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Early diagnosis of prostate cancer in healthy men with germline mutations in DNA Damage Response (DDR) pathways: A literature review and proposal for a screening strategy.
Pub Date : 2025-02-11 DOI: 10.1016/j.acuroe.2025.501686
A Rosino Sánchez, E García Torralba, E Girela Baena, J A Macías Cerrolaza, J Tudela Pallares, M Zafra Povés, I Barceló Bayonas, V Muñoz Guillermo, T Fernández Aparicio

Introduction: Men with mutations in DNA damage response (DDR) pathways have a higher risk of developing prostate neoplasia compared to the general population. The best studied alterations are mutations in BRCA1/2, ATM and MMR-Lynch syndrome.

Material and methods: A review of the clinical and prognostic implications of mutations in DDR pathways, as well as an evaluation of the different screening strategies available for affected patients.

Objective: To propose an early diagnostic strategy for men with mutations in DDR pathways.

Results: Current guidelines do not provide clear, specific recommendations for this subgroup of men. Among mutations in the MMR pathway, the germline MSH2 mutation is most strongly associated with prostate cancer. Men with germline mutations in BRCA1/2, ATM, and MSH2 have a higher incidence of prostate neoplasia, tend to develop the disease at a younger age, and are more likely to have aggressive forms of the disease. Furthermore, men with BRCA1/2 mutations have a lower cancer-specific survival rate compared to the general population. In these patients, PSA levels have important limitations in detecting prostate cancer. Multiparametric MRI of the prostate may be more effective than periodic PSA testing.

Conclusions: Patients with mutations in DDR pathways are at increased risk for aggressive prostate neoplasms and require earlier and more intensive screening. PSA-based screening has notable limitations. A screening strategy incorporating multiparametric MRI could offer a more effective strategy for this patient group.

{"title":"Early diagnosis of prostate cancer in healthy men with germline mutations in DNA Damage Response (DDR) pathways: A literature review and proposal for a screening strategy.","authors":"A Rosino Sánchez, E García Torralba, E Girela Baena, J A Macías Cerrolaza, J Tudela Pallares, M Zafra Povés, I Barceló Bayonas, V Muñoz Guillermo, T Fernández Aparicio","doi":"10.1016/j.acuroe.2025.501686","DOIUrl":"10.1016/j.acuroe.2025.501686","url":null,"abstract":"<p><strong>Introduction: </strong>Men with mutations in DNA damage response (DDR) pathways have a higher risk of developing prostate neoplasia compared to the general population. The best studied alterations are mutations in BRCA1/2, ATM and MMR-Lynch syndrome.</p><p><strong>Material and methods: </strong>A review of the clinical and prognostic implications of mutations in DDR pathways, as well as an evaluation of the different screening strategies available for affected patients.</p><p><strong>Objective: </strong>To propose an early diagnostic strategy for men with mutations in DDR pathways.</p><p><strong>Results: </strong>Current guidelines do not provide clear, specific recommendations for this subgroup of men. Among mutations in the MMR pathway, the germline MSH2 mutation is most strongly associated with prostate cancer. Men with germline mutations in BRCA1/2, ATM, and MSH2 have a higher incidence of prostate neoplasia, tend to develop the disease at a younger age, and are more likely to have aggressive forms of the disease. Furthermore, men with BRCA1/2 mutations have a lower cancer-specific survival rate compared to the general population. In these patients, PSA levels have important limitations in detecting prostate cancer. Multiparametric MRI of the prostate may be more effective than periodic PSA testing.</p><p><strong>Conclusions: </strong>Patients with mutations in DDR pathways are at increased risk for aggressive prostate neoplasms and require earlier and more intensive screening. PSA-based screening has notable limitations. A screening strategy incorporating multiparametric MRI could offer a more effective strategy for this patient group.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501686"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416071","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
Multicenter study of the impact of Urolift® implantation in patients undergoing medical treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia.
Pub Date : 2025-02-11 DOI: 10.1016/j.acuroe.2025.501708
C González Enguita, L López Martín, L M Herranz Fernández, B Sinues Ojas, C Barrera Rodríguez, J Extramiana Cameno, J Campá Bortoló, J M Oscá García, M Perán Teruel, V Gimeno Argente, A Navarro Beltrán, E López Alcina, I Povo Martín, Y Salvador Pallás Costa, A Budía Alba, J Ortiz Salvador, J J Salgado Plonski, P Suárez Sal, M Fernández Arjona

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

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

Results: 91 patients chose UroLift® and 45 continued with pharmacotherapy. At 6 months, a positive impact on quality of life was estimated with UroLift® (0.046; SD: 0.02; p = 0.067), being significant in subgroups of patients aged >65 years (diff.: 0.034), PSA > 2.2 (diff.: 0.108), diabetes mellitus (diff.: 0.023), hypertension (diff.: 0.011) or hypercholesterolemia (diff.: 0.016). The impact on symptomatology was superior with UroLift® (-10.07; SD: 1.65; p < 0.001), being significant in subgroups aged >65 (diff.: 1.37), prostate >40 cc (diff.: 0.74), PSA > 2.2 (diff.: 2.63), and diabetes mellitus (diff.: 1.66), hypertension (diff.: 1.23). Erectile function was not affected (-0.33; SD: 1.99; p = 0.868) while ejaculatory function showed a favorable impact (2.98; SD: 1.26; p = 0.019).

Conclusions: Minimally invasive Urolift® system treatment is associated with a positive impact on quality of life and urinary symptoms without adversely affecting sexual function.

{"title":"Multicenter study of the impact of Urolift® implantation in patients undergoing medical treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia.","authors":"C González Enguita, L López Martín, L M Herranz Fernández, B Sinues Ojas, C Barrera Rodríguez, J Extramiana Cameno, J Campá Bortoló, J M Oscá García, M Perán Teruel, V Gimeno Argente, A Navarro Beltrán, E López Alcina, I Povo Martín, Y Salvador Pallás Costa, A Budía Alba, J Ortiz Salvador, J J Salgado Plonski, P Suárez Sal, M Fernández Arjona","doi":"10.1016/j.acuroe.2025.501708","DOIUrl":"10.1016/j.acuroe.2025.501708","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>UroLift® is a minimally invasive treatment for patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia. The primary objective was to evaluate the impact of UroLift® system treatment on quality of life. Secondary objectives assessed the impact on urinary symptoms and sexual function.</p><p><strong>Patients and methods: </strong>Patients at 7 Spanish hospitals undergoing pharmacological treatment were offered the choice to continue this treatment or accept surgical intervention. The primary outcome, impact on quality of life, was assessed using the EuroQol-5D-5L questionnaire. Secondary outcomes, including impact on symptoms, erectile function, and ejaculatory function, were evaluated using the IPSS, SHIM-5, and MSHQ-EjD-SF questionnaires, respectively. Outcomes were compared between groups.</p><p><strong>Results: </strong>91 patients chose UroLift® and 45 continued with pharmacotherapy. At 6 months, a positive impact on quality of life was estimated with UroLift® (0.046; SD: 0.02; p = 0.067), being significant in subgroups of patients aged >65 years (diff.: 0.034), PSA > 2.2 (diff.: 0.108), diabetes mellitus (diff.: 0.023), hypertension (diff.: 0.011) or hypercholesterolemia (diff.: 0.016). The impact on symptomatology was superior with UroLift® (-10.07; SD: 1.65; p < 0.001), being significant in subgroups aged >65 (diff.: 1.37), prostate >40 cc (diff.: 0.74), PSA > 2.2 (diff.: 2.63), and diabetes mellitus (diff.: 1.66), hypertension (diff.: 1.23). Erectile function was not affected (-0.33; SD: 1.99; p = 0.868) while ejaculatory function showed a favorable impact (2.98; SD: 1.26; p = 0.019).</p><p><strong>Conclusions: </strong>Minimally invasive Urolift® system treatment is associated with a positive impact on quality of life and urinary symptoms without adversely affecting sexual function.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501708"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416318","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
Outcomes of Same-sitting bilateral Retrograde IntraRenal Surgery for renal stone in patients aged 70 years and above.
Pub Date : 2025-02-11 DOI: 10.1016/j.acuroe.2025.501716
C Giulioni, V De Stefano, O Traxer, D Ragoori, N Gadzhiev, Y Tanidir, T Inoue, E Emiliani, S Bin Hamri, M Amine Lakmichi, C Mohan Vaddi, C Tiong Heng, B Soebhali, S More, V Sridharan, M Ilker Gökce, A N Tursunkulov, A Ganpule, G M Pirola, A Naselli, C Aydin, F R de Fata Chillón, C Solano Mendoza, L Candela, B Hall Chew, B Kumar Somani, V Gauhar, D Castellani

Objective: To evaluate outcomes of same sitting Bilateral Retrograde IntraRenal Surgery (SSB-RISRS) for kidney stone in patients aged ≥70 years.

Methods: We retrospectively reviewed patients with bilateral kidney stones who underwent SSB-RISRS in 21 centers (January 2015-June 2022).

Inclusion criteria: patients aged ≥70 years, bilateral kidney stones diagnosed due to either unilateral or bilateral symptomatic presentation. Patients were divided into 2 groups. Group 1: patients aged 70-74 years, Group 2: patients aged ≥75 years.

Results: There were 86 patients in Group 1 and 60 patients in Group 2. There was no difference between the groups for gender, ASA score, BMI, comorbidities, presenting symptoms, and positive preoperative urine culture. Group 2 had a significantly higher proportion of recurrent stone formers (54.7% vs 35.0%, p=0.03). A higher proportion of bilaterally pre-stented patients were present in group 2 (37.9% vs 18.6%). There was no difference in total operation time and rate of post-operative uni- and bilateral stent positioning. Surgery was discontinued in 15.1% and 18.3% of cases in groups 1 and 2, respectively (p=0.773). Median length of postoperative stay was 2 days in both groups. The most frequent complication was fever requiring antibiotics and prolonged admission (10.5% in group 1 and 11.7% in group 2, p>0.99). Sepsis rate was 2.3% patients in group 1 and none in group 2. 1.2% in group 1 required a blood transfusion due to hematuria. Bilateral SFR was similar (60.0% vs 47.7%, p=0.194).

Conclusions: SSB-RISRS in elderly patients demonstrated an acceptable safety profile with good bilateral SFR.

目的评估年龄≥70岁的肾结石患者接受同坐双侧逆行肾内手术(SSB-RISRS)的疗效:纳入标准:年龄≥70岁,因单侧或双侧无症状表现而确诊为双侧肾结石的患者。患者分为两组。第1组:70-74岁患者,第2组:≥75岁患者:两组患者在性别、ASA评分、体重指数、合并症、主要症状和术前尿培养阳性等方面均无差异。第二组的复发性结石患者比例明显更高(54.7% 对 35.0%,P = 0.03)。第 2 组中双侧预留支架的患者比例更高(37.9% 对 18.6%)。总手术时间以及术后单侧和双侧支架定位率没有差异。第一组和第二组分别有 15.1% 和 18.3% 的病例终止了手术(p = 0.773)。两组患者术后住院时间的中位数均为 2 天。最常见的并发症是发烧,需要使用抗生素和延长住院时间(第一组为 10.5%,第二组为 11.7%,P > 0.99)。第一组中有 1.2% 的患者因血尿而需要输血。双侧 SFR 相似(60.0% vs 47.7%,P = 0.194):SSB-RISRS在老年患者中的安全性可接受,双侧SFR良好。
{"title":"Outcomes of Same-sitting bilateral Retrograde IntraRenal Surgery for renal stone in patients aged 70 years and above.","authors":"C Giulioni, V De Stefano, O Traxer, D Ragoori, N Gadzhiev, Y Tanidir, T Inoue, E Emiliani, S Bin Hamri, M Amine Lakmichi, C Mohan Vaddi, C Tiong Heng, B Soebhali, S More, V Sridharan, M Ilker Gökce, A N Tursunkulov, A Ganpule, G M Pirola, A Naselli, C Aydin, F R de Fata Chillón, C Solano Mendoza, L Candela, B Hall Chew, B Kumar Somani, V Gauhar, D Castellani","doi":"10.1016/j.acuroe.2025.501716","DOIUrl":"10.1016/j.acuroe.2025.501716","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate outcomes of same sitting Bilateral Retrograde IntraRenal Surgery (SSB-RISRS) for kidney stone in patients aged ≥70 years.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with bilateral kidney stones who underwent SSB-RISRS in 21 centers (January 2015-June 2022).</p><p><strong>Inclusion criteria: </strong>patients aged ≥70 years, bilateral kidney stones diagnosed due to either unilateral or bilateral symptomatic presentation. Patients were divided into 2 groups. Group 1: patients aged 70-74 years, Group 2: patients aged ≥75 years.</p><p><strong>Results: </strong>There were 86 patients in Group 1 and 60 patients in Group 2. There was no difference between the groups for gender, ASA score, BMI, comorbidities, presenting symptoms, and positive preoperative urine culture. Group 2 had a significantly higher proportion of recurrent stone formers (54.7% vs 35.0%, p=0.03). A higher proportion of bilaterally pre-stented patients were present in group 2 (37.9% vs 18.6%). There was no difference in total operation time and rate of post-operative uni- and bilateral stent positioning. Surgery was discontinued in 15.1% and 18.3% of cases in groups 1 and 2, respectively (p=0.773). Median length of postoperative stay was 2 days in both groups. The most frequent complication was fever requiring antibiotics and prolonged admission (10.5% in group 1 and 11.7% in group 2, p>0.99). Sepsis rate was 2.3% patients in group 1 and none in group 2. 1.2% in group 1 required a blood transfusion due to hematuria. Bilateral SFR was similar (60.0% vs 47.7%, p=0.194).</p><p><strong>Conclusions: </strong>SSB-RISRS in elderly patients demonstrated an acceptable safety profile with good bilateral SFR.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501716"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416397","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
Drainage of varicose veins during subinguinal microscopic varicocelectomy (vein milking): Does it affect pain, cosmetic appearance, and spermiogram?
Pub Date : 2025-02-11 DOI: 10.1016/j.acuroe.2025.501706
B Kati, E Ordek, I Demir, E S Pelit

Introduction: Varicocele, defined as abnormal convoluted enlargement of the pampiniform plexus veins, is the most common cause of correctable male infertility. This study aimed to investigate the effect of blood drainage in varicose veins on spermiogram parameters, postoperative pain, cosmetic appearance, and patient satisfaction in patients undergoing subinguinal microscopic varicocelectomy.

Methods: Patients diagnosed with clinical varicocele and admitted to our urology outpatient clinic between January 2020 and January 2024 were evaluated. Those with a venous vessel diameter ≥ 2.5 mm underwent subinguinal microscopic varicocelectomy. In 75 patients, a small incision was made in the thickest varicose vein, and the veins were ligated after venous blood was drained by hand patting. In another 75 patients, vessels were cut and ligated by the classical method without venous blood drainage. Exclusion criteria included patients younger than 18, those with secondary varicocelectomy history, undescended testis, testicular trauma or tumors, and prior infertility treatment. Preoperative and postoperative spermiogram values, pain scores, cosmetic appearance, and patient satisfaction were recorded and compared.

Results: The pain rate was significantly lower (p < 0.05) in the blood-milking varicocelectomy group during postoperative controls (7-10 days) compared to the classical method group. The blood-milking group also showed significantly higher (p < 0.05) sperm count and motility at the 3rd postoperative month. Cosmetic satisfaction was significantly higher (p < 0.05) in the blood-milking group.

Conclusions: Blood drainage during subinguinal microscopic varicocelectomy significantly reduces postoperative pain and enhances sperm values, cosmetic outcomes, and patient satisfaction. These findings suggest that vein-milking techniques during varicocelectomy can optimize postoperative outcomes.

{"title":"Drainage of varicose veins during subinguinal microscopic varicocelectomy (vein milking): Does it affect pain, cosmetic appearance, and spermiogram?","authors":"B Kati, E Ordek, I Demir, E S Pelit","doi":"10.1016/j.acuroe.2025.501706","DOIUrl":"10.1016/j.acuroe.2025.501706","url":null,"abstract":"<p><strong>Introduction: </strong>Varicocele, defined as abnormal convoluted enlargement of the pampiniform plexus veins, is the most common cause of correctable male infertility. This study aimed to investigate the effect of blood drainage in varicose veins on spermiogram parameters, postoperative pain, cosmetic appearance, and patient satisfaction in patients undergoing subinguinal microscopic varicocelectomy.</p><p><strong>Methods: </strong>Patients diagnosed with clinical varicocele and admitted to our urology outpatient clinic between January 2020 and January 2024 were evaluated. Those with a venous vessel diameter ≥ 2.5 mm underwent subinguinal microscopic varicocelectomy. In 75 patients, a small incision was made in the thickest varicose vein, and the veins were ligated after venous blood was drained by hand patting. In another 75 patients, vessels were cut and ligated by the classical method without venous blood drainage. Exclusion criteria included patients younger than 18, those with secondary varicocelectomy history, undescended testis, testicular trauma or tumors, and prior infertility treatment. Preoperative and postoperative spermiogram values, pain scores, cosmetic appearance, and patient satisfaction were recorded and compared.</p><p><strong>Results: </strong>The pain rate was significantly lower (p < 0.05) in the blood-milking varicocelectomy group during postoperative controls (7-10 days) compared to the classical method group. The blood-milking group also showed significantly higher (p < 0.05) sperm count and motility at the 3rd postoperative month. Cosmetic satisfaction was significantly higher (p < 0.05) in the blood-milking group.</p><p><strong>Conclusions: </strong>Blood drainage during subinguinal microscopic varicocelectomy significantly reduces postoperative pain and enhances sperm values, cosmetic outcomes, and patient satisfaction. These findings suggest that vein-milking techniques during varicocelectomy can optimize postoperative outcomes.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501706"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416034","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
Abiraterone and rosuvastatin-induced rhabdomyolysis.
Pub Date : 2025-02-11 DOI: 10.1016/j.acuroe.2025.501689
Ó Porto Fuentes, S Penado Nadela, S Martínez Breijo, B San Millán Tejado
{"title":"Abiraterone and rosuvastatin-induced rhabdomyolysis.","authors":"Ó Porto Fuentes, S Penado Nadela, S Martínez Breijo, B San Millán Tejado","doi":"10.1016/j.acuroe.2025.501689","DOIUrl":"10.1016/j.acuroe.2025.501689","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501689"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415942","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
Urinary diversion and quality of life: A six-year follow-up study of bladder cancer surgery.
Pub Date : 2025-02-11 DOI: 10.1016/j.acuroe.2025.501699
N Pyrgidis, J Hermans, P Keller, D Karatas, B Ebner, G Schulz, C Stief, Y Volz

Objectives: To evaluate health-related quality of life (HRQOL) six years post-radical cystectomy in patients with muscle-invasive bladder cancer, comparing orthotopic ileal neobladder (ONB) and ileal conduit (IC). Therefore, the study aims to analyze the under-investigated long-term impact of standard bladder cancer treatments on HRQOL and provide insights into the HRQOL differences associated with these two common urinary diversion methods.

Patients and methods: This prospective study included 39 patients with urothelial carcinoma treated with ONB or IC at our center between 03/2013 and 01/2023. Patients with variant histology, metastasis, neoadjuvant chemotherapy, or benign indications for cystectomy were excluded. HRQOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire preoperatively, at four and six years postoperatively. Statistical analyses included Chi-square tests, T-tests, and logistic regression models.

Results: Of the patients, 64% (25/39) underwent ONB, and 76.9% (30/39) were male, with an average age of 69 years. No significant differences in overall good HRQOL (GHS > 70) were observed between ONB and IC at six years (IC: 60 ± 22; ONB: 69 ± 23, p = 0.2). Patients with IC reported higher insomnia at both follow-ups (4 years: p = 0.01; 6 years: p = 0.03). Emotional function remained stable in ONB patients but declined in IC patients from the fourth to sixth years (p = 0.04).

Conclusion: Long-term HRQOL did not significantly differ between ONB and IC up to six years post-radical cystectomy. Both urinary diversion methods can be offered to patients, with tailored discussions in terms of HRQOL.

{"title":"Urinary diversion and quality of life: A six-year follow-up study of bladder cancer surgery.","authors":"N Pyrgidis, J Hermans, P Keller, D Karatas, B Ebner, G Schulz, C Stief, Y Volz","doi":"10.1016/j.acuroe.2025.501699","DOIUrl":"10.1016/j.acuroe.2025.501699","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate health-related quality of life (HRQOL) six years post-radical cystectomy in patients with muscle-invasive bladder cancer, comparing orthotopic ileal neobladder (ONB) and ileal conduit (IC). Therefore, the study aims to analyze the under-investigated long-term impact of standard bladder cancer treatments on HRQOL and provide insights into the HRQOL differences associated with these two common urinary diversion methods.</p><p><strong>Patients and methods: </strong>This prospective study included 39 patients with urothelial carcinoma treated with ONB or IC at our center between 03/2013 and 01/2023. Patients with variant histology, metastasis, neoadjuvant chemotherapy, or benign indications for cystectomy were excluded. HRQOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire preoperatively, at four and six years postoperatively. Statistical analyses included Chi-square tests, T-tests, and logistic regression models.</p><p><strong>Results: </strong>Of the patients, 64% (25/39) underwent ONB, and 76.9% (30/39) were male, with an average age of 69 years. No significant differences in overall good HRQOL (GHS > 70) were observed between ONB and IC at six years (IC: 60 ± 22; ONB: 69 ± 23, p = 0.2). Patients with IC reported higher insomnia at both follow-ups (4 years: p = 0.01; 6 years: p = 0.03). Emotional function remained stable in ONB patients but declined in IC patients from the fourth to sixth years (p = 0.04).</p><p><strong>Conclusion: </strong>Long-term HRQOL did not significantly differ between ONB and IC up to six years post-radical cystectomy. Both urinary diversion methods can be offered to patients, with tailored discussions in terms of HRQOL.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501699"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416406","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
Mixed epithelial and stromal kidney tumor with sarcomatous transformation. A case report.
Pub Date : 2025-02-11 DOI: 10.1016/j.acuroe.2025.501692
A C Jiménez Domínguez, A J G Álvarez Lucena, P Vila Braña, F Vázquez Alonso
{"title":"Mixed epithelial and stromal kidney tumor with sarcomatous transformation. A case report.","authors":"A C Jiménez Domínguez, A J G Álvarez Lucena, P Vila Braña, F Vázquez Alonso","doi":"10.1016/j.acuroe.2025.501692","DOIUrl":"10.1016/j.acuroe.2025.501692","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501692"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416391","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
Single-port retroperitoneal adrenalectomy: The current approach.
Pub Date : 2025-02-10 DOI: 10.1016/j.acuroe.2025.501694
D Vazquez-Martul
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引用次数: 0
Efficacy of preoperative-guided pelvic floor exercises on urinary incontinence and quality of life after robotic radical prostatectomy.
Pub Date : 2025-02-10 DOI: 10.1016/j.acuroe.2025.501702
C García-Sánchez, I García Obrero, C Muñoz-Calahorro, A J Rodríguez-Pérez, R A Medina-López

Introduction and objective: Radical prostatectomy has a great impact on urinary continence, although it is a multifactorial aspect. The aim of the study was to evaluate the effect of guided Pelvic Floor Exercises (PFE) versus written information prior to robotic radical prostatectomy (RRP) on the rate of urinary incontinence, and their effect on patients' quality of life.

Material and method: 62 patients were randomized to an experimental (physiotherapist-guided exercises) or control (written information) group. The primary outcome was incontinence rate (measured by pad test). Secondary outcomes were incontinence severity, quality of life (measured by the 36-Item Short Form Survey Instrument (SF-36) and the King's Health Questionnaire (KHQ)), voiding dynamics, correlation between incontinence and quality of life, and other incontinence-related factors.

Results: We found no differences in the incontinence rate between groups in the months of follow-up (82.61% vs. 84.62%, month 1; 61.54% vs. 75.86%, month 3; 50% vs. 53.33%, month 6; 30.77% vs. 40%, month 12) nor in the severity of incontinence between groups. There were significant differences in the quality of life related to "emotional problems" and "personal relationships", in favor of the control group. We found correlations between incontinence severity and age, severity and quality of life, urgency/frequency and quality of life.

Conclusions: Guided exercises prior to RRP do not seem to offer benefits over written information in either the rate or severity of incontinence. Urinary incontinence correlates with age and quality of life. Quality of life correlates with urgency and voiding frequency.

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引用次数: 0
Mastering the curve: Advances and challenges in teaching endoscopic enucleation of the prostate.
Pub Date : 2025-02-10 DOI: 10.1016/j.acuroe.2025.501695
I Schwartzmann
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引用次数: 0
期刊
Actas urologicas espanolas
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