI: 12-33.5) visited the emergency room more than once, while only 1.8% (95% CI: 0-5.1) were admitted to the ICU. Contact with palliative care services was documented in 49% (95% CI: 36.1-62) of patients, although only 5.3% (95% CI: 0-11.1) received early referral (more than 90 days before death).

Conclusions

Palliative care in mRCC is underutilized and predominantly offered as terminal care, with early referral being exceptional. Multidisciplinary strategies are needed to optimize these services.

姑息治疗是晚期癌症患者综合管理的基本组成部分，可显著提高患者的生活质量。由于大多数转移性肾细胞癌（mRCC）患者最终死于疾病进展，临终关怀是高质量癌症护理的关键要素。可以通过从行政数据中得出的具体指标来评估这一领域。材料与方法回顾性分析2012年9月至2019年9月在本中心开始治疗的mRCC患者，评估与临终关怀相关的质量指标。结果71例患者中，有57例（81.6%）在分析时死亡。共有59.6% （95% CI; 46.8-72.3）死于医院，其中64%死于姑息治疗病房。在生命的最后30天，22.8% （95% CI: 12-33.5）的患者不止一次去急诊室，而只有1.8% （95% CI: 0-5.1）的患者住进了ICU。49% （95% CI: 36.1-62）的患者接触过姑息治疗服务，尽管只有5.3% （95% CI: 0-11.1）的患者接受了早期转诊（死亡前90天以上）。结论姑息治疗未得到充分利用，主要作为晚期护理，早期转诊例外。需要多学科战略来优化这些服务。

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引用次数: 0

Resultados oncológicos en los pacientes con tumor vesical no músculo invasivo sometidos a cistectomía radical tras el fracaso a BCG según las definiciones propuestas por la Asociación Europea de Urología 根据欧洲泌尿学协会提出的定义，在卡介素治疗失败后进行根治性膀胱切除术的非侵入性肌肉肿瘤患者的肿瘤结果

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-11-01 Epub Date: 2025-07-24 DOI: 10.1016/j.acuro.2025.501834

A. Farré , J. Huguet , G. Basile, L. Diéguez, P. Izquierdo, R. Sánchez, P. Gavrilov, A. Gallioli, O. Rodríguez Faba, J.M. Gaya, J. Palou, A. Breda

Introduction

The management of non-muscle invasive bladder cancer (NMIBC) failing Bacillus Calmette-Guérin (BCG) therapy remains challenging. The European Association of Urology (EAU) has standardized definitions of BCG failure. We aim to evaluate oncological outcomes in patients undergoing radical cystectomy (RC) for NMIBC following BCG failure, as defined by the EAU.

Methods

Retrospective study analyzed 93 patients with NMIBC who underwent RC between 2011 and 2021 after BCG therapy failure. Patients were stratified into 4 groups: clinical NMIBC, clinical progression, subclinical progression (understaged), and pathological NMIBC (pNMIBC) groups. Oncological outcomes included cancer-specific survival (CSS) and overall survival (OS). Kaplan-Meier and logistic regression analyses were used to evaluate outcomes and predictors of disease progression.

Results

Among 93 patients, 64 (68.8%) had clinical NMIBC, and 29 (31.2%) showed clinical progression to muscle-invasive bladder cancer (MIBC) prior to RC. Of those with clinical NMIBC, 46 (71.9%) were confirmed as pNMIBC and 18 (28.1%) had subclinical progression. Patients with pNMIBC had significantly better 5-year CSS (95.5%) and OS (77.6%) compared to those with clinical (CSS 70.4%, OS 50.2%) or subclinical progression (CSS 64.1%, OS 43.8%). cT1 with concomitant carcinoma in situ and prostatic urethral involvement were independent predictors of muscle-invasive disease at RC.

Conclusions

Patients treated at an appropriate stage show superior survival outcomes compared to those with progression. These findings underscore the importance of timely surgical intervention in BCG-unresponsive NMIBC and support early RC in select high-risk patients to improve long-term prognosis.

卡介苗治疗失败的非肌肉浸润性膀胱癌（NMIBC）的治疗仍然具有挑战性。欧洲泌尿外科协会（EAU）对卡介苗失败有标准化的定义。我们的目的是评估在BCG失败后接受根治性膀胱切除术（RC）的NMIBC患者的肿瘤学结果。方法回顾性分析2011年至2021年间93例卡介苗治疗失败后接受RC治疗的NMIBC患者。将患者分为临床NMIBC组、临床进展组、亚临床进展组和病理性NMIBC组（pNMIBC）。肿瘤预后包括癌症特异性生存期（CSS）和总生存期（OS）。Kaplan-Meier和logistic回归分析用于评估结果和疾病进展的预测因素。结果93例患者中，64例（68.8%）有临床NMIBC， 29例（31.2%）在RC前有临床进展为肌肉浸润性膀胱癌（MIBC）。在临床NMIBC患者中，46例（71.9%）确诊为pNMIBC， 18例（28.1%）为亚临床进展。pNMIBC患者的5年CSS（95.5%）和OS（77.6%）明显优于临床（CSS 70.4%, OS 50.2%）或亚临床进展（CSS 64.1%, OS 43.8%）患者。cT1合并原位癌和前列腺尿道受累是RC肌肉侵袭性疾病的独立预测因子。结论：与进展期患者相比，在适当阶段治疗的患者具有更好的生存结果。这些发现强调了及时手术干预bcg无反应的NMIBC的重要性，并支持早期RC选择高危患者以改善长期预后。

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引用次数: 0

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 结构化记忆在识别慢性骨盆疼痛综合征表型方面的诊断效用：面向临床实践的回顾性研究

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-11-01 Epub Date: 2025-08-08 DOI: 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).

目的评估慢性盆腔疼痛是否表现出特定的定性特征，如患者所述，可以指导识别其潜在的临床表型。材料和方法一项回顾性研究，包括157例患者（81例男性，76例女性），由单一评估者采用结构化的10项表进行系统访谈，旨在确定三种可能的表型。分析预测表型（仅基于记忆）与最终表型（通过体格检查、治疗反应和临床进展建立）之间的相关性。根据表型和性别计算敏感性（Se）、特异性（Sp）、阳性预测值（PPV）、阴性预测值（NPV）和曲线下面积（AUC）。评估每个问题的诊断相关性，并使用卡方检验进行统计学显著性检验。结果在女性中，最终确诊的预测表型为：膀胱型64.5%，肌筋膜型19.7%，神经性30.2%。男性：8.6%膀胱，81.5%肌筋膜，23.5%神经性病变。女性膀胱：Se 0.92, Sp 0.74, PPV 0.90, NPV 0.72, AUC 0.82。肌筋膜：Se 0.44, Sp 0.93, PPV 0.79, NPV 0.75, AUC 0.76。神经性：Se 0.36, Sp 0.98, PPV 0.89, NPV 0.79, AUC 0.51。男性膀胱：Se 0.57, Sp 0.83, PPV 0.21, NPV 0.96, AUC 0.81。肌筋膜：Se 0.75, Sp 0.75, PPV 0.93, NPV 0.41, AUC 0.75。神经性：Se 0.29, Sp 1.00, PPV 1.00, NPV 0.80, AUC 0.64。结论结构化记忆有助于识别慢性盆腔疼痛（膀胱、肌筋膜或神经性）的临床表型。

{"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}

引用次数: 0

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 机器人骶髂垂体中网状紧固的困境：可吸收或不可吸收的缝合？大容量观测群数据

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-11-01 Epub Date: 2025-09-22 DOI: 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。

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引用次数: 0

Intervenciones farmacológicas en la anorgasmia masculina primaria o secundaria: una revisión sistemática 原发性或继发性男性性高潮的药物干预：系统综述

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-11-01 Epub Date: 2025-07-31 DOI: 10.1016/j.acuro.2025.501835

M.P. Gómez-Bueno , A.M. Diaz-Hung , H.A. García-Perdomo

Objective

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。

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引用次数: 0

Eficacia de la intervención dietética con calcio y control de oxalato en la prevención de los cálculos de oxalato cálcico: revisión integrativa 膳食钙干预和草酸盐控制预防草酸钙结石的有效性：综合综述

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-10-01 Epub Date: 2025-07-05 DOI: 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.

草酸钙肾结石是最常见的肾结石类型，与饮食和代谢因素密切相关。适当的饮食方法可以帮助预防它们的形成并降低复发的风险。目的探讨适当钙摄入与控制草酸盐摄入对预防草酸钙肾结石形成的影响。根据PRISMA指南，在PubMed®、Scopus®、Medline®和Dialnet®（2014-2024）中进行了一项综合评价，重点关注钙和草酸盐饮食管理在肾结石疾病中的作用。证据合成和结论综述的证据表明，足够的钙摄入量（800- 1200mg /天）可减少肠道草酸盐吸收，从而减少尿草酸盐排泄。此外，水合作用、限钠和用柠檬酸盐碱化尿液是补充的饮食策略。最近的研究还表明，尿微生物群和遗传易感性可能影响个体对饮食干预的反应。总的来说，个性化的饮食方法可能是预防草酸钙肾结石的一种有效和可行的策略。然而，目前的证据受到方法学约束和研究异质性的限制。

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引用次数: 0

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 用免疫辅助疗法治疗的转移性肾细胞癌和腔静脉肿瘤血栓的成人延迟细胞还原肾切除术：系统综述

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-10-01 Epub Date: 2025-05-30 DOI: 10.1016/j.acuro.2025.501799

E.S. Cruz Peralta , M. González Domínguez , R.J. Salgueiro Ergueta , M.L. Peralta Pedrero

Introduction

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.

肾细胞癌（RCC）侵袭下腔静脉（IVC）的病例占4%至10%，增加了影响肿瘤预后的手术并发症的风险。材料与方法本研究问题采用PICOST首字母缩略词进行定义。详尽的搜索，材料选择和数据提取进行了两份和独立。原始文章纳入了在IVC中有血栓的转移性肾癌（mRCC）患者，接受免疫检查点抑制剂联合或不联合酪氨酸激酶抑制剂（TKIs）和细胞减减性肾切除术（CN）治疗。排除了血栓仅局限于肾动脉或心房的患者。结果共纳入17篇文章：1篇回顾性队列，5篇回顾性病例系列，11篇回顾性病例报告。共分析32例患者；10例因无转移而被排除。在大多数病例中，原发肿瘤的大小减小。对于下腔静脉血栓，22例患者中，7例保持不变，13例减少（9例减少一级，3例减少二级，1例减少三级），1例增加。在另一种情况下，血栓大小或水平减少的幅度没有指定。即使在水平保持不变的情况下，肿瘤血栓的大小也会减小。结论mRCC和IVC血栓患者可能受益于免疫检查点抑制剂的新辅助治疗，联合或不联合TKIs，以及延迟的细胞减减性肾切除术。

{"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}

引用次数: 0

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 按尿道导管长度划分的儿科肾移植结果比较：由青年泌尿科学术组儿科泌尿学和肾移植工作组进行的系统综述

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-10-01 Epub Date: 2025-07-05 DOI: 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.

导读与目的肾移植术后泌尿系统并发症很常见，主要表现为输尿管梗阻或渗漏。常规输尿管支架置入术在减少尿路感染等其他并发症的基础上减少了这些并发症。关于支架的最佳持续时间尚无共识，且缺乏相关文献。本系统综述的目的是总结和比较儿童KTx术后使用短（2周）和长（≥2周）支架的支架相关并发症的发生率。材料和方法在Embase、MEDLINE、Cochrane和ClinicalTrial.gov中进行系统检索。研究报告的儿童（0-18岁）接受KTx术中输尿管支架置入至少一个月的随访。提取手术和结局特征的数据。结果从322篇文献中纳入14项研究，报告了971例儿科KTx，其中411例为女性（42%）。样本量从32例到146例不等。移植时的平均或中位年龄为3.36至14.7岁。采用系统综合的方法对结果进行总结。在4项比较研究中，只有一项研究显示长时间组移植后尿路感染明显增加，其他泌尿系统并发症无明显差异。结论由于缺乏高质量的研究，对于减少小儿KTx支架相关并发症的发生率，同时防止输尿管膀胱吻合口狭窄或渗漏，短支架时间是否更安全、更可行尚不确定。

{"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}

引用次数: 0

Perfil e interacción de los usuarios con una app de salud digital para urolitiasis: estudio descriptivo de los primeros 699 usuarios 尿路石症数字健康应用程序的用户简介和用户互动：对前699名用户的描述性研究

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-10-01 Epub Date: 2025-06-25 DOI: 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}

引用次数: 0