Actas urologicas espanolas最新文献

{"title":"Real-world data from a single-center cohort of patients with metastatic hormone-sensitive prostate cancer in Spain: Analysis of response, progression, and quality of life","authors":"J. García Rodríguez,&nbsp;A. López Tello,&nbsp;C. González Ruiz de león,&nbsp;R. Sacristán González,&nbsp;M. Hevia Suárez,&nbsp;J. Fuentes Pastor,&nbsp;I. Pérez Vera,&nbsp;J.M. Fernández Gómez","doi":"10.1016/j.acuroe.2025.501838","DOIUrl":"10.1016/j.acuroe.2025.501838","url":null,"abstract":"<div><h3>Introduction</h3><div>Real-world analyses reflect routine clinical practice. We reviewed treatment response and quality of life in metastatic hormone-sensitive prostate cancer (mHSPC) patients treated with androgen receptor inhibitors.</div></div><div><h3>Methods</h3><div>We analyzed 89 patients with mHSPC from a descriptive observational cohort. The median follow-up was 16.1 months, with quarterly assessments. We evaluated PSA response, disease progression, and quality-of-life data.</div></div><div><h3>Results</h3><div>Among the patients, 37% had high-volume disease and 63% low-volume; 60% had synchronous metastases. Using apalutamide, we observed PSA reductions of 90%, PSA &lt; 0.2 ng/ml, and ultra-low PSA (&lt;0.02 ng/ml) at 3 and 6 months in 63%, 65%, and 34% and in 65%, 71%, and 53% of patients, respectively. Radiographic progression-free survival (rPFS) was 88% at 15 months. When PET-PSMA was used for imaging, 94% and 92% of patients remained free of radiographic progression at 12 and 24 months, respectively. Regarding quality of life, the FACT-P score remained stable, and pain on the visual analog scale improved, with the proportion of patients scoring &gt;1 decreasing from 35% to 22% over 6 months.</div></div><div><h3>Conclusion</h3><div>Real-world analyses using androgen receptor inhibitors in mHSPC reproduce clinical trial results in terms of treatment response. Profound PSA declines and observed progression-free survival outcomes reflect treatment effectiveness without a negative impact on quality of life.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 10","pages":"Article 501838"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067078","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}

{"title":"Use of hormonal therapy for undescended testis? Results of a worldwide questionnaire","authors":"R.J.M. Lammers ,&nbsp;L.A. 't Hoen ,&nbsp;F. O’Kelly ,&nbsp;I. Selvi ,&nbsp;Y. Quiroz Madarriaga ,&nbsp;N. Baydilli ,&nbsp;B. Bañuelos Marco ,&nbsp;M.I. Dönmez ,&nbsp;S. Sforza ,&nbsp;E. Bindi ,&nbsp;B. Haid ,&nbsp;en representación del Grupo de Trabajo de Urología Pediátrica de la Sección de Jóvenes Urólogos Académicos (YAU) - Asociación Europea de Urología (EAU)","doi":"10.1016/j.acuroe.2025.501820","DOIUrl":"10.1016/j.acuroe.2025.501820","url":null,"abstract":"<div><div>The objective of this study was provide an overview of current practices on hormonal therapy (HT) in children with undescended testes (UDT).</div><div>An online questionnaire about HT, referral patterns, and orchidopexy was spread via several (social media) networks involved in pediatric urology.</div><div>A total of 283 individuals responded, with 54 countries sampled. The majority (84%) did not prescribe HT for UDT, predominantly due to a paucity of scientific evidence (76%). Among those who use HT, main reason was bilateral UDT (62%). There was no clear preference in administration type (50% intramuscular injection, 50% nasal spray). GnRH was slightly more favoured over HCG (50% vs. 32%). No standardized schedule was used. Most respondents (67%) felt all forms of UDT should be treated by either a pediatric urologist or -surgeon. Eighty-seven percent follow the current guidelines and perform orchidopexy between 6–18 months of age.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 10","pages":"Article 501820"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777480","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}

{"title":"Comparison of cognitive fusion and standard prostate biopsy after multiparametric prostate magnetic resonance imaging and place of multiparametric prostate magnetic resonance imaging in diagnosis","authors":"Ö. Faruk Akgün ,&nbsp;A. Altunkol ,&nbsp;E. Alma ,&nbsp;Ü. Uysal ,&nbsp;B. Aksay ,&nbsp;Y.E. Kök","doi":"10.1016/j.acuroe.2025.501839","DOIUrl":"10.1016/j.acuroe.2025.501839","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the diagnostic performance of cognitive fusion biopsy and/or standard systematic biopsy performed following multiparametric magnetic resonance imaging (mpMRI) in the detection of prostate cancer (PCa), and to assess the standalone diagnostic value of mpMRI.</div></div><div><h3>Materials and methods</h3><div>Initially, 1153 patients undergoing PBx from 2017 to 2022 were chosen. Patients were divided into three groups: those with standard PBx without mpMRI (1st group), those with standard PBx after mpMRI (2nd group) and those with standard and cognitive fusion PBx after mpMRI (3rd group). The correlations of general PCa and clinically significant PCa (csPCa) detection rates and Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) scores were evaluated.</div></div><div><h3>Results</h3><div>The overall PCa detection rate was highest in group 2 (47%). Additionally, the malignancy rate in group 3 was significantly higher compared to group 1 (<em>P</em> &lt; .05). Though the csPCa rate was higher in the third group (40%) compared to the other groups, no significant difference was identified. As the PI-RADS score increased, the malignancy rates appeared to increase. The rate of high-risk patients in the group with cognitive fusion biopsy performed (11, 17%) was higher compared to the second group (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Multiparametric MRI is valuable in prostate cancer diagnosis, particularly for lesion detection and biopsy guidance in patients with high PI-RADS scores. However, in our study, the addition of cognitive fusion biopsy did not significantly increase the detection rate of csPCa. Further prospective randomized studies are needed to clarify its diagnostic value.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 10","pages":"Article 501839"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067155","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}

{"title":"Sex-specific bladder cancer incidence trends and generational effects in Spain","authors":"L. Cayuela ,&nbsp;V. Achaval ,&nbsp;S. Cabrera Fernández ,&nbsp;M. Ortega Calvo ,&nbsp;A. Cayuela","doi":"10.1016/j.acuroe.2025.501863","DOIUrl":"10.1016/j.acuroe.2025.501863","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to assess long-term trends in bladder cancer incidence in Spain from 1992 to 2021, using Age-Period-Cohort (A-P-C) modelling to disentangle the contributions of age, period, and cohort effects.</div></div><div><h3>Methods</h3><div>An ecological trend study was conducted using data from the Global Burden of Disease (GBD) 2021 Study via the Global Health Data Exchange. Age- and sex-specific incidence counts for Spain (1992–2021) were analyzed. Joinpoint regression estimated annual percent changes (APCs) and average annual percent changes (AAPCs). A-P-C modelling assessed net and local drifts, as well as cohort and period rate ratios using 5-year age groups and calendar periods.</div></div><div><h3>Results</h3><div>From 1992 to 2021, 377,430 male and 66,191 female BC cases were estimated. In men, age-adjusted incidence declined (AAPC = –0.6 %), driven by favourable birth cohort and period effects. In women, a modest decline (AAPC = –0.3%) masked a mid-century cohort effect, with increased risk in those born between 1957 and 1967—consistent with a delayed tobacco epidemic. Incidence rose with age in both sexes, though male-to-female incidence ratios narrowed in older groups.</div></div><div><h3>Conclusion</h3><div>BC incidence in Spain reflects complex, sex-specific temporal dynamics. While male incidence is decreasing, women show persistent cohort-specific increases. These trends underscore the importance of sex-sensitive public health strategies targeting modifiable risk factors, particularly tobacco use.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 10","pages":"Article 501863"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208949","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}

{"title":"Cisplatin-induced AKI risk stratification and safety of dose reduction in urothelial carcinoma patients with renal impairment","authors":"S. Yamamoto,&nbsp;K. Higa,&nbsp;K. Kurokawa,&nbsp;H. Bamba,&nbsp;S. Kanaoka,&nbsp;K. Nakamura","doi":"10.1016/j.acuroe.2025.501864","DOIUrl":"10.1016/j.acuroe.2025.501864","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Cisplatin is essential for treating urothelial carcinoma but poses a high risk of AKI. Previous studies on CP-AKI risk factors had limitations. Gupta et al. (2020) proposed a simplified risk score linked to CP-AKI and 90-day survival, though validated only in patients with eGFR ≥50 mL/min.</div></div><div><h3>Materials and methods</h3><div>This single-center retrospective study analyzed 70 patients with urothelial carcinoma treated with cisplatin. Patients with eGFR ≥50 mL/min received full-dose cisplatin (n = 47); those with eGFR 30–49 mL/min received a 75% reduced dose (n = 23), per Japanese guidelines. All received intravenous magnesium. AKI was defined as a ≥ twofold rise in serum creatinine or initiation of renal replacement therapy. The study also evaluated the Gupta score’s association with 90-day survival in metastatic cases.</div></div><div><h3>Results</h3><div>AKI occurred in 9.3% of the full-dose group and 4.5% of the reduced-dose group (p = 1.000). Higher Gupta scores were significantly associated with lower 90-day survival (p = 0.003).</div></div><div><h3>Conclusion</h3><div>A 75% cisplatin dose reduction in patients with moderate renal impairment appears safe and maintains efficacy without increasing AKI risk. These findings support personalized dosing and highlight the need to refine clinical guidelines. Further prospective studies are warranted.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 10","pages":"Article 501864"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288103","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}

{"title":"Management of incontinence after classic bladder exstrophy closure","authors":"K. Godlewski,&nbsp;M. Davis,&nbsp;D. Weiss,&nbsp;A. Shukla","doi":"10.1016/j.acuroe.2025.501818","DOIUrl":"10.1016/j.acuroe.2025.501818","url":null,"abstract":"<div><h3>Introduction</h3><div>Classic bladder exstrophy presents a unique challenge for reconstructive surgeons given the significant alternations it has on normal pelvic anatomy. The ultimate goal of surgery, whether in one stage or more, is simple; close the bladder, reconstruct the bladder neck and urethra, and place the unit into a more orthotopic position deep in the pelvis, and establish normal genitalia. Despite significant improvements with the success of bladder exstrophy closure, a patient’s ability to volitionally void and achieve urinary continence after initial closure remain an elusive «holy grail» for bladder exstrophy surgeons. After closure many patients will endure persistent urinary incontinence post exstrophy closure. In this review, we will discuss the conservative strategies and surgical options to facilitate continence in our bladder exstrophy patients. Regardless of surgical approach or initial outcome, all patients with bladder exstrophy require lifelong urologic follow-up.</div></div><div><h3>Methods</h3><div>A comprehensive search of electronic databases (MEDLINE, PubMed, Embase, PsycINFO and CINAHL), and citation tracking platforms (Google Scholar and Web of Science) was performed. Keywords included Classic Bladder Exstrophy, Incontinence, behavioral therapy, urotherapy, biofeedback, bulking agents, artificial urinary sphincter, bladder neck reconstruction, bladder neck closure, urinary diversion.</div></div><div><h3>Results</h3><div>Conservative measures such as behavioral therapy, physical therapy and uropsychological counseling should be first line for the treatment of urinary incontinence after exstrophy closure. These interventions along with maturation of the child and bladder growth can improve incontinence without surgery. Patients should be counseled on the limited success of bulking agents and significant risk of erosion with sphincters. Although success after bladder neck reconstruction or bladder neck closure with or without augmentation and catheterizable channel can be variable, these surgical options can be offered to patients that have exhausted conservative treatment strategies.</div></div><div><h3>Conclusions</h3><div>A patient’s ability to volitionally void and achieve urinary continence remain an elusive goal for bladder exstrophy surgeons with many experiencing persistent urinary incontinence following exstrophy closure. Behavioral therapy, physical therapy and pyschological support should be provided to all bladder exstrophy patients and families. Giving children time to grow and mature can potentially facilitate continence without surgical intervention. If surgical intervention is pursued lifelong follow-up and monitoring is critical.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 10","pages":"Article 501818"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651710","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}

{"title":"The unit volume biopsy length in prostate biopsy: Does it matter?","authors":"J. Tang ,&nbsp;T. Wu ,&nbsp;K. Zhang ,&nbsp;Z. Wen","doi":"10.1016/j.acuroe.2025.501862","DOIUrl":"10.1016/j.acuroe.2025.501862","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer is a significant global health issue. Prostate biopsy remains the gold standard for diagnosis. However, the impact of biopsy tissue length on diagnostic performance remains controversial. This study investigates the relationship between biopsy tissue length and diagnostic efficacy, introducing a new parameter, \"unit volume biopsy length,\" to optimize clinical practice.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on the clinical data of 301 patients who underwent prostate biopsy. The biopsy tissue length and unit volume biopsy length were compared between patients with positive and negative results, and their impact on the detection rate of prostate cancer was analyzed to obtain the optimal threshold for unit volume biopsy length.</div></div><div><h3>Results</h3><div>Among the 301 patients, 130 (43.19%) had positive results, while 171 had negative results. The median unit volume biopsy length in the positive group was 0.39 cm/mL, which was significantly higher than that in the negative group (0.28 cm/mL; P &lt; 0.05). When the unit volume biopsy length exceeded 0.39 cm/mL, the detection rate of prostate cancer significantly increased (OR 2.879, 95% CI 1.728–4.796), with positive rates of 58.58% and 32.94% in the groups above and below the threshold, respectively (P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Unit volume biopsy length significantly affects the detection rate of prostate cancer. It is recommended that at least 0.39 cm of biopsy tissue be obtained per milliliter of prostate tissue to ensure adequate screening.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 10","pages":"Article 501862"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226474","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}

{"title":"Diagnostic value of structured anamnesis for phenotype identification in chronic pelvic pain syndrome: A practice-oriented retrospective study","authors":"E. Vicente Palacio ,&nbsp;P. Bosch Knape ,&nbsp;S. Tarragón Gabarro ,&nbsp;C. Centeno Álvarez ,&nbsp;L. de Verdonces Román ,&nbsp;A. Sanchez i Puy ,&nbsp;B. Juaneda Castell ,&nbsp;S. Cuadrench Solorzano ,&nbsp;E. Sotelo Burillo ,&nbsp;L.M. Marco Pérez ,&nbsp;L. Sabiote Rubio ,&nbsp;D. Salinas Duffo ,&nbsp;J.A. Peña González","doi":"10.1016/j.acuroe.2025.501858","DOIUrl":"10.1016/j.acuroe.2025.501858","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether chronic pelvic pain presents specific qualitative traits, as described by patients, that can guide identification of its underlying clinical phenotype.</div></div><div><h3>Materials and methods</h3><div>A retrospective study including 157 patients (81 men, 76 women), interviewed systematically by a single evaluator using a structured 10-item table aimed at identifying three possible phenotypes. The correlation between the predicted phenotype (based solely on anamnesis) and the final phenotype (established through physical examination, treatment response, and clinical evolution) was analyzed. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were calculated by phenotype and sex. The diagnostic relevance of each question was assessed, and statistical significance was tested using the Chi-square test.</div></div><div><h3>Results</h3><div>In women, the proportion of predicted phenotypes confirmed as final was: 64.5% bladder, 19.7% myofascial, 30.2% neuropathic. In men: 8.6% bladder, 81.5% myofascial, 23.5% neuropathic. Women-bladder: Se 0.92, Sp 0.74, PPV 0.90, NPV 0.72, AUC 0.82. Myofascial: Se 0.44, Sp 0.93, PPV 0.79, NPV 0.75, AUC 0.76. Neuropathic: Se 0.36, Sp 0.98, PPV 0.89, NPV 0.79, AUC 0.51. Men-bladder: Se 0.57, Sp 0.83, PPV 0.21, NPV 0.96, AUC 0.81. Myofascial: Se 0.75, Sp 0.75, PPV 0.93, NPV 0.41, AUC 0.75. Neuropathic: Se 0.29, Sp 1.00, PPV 1.00, NPV 0.80, AUC 0.64.</div></div><div><h3>Conclusions</h3><div>A structured anamnesis may help identify the clinical phenotype underlying chronic pelvic pain (bladder, myofascial, or neuropathic).</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 9","pages":"Article 501858"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067105","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}

{"title":"Prenatal ultrasonographic evaluation and management of renal and urogenital anomalies: A comprehensive review based on experience in a tertiary care center and literature analysis","authors":"K. Weller ,&nbsp;G.M. Eggenhuizen ,&nbsp;K. Zandbergen ,&nbsp;L.A. 't Hoen ,&nbsp;J. Mulder ,&nbsp;A.T.J.I. Go","doi":"10.1016/j.acuroe.2025.501816","DOIUrl":"10.1016/j.acuroe.2025.501816","url":null,"abstract":"<div><h3>Introduction</h3><div>Congenital renal and urogenital anomalies represent a major part of all congenital anomalies. These range from mild, transient conditions to severe forms leading to irreversible organ damage or perinatal mortality. Timely prenatal identification is crucial for expecting parents and their healthcare providers to decide about the continuation of a pregnancy or for careful planning of perinatal and postnatal care.</div></div><div><h3>Objective</h3><div>To describe the most common indications for referral of fetal renal and urogenital malformations, the process of narrowing the differential diagnosis based on prenatal ultrasonography and the coordination between prenatal and postnatal care in a tertiary care center in the Netherlands.</div></div><div><h3>Results</h3><div>The most common indications for referral of fetal renal and urogenital malformations are (1) Abnormal Renal Parenchyma, (2) Urinary Tract Dilatation, (3) Abnormal Bladder Appearance, and (4) Atypical Genitalia. In the differential diagnosis, ultrasonographic evaluation is crucial to determine the specific region of the urogenital system affected, its onset during pregnancy, and its progression throughout gestation. Integrated prenatal and postnatal care for these types of malformations relies on a multidisciplinary approach to guide parental decision-making in continuation of the pregnancy and optimize outcomes. Some cases only require routine perinatal care in secondary care centers, while complex malformations benefit from specialized planning at tertiary centers to improve outcomes.</div></div><div><h3>Conclusion</h3><div>Dedicated ultrasonographic evaluation of fetal renal and urogenital anomalies in a tertiary care center enables accurate diagnosis and individualized care planning, particularly in complex cases. This approach provides parents with timely information, supports decision-making, and guides individualized perinatal care.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 9","pages":"Article 501816"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602746","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}

{"title":"Does preoperative alpha-blocker use affect the results of flexible ureterorenoscopy?","authors":"A. Akinci ,&nbsp;A. Sanci ,&nbsp;M. Babayigit ,&nbsp;C. Gogus","doi":"10.1016/j.acuroe.2025.501836","DOIUrl":"10.1016/j.acuroe.2025.501836","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of alpha-blocker therapy during flexible ureterorenoscopy (F-URS) on the treatment of upper urinary tract stones.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 476 patients who underwent F-URS at the Department of Urology between January 2010 and January 2017. Data collected included alpha-blocker use, stone size, stone location, patient age and gender, success or failure of ureteral access sheath (UAS) placement, ability to reach the stone during the procedure, postoperative stone-free status, and complication rates. Patients were divided into two groups: alpha-blocker users (n = 90, 18.9%) and non-users (n = 386, 81.1%).</div></div><div><h3>Results</h3><div>No significant differences were observed in gender distribution (P = 0.86) or stone size (P = 0.21) between the two groups. Alpha-blocker users had a lower complication rate (P = 0.022), a higher rate of successful stone access during the procedure (P = 0.007), and a higher postoperative stone-free rate (P = 0.01) compared to non-users. Among alpha-blocker users, tamsulosin and silodosin were associated with higher stone clearance rates (P = 0.046 and P = 0.037, respectively).</div></div><div><h3>Conclusions</h3><div>Alpha-blocker therapy during F-URS for upper urinary tract stones is associated with improved outcomes, including higher stone access rates, reduced complications, and increased stone-free rates. These findings suggest that alpha-blockers, particularly tamsulosin and silodosin, may enhance the efficacy and safety of F-URS.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 9","pages":"Article 501836"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056514","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}