Pub Date : 2024-10-30DOI: 10.1016/j.acuroe.2024.10.005
A Borque-Fernando, D A Pérez-Fentes, M Rodrigo-Aliaga, J Puente-Vázquez, A Gómez-Iturriaga, M Unda, M A Calleja-Hernández, J M Cózar-Olmo, J L Álvarez-Ossorio
Triple therapy with docetaxel, androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) has demonstrated survival benefits in patients with metastatic hormone-sensitive prostate cancer (mHSPC), especially in those with high-risk disease. However, once the use of ADT and docetaxel is established, guidelines do not clearly specify which ARPI is most appropriate. In this work, a literature review to identify phase III clinical trials, systematic reviews, meta-analyses, and clinical practice guidelines on triple therapy in mHSPC was carried out. Evidence and recommendations were qualitatively reviewed to provide guidelines on the most suitable ARPI based on patient risk, disease volume, and nature of metastases (synchronous or metachronous). This review aims to update the previously published consensus on the optimal pharmacological treatment for mHSPC and to expose the opinions of hospital pharmacy, urology and medical and radiation oncology experts.
{"title":"Optimizing triple therapy in patients with metastatic hormone-sensitive prostate cancer.","authors":"A Borque-Fernando, D A Pérez-Fentes, M Rodrigo-Aliaga, J Puente-Vázquez, A Gómez-Iturriaga, M Unda, M A Calleja-Hernández, J M Cózar-Olmo, J L Álvarez-Ossorio","doi":"10.1016/j.acuroe.2024.10.005","DOIUrl":"10.1016/j.acuroe.2024.10.005","url":null,"abstract":"<p><p>Triple therapy with docetaxel, androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) has demonstrated survival benefits in patients with metastatic hormone-sensitive prostate cancer (mHSPC), especially in those with high-risk disease. However, once the use of ADT and docetaxel is established, guidelines do not clearly specify which ARPI is most appropriate. In this work, a literature review to identify phase III clinical trials, systematic reviews, meta-analyses, and clinical practice guidelines on triple therapy in mHSPC was carried out. Evidence and recommendations were qualitatively reviewed to provide guidelines on the most suitable ARPI based on patient risk, disease volume, and nature of metastases (synchronous or metachronous). This review aims to update the previously published consensus on the optimal pharmacological treatment for mHSPC and to expose the opinions of hospital pharmacy, urology and medical and radiation oncology experts.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565413","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}
Pub Date : 2024-10-30DOI: 10.1016/j.acuroe.2024.10.004
E Bohane, M Murphy, F Chierigo, G Mantica, J Adamowicz, F Campos-Juanatey, A Cocci, M Frankiewicz, C M Rosenbaum, W Verla, M Waterloos, Ł Białek, F X Madec, M Oszczudłowski, M W Vetterlein, E J Redmond
Introduction: The goal of hypospadias repair is to optimize urinary and sexual function, improve cosmesis and minimise the psychosocial effects associated with a penile anomaly. However, a lack of clarity exists regarding the role of surgery in milder hypospadias where the anomaly is inconspicuous and there is no anticipated impact on function. The aim of this study was to review the long term functional, cosmetic and psychosocial outcomes in men with uncorrected hypospadias. This information may be helpful for parents who are burdened with deciding the correct treatment for their child's hypospadias.
Methods: A scoping review of PubMed, EMBASE, and CINAHL + databases was performed in adherence with PRISMA guidelines. Eight studies were identified for inclusion in the review.
Results: Men with mild uncorrected hypospadias have similar functional outcomes to those without hypospadias, preferring to void standing and reporting similar IPSS scores. However, those with severe untreated hypospadias experience significant urinary difficulties, higher IPSS scores, and are more likely to sit when voiding. They reported worse SHIM scores, more ventral curvature, and greater difficulty with intercourse. Most men with incidentally identified hypospadias are unaware of their condition and are satisfied with their penile appearance. There was no difference in the attainment of psychosocial milestones between men with uncorrected hypospadias versus no hypospadias.
Conclusion: There is a lack of research regarding the experiences of adult men with uncorrected hypospadias. However, there is some evidence to support the non-operative management of mild hypospadias. Therefore, the decision to defer surgery in infancy should balance parental wishes and physician guidance, particularly in cases where the risk of functional impairment is low.
{"title":"Long term outcomes from uncorrected hypospadias: a scoping review.","authors":"E Bohane, M Murphy, F Chierigo, G Mantica, J Adamowicz, F Campos-Juanatey, A Cocci, M Frankiewicz, C M Rosenbaum, W Verla, M Waterloos, Ł Białek, F X Madec, M Oszczudłowski, M W Vetterlein, E J Redmond","doi":"10.1016/j.acuroe.2024.10.004","DOIUrl":"10.1016/j.acuroe.2024.10.004","url":null,"abstract":"<p><strong>Introduction: </strong>The goal of hypospadias repair is to optimize urinary and sexual function, improve cosmesis and minimise the psychosocial effects associated with a penile anomaly. However, a lack of clarity exists regarding the role of surgery in milder hypospadias where the anomaly is inconspicuous and there is no anticipated impact on function. The aim of this study was to review the long term functional, cosmetic and psychosocial outcomes in men with uncorrected hypospadias. This information may be helpful for parents who are burdened with deciding the correct treatment for their child's hypospadias.</p><p><strong>Methods: </strong>A scoping review of PubMed, EMBASE, and CINAHL + databases was performed in adherence with PRISMA guidelines. Eight studies were identified for inclusion in the review.</p><p><strong>Results: </strong>Men with mild uncorrected hypospadias have similar functional outcomes to those without hypospadias, preferring to void standing and reporting similar IPSS scores. However, those with severe untreated hypospadias experience significant urinary difficulties, higher IPSS scores, and are more likely to sit when voiding. They reported worse SHIM scores, more ventral curvature, and greater difficulty with intercourse. Most men with incidentally identified hypospadias are unaware of their condition and are satisfied with their penile appearance. There was no difference in the attainment of psychosocial milestones between men with uncorrected hypospadias versus no hypospadias.</p><p><strong>Conclusion: </strong>There is a lack of research regarding the experiences of adult men with uncorrected hypospadias. However, there is some evidence to support the non-operative management of mild hypospadias. Therefore, the decision to defer surgery in infancy should balance parental wishes and physician guidance, particularly in cases where the risk of functional impairment is low.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565411","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}
Pub Date : 2024-10-24DOI: 10.1016/j.acuroe.2024.10.002
J Morote Robles
{"title":"Towards population-based screening for prostate cancer in Spain.","authors":"J Morote Robles","doi":"10.1016/j.acuroe.2024.10.002","DOIUrl":"10.1016/j.acuroe.2024.10.002","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515750","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}
Pub Date : 2024-10-24DOI: 10.1016/j.acuroe.2024.10.001
A Alcántara Montero
{"title":"Towards a change of model in the management of benign prostatic hyperplasia: the importance of an individualized approach.","authors":"A Alcántara Montero","doi":"10.1016/j.acuroe.2024.10.001","DOIUrl":"10.1016/j.acuroe.2024.10.001","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515749","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}
Pub Date : 2024-10-01DOI: 10.1016/j.acuroe.2024.05.004
Introduction
In recent years, different urinary markers such as the Bladder Epicheck® have been developed in an attempt to reduce the number of cystoscopies in the follow-up of non-muscle invasive bladder cancer (NMIBC).
Aim
To provide a systematic review of Bladder Epicheck® and its current clinical utility in the follow-up and detection of recurrence of NMIBC.
Material and methods
Systematic review based on a literature search of PubMed, Web of Science and Scopus databases until October 2023, according to PRISMA and Quadas-2 criteria. Sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the marker were calculated. Diagnostic performance was evaluated by the area under the curve (AUC).
Results
Fifteen studies were analyzed (n = 3761) including 86.7% prospective studies. Of the patient series, 53.2% had received previous intravesical instillations. The mean Se of the biomarker in the detection of recurrence varied according to tumor grade (87.9%-high grade/HG vs. 44.9%-low grade/LG, respectively). Their weighted mean Se and Sp were 71.6% and 84.5%, respectively. The mean recurrence rate was 29.1%. The weighted mean PPV and NPV were 56.4% and 92.8% (97.7% non-LG), respectively. The mean AUC was 85.63%.
Conclusion
Bladder Epicheck® is a useful urinary marker in the follow-up of NMIBC, with significantly high Se and NPV in the detection of recurrences, especially in cases of HG disease. Its use can reduce the number of cystoscopies required in the follow-up of NMIBC, improving the quality of life of patients and potentially increasing health economic savings.
简介：目的：对膀胱Epicheck®及其在非肌层浸润性膀胱癌（NMIBC）随访和复发检测中的临床应用进行系统综述：根据PRISMA和Quadas-2标准，在PubMed、Web of Science和Scopus数据库中进行文献检索，系统综述截至2023年10月。计算标记物的敏感性（Se）、特异性（Sp）、阳性预测值（PPV）和阴性预测值（NPV）。诊断性能通过曲线下面积（AUC）进行评估：分析了 15 项研究（n = 3761），其中 86.7% 为前瞻性研究。53.2%的患者曾接受过膀胱内注射。生物标记物检测复发的平均 Se 因肿瘤级别而异（高级别/HG 与低级别/LG 分别为 87.9% 与 44.9%）。它们的加权平均 Se 和 Sp 分别为 71.6% 和 84.5%。平均复发率为 29.1%。加权平均PPV和NPV分别为56.4%和92.8%（非LG为97.7%）。平均AUC为85.63%：结论：膀胱Epicheck®是随访NMIBC的一种有用的尿液标记物，在检测复发，尤其是HG病例方面具有显著的高Se和NPV。使用它可以减少 NMIBC 随访中所需的膀胱镜检查次数，提高患者的生活质量，并有可能节约更多的医疗经济成本。
{"title":"Use of Bladder Epicheck® in the follow-up of non-muscle-invasive Bladder cancer: A systematic literature review","authors":"","doi":"10.1016/j.acuroe.2024.05.004","DOIUrl":"10.1016/j.acuroe.2024.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent years, different urinary<span> markers such as the Bladder<span> Epicheck® have been developed in an attempt to reduce the number of cystoscopies in the follow-up of non-muscle invasive bladder cancer (NMIBC).</span></span></div></div><div><h3>Aim</h3><div>To provide a systematic review<span> of Bladder Epicheck® and its current clinical utility in the follow-up and detection of recurrence of NMIBC.</span></div></div><div><h3>Material and methods</h3><div>Systematic review based on a literature search of PubMed, Web of Science and Scopus databases until October 2023, according to PRISMA and Quadas-2 criteria. Sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the marker were calculated. Diagnostic performance was evaluated by the area under the curve (AUC).</div></div><div><h3>Results</h3><div>Fifteen studies were analyzed (n = 3761) including 86.7% prospective studies. Of the patient series, 53.2% had received previous intravesical instillations. The mean Se of the biomarker in the detection of recurrence varied according to tumor grade (87.9%-high grade/HG vs. 44.9%-low grade/LG, respectively). Their weighted mean Se and Sp were 71.6% and 84.5%, respectively. The mean recurrence rate was 29.1%. The weighted mean PPV and NPV were 56.4% and 92.8% (97.7% non-LG), respectively. The mean AUC was 85.63%.</div></div><div><h3>Conclusion</h3><div>Bladder Epicheck® is a useful urinary<span><span> marker in the follow-up of NMIBC, with significantly high Se and NPV in the detection of recurrences, especially in cases of HG disease. Its use can reduce the number of cystoscopies required in the follow-up of NMIBC, improving the </span>quality of life of patients and potentially increasing health economic savings.</span></div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 555-564"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913627","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}
Pub Date : 2024-10-01DOI: 10.1016/j.acuroe.2024.05.012
Introduction
Pelvic organ prolapse is a condition with high prevalence in elderly women. With increasing life expectancy and a desire for improved quality of life, a rise in the frequency of surgical treatments for these women is anticipated. The aim is to compare complication, success, and satisfaction rates among elderly patients (aged >70 years) in comparison to younger women undergoing robotic sacrocolpopexy, thereby assessing the safety and efficacy of this surgery in this group of patients.
Method
A prospective observational comparative study of 123 robotic sacrocolpopexies conducted between December 2016 and June 2022. Patients were stratified by age (cutoff point: 70 years). Baseline characteristics, type, and grade of prolapse, intra and postoperative data, complications, functional and anatomical outcomes, and satisfaction levels were collected.
Results
Among the 123 patients, 62.6% were under 70 years old, while 37.4% were 70 years or older, exhibiting similar baseline characteristics, prolapse grade, and type. The percentages of intraoperative (6.5%) and postoperative complications (4.4–9%) were comparable in both age groups. Furthermore, success and satisfaction rates exceeded 90%, with no significant differences between women under and over 70 years during a two-year follow-up.
Conclusion
Robotic sacrocolpopexy is at least as effective and safe in women aged 70 years or older as in younger individuals, with no higher rates of intra and postoperative complications and similar rates of anatomical and subjective success.
{"title":"Robotic sacrocolpopexy for the treatment of pelvic organ prolapse in elderly women: comparative analysis of safety and efficacy versus younger women","authors":"","doi":"10.1016/j.acuroe.2024.05.012","DOIUrl":"10.1016/j.acuroe.2024.05.012","url":null,"abstract":"<div><h3>Introduction</h3><div><span><span>Pelvic organ prolapse is a condition with high prevalence in elderly women. With increasing life expectancy and a desire for improved </span>quality of life, a rise in the frequency of surgical treatments for these women is anticipated. The aim is to compare complication, success, and satisfaction rates among elderly patients (aged >70 years) in comparison to younger women undergoing robotic </span>sacrocolpopexy, thereby assessing the safety and efficacy of this surgery in this group of patients.</div></div><div><h3>Method</h3><div>A prospective observational comparative study of 123 robotic sacrocolpopexies conducted between December 2016 and June 2022. Patients were stratified by age (cutoff point: 70 years). Baseline characteristics, type, and grade of prolapse, intra and postoperative data, complications, functional and anatomical outcomes, and satisfaction levels were collected.</div></div><div><h3>Results</h3><div>Among the 123 patients, 62.6% were under 70 years old, while 37.4% were 70 years or older, exhibiting similar baseline characteristics, prolapse grade, and type. The percentages of intraoperative (6.5%) and postoperative complications (4.4–9%) were comparable in both age groups. Furthermore, success and satisfaction rates exceeded 90%, with no significant differences between women under and over 70 years during a two-year follow-up.</div></div><div><h3>Conclusion</h3><div>Robotic sacrocolpopexy is at least as effective and safe in women aged 70 years or older as in younger individuals, with no higher rates of intra and postoperative complications and similar rates of anatomical and subjective success.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 611-617"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917532","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}
Pub Date : 2024-10-01DOI: 10.1016/j.acuroe.2024.05.017
Introduction and objectives
Different degrees of testicular torsion result in varying degrees of testicular damage, which influences treatment options and outcomes. Therefore, establishing a testicular torsion model with different degrees is necessary for clinical diagnosis.
Materials and methods
Rabbits were randomly divided into four groups and their spermatic cords were twisted at 0 °, 180 °, 360 °, and 720 °, respectively. Color Doppler flow imaging (CDFI) were performed to evaluate the blood supply in testicles. The twisted testicles were surgically removed at six hours post-operation and were evaluated by morphological observation and Hematoxylin and Eosin staining.
Results
CDFI signals were gradually decreased as the degree of testicular torsion increased, and scores of CDFI in the 360 ° and 720 ° groups were significantly decreased at postoperative six hours compared to pre-surgery. Compared to the sham, the testicle in the 180 ° group exhibited slight congestion, whereas the testicles in the 360 ° and 720 ° groups were dark red in color and had severe congestion and unrecognizable vessels. Hematoxylin and Eosin staining showed mild spermatogenic cell reduction and testicular interstitial hemorrhage in the 180 ° group. In the 360 ° and 720 ° groups, disordered seminiferous tubules, shed spermatogenic cells in tubules, inflammatory cell infiltration, and severe hemorrhage were found. In comparison with the sham, interstitial hemorrhage scores in the 360 ° and 720 ° groups were significantly higher, and scores of germinal epithelial cell thickness in the three testicular torsion groups were significantly decreased.
Conclusions
Collectively, we successfully constructed a testicular torsion model with different degrees in rabbits.
{"title":"Establishment of a rabbit model of different degrees of testicular torsion","authors":"","doi":"10.1016/j.acuroe.2024.05.017","DOIUrl":"10.1016/j.acuroe.2024.05.017","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Different degrees of testicular torsion<span> result in varying degrees of testicular damage, which influences treatment options and outcomes. Therefore, establishing a testicular torsion model with different degrees is necessary for clinical diagnosis.</span></div></div><div><h3>Materials and methods</h3><div><span>Rabbits were randomly divided into four groups and their spermatic cords were twisted at 0 °, 180 °, 360 °, and 720 °, respectively. </span>Color Doppler<span><span><span><span> flow imaging (CDFI) were performed to evaluate the </span>blood supply<span> in testicles. The twisted testicles were surgically removed at six hours post-operation and were evaluated by morphological observation and </span></span>Hematoxylin and </span>Eosin staining.</span></div></div><div><h3>Results</h3><div><span><span>CDFI signals were gradually decreased as the degree of testicular torsion increased, and scores of CDFI in the 360 ° and 720 ° groups were significantly decreased at postoperative six hours compared to pre-surgery. Compared to the sham, the testicle in the 180 ° group exhibited slight congestion, whereas the testicles in the 360 ° and 720 ° groups were dark red in color and had severe congestion and unrecognizable vessels. Hematoxylin and </span>Eosin<span><span> staining showed mild spermatogenic cell reduction and testicular interstitial hemorrhage in the 180 ° group. In the 360 ° and 720 ° groups, disordered </span>seminiferous tubules, shed spermatogenic cells in tubules, </span></span>inflammatory cell infiltration, and severe hemorrhage were found. In comparison with the sham, interstitial hemorrhage scores in the 360 ° and 720 ° groups were significantly higher, and scores of germinal epithelial cell thickness in the three testicular torsion groups were significantly decreased.</div></div><div><h3>Conclusions</h3><div>Collectively, we successfully constructed a testicular torsion model with different degrees in rabbits.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 565-573"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141414948","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}
Pub Date : 2024-10-01DOI: 10.1016/j.acuroe.2024.05.006
Introduction and objective
Robotic-assisted laparoscopic prostatectomy (PLAR) seems to improve functional outcomes, however there is not a consensus of a standard procedure. The aim of this study was to identify the PLAR “state of art” in Catalonia, Spain.
Material and methods
This was a cross-sectional survey-based study conducted among urologists across Catalonia, Spain. The survey was distributed through online platforms and the professional urology society. All statistical analyses were performed using Stata software, v20.
Results
59 urologists completed the survey, revealing PLAR as the most commonly used technique (79.7%). Most urologist (70%) create the pneumoperitoneum using a controlled incision with direct access and 78.3% use the Airseal technology. The intraperitoneal approach is performed in >90% of cases. Endopelvic fascia preservation is not routinely performed. 34.5% of the survey not perform the dorsal vein complex suture. All preserves the bladder neck when oncologically safe. Nerve-vascular bundles bleeding control is performed using standard coagulation or suturing. 34% performed posterior reconstruction. Only use hemostatic devices when evident bleeding and 70% does not routinely left a drainage.
Multivariable analysis showed that center volume had a significant independent association with dorsal venous complex suturing (OR 0.073, 95%CI 0.07−0.826), nerve-vascular bundles suturing hemostasis (OR 11.67, 95%CI 1.07−127.60) and endopelvic fascia preservation (OR 13.64, 95%CI 1.087–201.27), but there was no correlation with time the bladder catheter or days hospitalized.
Conclusions
The study provides an overview of the state of PLAR in Catalonia, Spain, showing significant variability and reflecting a commitment to advancing surgical technology and patient care.
{"title":"State of art of robotic prostatectomy: the way we do it in Catalonia, Spain","authors":"","doi":"10.1016/j.acuroe.2024.05.006","DOIUrl":"10.1016/j.acuroe.2024.05.006","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Robotic-assisted laparoscopic prostatectomy (PLAR) seems to improve functional outcomes, however there is not a consensus of a standard procedure. The aim of this study was to identify the PLAR “state of art” in Catalonia, Spain.</div></div><div><h3>Material and methods</h3><div>This was a cross-sectional survey-based study conducted among urologists across Catalonia, Spain. The survey was distributed through online platforms and the professional urology society. All statistical analyses were performed using Stata software, v20.</div></div><div><h3>Results</h3><div>59 urologists completed the survey, revealing PLAR as the most commonly used technique (79.7%). Most urologist (70%) create the pneumoperitoneum using a controlled incision with direct access and 78.3% use the Airseal technology. The intraperitoneal approach is performed in >90% of cases. Endopelvic fascia preservation is not routinely performed. 34.5% of the survey not perform the dorsal vein complex suture. All preserves the bladder neck when oncologically safe. Nerve-vascular bundles bleeding control is performed using standard coagulation or suturing. 34% performed posterior reconstruction. Only use hemostatic devices when evident bleeding and 70% does not routinely left a drainage.</div><div>Multivariable analysis showed that center volume had a significant independent association with dorsal venous complex suturing (OR 0.073, 95%CI 0.07−0.826), nerve-vascular bundles suturing hemostasis (OR 11.67, 95%CI 1.07−127.60) and endopelvic fascia preservation (OR 13.64, 95%CI 1.087–201.27), but there was no correlation with time the bladder catheter or days hospitalized.</div></div><div><h3>Conclusions</h3><div>The study provides an overview of the state of PLAR in Catalonia, Spain, showing significant variability and reflecting a commitment to advancing surgical technology and patient care.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 581-587"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917557","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}
Pub Date : 2024-10-01DOI: 10.1016/j.acuroe.2024.05.003
Background
Testicular cancer, primarily affecting young men, has seen an alarming rise globally. This study delves into incidence and mortality trends in Spain from 1990 to 2019 using the Global Burden of Disease (GBD) database and the Age-Period-Cohort (A-P-C) model.
Methods
We analyzed GBD data on testicular cancer cases and deaths in Spain, calculating age-standardized rates (ASIR and ASMR) and employing Joinpoint regression to identify significant shifts. The A-P-C model further dissected the effects of age, period, and birth cohort on these trends.
Results
A striking doubling in testicular cancer incidence was observed, from 3.09 to 5.40 per 100,000 men (1.9% annual increase), while mortality rates remained stable and even decreased in younger age groups (0.34 to 0.26 per 100,000, 0.8% annual decrease). Joinpoint analysis revealed four distinct periods of increasing incidence, with a recent slowdown. The A-P-C model highlighted a consistent rise in incidence risk with each successive generation born after 1935, contrasting with a progressive decline in mortality risk across cohorts, particularly marked for those born since the 1960s.
Conclusion
While mortality rates are encouraging, Spain reflects the global trend of escalating testicular cancer incidence. The A-P-C analysis suggests a generational influence, but the underlying causes remain elusive. Further research is crucial to understand these trends and implement effective prevention strategies to combat this growing health concern.
{"title":"Rising testicular cancer incidence in Spain despite declining mortality: an age-period-cohort analysis","authors":"","doi":"10.1016/j.acuroe.2024.05.003","DOIUrl":"10.1016/j.acuroe.2024.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Testicular cancer<span>, primarily affecting young men, has seen an alarming rise globally. This study delves into incidence and mortality trends in Spain from 1990 to 2019 using the Global Burden of Disease (GBD) database and the Age-Period-Cohort (A-P-C) model.</span></div></div><div><h3>Methods</h3><div>We analyzed GBD data on testicular cancer cases and deaths in Spain, calculating age-standardized rates (ASIR and ASMR) and employing Joinpoint regression to identify significant shifts. The A-P-C model further dissected the effects of age, period, and birth cohort on these trends.</div></div><div><h3>Results</h3><div>A striking doubling in testicular cancer incidence was observed, from 3.09 to 5.40 per 100,000 men (1.9% annual increase), while mortality rates remained stable and even decreased in younger age groups (0.34 to 0.26 per 100,000, 0.8% annual decrease). Joinpoint analysis revealed four distinct periods of increasing incidence, with a recent slowdown. The A-P-C model highlighted a consistent rise in incidence risk with each successive generation born after 1935, contrasting with a progressive decline in mortality risk across cohorts, particularly marked for those born since the 1960s.</div></div><div><h3>Conclusion</h3><div>While mortality rates are encouraging, Spain reflects the global trend of escalating testicular cancer incidence. The A-P-C analysis suggests a generational influence, but the underlying causes remain elusive. Further research is crucial to understand these trends and implement effective prevention strategies to combat this growing health concern.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 596-602"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909717","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}
Pub Date : 2024-10-01DOI: 10.1016/j.acuroe.2024.05.010
Objective
To analyze the predictive capacity of the nephrolithometry scoring systems (GSS, STONE, CROES and S-ReSC) and stone surface regarding success and complications following percutaneous nephrolithotomy (PCNL).
Methods
We studied 392 patients who had undergone PCNL in our center. Only patients with a non-contrast CT (n = 240) were finally included for analysis. The predictive capacities for success and complications of the different scoring systems were evaluated using ROC curves and their area under the curve (AUC).
Results
Regarding success, the S-ReSC system had the highest predictive capacity with an AUC of 0.681 (95% CI 0.610−0.751), followed by the CROES with 0.667 (95% CI 0.595−0.738), the STONE with 0.654 (95% CI 0.579−0.728) and finally the GSS with 0.626 (95% CI 0.555−0.698). The stone surface as a single variable had an AUC of 0.641 (95% CI 0.565−0.718). As for complications, the S-ReSC had the highest AUC with 0.664 (95% CI 0.57−0.758), followed by STONE with 0.663 (95% CI 0.572−0.755), GSS with 0.626 (95% CI 0.555).−0.698) and CROES with 0.614 (95% CI 0.518−0.7). The stone surface alone had an AUC of 0.616 (95% CI 0.522−0.715).
Conclusion
The nephrolithometry scales analyzed show a moderate predictive capacity for success and complications in patients undergoing PCNL in our center. Moreover, stone surface as an independent variable demonstrates moderate predictive capacity for both outcomes.
目的分析肾石测量评分系统（GSS、STONE、CROES 和 S-ReSC）和结石表面对经皮肾镜取石术（PCNL）成功率和并发症的预测能力：我们对本中心接受 PCNL 的 392 例患者进行了研究。方法：我们对本中心接受 PCNL 的 392 例患者进行了研究，最终只分析了接受非对比 CT 检查的患者（240 例）。使用 ROC 曲线及其曲线下面积（AUC）评估了不同评分系统对成功率和并发症的预测能力：在成功率方面，S-ReSC 系统的预测能力最高，其 AUC 为 0.681（95% CI 0.610 - 0.751），其次是 CROES，为 0.667（95% CI 0.595 - 0.738），STONE 为 0.654（95% CI 0.579 - 0.728），最后是 GSS，为 0.626（95% CI 0.555 - 0.698）。结石表面作为单一变量的 AUC 为 0.641（95% CI 0.565 - 0.718）。在并发症方面，S-ReSC 的 AUC 最高，为 0.664 (95% CI 0.57 - 0.758)，其次是 STONE，为 0.663 (95% CI 0.572 - 0.755)，GSS 为 0.626 (95% CI 0.555).- 0.698），CROES 为 0.614（95% CI 0.518 - 0.7）。结石表面单独的 AUC 为 0.616（95% CI 0.522 - 0.715）：结论：所分析的肾石量表对在本中心接受 PCNL 治疗的患者的成功率和并发症具有一定的预测能力。此外，结石表面作为一个独立变量，对这两种结果也有一定的预测能力。
{"title":"Does success in percutaneous nephrolithotomy depend only on stone size? Analysis of the predictive capacity for success and complications of the current nephrolithometry scoring systems and their relationship with the stone surface","authors":"","doi":"10.1016/j.acuroe.2024.05.010","DOIUrl":"10.1016/j.acuroe.2024.05.010","url":null,"abstract":"<div><h3>Objective</h3><div><span>To analyze the predictive capacity of the nephrolithometry scoring systems (GSS, STONE, </span>CROES<span> and S-ReSC) and stone surface regarding success and complications following percutaneous nephrolithotomy (PCNL).</span></div></div><div><h3>Methods</h3><div>We studied 392 patients who had undergone PCNL in our center. Only patients with a non-contrast CT (n = 240) were finally included for analysis. The predictive capacities for success and complications of the different scoring systems were evaluated using ROC curves and their area under the curve (AUC).</div></div><div><h3>Results</h3><div>Regarding success, the S-ReSC system had the highest predictive capacity with an AUC of 0.681 (95% CI 0.610−0.751), followed by the CROES with 0.667 (95% CI 0.595−0.738), the STONE with 0.654 (95% CI 0.579−0.728) and finally the GSS with 0.626 (95% CI 0.555−0.698). The stone surface as a single variable had an AUC of 0.641 (95% CI 0.565−0.718). As for complications, the S-ReSC had the highest AUC with 0.664 (95% CI 0.57−0.758), followed by STONE with 0.663 (95% CI 0.572−0.755), GSS with 0.626 (95% CI 0.555).−0.698) and CROES with 0.614 (95% CI 0.518−0.7). The stone surface alone had an AUC of 0.616 (95% CI 0.522−0.715).</div></div><div><h3>Conclusion</h3><div>The nephrolithometry scales analyzed show a moderate predictive capacity for success and complications in patients undergoing PCNL in our center. Moreover, stone surface as an independent variable demonstrates moderate predictive capacity for both outcomes.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 603-610"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913638","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}
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