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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
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。
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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。
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。
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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。
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。
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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。
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。
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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。
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 ,&nbsp;L. Vale ,&nbsp;J.V. Sousa ,&nbsp;T. Antunes-Lopes ,&nbsp;C.M. Silva ,&nbsp;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":"48 6","pages":"Pages 448-453"},"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。
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 ,&nbsp;K. Erdem ,&nbsp;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":"48 6","pages":"Pages 454-460"},"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。
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
{"title":"Initial results of pulsed thulium fiber laser (Dornier®) for the treatment of renal and ureteral stones with ureteroscopy","authors":"M.C. Cano-García ,&nbsp;C. Abad Rodríguez-Hesles ,&nbsp;V. Yuste-Mascarós ,&nbsp;M.Á. Arrabal Polo","doi":"10.1016/j.acuroe.2024.04.004","DOIUrl":"10.1016/j.acuroe.2024.04.004","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 6","pages":"Pages 484-485"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762822","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
Clinical evaluation and treatment in men with low testosterone levels and prostate cancer 男性睾酮水平低和前列腺癌患者的临床评估和治疗。
Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2023.12.001
B.M. Ljubetic, F. Parada, J.M. Flores

Introduction

A high prevalence of low testosterone levels has been reported in men with prostate cancer. The use of testosterone therapy in men with a history of prostate cancer is still controversial, and there is uncertainty regarding the management of these patients.

Methods

We analyzed the European and American guidelines on this topic and presented the clinical experience in the management of patients with low testosterone levels and a history of prostate cancer in one of the world's leading cancer centers.

Results

According to the published evidence to date, testosterone therapy in men with prostate cancer does not increase the risk of prostate cancer recurrence in the short and medium term, but there is a lack of data on the long term. Symptomatic men with low testosterone levels who are candidates for this therapy need a thorough clinical evaluation before commencing testosterone therapy. Evaluation of prostate cancer history including type of treatment administered, pathologic stage of prostate cancer and prostate specific antigen should be requested before and during testosterone treatment to assess its trend.

Conclusion

Prostate-specific antigen should remain undetectable after radical prostatectomy or stable after radiotherapy. Otherwise, it would be a sign of uncontrolled prostate cancer, and the patient may require cessation of testosterone therapy and referral to oncology for further evaluation.

导言:据报道,在患有前列腺癌的男性中,睾酮水平低的发病率很高。对有前列腺癌病史的男性使用睾酮治疗仍存在争议,对这些患者的管理也存在不确定性:方法:我们分析了欧洲和美国的相关指南,并介绍了世界领先的癌症中心之一在治疗睾酮水平低且有前列腺癌病史的患者方面的临床经验:结果:根据迄今为止已发表的证据,前列腺癌男性患者接受睾酮治疗在短期和中期内不会增加前列腺癌复发的风险,但缺乏长期治疗的数据。睾酮水平低且有症状的男性患者在开始睾酮治疗前需要进行全面的临床评估。在睾酮治疗前和治疗期间,应要求评估前列腺癌病史,包括治疗类型、前列腺癌病理分期和前列腺特异性抗原,以评估其趋势:前列腺特异性抗原在根治性前列腺切除术后应保持检测不到,或在放疗后保持稳定。结论:前列腺特异性抗原在根治性前列腺切除术后应保持检测不到,或在放疗后保持稳定,否则将是前列腺癌未得到控制的迹象,患者可能需要停止睾酮治疗,并转到肿瘤科做进一步评估。
{"title":"Clinical evaluation and treatment in men with low testosterone levels and prostate cancer","authors":"B.M. Ljubetic,&nbsp;F. Parada,&nbsp;J.M. Flores","doi":"10.1016/j.acuroe.2023.12.001","DOIUrl":"10.1016/j.acuroe.2023.12.001","url":null,"abstract":"<div><h3>Introduction</h3><p>A high prevalence of low testosterone levels has been reported in men with prostate cancer<span>. The use of testosterone therapy in men with a history of prostate cancer is still controversial, and there is uncertainty regarding the management of these patients.</span></p></div><div><h3>Methods</h3><p>We analyzed the European and American guidelines on this topic and presented the clinical experience in the management of patients with low testosterone levels and a history of prostate cancer in one of the world's leading cancer centers.</p></div><div><h3>Results</h3><p><span><span>According to the published evidence to date, testosterone therapy in men with prostate cancer does not increase the risk of prostate </span>cancer recurrence in the short and medium term, but there is a lack of data on the long term. Symptomatic men with low testosterone levels who are candidates for this therapy need a thorough </span>clinical evaluation<span> before commencing testosterone therapy. Evaluation of prostate cancer history including type of treatment administered, pathologic stage of prostate cancer and prostate specific antigen should be requested before and during testosterone treatment to assess its trend.</span></p></div><div><h3>Conclusion</h3><p>Prostate-specific antigen should remain undetectable after radical prostatectomy<span> or stable after radiotherapy. Otherwise, it would be a sign of uncontrolled prostate cancer, and the patient may require cessation of testosterone therapy and referral to oncology for further evaluation.</span></p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 6","pages":"Pages 410-415"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815487","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
Controversies in prostate cancer management: Consensus recommendations from experts in northern Spain. 前列腺癌治疗中的争议:西班牙北部专家的共识建议。
Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.06.005
D Pérez Fentes, P Willisch, S Martínez Breijoo, M Domínguez, U Anido, C Álvarez, A Gómez Caamaño

In recent years, various aspects of prostate cancer (PC) management have undergone significant changes, including the implementation of therapeutic strategies such as the use of new hormonal agents like abiraterone, apalutamide, enzalutamide or darolutamide and the incorporation of next generation imaging techniques (NGI). However, the evidence regarding the role of NGI and the therapeutic decision-making based on their findings is not solid. Following the methodology of the Advanced Prostate Cancer Consensus Conference (APCCC), a multidisciplinary expert consensus was developed to address controversial questions concerning the use of NGI and clinical management in four priority scenarios: localized PC, PC after radical prostatectomy, PC after radiotherapy with curative intent, and metastatic hormone-sensitive PC. This consensus represents the opinions of medical oncology, radiation oncology and urology physicians and provides useful recommendations for clinical practice.

近年来,前列腺癌(PC)治疗的各个方面都发生了重大变化,包括实施治疗策略,如使用阿比特龙、阿帕鲁胺、恩扎鲁胺或达罗鲁胺等新型激素药物,以及采用新一代成像技术(NGI)。然而,有关 NGI 的作用以及根据其结果做出治疗决策的证据并不充分。按照晚期前列腺癌共识会议(APCCC)的方法,多学科专家达成了一项共识,以解决与 NGI 的使用和四种重点情况下的临床管理有关的争议问题:局部 PC、根治性前列腺切除术后 PC、根治性放疗后 PC 和转移性激素敏感 PC。该共识代表了肿瘤内科、肿瘤放射科和泌尿科医生的观点,为临床实践提供了有用的建议。
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引用次数: 0
Biomarkers in kidney transplantation: Where do we stand? 肾移植中的生物标志物:我们的现状如何?
Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.01.003
A. López-Abad , A. Piana , T. Prudhomme , B. Bañuelos Marco , M.I. Dönmez , A. Pecoraro , R. Boissier , R. Campi , A. Breda , A. Territo , en representación del grupo de trabajo de trasplante renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU)
{"title":"Biomarkers in kidney transplantation: Where do we stand?","authors":"A. López-Abad ,&nbsp;A. Piana ,&nbsp;T. Prudhomme ,&nbsp;B. Bañuelos Marco ,&nbsp;M.I. Dönmez ,&nbsp;A. Pecoraro ,&nbsp;R. Boissier ,&nbsp;R. Campi ,&nbsp;A. Breda ,&nbsp;A. Territo ,&nbsp;en representación del grupo de trabajo de trasplante renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU)","doi":"10.1016/j.acuroe.2024.01.003","DOIUrl":"10.1016/j.acuroe.2024.01.003","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 6","pages":"Pages 407-409"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379098","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
期刊
Actas urologicas espanolas
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