Actas urologicas espanolas最新文献

英文中文

Ablative techniques in renal tumours for inoperable patients: Step forward in SBRT 不能手术患者的肾肿瘤消融技术：SBRT的新进展。

Actas urologicas espanolas

Pub Date : 2026-01-01 DOI: 10.1016/j.acuroe.2025.501857

A. Ocanto , R. Ciérvide , V. Hevia-Palacios , R. García , V. Gómez , P. Cruz , A. Olavarría , F. Couñago , F. López-Campos

Introduction

The localized renal cell carcinoma (RCC) is the eighth most common tumour in Spain. While surgical resection remains the gold standard for treatment, some elderly and frail patients may not be suitable candidates for this procedure. In selected cases, ablative therapies provide less invasive alternatives. Recent research has highlighted the potential of Stereotactic Body Radiotherapy (SBRT) as a non-invasive, well-tolerated, and effective treatment for RCC. This review aims to examine recent advances in SBRT for localized RCC, focusing on patient selection, treatment modalities and delivery, as well as efficacy and tolerance assessment.

Material and methods

A narrative literature review of English articles using Pubmed, Scopus, Cochrane, Google Scholar and Science Direct databases was performed focusing on prospective and relevant retrospective studies. Search terms included “kidney cancer”, “renal cell carcinoma”, “stereotactic radiotherapy”, “radiofrequency ablation”, “cryoablation”, “microwave ablation”, “SBRT” and “SABR”.

Results

Studies have reported local control rates ranging from 80% to 100% with SBRT. The decline in glomerular filtration rate following SBRT is approximately -10 to −13 mL/min over the years. Common toxicities are rare and are mostly classified as CTCAE grade I.

Conclusion

Based on available evidence, SBRT appears to be a viable option for patients with localized RCC who are not surgical candidates, given its high local control rate and favorable safety profile. Therefore, some indications for its use in clinical practice have been purposed according to the available evidence and recommending a case by case discussion in a uro-oncology multidisciplinary setting to optimize patient selection and treatment planning.

简介：局限性肾细胞癌（RCC）是西班牙第八大常见肿瘤。虽然手术切除仍然是治疗的金标准，但一些老年人和虚弱的患者可能不适合这种手术。在某些情况下，消融治疗提供了侵入性较小的选择。最近的研究强调了立体定向放射治疗（SBRT）作为一种无创、耐受性良好、有效的RCC治疗方法的潜力。本综述旨在探讨SBRT治疗局部RCC的最新进展，重点是患者选择，治疗方式和递送，以及疗效和耐受性评估。材料和方法：对Pubmed、Scopus、Cochrane、谷歌Scholar和Science Direct数据库中的英文文章进行叙述性文献综述，重点进行前瞻性和相关回顾性研究。搜索词包括“肾癌”、“肾细胞癌”、“立体定向放疗”、“射频消融”、“冷冻消融”、“微波消融”、“SBRT”和“SABR”。结果：研究报告SBRT的局部控制率为80%至100%。多年来，SBRT后肾小球滤过率的下降约为-10至-13 mL/min。结论：基于现有证据，SBRT具有较高的局部控制率和良好的安全性，对于不适合手术的局限性RCC患者来说，SBRT似乎是一种可行的选择。因此，在临床实践中，一些适应症的使用是根据现有的证据，并建议在泌尿肿瘤多学科背景下逐个病例讨论，以优化患者选择和治疗计划。

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引用次数: 0

Atypical prostate cancer recurrence in the vas deferens detected by [18F]F-piflufolastat PET/CT imaging 通过 [18F]F-piflufolastat PET/CT 成像检测输精管内的非典型前列腺癌复发。

Actas urologicas espanolas

Pub Date : 2026-01-01 DOI: 10.1016/j.acuroe.2025.501690

S. Bondia-Bescós, J.J. Martín-Marcuartu, J.J. Robles-Barba, M. Cortés-Romera

引用次数: 0

Mixed epithelial and stromal kidney tumor with sarcomatous transformation. A case report 肾混合性上皮间质瘤中发生恶性肉瘤性肿瘤：1例女性病例报告。

Actas urologicas espanolas

Pub Date : 2026-01-01 DOI: 10.1016/j.acuroe.2025.501692

A.C. Jiménez Domínguez , A.J.G. Álvarez Lucena , P. Vila Braña , F. Vázquez Alonso

引用次数: 0

Evaluation of treatment efficacy according to RECIP 1.0 criteria in castration-sensitive prostate cancer 按照RECIP 1.0标准评价去势敏感前列腺癌的治疗效果。

Actas urologicas espanolas

Pub Date : 2026-01-01 DOI: 10.1016/j.acuroe.2025.501837

Ilkay Gulturk , Caner Kapar , Esra Arslan , Murat Polat , Gulru Birce Sonmezoz , Deniz Tural

Objective

To evaluate the relationship between treatment response and radiological progression-free survival (rPFS) in patients with metastatic castration-sensitive prostate cancer (mCSPC) assessed by PSMA-PET/CT using Response Evaluation Criteria on PSMA (RECIP 1.0) criteria.

Methods

In this study, 116 patients were analyzed retrospectively. At the beginning of the treatment and week 12 were PSMA PET/CT images evaluated for changes in total tumor volüme and new lesions. Patients were divided into four groups according to RECIP criteria; complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). The primary outcome was the correlation of RECIP criteria with rPFS.

Results

Mean age of the patients was 67 years [IQR: 62–72]. Total of 116 patients; 65 (56%) hadPR, 17 (14,6%) SD, 19 (16,3%) PD, and 15 (12%) CR. rPFS was found to be statistically significantly different among these four groups (p < 0.001). RECIP PD was found to be significantly shorter rPFS compared with non-PD (p < 0.001), with an rPFS of 7 months (95% CI: 3.45–10.56). PSA values were measured at nadir in 40 patients and no patient in this group was evaluated as having PD.

Conclusion

RECIP criteria have been shown to have prognostic significance in terms of evaluating treatment response and rPFS in mCSPC patients.

目的：应用PSMA反应评价标准（RECIP 1.0）评价PSMA- pet /CT评估转移性去雄敏感前列腺癌（mCSPC）患者治疗反应与放射学无进展生存期（rPFS）的关系。方法：对116例患者进行回顾性分析。在治疗开始和第12周时，评估PSMA PET/CT图像，以评估总肿瘤体积和新病变的变化。根据RECIP标准将患者分为4组；完全缓解（CR）、部分缓解（PR）、病情稳定（SD）和病情进展（PD）。主要结局是RECIP标准与rPFS的相关性。结果：患者平均年龄67岁[IQR: 62-72]。116例患者；hadPR 65例（56%），SD 17例（14.6%），PD 19例（16.3%），cr 15例（12%）。四组患者的rPFS差异有统计学意义(p结论：RECIP标准在评估mCSPC患者的治疗反应和rPFS方面具有预后意义。

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引用次数: 0

Advances, challenges, and future perspectives in pediatric urology 儿科泌尿外科的进展、挑战和未来展望。

Actas urologicas espanolas

Pub Date : 2026-01-01 DOI: 10.1016/j.acuroe.2025.501831

A. Bujons Tur

引用次数: 0

International Overview on Diagnosis and Treatment of Nocturnal Enuresis: A Survey Study by EAU YAU Paediatric Urology Working Group 夜间遗尿症的诊断和治疗的国际综述：一项由EAU YAU儿科泌尿外科工作组进行的调查研究。

Actas urologicas espanolas

Pub Date : 2026-01-01 DOI: 10.1016/j.acuroe.2025.501822

N. Baydilli , M.İ. Dönmez , Y. Quiroz Madarriaga , B. Banuelos Marco , İ. Selvi , E. Bindi , R. Lammers , S. Sforza , L.A. 't Hoen , en representación del Grupo de Trabajo de Urología Pediátrica de la Sección de Jóvenes Urólogos – Asociación Europea de Urología (EAU-YAU)

Objective

This study assessed global diagnostic and therapeutic approaches to nocturnal enuresis (NE), highlighting current practices and variations.

Materials and methods

An 18-question survey by the European Association of Urology (EAU) Young Academic Urologist (YAU) Paediatric Urology Working Group targeted clinicians managing NE. Distributed online, it reached Urologists, Pediatric Urologists, Pediatricians, Nephrologists, and Urotherapists. The survey collected demographic data and details on diagnostic and treatment practices. Responses were analyzed using descriptive statistics.

Results

Most respondents worked in university or government hospitals, with pediatric urologists forming the largest group (43.6%). A significant portion had 11–20 years of NE management experience. Initial treatment favored behavioral strategies and urotherapy (84.5%), with desmopressin as a common first-line medication (23.8%). Most clinicians initiated treatment at ages 5–6. Bladder diaries were widely used (82.0%), while airway assessments were inconsistent (52.1%). Diagnostic test usage varied, with urinary tract ultrasonography (53.65%) and urinalysis (51.5%) employed to identify underlying abnormalities. Psychological referrals were common for secondary enuresis (58.9%).

Conclusion

NE management varies globally due to regional practices, clinician experience, and specialty focus. The findings emphasize the need for standardized guidelines and education on comprehensive assessments, including sleep-related factors. International collaboration and guideline development could enhance consistency and improve patient outcomes.

目的：本研究评估了全球夜间遗尿症（NE）的诊断和治疗方法，强调了当前的做法和变化。材料和方法：欧洲泌尿外科协会（EAU）青年学术泌尿科医师（YAU）儿科泌尿外科工作组针对临床医生管理NE进行了18个问题的调查。在网上分发，它到达泌尿科医生、儿科泌尿科医生、儿科医生、肾病科医生和泌尿治疗师。该调查收集了人口统计数据以及诊断和治疗实践的细节。采用描述性统计对反馈进行分析。结果：大多数受访医师在大学或公立医院工作，其中儿科泌尿科医师占43.6%。相当一部分人有11-20年的网络资源管理经验。初始治疗倾向于行为策略和泌尿治疗（84.5%），去氨加压素作为常见的一线药物（23.8%）。大多数临床医生在5-6岁时开始治疗。膀胱日记被广泛使用（82.0%），而气道评估不一致（52.1%）。诊断检查的使用各不相同，使用尿路超声检查（53.65%）和尿液分析（51.5%）来识别潜在的异常。继发性遗尿常见心理转诊（58.9%）。结论：由于地区实践、临床医生经验和专业重点不同，全球范围内的NE管理各不相同。研究结果强调了对包括睡眠相关因素在内的综合评估进行标准化指导和教育的必要性。国际合作和指南的制定可以增强一致性并改善患者的预后。

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引用次数: 0

Comparing «Prostatype® P-score and traditional risk models for predicting prostate cancer outcomes in Spain». Author reply 比较«前列腺类型®p -评分和传统的风险模型预测前列腺癌的结果在西班牙»。作者回复。

Actas urologicas espanolas

Pub Date : 2026-01-01 DOI: 10.1016/j.acuroe.2025.501828

P. González-Peramato , E. Berglund

引用次数: 0

Laparoscopic heminephroureterectomy of horseshoe kidney with suspected urothelial carcinoma using a hyper accuracy 3D virtual model 应用超精确3D虚拟模型对疑似尿路上皮癌的马蹄肾进行腹腔镜半肾输尿管切除术。

Actas urologicas espanolas

Pub Date : 2026-01-01 DOI: 10.1016/j.acuroe.2025.501747

A. Garcia-Segui, M. Ferrández-Jimenez, N. García-Cárceles, C. Soler-López

引用次数: 0

Outcomes of surgical treatment of large paraurethral cysts 大尿道旁囊肿的手术治疗效果。

Actas urologicas espanolas

Pub Date : 2025-12-01 DOI: 10.1016/j.acuroe.2025.501865

N. Kulchenko , G. Demyashkin , A. Mansur , A. Strachuk , E. Korovyakova , R. Frantsev , K. Neklyudov , A. Mirontsev , V. Rostovskaya , K. Silakov

Introduction

Paraurethral cysts are rare in females and are often incidental findings during routine medical examinations. To date, no standardized approach exists for the surgical management of large cysts, which tend to cause the most discomfort to patients.

Objective

To evaluate the effectiveness of surgical treatment for large paraurethral cysts through excision and laser vaporization.

Methods

The study included 49 female patients diagnosed with paraurethral cysts larger than 4 cm in diameter. The patients were divided into two groups: Group 1 (n = 26) underwent excision of the paraurethral cyst, and Group 2 (n = 23) underwent laser vaporization. All patients were monitored throughout their hospitalization. The parameters assessed included operation time, the number and type of intraoperative complications, the duration of bladder catheterization, and the length of hospital stay.

Results

Laser vaporization was, on average, 8.6 min shorter than excision (p < 0.05), with a strong correlation between the surgical method and operation time (r = 0.70). Intraoperative complications (bleeding, urethral injury, cyst rupture) occurred 2.8 times less frequently in Group 2 compared to Group 1. The length of hospital stay was 1.3 days shorter following laser vaporization. The correlation between hospital stay duration and surgical method was moderate (r = 0.31).

Conclusion

Laser vaporization offers significant advantages for the treatment of large paraurethral cysts, including shorter operation time, fewer intraoperative complications, and a faster recovery period. Therefore, laser vaporization should be considered the treatment of choice for large paraurethral cysts.

简介：尿道旁囊肿在女性中很少见，通常是在常规医学检查中偶然发现的。迄今为止，对于大囊肿的外科治疗尚无标准化的方法，而大囊肿往往会给患者带来最大的不适。目的：探讨激光汽化术治疗尿道旁大囊肿的疗效。方法：本研究纳入49例经诊断为直径大于4cm的尿道旁囊肿的女性患者。患者分为两组：1组（26例）行尿道旁囊肿切除术，2组（23例）行激光汽化。所有患者在住院期间均接受监测。评估的参数包括手术时间、术中并发症的数量和类型、膀胱导尿时间和住院时间。结果：激光汽化术比切除术平均缩短8.6分钟(p)。结论：激光汽化术治疗大型尿道旁囊肿具有手术时间短、术中并发症少、恢复期快等显著优势。因此，对于较大的尿道旁囊肿，应考虑激光汽化治疗的选择。

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引用次数: 0

FocalONE high-intensity focused ultrasound for localized prostate cancer: A systematic review of oncologic outcomes, functional preservation, and technological evolution 聚焦高强度聚焦超声治疗局限性前列腺癌：肿瘤预后、功能保存和技术发展的系统回顾。

Actas urologicas espanolas

Pub Date : 2025-12-01 DOI: 10.1016/j.acuroe.2025.501869

K. Eskandar

Introduction

Focal therapy offers a middle-ground approach for localized prostate cancer, preserving the prostate while avoiding the morbidity of radical treatment. High-Intensity Focused Ultrasound (HIFU) is the most studied focal modality, with FocalONE representing the most widely adopted modern platform enabling precise image-guided ablation.

Objective

To systematically assess the oncologic control, functional outcomes, safety, and technological advancements of focal and hemiablation HIFU with an emphasis on the FocalONE platform.

Methodology

This systematic review followed PRISMA guidelines and was registered in PROSPERO. A comprehensive search of PubMed, Embase, and Cochrane databases identified prospective studies using FocalONE or earlier-generation transrectal HIFU devices for focal or hemiablation in localized prostate cancer. Key outcomes included biopsy negativity, salvage-free survival, urinary continence, erectile function, and complications. Study quality was appraised using the JBI tool.

Results

Five prospective studies involving 701 patients were included. Biopsy negativity ranged from 84% to 95%, with salvage-free survival reaching up to 92% at mid-term follow-up. Urinary continence was preserved in 96–100% of patients, and erectile function in 74–95%, with the most favorable functional outcomes consistently observed in FocalONE-based cohorts. Most adverse events were minor (grade I–II), with few serious complications. Compared to focal cryotherapy and irreversible electroporation, HIFU showed comparable cancer control and better or similar functional preservation. PSA density and MRI-visible lesions were strong predictors of success.

Conclusion

FocalONE-based focal HIFU provides effective cancer control with excellent functional preservation in selected patients. While evidence from earlier-generation devices supports these trends, generalizability across all HIFU platforms remains to be validated. Its precision and safety profile make it a promising alternative between active surveillance and radical therapies, especially in favorable intermediate-risk cases.

局灶性治疗为局部前列腺癌提供了一种中间方法，既保留了前列腺，又避免了根治性治疗的发病率。高强度聚焦超声（HIFU）是研究最多的聚焦方式，FocalONE代表了最广泛采用的现代平台，可以实现精确的图像引导消融。目的：以FocalONE平台为重点，系统评估局灶性和半消融HIFU的肿瘤控制、功能结局、安全性和技术进步。方法：本系统评价遵循PRISMA指南，并在PROSPERO注册。PubMed、Embase和Cochrane数据库的综合检索确定了使用FocalONE或早期经直肠HIFU设备治疗局限性前列腺癌局灶性或半消融的前瞻性研究。主要结局包括活检阴性、无抢救生存、尿失禁、勃起功能和并发症。采用JBI工具评价研究质量。结果：纳入5项前瞻性研究，涉及701例患者。活检阴性范围为84%至95%，中期随访时无打捞生存率高达92%。96-100%的患者保留了尿失禁，74-95%的患者保留了勃起功能，在以福卡龙为基础的队列中观察到最有利的功能结果。大多数不良事件轻微（I-II级），很少有严重并发症。与局部冷冻治疗和不可逆电穿孔相比，HIFU显示出相当的癌症控制和更好或相似的功能保存。PSA密度和mri可见病变是成功的有力预测指标。结论：以focalone为基础的局灶HIFU可有效控制肿瘤，并保留部分患者的功能。虽然来自早期设备的证据支持这些趋势，但所有HIFU平台的普遍性仍有待验证。其准确性和安全性使其成为主动监测和根治性治疗之间的一个有希望的替代方案，特别是在有利的中等风险病例中。

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