Actas urologicas espanolas最新文献_第6页

Cumulative morbidity of ureteroscopy for upper tract urothelial carcinoma. 输尿管镜检查上尿路上皮癌的累积发病率。

Actas urologicas espanolas

Pub Date : 2024-05-10 DOI: 10.1016/j.acuroe.2024.05.007

G Basile, A Gallioli, A Territo, P Verri, J M Gaya, L Afferi, P Diana, I Sanz, L Dieguez, A Uleri, C Berquin, P Gavrilov, F Algaba, J Palou, A Breda

Objective: To assess complications after ureteroscopy (URS) for upper tract urothelial carcinoma (UTUC) management and to assess its postoperative cumulative morbidity burden using the Comprehensive Complication Index (CCI).

Materials and methods: Single center retrospective study including patients submitted to URS for UTUC suspicion. URSs were both diagnostic and operative. Postoperative complications were recorded according to the EAU Guidelines and graded according to Clavien-Dindo Classification (CDC). The cumulative postoperative morbidity burden developed by patients experiencing multiple events was assessed using the CCI. Multivariable logistic regression (MLR) analyses identified factors independently associated with the development of any grade and major postoperative complications.

Results: Overall, 360 patients with UTUC suspicion were included with a total of 575 URSs performed. The cumulative number of all postoperative complications recorded was 111. In 86 (15%) procedures, patients experienced at least one postoperative complication, while 25 (4.3%) experienced more than one complication. Of these, 16 (14%) were severe (CDC ≥ IIIa). The most frequent type of complications were urinary (34%), bleeding (30%) and infectious (30%). The higher the CDC grade, the higher the median CCI, with a statistically significant increase in median CCI from CDC II to major complications. Patients who experienced intraoperative complications were at higher risk of developing any grade and major postoperative complications at MLR.

Conclusions: Complications after ureteroscopy for UTUC are relatively uncommon events. Patients who experience intraoperative complications are at higher risk of developing postoperative complications. The comprehensive complication index appeared more representative of the cumulative postoperative morbidity rather than the Clavien-Dindo classification.

目的：评估输尿管镜检查（URS）治疗上尿路上皮癌（UTUC）后的并发症，并使用综合并发症指数（CCI）评估术后累积发病率：单中心回顾性研究，包括因怀疑UTUC而接受URS的患者。URS包括诊断性URS和手术性URS。根据EAU指南记录术后并发症，并根据克拉维恩-丁多分类法（CDC）进行分级。使用 CCI 评估了发生多次并发症的患者的累积术后发病负担。多变量逻辑回归（MLR）分析确定了与术后发生任何等级并发症和主要并发症独立相关的因素：共纳入 360 名疑似 UTUC 患者，进行了 575 次 URS。所有术后并发症的累计记录为 111 例。在86例（15%）手术中，患者至少出现了一种术后并发症，25例（4.3%）出现了一种以上的并发症。其中，16 例（14%）为严重并发症（CDC ≥ IIIa）。最常见的并发症类型是泌尿系统（34%）、出血（30%）和感染（30%）。CDC 等级越高，CCI 中位数越高，从 CDC II 到主要并发症，CCI 中位数有显著的统计学增长。术中出现并发症的患者在MLR时出现任何级别和主要术后并发症的风险更高：结论：UTUC输尿管镜检查后的并发症相对少见。结论：UTUC 输尿管镜检查术后并发症相对少见，术中出现并发症的患者术后出现并发症的风险更高。综合并发症指数似乎比克拉维恩-丁多分类法更能代表术后累积发病率。

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引用次数: 0

Rising testicular cancer incidence in Spain despite declining mortality: an age-period-cohort analysis. 西班牙睾丸癌发病率上升而死亡率下降：年龄-时期-队列分析》。

Actas urologicas espanolas

Pub Date : 2024-05-09 DOI: 10.1016/j.acuroe.2024.05.003

L Cayuela, S Cabrera Fernández, J J Pereyra-Rodríguez, J C Hernández-Rodríguez, A Cayuela

Background: Testicular cancer, primarily affecting young men, has seen an alarming rise globally. This study delves into incidence and mortality trends in Spain from 1990 to 2019 using the Global Burden of Disease (GBD) database and the Age-Period-Cohort (A-P-C) model.

Methods: We analyzed GBD data on testicular cancer cases and deaths in Spain, calculating age-standardized rates (ASIR and ASMR) and employing Joinpoint regression to identify significant shifts. The A-P-C model further dissected the effects of age, period, and birth cohort on these trends.

Results: A striking doubling in testicular cancer incidence was observed, from 3.09 to 5.40 per 100,000 men (1.9% annual increase), while mortality rates remained stable and even decreased in younger age groups (0.34 to 0.26 per 100,000, 0.8% annual decrease). Joinpoint analysis revealed four distinct periods of increasing incidence, with a recent slowdown. The A-P-C model highlighted a consistent rise in incidence risk with each successive generation born after 1935, contrasting with a progressive decline in mortality risk across cohorts, particularly marked for those born since the 1960s.

Conclusion: While mortality rates are encouraging, Spain reflects the global trend of escalating testicular cancer incidence. The A-P-C analysis suggests a generational influence, but the underlying causes remain elusive. Further research is crucial to understand these trends and implement effective prevention strategies to combat this growing health concern.

背景：睾丸癌主要影响年轻男性，其发病率在全球范围内呈惊人上升趋势。本研究利用全球疾病负担（GBD）数据库和年龄-时期-队列（A-P-C）模型，深入研究了1990年至2019年西班牙的发病率和死亡率趋势：我们分析了西班牙睾丸癌病例和死亡的 GBD 数据，计算了年龄标准化比率（ASIR 和 ASMR），并采用 Joinpoint 回归法确定了显著的变化。A-P-C模型进一步剖析了年龄、时期和出生队列对这些趋势的影响：结果：观察到睾丸癌发病率翻了一番，从每 10 万名男性中 3.09 例增加到 5.40 例（年增长率为 1.9%），而死亡率保持稳定，年轻年龄组的死亡率甚至有所下降（每 10 万名男性中 0.34 例下降到 0.26 例，年下降率为 0.8%）。结合点分析显示，发病率有四个不同的上升期，最近有所放缓。A-P-C模型突出表明，1935年后出生的每一代人的发病风险都在持续上升，与此形成鲜明对比的是，各年龄组的死亡率风险在逐步下降，这在20世纪60年代后出生的人群中尤为明显：结论：西班牙的死亡率令人鼓舞，但也反映了全球睾丸癌发病率不断上升的趋势。A-P-C分析表明，睾丸癌的发病率与世代因素有关，但其根本原因仍难以捉摸。要了解这些趋势并实施有效的预防策略来应对这一日益严重的健康问题，进一步的研究至关重要。

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引用次数: 0

What is the relationship between penile cancer and the microbiome? A scoping review. 阴茎癌与微生物组之间有什么关系？范围综述。

Actas urologicas espanolas

Pub Date : 2024-05-09 DOI: 10.1016/j.acuroe.2024.05.001

H A García-Perdomo, V Granados-Duque, P E Spiess

Introduction: The microbiota is defined as the microorganisms in a particular environment. Conversely, the term microbiome is less firmly defined and is used to reference the habitat.

Objective: To identify the association between the microbiome and the penile cancer EVIDENCE ACQUISITION: We performed this scoping review according to the recommendations of the Joanna Briggs Institute. We found five articles that fulfilled the inclusion criteria. We focused on oncogenesis and factors that alter the penile microbiome. We were not limited to language or setting. We searched MEDLINE (Ovid), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and LILACS from inception to the present day.

Evidence synthesis: We found nine studies describing multiple factors that could disturb the microbiome, such as sexual behavior, anatomic alterations including circumcision, and inflammatory factors: lichen sclerosus, poor genital hygiene, compromised immune system, smoking, and HPV infection.

Conclusion: Overall, knowledge of the composition of the penile microbiota and its role in penile cancer oncogenesis is minimal.

Patient summary: Future studies should focus on the relationship between the microbiome and penile cancer to broaden this field of knowledge.

引言微生物群被定义为特定环境中的微生物。相反，"微生物群"（microbiome）一词的定义则不那么明确，而是指栖息地：证据采集：我们根据乔安娜-布里格斯研究所（Joanna Briggs Institute）的建议进行了此次范围界定综述。我们找到了五篇符合纳入标准的文章。我们重点研究了致癌因素和改变阴茎微生物组的因素。我们不受语言或环境的限制。我们检索了MEDLINE (Ovid)、Embase、Cochrane对照试验中央注册中心(CENTRAL)和LILACS从开始至今的文献：我们发现九项研究描述了可能干扰微生物组的多种因素，如性行为、包括包皮环切术在内的解剖学改变以及炎症因素：硬皮病、生殖器卫生不良、免疫系统受损、吸烟和人乳头瘤病毒感染：总体而言，人们对阴茎微生物群的组成及其在阴茎癌致癌过程中的作用知之甚少：未来的研究应关注微生物群与阴茎癌之间的关系，以拓宽这一知识领域。

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引用次数: 0

Cost analysis of next-generation imaging in high-risk prostate cancer staging 新一代成像技术在高风险前列腺癌分期中的成本分析。

Actas urologicas espanolas

Pub Date : 2024-05-01 DOI: 10.1016/j.acuroe.2023.12.003

J.J. Szczesniewski , C. Tellez Fouz , A. García Tello , M. de la Rubia Marcos , M.P. García Alonso , L. Llanes González

Introduction and objective

Next-generation imaging (NGI) tests, such as choline PET/CT and PSMA PET, have shown to increase sensitivity in the detection of nodal and metastatic disease in prostate cancer. However, their use implies an increase in diagnostic costs compared to conventional imaging (CI) tests such as CT and bone scan. The aim of our study was to determine which diagnostic pathway is more cost-effective in high-risk prostate cancer.

Material and method

Cost-effectiveness analysis of the available imaging tests (CI, Choline/PSMA PET) for the staging of high-risk prostate cancer. Sensitivity and specificity were estimated based on published evidence, and costs were collected from the Management Department. In order to carry out a cost-effectiveness analysis, five diagnostic pathways were proposed estimating the accurate diagnoses.

Results

PSMA PET was the most accurate diagnostic option. The CI diagnostic workup was the most economical and CI + PSMA the most expensive. Analyzing the diagnostic cost-effectiveness ratio, CI + PSMA proved to be the most expensive (€5627.30 per correct diagnosis) followed by PET PSMA (€4987.11), choline (€4599.84) and CI (€4444.22).

Conclusions

PSMA PET is the most accurate strategy in staging distant disease in patients with high-risk prostate cancer. Radiotracer uptake tests such as CI have been shown to be the most cost-effective option, followed by choline and PSMA.

简介和目的：新一代成像（NGI）检查，如胆碱 PET/CT 和 PSMA PET，已证明可提高前列腺癌结节和转移性疾病的检测灵敏度。然而，与 CT 和骨扫描等传统成像 (CI) 检查相比，使用这些检查意味着诊断成本的增加。我们的研究旨在确定哪种诊断途径对高危前列腺癌更具成本效益：对用于高危前列腺癌分期的现有成像检测（CI、胆碱/PSMA PET）进行成本效益分析。灵敏度和特异性是根据已发表的证据估算的，费用则从管理部门收集。为了进行成本效益分析，我们提出了五种诊断路径，对准确诊断结果进行了估算：结果：PSMA PET 是最准确的诊断方案。结果：PSMA PET 是最准确的诊断方案，CI 诊断工作最经济，CI + PSMA 最昂贵。从诊断成本效益比分析，CI + PSMA 最昂贵（每次正确诊断 5627.30 欧元），其次是 PSMA PET（4987.11 欧元）、胆碱（4599.84 欧元）和 CI（4444.22 欧元）：结论：PSMA PET 是对高危前列腺癌患者远处疾病进行分期的最准确策略。CI等放射性示踪剂摄取检测被证明是最具成本效益的选择，其次是胆碱和PSMA。

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引用次数: 0

External urology consultation quality at a third-level public hospital in Mexico 墨西哥一家三级公立医院泌尿外科的门诊质量。

Actas urologicas espanolas

Pub Date : 2024-05-01 DOI: 10.1016/j.acuroe.2023.12.004

R. Cortés-Ramírez , C.B. Ruíz-Velasco , A. González-Ojeda , R.A. Ramírez-Aguado , N.G. Barrera-López , E. Gómez-Mejía , K. Toala-Díaz , G. Delgado-Hernández , N.E. López-Bernal , J.A. Tavares-Ortega , J.M. Chejfec-Ciociano , G. Cervantes-Guevara , G. Cervantes-Cardona , E. Cervantes-Pérez , S. Ramírez-Ochoa , A. Nápoles-Echauri , A.S. Álvarez-Villaseñor , A.O. Cortés-Flores , C. Fuentes-Orozco

Introduction

Patient satisfaction is the degree of conformity with the healthcare they receive. It is real evidence and one of the most important factors in determining the effectiveness and quality of healthcare systems.

Objective

To identify the quality of care in the Urology outpatient department of a third-level hospital.

Materials and methods

The NHS (National Health Service) 2018 quality of care questionnaire with 11 sections, 133 items, and duration of approximately 25 min was randomly administered to 250 patients attending Urology outpatients at a third-level public hospital in Mexico.

Results

According to responses, 92% (n = 230) knew the reason for the consultation. 64.8% (n = 162) had a consultation with the same physician by whom they were initially seen. The longest reported hospital wait time before being seen was more than 2 h in 29.6% (n = 74). As for consultation time, 212 patients responded and the duration was 11−20 min in 52.8% (n = 112). Finally, 33.2% (n = 83) considered the quality of service to be good.

Conclusions

The use of the NHS 2018 survey in the Urology service at a third-level public hospital in Mexico is feasible, since we managed to obtain a significant and continuous improvement in all its indicators which is satisfactory for all.

导言患者满意度是指患者对所接受的医疗服务的满意程度。它是真实的证据，也是决定医疗系统有效性和质量的最重要因素之一：材料与方法：对墨西哥一家三级公立医院泌尿外科门诊的 250 名患者随机发放了 2018 年 NHS（国家卫生服务体系）护理质量调查问卷，共 11 个部分，133 个项目，时长约 25 分钟：根据回答，92%（n = 230）的患者知道就诊原因。64.8%（n = 162）的患者与最初就诊的医生进行了会诊。29.6%的患者（人数=74）表示在就诊前最长的医院等待时间超过 2 小时。至于会诊时间，212 名患者做出了回答，52.8% 的患者（n = 112）的会诊时间为 11 至 20 分钟。最后，33.2%（n = 83）的患者认为服务质量良好：在墨西哥一家三级公立医院的泌尿外科服务中使用 2018 年国家医疗服务体系调查是可行的，因为我们成功地在所有指标上都取得了令人满意的显著和持续改善。

{"title":"External urology consultation quality at a third-level public hospital in Mexico","authors":"R. Cortés-Ramírez , C.B. Ruíz-Velasco , A. González-Ojeda , R.A. Ramírez-Aguado , N.G. Barrera-López , E. Gómez-Mejía , K. Toala-Díaz , G. Delgado-Hernández , N.E. López-Bernal , J.A. Tavares-Ortega , J.M. Chejfec-Ciociano , G. Cervantes-Guevara , G. Cervantes-Cardona , E. Cervantes-Pérez , S. Ramírez-Ochoa , A. Nápoles-Echauri , A.S. Álvarez-Villaseñor , A.O. Cortés-Flores , C. Fuentes-Orozco","doi":"10.1016/j.acuroe.2023.12.004","DOIUrl":"10.1016/j.acuroe.2023.12.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Patient satisfaction is the degree of conformity with the healthcare they receive. It is real evidence and one of the most important factors in determining the effectiveness and quality of healthcare systems.</p></div><div><h3>Objective</h3><p>To identify the quality of care in the Urology outpatient department of a third-level hospital.</p></div><div><h3>Materials and methods</h3><p>The NHS (National Health Service) 2018 quality of care questionnaire with 11 sections, 133 items, and duration of approximately 25min was randomly administered to 250 patients attending Urology outpatients at a third-level public hospital in Mexico.</p></div><div><h3>Results</h3><p>According to responses, 92% (n=230) knew the reason for the consultation. 64.8% (n=162) had a consultation with the same physician by whom they were initially seen. The longest reported hospital wait time before being seen was more than 2h in 29.6% (n=74). As for consultation time, 212 patients responded and the duration was 11−20min in 52.8% (n=112). Finally, 33.2% (n=83) considered the quality of service to be good.</p></div><div><h3>Conclusions</h3><p>The use of the NHS 2018 survey in the Urology service at a third-level public hospital in Mexico is feasible, since we managed to obtain a significant and continuous improvement in all its indicators which is satisfactory for all.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139072513","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

Tislelizumab, a novel PD-1 monoclonal antibody in urothelial cancer: A real-world study 新型 PD-1 单克隆抗体 Tislelizumab 治疗尿路上皮癌：一项真实世界研究。

Actas urologicas espanolas

Pub Date : 2024-05-01 DOI: 10.1016/j.acuroe.2023.12.006

Z. Wang, H. Bi, Y.D. Wang, Q. Liu, B. Shao, C.Q. Li, C. Fu, S. Fu, G.Y. Shan, A. Chen, C.C. Lv, Y. Zeng

Objective

Tislelizumab, a monoclonal antibody against programed death protein-1 (PD-1), has shown encouraging antitumor activity in urothelial cancer. This study was designed to assess the efficacy and safety of tislelizumab in urotelial cancer in a real-world setting.

Methods

The study was a real-world retrospective study undertaken at Liaoning Cancer Hospital & Institute, China. Eligible patients were ≥18 years. Patients received 200-mg tislelizumab monotherapy intravenously every 3 weeks until the disease progressed to intolerable toxicity. Outcomes included an objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and safety.

Results

Between March 2020 and December 2022, 33 patients were enrolled. The median follow-up was 10.17 (IQR 5.73–12.47) months. Of all 33 patients, ORR and DCR were 30.30% (95% CI 15.6%–48.7%) and 42.42% (95% CI 25.48%–60.78%), respectively. The median PFS was 5.73 (95% CI 3.27–13.00) months, with a 12-month PFS rate of 31.90% (95% CI 19.20%–53.00%). The median OS was 17.7 (95% CI 12.80-not reach) months, with a 12-month OS rate of 67.50% (95% CI 52.70%–86.40%). Eleven (33.33%) and 8 (24.24%) experienced ≥grade 3 treatment-related adverse events (TRAEs) and immune-related Aes, respectively. No treatment-related deaths occurred.

Conclusion

The excellent efficacy and controllable safety of tislelizumab in locally advanced or metastatic urothelial cancer suggest that it may be a promising therapeutic option for this population.

研究目的Tislelizumab是一种针对程序性死亡蛋白-1（PD-1）的单克隆抗体，在泌尿道癌中显示出令人鼓舞的抗肿瘤活性。本研究旨在评估 tislelizumab 在真实世界环境中对尿路癌的疗效和安全性：本研究是一项在中国辽宁省肿瘤医院进行的真实世界回顾性研究。符合条件的患者年龄≥18岁。患者接受200毫克替斯利珠单抗单药治疗，每3周静脉注射1次，直至病情恶化至不可耐受毒性。结果包括客观反应率（ORR）、疾病控制率（DCR）、无进展生存期（PFS）、总生存期（OS）和安全性：结果：2020 年 3 月至 2022 年 12 月期间，共有 33 名患者入组。中位随访时间为 10.17 个月（IQR 5.73-12.47 个月）。在所有33名患者中，ORR和DCR分别为30.30%（95% CI 15.6-48.7%）和42.42%（95% CI 25.48-60.78%）。中位 PFS 为 5.73 个月（95% CI 3.27-13.00），12 个月的 PFS 率为 31.90%（95% CI 19.20-53.00%）。中位OS为17.7个月（95% CI为12.80个月，未达标），12个月OS率为67.50%（95% CI为52.70-86.40%）。分别有11人（33.33%）和8人（24.24%）出现≥3级的治疗相关不良事件（TRAE）和免疫相关不良事件。无治疗相关死亡病例发生：tislelizumab对局部晚期或转移性尿路上皮癌的卓越疗效和可控安全性表明，它可能是这一人群的一种有前途的治疗选择。

{"title":"Tislelizumab, a novel PD-1 monoclonal antibody in urothelial cancer: A real-world study","authors":"Z. Wang, H. Bi, Y.D. Wang, Q. Liu, B. Shao, C.Q. Li, C. Fu, S. Fu, G.Y. Shan, A. Chen, C.C. Lv, Y. Zeng","doi":"10.1016/j.acuroe.2023.12.006","DOIUrl":"10.1016/j.acuroe.2023.12.006","url":null,"abstract":"<div><h3>Objective</h3><p>Tislelizumab, a monoclonal antibody against programed death protein-1 (PD-1), has shown encouraging antitumor activity in urothelial cancer. This study was designed to assess the efficacy and safety of tislelizumab in urotelial cancer in a real-world setting.</p></div><div><h3>Methods</h3><p>The study was a real-world retrospective study undertaken at Liaoning Cancer Hospital & Institute, China. Eligible patients were ≥18 years. Patients received 200-mg tislelizumab monotherapy intravenously every 3 weeks until the disease progressed to intolerable toxicity. Outcomes included an objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and safety.</p></div><div><h3>Results</h3><p>Between March 2020 and December 2022, 33 patients were enrolled. The median follow-up was 10.17 (IQR 5.73–12.47) months. Of all 33 patients, ORR and DCR were 30.30% (95% CI 15.6%–48.7%) and 42.42% (95% CI 25.48%–60.78%), respectively. The median PFS was 5.73 (95% CI 3.27–13.00) months, with a 12-month PFS rate of 31.90% (95% CI 19.20%–53.00%). The median OS was 17.7 (95% CI 12.80-not reach) months, with a 12-month OS rate of 67.50% (95% CI 52.70%–86.40%). Eleven (33.33%) and 8 (24.24%) experienced ≥grade 3 treatment-related adverse events (TRAEs) and immune-related Aes, respectively. No treatment-related deaths occurred.</p></div><div><h3>Conclusion</h3><p>The excellent efficacy and controllable safety of tislelizumab in locally advanced or metastatic urothelial cancer suggest that it may be a promising therapeutic option for this population.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139072517","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

Cocaine-related ischemic priapism. Systematic review and presentation of a single center series 与可卡因相关的缺血性前列腺增生症。

Actas urologicas espanolas

Pub Date : 2024-05-01 DOI: 10.1016/j.acuroe.2024.02.007

C. Altez-Fernandez , L. Lamas , M. Bohorquez , V. Chantada , D. Ralph

Introduction

Ischemic priapism is a medical emergency that, if not treated, could lead to permanent erectile dysfunction. The association between cocaine and priapism is well-known; however, data on patient characteristics, treatment, and outcomes is missing.

This work aimed to answer the research question: What are the characteristics, management strategies, and erectile prognosis of patients consuming cocaine and presenting with priapism?

Methods

We conducted a systematic review according to PRISMA guidelines and described our case series.

Results

Eight studies were selected for qualitative synthesis, presenting information on ten patients. In our case series, we showed information regarding four patients. From the systematic review, the mean presentation time was 42.6 h, and the mean number of procedures to solve priapism was 2,4; in our case series was 42.75 h and 2, respectively.

Conclusion

Cocaine-related priapism might present with a delayed diagnosis, need more procedures to be managed, and have a worse prognosis. More extensive and prospective studies are required.

简介缺血性勃起功能障碍是一种医学急症，如果不加以治疗，可能会导致永久性勃起功能障碍。可卡因与勃起功能障碍之间的关系众所周知，但有关患者特征、治疗和结果的数据却十分缺乏。这项研究旨在回答以下问题吸食可卡因并出现勃起功能障碍的患者有哪些特征、治疗策略和勃起功能预后？我们根据PRISMA指南进行了系统性综述，并描述了我们的病例系列：结果：我们选择了八项研究进行定性综述，这些研究提供了十名患者的信息。在我们的病例系列中，我们展示了四名患者的信息。从系统综述来看，患者的平均就诊时间为 42.6 小时，解决前列腺增生症的平均手术次数为 2 次和 4 次；而在我们的病例系列中，患者的平均就诊时间和手术次数分别为 42.75 小时和 2 次：结论：可卡因相关性前列腺增生症可能会延迟诊断，需要更多的手术治疗，预后较差。需要进行更广泛的前瞻性研究。

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引用次数: 0

Long-term functional success and patient-reported outcomes after female one-stage buccal mucosal graft urethroplasty. 女性一期口腔粘膜移植尿道成形术后的长期功能成功率和患者报告结果。

Actas urologicas espanolas

Pub Date : 2024-05-01 DOI: 10.1016/j.acuroe.2024.05.014

J. Klemm, P. Marks, R. J. Schulz, D. K. Filipas, D. Stelzl, R. Dahlem, M. Fisch, M. Vetterlein

引用次数: 0

Effects of androgen deprivation therapy on elderly men with high-risk prostate cancer: PROSARC observational study 雄激素剥夺疗法对高危前列腺癌老年男性的影响：PROSARC 观察性研究。

Actas urologicas espanolas

Pub Date : 2024-05-01 DOI: 10.1016/j.acuroe.2024.02.012

Ó. Legido-Gómez , S. Rico-Marco , M.V. Lorenzo-Sánchez , S. Navarro-Jiménez , M.A. Tárraga-Honrubia , J. Martínez-Ruiz , J.M. Giménez-Bachs , M.J. Donate-Moreno , I. Díaz de Mera-Sánchez-Migallón , M. Segura-Martín , R. Alcantud-Córcoles , P. Abizanda-Soler , A.S. Salinas-Sánchez

Introduction

Prostatic carcinoma (PC) is a frequent neoplasm in elderly patients. Although androgen deprivation is associated with survival benefits, it is also related to adverse effects such as osteoporosis, frailty, or sarcopenia, which can negatively affect the patient’s quality of life. This study aims to quantify and evaluate the prevalence of osteoporosis, frailty, or sarcopenia in elderly PC patients before and after androgen deprivation. We present data from an interim analysis.

Materials and methods

PROSARC is a national (Spain) prospective observational study (May-2022–May-2025) still in progress in 2 hospitals. It includes patients with high-risk PC, aged ≥70 years, non-candidates for local treatment and scheduled to start androgen deprivation therapy. The following variables are analyzed: comorbidity, frailty (Fried frailty phenotype criteria), osteoporosis, sarcopenia (EWGSOP2), fat mass and muscle mass, before treatment and after 6 months of follow-up.

Results

A 6-month follow-up was completed by 12/25 included patients (mean age, 84 years), with a high baseline prevalence of pre-frailty/frailty (67.7%), sarcopenia (66.7%) and osteoporosis (25%). Treatment did not significantly alter these variables or comorbidity. We observed changes in body mass index (p = 0.666), decreased mean value of appendicular muscle mass (p = 0.01) and increased percentage of fat mass (p = 0.012).

Conclusion

In patients with high-risk PC, advanced age and a considerable prevalence of osteoporosis, frailty and sarcopenia, androgen deprivation (ADT; 6 months) produces decreased muscle mass without impact on the incidence of the known adverse effects of androgen deprivation.

简介前列腺癌（PC）是老年患者的常见肿瘤。虽然雄激素剥夺对患者的生存有好处，但它也与骨质疏松症、虚弱或肌肉疏松等不良反应有关，会对患者的生活质量产生负面影响。本研究旨在量化和评估老年 PC 患者在雄激素剥夺前后骨质疏松症、虚弱或肌肉疏松症的发生率。我们将提供中期分析的数据：PROSARC 是一项全国性（西班牙）前瞻性观察研究（2022 年 5 月至 2025 年 5 月），目前仍在两家医院进行。研究对象包括高危 PC 患者，年龄≥ 70 岁，不适合接受局部治疗，并计划开始雄激素剥夺治疗。对以下变量进行了分析：合并症、虚弱（弗里德虚弱表型标准）、骨质疏松症、肌少症（EWGSOP2）、脂肪量和肌肉量、治疗前和随访 6 个月后的情况：12/25名患者（平均年龄84岁）完成了为期6个月的随访，其中虚弱前/虚弱（67.7%）、肌肉疏松（66.7%）和骨质疏松症（25%）的基线发病率较高。治疗并未明显改变这些变量或合并症。我们观察到身体质量指数的变化（P = .666）、附着肌质量平均值的下降（P = .01）和脂肪质量百分比的增加（P = .012）：结论：对于高危 PC 患者、高龄患者以及骨质疏松症、虚弱和肌肉疏松症的高发人群，雄激素剥夺（ADT；6 个月）会导致肌肉质量下降，但不会影响雄激素剥夺已知不良反应的发生率。

{"title":"Effects of androgen deprivation therapy on elderly men with high-risk prostate cancer: PROSARC observational study","authors":"Ó. Legido-Gómez , S. Rico-Marco , M.V. Lorenzo-Sánchez , S. Navarro-Jiménez , M.A. Tárraga-Honrubia , J. Martínez-Ruiz , J.M. Giménez-Bachs , M.J. Donate-Moreno , I. Díaz de Mera-Sánchez-Migallón , M. Segura-Martín , R. Alcantud-Córcoles , P. Abizanda-Soler , A.S. Salinas-Sánchez","doi":"10.1016/j.acuroe.2024.02.012","DOIUrl":"10.1016/j.acuroe.2024.02.012","url":null,"abstract":"<div><h3>Introduction</h3><p>Prostatic carcinoma (PC) is a frequent neoplasm in elderly patients. Although androgen deprivation is associated with survival benefits, it is also related to adverse effects such as osteoporosis, frailty, or sarcopenia, which can negatively affect the patient’s quality of life. This study aims to quantify and evaluate the prevalence of osteoporosis, frailty, or sarcopenia in elderly PC patients before and after androgen deprivation. We present data from an interim analysis.</p></div><div><h3>Materials and methods</h3><p>PROSARC is a national (Spain) prospective observational study (May-2022–May-2025) still in progress in 2 hospitals. It includes patients with high-risk PC, aged ≥70 years, non-candidates for local treatment and scheduled to start androgen deprivation therapy. The following variables are analyzed: comorbidity, frailty (Fried frailty phenotype criteria), osteoporosis, sarcopenia (EWGSOP2), fat mass and muscle mass, before treatment and after 6 months of follow-up.</p></div><div><h3>Results</h3><p>A 6-month follow-up was completed by 12/25 included patients (mean age, 84 years), with a high baseline prevalence of pre-frailty/frailty (67.7%), sarcopenia (66.7%) and osteoporosis (25%). Treatment did not significantly alter these variables or comorbidity. We observed changes in body mass index (<em>p</em>  =0.01) and increased percentage of fat mass (<em>p</em>  <!-->0.012).</p></div><div><h3>Conclusion</h3><p>In patients with high-risk PC, advanced age and a considerable prevalence of osteoporosis, frailty and sarcopenia, androgen deprivation (ADT; 6 months) produces decreased muscle mass without impact on the incidence of the known adverse effects of androgen deprivation.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907264","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

Multidisciplinary consensus document on the current treatment of bacille Calmette-Guérin-unresponsive non-muscle invasive bladder tumor 关于目前治疗对卡介苗无反应的非肌肉浸润性膀胱肿瘤的多学科共识文件。

Actas urologicas espanolas

Pub Date : 2024-05-01 DOI: 10.1016/j.acuroe.2024.04.005

F. Guerrero-Ramos , M. Álvarez-Maestro , Á. Pinto Marín , J.L. Domínguez Escrig , Ó. Rodríguez Faba

Radical cystectomy is the current treatment of choice for patients with BCG-unresponsive non-muscle invasive bladder tumor (NMIBC). However, the high comorbidity of this surgery and its effects on the quality of life of patients require the investigation and implementation of bladder-sparing treatment options. These must be evaluated individually by the uro-oncology committee based on the characteristics of the BCG failure, type of tumor, patient preferences and treatment options available in each center. Based on FDA-required oncologic outcomes (6-month complete response rate for CIS: 50%; duration of response in responders for CIS and papillary: 30% at 12 months and 25% at 18 months), there is not currently a strong preference for one treatment over another, although the intravesical route seems to offer less toxicity. This work summarizes the evidence on the management of BCG-unresponsive NMIBC based on current scientific evidence and provides consensus recommendations on the most appropriate treatment.

根治性膀胱切除术是目前治疗对卡介苗无反应的非肌层浸润性膀胱肿瘤（NMIBC）患者的首选方法。然而，这种手术的并发症较高，对患者的生活质量也有影响，因此需要研究和实施保膀胱治疗方案。这些方案必须由泌尿肿瘤学委员会根据卡介苗失败的特点、肿瘤类型、患者偏好以及各中心现有的治疗方案进行单独评估。根据 FDA 要求的肿瘤学结果（CIS 的 6 个月完全反应率：50%；CIS 和乳头状瘤反应者的反应持续时间：30%（12 个月）和 25%（18 个月）），尽管膀胱内途径似乎毒性较小，但目前并没有一种治疗方法优于另一种治疗方法的强烈偏好。本研究根据目前的科学证据总结了卡介苗无反应 NMIBC 的治疗方法，并就最合适的治疗方法提出了共识性建议。

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