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Dominando la curva: avances y desafíos en la enseñanza de la enucleación endoscópica de la próstata 主导曲线:内窥镜前列腺增生教育的进展和挑战
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501695
I. Schwartzmann
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引用次数: 0
Cirugía laparoscópica oncológica renal en pacientes de 85 años o mayor edad 对85岁或85岁以上患者进行肾肿瘤腹腔镜手术
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501688
P. Izquierdo , J. Huguet , A. Bravo-Balado , S. Fontanet , A. Farré , R. Sánchez , J.M. Gaya , Ó. Rodríguez-Faba , J. Palou , A. Breda

Objective

To analyze our series of radical nephrectomies and laparoscopic nephroureterectomies in elderly patients.

Materials and methods

A retrospective review of patients aged 85 years and older who underwent major laparoscopic surgery for renal tumors at our center between April 2005 and March 2022 was conducted. Clinical-pathological characteristics, complications, and postoperative outcomes were analyzed.

Results

Forty-seven patients were included, with a median age of 87 years. Fifteen nephrectomies for renal tumors (Group 1), and 32 nephroureterectomies for urinary tract tumors (Group 2) were performed. In Group 1, 4 postoperative complications were observed: 2 Clavien 1, one Clavien 2, and one Clavien 4a. The most common histology was clear cell carcinoma; 9 patients had locally advanced tumors (TNM  T3) at diagnosis. Five-year cancer-specific survival and overall survival rates were 73% and 40%, respectively. In Group 2, 14 postoperative complications occurred: 6 (18.8%) Clavien 1, 4 (12.5%) Clavien 2, and 5 (15.6%) Clavien 5. All patients had urothelial carcinoma in their pathology reports. Twenty (62.5%) had invasive tumors (TNM  T2) at diagnosis. Five-year cancer-specific survival and overall survival rates were 45% and 30%, respectively.

Conclusion

Laparoscopic renal oncologic surgery in elderly patients is feasible, although it is associated with a high morbimortality rate, particularly in those with urinary tract tumors. It is essential to provide this patient group with adequate information regarding the elevated surgical risks associated with the procedure.
目的分析我院系列根治性肾切除术和腹腔镜肾输尿管切除术在老年患者中的应用。材料与方法回顾性分析2005年4月至2022年3月在我中心行大腹腔镜肾肿瘤手术的85岁及以上患者。分析临床病理特征、并发症及术后结果。结果纳入47例患者,中位年龄87岁。1组15例肾肿瘤切除术,2组32例尿路肿瘤肾输尿管切除术。1组术后并发症4例:Clavien 1 2例,Clavien 2 1例,Clavien 4a 1例。最常见的组织学为透明细胞癌;9例确诊为局部晚期肿瘤(TNM≥T3)。5年癌症特异性生存率和总生存率分别为73%和40%。2组术后并发症14例,Clavien 1 6例(18.8%),Clavien 2 4例(12.5%),Clavien 5 5例(15.6%)。所有患者病理报告均为尿路上皮癌。诊断时有浸润性肿瘤(TNM≥T2) 20例(62.5%)。5年癌症特异性生存率和总生存率分别为45%和30%。结论腹腔镜肾肿瘤手术在老年患者中是可行的,但其死亡率较高,特别是尿路肿瘤患者。向这组患者提供与手术相关的手术风险升高的充分信息是至关重要的。
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引用次数: 0
Experiencia clínica inicial con PET-TAC Zr-Girentuximab para valoración de masas renales en pacientes con riñones solitarios PET-TAC Zr-Girentuximab用于孤肾患者肾量评估的初步临床经验
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501691
D.A. González-Padilla , D. Sánchez Zalabardo , E.F. Fernando-Valderrama , F. Villacampa-Aubá
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引用次数: 0
Nuevos factores de riesgo de tromboembolismo venoso después de la resección transuretral de tumor vesical: modelos de regresión multivariable escalonada y LASSO basados en datos de reclamaciones de seguros de EE. UU. 经尿道膀胱肿瘤切除后静脉血栓栓塞的新风险因素:分级多变量回归模型和基于美国保险索赔数据的LASSO哦。
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501738
J. Łaszkiewicz , F. del Giudice , S. Li , W. Krajewski , Ł. Nowak , T. Szydełko , S. Basran , E. De Berardinis , D. Carino , R. Corvino , V. Santerelli , M. Ferro , B. Rocco , M.C. Sighinolfi , F. Crocetto , B. Barone , F. Dinacci , R. Pichler , J.D. Subiela , B. Pradere , B.I. Chung

Introduction and Objectives

Transurethral resection of the bladder tumor (TURBT) is a standard procedure in bladder cancer (BC), which is associated with low risk of venous thrombo-embolism (VTE). The aim of this study was to find the predictors of postoperative VTE in patients undergoing TURBT for BC.

Materials and Methods

In this retrospective cohort analysis, patients aged ≥18 years with BC diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de-identified databases in 2007-2021. Patients with prior VTE events were excluded. Preoperative diagnostic codes and outpatient prescriptions present in at least 1% of the cohort were recorded (205 variables). Then, logistic regressions were performed including each variable separately, all variables together, as well as variables selected by stepwise and Least Absolute Shrinkage and Selection Operator (LASSO) selection methods. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated.

Results

In total, 132,425 patients were included in this study, with 1,959 (1.5%) individuals diagnosed with postoperative VTE. Various malignant neoplasms diagnosed before BC were significant risk factors of postoperative VTE, with aOR reaching up to 2.26 (95% CI: 1.96-2.61). Another strong predictor of VTE was a diagnosis of nephritis, nephrotic syndrome, and nephrosis (aOR: 1.67; 95% CI: 1.48-1.87 stepwise; aOR: 1.65; 95% CI: 1.46-1.85 LASSO). Also, patients with diseases of the urinary system, non-specific symptoms, diseases of the respiratory system, anemias, and other cardiovascular diseases were associated with increased VTE risk. Regarding drugs, antidiabetic agents and gastrointestinal drugs reduced the probability of VTE.

Conclusions

Numerous preoperative factors have influence on the risk of VTE after TURBT. These findings might facilitate the clinical decision about the implementation of thromboprophylaxis in the appropriate patients.
前言与目的经尿道膀胱肿瘤切除术(turt)是膀胱癌(BC)的标准手术,与静脉血栓栓塞(VTE)的低风险相关。本研究的目的是寻找行TURBT治疗BC患者术后静脉血栓栓塞的预测因素。材料和方法在这项回顾性队列分析中,年龄≥18岁的BC诊断接受TURBT的患者在2007-2021年的Merative®Marketscan®Research去识别数据库中被识别出来。排除既往有静脉血栓栓塞事件的患者。记录了至少1%队列患者的术前诊断代码和门诊处方(205个变量)。然后,分别对每个变量进行logistic回归,对所有变量进行logistic回归,对逐步回归和最小绝对收缩和选择算子(LASSO)选择方法选择的变量进行logistic回归。计算校正优势比(aOR)和95%可信区间(CI)。结果本研究共纳入132425例患者,其中1959例(1.5%)被诊断为术后静脉血栓栓塞。BC前诊断的各种恶性肿瘤是术后静脉血栓栓塞的重要危险因素,aOR高达2.26 (95% CI: 1.96 ~ 2.61)。静脉血栓栓塞的另一个强预测因子是肾炎、肾病综合征和肾病的诊断(aOR: 1.67;95% CI: 1.48-1.87;优势:1.65;95% ci: 1.46-1.85套索)。此外,患有泌尿系统疾病、非特异性症状、呼吸系统疾病、贫血和其他心血管疾病的患者与静脉血栓栓塞风险增加有关。在药物方面,抗糖尿病药物和胃肠道药物降低了静脉血栓栓塞的可能性。结论术前多种因素影响TURBT术后静脉血栓栓塞的发生。这些发现可能有助于在适当的患者中实施血栓预防的临床决策。
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引用次数: 0
Percepción real de los informes de anatomía patológica en urología 对泌尿科病理解剖学报告的真实看法
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501751
A. Cimadamore , M. Moschini , J. Teoh , S. Albisinni , Z. Adwin , W. Shen Tan , K. Mori , M. Wroclawski , F. Soria , A. Aziz , E. Laukhtina , D.M. Carrión , W. Krajewski , M. Karavitakis , M. Abufaraj , A. Uleri , A. Gallioli , B. Pradere , en representación del Grupo de Trabajo de Carcinoma Urotelial de la Sección de Jóvenes Urólogos Académicos - Asociación Europea de Urología (EAU-YAU)

Introduction

Collaboration between pathologists and urologists is crucial for accurate diagnostic reporting and patient management, particularly in urology. This study aims to evaluate international practices regarding pathology reporting of bladder specimens to identify areas for improvement.

Materials and methods

A web-based survey with 32 questions was developed in collaboration with the EAU Young Academic Urologists Urothelial Cancer Working Party. It was sent to urologists with more than 5 years of experience across different institutions globally. Descriptive statistics were used to evaluate the responses.

Results

A total of 157 responses were received from urologists, representing a response rate of 65%. Most respondents (64.3%) found pathological reports comprehensive, although 36% reported unclear reports in some cases. Pathologists were contacted for clarification in less than 20% of cases. Notably, the reporting of pathological subtypes and depth of invasion was inconsistent among institutions.

Conclusion

The survey highlights variability in pathology report quality across centers. Standardized reporting, increased pathologist involvement in multidisciplinary teams, and adherence to international guidelines are necessary to improve the accuracy and clarity of pathology reports in urology.
病理学家和泌尿科医生之间的合作对于准确的诊断报告和患者管理至关重要,特别是在泌尿科。本研究旨在评估膀胱标本病理报告的国际惯例,以找出需要改进的地方。材料和方法一项包含32个问题的网络调查是与欧亚大学青年学术泌尿科医师泌尿上皮癌工作组合作开发的。它被发送给在全球不同机构拥有5年以上经验的泌尿科医生。使用描述性统计来评估反应。结果共收到157份泌尿科医生的回复,应答率为65%。大多数受访者(64.3%)认为病理报告是全面的,尽管36%的受访者在某些情况下报告不清楚。在不到20%的病例中,联系了病理学家进行澄清。值得注意的是,各机构对病理亚型和侵袭深度的报告不一致。结论:该调查突出了各中心病理报告质量的差异。标准化报告、增加病理学家在多学科团队中的参与以及遵守国际指南对于提高泌尿外科病理报告的准确性和清晰度是必要的。
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引用次数: 0
AINE: ¿una alternativa a los antibióticos en el tratamiento de las infecciones urinarias en las mujeres? Una revisión basada en la evidencia AINE:治疗女性尿路感染的抗生素替代品?基于证据的审查
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501684
I. Milhazes Martins , S.C. Dias Batista

Introduction

Urinary tract infections (UTIs) remain a major cause of morbidity in otherwise healthy women. It is estimated at least 50% of women will have at least 1 UTI in their lifetime. Current guidelines recommend the use of antibiotics (ABs) for treatment, constituting the 2 nd most common reason for their prescribing. However, antibiotic resistance remains a worrying problem, therefore it is almost imperative to find alternatives for UTIs. One of the most suggested alternatives are Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Some clinical trials have shown that these are similar to ABs in resolving urinary symptoms.

Objectives

To evaluate the NSAIDs’ effectiveness in the treatment of uncomplicated UTIs in healthy, non-pregnant women and to prove their non-inferiority to ABs.

Methods

This evidence-based review study encompasses articles published between January 2010 and December 2021, in the medical databases, using the keywords MeSH: “NSAIDs”, “UTI” and “Treatment”. The Strength of Recommendation Taxonomy scale was used to classify the level of evidence.

Results

There were 8 articles selected and the majority concluded ABs are superior in the treatment of UTIs, as the clinical condition resolved more quickly. However, it considered NSAIDs also demonstrated effectiveness. Furthermore, it was also found that treatment with NSAIDs didn’t present as greater risk of complications.

Conclusion

ABs remain the most preferred therapy for treating UTIs and there is not yet sufficient evidence to support the use of NSAIDs. However, more studies are needed to evaluate its effectiveness in resolving UTIs’ symptomatology. This may be an opportunity to reduce the prescription of ABs.
导读:尿路感染(uti)仍然是健康妇女发病的主要原因。据估计,至少50%的女性一生中至少会有一次尿路感染。目前的指南建议使用抗生素(ABs)进行治疗,这是开抗生素处方的第二大常见原因。然而,抗生素耐药性仍然是一个令人担忧的问题,因此寻找尿路感染的替代品几乎势在必行。非甾体抗炎药(NSAIDs)是非甾体抗炎药之一。一些临床试验表明,这些药物在解决泌尿系统症状方面与抗体相似。目的评价非甾体抗炎药(NSAIDs)治疗健康、非孕妇非复杂性UTI的有效性,并证明其对abs的非劣效性。方法本循证综述研究纳入了2010年1月至2021年12月在医学数据库中发表的论文,关键词为MeSH:“NSAIDs”、“UTI”和“治疗”。使用推荐强度分类法量表对证据水平进行分类。结果共入选8篇文章,多数认为抗体治疗尿路感染的效果较好,临床症状缓解较快。然而,它认为非甾体抗炎药也证明了有效性。此外,研究还发现,使用非甾体抗炎药治疗并不会增加并发症的风险。结论抗炎药仍是治疗尿路感染的首选药物,目前尚没有足够的证据支持使用非甾体抗炎药。然而,需要更多的研究来评估其在解决尿路感染症状方面的有效性。这可能是一个减少ABs处方的机会。
{"title":"AINE: ¿una alternativa a los antibióticos en el tratamiento de las infecciones urinarias en las mujeres? Una revisión basada en la evidencia","authors":"I. Milhazes Martins ,&nbsp;S.C. Dias Batista","doi":"10.1016/j.acuro.2025.501684","DOIUrl":"10.1016/j.acuro.2025.501684","url":null,"abstract":"<div><h3>Introduction</h3><div>Urinary tract infections (UTIs) remain a major cause of morbidity in otherwise healthy women. It is estimated at least 50% of women will have at least 1 UTI in their lifetime. Current guidelines recommend the use of antibiotics (ABs) for treatment, constituting the 2<!--> <!-->nd most common reason for their prescribing. However, antibiotic resistance remains a worrying problem, therefore it is almost imperative to find alternatives for UTIs. One of the most suggested alternatives are Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Some clinical trials have shown that these are similar to ABs in resolving urinary symptoms.</div></div><div><h3>Objectives</h3><div>To evaluate the NSAIDs’ effectiveness in the treatment of uncomplicated UTIs in healthy, non-pregnant women and to prove their non-inferiority to ABs.</div></div><div><h3>Methods</h3><div>This evidence-based review study encompasses articles published between January 2010 and December 2021, in the medical databases, using the keywords MeSH: “NSAIDs”, “UTI” and “Treatment”. The Strength of Recommendation Taxonomy scale was used to classify the level of evidence.</div></div><div><h3>Results</h3><div>There were 8 articles selected and the majority concluded ABs are superior in the treatment of UTIs, as the clinical condition resolved more quickly. However, it considered NSAIDs also demonstrated effectiveness. Furthermore, it was also found that treatment with NSAIDs didn’t present as greater risk of complications.</div></div><div><h3>Conclusion</h3><div>ABs remain the most preferred therapy for treating UTIs and there is not yet sufficient evidence to support the use of NSAIDs. However, more studies are needed to evaluate its effectiveness in resolving UTIs’ symptomatology. This may be an opportunity to reduce the prescription of ABs.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501684"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890501","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
Estudio multicéntrico del impacto de la implantación de UroLift® en pacientes en tratamiento médico por sintomatología del tracto urinario inferior secundaria a hiperplasia benigna de próstata 多中心研究植入UroLift®对继发性下尿路至良性前列腺增生的患者的影响
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-05-01 DOI: 10.1016/j.acuro.2025.501708
C. González Enguita , L. López Martín , L.M. Herranz Fernández , B. Sinues Ojas , C. Barrera Rodríguez , J. Extramiana Cameno , J. Campá Bortoló , J.M. Oscá García , M. Perán Teruel , V. Gimeno Argente , A. Navarro Beltrán , E. López Alcina , I. Povo Martín , Y.S. Pallás Costa , A. Budía Alba , J. Ortiz Salvador , J.J. Salgado Plonski , P. Suárez Sal , M. Fernández Arjona

Introduction and objectives

UroLift® is a minimally invasive treatment for patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia. The primary objective was to evaluate the impact of UroLift® system treatment on quality of life. Secondary objectives assessed the impact on urinary symptoms and sexual function.

Patients and methods

Patients at 7 Spanish hospitals undergoing pharmacological treatment were offered the choice to continue this treatment or accept surgical intervention. The primary outcome, impact on quality of life, was assessed using the EuroQol-5D-5L questionnaire. Secondary outcomes, including impact on symptoms, erectile function, and ejaculatory function, were evaluated using the IPSS, SHIM-5, and MSHQ-EjD-SF questionnaires, respectively. Outcomes were compared between groups.

Results

91 patients chose UroLift® and 45 continued with pharmacotherapy. At 6 months, a positive impact on quality of life was estimated with UroLift® (0.046; SD: 0.02; P = .067), being significant in subgroups of patients aged > 65 years (diff.: 0.034), PSA > 2.2 (diff.: 0.108), diabetes mellitus (diff.: 0.023), hypertension (diff.: 0.011) or hypercholesterolemia (diff.: 0.016). The impact on symptomatology was superior with UroLift® (−10.07; SD: 1.65; P < .001), being significant in subgroups aged > 65 (diff.: 1.37), prostate > 40 cc (diff.: 0.74), PSA > 2.2 (diff.: 2.63), and diabetes mellitus (diff.: 1.66), hypertension (diff.: 1.23). Erectile function was not affected (−0.33; SD: 1.99; P = .868) while ejaculatory function showed a favourable impact (2.98; SD: 1.26; P = .019).

Conclusions

Minimally invasive UroLift® system treatment is associated with a positive impact on quality of life and urinary symptoms without adversely affecting sexual function.
简介和目的urolift®是一种微创治疗下尿路继发于良性前列腺增生的患者。主要目的是评估UroLift®系统治疗对生活质量的影响。次要目的评估对泌尿系统症状和性功能的影响。患者和方法在西班牙7家医院接受药物治疗的患者可选择继续药物治疗或接受手术干预。使用EuroQol-5D-5L问卷评估主要结局(对生活质量的影响)。次要结局,包括对症状、勃起功能和射精功能的影响,分别使用IPSS、SHIM-5和MSHQ-EjD-SF问卷进行评估。比较两组间的结果。结果91例患者选择了UroLift®,45例患者继续接受药物治疗。在6个月时,UroLift®对生活质量的积极影响(0.046;SD: 0.02;P = .067),在年龄>;65岁(差异:0.034),PSA >;2.2 (diff. 0.108)、糖尿病(diff. 0.023)、高血压(diff. 0.011)或高胆固醇血症(diff. 0.016)。对症状学的影响优于UroLift®(- 10.07;SD: 1.65;P & lt;.001),在年龄>;65(差异:1.37),前列腺>;40cc(差值:0.74),PSA >;2.2 (diff. 2.63),糖尿病(diff. 1.66),高血压(diff. 1.23)。勃起功能未受影响(−0.33;SD: 1.99;P = .868),而射精功能表现出良好的影响(2.98;SD: 1.26;p = .019)。结论微创UroLift®系统治疗与生活质量和泌尿系统症状的积极影响相关,而不会对性功能产生不利影响。
{"title":"Estudio multicéntrico del impacto de la implantación de UroLift® en pacientes en tratamiento médico por sintomatología del tracto urinario inferior secundaria a hiperplasia benigna de próstata","authors":"C. González Enguita ,&nbsp;L. López Martín ,&nbsp;L.M. Herranz Fernández ,&nbsp;B. Sinues Ojas ,&nbsp;C. Barrera Rodríguez ,&nbsp;J. Extramiana Cameno ,&nbsp;J. Campá Bortoló ,&nbsp;J.M. Oscá García ,&nbsp;M. Perán Teruel ,&nbsp;V. Gimeno Argente ,&nbsp;A. Navarro Beltrán ,&nbsp;E. López Alcina ,&nbsp;I. Povo Martín ,&nbsp;Y.S. Pallás Costa ,&nbsp;A. Budía Alba ,&nbsp;J. Ortiz Salvador ,&nbsp;J.J. Salgado Plonski ,&nbsp;P. Suárez Sal ,&nbsp;M. Fernández Arjona","doi":"10.1016/j.acuro.2025.501708","DOIUrl":"10.1016/j.acuro.2025.501708","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>UroLift® is a minimally invasive treatment for patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia. The primary objective was to evaluate the impact of UroLift® system treatment on quality of life. Secondary objectives assessed the impact on urinary symptoms and sexual function.</div></div><div><h3>Patients and methods</h3><div>Patients at 7 Spanish hospitals undergoing pharmacological treatment were offered the choice to continue this treatment or accept surgical intervention. The primary outcome, impact on quality of life, was assessed using the EuroQol-5D-5L questionnaire. Secondary outcomes, including impact on symptoms, erectile function, and ejaculatory function, were evaluated using the IPSS, SHIM-5, and MSHQ-EjD-SF questionnaires, respectively. Outcomes were compared between groups.</div></div><div><h3>Results</h3><div>91 patients chose UroLift® and 45 continued with pharmacotherapy. At 6<!--> <!-->months, a positive impact on quality of life was estimated with UroLift® (0.046; SD: 0.02; <em>P</em> <!-->=<!--> <!-->.067), being significant in subgroups of patients aged &gt;<!--> <!-->65<!--> <!-->years (diff.: 0.034), PSA<!--> <!-->&gt;<!--> <!-->2.2 (diff.: 0.108), diabetes mellitus (diff.: 0.023), hypertension (diff.: 0.011) or hypercholesterolemia (diff.: 0.016). The impact on symptomatology was superior with UroLift® (−10.07; SD: 1.65; <em>P</em> <!-->&lt;<!--> <!-->.001), being significant in subgroups aged &gt;<!--> <!-->65 (diff.: 1.37), prostate &gt;<!--> <!-->40<!--> <!-->cc (diff.: 0.74), PSA<!--> <!-->&gt;<!--> <!-->2.2 (diff.: 2.63), and diabetes mellitus (diff.: 1.66), hypertension (diff.: 1.23). Erectile function was not affected (−0.33; SD: 1.99; <em>P</em> <!-->=<!--> <!-->.868) while ejaculatory function showed a favourable impact (2.98; SD: 1.26; <em>P</em> <!-->=<!--> <!-->.019).</div></div><div><h3>Conclusions</h3><div>Minimally invasive UroLift® system treatment is associated with a positive impact on quality of life and urinary symptoms without adversely affecting sexual function.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501708"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891214","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
Seguridad y viabilidad de la cirugía retrógrada intrarrenal sin fluoroscopia para la litiasis ureteral y renal no complicada: estudio unicéntrico en una serie amplia de pacientes 无荧光肾内逆行手术治疗简单的尿路和肾石症的安全性和可行性:一项多组患者的单中心研究
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.acuro.2025.501709
S. Bürlukkara, Ö. Baran, M. Cemre Cevrin

Introduction

Aimed to investigate the feasibility and availability of fluoroless retrograde intrarenal surgery (fRIRS) in a large patient population.

Methods

Patients who underwent fRIRS for ureteral or renal calculi in our center between June 2019 and June 2024 were reviewed. Demographic data, stone characteristics, operation time, perioperative-postoperative complications, perioperative complications, and stone-free rates of patients who underwent fRIRS for ureteral or renal calculi were evaluated. Clavien-Dindo classification was used for complications. All procedures were performed under spinal or general anesthesia.

Results

1079 patients were included in the study. Of the 1079 patients, 352 (32.6%) were female and 727 (67.4%) were male. The mean age was 47.33 ± 14.31 years. The mean size of the stones was 13.1 ± 6.33 mm3. Of the patients, 208 (19.27%) received general anesthesia and 871 (80.73%) received spinal anesthesia. The mean operation time was 37.14 ± 17.65 minutes. All patients received a Double J (DJ) stent postoperatively. The rate of complications was 8% overall. The complications observed in general were minor; postoperative colic pain and hematuria were observed in 36 (3.3%) patients and 26 (2.4%) patients, respectively. Stone-free rate was 86.4%.

Conclusion

The fRIRS is a safe and feasible method for the treatment of uncomplicated ureteral and renal calculi. In uncomplicated patients, it has similar complication and success rates to conventional methods and eliminates radiation exposure.
目的探讨无氟逆行肾内手术(fRIRS)在大量患者中的可行性和可用性。方法回顾本中心2019年6月至2024年6月期间因输尿管结石或肾结石接受fRIRS治疗的患者。对输尿管结石或肾结石行fRIRS治疗患者的人口学资料、结石特征、手术时间、围手术期-术后并发症、围手术期并发症和结石无结石率进行评估。并发症采用Clavien-Dindo分型。所有手术均在脊髓或全身麻醉下进行。结果1079例患者纳入研究。1079例患者中,女性352例(32.6%),男性727例(67.4%)。平均年龄47.33±14.31岁。结石的平均大小为13.1±6.33 mm3。全麻208例(19.27%),脊髓麻醉871例(80.73%)。平均手术时间37.14±17.65 min。所有患者术后均行双J (DJ)支架置入。并发症发生率为8%。观察到的并发症一般较轻;术后腹痛36例(3.3%),血尿26例(2.4%)。脱石率为86.4%。结论fRIRS是一种安全可行的治疗无并发症输尿管结石和肾结石的方法。在无并发症的患者中,它具有与传统方法相似的并发症和成功率,并且消除了辐射暴露。
{"title":"Seguridad y viabilidad de la cirugía retrógrada intrarrenal sin fluoroscopia para la litiasis ureteral y renal no complicada: estudio unicéntrico en una serie amplia de pacientes","authors":"S. Bürlukkara,&nbsp;Ö. Baran,&nbsp;M. Cemre Cevrin","doi":"10.1016/j.acuro.2025.501709","DOIUrl":"10.1016/j.acuro.2025.501709","url":null,"abstract":"<div><h3>Introduction</h3><div>Aimed to investigate the feasibility and availability of fluoroless retrograde intrarenal surgery (fRIRS) in a large patient population.</div></div><div><h3>Methods</h3><div>Patients who underwent fRIRS for ureteral or renal calculi in our center between June 2019 and June 2024 were reviewed. Demographic data, stone characteristics, operation time, perioperative-postoperative complications, perioperative complications, and stone-free rates of patients who underwent fRIRS for ureteral or renal calculi were evaluated. Clavien-Dindo classification was used for complications. All procedures were performed under spinal or general anesthesia.</div></div><div><h3>Results</h3><div>1079 patients were included in the study. Of the 1079 patients, 352 (32.6%) were female and 727 (67.4%) were male. The mean age was 47.33<!--> <!-->±<!--> <!-->14.31 years. The mean size of the stones was 13.1<!--> <!-->±<!--> <!-->6.33 mm3. Of the patients, 208 (19.27%) received general anesthesia and 871 (80.73%) received spinal anesthesia. The mean operation time was 37.14<!--> <!-->±<!--> <!-->17.65<!--> <!-->minutes. All patients received a Double J (DJ) stent postoperatively. The rate of complications was 8% overall. The complications observed in general were minor; postoperative colic pain and hematuria were observed in 36 (3.3%) patients and 26 (2.4%) patients, respectively. Stone-free rate was 86.4%.</div></div><div><h3>Conclusion</h3><div>The fRIRS is a safe and feasible method for the treatment of uncomplicated ureteral and renal calculi. In uncomplicated patients, it has similar complication and success rates to conventional methods and eliminates radiation exposure.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501709"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737969","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
Suprarrenalectomía retroperitoneal por puerto único: el abordaje del presente 单端口腹膜后肾外切除术:现在的方法
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.acuro.2025.501694
D. Vazquez-Martul
{"title":"Suprarrenalectomía retroperitoneal por puerto único: el abordaje del presente","authors":"D. Vazquez-Martul","doi":"10.1016/j.acuro.2025.501694","DOIUrl":"10.1016/j.acuro.2025.501694","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501694"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738362","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
Impacto oncológico de la resección transuretral de vejiga completa antes de la quimioterapia neoadyuvante en el cáncer de vejiga músculo invasor 新辅助化疗前经尿道切除整个膀胱对侵入性膀胱癌的肿瘤影响
IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.acuro.2025.501712
C. Fernandes , I. Baptista , M. Manso , C. Ferreira , F. Botelho , J. Silva , C. Silva , L. Vale

Objectives

To assess the impact of cTURBT on pathologic response. Secondary endpoints involved survival and oncologic outcomes.

Methods

Tertiary centre data from patients with MIBC submitted to NAC and radical cystectomy between March 2010 and November 2022 was retrospectively analysed. Patients with complete resection (cTURBT) before NAC were compared to those with incomplete (iTURBT).

Results

Thirty-seven patients were included in this study. NAC regime was identical between groups. cTURBT group demonstrated a higher rate of downstaging than the iTURBT group (50% vs 20%, p = 0.022). During the mean 49-month follow-up period, overall survival (86.4% vs. 40%, p = 0.005), relapse-free survival (81.8% vs. 46.7% p = 0.036), and cancer-specific survival (90.9% vs 60%, p = 0.042) were higher in the cTURBT group. Furthermore, we observed significantly fewer relapses, higher survival rates, and lower oncological-related deaths in patients who exhibited downstaging.

Conclusion

cTURBT demonstrated a favourable impact on patients with MIBC undergoing NAC, enhancing pathologic downstaging and improving survival outcomes. Our results can be confounded by cTURBT being a proxy for less aggressive disease.
目的探讨ctturt对患者病理反应的影响。次要终点包括生存和肿瘤预后。方法回顾性分析2010年3月至2022年11月期间接受NAC和根治性膀胱切除术的MIBC患者的中心数据。NAC前完全切除(ctturt)的患者与不完全切除(iTURBT)的患者进行比较。结果37例患者纳入本研究。各组间NAC状态相同。ctturt组的降期率高于iTURBT组(50% vs 20%, p = 0.022)。在平均49个月的随访期间,ctturt组的总生存率(86.4% vs. 40%, p = 0.005)、无复发生存率(81.8% vs. 46.7% p = 0.036)和癌症特异性生存率(90.9% vs. 60%, p = 0.042)更高。此外,我们还观察到,表现出低分期的患者复发更少,生存率更高,肿瘤相关死亡率更低。结论cturbt对MIBC行NAC的患者有良好的影响,增强了病理降期,改善了生存结果。我们的结果可能会被ctturt作为侵袭性较低疾病的代表而混淆。
{"title":"Impacto oncológico de la resección transuretral de vejiga completa antes de la quimioterapia neoadyuvante en el cáncer de vejiga músculo invasor","authors":"C. Fernandes ,&nbsp;I. Baptista ,&nbsp;M. Manso ,&nbsp;C. Ferreira ,&nbsp;F. Botelho ,&nbsp;J. Silva ,&nbsp;C. Silva ,&nbsp;L. Vale","doi":"10.1016/j.acuro.2025.501712","DOIUrl":"10.1016/j.acuro.2025.501712","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the impact of cTURBT on pathologic response. Secondary endpoints involved survival and oncologic outcomes.</div></div><div><h3>Methods</h3><div>Tertiary centre data from patients with MIBC submitted to NAC and radical cystectomy between March 2010 and November 2022 was retrospectively analysed. Patients with complete resection (cTURBT) before NAC were compared to those with incomplete (iTURBT).</div></div><div><h3>Results</h3><div>Thirty-seven patients were included in this study. NAC regime was identical between groups. cTURBT group demonstrated a higher rate of downstaging than the iTURBT group (50% vs 20%, <em>p</em> <!-->=<!--> <!-->0.022). During the mean 49-month follow-up period, overall survival (86.4% vs. 40%, <em>p</em> <!-->=<!--> <!-->0.005), relapse-free survival (81.8% vs. 46.7% <em>p</em> <!-->=<!--> <!-->0.036), and cancer-specific survival (90.9% vs 60%, <em>p</em> <!-->=<!--> <!-->0.042) were higher in the cTURBT group. Furthermore, we observed significantly fewer relapses, higher survival rates, and lower oncological-related deaths in patients who exhibited downstaging.</div></div><div><h3>Conclusion</h3><div>cTURBT demonstrated a favourable impact on patients with MIBC undergoing NAC, enhancing pathologic downstaging and improving survival outcomes. Our results can be confounded by cTURBT being a proxy for less aggressive disease.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501712"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737900","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
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Actas urologicas espanolas
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