Actas urologicas espanolas最新文献

英文中文

What do men know about prostate cancer? 男性对前列腺癌了解多少？

Actas urologicas espanolas

Pub Date : 2025-03-01 DOI: 10.1016/j.acuroe.2025.501698

C. Vargas-Blasco , J. Arimany-Manso

引用次数: 0

Oncological outcomes of patients with node positive disease following neoadjuvant chemotherapy and radical cystectomy for muscle-invasive bladder cancer: A multicenter observational study of the EAU Young Academic Urologists (YAU) urothelial carcinoma working group

Actas urologicas espanolas

Pub Date : 2025-03-01 DOI: 10.1016/j.acuroe.2025.501701

G. Marcq , W. Kassouf , M. Roumiguié , B. Pradere , L.S. Mertens , S. Albisinni , A. Cimadamore , J. Yuen-Chun Teoh , M. Moschini , E. Laukhtina , A. Mari , F. Soria , A. Gallioli , F. del Giudice , D. d’Andrea , W. Krajewski , J.B. Beauval , E. Xylinas , D. Pouessel , P. Sargos , G. Ploussard

Introduction

Until recently there was no recommended adjuvant therapy for patients with lymph nodes metastasis (ypN+) following neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). The aim of the study was to describe the oncological outcomes of ypN+ patients following NAC and RC for MIBC.

Methods

This collaborative retrospective study included 195 patients with ypN+ disease after NAC followed by RC and bilateral pelvic lymph node dissection for MIBC between 2000 and 2019 in seven centers. Patients’ demographics, clinical and pathological features were collected. Survival analyses were carried out with Kaplan-Meier estimates and a Cox model was generated.

Results

A total of 120 patients (62%) were pN1, 51 pN2 (26%) and 24 pN3 (12%). Adjuvant radiation therapy was performed in 18 (9%), adjuvant chemotherapy in 40 (21%) and the remaining 137 (70%) patients were observed. The median follow-up time was 51 months (95%CI 44–62). Median times for recurrence-free survival, cancer-specific survival and overall survival (OS) were 18 months (95%CI 16−21), 47 months (95%CI 31−70) and 28 months (95%CI 22−34) respectively. On multivariable analysis, female gender (HR = 1.5, 95%CI 1.002–2.21, p = 0.049) and positive surgical margins (HR = 1.6, 95%CI 1.06–2.38, p = 0.026) were the only independent predictor of OS. The type of adjuvant therapy did not impact OS (adjuvant chemotherapy, p = 0.44; adjuvant radiotherapy p = 0.40).

Conclusion

MIBC patients with residual node positive disease following NAC and RC have poor survival outcomes. Females and patients with positive margin status at RC carry a poorer prognosis. These results may be beneficial for clinical trial design.

{"title":"Oncological outcomes of patients with node positive disease following neoadjuvant chemotherapy and radical cystectomy for muscle-invasive bladder cancer: A multicenter observational study of the EAU Young Academic Urologists (YAU) urothelial carcinoma working group","authors":"G. Marcq , W. Kassouf , M. Roumiguié , B. Pradere , L.S. Mertens , S. Albisinni , A. Cimadamore , J. Yuen-Chun Teoh , M. Moschini , E. Laukhtina , A. Mari , F. Soria , A. Gallioli , F. del Giudice , D. d’Andrea , W. Krajewski , J.B. Beauval , E. Xylinas , D. Pouessel , P. Sargos , G. Ploussard","doi":"10.1016/j.acuroe.2025.501701","DOIUrl":"10.1016/j.acuroe.2025.501701","url":null,"abstract":"<div><h3>Introduction</h3><div>Until recently there was no recommended adjuvant therapy for patients with lymph nodes metastasis (ypN+) following neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). The aim of the study was to describe the oncological outcomes of ypN+ patients following NAC and RC for MIBC.</div></div><div><h3>Methods</h3><div>This collaborative retrospective study included 195 patients with ypN+ disease after NAC followed by RC and bilateral pelvic lymph node dissection for MIBC between 2000 and 2019 in seven centers. Patients’ demographics, clinical and pathological features were collected. Survival analyses were carried out with Kaplan-Meier estimates and a Cox model was generated.</div></div><div><h3>Results</h3><div>A total of 120 patients (62%) were pN1, 51 pN2 (26%) and 24 pN3 (12%). Adjuvant radiation therapy was performed in 18 (9%), adjuvant chemotherapy in 40 (21%) and the remaining 137 (70%) patients were observed. The median follow-up time was 51 months (95%CI 44–62). Median times for recurrence-free survival, cancer-specific survival and overall survival (OS) were 18 months (95%CI 16−21), 47 months (95%CI 31−70) and 28 months (95%CI 22−34) respectively. On multivariable analysis, female gender (HR = 1.5, 95%CI 1.002–2.21, <em>p</em> = 0.049) and positive surgical margins (HR = 1.6, 95%CI 1.06–2.38, <em>p</em> = 0.026) were the only independent predictor of OS. The type of adjuvant therapy did not impact OS (adjuvant chemotherapy, <em>p</em> = 0.44; adjuvant radiotherapy <em>p</em> = 0.40).</div></div><div><h3>Conclusion</h3><div>MIBC patients with residual node positive disease following NAC and RC have poor survival outcomes. Females and patients with positive margin status at RC carry a poorer prognosis. These results may be beneficial for clinical trial design.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501701"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of body image perception, pain, fatigue and anxiety levels of individuals on hemodialysis and waiting for kidney transplantation and individuals with kidney transplantation

Actas urologicas espanolas

Pub Date : 2025-03-01 DOI: 10.1016/j.acuroe.2025.501707

F. Hassan , N. Doğan

Objective

This study was conducted to evaluate the body image perception, pain, fatigue and anxiety levels of individuals with kidney transplantation and undergoing hemodialysis and waiting for kidney transplantation.

Materials and methods

This cross-sectional study was conducted with 240 individuals who applied to the nephrology outpatient clinic and dialysis unit between 29 August 2021 and 20 May 2022. Data in the study were collected using Patient Information Form, LANSS Pain Scale, Visual Similarity Scale for Fatigue, Beck Anxiety Scale and Body Image Scale.

Results

The Body Image Scale total score average of individuals undergoing hemodialysis is 104.8 ± 15.4, the LANSS Pain Scale total score average is 18.7 ± 5.4, the Visual Similarity Scale total score average for Fatigue is 29.5 ± 1.2, and the Beck Anxiety Scale total score average is 104.8 ± 15.4. The total score average is 47.6 ± 6.8.

The LANSS Pain Scale total mean score of individuals with kidney transplantation is 8.2 ± 2.0, the Body Image Scale total score mean is 75.6 ± 3.5, the Visual Similarity Scale total score mean for Fatigue is 24.3 ± 1, and the Beck Anxiety Scale total score mean is 24.3 ± 1. The mean total score of the scale was found to be 25.6 ± 4.1.

Conclusion

It has been determined that hemodialysis patients waiting for a kidney transplant are not satisfied with their body image, experience more pain, and have higher levels of fatigue and anxiety than patients who have had a kidney transplant.

{"title":"Evaluation of body image perception, pain, fatigue and anxiety levels of individuals on hemodialysis and waiting for kidney transplantation and individuals with kidney transplantation","authors":"F. Hassan , N. Doğan","doi":"10.1016/j.acuroe.2025.501707","DOIUrl":"10.1016/j.acuroe.2025.501707","url":null,"abstract":"<div><h3>Objective</h3><div>This study was conducted to evaluate the body image perception, pain, fatigue and anxiety levels of individuals with kidney transplantation and undergoing hemodialysis and waiting for kidney transplantation.</div></div><div><h3>Materials and methods</h3><div>This cross-sectional study was conducted with 240 individuals who applied to the nephrology outpatient clinic and dialysis unit between 29 August 2021 and 20 May 2022. Data in the study were collected using Patient Information Form, LANSS Pain Scale, Visual Similarity Scale for Fatigue, Beck Anxiety Scale and Body Image Scale.</div></div><div><h3>Results</h3><div>The Body Image Scale total score average of individuals undergoing hemodialysis is 104.8 ± 15.4, the LANSS Pain Scale total score average is 18.7 ± 5.4, the Visual Similarity Scale total score average for Fatigue is 29.5 ± 1.2, and the Beck Anxiety Scale total score average is 104.8 ± 15.4. The total score average is 47.6 ± 6.8.</div><div>The LANSS Pain Scale total mean score of individuals with kidney transplantation is 8.2 ± 2.0, the Body Image Scale total score mean is 75.6 ± 3.5, the Visual Similarity Scale total score mean for Fatigue is 24.3 ± 1, and the Beck Anxiety Scale total score mean is 24.3 ± 1. The mean total score of the scale was found to be 25.6 ± 4.1.</div></div><div><h3>Conclusion</h3><div>It has been determined that hemodialysis patients waiting for a kidney transplant are not satisfied with their body image, experience more pain, and have higher levels of fatigue and anxiety than patients who have had a kidney transplant.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501707"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adjuvant treatment in intermediate/high-risk clear cell renal cell carcinoma. Systematic review

Actas urologicas espanolas

Pub Date : 2025-03-01 DOI: 10.1016/j.acuroe.2025.501685

M.Á. Arrabal-Polo , L. Gómez-Morón , F. Gutiérrez-Tejero , A. Zambudio-Munuera , I. Millán-Ramos , M. Arrabal-Martín

Introduction

Given the lack of comparative studies on adjuvant treatment for clear cell renal cell carcinoma, we present an updated systematic review, exploring the various options for adjuvant therapy. This review is conducted in accordance with the PRISMA guidelines.

Material and method

A systematic review was conducted, and 13 clinical trials were included after applying the pre-specified inclusion criteria. The risk of bias and the level of evidence were assessed. Subsequently, the requisite data were extracted in order to present the findings of the studies.

Results and discussion

The present systematic review establishes that pembrolizumab can be used as adjuvant therapy in patients with advanced renal cancer at high risk after nephrectomy. This is supported by the KEYNOTE-564 study, which concluded that it increased disease-free survival (DFS) and overall survival (OS). The use of sunitinib is discussed, since the study published in NEJM shows a modest benefit in terms of DFS, but only in an independent and blinded central review. According to the PROTECT study, pazopanib has no overall benefit. The EVEREST study showed no significant benefit over everolimus. Further studies are needed to confirm the use of axitinib, as the ATLAS trial showed statistically significant results in DFS in higher-risk population based on investigator assessment, but not based on independent central review. Therapy with 5-FU, α-IFN and IL-2, atezolizumab, sorafenib, thalidomide, nivolumab + ipilimumab should not be used in the adjuvant setting.

{"title":"Adjuvant treatment in intermediate/high-risk clear cell renal cell carcinoma. Systematic review","authors":"M.Á. Arrabal-Polo , L. Gómez-Morón , F. Gutiérrez-Tejero , A. Zambudio-Munuera , I. Millán-Ramos , M. Arrabal-Martín","doi":"10.1016/j.acuroe.2025.501685","DOIUrl":"10.1016/j.acuroe.2025.501685","url":null,"abstract":"<div><h3>Introduction</h3><div>Given the lack of comparative studies on adjuvant treatment for clear cell renal cell carcinoma, we present an updated systematic review, exploring the various options for adjuvant therapy. This review is conducted in accordance with the PRISMA guidelines.</div></div><div><h3>Material and method</h3><div>A systematic review was conducted, and 13 clinical trials were included after applying the pre-specified inclusion criteria. The risk of bias and the level of evidence were assessed. Subsequently, the requisite data were extracted in order to present the findings of the studies.</div></div><div><h3>Results and discussion</h3><div>The present systematic review establishes that pembrolizumab can be used as adjuvant therapy in patients with advanced renal cancer at high risk after nephrectomy. This is supported by the KEYNOTE-564 study, which concluded that it increased disease-free survival (DFS) and overall survival (OS). The use of sunitinib is discussed, since the study published in NEJM shows a modest benefit in terms of DFS, but only in an independent and blinded central review. According to the PROTECT study, pazopanib has no overall benefit. The EVEREST study showed no significant benefit over everolimus. Further studies are needed to confirm the use of axitinib, as the ATLAS trial showed statistically significant results in DFS in higher-risk population based on investigator assessment, but not based on independent central review. Therapy with 5-FU, α-IFN and IL-2, atezolizumab, sorafenib, thalidomide, nivolumab + ipilimumab should not be used in the adjuvant setting.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501685"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sutureless versus conventional suture renorrhaphy in clampless robotic partial nephrectomy: A single center propensity score matching analysis

Actas urologicas espanolas

Pub Date : 2025-03-01 DOI: 10.1016/j.acuroe.2025.501704

S. Kilic, M. Ates

Introduction and objectives

Suture renorrhaphy remains as time-consuming in partial nephrectomy (PN) and carries the risk of renal arterial damage and renal functional loss. This study aims to compare the functional and oncological outcomes of the clampless and sutureless robotic PN (sRPN) with clampless conventional suture renorrhaphy RPN (cRPN).

Patients

A total of 173 consecutive patients who underwent RPN between January 2019 and December 2023 were identified from our center’s database and reviewed. Seventy-six clampless (sutureless: 23, conventional suture renorrhaphy: 53) RPN were identified. A propensity score-matchedpair analysis (PSM) was performed to homogenize the characteristics of the groups. Comprehensive evaluations of perioperative variables, functional and oncological results were performed before and after the PSM between the sRPN and cRPN.

Results

Before the PSM, median console time was 10 min shorter in the sRPN group but was not statistically significant. Estimated median blood loss was significantly lower in the sRPN group (p < 0.05). After PSM, 22 patients were matched in each group and all of the preoperative baseline characteristics were similar. Ratio of interpolar lines located tumors was higher in sRPN group (68.2% vs. 31.2%) (p < 0.05). Median tumor diameter was 3 (1.5–7) cm in each group. The trifecta achievement rates were 90.9% and 77.2% for the sRPN and cRPN groups, respectively (p > 0.05). There were no differences in terms of median console times, estimated blood loss, drain removal times or eGFR changes.

Conclusions

In the treatment of small renal masses with clampless RPN, the sutureless technique can be applied with similar complication rates and functional, oncological outcomes as conventional sutured renorrhaphy.

{"title":"Sutureless versus conventional suture renorrhaphy in clampless robotic partial nephrectomy: A single center propensity score matching analysis","authors":"S. Kilic, M. Ates","doi":"10.1016/j.acuroe.2025.501704","DOIUrl":"10.1016/j.acuroe.2025.501704","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Suture renorrhaphy remains as time-consuming in partial nephrectomy (PN) and carries the risk of renal arterial damage and renal functional loss. This study aims to compare the functional and oncological outcomes of the clampless and sutureless robotic PN (sRPN) with clampless conventional suture renorrhaphy RPN (cRPN).</div></div><div><h3>Patients</h3><div>A total of 173 consecutive patients who underwent RPN between January 2019 and December 2023 were identified from our center’s database and reviewed. Seventy-six clampless (sutureless: 23, conventional suture renorrhaphy: 53) RPN were identified. A propensity score-matchedpair analysis (PSM) was performed to homogenize the characteristics of the groups. Comprehensive evaluations of perioperative variables, functional and oncological results were performed before and after the PSM between the sRPN and cRPN.</div></div><div><h3>Results</h3><div>Before the PSM, median console time was 10 min shorter in the sRPN group but was not statistically significant. Estimated median blood loss was significantly lower in the sRPN group (p < 0.05). After PSM, 22 patients were matched in each group and all of the preoperative baseline characteristics were similar. Ratio of interpolar lines located tumors was higher in sRPN group (68.2% vs. 31.2%) (p < 0.05). Median tumor diameter was 3 (1.5–7) cm in each group. The trifecta achievement rates were 90.9% and 77.2% for the sRPN and cRPN groups, respectively (p > 0.05). There were no differences in terms of median console times, estimated blood loss, drain removal times or eGFR changes.</div></div><div><h3>Conclusions</h3><div>In the treatment of small renal masses with clampless RPN, the sutureless technique can be applied with similar complication rates and functional, oncological outcomes as conventional sutured renorrhaphy.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501704"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Health literacy in prostate cancer: What do Spanish men know about prostate cancer? A cross-sectional descriptive study. Author’s reply

Actas urologicas espanolas

Pub Date : 2025-03-01 DOI: 10.1016/j.acuroe.2025.501697

C. Romojaro-Pérez , B. Navarro-Brazález , J. Bailón-Cerezo , M. Torres-Lacomba

引用次数: 0

Initial linguistic and cultural validation of the satisfaction survey for inflatable penile implant (SSIPI) in Spanish

Actas urologicas espanolas

Pub Date : 2025-03-01 DOI: 10.1016/j.acuroe.2025.501700

B.M. Ljubetic , S.L. Thorogood , E.F. Becher , I. Alvarez de Toledo , R. Carrion , A. Carvajal , E. Fernández-Pascual , J.I. Martinez-Salamanca , C. Nelson , J. Quesada , C.A. Salter , J. Torremade , M. D'Anna , R. Valenzuela , J.P. Mulhall , J.M. Flores

Introduction

The Satisfaction Survey for Inflatable Penile Implant (SSIPI) is useful tool to assess patient outcomes after inflatable penile prosthesis (IPP) surgery. However, this survey is not validated in Spanish. This work aims to report the initial steps carried out for the linguistic validation of the SSIPI translation into Spanish.

Method

The linguistic validation process had the following steps: (i) SSIPI forward translation, (ii) reconciliation, (iii) back translation, (iv) harmonization, review, and correction of the translation, and (v) cognitive interviewing and testing the new translated version. Urologists from Spain, South America, and the United States participated in these steps. The last step was performed in 3 centers: (i) Medellín, Colombia; (ii) Florida, United States; and (iii) Madrid, Spain.

Results

19 Spanish-speaking patients tested the initial translated version of SSIPI. Most patients found the translated SSIPI questionnaire easy to understand; however, of the 16 questions, patients most frequently commented that questions 3, 5, and 7 should be modified. The median number of observations or comments per question was 1 (1, 3). Based on these suggestions, the research group adapted the questionnaire to obtain the final version in Spanish.

Conclusion

This study evaluates the initial steps for the translation and linguistic validation of the SSIPI questionnaire into Spanish. The results indicate a remarkable level of readability and comprehension, while some challenges were observed in certain questions. This work demonstrates that a standardized and protocolized process is needed to translate and validate surveys into Spanish.

{"title":"Initial linguistic and cultural validation of the satisfaction survey for inflatable penile implant (SSIPI) in Spanish","authors":"B.M. Ljubetic , S.L. Thorogood , E.F. Becher , I. Alvarez de Toledo , R. Carrion , A. Carvajal , E. Fernández-Pascual , J.I. Martinez-Salamanca , C. Nelson , J. Quesada , C.A. Salter , J. Torremade , M. D'Anna , R. Valenzuela , J.P. Mulhall , J.M. Flores","doi":"10.1016/j.acuroe.2025.501700","DOIUrl":"10.1016/j.acuroe.2025.501700","url":null,"abstract":"<div><h3>Introduction</h3><div>The Satisfaction Survey for Inflatable Penile Implant (SSIPI) is useful tool to assess patient outcomes after inflatable penile prosthesis (IPP) surgery. However, this survey is not validated in Spanish. This work aims to report the initial steps carried out for the linguistic validation of the SSIPI translation into Spanish.</div></div><div><h3>Method</h3><div>The linguistic validation process had the following steps: (i) SSIPI forward translation, (ii) reconciliation, (iii) back translation, (iv) harmonization, review, and correction of the translation, and (v) cognitive interviewing and testing the new translated version. Urologists from Spain, South America, and the United States participated in these steps. The last step was performed in 3 centers: (i) Medellín, Colombia; (ii) Florida, United States; and (iii) Madrid, Spain.</div></div><div><h3>Results</h3><div>19 Spanish-speaking patients tested the initial translated version of SSIPI. Most patients found the translated SSIPI questionnaire easy to understand; however, of the 16 questions, patients most frequently commented that questions 3, 5, and 7 should be modified. The median number of observations or comments per question was 1 (1, 3). Based on these suggestions, the research group adapted the questionnaire to obtain the final version in Spanish.</div></div><div><h3>Conclusion</h3><div>This study evaluates the initial steps for the translation and linguistic validation of the SSIPI questionnaire into Spanish. The results indicate a remarkable level of readability and comprehension, while some challenges were observed in certain questions. This work demonstrates that a standardized and protocolized process is needed to translate and validate surveys into Spanish.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501700"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relationship between intraoperative intestinal cultures and postoperative urinary infection in radical cystectomy with ileal diversion patients

Actas urologicas espanolas

Pub Date : 2025-03-01 DOI: 10.1016/j.acuroe.2025.501703

I.P. Tobia, C. Pedergrana, A.G. Alfieri, J.C. Tejerizo, M.I. González, G.A. Favre

Introduction

Radical cystectomy (RC) is a preferred treatment for muscle-invasive bladder cancer (T2-T4) and certain non-muscle-invasive tumors. Post-cystectomy, urinary diversions often utilize intestinal segments, which are prone to complications, notably urinary tract infections (UTIs).

Objective

To estimate the association between intraoperative cultures of the isolated intestinal loop and urine cultures during UTI episodes in RC patients with urinary diversion. Additionally, to compare urinary cultures from catheters at discharge with UTI cultures and calculate UTI prevalence and readmission rates within three months postoperatively.

Materials and methods

This prospective, observational cohort study included patients who underwent RC with ileal segment diversion our center between April 2021 and January 2024. Intraoperative cultures were obtained by washing the isolated ileal loop, and urine cultures were taken during postoperative UTI episodes. Patients were followed for 90 days post-surgery, and new cultures were performed if UTI symptoms appeared.

Results

Among 118 cystectomies, 82 patients were included, with a mean age of 67.8 years. UTI prevalence within the first three months was 43.9%. The kappa concordance index for bacteria between intraoperative and UTI cultures was 0.033 (poor), and for cultures from discharge catheters and UTI episodes, it was 0.251 (fair). UTI readmission rate was 28.9%, with no significant predictors identified.

Conclusion

There is no significant association between germs in intraoperative intestinal cultures or discharge catheters and those in UTI cultures in RC patients with urinary diversion. The three-month UTI prevalence is 43.9%, with a 28.9% readmission rate. Continuous epidemiological surveillance is recommended for appropriate antibiotic therapy.

{"title":"Relationship between intraoperative intestinal cultures and postoperative urinary infection in radical cystectomy with ileal diversion patients","authors":"I.P. Tobia, C. Pedergrana, A.G. Alfieri, J.C. Tejerizo, M.I. González, G.A. Favre","doi":"10.1016/j.acuroe.2025.501703","DOIUrl":"10.1016/j.acuroe.2025.501703","url":null,"abstract":"<div><h3>Introduction</h3><div>Radical cystectomy (RC) is a preferred treatment for muscle-invasive bladder cancer (T2-T4) and certain non-muscle-invasive tumors. Post-cystectomy, urinary diversions often utilize intestinal segments, which are prone to complications, notably urinary tract infections (UTIs).</div></div><div><h3>Objective</h3><div>To estimate the association between intraoperative cultures of the isolated intestinal loop and urine cultures during UTI episodes in RC patients with urinary diversion. Additionally, to compare urinary cultures from catheters at discharge with UTI cultures and calculate UTI prevalence and readmission rates within three months postoperatively.</div></div><div><h3>Materials and methods</h3><div>This prospective, observational cohort study included patients who underwent RC with ileal segment diversion our center between April 2021 and January 2024. Intraoperative cultures were obtained by washing the isolated ileal loop, and urine cultures were taken during postoperative UTI episodes. Patients were followed for 90 days post-surgery, and new cultures were performed if UTI symptoms appeared.</div></div><div><h3>Results</h3><div>Among 118 cystectomies, 82 patients were included, with a mean age of 67.8 years. UTI prevalence within the first three months was 43.9%. The kappa concordance index for bacteria between intraoperative and UTI cultures was 0.033 (poor), and for cultures from discharge catheters and UTI episodes, it was 0.251 (fair). UTI readmission rate was 28.9%, with no significant predictors identified.</div></div><div><h3>Conclusion</h3><div>There is no significant association between germs in intraoperative intestinal cultures or discharge catheters and those in UTI cultures in RC patients with urinary diversion. The three-month UTI prevalence is 43.9%, with a 28.9% readmission rate. Continuous epidemiological surveillance is recommended for appropriate antibiotic therapy.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501703"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effect of hemostatic sutures on open suprapubic prostatectomy outcomes: A retrospective observational study

Actas urologicas espanolas

Pub Date : 2025-03-01 DOI: 10.1016/j.acuroe.2025.501711

A. Utlu , T. Aksakalli , F. Celik , A. Emre Cinislioglu , S. Oguz Demirdogen

Objective

To evaluate the effect of suturing the bladderneck in benign prostatic hyperplasia surgery on bleeding parameter sand surgical outcomes.

Methods

The age, comorbidities, preoperative findings, surgical treatment techniques, peroperative and postoperative bleedingrates, blood transfusion rates, complication rates, surgery note sand postoperative patient follow-ups of the patients operated on for benign prostatic hyperplasia were taken from the patient files. Patients who were sutured to the bladder neck and those who were not were divided into two group sand compared in terms of bleeding and surgical results.

Results

A total of 170 patients were included in the study, 106 patients whounder went bladder neck suturing and 64 patients who did not undergo bladder neck suturing. While the mean operation time in hemostatic suture applied group 84.2 ± 7.8 min, this time was 61.4 ± 6.3 min hemostatic suture not applied group (p < 0.001). The mean decrease in hemoglobin levels at the 2nd postoperative hour in the suturing group was observed to be greater than in the non-suturing group (2.1 g/dl, 2 g/dl, respectively). There was no statistical difference in postoperative blood transfusion rates (15.1%, 15.6%, respectively, p = 0.137). Postoperative complications and follow-updata were similar for bothgroup. Bladder neck contracture was higher rate (7.5% vs. 3.1%) in hemostatic suture applied group but ıt was not statistically significant.

Conclusion

Application of hemostatic suture prolongs the operation time of open prostatectomy without affecting bleeding parameter sand postoperative results. For this reason, open prostatectomy surgery is a surgical method that can be performed safely without applying sutures.

{"title":"The effect of hemostatic sutures on open suprapubic prostatectomy outcomes: A retrospective observational study","authors":"A. Utlu , T. Aksakalli , F. Celik , A. Emre Cinislioglu , S. Oguz Demirdogen","doi":"10.1016/j.acuroe.2025.501711","DOIUrl":"10.1016/j.acuroe.2025.501711","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of suturing the bladderneck in benign prostatic hyperplasia surgery on bleeding parameter sand surgical outcomes.</div></div><div><h3>Methods</h3><div>The age, comorbidities, preoperative findings, surgical treatment techniques, peroperative and postoperative bleedingrates, blood transfusion rates, complication rates, surgery note sand postoperative patient follow-ups of the patients operated on for benign prostatic hyperplasia were taken from the patient files. Patients who were sutured to the bladder neck and those who were not were divided into two group sand compared in terms of bleeding and surgical results.</div></div><div><h3>Results</h3><div>A total of 170 patients were included in the study, 106 patients whounder went bladder neck suturing and 64 patients who did not undergo bladder neck suturing. While the mean operation time in hemostatic suture applied group 84.2 ± 7.8 min, this time was 61.4 ± 6.3 min hemostatic suture not applied group (p < 0.001). The mean decrease in hemoglobin levels at the 2nd postoperative hour in the suturing group was observed to be greater than in the non-suturing group (2.1 g/dl, 2 g/dl, respectively). There was no statistical difference in postoperative blood transfusion rates (15.1%, 15.6%, respectively, p = 0.137). Postoperative complications and follow-updata were similar for bothgroup. Bladder neck contracture was higher rate (7.5% vs. 3.1%) in hemostatic suture applied group but ıt was not statistically significant.</div></div><div><h3>Conclusion</h3><div>Application of hemostatic suture prolongs the operation time of open prostatectomy without affecting bleeding parameter sand postoperative results. For this reason, open prostatectomy surgery is a surgical method that can be performed safely without applying sutures.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501711"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Time trend and age-period-cohort effect on kidney cancer mortality in Spain, 1983–2022

Actas urologicas espanolas

Pub Date : 2025-03-01 DOI: 10.1016/j.acuroe.2025.501714

L. Cayuela , R. Roldán Testillano , S. Cabrera Fernández , L. Rodríguez-Sánchez , A. Cayuela

Objective

This study examines trends and disparities in kidney cancer (KC) mortality in Spain from 1983 to 2022, focusing on gender, birth cohort, and age influences.

Methods

Data from the Spanish National Institute of Statistics were analyzed using age-standardized mortality rates (ASMRs). Joinpoint regression identified temporal trends and annual percentage changes, while Age-Period-Cohort (A-P-C) analysis assessed the impacts of age, calendar period, and birth cohort on mortality.

Results

KC mortality increased significantly for both sexes, with men experiencing a steeper rise (1.2% annually) compared to women (0.6% annually). Joinpoint analysis revealed distinct phases: a sharp increase until the mid-1990s, followed by stabilization for men and a slight decline for women. Men aged over 50, particularly those above 80, showed pronounced increases. A-P-C analysis confirmed age as a significant risk factor, with consistently higher mortality rates observed among men across all age groups. Men born from the early 20th century until the 1960s faced increasing mortality risks, while women's risk, after an increase in the early 20th century, stabilized after the 1933 birth cohort. For those born after 1960, both sexes show a potential decline in KC mortality, with a slight upturn in men from the 1980s onwards. The period effect exhibited an increase during the 1980s–1990s, followed by stabilization for men and a continuous decrease for women.

Conclusion

This study reveals significant disparities in KC mortality trends in Spain across genders, birth cohorts, and age groups. Despite advancements in diagnosis and treatment, substantial public health challenges remain.

{"title":"Time trend and age-period-cohort effect on kidney cancer mortality in Spain, 1983–2022","authors":"L. Cayuela , R. Roldán Testillano , S. Cabrera Fernández , L. Rodríguez-Sánchez , A. Cayuela","doi":"10.1016/j.acuroe.2025.501714","DOIUrl":"10.1016/j.acuroe.2025.501714","url":null,"abstract":"<div><h3>Objective</h3><div>This study examines trends and disparities in kidney cancer (KC) mortality in Spain from 1983 to 2022, focusing on gender, birth cohort, and age influences.</div></div><div><h3>Methods</h3><div>Data from the Spanish National Institute of Statistics were analyzed using age-standardized mortality rates (ASMRs). Joinpoint regression identified temporal trends and annual percentage changes, while Age-Period-Cohort (A-P-C) analysis assessed the impacts of age, calendar period, and birth cohort on mortality.</div></div><div><h3>Results</h3><div>KC mortality increased significantly for both sexes, with men experiencing a steeper rise (1.2% annually) compared to women (0.6% annually). Joinpoint analysis revealed distinct phases: a sharp increase until the mid-1990s, followed by stabilization for men and a slight decline for women. Men aged over 50, particularly those above 80, showed pronounced increases. A-P-C analysis confirmed age as a significant risk factor, with consistently higher mortality rates observed among men across all age groups. Men born from the early 20th century until the 1960s faced increasing mortality risks, while women's risk, after an increase in the early 20th century, stabilized after the 1933 birth cohort. For those born after 1960, both sexes show a potential decline in KC mortality, with a slight upturn in men from the 1980s onwards. The period effect exhibited an increase during the 1980s–1990s, followed by stabilization for men and a continuous decrease for women.</div></div><div><h3>Conclusion</h3><div>This study reveals significant disparities in KC mortality trends in Spain across genders, birth cohorts, and age groups. Despite advancements in diagnosis and treatment, substantial public health challenges remain.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501714"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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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