Pub Date : 2024-11-01DOI: 10.1016/j.acuroe.2024.05.013
Introduction and objectives
A Consensus document on the management of patients with neurogenic detrusor overactivity (NDO) was published in 2018. The present document aims to update its recommendations regarding treatment considering the new evidence available, and to contribute to the standardization of the management of this disorder.
Methods
The methodology used was based on a systematic review and the Nominal Group Technique. The clinical coordinator (CC) and the Consensus update group (CUG) defined the questions to be updated and carried out a systematic review to identify the new available evidence. After being evaluated by the expert panel, the relevant recommendations were updated and agreed in a consensus meeting.
Results
A total of 3210 publications were identified and 26 publications that met the inclusion criteria were included. The CUG updated 18 recommendations on the therapeutic approach to NDO. Unanimous consensus was reached on all of them.
Conclusions
Previous recommendations need to be revised due to the availability of new drugs, the increasing evidence on the use of botulinum toxin or neuromodulation procedures, and new surgical options.
{"title":"Consensus update on the therapeutic approach to patients with neurogenic detrusor overactivity","authors":"","doi":"10.1016/j.acuroe.2024.05.013","DOIUrl":"10.1016/j.acuroe.2024.05.013","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>A Consensus document on the management of patients with neurogenic detrusor overactivity (NDO) was published in 2018. The present document aims to update its recommendations regarding treatment considering the new evidence available, and to contribute to the standardization of the management of this disorder.</div></div><div><h3>Methods</h3><div>The methodology used was based on a systematic review and the Nominal Group Technique. The clinical coordinator (CC) and the Consensus update group (CUG) defined the questions to be updated and carried out a systematic review to identify the new available evidence. After being evaluated by the expert panel, the relevant recommendations were updated and agreed in a consensus meeting.</div></div><div><h3>Results</h3><div>A total of 3210 publications were identified and 26 publications that met the inclusion criteria were included. The CUG updated 18 recommendations on the therapeutic approach to NDO. Unanimous consensus was reached on all of them.</div></div><div><h3>Conclusions</h3><div>Previous recommendations need to be revised due to the availability of new drugs, the increasing evidence on the use of botulinum toxin or neuromodulation procedures, and new surgical options.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 674-682"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961418","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 : 2024-11-01DOI: 10.1016/j.acuroe.2024.05.008
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":"","doi":"10.1016/j.acuroe.2024.05.008","DOIUrl":"10.1016/j.acuroe.2024.05.008","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 623-631"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.acuroe.2024.05.007
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.
{"title":"Cumulative morbidity of ureteroscopy for upper tract urothelial carcinoma","authors":"","doi":"10.1016/j.acuroe.2024.05.007","DOIUrl":"10.1016/j.acuroe.2024.05.007","url":null,"abstract":"<div><h3>Objective</h3><div><span>To assess complications after ureteroscopy (URS) for </span>upper tract urothelial carcinoma (UTUC) management and to assess its postoperative cumulative morbidity burden using the Comprehensive Complication Index (CCI).</div></div><div><h3>Materials and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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<span> (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.</span></div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 665-673"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913637","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 : 2024-11-01DOI: 10.1016/j.acuroe.2024.06.002
{"title":"Testicular cancer in Ibero-America: Proper prevention and diagnostic strategies","authors":"","doi":"10.1016/j.acuroe.2024.06.002","DOIUrl":"10.1016/j.acuroe.2024.06.002","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 621-622"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289094","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 : 2024-11-01DOI: 10.1016/j.acuroe.2024.05.001
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.
{"title":"What is the relationship between penile cancer and the microbiome? A scoping review","authors":"","doi":"10.1016/j.acuroe.2024.05.001","DOIUrl":"10.1016/j.acuroe.2024.05.001","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Objective</h3><div>To identify the association between the microbiome and the penile cancer</div></div><div><h3>Evidence Acquisition</h3><div>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.</div></div><div><h3>Evidence Synthesis</h3><div><span><span>We found nine studies describing multiple factors that could disturb the microbiome, such as sexual behavior, anatomic alterations including circumcision, and inflammatory factors: </span>lichen sclerosus, poor genital hygiene, compromised immune system, smoking, and </span>HPV infection.</div></div><div><h3>Conclusion</h3><div>Overall, knowledge of the composition of the penile microbiota and its role in penile cancer oncogenesis is minimal.</div></div><div><h3>Patient Summary</h3><div>Future studies should focus on the relationship between the microbiome and penile cancer to broaden this field of knowledge.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 632-641"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909719","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 : 2024-11-01DOI: 10.1016/j.acuroe.2024.06.004
Introduction and objectives
Long-term use of an indwelling catheter is associated with complications such as catheter encrustation and infection. Canoxidin® is a novel oral treatment that can potentially prevent catheter encrustation, as it contains a urine acidifier and a combination of two crystallization inhibitors. This study aimed to evaluate the effects of Canoxidin® on catheter encrustation in patients with indwelling Foley catheters.
Patients and methods
This was a single-center, double-blind, randomized, placebo-controlled study. Neuro-urology patients aged ≥18 years with an indwelling catheter (urethral or suprapubic) were randomized to treatment consisting of either Canoxidin® or placebo for one month. Foley catheters (two per patient, one before treatment and one after treatment) were removed for analysis of the presence and degree of encrustation.
Results
A total of 40 patients were enrolled and randomized, 28 of whom had analyzable catheters (13 assigned to Canoxidin® and 15 assigned to placebo). The patients had a mean age of 51.8 years, and eight (28.6%) were female. Two patients (13.3%) in the placebo group and eight patients (61.5%) in the Canoxidin® group experienced an improvement (less encrustation). There was a significant association between Canoxidin® and improvement (odds ratio: 10.4, 95% confidence interval: 1.6 to 66.9, P = 0.016). No adverse effects attributable to the treatment were reported.
Conclusions
The overall rate of catheter encrustation was high among those with indwelling Foley catheters. One-month treatment with Canoxidin® reduced the formation of these encrustations, with an excellent short-term safety profile.
{"title":"Single-center, double-blind, randomized, placebo-controlled pilot study of Canoxidin® for prevention of catheter encrustation in patients with indwelling catheters","authors":"","doi":"10.1016/j.acuroe.2024.06.004","DOIUrl":"10.1016/j.acuroe.2024.06.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Long-term use of an indwelling catheter is associated with complications such as catheter encrustation and infection. Canoxidin® is a novel oral treatment that can potentially prevent catheter encrustation, as it contains a urine acidifier and a combination of two crystallization inhibitors. This study aimed to evaluate the effects of Canoxidin® on catheter encrustation in patients with indwelling Foley catheters.</div></div><div><h3>Patients and methods</h3><div>This was a single-center, double-blind, randomized, placebo-controlled study. Neuro-urology patients aged ≥18 years with an indwelling catheter (urethral or suprapubic) were randomized to treatment consisting of either Canoxidin® or placebo for one month. Foley catheters (two per patient, one before treatment and one after treatment) were removed for analysis of the presence and degree of encrustation.</div></div><div><h3>Results</h3><div>A total of 40 patients were enrolled and randomized, 28 of whom had analyzable catheters (13 assigned to Canoxidin® and 15 assigned to placebo). The patients had a mean age of 51.8 years, and eight (28.6%) were female. Two patients (13.3%) in the placebo group and eight patients (61.5%) in the Canoxidin® group experienced an improvement (less encrustation). There was a significant association between Canoxidin® and improvement (odds ratio: 10.4, 95% confidence interval: 1.6 to 66.9, P = 0.016). No adverse effects attributable to the treatment were reported.</div></div><div><h3>Conclusions</h3><div>The overall rate of catheter encrustation was high among those with indwelling Foley catheters. One-month treatment with Canoxidin® reduced the formation of these encrustations, with an excellent short-term safety profile.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 658-664"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500114","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 : 2024-11-01DOI: 10.1016/j.acuroe.2024.06.003
Introduction
Prostate cancer is the tumor with the highest incidence in Spanish men. The implementation of health literacy and therapeutic education programs adapted to the needs of the population could be a resource to minimize the sequelae derived from the treatments used to combat this pathology. To this end, it would be necessary to know the level of health literacy about prostate cancer.
Objective
To determine the level of health literacy in prostate cancer in the Spanish male population using the validated version of the PCKQ-12 for the Spanish population.
Methodology
Cross-sectional, population-based, descriptive study. Spanish-speaking men of legal age were included. To carry out the study, an ad hoc questionnaire was designed on the Google Forms platform, which was distributed via WhatsApp. Previously, it was necessary to validate the PCKQ-12 to the Spanish population in two phases, a first phase for translation and cross-cultural adaptation and a second phase to test the measurement properties.
Results
The Spanish version of the PCKQ-12 showed good language, conceptual, semantic and content equivalence and could be used to assess health literacy in prostate cancer. Three hundred and seventy Spanish men with a mean age of 43.87 (SD 13.65) years responded to the questionnaire. The level of prostate cancer health literacy found was low (6.72 points), being 2 points higher in health men.
Conclusion
Health literacy about prostate cancer in the Spanish male population is low.
{"title":"Health literacy in prostate cancer: What do Spanish men know about prostate cancer? A cross-sectional descriptive study","authors":"","doi":"10.1016/j.acuroe.2024.06.003","DOIUrl":"10.1016/j.acuroe.2024.06.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer is the tumor with the highest incidence in Spanish men. The implementation of health literacy and therapeutic education programs adapted to the needs of the population could be a resource to minimize the sequelae derived from the treatments used to combat this pathology. To this end, it would be necessary to know the level of health literacy about prostate cancer.</div></div><div><h3>Objective</h3><div>To determine the level of health literacy in prostate cancer in the Spanish male population using the validated version of the PCKQ-12 for the Spanish population.</div></div><div><h3>Methodology</h3><div>Cross-sectional, population-based, descriptive study. Spanish-speaking men of legal age were included. To carry out the study, an ad hoc questionnaire was designed on the Google Forms platform, which was distributed via WhatsApp. Previously, it was necessary to validate the PCKQ-12 to the Spanish population in two phases, a first phase for translation and cross-cultural adaptation and a second phase to test the measurement properties.</div></div><div><h3>Results</h3><div>The Spanish version of the PCKQ-12 showed good language, conceptual, semantic and content equivalence and could be used to assess health literacy in prostate cancer. Three hundred and seventy Spanish men with a mean age of 43.87 (SD 13.65) years responded to the questionnaire. The level of prostate cancer health literacy found was low (6.72 points), being 2 points higher in health men.</div></div><div><h3>Conclusion</h3><div>Health literacy about prostate cancer in the Spanish male population is low.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 642-650"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441233","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 : 2024-10-01DOI: 10.1016/j.acuroe.2024.05.004
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 non-muscle-invasive Bladder cancer: A systematic literature review","authors":"","doi":"10.1016/j.acuroe.2024.05.004","DOIUrl":"10.1016/j.acuroe.2024.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent years, different urinary<span> markers such as the Bladder<span> Epicheck® have been developed in an attempt to reduce the number of cystoscopies in the follow-up of non-muscle invasive bladder cancer (NMIBC).</span></span></div></div><div><h3>Aim</h3><div>To provide a systematic review<span> of Bladder Epicheck® and its current clinical utility in the follow-up and detection of recurrence of NMIBC.</span></div></div><div><h3>Material and methods</h3><div>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).</div></div><div><h3>Results</h3><div>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%.</div></div><div><h3>Conclusion</h3><div>Bladder Epicheck® is a useful urinary<span><span> 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 </span>quality of life of patients and potentially increasing health economic savings.</span></div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 555-564"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","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 : 2024-10-01DOI: 10.1016/j.acuroe.2024.05.012
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":"","doi":"10.1016/j.acuroe.2024.05.012","DOIUrl":"10.1016/j.acuroe.2024.05.012","url":null,"abstract":"<div><h3>Introduction</h3><div><span><span>Pelvic organ prolapse is a condition with high prevalence in elderly women. With increasing life expectancy and a desire for improved </span>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 </span>sacrocolpopexy, thereby assessing the safety and efficacy of this surgery in this group of patients.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 611-617"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","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}
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