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IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-06-01 DOI: 10.1016/j.acuro.2025.501739

R. Mehta , S. Kumar

引用次数: 0

Microbiota intestinal y cáncer de próstata: análisis de las comunidades bacterianas en distintos escenarios clínicos 肠道微生物群与前列腺癌：不同临床情景下的细菌群落分析

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-06-01 DOI: 10.1016/j.acuro.2025.501748

M. Carballo Quintá , S. Perez Castro , A. Freire Rodriguez , C. Daviña Nuñez , A. Bellas Pereira , J.J. Cabrera Alvargonzalez , M. Perez Schoch , C.A. Muller Arteaga , J.F. Sanchez Garcia , E. Cespón Outeda , E. Lopez Diez

Introduction and objectives

Gut microbiota (GM) comprises a diverse community of bacteria associated with a wide range of diseases. Emerging research indicates that GM dysbiosis may affect the progression of prostate cancer (PC) and its response to treatment. This study aimed to describe GM in patients with PC at various disease stages.

Materials and methods

A cross-sectional study was conducted at Complejo Hospitalario Universitario de Vigo between 2023 and 2024. 49 patients were classified into three groups: active surveillance (AS), disease-free post-treatment (DF) and advanced disease (AD). Faecal samples were obtained for GM analysis and DNA was used for 16S Rrna sequencing. The structure of the microbial community was examined via alpha and beta diversity analysis, and differential abundance was measured using the LinDA model.

Results

Alpha diversity analysis revealed diminished taxon richness in patients under AS and in those treated with androgen receptor pathway inhibitors (ARPI). Beta diversity analysis indicated substantial changes attributable to the treatment group, radiation, hormone therapy, and ARPI. The AD group had a diminished number of potentially advantageous bacteria (Methanobrevibacter, Paraprevotella, Colidextribacter) and an elevated abundance of Terrisporobacter and Streptococcus compared to the DF group. The AS group showed reduction in Intestinibacter, Adlercreutzia, Subdoligranulum, and Methanobrevibacter, along with an increase in Fusicatenibacter, Lachnospiraceae, and Lachnoclostridium.

Conclusions

Patients who remain disease-free after therapy have restored microbiota abundant in potential beneficial bacteria, in contrast to individuals with severe disease or those under active monitoring. This study indicates that gut microbiome characteristics could assist in risk assessment and act as possible treatment targets for prostate cancer.

肠道菌群（GM）包括与多种疾病相关的多种细菌群落。新的研究表明，基因失调可能影响前列腺癌（PC）的进展及其对治疗的反应。本研究旨在描述不同疾病阶段PC患者的GM。材料与方法横断面研究于2023年至2024年在维戈大学综合医院进行。49例患者分为主动监测组（AS）、无病后治疗组（DF）和晚期疾病组（AD）。取粪便样本进行转基因分析，采用DNA进行16S Rrna测序。通过α和β多样性分析研究了微生物群落结构，并用LinDA模型测量了差异丰度。结果pha多样性分析显示，AS患者和雄激素受体途径抑制剂（ARPI）治疗组的分类群丰富度降低。β多样性分析表明，治疗组、放疗、激素治疗和ARPI均有实质性变化。与DF组相比，AD组潜在有利细菌（Methanobrevibacter, Paraprevotella, Colidextribacter）的数量减少，而恐怖杆菌和链球菌的丰度升高。AS组显示无肠杆菌、克氏Adlercreutzia、Subdoligranulum和methanobrebacter减少，Fusicatenibacter、Lachnospiraceae和Lachnoclostridium增加。结论与严重疾病患者或积极监测的患者相比，治疗后无疾病的患者恢复了丰富的潜在有益菌群。这项研究表明，肠道微生物组特征可以帮助评估前列腺癌的风险，并作为可能的治疗靶点。

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引用次数: 0

Relación de los parámetros del tracto urinario inferior y el residuo posmiccional en grupos de edad pediátrica y adolescente: estudio de cohortes en un centro terciario de referencia 儿童和青少年组下尿路参数与尿后残留物的关系：三级参考中心的队列研究

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-06-01 DOI: 10.1016/j.acuro.2025.501752

Y.E. Genc , C.A. Sekerci , O.C. Ozkan , D. Dorucu , F. Arslan , R. Ergun , S. Yucel , T. Tarcan

Introduction and objectives

Uroflowmetry and postvoid residual urine volume measurement remain essential in evaluating patients with lower urinary tract dysfunction. The objective was to identify patients with a high risk of infection or renal damage based on the lower urinary tract parameters.

Materials and methods

Over a one-year period we investigated patients who had an indication for uroflowmetry and postvoid residual urine volume measurement between 5-18 years of age. All parameters were prospectively recorded. After the initial evaluation, patients were divided into increased/normal postvoid residual urine volume groups. Lower urinary tract parameters, urinary tract infection and hydronephrosis status were analyzed.

Results

A total of 176 girls and 140 boys with an age of 9 (5-16) were assessed. When increased (n = 135) / normal postvoid residual urine volume (n = 181) groups of patients were analysed, patients with a diagnosis of dysfunctional voiding, staccato and interrupted-shaped flow pattern, decreased Qavg, increased micrution duration, decreased daytime voiding frequency, and constipation were found to be prone to increased postvoid residual urine volume. A diagnosis of overactive bladder or dysfunctional voiding and high postvoid residual urine volume were both found to be related to infections.

Conclusions

We contributed to the literature by evaluating different types of lower urinary tract conditions and their clinical parameters to better understand the predisposing factors to detect patients at risk of infections or renal damage such as dysfunctional voiding, staccato and interrupted-shaped flow pattern, constipation, decreased Qavg, prolonged duration of micturition and decreased daytime voiding frequency regardless of age and gender status.

介绍和目的尿流量测定和空后残余尿量测量在评估下尿路功能障碍患者中仍然是必不可少的。目的是根据下尿路参数确定感染或肾损害高风险的患者。材料和方法在一年的时间里，我们调查了5-18岁之间有尿流仪和空后残余尿量测量指征的患者。前瞻性记录所有参数。初步评估后，将患者分为空后残余尿量增加/正常组。分析下尿路参数、尿路感染及肾积水情况。结果共对176名9岁（5 ~ 16岁）女孩和140名9岁男孩进行评估。当分析空后残余尿量增加(n = 135) /正常（n = 181）组患者时，发现诊断为排尿功能障碍、流型断断和中断、Qavg降低、微尿时间增加、白天排尿次数减少和便秘的患者易出现空后残余尿量增加。诊断为膀胱过度活动或排尿功能障碍以及排尿后残余尿量高均与感染有关。结论通过对不同类型的下尿路疾病及其临床参数进行评价，以更好地了解尿功能障碍、断流和断流型、便秘、Qavg降低、排尿时间延长、白天排尿次数减少等感染或肾损害风险患者的易感因素，并对其进行文献评价。

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引用次数: 0

¿Influye el tipo de anestesia en los resultados de la nefrolitotomía percutánea? Un metaanálisis de ensayos controlados aleatorizados 麻醉的类型会影响经皮肾结石切除术的结果吗？随机对照试验的荟萃分析

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-06-01 DOI: 10.1016/j.acuro.2025.501755

C. Giulioni , A. Singh , S.K. Yuen , C. Nedbal , V. de Stefano , E.J. Lim , M.L. Wroclawski , C.A. Chai , M. Maggi , A. Cafarelli , D. Castellani , R. Tp , A. Satapathy , V. Gauhar

Objective

To systematically review the outcomes of Percutaneous nephrolithotomy (PCNL) performed in local (LA) or regional anaesthesia (RA) as compared to general anaesthesia (GA).

Methods

Literature search was conducted on 12^th April 2024 including PubMed, Medline, Embase, and Scopus database. Complications were assessed using the Cochran-Mantel-Haenszel Method with the random effect model and reported as odds ratio (OR), 95% confidence interval (CI), and p-values. Analyses were two-tailed and the significance was set at P<.05 and a 95% CI. Continuous variables were pooled using the inverse variance of the mean difference with a random effect, 95% CI, and p-values.

Results

Fourteen studies were included. Overall, there were 1413 patients, with 703 patients in the LA/RA group and 710 in the GA group. There was no difference in Clavien grade I-II and ≥III complications, postoperative pain, postoperative headache, Operative Time, postoperative stay, stone-free rate, and intraoperative mean heart rate between LA/RA and GA. Meta-analysis shows that the Nausea and Vomiting rate favors the LA/RA group (OR 0.10), Blood Transfusion rate is lower in LA/RA group (OR 0.40), Intraoperative Blood Loss is lower in LA/RA group (MD −59.63 ml) and Intraoperative Mean Arterial Pressure is lower in LA/RA group (MD −10.80 mmHg).

Conclusions

This meta-analysis shows no difference in stone-free and complication rates or hospital stay if PCNL is done under GA or LA/RA. LA/RA offers advantages for better intraoperative hemodynamic stability with lesser post-operative nausea and vomiting. PCNL under RA adoption in clinical practice is perhaps limited to centers where specialist anesthetist services can support this procedure.

目的系统评价局部麻醉（LA）或区域麻醉（RA）下经皮肾镜取石术（PCNL）与全身麻醉（GA）的效果。方法于2024年4月12日检索PubMed、Medline、Embase、Scopus数据库。采用随机效应模型的Cochran-Mantel-Haenszel方法评估并发症，并以比值比（OR）、95%置信区间（CI）和p值报告。分析采用双尾分析，显著性设为P<；0.05和95% CI。使用随机效应、95% CI和p值的均值差的逆方差合并连续变量。结果共纳入14项研究。总的来说，共有1413例患者，其中LA/RA组703例，GA组710例。LA/RA和GA在Clavien I-II级和≥III级并发症、术后疼痛、术后头痛、手术时间、术后住院时间、结石清除率和术中平均心率方面无差异。meta分析显示，LA/RA组的恶心呕吐率优于LA/RA组（OR 0.10），输血率低于LA/RA组（OR 0.40），术中出血量低于LA/RA组（MD−59.63 ml），术中平均动脉压低于LA/RA组（MD−10.80 mmHg）。结论：本荟萃分析显示，在GA或LA/RA下进行PCNL在无结石和并发症发生率或住院时间方面没有差异。LA/RA具有术中血流动力学稳定性好、术后恶心呕吐少的优点。在临床实践中采用RA下的PCNL可能仅限于专科麻醉师服务可以支持该程序的中心。

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引用次数: 0

Enucleación prostática con láser holmium (HoLEP) En-bloc: experiencia inicial y consolidación de la técnica Holmium激光前列腺造影（HoLEP）嵌块：初步经验和技术巩固

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501745

J. Pineda-Murillo, O. Hernández-León, J.S. Cuéllar del Río, J.R. Arellano-Cuadros, G. Martínez-Carrillo, G.A. Quintero-Cortés, S.P. de la Paz-Martínez, J.C. Ávalos-Ramón, J.A. Lugo-García

Introduction and objectives

Benign prostatic enlargement has a prevalence of approximately 60% in 60-year-old men. En bloc enucleation and its variants, which emerged in 2010, are methods to enucleate the 3 lobes of the prostatic capsule completely, maintaining the capsular plane and the urethral sphincter while removing the prostate. The aim of the present study is to analyze the implementation of the surgical technique, considering the learning curve and the experience accumulated in a group of patients before and after its development.

Material and methods

Retrospective study from July 2022 to November 2024, in which 136 patients with lower urinary tract symptoms due to prostate growth with indication for surgical treatment were included. Bleeding, surgical time, hospital stay, enucleated prostate volume, as well as enucleation, morcellation, time and laser energy efficiencies were analyzed.

Results

The efficacy of the procedure was higher in the post-curve group with a P < 0.0001 compared to the pre-curve group with a coefficient of determination R² = 0.8091. Enucleation efficiencies, laser time and energy showed a statistically significant difference (P 0.05) in favor of the post-curve group.

Conclusions

Holmium laser enucleation of the prostate has proven to be an effective and safe surgical treatment, even during the learning curve. The turning point of the procedure depends on proper mentoring and the appropriate selection of cases during the training process.

简介和目的良性前列腺增大在60岁男性中的患病率约为60%。En bloc enucation及其变体于2010年出现，是指在切除前列腺的同时将前列腺包膜的3叶完全去核，保留包膜平面和尿道括约肌的方法。本研究的目的是分析该手术技术的实施情况，考虑其发展前后一组患者的学习曲线和经验积累。材料与方法回顾性研究于2022年7月至2024年11月，纳入136例因前列腺增生而出现下尿路症状并有手术指征的患者。分析出血、手术时间、住院时间、去核前列腺体积以及去核、碎裂、时间和激光能量效率。结果术后P <组手术疗效显著；与曲线前组相比为0.0001，决定系数R2 = 0.8091。曲线后组去核效率、激光时间和能量差异有统计学意义（p0.05）。结论钬激光前列腺摘除是一种安全有效的手术治疗方法，即使在学习阶段也是如此。该程序的转折点取决于在培训过程中适当的指导和适当的案例选择。

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引用次数: 0

Precisión de Bladder EpiCheck en el diagnóstico del carcinoma urotelial del tracto urinario superior: un metaanálisis 膀胱EpiCheck在上尿道输尿管癌诊断中的准确性：荟萃分析

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501720

S. Artero Fullana , J. Caño Velasco , A. Lafuente Puentedura , L. Polanco Pujol , V. Bataller Monfort , M. Moralejo Gárate , J.D. Subiela , A. Gallioli , M. Moschini , R. Pichler , F. del Giudice , G. Marcq , J. Teoh , F. Soria , L. Mertens , W. Krajewski , E. Laukhtina , K. Mori , B. Pradere , L. Afferi , C. Hernández Fernández

Introduction and objective

Current upper tract urothelial carcinoma (UTUC) diagnosis and disease management rely on the combination of CT Urography (CTU), cytology and ureteroscopy (URS). The limited accuracy and complications associated with these tools have led to the search for non-invasive and reliable biomarkers. Our aim was to review and analyse the existing data on the use of Bladder EpiCheck® to assess its performance as a diagnostic tool for UTUC.

Material and methods

A literature search on the diagnostic value of Bladder EpiCheck® as a urinary biomarker in UTUC was conducted through PubMed, Web of Science and Scopus until February 2024. Pooled sensitivity (Se), specificity (Sp), negative predictive value (NPV) and positive predictive value (PPV) of the biomarker were calculated. Diagnostic performance was assessed through the area under the curve (AUC).

Results

Four studies, including 334 patients, were included in the quantitative analysis. Bladder EpiCheck® showed promising pooled diagnostic values with Se of 0.85 (95% CI: 0.55-0.96), Sp of 0.93 (95% CI: 0.56-0.99), PPV of 0.74 (95% CI: 0.54-0.87) and NPV of 0.84 (95% CI: 0.77-0.89). The exact AUC obtained was 0.912.

Conclusions

Bladder EpiCheck® is an effective diagnostic tool in UTUC, showing a promising diagnostic accuracy, with a Se and NPV of 85% and 84%, respectively. Its use in UTUC diagnosis and follow-up could reduce or postpone the need for more invasive procedures, such as URS, thereby reducing the procedure-associated risks and improving patients’ quality of life. Although further research and large prospective studies are needed, the current results indicate that Bladder EpiCheck® is a promising tool in UTUC diagnosis, treatment decision-making, and follow-up.

简介与目的目前上尿路上皮癌（UTUC）的诊断和治疗依赖于CT尿路造影（CTU）、细胞学和输尿管镜检查（URS）的结合。这些工具有限的准确性和相关的并发症促使人们寻找非侵入性和可靠的生物标志物。我们的目的是回顾和分析膀胱EpiCheck®使用的现有数据，以评估其作为UTUC诊断工具的性能。材料与方法通过PubMed、Web of Science和Scopus检索膀胱EpiCheck®作为尿液生物标志物在UTUC诊断价值的文献，检索截止至2024年2月。计算该生物标志物的综合敏感性（Se）、特异性（Sp）、阴性预测值（NPV）和阳性预测值（PPV）。通过曲线下面积（AUC）评估诊断效果。结果纳入4项研究，共纳入334例患者。膀胱EpiCheck®显示出有希望的综合诊断价值，Se为0.85 (95% CI: 0.55-0.96)， Sp为0.93 (95% CI: 0.56-0.99)， PPV为0.74 (95% CI: 0.54-0.87)， NPV为0.84 （95% CI: 0.77-0.89）。得到的精确AUC为0.912。结论膀胱EpiCheck®是一种有效的诊断UTUC的工具，其Se和NPV分别为85%和84%，具有良好的诊断准确性。它在UTUC诊断和随访中的应用可以减少或推迟对更具侵入性的手术的需要，例如尿路手术，从而减少手术相关的风险，提高患者的生活质量。虽然还需要进一步的研究和大规模的前瞻性研究，但目前的结果表明，膀胱EpiCheck®在UTUC的诊断、治疗决策和随访中是一个很有前景的工具。

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引用次数: 0

Biopsia dinámica de ganglio centinela en cáncer de pene: 25 años de experiencia en un centro oncológico terciario 阴茎癌前哨节动态活检：在三级肿瘤中心25年的经验

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501721

C. Rodríguez , M. Hassi , Á. García , A. Calatrava , P. De Pablos-Rodríguez , J. Casanova , Á. Gómez-Ferrer

Introduction

Penile cancer lymph node (LN) metastases are critical prognostic factors. The European Association of Urology (EAU) guidelines recommend dynamic sentinel node biopsy (DSNB) as a less invasive alternative for cN0 patients with intermediate- to high-risk tumors. Due to the rarity of penile cancer, lymph node staging tends to be underutilized, and few centers have a significant number of patients to develop the DSNB technique and observe its evolution over time. Previously, our series reported a sensitivity of 66%, and our aim is to contribute to the available evidence, based on 25 years of real-world experience.

Materials and methods

Retrospective single-center study involving 95 groins of 51 patients with intermediate or high-risk penile squamous carcinoma, who underwent DSNB between November 1999 and July 2024. Clinical data, including histology, surgical treatment, and complications, were analyzed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Complications were registered using the Clavien-Dindo system.

Results

The median age of patients was 60 (range 30 – 84) years. 10/51 patients (21%) had metastatic sentinel node. DSNB successfully identified sentinel nodes in 95.7% for right and 89.5% for left groins. The false-negative rate was 8.1%, with a sensitivity of 77%, specificity of 100%, PPV of 100%, and NPV of 92%. 18% (9/51) of patients suffered complications being most of them minor (6/9), 3 patients experimented major complications.

Discussion and conclusion

The updated DSNB outcomes show improved diagnostic accuracy compared to previous reports, reflecting enhanced techniques and learning curves. The study highlights the accuracy and the low morbidity of DSNB.

阴茎癌淋巴结（LN）转移是预后的关键因素。欧洲泌尿外科协会（EAU）指南推荐动态前哨淋巴结活检（DSNB）作为一种侵袭性较小的替代方案，用于cN0患者中至高危肿瘤。由于阴茎癌的罕见性，淋巴结分期往往未被充分利用，很少有中心有大量患者发展DSNB技术并观察其随时间的发展。之前，我们的系列报告敏感度为66%，我们的目标是根据25年的实际经验，为现有证据做出贡献。材料与方法回顾性单中心研究，纳入1999年11月至2024年7月间行DSNB的51例中、高危阴茎鳞状癌患者的95个腹股沟。分析临床资料，包括组织学、手术治疗和并发症。计算敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。使用Clavien-Dindo系统记录并发症。结果患者年龄中位数为60岁（30 ~ 84岁）。10/51例（21%）有前哨淋巴结转移。DSNB成功识别右侧和左侧腹股沟前哨淋巴结的成功率分别为95.7%和89.5%。假阴性率为8.1%，敏感性为77%，特异性为100%，PPV为100%，NPV为92%。18%（9/51）的患者出现并发症，其中大多数为轻微并发症（6/9），3例出现严重并发症。讨论与结论与之前的报道相比，更新的DSNB结果显示诊断准确性提高，反映了技术和学习曲线的改进。该研究强调了DSNB的准确性和低发病率。

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引用次数: 0

Valor de HCY, c-sdLDL, creatinina, IL-6 y PSA en el diagnóstico de la hiperplasia prostática benigna en el anciano HCY、c-sdLDL、肌酐、IL-6和PSA在老年人良性前列腺增生诊断中的值

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501744

W. Qin, S. Liu, L. Liu, M. Liu, J. Chen, P. Dai

Objective

To investigate the diagnostic value of serum metabolic markers such as HCY, sdLDL-C, Crea, inflammatory factor IL-6 and prostate-specific antigen in elderly patients with prostatic hyperplasia (BPH).

Methods

150 senile patients with hyperplasia of prostate were selected as observation group and 169 healthy senile patients were selected as control group. The tPSA, fPSA, fPSA/tPSA and prostate size data of the two groups were collected, and serum samples of the subjects were collected for the detection of HCY, sdLDL, Crea, IL-6 and other indicators. Univariate analysis, correlation analysis and logistic regression analysis were conducted to analyze the relationship between each index and senility prostatic hyperplasia. The diagnostic efficiency of each serum metabolite was analyzed by receiver operating characteristic curve (ROC).

Results

Serum levels of tPSA, fPSA, Crea, HCY, sdLDL-C and IL-6 were significantly increased, fPSA/tPSA ratio and HDL were significantly decreased, and TCHO, TG and LDL had no statistical significance. Serum tPSA and fPSA levels were positively correlated with prostate size, serum IL-6, Crea and HCY levels were positively correlated with tPSA and fPSA levels, and serum sdLDL-C levels were negatively correlated with fPSA levels. Logistic regression analysis showed that tPSA, fPSA, prostate size, HCY, Crea and IL-6 were risk factors for prostate hyperplasia. HDL and fPSA/tPSA are protective factors for benign prostatic hyperplasia. ROC curve analysis showed that the sensitivity and specificity of fPSA/tPSA and IL-6 were 82.7% and 72%, 83.4% and 80.5%, and the area under ROC curve were 0.840 and 0.825, respectively. tPSA and fPSA combined with HCY, IL-6 and Crea had the best diagnostic efficiency, with the area under ROC curve reaching 0.881, specificity and sensitivity reaching 84% and 77.3%, respectively.

Conclusion

The combined detection of prostate-specific antigen, HCY, Crea and IL-6 can significantly improve the diagnostic efficiency of senile prostatic hyperplasia, and optimize the diagnosis and treatment scheme can even be used as a major screening index to evaluate and predict the incidence of BPH in senile prostatic hyperplasia.

目的探讨血清代谢指标HCY、sdLDL-C、Crea、炎性因子IL-6、前列腺特异性抗原对老年前列腺增生（BPH）的诊断价值。方法选择老年前列腺增生患者150例作为观察组，健康老年患者169例作为对照组。收集两组患者的tPSA、fPSA、fPSA/tPSA及前列腺大小数据，采集受试者血清样本检测HCY、sdLDL、Crea、IL-6等指标。采用单因素分析、相关分析和logistic回归分析分析各指标与老年性前列腺增生的关系。采用受试者工作特征曲线（ROC）分析各血清代谢物的诊断效能。结果患者血清tPSA、fPSA、Crea、HCY、sdLDL-C、IL-6水平均显著升高，fPSA/tPSA比值、HDL显著降低，TCHO、TG、LDL水平差异均无统计学意义。血清tPSA、fPSA水平与前列腺大小呈正相关，血清IL-6、Crea、HCY水平与tPSA、fPSA水平呈正相关，血清sdLDL-C水平与fPSA水平呈负相关。Logistic回归分析显示tPSA、fPSA、前列腺大小、HCY、Crea、IL-6是前列腺增生的危险因素。HDL和fPSA/tPSA是良性前列腺增生的保护因子。ROC曲线分析显示，fPSA/tPSA和IL-6的敏感性和特异性分别为82.7%和72%，83.4%和80.5%，ROC曲线下面积分别为0.840和0.825。tPSA和fPSA联合HCY、IL-6和Crea的诊断效果最好，ROC曲线下面积为0.881，特异性和敏感性分别为84%和77.3%。结论前列腺特异性抗原、HCY、Crea、IL-6联合检测可显著提高老年性前列腺增生的诊断效率，优化诊断和治疗方案，甚至可作为评价和预测老年性前列腺增生中BPH发生的主要筛查指标。

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引用次数: 0

ADN tumoral circulante en el cáncer de vejiga músculo invasivo: una revisión sistemática 侵袭性肌肉膀胱癌的循环肿瘤DNA：系统综述

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501717

A.A. Grosso , A. Cadenar , S. Pillozzi , G. Carli , F. Lipparini , F. Di Maida , R. Pichler , W. Krajewski , S. Albisinni , E. Laukhtina , S. Mancon , F. del Giudice , M.C. Mir , F. Soria , M. Moschini , S.F. Shariat , M. Roupret , J. Yuen-Chun Teoh , L. Antonuzzo , A. Breda , A. Mari

Objectives

To evaluate the role of circulating tumor DNA (ctDNA) as a prognostic and predictive biomarker in the perioperative management of muscle-invasive bladder cancer (MIBC).

Methods

We conducted a systematic literature review using PubMed, Medline, and Embase, following PRISMA guidelines. Studies from January 2013 to March 2024 were included if they examined ctDNA in MIBC patients undergoing radical cystectomy (RC) and perioperative chemotherapy or immunotherapy.

Results

Eight studies were included. ctDNA detected before RC was associated with poor recurrence-free survival and higher risk of nodal and locally advanced disease. Postoperative ctDNA levels correlated with shorter disease-free survival and higher recurrence rates. ctDNA clearance during neoadjuvant chemotherapy was predictive of treatment response. ctDNA status post-neoadjuvant immunotherapy correlated with pathological outcomes and recurrence rates.

Conclusions

ctDNA is a promising biomarker for predicting oncological outcomes in MIBC, with potential to guide perioperative treatment decisions. Further randomized controlled trials are needed to validate these findings.

目的评价循环肿瘤DNA （ctDNA）在肌肉浸润性膀胱癌（MIBC）围手术期治疗中作为预后和预测性生物标志物的作用。方法按照PRISMA指南，使用PubMed、Medline和Embase进行了系统的文献综述。2013年1月至2024年3月的研究纳入了接受根治性膀胱切除术（RC）和围手术期化疗或免疫治疗的MIBC患者的ctDNA检测。结果共纳入8项研究。在RC之前检测到ctDNA与较差的无复发生存和较高的淋巴结和局部晚期疾病风险相关。术后ctDNA水平与较短的无病生存期和较高的复发率相关。新辅助化疗期间ctDNA清除可预测治疗反应。新辅助免疫治疗后ctDNA状态与病理结果和复发率相关。结论dna是一种很有前景的生物标志物，可用于预测MIBC的肿瘤预后，并有可能指导围手术期的治疗决策。需要进一步的随机对照试验来验证这些发现。

{"title":"ADN tumoral circulante en el cáncer de vejiga músculo invasivo: una revisión sistemática","authors":"A.A. Grosso , A. Cadenar , S. Pillozzi , G. Carli , F. Lipparini , F. Di Maida , R. Pichler , W. Krajewski , S. Albisinni , E. Laukhtina , S. Mancon , F. del Giudice , M.C. Mir , F. Soria , M. Moschini , S.F. Shariat , M. Roupret , J. Yuen-Chun Teoh , L. Antonuzzo , A. Breda , A. Mari","doi":"10.1016/j.acuro.2025.501717","DOIUrl":"10.1016/j.acuro.2025.501717","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the role of circulating tumor DNA (ctDNA) as a prognostic and predictive biomarker in the perioperative management of muscle-invasive bladder cancer (MIBC).</div></div><div><h3>Methods</h3><div>We conducted a systematic literature review using PubMed, Medline, and Embase, following PRISMA guidelines. Studies from January 2013 to March 2024 were included if they examined ctDNA in MIBC patients undergoing radical cystectomy (RC) and perioperative chemotherapy or immunotherapy.</div></div><div><h3>Results</h3><div>Eight studies were included. ctDNA detected before RC was associated with poor recurrence-free survival and higher risk of nodal and locally advanced disease. Postoperative ctDNA levels correlated with shorter disease-free survival and higher recurrence rates. ctDNA clearance during neoadjuvant chemotherapy was predictive of treatment response. ctDNA status post-neoadjuvant immunotherapy correlated with pathological outcomes and recurrence rates.</div></div><div><h3>Conclusions</h3><div>ctDNA is a promising biomarker for predicting oncological outcomes in MIBC, with potential to guide perioperative treatment decisions. Further randomized controlled trials are needed to validate these findings.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501717"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890638","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

Análisis de satisfacción de las parejas femeninas de pacientes con implante de prótesis de pene 阴茎假体植入患者的女性伴侣满意度分析

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas

Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501713

C. Calzas Montalvo , M. Alonso Isa , M. Lo Re , M.P. Caro González , S. Juste Álvarez , A. de la Calle Moreno , C. García-Rayo Encina , I. González Ginel , J. Romero Otero , A. Rodríguez Antolín , B. García Gómez

Introduction and objectives

There is limited evidence regarding sexual satisfaction among female partners of patients with penile prosthesis (PP) and factors influencing it.

Materials and methods

Single-center, retrospective, observational study including all patients aged ≥18 years who underwent PP implantation (inflatable and malleable types) between October 2007-December 2022 at Hospital 12 de Octubre, Madrid, Spain. 73 female partners completed the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire (5-item partner version). Each question was scored from 0 (lowest satisfaction) to 4 (highest satisfaction), resulting in an overall EDITS score ranging from 0 to 100. Variables collected: time since surgery, monthly intercourse frequency, type and brand of PP, initial placement rationale, new versus replacement surgery, total and inflatable PP part length.

Results

Average (standard deviation) scores were: 3.3 (0.9), 3.19 (0.9), 2.42 (0.8), 3.45 (0.9), and 3.67 (0.8). The overall average satisfaction score was 80 (12.4). Statistical analysis revealed no significant correlations between female partners’ satisfaction and their age (r = -0.128), actual age of the patient (r = -0.041), time since surgery (r = -0.072), monthly intercourse frequency (r = 0.164), type of PP (p = 0.521), brand of inflatable PP (p = 0.582), causes of erectile dysfunction (p = 0.174), number of replacements (p = 0.705), total (r = 0.167) or inflatable PP part length (r = 0.134).

Conclusions

Sexual satisfaction among female partners in our cohort is high but we did not demonstrate any predictors of couple satisfaction.

前言与目的关于阴茎假体（PP）患者女性伴侣的性满意度及其影响因素的证据有限。材料与方法单中心、回顾性、观察性研究，纳入2007年10月至2022年12月在西班牙马德里12 de ocbre医院接受PP植入（充气型和可塑型）的年龄≥18岁的患者。73名女性伴侣完成了勃起功能障碍治疗满意度调查表（EDITS）（5项伴侣版）。每个问题的得分从0（最低满意度）到4（最高满意度），导致总体edit得分从0到100。收集的变量：手术后时间，每月性交频率，PP的类型和品牌，初次放置的理由，新手术与替代手术，总PP部分长度和充气PP部分长度。结果平均（标准差）得分分别为：3.3（0.9）、3.19（0.9）、2.42（0.8）、3.45（0.9）、3.67（0.8）。总体平均满意度为80分（12.4分）。统计分析显示，女性伴侣满意度与年龄（r = -0.128）、患者实际年龄（r = -0.041）、术后时间（r = -0.072）、每月性交次数（r = 0.164）、PP类型（p = 0.521）、充气PP品牌（p = 0.582）、勃起功能障碍原因（p = 0.174）、更换次数（p = 0.705）、总数（r = 0.167）、充气PP部分长度（r = 0.134）无显著相关。结论在我们的队列中，女性伴侣的性满意度很高，但我们没有证明任何预测夫妻满意度的因素。

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引用次数: 0