Pub Date : 2024-05-14DOI: 10.1016/j.acuroe.2024.05.014
J Klemm, P Marks, R J Schulz, D K Filipas, D R Stelzl, R Dahlem, M Fisch, M W Vetterlein
Introduction and objectives: Female urethral strictures are a rare condition that significantly impacts patients' quality of life. Patient-reported outcomes are crucial, yet data regarding sexual function and treatment satisfaction are scarce. We aimed to provide insights from a reconstructive referral center.
Patients and methods: We conducted a retrospective analysis of women treated with ventral onlay one-stage buccal mucosa graft urethroplasty for urethral strictures between 2009-2023. We assessed objective (retreatment-free survival, ΔQmax) and subjective outcomes (validated patient-reported outcomes).
Results: Of 12 women, 83% and 17% had iatrogenic and idiopathic strictures, respectively. Median number of prior interventions was 6. Strictures were located meatal and mid-urethral in 25% and 75%, respectively, 22% had the bladder neck involved. Median graft length was 2 cm. At median follow-up of 66 months, 33% of patients underwent stricture retreatment, but only one case occurred within the first 2 years postoperatively. The median improvement in maximum flow rate (ΔQmax) was 10 ml/s. Median International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ-FLUTS) scores were 8 for filling symptoms, 6 for voiding symptoms, and 3 for incontinence symptoms. Median ICIQ-FLUTSsex score was 4. Higher scores indicate a higher symptom burden. Median ICIQ-Satisfaction outcome and satisfaction scores were 18 and 7, respectively, reflecting high treatment satisfaction.
Conclusions: Buccal mucosal graft urethroplasty by ventral onlay for female urethral strictures yields effective, durable, and positively received outcomes. However, larger studies across multiple institutions are necessary to further assess its efficacy, especially regarding patient-reported experiences and sexual function.
{"title":"Long-term functional success and patient-reported outcomes after female one-stage buccal mucosal graft urethroplasty.","authors":"J Klemm, P Marks, R J Schulz, D K Filipas, D R Stelzl, R Dahlem, M Fisch, M W Vetterlein","doi":"10.1016/j.acuroe.2024.05.014","DOIUrl":"10.1016/j.acuroe.2024.05.014","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Female urethral strictures are a rare condition that significantly impacts patients' quality of life. Patient-reported outcomes are crucial, yet data regarding sexual function and treatment satisfaction are scarce. We aimed to provide insights from a reconstructive referral center.</p><p><strong>Patients and methods: </strong>We conducted a retrospective analysis of women treated with ventral onlay one-stage buccal mucosa graft urethroplasty for urethral strictures between 2009-2023. We assessed objective (retreatment-free survival, ΔQmax) and subjective outcomes (validated patient-reported outcomes).</p><p><strong>Results: </strong>Of 12 women, 83% and 17% had iatrogenic and idiopathic strictures, respectively. Median number of prior interventions was 6. Strictures were located meatal and mid-urethral in 25% and 75%, respectively, 22% had the bladder neck involved. Median graft length was 2 cm. At median follow-up of 66 months, 33% of patients underwent stricture retreatment, but only one case occurred within the first 2 years postoperatively. The median improvement in maximum flow rate (ΔQmax) was 10 ml/s. Median International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ-FLUTS) scores were 8 for filling symptoms, 6 for voiding symptoms, and 3 for incontinence symptoms. Median ICIQ-FLUTSsex score was 4. Higher scores indicate a higher symptom burden. Median ICIQ-Satisfaction outcome and satisfaction scores were 18 and 7, respectively, reflecting high treatment satisfaction.</p><p><strong>Conclusions: </strong>Buccal mucosal graft urethroplasty by ventral onlay for female urethral strictures yields effective, durable, and positively received outcomes. However, larger studies across multiple institutions are necessary to further assess its efficacy, especially regarding patient-reported experiences and sexual function.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-14DOI: 10.1016/j.acuroe.2024.05.015
F Algaba
{"title":"Determining PD-L1 expression in invasive urothelial carcinoma: Recommendations from the Spanish society of anatomic pathology.","authors":"F Algaba","doi":"10.1016/j.acuroe.2024.05.015","DOIUrl":"https://doi.org/10.1016/j.acuroe.2024.05.015","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-11DOI: 10.1016/j.acuroe.2024.05.012
D Carracedo Calvo, N Pereira Rodriguez, P Moscatiello, T Jerez Izquierdo, E Meilán Hernández, M Toledo Jimenez, I Hernández Bermejo, H Gimbernat Diaz, M Sánchez Encinas
Introduction: Pelvic organ prolapse is a condition with high prevalence in elderly women. With increasing life expectancy and a desire for improved quality of life, a rise in the frequency of surgical treatments for these women is anticipated. The aim is to compare complication, success, and satisfaction rates among elderly patients (aged >70 years) in comparison to younger women undergoing robotic sacrocolpopexy, thereby assessing the safety and efficacy of this surgery in this group of patients.
Method: A prospective observational comparative study of 123 robotic sacrocolpopexies conducted between December 2016 and June 2022. Patients were stratified by age (cutoff point: 70 years). Baseline characteristics, type, and grade of prolapse, intra and postoperative data, complications, functional and anatomical outcomes, and satisfaction levels were collected.
Results: Among the 123 patients, 62.6% were under 70 years old, while 37.4% were 70 years or older, exhibiting similar baseline characteristics, prolapse grade, and type. The percentages of intraoperative (6.5%) and postoperative complications (4.4-9%) were comparable in both age groups. Furthermore, success and satisfaction rates exceeded 90%, with no significant differences between women under and over 70 years during a two-year follow-up.
Conclusion: Robotic sacrocolpopexy is at least as effective and safe in women aged 70 years or older as in younger individuals, with no higher rates of intra and postoperative complications and similar rates of anatomical and subjective success.
{"title":"Robotic sacrocolpopexy for the treatment of pelvic organ prolapse in elderly women: comparative analysis of safety and efficacy versus younger women.","authors":"D Carracedo Calvo, N Pereira Rodriguez, P Moscatiello, T Jerez Izquierdo, E Meilán Hernández, M Toledo Jimenez, I Hernández Bermejo, H Gimbernat Diaz, M Sánchez Encinas","doi":"10.1016/j.acuroe.2024.05.012","DOIUrl":"10.1016/j.acuroe.2024.05.012","url":null,"abstract":"<p><strong>Introduction: </strong>Pelvic organ prolapse is a condition with high prevalence in elderly women. With increasing life expectancy and a desire for improved quality of life, a rise in the frequency of surgical treatments for these women is anticipated. The aim is to compare complication, success, and satisfaction rates among elderly patients (aged >70 years) in comparison to younger women undergoing robotic sacrocolpopexy, thereby assessing the safety and efficacy of this surgery in this group of patients.</p><p><strong>Method: </strong>A prospective observational comparative study of 123 robotic sacrocolpopexies conducted between December 2016 and June 2022. Patients were stratified by age (cutoff point: 70 years). Baseline characteristics, type, and grade of prolapse, intra and postoperative data, complications, functional and anatomical outcomes, and satisfaction levels were collected.</p><p><strong>Results: </strong>Among the 123 patients, 62.6% were under 70 years old, while 37.4% were 70 years or older, exhibiting similar baseline characteristics, prolapse grade, and type. The percentages of intraoperative (6.5%) and postoperative complications (4.4-9%) were comparable in both age groups. Furthermore, success and satisfaction rates exceeded 90%, with no significant differences between women under and over 70 years during a two-year follow-up.</p><p><strong>Conclusion: </strong>Robotic sacrocolpopexy is at least as effective and safe in women aged 70 years or older as in younger individuals, with no higher rates of intra and postoperative complications and similar rates of anatomical and subjective success.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-11DOI: 10.1016/j.acuroe.2024.05.006
L Regis, J Bertholle, J Planas, F Lozano, D Lorente, A Celma, M Cuadras, M Costa, J Morote, E Trilla
Introduction and objective: Robotic-assisted laparoscopic prostatectomy (PLAR) seems to improve functional outcomes, however there is not a consensus of a standard procedure. The aim of this study was to identify the PLAR "state of art" in Catalonia, Spain.
Material and methods: This was a cross-sectional survey-based study conducted among urologists across Catalonia, Spain. The survey was distributed through online platforms and the professional urology society. All statistical analyses were performed using Stata software, v20.
Results: 59 urologists completed the survey, revealing PLAR as the most commonly used technique (79.7%). Most urologist (70%) create the pneumoperitoneum using a controlled incision with direct access and 78.3% use the Airseal technology. The intraperitoneal approach is performed in >90% of cases. Endopelvic fascia preservation is not routinely performed. 34.5% of the survey not perform the dorsal vein complex suture. All preserves the bladder neck when oncologically safe. Nerve-vascular bundles bleeding control is performed using standard coagulation or suturing. 34% performed posterior reconstruction. Only use hemostatic devices when evident bleeding and 70% does not routinely left a drainage. Multivariable analysis showed that center volume had a significant independent association with dorsal venous complex suturing (OR 0.073, 95%CI 0.07-0.826), nerve-vascular bundles suturing hemostasis (OR 11.67, 95%CI 1.07-127.60) and endopelvic fascia preservation (OR 13.64, 95%CI 1.087-201.27), but there was no correlation with time the bladder catheter or days hospitalized.
Conclusions: The study provides an overview of the state of PLAR in Catalonia, Spain, showing significant variability and reflecting a commitment to advancing surgical technology and patient care.
{"title":"State of art of robotic prostatectomy: the way we do it in Catalonia, Spain.","authors":"L Regis, J Bertholle, J Planas, F Lozano, D Lorente, A Celma, M Cuadras, M Costa, J Morote, E Trilla","doi":"10.1016/j.acuroe.2024.05.006","DOIUrl":"10.1016/j.acuroe.2024.05.006","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Robotic-assisted laparoscopic prostatectomy (PLAR) seems to improve functional outcomes, however there is not a consensus of a standard procedure. The aim of this study was to identify the PLAR \"state of art\" in Catalonia, Spain.</p><p><strong>Material and methods: </strong>This was a cross-sectional survey-based study conducted among urologists across Catalonia, Spain. The survey was distributed through online platforms and the professional urology society. All statistical analyses were performed using Stata software, v20.</p><p><strong>Results: </strong>59 urologists completed the survey, revealing PLAR as the most commonly used technique (79.7%). Most urologist (70%) create the pneumoperitoneum using a controlled incision with direct access and 78.3% use the Airseal technology. The intraperitoneal approach is performed in >90% of cases. Endopelvic fascia preservation is not routinely performed. 34.5% of the survey not perform the dorsal vein complex suture. All preserves the bladder neck when oncologically safe. Nerve-vascular bundles bleeding control is performed using standard coagulation or suturing. 34% performed posterior reconstruction. Only use hemostatic devices when evident bleeding and 70% does not routinely left a drainage. Multivariable analysis showed that center volume had a significant independent association with dorsal venous complex suturing (OR 0.073, 95%CI 0.07-0.826), nerve-vascular bundles suturing hemostasis (OR 11.67, 95%CI 1.07-127.60) and endopelvic fascia preservation (OR 13.64, 95%CI 1.087-201.27), but there was no correlation with time the bladder catheter or days hospitalized.</p><p><strong>Conclusions: </strong>The study provides an overview of the state of PLAR in Catalonia, Spain, showing significant variability and reflecting a commitment to advancing surgical technology and patient care.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-11DOI: 10.1016/j.acuroe.2024.05.008
Á Borque-Fernando, A Zapatero, R Manneh, T Alonso-Gordoa, F Couñago, M Domínguez-Esteban, M López-Valcárcel, A Rodríguez-Antolín, N Sala-González, N Sanmamed, P Maroto
The standard treatment for metastatic hormone-sensitive prostate cancer (mHSPC) is now a combination of androgen deprivation therapy plus an androgen receptor-targeted therapy (abiraterone, apalutamide, enzalutamide or darolutamide), with or without chemotherapy (docetaxel). The selection of suitable patients for each therapeutic approach has become a determining factor to ensure efficacy and minimize side effects. This article combines recent clinical evidence with the accumulated experience of experts in medical oncology, radiation oncology and urology, to provide a comprehensive view and therapeutic recommendations for mHSPC.
{"title":"Recommendations on the treatment of metastatic hormone-sensitive prostate cancer: Patient selection.","authors":"Á Borque-Fernando, A Zapatero, R Manneh, T Alonso-Gordoa, F Couñago, M Domínguez-Esteban, M López-Valcárcel, A Rodríguez-Antolín, N Sala-González, N Sanmamed, P Maroto","doi":"10.1016/j.acuroe.2024.05.008","DOIUrl":"10.1016/j.acuroe.2024.05.008","url":null,"abstract":"<p><p>The standard treatment for metastatic hormone-sensitive prostate cancer (mHSPC) is now a combination of androgen deprivation therapy plus an androgen receptor-targeted therapy (abiraterone, apalutamide, enzalutamide or darolutamide), with or without chemotherapy (docetaxel). The selection of suitable patients for each therapeutic approach has become a determining factor to ensure efficacy and minimize side effects. This article combines recent clinical evidence with the accumulated experience of experts in medical oncology, radiation oncology and urology, to provide a comprehensive view and therapeutic recommendations for mHSPC.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-10DOI: 10.1016/j.acuroe.2024.05.004
J Caño Velasco, S Artero Fullana, L Polanco Pujol, A Lafuente Puentedura, J D Subiela, J Aragón Chamizo, M Moralejo Gárate, C Hernández Fernández
Introduction: In recent years, different urinary markers such as the Bladder Epicheck® have been developed in an attempt to reduce the number of cystoscopies in the follow-up of non-muscle invasive bladder cancer (NMIBC).
Aim: To provide a systematic review of Bladder Epicheck® and its current clinical utility in the follow-up and detection of recurrence of NMIBC.
Material and methods: Systematic review based on a literature search of PubMed, Web of Science and Scopus databases until October 2023, according to PRISMA and Quadas-2 criteria. Sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the marker were calculated. Diagnostic performance was evaluated by the area under the curve (AUC).
Results: Fifteen studies were analyzed (n = 3761) including 86.7% prospective studies. Of the patient series, 53.2% had received previous intravesical instillations. The mean Se of the biomarker in the detection of recurrence varied according to tumor grade (87.9%-high grade/HG vs. 44.9%-low grade/LG, respectively). Their weighted mean Se and Sp were 71.6% and 84.5%, respectively. The mean recurrence rate was 29.1%. The weighted mean PPV and NPV were 56.4% and 92.8% (97.7% non-LG), respectively. The mean AUC was 85.63%.
Conclusion: Bladder Epicheck® is a useful urinary marker in the follow-up of NMIBC, with significantly high Se and NPV in the detection of recurrences, especially in cases of HG disease. Its use can reduce the number of cystoscopies required in the follow-up of NMIBC, improving the quality of life of patients and potentially increasing health economic savings.
简介:目的:对膀胱Epicheck®及其在非肌层浸润性膀胱癌(NMIBC)随访和复发检测中的临床应用进行系统综述:根据PRISMA和Quadas-2标准,在PubMed、Web of Science和Scopus数据库中进行文献检索,系统综述截至2023年10月。计算标记物的敏感性(Se)、特异性(Sp)、阳性预测值(PPV)和阴性预测值(NPV)。诊断性能通过曲线下面积(AUC)进行评估:分析了 15 项研究(n = 3761),其中 86.7% 为前瞻性研究。53.2%的患者曾接受过膀胱内注射。生物标记物检测复发的平均 Se 因肿瘤级别而异(高级别/HG 与低级别/LG 分别为 87.9% 与 44.9%)。它们的加权平均 Se 和 Sp 分别为 71.6% 和 84.5%。平均复发率为 29.1%。加权平均PPV和NPV分别为56.4%和92.8%(非LG为97.7%)。平均AUC为85.63%:结论:膀胱Epicheck®是随访NMIBC的一种有用的尿液标记物,在检测复发,尤其是HG病例方面具有显著的高Se和NPV。使用它可以减少 NMIBC 随访中所需的膀胱镜检查次数,提高患者的生活质量,并有可能节约更多的医疗经济成本。
{"title":"Use of Bladder Epicheck® in the follow-up of high-risk non-muscle-invasive Bladder cancer: A systematic literature review.","authors":"J Caño Velasco, S Artero Fullana, L Polanco Pujol, A Lafuente Puentedura, J D Subiela, J Aragón Chamizo, M Moralejo Gárate, C Hernández Fernández","doi":"10.1016/j.acuroe.2024.05.004","DOIUrl":"10.1016/j.acuroe.2024.05.004","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, different urinary markers such as the Bladder Epicheck® have been developed in an attempt to reduce the number of cystoscopies in the follow-up of non-muscle invasive bladder cancer (NMIBC).</p><p><strong>Aim: </strong>To provide a systematic review of Bladder Epicheck® and its current clinical utility in the follow-up and detection of recurrence of NMIBC.</p><p><strong>Material and methods: </strong>Systematic review based on a literature search of PubMed, Web of Science and Scopus databases until October 2023, according to PRISMA and Quadas-2 criteria. Sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the marker were calculated. Diagnostic performance was evaluated by the area under the curve (AUC).</p><p><strong>Results: </strong>Fifteen studies were analyzed (n = 3761) including 86.7% prospective studies. Of the patient series, 53.2% had received previous intravesical instillations. The mean Se of the biomarker in the detection of recurrence varied according to tumor grade (87.9%-high grade/HG vs. 44.9%-low grade/LG, respectively). Their weighted mean Se and Sp were 71.6% and 84.5%, respectively. The mean recurrence rate was 29.1%. The weighted mean PPV and NPV were 56.4% and 92.8% (97.7% non-LG), respectively. The mean AUC was 85.63%.</p><p><strong>Conclusion: </strong>Bladder Epicheck® is a useful urinary marker in the follow-up of NMIBC, with significantly high Se and NPV in the detection of recurrences, especially in cases of HG disease. Its use can reduce the number of cystoscopies required in the follow-up of NMIBC, improving the quality of life of patients and potentially increasing health economic savings.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-10DOI: 10.1016/j.acuroe.2024.05.010
C Fernández Baltar, F Gude Sampedro, D Pérez Fentes
Objective: To analyze the predictive capacity of the nephrolithometry scoring systems (GSS, STONE, CROES and S-ReSC) and stone surface regarding success and complications following percutaneous nephrolithotomy (PCNL).
Methods: We studied 392 patients who had undergone PCNL in our center. Only patients with a non-contrast CT (n = 240) were finally included for analysis. The predictive capacities for success and complications of the different scoring systems were evaluated using ROC curves and their area under the curve (AUC).
Results: Regarding success, the S-ReSC system had the highest predictive capacity with an AUC of 0.681 (95% CI 0.610-0.751), followed by the CROES with 0.667 (95% CI 0.595-0.738), the STONE with 0.654 (95% CI 0.579-0.728) and finally the GSS with 0.626 (95% CI 0.555-0.698). The stone surface as a single variable had an AUC of 0.641 (95% CI 0.565-0.718). As for complications, the S-ReSC had the highest AUC with 0.664 (95% CI 0.57-0.758), followed by STONE with 0.663 (95% CI 0.572-0.755), GSS with 0.626 (95% CI 0.555).-0.698) and CROES with 0.614 (95% CI 0.518-0.7). The stone surface alone had an AUC of 0.616 (95% CI 0.522-0.715).
Conclusion: The nephrolithometry scales analyzed show a moderate predictive capacity for success and complications in patients undergoing PCNL in our center. Moreover, stone surface as an independent variable demonstrates moderate predictive capacity for both outcomes.
目的分析肾石测量评分系统(GSS、STONE、CROES 和 S-ReSC)和结石表面对经皮肾镜取石术(PCNL)成功率和并发症的预测能力:我们对本中心接受 PCNL 的 392 例患者进行了研究。方法:我们对本中心接受 PCNL 的 392 例患者进行了研究,最终只分析了接受非对比 CT 检查的患者(240 例)。使用 ROC 曲线及其曲线下面积(AUC)评估了不同评分系统对成功率和并发症的预测能力:在成功率方面,S-ReSC 系统的预测能力最高,其 AUC 为 0.681(95% CI 0.610 - 0.751),其次是 CROES,为 0.667(95% CI 0.595 - 0.738),STONE 为 0.654(95% CI 0.579 - 0.728),最后是 GSS,为 0.626(95% CI 0.555 - 0.698)。结石表面作为单一变量的 AUC 为 0.641(95% CI 0.565 - 0.718)。在并发症方面,S-ReSC 的 AUC 最高,为 0.664 (95% CI 0.57 - 0.758),其次是 STONE,为 0.663 (95% CI 0.572 - 0.755),GSS 为 0.626 (95% CI 0.555).- 0.698),CROES 为 0.614(95% CI 0.518 - 0.7)。结石表面单独的 AUC 为 0.616(95% CI 0.522 - 0.715):结论:所分析的肾石量表对在本中心接受 PCNL 治疗的患者的成功率和并发症具有一定的预测能力。此外,结石表面作为一个独立变量,对这两种结果也有一定的预测能力。
{"title":"Does success in percutaneous nephrolithotomy depend only on stone size? Analysis of the predictive capacity for success and complications of the current nephrolithometry scoring systems and their relationship with the stone surface.","authors":"C Fernández Baltar, F Gude Sampedro, D Pérez Fentes","doi":"10.1016/j.acuroe.2024.05.010","DOIUrl":"10.1016/j.acuroe.2024.05.010","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the predictive capacity of the nephrolithometry scoring systems (GSS, STONE, CROES and S-ReSC) and stone surface regarding success and complications following percutaneous nephrolithotomy (PCNL).</p><p><strong>Methods: </strong>We studied 392 patients who had undergone PCNL in our center. Only patients with a non-contrast CT (n = 240) were finally included for analysis. The predictive capacities for success and complications of the different scoring systems were evaluated using ROC curves and their area under the curve (AUC).</p><p><strong>Results: </strong>Regarding success, the S-ReSC system had the highest predictive capacity with an AUC of 0.681 (95% CI 0.610-0.751), followed by the CROES with 0.667 (95% CI 0.595-0.738), the STONE with 0.654 (95% CI 0.579-0.728) and finally the GSS with 0.626 (95% CI 0.555-0.698). The stone surface as a single variable had an AUC of 0.641 (95% CI 0.565-0.718). As for complications, the S-ReSC had the highest AUC with 0.664 (95% CI 0.57-0.758), followed by STONE with 0.663 (95% CI 0.572-0.755), GSS with 0.626 (95% CI 0.555).-0.698) and CROES with 0.614 (95% CI 0.518-0.7). The stone surface alone had an AUC of 0.616 (95% CI 0.522-0.715).</p><p><strong>Conclusion: </strong>The nephrolithometry scales analyzed show a moderate predictive capacity for success and complications in patients undergoing PCNL in our center. Moreover, stone surface as an independent variable demonstrates moderate predictive capacity for both outcomes.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-10DOI: 10.1016/j.acuroe.2024.05.011
A Vives, C A Muñoz, C Alonso-Tarres, M Cosentino
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Pub Date : 2024-05-10DOI: 10.1016/j.acuroe.2024.05.005
A Sierra, C Mercader, R Pagés, E Seguí, M Musquera, M J Ribal
Introduction: Gender equity in urological meetings is pivotal for fostering diversity and inclusivity in the field. This study aims to evaluate the representation of Spanish urologist and regional disparities, and to assess its alignment with the demographic composition of the urological community.
Materials and methods: All urology meetings organized by the AEU between January 2012 and December 2022 were reviewed, including meeting information and details of the faculty. Additionally, we analysed geographic distribution of speakers across 17 different regions. Gender demographics were obtained disaggregating data by sex and year from the Organización Médica Colegial de España (OMC) and from those urologists affiliated to the AEU.
Results: Analysing 52 AEU congresses held from 2012 to 2022, encompassing 3,407 speakers, the study found that 95.25% of speakers were from Spain and 89.6% were male speakers. Over the years, there was a positive trend in female speaker representation, increasing by 1.1% annually, slightly lagging the 1.8% annual rise in the number of female urologists in Spain. In specific subfields like functional, transplantation, and oncology sessions, the study revealed a higher representation of women, indicating focused efforts in these areas. Geographically, Madrid, Catalonia and Andalusia exhibited the highest representation.
Conclusions: Although there was a positive trend towards an increased participation of female urologists in Spanish urological meetings, it fails to accurately reflect the proportional increase in the number of women entering the urology profession in recent years. This study underscores the importance of ongoing efforts to ensure diverse and balanced representation in urological forum.
导言:泌尿外科会议中的性别平等对于促进该领域的多样性和包容性至关重要。本研究旨在评估西班牙泌尿外科医生的代表性和地区差异,并评估其与泌尿外科界人口构成的一致性:我们回顾了 2012 年 1 月至 2022 年 12 月间由 AEU 组织的所有泌尿外科会议,包括会议信息和教师详情。此外,我们还分析了发言人在 17 个不同地区的地理分布情况。我们还从Organización Médica Colegial de España (OMC)和隶属于AEU的泌尿科医生那里获得了按性别和年份分列的性别人口统计数据:研究分析了2012年至2022年期间举行的52次AEU大会,共有3407人发言,发现95.25%的发言者来自西班牙,89.6%的发言者为男性。多年来,女性发言人的比例呈上升趋势,每年增加1.1%,略低于西班牙泌尿科女医生人数每年1.8%的增幅。研究显示,在功能、移植和肿瘤等特定子领域的会议上,女性代表的比例较高,这表明这些领域的工作重点是女性。从地域上看,马德里、加泰罗尼亚和安达卢西亚的女性比例最高:尽管西班牙泌尿外科会议中女性泌尿科医生的参与率呈上升趋势,但这并不能准确反映近年来进入泌尿外科行业的女性人数的增长比例。这项研究强调了持续努力确保泌尿外科论坛的多元化和均衡代表性的重要性。
{"title":"Gender trends at the annual Spanish Urologic Association (AEU) meeting: A review of AEU programmes over a 10-year period (2012-2022).","authors":"A Sierra, C Mercader, R Pagés, E Seguí, M Musquera, M J Ribal","doi":"10.1016/j.acuroe.2024.05.005","DOIUrl":"10.1016/j.acuroe.2024.05.005","url":null,"abstract":"<p><strong>Introduction: </strong>Gender equity in urological meetings is pivotal for fostering diversity and inclusivity in the field. This study aims to evaluate the representation of Spanish urologist and regional disparities, and to assess its alignment with the demographic composition of the urological community.</p><p><strong>Materials and methods: </strong>All urology meetings organized by the AEU between January 2012 and December 2022 were reviewed, including meeting information and details of the faculty. Additionally, we analysed geographic distribution of speakers across 17 different regions. Gender demographics were obtained disaggregating data by sex and year from the Organización Médica Colegial de España (OMC) and from those urologists affiliated to the AEU.</p><p><strong>Results: </strong>Analysing 52 AEU congresses held from 2012 to 2022, encompassing 3,407 speakers, the study found that 95.25% of speakers were from Spain and 89.6% were male speakers. Over the years, there was a positive trend in female speaker representation, increasing by 1.1% annually, slightly lagging the 1.8% annual rise in the number of female urologists in Spain. In specific subfields like functional, transplantation, and oncology sessions, the study revealed a higher representation of women, indicating focused efforts in these areas. Geographically, Madrid, Catalonia and Andalusia exhibited the highest representation.</p><p><strong>Conclusions: </strong>Although there was a positive trend towards an increased participation of female urologists in Spanish urological meetings, it fails to accurately reflect the proportional increase in the number of women entering the urology profession in recent years. This study underscores the importance of ongoing efforts to ensure diverse and balanced representation in urological forum.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-10DOI: 10.1016/j.acuroe.2024.05.009
P Cruz Garcia Villa, A Izunza Laisequilla, E Puga Ortega, C Alaez Verson
Introduction and objective: Mexico reported 26,742 new cases of prostate cancer in 2020. Different risk factors have been identified in the pathogenesis of prostate cancer. Among them, genetic factors and alterations or mutations in specific genes have been described in different ethnic groups worldwide. The aim of our study is to report the prevalence of germline DNA-repair gene mutations in Mexican patients with prostate cancer.
Material and method: We performed germline genetic testing in 50 patients with localized prostate cancer and 50 patients with metastatic prostate cancer. Demographic, clinical, and histopathological data were collected.
Results: Thirty-seven germline mutations were identified in 32 patients. The most commonly affected genes were ATM in 6%, followed by FANCA (5%), and ATR (4%). BRCA2 mutations were identified in 3%. The frequency of mutations was higher in the metastatic group.
Discussion and conclusion: The results of our study show different mutations from those reported in different populations or regions. The use of PARP inhibitors is indicated in patients with germline mutations, specifically BRCA2, showing improvement in overall survival and progression free survival. To our knowledge, this is the first study reporting the prevalence of mutations in DNA-repair genes in Mexican patients with prostate cancer.
导言和目标:据报告,2020 年墨西哥新增前列腺癌病例 26 742 例。在前列腺癌的发病机制中发现了不同的风险因素。其中,遗传因素和特定基因的改变或突变已在全球不同种族群体中得到描述。我们的研究旨在报告墨西哥前列腺癌患者种系 DNA 修复基因突变的发生率:我们对 50 名局部前列腺癌患者和 50 名转移性前列腺癌患者进行了种系基因检测。收集了人口统计学、临床和组织病理学数据:结果:在 32 名患者中发现了 37 个基因突变。最常受影响的基因是ATM,占6%,其次是FANCA(5%)和ATR(4%)。BRCA2基因突变占3%。在转移组中,基因突变的频率更高:我们的研究结果显示,不同人群或地区的突变情况有所不同。PARP抑制剂适用于有基因突变(尤其是BRCA2)的患者,可改善总生存期和无进展生存期。据我们所知,这是第一项报告墨西哥前列腺癌患者 DNA 修复基因突变发生率的研究。
{"title":"Prevalence of DNA-Repair Gene mutations in Mexican men with prostate cancer.","authors":"P Cruz Garcia Villa, A Izunza Laisequilla, E Puga Ortega, C Alaez Verson","doi":"10.1016/j.acuroe.2024.05.009","DOIUrl":"10.1016/j.acuroe.2024.05.009","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Mexico reported 26,742 new cases of prostate cancer in 2020. Different risk factors have been identified in the pathogenesis of prostate cancer. Among them, genetic factors and alterations or mutations in specific genes have been described in different ethnic groups worldwide. The aim of our study is to report the prevalence of germline DNA-repair gene mutations in Mexican patients with prostate cancer.</p><p><strong>Material and method: </strong>We performed germline genetic testing in 50 patients with localized prostate cancer and 50 patients with metastatic prostate cancer. Demographic, clinical, and histopathological data were collected.</p><p><strong>Results: </strong>Thirty-seven germline mutations were identified in 32 patients. The most commonly affected genes were ATM in 6%, followed by FANCA (5%), and ATR (4%). BRCA2 mutations were identified in 3%. The frequency of mutations was higher in the metastatic group.</p><p><strong>Discussion and conclusion: </strong>The results of our study show different mutations from those reported in different populations or regions. The use of PARP inhibitors is indicated in patients with germline mutations, specifically BRCA2, showing improvement in overall survival and progression free survival. To our knowledge, this is the first study reporting the prevalence of mutations in DNA-repair genes in Mexican patients with prostate cancer.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913626","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}