Actas urologicas espanolas最新文献_第2页

The effect of electroacupuncture applied to women with stress urinary incontinence on urinary incontinence severity and symptoms: Systematic review and meta-analysis of randomized controlled trials 对压力性尿失禁妇女进行电针治疗对尿失禁严重程度和症状的影响：随机对照试验的系统回顾和荟萃分析。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.03.002

F.Ş. Bilgiç , N. Gençtürk , B. Arıkan

Introduction

Stress Urinary Incontinence is a condition that impairs the quality of life in women and randomized controlled trials of electroacupuncture for stress urinary incontinence have been conducted.

Objective

The aim of this systematic review and meta-analysis was to examine the effect of electroacupuncture on the severity and symptoms of urinary incontinence in women with stress urinary incontinence.

Methods

Literature searches were conducted in PubMed, CINAHL, Scopus and Science Citation Index until November 2023. This study was based on the recommendations of the Cochrane guidelines. Data were analyzed using the Review Manager computer program (Version 5.4). The methodological quality of the studies was assessed using the RoB-2 tool.

Results

The analysis included 888 women with stress urinary incontinence and three studies. In women with stress urinary incontinence, electroacupuncture intervention improved urinary incontinence severity and quality of life (MD: −2.37, 95% CI: −3.29 to 1.45, Z = 5.07, p < 0.001), urinary leakage (SMD: −0.79, 95% CI: −1.02 to −0.55, Z = 6.60, p = 0.001) and incontinence episode frequency (SMD: −2.24, 95% CI: −4.17 to −0.32, Z = 2.29, p < 0.02).

Conclusion

In women with stress urinary incontinence, electroacupuncture intervention decreased the severity of urinary incontinence and improved the quality of life. Symptoms related to urinary incontinence were found to decrease urinary leakage and incontinence episode frequency. The studies included in the analysis were determined to be low-risk studies in quality assessment.

简介：压力性尿失禁是一种影响女性生活质量的疾病：压力性尿失禁是一种影响女性生活质量的疾病，目前已经开展了电针治疗压力性尿失禁的随机对照试验：本系统综述和荟萃分析旨在研究电针对压力性尿失禁女性尿失禁严重程度和症状的影响：在PubMed、CINAHL、Scopus和《科学引文索引》中进行文献检索，直至2023年11月。本研究以 Cochrane 指南的建议为基础。数据使用 Review Manager 计算机程序（5.4 版）进行分析。使用 RoB-2 工具对研究的方法学质量进行评估：分析包括 888 名压力性尿失禁女性和三项研究。在患有压力性尿失禁的妇女中，电针干预改善了尿失禁的严重程度和生活质量（MD:-2.37, 95% CI:-3.29 to 1.45, Z = 5.07,p 结论：在患有压力性尿失禁的妇女中，电针干预改善了尿失禁的严重程度和生活质量：对患有压力性尿失禁的女性而言，电针干预可降低尿失禁的严重程度并提高生活质量。与尿失禁相关的症状可减少漏尿和尿失禁发作频率。纳入分析的研究在质量评估中被确定为低风险研究。

{"title":"The effect of electroacupuncture applied to women with stress urinary incontinence on urinary incontinence severity and symptoms: Systematic review and meta-analysis of randomized controlled trials","authors":"F.Ş. Bilgiç , N. Gençtürk , B. Arıkan","doi":"10.1016/j.acuroe.2024.03.002","DOIUrl":"10.1016/j.acuroe.2024.03.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Stress Urinary Incontinence is a condition that impairs the quality of life in women and randomized controlled trials of electroacupuncture for stress urinary incontinence have been conducted.</p></div><div><h3>Objective</h3><p>The aim of this systematic review and meta-analysis was to examine the effect of electroacupuncture on the severity and symptoms of urinary incontinence in women with stress urinary incontinence.</p></div><div><h3>Methods</h3><p>Literature searches were conducted in PubMed, CINAHL, Scopus and Science Citation Index until November 2023. This study was based on the recommendations of the Cochrane guidelines. Data were analyzed using the Review Manager computer program (Version 5.4). The methodological quality of the studies was assessed using the RoB-2 tool.</p></div><div><h3>Results</h3><p>The analysis included 888 women with stress urinary incontinence and three studies. In women with stress urinary incontinence, electroacupuncture intervention improved urinary incontinence severity and quality of life (MD: −2.37, 95% CI: −3.29 to 1.45, Z = 5.07, p < 0.001), urinary leakage (SMD: −0.79, 95% CI: −1.02 to −0.55, Z = 6.60, p = 0.001) and incontinence episode frequency (SMD: −2.24, 95% CI: −4.17 to −0.32, Z = 2.29, p < 0.02).</p></div><div><h3>Conclusion</h3><p>In women with stress urinary incontinence, electroacupuncture intervention decreased the severity of urinary incontinence and improved the quality of life. Symptoms related to urinary incontinence were found to decrease urinary leakage and incontinence episode frequency. The studies included in the analysis were determined to be low-risk studies in quality assessment.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332416","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 association between the human papillomavirus (HPV) and the diagnosis of bladder cancer: systematic review and meta-analysis 人类乳头瘤病毒（hpv）与膀胱癌诊断之间的关联：系统回顾与荟萃分析。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.05.002

I.J. Otero-Muriel , S. Jiménez Giraldo , H.A. García-Perdomo

Background

Bladder cancer (BC) is the seventh most common cancer worldwide. Not every infection ends as cancer, although the HPV-induced carcinogenesis is a complex process consequence of inflammation. To determine the association between human papillomavirus (HPV) and the diagnosis of bladder cancer.

Methods

We carried out a systematic review according to Cochrane and PRISMA recommendations. We searched in EMBASE, Medline (Ovid), and The Cochrane Central Register of Controlled Trials (CENTRAL), from inception to nowadays. We included case-control studies. The risk of bias assessment was performed based on QUADAS2. We performed a random effect Meta-analysis.

Results

We included 14 studies in qualitative and quantitative analysis. There was mainly a low risk of bias. We finally found a strong association between the presence of HPV and bladder cancer diagnosis (OR 4.18 95%CI 2.63–6.66; I2 = 40%).

Conclusions

HPV is currently associated with the diagnosis of bladder cancer.

背景：膀胱癌（BC）是全球第七大常见癌症：膀胱癌（BC）是全球第七大常见癌症。尽管人乳头瘤病毒（HPV）诱发的癌变是一个复杂的炎症过程，但并非所有感染都会导致癌症。为了确定人类乳头瘤病毒（HPV）与膀胱癌诊断之间的关联：方法：我们根据 Cochrane 和 PRISMA 建议进行了系统性回顾。我们检索了 EMBASE、Medline (Ovid) 和 Cochrane 对照试验中央注册中心 (CENTRAL)，检索时间从开始到现在。我们纳入了病例对照研究。偏倚风险评估基于 QUADAS2 进行。我们进行了随机效应 Meta 分析：我们对 14 项研究进行了定性和定量分析。主要存在低偏倚风险。我们最终发现，HPV 的存在与膀胱癌诊断之间存在密切联系（OR 4.18 95%CI 2.63 至 6.66；I2 = 40%）：目前，HPV 与膀胱癌的诊断有关。

引用次数: 0

Management of pudendal neuralgia with electrical stimulation. A systematic review 用电刺激治疗阴部神经痛。系统综述。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.02.001

L. Piñeiro-Franco , A. Alonso-Calvete , Iria Da Cuña-Carrera

Introduction and objective

Pudendal neuralgia is a severely intense, painful, neuropathic condition, involving the dermatome of the pudendal nerve (S2, S3, S4). The diagnosis is complex and usually takes many years to be made. Techniques that use electrical current have been shown to decrease pain and improve quality of life in patients with this condition. The aim of this review was to analyze the existing literature on the effects of electrical current in the treatment of patients with pudendal neuralgia.

Material and methods

A literature search was carried out in PubMed, Cinahl, Medline, Cochrane Library, ENFISPO, PEDro, Scopus and Web of Science databases, using the search terms “Electric Stimulation Therapy”, “pudendal neuralgia” and “pudendal nerve entrapment”.

Results

The most frequently repeated intervention is pulsed radiofrequency. Other techniques used are transcutaneous electrical nerve stimulation, pulsed electromagnetic field therapy and neuromodulation. All studies show significant improvement in pain, analgesic intake, depression-anxiety or quality of life.

Conclusions

The application of electrical current seems to be effective in the management of pudendal neuralgia. The scientific evidence is scarce, of poor methodological quality, and its use is based on the efficacy demonstrated in other indications of chronic pain.

简介和目的：阴部神经痛是一种严重的剧烈疼痛性神经病变，累及阴部神经皮节（S2、S3、S4）。该病诊断复杂，通常需要多年才能确诊。使用电流的技术已被证明可以减轻疼痛并改善该病患者的生活质量。本综述旨在分析现有文献中有关电流治疗阴部神经痛患者效果的内容：在 PubMed、Cinahl、Medline、Cochrane Library、ENFISPO、PEDro、Scopus 和 Web of Science 数据库中使用 "电刺激疗法"、"会阴神经痛 "和 "会阴神经卡压 "等检索词进行了文献检索：结果：最常用的干预方法是脉冲射频。其他技术包括经皮神经电刺激、脉冲电磁场疗法和神经调控。所有研究均显示，疼痛、镇痛药摄入量、抑郁焦虑或生活质量均有明显改善：结论：应用电流治疗阴部神经痛似乎很有效。结论：应用电流治疗阴部神经痛似乎是有效的，但科学证据很少，方法质量不高，其应用是基于对其他慢性疼痛适应症的疗效。

{"title":"Management of pudendal neuralgia with electrical stimulation. A systematic review","authors":"L. Piñeiro-Franco , A. Alonso-Calvete , Iria Da Cuña-Carrera","doi":"10.1016/j.acuroe.2024.02.001","DOIUrl":"10.1016/j.acuroe.2024.02.001","url":null,"abstract":"<div><h3>Introduction and objective</h3><p>Pudendal neuralgia is a severely intense, painful, neuropathic condition, involving the dermatome of the pudendal nerve (S2, S3, S4). The diagnosis is complex and usually takes many years to be made. Techniques that use electrical current have been shown to decrease pain and improve quality of life in patients with this condition. The aim of this review was to analyze the existing literature on the effects of electrical current in the treatment of patients with pudendal neuralgia.</p></div><div><h3>Material and methods</h3><p>A literature search was carried out in PubMed, Cinahl, Medline, Cochrane Library, ENFISPO, PEDro, Scopus and Web of Science databases, using the search terms “Electric Stimulation Therapy”, “pudendal neuralgia” and “pudendal nerve entrapment”.</p></div><div><h3>Results</h3><p>The most frequently repeated intervention is pulsed radiofrequency. Other techniques used are transcutaneous electrical nerve stimulation, pulsed electromagnetic field therapy and neuromodulation. All studies show significant improvement in pain, analgesic intake, depression-anxiety or quality of life.</p></div><div><h3>Conclusions</h3><p>The application of electrical current seems to be effective in the management of pudendal neuralgia. The scientific evidence is scarce, of poor methodological quality, and its use is based on the efficacy demonstrated in other indications of chronic pain.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139748038","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

A new promising indicator in prostate cancer screening: Prostate-specific antigen fluctuation rate 前列腺癌筛查的一个新指标：前列腺特异性抗原波动率

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.02.006

U. Can , A. Coskun , C. Canakci , B. Simsek , Y. Karaca , K. Sabuncu , O. Akca

Objectives

To evaluate whether PSA fluctuation can be used to predict the risk of prostate cancer.

Materials and methods

The study included 1244 patients who underwent prostate biopsy at Kartal Dr. Lutfi Kirdar City Hospital between 2013 and 2021 (848 in non-cancer; 396 in cancer). The patient's age, last two PSA values (PSA₁ and PSA₂) within three months before the biopsy, the duration between two PSAs (days), prostate size (g) and PSA density (PSAD) were all recorded. PSA fluctuation rate (PSAfr) was defined as the change rate between two PSA values.

Results

PSAfr was significantly higher in the non-cancer group than in the prostate cancer group (15.2% (20.5) and 9.6% (14.4), P = .019). A Simple linear regression was used to examine the relationship between PSAfr and other factors such as age, PSA, PSAD, and prostate volume, but it was shown that these had no effect on PSA fluctuations. ROC analysis revealed a relatively low Area Under the Curve (AUC) for PSAfr (AUC, 0.584 (0.515–0.653)). However, the cut-off value of 12.35% was found to be significant, with a sensitivity of 58% and a specificity of 59% (P:.019, 95%CI). The odds ratio, adjusted for age, PSAD, and PSA2, was calculated as 0.545 (0.33−0.89) using logistic regression analysis to show the relationship between prostate cancer and PSAfr. As a result, those with high PSAfr were found to be 1.83 times less likely to be diagnosed with prostate cancer than those with low fluctuations.

Conclusion

PSAfr could be used in nomograms to predict prostate cancer risk and reduce the number of unnecessary biopsies.

目的：评估 PSA 波动是否可用于预测前列腺癌风险：评估 PSA 波动是否可用于预测前列腺癌风险：研究纳入了 2013 年至 2021 年期间在 Kartal Dr. Lutfi Kirdar 市医院接受前列腺活检的 1244 名患者（非癌症患者 848 名；癌症患者 396 名）。患者的年龄、活检前三个月内最后两次 PSA 值（PSA1 和 PSA2）、两次 PSA 之间的间隔时间（天数）、前列腺大小（g）和 PSA 密度（PSAD）均被记录在案。PSA波动率（PSAfr）是指两次PSA值之间的变化率：结果：非癌症组的 PSAfr 明显低于前列腺癌组（15.2% (20.5) 和 9.6% (14.4)，P = 0.019）。简单线性回归用于研究 PSAfr 与年龄、PSA、PSAD 和前列腺体积等其他因素之间的关系，但结果显示这些因素对 PSA 波动没有影响。ROC分析显示，PSAfr的曲线下面积（AUC）相对较低（AUC, 0.584 (0.515-0.653)），但12.35%的临界值具有显著性，灵敏度为58%，特异度为59%（p:0.019,95%CI）。结果发现，PSAfr值高的人被诊断为前列腺癌的几率是PSAfr值低的人的1.83倍：结论：PSAfr 可用于预测前列腺癌风险的提名图，减少不必要的活检次数。

{"title":"A new promising indicator in prostate cancer screening: Prostate-specific antigen fluctuation rate","authors":"U. Can , A. Coskun , C. Canakci , B. Simsek , Y. Karaca , K. Sabuncu , O. Akca","doi":"10.1016/j.acuroe.2024.02.006","DOIUrl":"10.1016/j.acuroe.2024.02.006","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate whether PSA fluctuation can be used to predict the risk of prostate cancer.</p></div><div><h3>Materials and methods</h3><p>The study included 1244 patients who underwent prostate biopsy at Kartal Dr. Lutfi Kirdar City Hospital between 2013 and 2021 (848 in non-cancer; 396 in cancer). The patient's age, last two PSA values (PSA<sub>1</sub> and PSA<sub>2</sub>) within three months before the biopsy, the duration between two PSAs (days), prostate size (g) and PSA density (PSAD) were all recorded. PSA fluctuation rate (PSAfr) was defined as the change rate between two PSA values.</p></div><div><h3>Results</h3><p>PSAfr was significantly higher in the non-cancer group than in the prostate cancer group (15.2% (20.5) and 9.6% (14.4), <em>P</em>  <!-->.019). A Simple linear regression was used to examine the relationship between PSAfr and other factors such as age, PSA, PSAD, and prostate volume, but it was shown that these had no effect on PSA fluctuations. ROC analysis revealed a relatively low Area Under the Curve (AUC) for PSAfr (AUC, 0.584 (0.515–0.653)). However, the cut-off value of 12.35% was found to be significant, with a sensitivity of 58% and a specificity of 59% (<em>P</em>:.019, 95%CI). The odds ratio, adjusted for age, PSAD, and PSA2, was calculated as 0.545 (0.33−0.89) using logistic regression analysis to show the relationship between prostate cancer and PSAfr. As a result, those with high PSAfr were found to be 1.83 times less likely to be diagnosed with prostate cancer than those with low fluctuations.</p></div><div><h3>Conclusion</h3><p>PSAfr could be used in nomograms to predict prostate cancer risk and reduce the number of unnecessary biopsies.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139901051","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

Association between varicocele and hypogonadism, or erectile dysfunction: A systematic review and meta-analysis. 精索静脉曲张与性腺功能减退或勃起功能障碍之间的关系：系统回顾和荟萃分析。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.06.006

S J Gonzalez-Daza, A M Díaz-Hung, H A García-Perdomo

Objective: To assess the association between varicocele and hypogonadism, or erectile dysfunction.

Methods: We searched MEDLINE, EMBASE, LILACS, CENTRAL, and other sources. We included cohort, case-control, and cross-sectional studies. The primary outcome was the association between varicocele and hypogonadism, or erectile dysfunction, and the secondary outcome included semen analysis. We assessed the risk of bias with the Newcastle-Ottawa Scale. We performed statistical analysis in Review Manager 5.3 and reported information about the Odds Ratio (OR) with a 95% confidence interval. We produced a forest plot for the primary outcome.

Results: We included ten studies in qualitative analysis and six studies in quantitative analysis. Most of the cross-sectional studies showed a low risk of bias, not so for the two case-control studies, which represented a high risk of bias. Most of the reports described a correlation between having varicocele and presenting low testosterone levels: the meta-analysis showed that there is a significant association between varicocele and hypogonadism (OR 3.27 95% CI 1.23 to 8.68). Regarding varicocele and erectile, only one study showed a significant difference in erectile function in comparison to varicocele patients and men without varicocele.

Conclusion: There is an association between varicocele presence and hypogonadism, although more studies are needed. Besides, not much is reported about an association between varicocele and erectile dysfunction, but impairment can occur through hormone disturbances.

目的：评估精索静脉曲张与性腺功能减退或勃起功能障碍之间的关系：评估精索静脉曲张与性腺功能减退或勃起功能障碍之间的关系：我们检索了 MEDLINE、EMBASE、LILACS、CENTRAL 和其他资料来源。我们纳入了队列研究、病例对照研究和横断面研究。主要结果是精索静脉曲张与性腺功能减退或勃起功能障碍之间的关系，次要结果包括精液分析。我们使用纽卡斯尔-渥太华量表评估了偏倚风险。我们在Review Manager 5.3中进行了统计分析，并报告了带有95%置信区间的比值比（OR）信息。我们为主要结果绘制了森林图：我们在定性分析中纳入了 10 项研究，在定量分析中纳入了 6 项研究。大多数横断面研究的偏倚风险较低，而两项病例对照研究的偏倚风险较高。大多数报告都描述了精索静脉曲张与睾酮水平低之间的相关性：荟萃分析表明，精索静脉曲张与性腺功能减退之间存在显著关联（OR 3.27 95%CI 1.23 至 8.68）。关于精索静脉曲张和勃起功能，只有一项研究显示，精索静脉曲张患者和无精索静脉曲张的男性在勃起功能方面存在显著差异：结论：精索静脉曲张与性腺功能减退之间存在关联，但还需要更多的研究。此外，关于精索静脉曲张与勃起功能障碍之间关系的报道并不多，但激素紊乱可能会导致勃起功能障碍。

{"title":"Association between varicocele and hypogonadism, or erectile dysfunction: A systematic review and meta-analysis.","authors":"S J Gonzalez-Daza, A M Díaz-Hung, H A García-Perdomo","doi":"10.1016/j.acuroe.2024.06.006","DOIUrl":"10.1016/j.acuroe.2024.06.006","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between varicocele and hypogonadism, or erectile dysfunction.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE, LILACS, CENTRAL, and other sources. We included cohort, case-control, and cross-sectional studies. The primary outcome was the association between varicocele and hypogonadism, or erectile dysfunction, and the secondary outcome included semen analysis. We assessed the risk of bias with the Newcastle-Ottawa Scale. We performed statistical analysis in Review Manager 5.3 and reported information about the Odds Ratio (OR) with a 95% confidence interval. We produced a forest plot for the primary outcome.</p><p><strong>Results: </strong>We included ten studies in qualitative analysis and six studies in quantitative analysis. Most of the cross-sectional studies showed a low risk of bias, not so for the two case-control studies, which represented a high risk of bias. Most of the reports described a correlation between having varicocele and presenting low testosterone levels: the meta-analysis showed that there is a significant association between varicocele and hypogonadism (OR 3.27 95% CI 1.23 to 8.68). Regarding varicocele and erectile, only one study showed a significant difference in erectile function in comparison to varicocele patients and men without varicocele.</p><p><strong>Conclusion: </strong>There is an association between varicocele presence and hypogonadism, although more studies are needed. Besides, not much is reported about an association between varicocele and erectile dysfunction, but impairment can occur through hormone disturbances.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500112","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

Laparoscopic approach for xanthogranulomatous pyelonephritis and pyonephrosis 黄疽性肾盂肾炎和肾盂积水的腹腔镜治疗方法。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.03.001

T. Telecan , I. Andras , N. Crousen , E.D. Cata , P. Medan , D.V. Stanca , A. Territo , I. Coman , N. Crisan

Introduction

Xanthogranulomatous pyelonephritis (XGPN) is a rare form of chronic renal inflammation, caused by long-term obstruction of the urinary tract. Pyonephrosis is a severe suppurative complication of acute obstructive pyelonephritis. Although minimally invasive approaches have many advantages, the safe dissection of the kidney may not be always achievable.

Materials and methods

We reviewed 27 cases diagnosed with either XGPN or pyonephrosis, who underwent laparoscopic total nephrectomy between October 2016 and March 2022 in our department. All interventions were performed using the Karl Storz 3D laparoscopic system. The surgical approach was standard transperitoneal nephrectomy for the majority of XGPN, while pyonephrosis cases were carried out in a retroperitoneally. All procedures were performed or supervised by the same surgeon.

Results

The mean operative time was 269.85 minutes (range 145–360). The mean hemoglobin drop after surgery was 1.41 g/dl (range 0.3–2.3 g/dl). Difficult dissection was encountered in 13 cases (48.14%). Nine out of 13 interventions were carried out in a complete intracorporeal fashion, while conversion to open surgery was needed in 4 cases. Vascular complications involving the major blood vessels comprised of one case of inferior vena cava (IVC) tear. Digestive tract-related complications comprised two fistulas of the descending colon and one peritoneal breach. Multiorgan resection was performed in 6 cases.

Conclusion

Total nephrectomy in cases of XGPN and pyonephrosis is a challenging procedure. The laparoscopic approach is feasible, as most complications are resolved intracorporeally. However, it may remain reserved for large-volume centers with experienced surgeons.

简介黄疽性肾盂肾炎（XGPN）是一种罕见的慢性肾脏炎症，由尿路长期梗阻引起。肾盂积脓是急性梗阻性肾盂肾炎的一种严重化脓性并发症。虽然微创方法有很多优点，但并非总能安全地剥离肾脏：我们回顾了 2016 年 10 月至 2022 年 3 月期间在我科接受腹腔镜全肾切除术的 27 例诊断为 XGPN 或肾盂肾炎的病例。所有手术均使用 Karl Storz 3D 腹腔镜系统进行。大多数XGPN的手术方式为标准的经腹膜肾切除术，而肾盂成形术则在腹膜后进行。所有手术均由同一名外科医生实施或指导：平均手术时间为 269.85 分钟（145-360 分钟不等）。术后血红蛋白平均下降 1.41 g/dl（范围 0.3-2.3 g/dl）。有 13 例（48.14%）患者遇到了剥离困难。13 例手术中有 9 例完全在体腔内完成，4 例需要转为开放手术。涉及大血管的并发症包括一例下腔静脉（IVC）撕裂。消化道相关并发症包括两例降结肠瘘和一例腹膜破损。6例患者进行了多器官切除术：结论：XGPN和肾盂肾炎病例的全肾切除术是一项具有挑战性的手术。腹腔镜方法是可行的，因为大多数并发症都能在体腔内解决。不过，腹腔镜手术仍需在拥有经验丰富外科医生的大型医疗中心进行。

{"title":"Laparoscopic approach for xanthogranulomatous pyelonephritis and pyonephrosis","authors":"T. Telecan , I. Andras , N. Crousen , E.D. Cata , P. Medan , D.V. Stanca , A. Territo , I. Coman , N. Crisan","doi":"10.1016/j.acuroe.2024.03.001","DOIUrl":"10.1016/j.acuroe.2024.03.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Xanthogranulomatous pyelonephritis (XGPN) is a rare form of chronic renal inflammation, caused by long-term obstruction of the urinary tract. Pyonephrosis is a severe suppurative complication of acute obstructive pyelonephritis. Although minimally invasive approaches have many advantages, the safe dissection of the kidney may not be always achievable.</p></div><div><h3>Materials and methods</h3><p>We reviewed 27 cases diagnosed with either XGPN or pyonephrosis, who underwent laparoscopic total nephrectomy between October 2016 and March 2022 in our department. All interventions were performed using the Karl Storz 3D laparoscopic system. The surgical approach was standard transperitoneal nephrectomy for the majority of XGPN, while pyonephrosis cases were carried out in a retroperitoneally. All procedures were performed or supervised by the same surgeon.</p></div><div><h3>Results</h3><p>The mean operative time was 269.85 minutes (range 145–360). The mean hemoglobin drop after surgery was 1.41 g/dl (range 0.3–2.3 g/dl). Difficult dissection was encountered in 13 cases (48.14%). Nine out of 13 interventions were carried out in a complete intracorporeal fashion, while conversion to open surgery was needed in 4 cases. Vascular complications involving the major blood vessels comprised of one case of inferior vena cava (IVC) tear. Digestive tract-related complications comprised two fistulas of the descending colon and one peritoneal breach. Multiorgan resection was performed in 6 cases.</p></div><div><h3>Conclusion</h3><p>Total nephrectomy in cases of XGPN and pyonephrosis is a challenging procedure. The laparoscopic approach is feasible, as most complications are resolved intracorporeally. However, it may remain reserved for large-volume centers with experienced surgeons.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332414","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

Changes in benign prostatic hyperplasia management in Valencia: a real-world evidence analysis 巴伦西亚良性前列腺增生管理的变化：真实世界证据分析。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.02.005

J. Navarro-Pérez , E. López Alcina , J. Calabiug Pérez , F. Brotons Muntó , A. Martínez , L. Vallejo , J. Jiménez

Introduction and objectives

A training program was developed to increase general practitioners' engagement in the optimal management of Benign Prostatic Hyperplasia (BPH). The goal of this study was to evaluate changes in BPH management after the implementation of a training program.

Material and Methods

This observational retrospective cohort study was conducted between 2019 and 2020. Aggregated data were analyzed in three evaluation periods (2010, 2012 and 2015), addressing quality indicators for diagnosis, treatment, and treatment outcomes.

Results

Overall, 118 795 patients who presented any data points were included. All quality indicators (number of IPSS and PSA determinations) increased between the first period and the last. Combination (α-blocker + 5-ARI) therapy was increasingly prescribed during the study periods whereas the proportion of prescriptions for single-agent α-blocker showed no significant differences among the periods analyzed. However, the total number of patients eligible for combination therapy who actually received this treatment was low in all periods (7.5%, 17.9%, and 20.1%, in 2010, 2012, and 2015, respectively). The outcome indicators revealed a decrease in referrals to the urology unit mostly among newly diagnosed patients. Even though the proportion of patients who underwent BPH-related surgeries increased significantly from the first to the second period, the number of surgeries remained stable between the second and third periods.

Conclusions

The training program had a generally positive impact on the management of BPH patients in PC, but the overall study period may be insufficient to show an effect on some outcome indicators such as the number of surgeries.

简介和目标：为提高全科医生对良性前列腺增生症（BPH）最佳治疗的参与度，我们制定了一项培训计划。本研究旨在评估培训计划实施后良性前列腺增生症管理的变化：这项观察性回顾性队列研究于 2019 年至 2020 年间进行。针对诊断、治疗和治疗结果的质量指标，对三个评估期（2010 年、2012 年和 2015 年）的汇总数据进行了分析：总共纳入了 118 795 名提供任何数据点的患者。所有质量指标（IPSS和PSA测定次数）在第一个评估期和最后一个评估期之间都有所增加。在研究期间，联合（α-受体阻滞剂+5-ARI）疗法的处方量越来越多，而单药α-受体阻滞剂的处方比例在分析期间没有显著差异。然而，在所有研究期间，符合联合治疗条件并实际接受该治疗的患者总人数较少（2010 年、2012 年和 2015 年分别为 7.5%、17.9% 和 20.1%）。结果指标显示，转诊到泌尿科的患者有所减少，其中大部分是新确诊的患者。尽管接受良性前列腺增生相关手术的患者比例从第一期到第二期显著增加，但手术数量在第二期和第三期之间保持稳定：培训计划总体上对 PC 中良性前列腺增生症患者的管理产生了积极影响，但整个研究期间可能不足以显示对某些结果指标（如手术次数）的影响。

{"title":"Changes in benign prostatic hyperplasia management in Valencia: a real-world evidence analysis","authors":"J. Navarro-Pérez , E. López Alcina , J. Calabiug Pérez , F. Brotons Muntó , A. Martínez , L. Vallejo , J. Jiménez","doi":"10.1016/j.acuroe.2024.02.005","DOIUrl":"10.1016/j.acuroe.2024.02.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>A training program was developed to increase general practitioners' engagement in the optimal management of Benign Prostatic Hyperplasia (BPH). The goal of this study was to evaluate changes in BPH management after the implementation of a training program.</p></div><div><h3>Material and Methods</h3><p>This observational retrospective cohort study was conducted between 2019 and 2020. Aggregated data were analyzed in three evaluation periods (2010, 2012 and 2015), addressing quality indicators for diagnosis, treatment, and treatment outcomes.</p></div><div><h3>Results</h3><p>Overall, 118 795 patients who presented any data points were included. All quality indicators (number of IPSS and PSA determinations) increased between the first period and the last. Combination (α-blocker + 5-ARI) therapy was increasingly prescribed during the study periods whereas the proportion of prescriptions for single-agent α-blocker showed no significant differences among the periods analyzed. However, the total number of patients eligible for combination therapy who actually received this treatment was low in all periods (7.5%, 17.9%, and 20.1%, in 2010, 2012, and 2015, respectively). The outcome indicators revealed a decrease in referrals to the urology unit mostly among newly diagnosed patients. Even though the proportion of patients who underwent BPH-related surgeries increased significantly from the first to the second period, the number of surgeries remained stable between the second and third periods.</p></div><div><h3>Conclusions</h3><p>The training program had a generally positive impact on the management of BPH patients in PC, but the overall study period may be insufficient to show an effect on some outcome indicators such as the number of surgeries.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S217357862400012X/pdfft?md5=5bb6724dbd3f730048623cade5545887&pid=1-s2.0-S217357862400012X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139901052","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

Surgeon experience in second-look transurethral resection of bladder cancer – a prospective study 膀胱癌二期经尿道切除术的外科医生经验--一项前瞻性研究。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2023.12.007

C.N. Fernandes , L. Vale , J.V. Sousa , T. Antunes-Lopes , C.M. Silva , J. Silva

Introduction and objectives

Transurethral resection of bladder tumor (TURBT) is crucial in the treatment of bladder tumors and when incorrectly performed can cause staging mistakes. To avoid these errors, a second resection is recommended in selected cases. The aim of this study is to evaluate the surgeon's ability to predict histologically complete primary resection of newly diagnosed bladder tumors avoiding the need for a second TURBT.

Methods

This is a prospective, observational study involving 47 consecutive patients with newly diagnosed bladder tumors who had previously undergone primary TURBT, and met EAU criteria for second-look TURBT. Second-look TURBT specimens were analyzed for routine histological assessment and compared with the surgeon's impression of the tumor at initial resection.

Results

Of 91 patients submitted to primary TURBT, 47 met the criteria for second-look TURBT. Second-look specimens revealed residual disease in 20.9% of patients and 3 (6.4%) of patients showed upstaging disease. The sensitivity of a senior to detect disease on second-look TURBT in relation to muscle invasion was 75%, and the specificity was 85%.

Conclusions

Second-look TURBT is crucial in the treatment of bladder cancer and cannot be replaced by a surgeon's opinion, so international recommendations should be followed. Supervision of less experienced surgeons is a cornerstone.

导言和目的：经尿道膀胱肿瘤切除术（TURBT）是治疗膀胱肿瘤的关键，如果操作不当，会导致分期错误。为避免这些错误，建议在选定的病例中进行第二次切除。本研究的目的是评估外科医生预测新诊断的膀胱肿瘤在组织学上完成初次切除的能力，以避免需要进行第二次 TURBT：这是一项前瞻性观察研究，涉及 47 名连续的新确诊膀胱肿瘤患者，他们之前都接受过初次膀胱肿瘤切除术，并符合 EAU 关于二次膀胱肿瘤切除术的标准。研究人员对二次TURBT标本进行了常规组织学评估分析，并将其与外科医生初次切除肿瘤时对肿瘤的印象进行了比较：结果：在91名接受初次前列腺电切术的患者中，有47人符合二次前列腺电切术的标准。二诊标本显示，20.9%的患者有残留病灶，3 例（6.4%）患者有病灶上移。一名资深医师在二次TURBT检查中发现与肌肉侵犯有关的疾病的敏感性为75%，特异性为85%：结论：二诊 TURBT 对膀胱癌的治疗至关重要，外科医生的意见无法取代，因此应遵循国际建议。对经验不足的外科医生进行指导是基础。

{"title":"Surgeon experience in second-look transurethral resection of bladder cancer – a prospective study","authors":"C.N. Fernandes , L. Vale , J.V. Sousa , T. Antunes-Lopes , C.M. Silva , J. Silva","doi":"10.1016/j.acuroe.2023.12.007","DOIUrl":"10.1016/j.acuroe.2023.12.007","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Transurethral resection of bladder tumor (TURBT) is crucial in the treatment of bladder tumors and when incorrectly performed can cause staging mistakes. To avoid these errors, a second resection is recommended in selected cases. The aim of this study is to evaluate the surgeon's ability to predict histologically complete primary resection of newly diagnosed bladder tumors avoiding the need for a second TURBT.</p></div><div><h3>Methods</h3><p>This is a prospective, observational study involving 47 consecutive patients with newly diagnosed bladder tumors who had previously undergone primary TURBT, and met EAU criteria for second-look TURBT. Second-look TURBT specimens were analyzed for routine histological assessment and compared with the surgeon's impression of the tumor at initial resection.</p></div><div><h3>Results</h3><p>Of 91 patients submitted to primary TURBT, 47 met the criteria for second-look TURBT. Second-look specimens revealed residual disease in 20.9% of patients and 3 (6.4%) of patients showed upstaging disease. The sensitivity of a senior to detect disease on second-look TURBT in relation to muscle invasion was 75%, and the specificity was 85%.</p></div><div><h3>Conclusions</h3><p>Second-look TURBT is crucial in the treatment of bladder cancer and cannot be replaced by a surgeon's opinion, so international recommendations should be followed. Supervision of less experienced surgeons is a cornerstone.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139072515","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

Association between COVID-19 and increased incidence of overactive bladder symptoms in female patients: A retrospective analysis COVID-19与女性患者膀胱过度活动症状发病率增加之间的关系：一项回顾性分析。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.01.002

A. Coşkun , K. Erdem , U. Can

Introduction and objectives

To investigate female patients' post-COVID-19 voiding symptoms and to research how they relate to overactive bladder (OAB).

Patients

One hundred and forty patients aged 20–50 years who were hospitalised and discharged due to COVID-19 at Kartal Dr. Lütfi Kırdar City Hospital between 2021 and 2022 and 50 patients with a history of COVID-19 among two hundred female patients who presented to the urology outpatient clinic with symptoms related to OAB were retrospectively analysed. Bladder diary, overactive bladder symptom score (OABSS), uroflowmetry values and time of onset of symptoms of symptomatic patients were recorded for all patients. Disease-free individuals for control purposes were not included in the study.

Results

It was observed that 38% of 140 hospitalized patients had a symptomatic change related to OAB, and there was a significant difference in voiding diary, OABSS, and uroflowmetry Qmax values between symptomatic and non-symptomatic patients after COVID-19. (p:0.001) There was a significant difference between the pre-COVID-19 (estimated) and post-COVID-19 (current) voiding diary and OABSS values of all symptomatic patients (with and without a history of hospitalization). (p:0.001) When these two groups were compared with each other, there was a significant difference between the post-COVID-19 voiding diary, OABSS values, and the meantime to the onset of symptoms in inpatients and outpatients (p:0.001)

Conclusion

COVID-19 may be associated with urgency/urge incontinence and overactive bladder in female patients.

简介和目的：调查女性患者 COVID-19 后的排尿症状，并研究这些症状与膀胱过度活动症 (OAB) 的关系：回顾性分析了2021年至2022年期间在Kartal Dr. Lütfi Kırdar市医院因COVID-19住院并出院的140名20-50岁患者，以及泌尿科门诊就诊的200名有OAB相关症状的女性患者中50名有COVID-19病史的患者。所有患者的膀胱日记、膀胱过度活动症状评分（OABSS）、尿流率测量值和有症状患者的发病时间均被记录在案。研究不包括作为对照的无症状患者：结果显示：在 140 名住院患者中，有 38% 的患者出现了与 OAB 相关的症状变化，在 COVID-19 治疗后，有症状和无症状患者的排尿日记、OABSS 和尿流测定 Qmax 值存在显著差异（P:0.001）。(p:0.001) COVID-19 前（估计值）和 COVID-19 后（当前值）所有症状患者（有住院史和无住院史）的排尿日记和 OABSS 值之间存在显著差异。(结论：COVID-19 可能与女性患者的急迫性/紧急性尿失禁和膀胱过度活动症有关。

{"title":"Association between COVID-19 and increased incidence of overactive bladder symptoms in female patients: A retrospective analysis","authors":"A. Coşkun , K. Erdem , U. Can","doi":"10.1016/j.acuroe.2024.01.002","DOIUrl":"10.1016/j.acuroe.2024.01.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>To investigate female patients' post-COVID-19 voiding symptoms and to research how they relate to overactive bladder (OAB).</p></div><div><h3>Patients</h3><p>One hundred and forty patients aged 20–50 years who were hospitalised and discharged due to COVID-19 at Kartal Dr. Lütfi Kırdar City Hospital between 2021 and 2022 and 50 patients with a history of COVID-19 among two hundred female patients who presented to the urology outpatient clinic with symptoms related to OAB were retrospectively analysed. Bladder diary, overactive bladder symptom score (OABSS), uroflowmetry values and time of onset of symptoms of symptomatic patients were recorded for all patients. Disease-free individuals for control purposes were not included in the study.</p></div><div><h3>Results</h3><p>It was observed that 38% of 140 hospitalized patients had a symptomatic change related to OAB, and there was a significant difference in voiding diary, OABSS, and uroflowmetry Qmax values between symptomatic and non-symptomatic patients after COVID-19. (p:0.001) There was a significant difference between the pre-COVID-19 (estimated) and post-COVID-19 (current) voiding diary and OABSS values of all symptomatic patients (with and without a history of hospitalization). (p:0.001) When these two groups were compared with each other, there was a significant difference between the post-COVID-19 voiding diary, OABSS values, and the meantime to the onset of symptoms in inpatients and outpatients (p:0.001)</p></div><div><h3>Conclusion</h3><p>COVID-19 may be associated with urgency/urge incontinence and overactive bladder in female patients.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379097","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

Initial results of pulsed thulium fiber laser (Dornier®) for the treatment of renal and ureteral stones with ureteroscopy 脉冲铥光纤激光器（Dornier®）治疗输尿管镜下肾结石和输尿管结石的初步结果。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.04.004

M.C. Cano-García , C. Abad Rodríguez-Hesles , V. Yuste-Mascarós , M.Á. Arrabal Polo

引用次数: 0