Pub Date : 2025-09-01DOI: 10.1016/j.acuro.2025.501814
G. Sánchez-Villaseñor , E.A. Pérez-Du Pond , I. Jasso-García , S.J. Vázquez-Sánchez , R.C. García-Romero , J.P. Gómez-Sierra , M.G. Castillo Cardiel , A.S. Álvarez-Villaseñor , G. Cervantes-Guevara , E. Cervantes-Pérez , S. Ramírez-Ochoa , A. González-Ojeda , C. Fuentes-Orozco
Introduction
Renal cell carcinoma, ranked 14th in global incidence, is more common in men. Its incidence rates increase with age, peaking in individuals older than 75 years. The classic triad is present in only 17% of cases. Surgical management involves total or partial nephrectomy, both associated with potential complications.
Objective
To identify the clinical profile and risk factors in patients with renal cell carcinoma.
Methodology
An observational, cross-sectional, and analytical study was conducted on patients with renal cell carcinoma treated surgically in the Urology Department from January 2020 to June 2023. Demographic and clinical characteristics were analyzed in relation to TNM staging, histologic subtype, and morbidity and mortality.
Results
Among 83 patients, 48 (57%) were men, with a mean age of 59.2 years (SD 10.5). Hypertension (HTN) and obesity were the most frequent comorbidities, each affecting 37 patients (44.6%). Flank pain (37 patients, 44.6%) and hematuria (23 patients, 27.7%) were the most common manifestations. Age > 50 years was associated with advanced stages (P = .003, OR: 5.744, 95% CI: 1.698-19.424), while obesity was associated with a lower risk of advanced stages (P = .0042, OR: 0.220, 95% CI: 0.075-0.648). Complications of open nephrectomy included bleeding in 26 patients (38.8%) and organ injury in 2 patients (2.9%). Mortality was reported in 1 patient.
Conclusion
Age > 50 years is a risk factor for advanced stages, while obesity is associated with a lower risk. Hematuria and flank pain were common, whereas abdominal mass was rarely reported.
{"title":"Perfil clínico y factores de riesgo identificados en pacientes con cáncer renal en población mexicana","authors":"G. Sánchez-Villaseñor , E.A. Pérez-Du Pond , I. Jasso-García , S.J. Vázquez-Sánchez , R.C. García-Romero , J.P. Gómez-Sierra , M.G. Castillo Cardiel , A.S. Álvarez-Villaseñor , G. Cervantes-Guevara , E. Cervantes-Pérez , S. Ramírez-Ochoa , A. González-Ojeda , C. Fuentes-Orozco","doi":"10.1016/j.acuro.2025.501814","DOIUrl":"10.1016/j.acuro.2025.501814","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal cell carcinoma, ranked 14th in global incidence, is more common in men. Its incidence rates increase with age, peaking in individuals older than 75<!--> <!-->years. The classic triad is present in only 17% of cases. Surgical management involves total or partial nephrectomy, both associated with potential complications.</div></div><div><h3>Objective</h3><div>To identify the clinical profile and risk factors in patients with renal cell carcinoma.</div></div><div><h3>Methodology</h3><div>An observational, cross-sectional, and analytical study was conducted on patients with renal cell carcinoma treated surgically in the Urology Department from January 2020 to June 2023. Demographic and clinical characteristics were analyzed in relation to TNM staging, histologic subtype, and morbidity and mortality.</div></div><div><h3>Results</h3><div>Among 83 patients, 48 (57%) were men, with a mean age of 59.2 years (SD 10.5). Hypertension (HTN) and obesity were the most frequent comorbidities, each affecting 37 patients (44.6%). Flank pain (37 patients, 44.6%) and hematuria (23 patients, 27.7%) were the most common manifestations. Age ><!--> <!-->50<!--> <!-->years was associated with advanced stages (<em>P</em> <!-->=<!--> <!-->.003, OR: 5.744, 95%<!--> <!-->CI: 1.698-19.424), while obesity was associated with a lower risk of advanced stages (<em>P</em> <!-->=<!--> <!-->.0042, OR: 0.220, 95%<!--> <!-->CI: 0.075-0.648). Complications of open nephrectomy included bleeding in 26 patients (38.8%) and organ injury in 2 patients (2.9%). Mortality was reported in 1 patient.</div></div><div><h3>Conclusion</h3><div>Age ><!--> <!-->50<!--> <!-->years is a risk factor for advanced stages, while obesity is associated with a lower risk. Hematuria and flank pain were common, whereas abdominal mass was rarely reported.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501814"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922084","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 : 2025-07-01DOI: 10.1016/j.acuro.2025.501788
P. González-Peramato , M. Álvarez-Maestro , V. Heredia-Soto , M. Mendiola Sabio , E. Linares , Á. Serrano , J.L. Álvarez-Ossorio , E. López Alcina , L. Prieto , F. Vázquez Alonso , M. Aller Rodríguez , E. Berglund
Introduction
Prostate cancer (PCa) shows varied aggressiveness, complicating personalised treatment decisions. Traditional risk stratification systems rely on clinical parameters but may miss crucial genetic insights. The Prostatype® score (P-score) integrates gene expression with clinical data to improve PCa risk assessment precision.
Objectives
To validate the P-score's predictive performance for prostate cancer-specific mortality (PCSM) and metastasis in a Spanish cohort, comparing it with NCCN, D’Amico, and EAU systems.
Materials and Methods
This study was multicentre, retrospective and included seven Spanish hospitals. Of 154 core needle biopsies, 93 met RNA criteria, and for those, P-score was calculated based on IGFBP3, VGLL3, and F3 genes expression and clinical data.
The primary endpoint was PCa-specific mortality (PCSM), with secondary endpoints being development of metastasis, adverse pathology (AP), and International Society of Urological Pathology (ISUP) grading.
Results
The P-score demonstrated superior accuracy in predicting 10-year PCSM, with an AUC of 0.81 and a C-index of 0.75, outperforming NCCN (AUC 0.77, C-index 0.69) and D’Amico/EAU (AUC 0.70, C-index 0.62). For metastasis prediction, the P-score achieved a C-index of 0.77, significantly higher than NCCN, D’Amico, and EAU (0.58). Kaplan-Meier analysis underscored the P-score's ability to better stratify patients by risk, especially high-risk groups. Additionally, the P-score correlated with tumour burden, showing significant associations with positive biopsy cores (p = 0.017) and ISUP grade at radical prostatectomy (p = 0.0028).
Conclusions
In this Spanish cohort, the P-score outperformed traditional clinicopathological systems in predicting PCSM, development of metastasis, and pathological markers, supporting its clinical utility for more personalised PCa management.
{"title":"Comparación del P-score de Prostatype® y los modelos de riesgo tradicionales para predecir los resultados del cáncer de próstata en España","authors":"P. González-Peramato , M. Álvarez-Maestro , V. Heredia-Soto , M. Mendiola Sabio , E. Linares , Á. Serrano , J.L. Álvarez-Ossorio , E. López Alcina , L. Prieto , F. Vázquez Alonso , M. Aller Rodríguez , E. Berglund","doi":"10.1016/j.acuro.2025.501788","DOIUrl":"10.1016/j.acuro.2025.501788","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer (PCa) shows varied aggressiveness, complicating personalised treatment decisions. Traditional risk stratification systems rely on clinical parameters but may miss crucial genetic insights. The Prostatype® score (P-score) integrates gene expression with clinical data to improve PCa risk assessment precision.</div></div><div><h3>Objectives</h3><div>To validate the P-score's predictive performance for prostate cancer-specific mortality (PCSM) and metastasis in a Spanish cohort, comparing it with NCCN, D’Amico, and EAU systems.</div></div><div><h3>Materials and Methods</h3><div>This study was multicentre, retrospective and included seven Spanish hospitals. Of 154 core needle biopsies, 93 met RNA criteria, and for those, P-score was calculated based on <em>IGFBP3</em>, <em>VGLL3</em>, and <em>F3</em> genes expression and clinical data.</div><div>The primary endpoint was PCa-specific mortality (PCSM), with secondary endpoints being development of metastasis, adverse pathology (AP), and International Society of Urological Pathology (ISUP) grading.</div></div><div><h3>Results</h3><div>The P-score demonstrated superior accuracy in predicting 10-year PCSM, with an AUC of 0.81 and a C-index of 0.75, outperforming NCCN (AUC 0.77, C-index 0.69) and D’Amico/EAU (AUC 0.70, C-index 0.62). For metastasis prediction, the P-score achieved a C-index of 0.77, significantly higher than NCCN, D’Amico, and EAU (0.58). Kaplan-Meier analysis underscored the P-score's ability to better stratify patients by risk, especially high-risk groups. Additionally, the P-score correlated with tumour burden, showing significant associations with positive biopsy cores (p<!--> <!-->=<!--> <!-->0.017) and ISUP grade at radical prostatectomy (p<!--> <!-->=<!--> <!-->0.0028).</div></div><div><h3>Conclusions</h3><div>In this Spanish cohort, the P-score outperformed traditional clinicopathological systems in predicting PCSM, development of metastasis, and pathological markers, supporting its clinical utility for more personalised PCa management.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501788"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517658","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 : 2025-07-01DOI: 10.1016/j.acuro.2025.501785
U. Aydin , S. Cetin , M. Yavuz Koparal , C. Coskun , I.I. Gonul , S. Yesil , T.S. Sozen
Introduction and objectives
To investigate whether lymphovascular invasion (LVI) could be a factor in predicting recurrence and progression in patients with high and very high-risk non-muscle-invasive bladder cancer (NMIBC) who received Bacillus Calmette-Guérin (BCG) treatment.
Methods
Ninety-three patients with high and very high-risk NMIBC, diagnosed initially in our clinic, were treated with at least 1 year of BCG therapy, and they were followed up to assess recurrence and progression, comparing those with and without LVI at the time of diagnosis.
Results
In the entire cohort, LVI was present in 33 (35.5%) patients while absent in 60 (64.5%) patients. Among patients with LVI, 17 (51.5%) showed recurrence, and 11 (33.3%) showed progression. Statistically significant differences were observed in both recurrence and progression in patients with LVI compared to those without LVI (P < .001 and .04, respectively). Additionally, univariate and multivariate regression analysis revealed that the presence of LVI was an independent factor predicting recurrence (P = .001).
Conclusion
In our study, we demonstrated the importance of being cautious regarding recurrence and progression in patients with high and very high-risk NMIBC who also have LVI despite receiving standard treatment. We found that approximately one-third of these patients may experience recurrence within one year.
{"title":"La influencia de la invasión linfovascular en la recurrencia y progresión del cáncer vesical no músculo invasivo tratado con bacilo de Calmette-Guérin","authors":"U. Aydin , S. Cetin , M. Yavuz Koparal , C. Coskun , I.I. Gonul , S. Yesil , T.S. Sozen","doi":"10.1016/j.acuro.2025.501785","DOIUrl":"10.1016/j.acuro.2025.501785","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To investigate whether lymphovascular invasion (LVI) could be a factor in predicting recurrence and progression in patients with high and very high-risk non-muscle-invasive bladder cancer (NMIBC) who received Bacillus Calmette-Guérin (BCG) treatment.</div></div><div><h3>Methods</h3><div>Ninety-three patients with high and very high-risk NMIBC, diagnosed initially in our clinic, were treated with at least 1 year of BCG therapy, and they were followed up to assess recurrence and progression, comparing those with and without LVI at the time of diagnosis.</div></div><div><h3>Results</h3><div>In the entire cohort, LVI was present in 33 (35.5%) patients while absent in 60 (64.5%) patients. Among patients with LVI, 17 (51.5%) showed recurrence, and 11 (33.3%) showed progression. Statistically significant differences were observed in both recurrence and progression in patients with LVI compared to those without LVI (<em>P</em> <!--><<!--> <!-->.001 and .04, respectively). Additionally, univariate and multivariate regression analysis revealed that the presence of LVI was an independent factor predicting recurrence (<em>P</em> <!-->=<!--> <!-->.001).</div></div><div><h3>Conclusion</h3><div>In our study, we demonstrated the importance of being cautious regarding recurrence and progression in patients with high and very high-risk NMIBC who also have LVI despite receiving standard treatment. We found that approximately one-third of these patients may experience recurrence within one year.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501785"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517662","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 : 2025-07-01DOI: 10.1016/j.acuro.2025.501793
B. Nakdali Kassab , J.V. Segura Heras , M. Gómez Garberí , J.J. Pacheco Bru , M.A. Ortiz Gorraiz , J.J. Mira Solves
Introduction
Burnout syndrome is a significant occupational phenomenon among healthcare professionals, characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. Urologists, due to the demands of their specialty, are particularly vulnerable. This study aims to assess the prevalence and risk factors for burnout syndrome among urologists in Spain.
Method
A cross-sectional survey was conducted among 257 practicing urologists in Spain. Data were collected using the Maslach Burnout Inventory and additional demographic and occupational questions. Burnout was defined based on high emotional exhaustion combined with either high depersonalization or low personal accomplishment. Statistical analyses included univariate and multivariate logistic regression to identify significant predictors.
Results
In the study, the prevalence of burnout among Spanish urologists was 54.9%. Fewer years of experience and female gender were associated with higher burnout rates. Significant stressors included workload and work schedule. Despite the high prevalence, only one third of affected professionals sought psychological support.
Conclusions
Burnout is highly prevalent among Spanish urologists and poses serious risks to both healthcare professionals and patients. Its impact on patient care includes increased likelihood of medical errors, reduced quality of care and patient satisfaction. Targeted interventions and psychological support are urgently needed to address this issue.
{"title":"El síndrome de burnout en urólogos españoles: prevalencia, factores de riesgo e implicaciones para la salud mental","authors":"B. Nakdali Kassab , J.V. Segura Heras , M. Gómez Garberí , J.J. Pacheco Bru , M.A. Ortiz Gorraiz , J.J. Mira Solves","doi":"10.1016/j.acuro.2025.501793","DOIUrl":"10.1016/j.acuro.2025.501793","url":null,"abstract":"<div><h3>Introduction</h3><div>Burnout syndrome is a significant occupational phenomenon among healthcare professionals, characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. Urologists, due to the demands of their specialty, are particularly vulnerable. This study aims to assess the prevalence and risk factors for burnout syndrome among urologists in Spain.</div></div><div><h3>Method</h3><div>A cross-sectional survey was conducted among 257 practicing urologists in Spain. Data were collected using the Maslach Burnout Inventory and additional demographic and occupational questions. Burnout was defined based on high emotional exhaustion combined with either high depersonalization or low personal accomplishment. Statistical analyses included univariate and multivariate logistic regression to identify significant predictors.</div></div><div><h3>Results</h3><div>In the study, the prevalence of burnout among Spanish urologists was 54.9%. Fewer years of experience and female gender were associated with higher burnout rates. Significant stressors included workload and work schedule. Despite the high prevalence, only one third of affected professionals sought psychological support.</div></div><div><h3>Conclusions</h3><div>Burnout is highly prevalent among Spanish urologists and poses serious risks to both healthcare professionals and patients. Its impact on patient care includes increased likelihood of medical errors, reduced quality of care and patient satisfaction. Targeted interventions and psychological support are urgently needed to address this issue.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501793"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517904","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 : 2025-07-01DOI: 10.1016/j.acuro.2025.501790
O. Mar-Herrera, J. Llaca-Díaz, A. Flores-Aréchiga, N. Casillas-Vega
Introduction and objective
Urethritis is the most common sexually transmitted infection in men. Haemophilus influenzae and Haemophilus parainfluenzae, commensal microorganisms of the respiratory and oral tract, have been proposed as potential etiological agents of non-gonococcal urethritis (NGU). This study aimed to determine the prevalence of these species in urine samples from men with urethritis and analyze their clinical correlation.
Methods
A total of 200 urinary DNA samples from patients diagnosed with urethritis were analyzed. Microorganisms were identified through multiplex PCR, amplifying the P6 and 16S rRNA genes. Associations between risk factors and infection were evaluated by calculating odds ratios (OR) and 95% confidence intervals (CI) using OpenEpi 3.03a.
Results
The mean age of the population was 55 years (range 20-95). Among the participants, 32.5% had received prior sexual education, and 75% reported not using contraceptive methods. H. influenzae was not detected in any sample, whereas H. parainfluenzae was present in 9.5% (n = 19) of cases. Significant associations were identified with the absence of formal education, a history of more than ten sexual partners, masturbation, and sexual intercourse under the influence of alcohol and/or drugs.
Conclusions
Although H. influenzae and H. parainfluenzae have been rarely identified in urethritis, their high transmissibility and clinical relevance suggest the need for their detection in high-risk populations. Their identification may contribute to improving diagnosis and the implementation of therapeutic strategies.
{"title":"Detección molecular y relevancia clínica de Haemophilus spp. en uretritis masculina: prevalencia y factores asociados","authors":"O. Mar-Herrera, J. Llaca-Díaz, A. Flores-Aréchiga, N. Casillas-Vega","doi":"10.1016/j.acuro.2025.501790","DOIUrl":"10.1016/j.acuro.2025.501790","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Urethritis is the most common sexually transmitted infection in men. <em>Haemophilus influenzae</em> and <em>Haemophilus parainfluenzae</em>, commensal microorganisms of the respiratory and oral tract, have been proposed as potential etiological agents of non-gonococcal urethritis (NGU). This study aimed to determine the prevalence of these species in urine samples from men with urethritis and analyze their clinical correlation.</div></div><div><h3>Methods</h3><div>A total of 200 urinary DNA samples from patients diagnosed with urethritis were analyzed. Microorganisms were identified through multiplex PCR, amplifying the <em>P6</em> and <em>16S rRNA</em> genes. Associations between risk factors and infection were evaluated by calculating odds ratios (OR) and 95% confidence intervals (CI) using OpenEpi 3.03a.</div></div><div><h3>Results</h3><div>The mean age of the population was 55 years (range 20-95). Among the participants, 32.5% had received prior sexual education, and 75% reported not using contraceptive methods. <em>H. influenzae</em> was not detected in any sample, whereas <em>H. parainfluenzae</em> was present in 9.5% (n<!--> <!-->=<!--> <!-->19) of cases. Significant associations were identified with the absence of formal education, a history of more than ten sexual partners, masturbation, and sexual intercourse under the influence of alcohol and/or drugs.</div></div><div><h3>Conclusions</h3><div>Although <em>H. influenzae</em> and <em>H. parainfluenzae</em> have been rarely identified in urethritis, their high transmissibility and clinical relevance suggest the need for their detection in high-risk populations. Their identification may contribute to improving diagnosis and the implementation of therapeutic strategies.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501790"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517659","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 : 2025-07-01DOI: 10.1016/j.acuro.2025.501786
C. Mínguez Ojeda, A. Artiles Medina, A. Fraile Poblador, Á. Sánchez González, J.D. Subiela Henríquez, J. Brasero Burgos, I. de la Parra Sánchez, D. López Curtis, P. del Olmo Durán, A. Fernández-Mardomingo Díaz, M.Á. Jiménez Cidre, V. Gómez Dos Santos, F.J. Burgos Revilla
Introduction
Stress urinary incontinence (SUI) affects between 2.5% and 40% of patients after radical prostatectomy. Although the implantation of an artificial urinary sphincter (AUS) offers continence rates of 70-80%, its failure rate reaches 25% in some series. This single-center retrospective study analyzed the survival of AUS and the factors associated with its failure.
Materials and methods
A total of 145 patients treated with the AMS 800® device (Boston Scientific) between 2010 and 2023 were included. Kaplan-Meier analysis and the Cox proportional hazards model were used to evaluate device survival and identify predictive factors for failure.
Results
The mean age was 68.6 years; 28% of patients were smokers, 43.7% had diabetes, and 26.2% had undergone prior radiation therapy. Radical prostatectomy was the main cause of SUI (86.9%). In the majority of cases (91.5%), the artificial urinary sphincter was implanted around the bulbar urethra. During follow-up, 25.5% of patients required revision surgery. The probability of functional sphincter survival was 89% at 1 year, 78% at 2 years, 64% at 5 years, and 51% at 10 years. On multivariate analysis, prior radiation therapy (HR: 2.06; P=.029) and diabetes (HR: 2.24; P=.04]) were associated with poorer device survival.
Conclusions
The AUS is an effective and safe treatment for severe SUI, although radiotherapy and diabetes may adversely affect its durability.
{"title":"Análisis de la supervivencia del dispositivo y los factores predictivos de la misma en una cohorte de pacientes intervenidos de esfínter urinario artificial masculino","authors":"C. Mínguez Ojeda, A. Artiles Medina, A. Fraile Poblador, Á. Sánchez González, J.D. Subiela Henríquez, J. Brasero Burgos, I. de la Parra Sánchez, D. López Curtis, P. del Olmo Durán, A. Fernández-Mardomingo Díaz, M.Á. Jiménez Cidre, V. Gómez Dos Santos, F.J. Burgos Revilla","doi":"10.1016/j.acuro.2025.501786","DOIUrl":"10.1016/j.acuro.2025.501786","url":null,"abstract":"<div><h3>Introduction</h3><div>Stress urinary incontinence (SUI) affects between 2.5% and 40% of patients after radical prostatectomy. Although the implantation of an artificial urinary sphincter (AUS) offers continence rates of 70-80%, its failure rate reaches 25% in some series. This single-center retrospective study analyzed the survival of AUS and the factors associated with its failure.</div></div><div><h3>Materials and methods</h3><div>A total of 145 patients treated with the AMS 800® device (Boston Scientific) between 2010 and 2023 were included. Kaplan-Meier analysis and the Cox proportional hazards model were used to evaluate device survival and identify predictive factors for failure.</div></div><div><h3>Results</h3><div>The mean age was 68.6 years; 28% of patients were smokers, 43.7% had diabetes, and 26.2% had undergone prior radiation therapy. Radical prostatectomy was the main cause of SUI (86.9%). In the majority of cases (91.5%), the artificial urinary sphincter was implanted around the bulbar urethra. During follow-up, 25.5% of patients required revision surgery. The probability of functional sphincter survival was 89% at 1 year, 78% at 2 years, 64% at 5 years, and 51% at 10 years. On multivariate analysis, prior radiation therapy (HR: 2.06; <em>P</em>=.029) and diabetes (HR: 2.24; <em>P</em>=.04]) were associated with poorer device survival.</div></div><div><h3>Conclusions</h3><div>The AUS is an effective and safe treatment for severe SUI, although radiotherapy and diabetes may adversely affect its durability.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501786"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517660","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 : 2025-07-01DOI: 10.1016/j.acuro.2025.501791
J. Iregui-Parra , V. Rojas Ossa , C.M. Arias Salazar , A.D. López Estupiñán , D. Díaz Varela , L.M. Sinisterra Parra , L. Diéguez , E. Emiliani
Introduction and objectives
Nephrolithiasis is one of the most prevalent urological pathologies worldwide, with an increasing incidence and multifactorial etiology, particularly influenced by diet. Surgical interventions or extracorporeal shock wave lithotripsy (ESWL) are the cornerstone treatments. However, as emphasized by the EAU and AUA guidelines, post-surgical medical management is recommended to reduce recurrence risk. Phyllanthus niruri (PN), widely used in traditional medicine, has been extensively researched, yielding mixed results and presenting an opportunity to explore its role further. This review aims to evaluate PN's potential in enhancing treatment efficacy and reducing stone recurrence.
Materials and Methods
A systematic literature review was conducted, encompassing articles published from January 1994 to September 2022 in English and Spanish. The review included studies on humans and rats accessible through the authors’ institutional affiliations. Titles and abstracts were screened, and relevant studies were selected for in-depth analysis.
Results
Out of the 16 selected studies, various mechanisms of action for PN were identified, such as promoting glycosaminoglycan (GAG) aggregation, inhibiting nucleation processes, and altering stone density to favor a stone-free state (SFR). Evidence consistently supports PN's long-term safety, confirmed by serial measurements of serum electrolytes and liver function. Novel applications, such as PN as an adjuvant to ESWL, show benefits for lower renal pole stones.
Conclusions
Growing evidence suggests that PN, when used alongside traditional interventions, is safe, without significant adverse effects, and may improve SFR outcomes after ESWL.
{"title":"Phyllanthus niruri en el manejo de las litiasis urinarias: revisión sistemática de la literatura","authors":"J. Iregui-Parra , V. Rojas Ossa , C.M. Arias Salazar , A.D. López Estupiñán , D. Díaz Varela , L.M. Sinisterra Parra , L. Diéguez , E. Emiliani","doi":"10.1016/j.acuro.2025.501791","DOIUrl":"10.1016/j.acuro.2025.501791","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Nephrolithiasis is one of the most prevalent urological pathologies worldwide, with an increasing incidence and multifactorial etiology, particularly influenced by diet. Surgical interventions or extracorporeal shock wave lithotripsy (ESWL) are the cornerstone treatments. However, as emphasized by the EAU and AUA guidelines, post-surgical medical management is recommended to reduce recurrence risk. Phyllanthus niruri (PN), widely used in traditional medicine, has been extensively researched, yielding mixed results and presenting an opportunity to explore its role further. This review aims to evaluate PN's potential in enhancing treatment efficacy and reducing stone recurrence.</div></div><div><h3>Materials and Methods</h3><div>A systematic literature review was conducted, encompassing articles published from January 1994 to September 2022 in English and Spanish. The review included studies on humans and rats accessible through the authors’ institutional affiliations. Titles and abstracts were screened, and relevant studies were selected for in-depth analysis.</div></div><div><h3>Results</h3><div>Out of the 16 selected studies, various mechanisms of action for PN were identified, such as promoting glycosaminoglycan (GAG) aggregation, inhibiting nucleation processes, and altering stone density to favor a stone-free state (SFR). Evidence consistently supports PN's long-term safety, confirmed by serial measurements of serum electrolytes and liver function. Novel applications, such as PN as an adjuvant to ESWL, show benefits for lower renal pole stones.</div></div><div><h3>Conclusions</h3><div>Growing evidence suggests that PN, when used alongside traditional interventions, is safe, without significant adverse effects, and may improve SFR outcomes after ESWL.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501791"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517903","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 : 2025-07-01DOI: 10.1016/j.acuro.2025.501759
R. Monsonís-Usó , P. Ponce-Blasco , B. Amaya-Barroso , P. Martínez-Meneu , A. Sánchez-Llopis , L. Barrios-Arnau , C. Garau-Perelló , P. Juan , M. Rodrigo-Aliaga
Introduction
Abdominal wall closure defects represent a cause of morbidity and mortality in patients undergoing laparotomy.
Objective
The aim of this study was to determine the risk factors contributing to the appearance of abdominal wall closure defects in open radical cystectomy.
Methods
A retrospective, analytical, observational, descriptive study and multivariate analysis was conducted including patients who underwent open radical cystectomy for bladder cancer at the General University Hospital of Castellón between January 2018 and December 2021.
Results
A total of 80 patients were included. The mean age was 70 years, with 86.3% being men. Sixteen presented with an evisceration (20%). Risk factors in the multivariate analysis were age, history of vascular or coronary disease, preoperative albumin, hemodynamic instability, and surgical time. Eight patients presented with an eventration (10%). A higher body mass index and a lower preoperative hemoglobin level were associated with eventration.
Conclusion
The risk factors associated with abdominal wall closure defects are identifiable and preventable.
{"title":"Identificación de los factores de riesgo de evisceración en la cistectomía radical abierta","authors":"R. Monsonís-Usó , P. Ponce-Blasco , B. Amaya-Barroso , P. Martínez-Meneu , A. Sánchez-Llopis , L. Barrios-Arnau , C. Garau-Perelló , P. Juan , M. Rodrigo-Aliaga","doi":"10.1016/j.acuro.2025.501759","DOIUrl":"10.1016/j.acuro.2025.501759","url":null,"abstract":"<div><h3>Introduction</h3><div>Abdominal wall closure defects represent a cause of morbidity and mortality in patients undergoing laparotomy.</div></div><div><h3>Objective</h3><div>The aim of this study was to determine the risk factors contributing to the appearance of abdominal wall closure defects in open radical cystectomy.</div></div><div><h3>Methods</h3><div>A retrospective, analytical, observational, descriptive study and multivariate analysis was conducted including patients who underwent open radical cystectomy for bladder cancer at the General University Hospital of Castellón between January 2018 and December 2021.</div></div><div><h3>Results</h3><div>A total of 80 patients were included. The mean age was 70 years, with 86.3% being men. Sixteen presented with an evisceration (20%). Risk factors in the multivariate analysis were age, history of vascular or coronary disease, preoperative albumin, hemodynamic instability, and surgical time. Eight patients presented with an eventration (10%). A higher body mass index and a lower preoperative hemoglobin level were associated with eventration.</div></div><div><h3>Conclusion</h3><div>The risk factors associated with abdominal wall closure defects are identifiable and preventable.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501759"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517657","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 : 2025-07-01DOI: 10.1016/j.acuro.2025.501789
E. Kasperczyk , M. Lesicka , E. Reszka
Objective
To summarize the key findings of occupational exposures during aluminium production in cohort studies on bladder cancer published between 1979 and 2023.
Materials and methods
This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO. Study quality was evaluated using the Newcastle–Ottawa scale.
Results
The literature search identified 24 cohort studies examining the standardized incidence (SIR) and mortality ratios (SMR) of bladder cancer among aluminum production workers. Five of the 13 studies examined SIR (95% CI) and three of the 16 studies that examined SMR (95% CI) reported a statistically significant increased risk of bladder cancer among aluminum production workers. The highest SIR was recorded in the secondary aluminum smelter (2.85; 95% CI: 1.23–5.62), suggesting a significantly elevated risk. In aluminum reduction plants, the SIR was 1.82 (95% CI: 1.59–2.07), while in Söderberg plants, it was 1.69 (95% CI: 1.06–2.57) and 1.4 (95% CI: 1.0–1.9), respectively. For aluminum plants overall, the SIR was 1.30 (95% CI: 1.10–1.50). The results indicate an increased risk, with the highest SMR of 5.90 (95% CI: 1.58–15.1), suggesting a significantly elevated hazard in the secondary aluminum smelter. The other values—3.47 (95% CI: 1.25–9.62) for the aluminum smelter and 2.24 (95% CI: 1.77–2.79) for the aluminum reduction plant—also indicate an increased risk, albeit with varying degrees of statistical certainty.
Conclusion
The International Agency for Research on Cancer has classified aluminum production as a Group 1 carcinogenic activity, providing strong evidence of its association with bladder cancer. The studies primarily included workers from Prebake, Söderberg, and aluminum reduction plants. Some findings indicate a significant yet variable risk across different segments of aluminum production. However, the review did not clearly confirm an increased risk of bladder cancer in specific aluminum-related occupations. Aluminum exposure may influence the lifetime risk of bladder cancer among these workers.
{"title":"Riesgo de cáncer de vejiga en trabajadores de la industria del aluminio: una revisión sistemática","authors":"E. Kasperczyk , M. Lesicka , E. Reszka","doi":"10.1016/j.acuro.2025.501789","DOIUrl":"10.1016/j.acuro.2025.501789","url":null,"abstract":"<div><h3>Objective</h3><div>To summarize the key findings of occupational exposures during aluminium production in cohort studies on bladder cancer published between 1979 and 2023.</div></div><div><h3>Materials and methods</h3><div>This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO. Study quality was evaluated using the Newcastle–Ottawa scale.</div></div><div><h3>Results</h3><div>The literature search identified 24 cohort studies examining the standardized incidence (SIR) and mortality ratios (SMR) of bladder cancer among aluminum production workers. Five of the 13 studies examined SIR (95% CI) and three of the 16 studies that examined SMR (95% CI) reported a statistically significant increased risk of bladder cancer among aluminum production workers. The highest SIR was recorded in the secondary aluminum smelter (2.85; 95% CI: 1.23–5.62), suggesting a significantly elevated risk. In aluminum reduction plants, the SIR was 1.82 (95% CI: 1.59–2.07), while in Söderberg plants, it was 1.69 (95% CI: 1.06–2.57) and 1.4 (95% CI: 1.0–1.9), respectively. For aluminum plants overall, the SIR was 1.30 (95% CI: 1.10–1.50). The results indicate an increased risk, with the highest SMR of 5.90 (95% CI: 1.58–15.1), suggesting a significantly elevated hazard in the secondary aluminum smelter. The other values—3.47 (95% CI: 1.25–9.62) for the aluminum smelter and 2.24 (95% CI: 1.77–2.79) for the aluminum reduction plant—also indicate an increased risk, albeit with varying degrees of statistical certainty.</div></div><div><h3>Conclusion</h3><div>The International Agency for Research on Cancer has classified aluminum production as a Group 1 carcinogenic activity, providing strong evidence of its association with bladder cancer. The studies primarily included workers from Prebake, Söderberg, and aluminum reduction plants. Some findings indicate a significant yet variable risk across different segments of aluminum production. However, the review did not clearly confirm an increased risk of bladder cancer in specific aluminum-related occupations. Aluminum exposure may influence the lifetime risk of bladder cancer among these workers.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501789"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517902","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 : 2025-07-01DOI: 10.1016/j.acuro.2025.501756
C. Muller-Arteaga , L. Resel Folkersma , J. Medina-Polo , A.M. López García-Moreno , R. González López , C. García Sánchez , B. Madurga Patuel , C. Zubiaur Libano , P. Blasco Hernández , en representación del Grupo Registro de Cateterismo Limpio Intermitente en España (CILREG) (AEU-PIEM/2017/001)
Introduction
Clean intermittent catheterization (CIC) is a technique used for bladder emptying in patients with neurogenic or non-neurogenic lower urinary tract dysfunction. CIC is considered the best option for most patients with dysfunctional voiding, as it improves their quality of life with a low complication rate. However, there is considerable variability in the management of CIC across regions and countries, as well as a lack of standardized guidelines. This study aims to determine the patient profile, associated complications and resource utilization related to the procedure.
Methods
This descriptive, multicenter, cross-sectional study was conducted in the functional urology and urodynamics units of 23 hospitals across Spain between April 2019 and April 2021. Patient characteristics were collected and stored in the Multicenter Studies Research Platform of the Spanish Urology Association.
Results
This study included 573 CIC users, with a mean age of 54.1 years (SD 19.1). Of the participants, 78.6% lived in urban areas, and 53.9% had additional comorbidities. The primary indication for CIC was spinal cord injury (29.5%), followed by hypocontractile neurogenic bladder (20.8%). Most patients performed one CIC per day (87.3%), with a median of 3. The most common complication observed was urinary tract infection (51.8%). Additionally, 95.3% of patients attended at least one urology consultation in the past year.
Conclusions
CIC is mostly indicated for neurological pathologies, and urinary tract infection is the most common associated complication. CIC is a fundamental procedure in functional urology units and is linked to significant healthcare resource consumption. Knowledge on the patient profile and the characteristics associated with CIC is crucial for comprehensive patient management, as it helps reduce and prevent potential complications while also informing healthcare strategies for more efficient resource management.
{"title":"Perfil de los pacientes con cateterismo intermitente limpio y consumo de recursos asociados. Estudio multicéntrico en España","authors":"C. Muller-Arteaga , L. Resel Folkersma , J. Medina-Polo , A.M. López García-Moreno , R. González López , C. García Sánchez , B. Madurga Patuel , C. Zubiaur Libano , P. Blasco Hernández , en representación del Grupo Registro de Cateterismo Limpio Intermitente en España (CILREG) (AEU-PIEM/2017/001)","doi":"10.1016/j.acuro.2025.501756","DOIUrl":"10.1016/j.acuro.2025.501756","url":null,"abstract":"<div><h3>Introduction</h3><div>Clean intermittent catheterization (<span>C</span>I<span>C</span>) is a technique used for bladder emptying in patients with neurogenic or non-neurogenic lower urinary tract dysfunction. CIC is considered the best option for most patients with dysfunctional voiding, as it improves their quality of life with a low complication rate. However, there is considerable variability in the management of CIC across regions and countries, as well as a lack of standardized guidelines. This study aims to determine the patient profile, associated complications and resource utilization related to the procedure.</div></div><div><h3>Methods</h3><div>This descriptive, multicenter, cross-sectional study was conducted in the functional urology and urodynamics units of 23 hospitals across Spain between April 2019 and April 2021. Patient characteristics were collected and stored in the Multicenter Studies Research Platform of the Spanish Urology Association.</div></div><div><h3>Results</h3><div>This study included 573 CIC users, with a mean age of 54.1 years (SD 19.1). Of the participants, 78.6% lived in urban areas, and 53.9% had additional comorbidities. The primary indication for CIC was spinal cord injury (29.5%), followed by hypocontractile neurogenic bladder (20.8%). Most patients performed one CIC per day (87.3%), with a median of 3. The most common complication observed was urinary tract infection (51.8%). Additionally, 95.3% of patients attended at least one urology consultation in the past year.</div></div><div><h3>Conclusions</h3><div>CIC is mostly indicated for neurological pathologies, and urinary tract infection is the most common associated complication. CIC is a fundamental procedure in functional urology units and is linked to significant healthcare resource consumption. Knowledge on the patient profile and the characteristics associated with CIC is crucial for comprehensive patient management, as it helps reduce and prevent potential complications while also informing healthcare strategies for more efficient resource management.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501756"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517661","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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