Pub Date : 2024-05-01DOI: 10.1016/j.acuroe.2024.01.007
S.C. Mantilla Toloza, A.F. Villareal Cogollo, K.M. Peña García
Introduction
Stress urinary incontinence (SUI) is a common disorder in women that has a negative impact on quality of life. Pregnancy and childbirth are considered important risk factors that directly affect the pelvic floor during pregnancy and labour, increasing the risk of pelvic floor dysfunction, with prevalence rates of SUI in the postpartum period ranging from 30 to 47% during the first 12 months.
Objective
To determine the effectiveness of pelvic floor muscle training (PFMT) in the prevention of SUI in women during the antenatal and postnatal period by reviewing and evaluating the available scientific literature.
Methods
This is a systematic review, using only randomised controlled trials. We searched the databases Pubmed, Scopus, Cochrane and PEDro. We reviewed 7 prospective studies in English and Portuguese, which included 1,401 pregnant women of legal age who underwent PFMT to prevent SUI.
Results
The results allowed us to establish that PFMT is used for pelvic floor muscles and that this intervention, applied with the appropriate methodology, can prevent or cure SUI.
Conclusions
The application of PFMT in an early stage of pregnancy has positive effects on the continence capacity after delivery.
简介压力性尿失禁（SUI）是女性常见的一种疾病，对生活质量有负面影响。妊娠和分娩被认为是重要的风险因素，在妊娠和分娩过程中直接影响盆底，增加了盆底功能障碍的风险，产后头 12 个月中 SUI 的患病率为 30% 至 47%：目的：通过回顾和评估现有的科学文献，确定盆底肌肉训练（PFMT）在预防产前和产后妇女 SUI 方面的有效性：这是一项系统性综述，仅使用随机对照试验。我们检索了 Pubmed、Scopus、Cochrane 和 PEDro 等数据库。我们回顾了 7 项英语和葡萄牙语的前瞻性研究，其中包括 1401 名达到法定年龄的孕妇，她们接受了 PFMT 以预防 SUI：结果：研究结果使我们确定，PFMT 可用于盆底肌肉治疗，而且这种干预措施如果采用适当的方法，可以预防或治疗 SUI：结论：在妊娠早期使用盆底肌肉运动疗法对产后排尿能力有积极影响。
{"title":"Pelvic floor training to prevent stress urinary incontinence: A systematic review","authors":"S.C. Mantilla Toloza, A.F. Villareal Cogollo, K.M. Peña García","doi":"10.1016/j.acuroe.2024.01.007","DOIUrl":"10.1016/j.acuroe.2024.01.007","url":null,"abstract":"<div><h3>Introduction</h3><p>Stress urinary incontinence (SUI) is a common disorder in women that has a negative impact on quality of life. Pregnancy and childbirth are considered important risk factors that directly affect the pelvic floor during pregnancy and labour, increasing the risk of pelvic floor dysfunction, with prevalence rates of SUI in the postpartum period ranging from 30 to 47% during the first 12 months.</p></div><div><h3>Objective</h3><p>To determine the effectiveness of pelvic floor muscle training (PFMT) in the prevention of SUI in women during the antenatal and postnatal period by reviewing and evaluating the available scientific literature.</p></div><div><h3>Methods</h3><p>This is a systematic review, using only randomised controlled trials. We searched the databases Pubmed, Scopus, Cochrane and PEDro. We reviewed 7 prospective studies in English and Portuguese, which included 1,401 pregnant women of legal age who underwent PFMT to prevent SUI.</p></div><div><h3>Results</h3><p>The results allowed us to establish that PFMT is used for pelvic floor muscles and that this intervention, applied with the appropriate methodology, can prevent or cure SUI.</p></div><div><h3>Conclusions</h3><p>The application of PFMT in an early stage of pregnancy has positive effects on the continence capacity after delivery.</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":"140332415","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 : 2024-05-01DOI: 10.1016/j.acuroe.2024.05.013
A. Borau, J. Salinas, M. Allué, D. Castro-Diaz, M. Esteban, S. Arlandis, M. Vírseda, J. M. Adot
{"title":"Consensus update on the therapeutic approach to patients with neurogenic detrusor overactivity.","authors":"A. Borau, J. Salinas, M. Allué, D. Castro-Diaz, M. Esteban, S. Arlandis, M. Vírseda, J. M. Adot","doi":"10.1016/j.acuroe.2024.05.013","DOIUrl":"https://doi.org/10.1016/j.acuroe.2024.05.013","url":null,"abstract":"","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":"141036584","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 : 2024-05-01DOI: 10.1016/j.acuroe.2024.04.002
N. Sengul , I. Gültürk , M. Yilmaz , E. Celik , N. Paksoy , E. Yekedüz , Y. Ürün , M. Basaran , M. Özgüroğlu
Introduction
Patients with renal insufficiency, usually defined as those with creatinine clearance < 40 mL/min, were excluded from pivotal clinical trials, especially in studies involving nivolumab therapy in patients with renal cell carcinoma (RCC). The aim of the study is to evaluate the efficacy and safety of nivolumab in patients with metastatic RCC (mRCC) stratified according to creatinine clearance.
Material and methods
Data from mRCC patients treated with nivolumab were retrospectively analyzed. Patients were classified into two categories according to their estimated glomerular filtration rate (eGFR); the first category (C1) included patients with eGFR < 40 mL/min/1.73 m2 and the second category (C2) included those with eGFR ≥ 40 mL/min/1.73 m2.
Results
Of the 95 patients enrolled, 1. group included 26 patients (27.4%) and 2. group included 69 patients (72.6%). None of the pts in category 1 were on hemodialysis. Overall incidence of adverse events was not statistically different between the two groups (P = .469). The overall response rate ORR was 50% in the first group and 42.0% in the second group (P = .486). Median overall survival (OS) was longer with 23.3 months in the 2. group versus 11 months in the 1. group (P = .415).
Conclusion
Renal insufficiency is a common problem in patients with advanced renal cancer since they often undergo nephrectomy and their renal function may also worsen while receiving tyrosine kinase inhibitor therapy. We found that there is no significant difference in the safety and efficacy of nivolumab treatment between two groups. Nivolumab appears to be a safe and effective agent in patients with renal impairment.
{"title":"Safety and efficacy of nivolumab therapy in patients with metastatic renal cell carcinoma and impaired kidney function","authors":"N. Sengul , I. Gültürk , M. Yilmaz , E. Celik , N. Paksoy , E. Yekedüz , Y. Ürün , M. Basaran , M. Özgüroğlu","doi":"10.1016/j.acuroe.2024.04.002","DOIUrl":"10.1016/j.acuroe.2024.04.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with renal insufficiency, usually defined as those with creatinine clearance < 40 mL/min, were excluded from pivotal clinical trials, especially in studies involving nivolumab therapy in patients with renal cell carcinoma (RCC). The aim of the study is to evaluate the efficacy and safety of nivolumab in patients with metastatic RCC (mRCC) stratified according to creatinine clearance.</p></div><div><h3>Material and methods</h3><p>Data from mRCC patients treated with nivolumab were retrospectively analyzed. Patients were classified into two categories according to their estimated glomerular filtration rate (eGFR); the first category (C1) included patients with eGFR < 40 mL/min/1.73 m<sup>2</sup> and the second category (C2) included those with eGFR ≥ 40 mL/min/1.73 m<sup>2</sup>.</p></div><div><h3>Results</h3><p>Of the 95 patients enrolled, 1. group included 26 patients (27.4%) and 2. group included 69 patients (72.6%). None of the pts in category 1 were on hemodialysis. Overall incidence of adverse events was not statistically different between the two groups (<em>P</em> = .469). The overall response rate ORR was 50% in the first group and 42.0% in the second group (<em>P</em> = .486). Median overall survival (OS) was longer with 23.3 months in the 2. group versus 11 months in the 1. group (<em>P</em> = .415).</p></div><div><h3>Conclusion</h3><p>Renal insufficiency is a common problem in patients with advanced renal cancer since they often undergo nephrectomy and their renal function may also worsen while receiving tyrosine kinase inhibitor therapy. We found that there is no significant difference in the safety and efficacy of nivolumab treatment between two groups. Nivolumab appears to be a safe and effective agent in patients with renal impairment.</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":"140760574","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 : 2024-05-01DOI: 10.1016/j.acuroe.2024.02.004
G. Çil, M. Yilmaz, Y. Sahin, İ. Ulus, İ.O. Canıtez, İ.E. Kandıralı
Objectives
The objective of this study is predict positive surgical margin (PSM) and pathological T3a (pT3a) upstaging in patients with clinical T1 (cT1) renal cell carcinoma (RCC).
Materials and methods
159 patients who underwent radical nephrectomy (RN) or partial nephrectomy (PN) for RCC. Patients’ demographic, laboratory, radiological and pathological data that could predict PSM and pT3a upstaging pre-operatively were evaluated. The categorical and continuous variables were compared between the patient groups with or without PSM and/or pT3a upstaging using Pearson’s chi-square test, and independent samples t-test or the Mann-Whitney U test, respectively.
Results
PT3a upstaging was detected in 32 (20.1%) patients, and PSM was detected in 28 (17.6%) patients. PT3a upstaging was detected in 27 and 5 patients who underwent open surgery and laparoscopic surgery, respectively (P < .001). In addition, pT3a upstaging was detected in 6 and 26 patients who underwent RN and PN, respectively (P < .001). Peritumoral fatty tissue thickness was 11.97 and 15.38 in the pT1 and pT3a patient groups, respectively (P = .022). In patients with pT3a upstaging, tumor size was larger, and renal nephrometry score and systemic immune-inflammation index (SII) were higher (P < .001, P < .001, and P = .022, respectively). It was determined that De Ritis ratio (DRR) and albumin-to-alkaline phosphatase (ALP) ratio (AAPR) parameters had significant prognostic values in predicting PSM (P = .024, and P = .001, respectively). ROC analysis indicated that tumor size predicted pT3a upstaging with 100% sensitivity and 98.6% specificity when its cut-off value was taken as 6.85 mm (AUC: 1.000, P < .001). In addition, logistic regression analysis revealed AAPR and DRR as significant predictors of PSM (P < .001, and P = .009, repsectively).
Conclusion
The findings of this study indicated that the surgical technique of choice and the type of operation, tumor size, RNS value, peritumoral fatty tissue thickness, HU values of peritumoral and tumor side fatty tissues, and DRR and SII values can predict pT3a upstaging of patients with cT1 RCC, and that AAPR and DRR values can predict PSM.
{"title":"The preoperative predictive factors for pathological T3a upstaging and positive surgical margin of clinical T1 renal cell carcinoma","authors":"G. Çil, M. Yilmaz, Y. Sahin, İ. Ulus, İ.O. Canıtez, İ.E. Kandıralı","doi":"10.1016/j.acuroe.2024.02.004","DOIUrl":"10.1016/j.acuroe.2024.02.004","url":null,"abstract":"<div><h3>Objectives</h3><p>The objective of this study is predict positive surgical margin (PSM) and pathological T3a (pT3a) upstaging in patients with clinical T1 (cT1) renal cell carcinoma (RCC).</p></div><div><h3>Materials and methods</h3><p>159 patients who underwent radical nephrectomy (RN) or partial nephrectomy (PN) for RCC. Patients’ demographic, laboratory, radiological and pathological data that could predict PSM and pT3a upstaging pre-operatively were evaluated. The categorical and continuous variables were compared between the patient groups with or without PSM and/or pT3a upstaging using Pearson’s chi-square test, and independent samples <em>t</em>-test or the Mann-Whitney U test, respectively.</p></div><div><h3>Results</h3><p>PT3a upstaging was detected in 32 (20.1%) patients, and PSM was detected in 28 (17.6%) patients. PT3a upstaging was detected in 27 and 5 patients who underwent open surgery and laparoscopic surgery, respectively (<em>P</em> < .001). In addition, pT3a upstaging was detected in 6 and 26 patients who underwent RN and PN, respectively (<em>P</em> < .001). Peritumoral fatty tissue thickness was 11.97 and 15.38 in the pT1 and pT3a patient groups, respectively (<em>P</em> = .022). In patients with pT3a upstaging, tumor size was larger, and renal nephrometry score and systemic immune-inflammation index (SII) were higher (<em>P</em> < .001, <em>P</em> < .001, and <em>P</em> = .022, respectively). It was determined that De Ritis ratio (DRR) and albumin-to-alkaline phosphatase (ALP) ratio (AAPR) parameters had significant prognostic values in predicting PSM (<em>P</em> = .024, and <em>P</em> = .001, respectively). ROC analysis indicated that tumor size predicted pT3a upstaging with 100% sensitivity and 98.6% specificity when its cut-off value was taken as 6.85 mm (AUC: 1.000, <em>P</em> < .001). In addition, logistic regression analysis revealed AAPR and DRR as significant predictors of PSM (<em>P</em> < .001, and <em>P</em> = .009, repsectively).</p></div><div><h3>Conclusion</h3><p>The findings of this study indicated that the surgical technique of choice and the type of operation, tumor size, RNS value, peritumoral fatty tissue thickness, HU values of peritumoral and tumor side fatty tissues, and DRR and SII values can predict pT3a upstaging of patients with cT1 RCC, and that AAPR and DRR values can predict PSM.</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":"139901058","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 : 2024-05-01DOI: 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":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141029345","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 : 2024-05-01DOI: 10.1016/j.acuroe.2023.11.006
W.F. Fernández-Zapata, W.D. Cardona-Maya
{"title":"Male infertility and sleep quality: Another key point to evaluate during the medical consultation","authors":"W.F. Fernández-Zapata, W.D. Cardona-Maya","doi":"10.1016/j.acuroe.2023.11.006","DOIUrl":"10.1016/j.acuroe.2023.11.006","url":null,"abstract":"","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":"138178397","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 : 2024-05-01DOI: 10.1016/j.acuroe.2023.11.007
F. Couñago , F. López-Campos
{"title":"Stereotactic body radiation therapy (SBRT): A new treatment option in renal cancer","authors":"F. Couñago , F. López-Campos","doi":"10.1016/j.acuroe.2023.11.007","DOIUrl":"10.1016/j.acuroe.2023.11.007","url":null,"abstract":"","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":"138178398","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 : 2024-05-01DOI: 10.1016/j.acuroe.2024.03.003
Mario I. Fernández
{"title":"Implementation of new treatments for BCG-unresponsive non-muscle-invasive bladder cancer. Considerations in Latin America","authors":"Mario I. Fernández","doi":"10.1016/j.acuroe.2024.03.003","DOIUrl":"10.1016/j.acuroe.2024.03.003","url":null,"abstract":"","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":"140769965","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 : 2024-04-01DOI: 10.1016/j.acuroe.2023.08.001
C. Toribio-Vázquez , J. Gómez Rivas , F. Amigo , D.M. Carrión , Á. Yebes , M. Alonso-Bartolomé , H. Ayllon , A. Aguilera , L. Martinez-Piñeiro , M. Antón-Juanilla , V. Crespo-Atín , H. Otaola-Arca , J.A. Herranz-Yague , M.V. Munoz Rivero , K.R. MacKenzie , T.T. Shah , C. Gao , E. Zimmermann , M. Jefferies , A. Nambiar , V. Kasivisvanathan
Introduction
Malignant tumors of the urinary tract are associated with high morbidity and mortality, and their prevalence can vary worldwide. Recently, the IDENTIFY study has published results on the prevalence of urinary tract cancer at a global level. This study evaluates the prevalence of cancer within the Spanish cohort of the IDENTIFY study to determine whether the published results can be extrapolated to our population.
Patients and methods
An analysis of the data from the Spanish cohort of patients in the IDENTIFY study was performed. This is a prospective cohort of patients referred to secondary care with suspected cancer, predominantly due to hematuria. Patients were recruited between December 2017 and December 2018.
Results
A total of 706 patients from 9 Spanish centers were analyzed. Of these, 277 (39.2%) were diagnosed with cancer: 259 (36.7%) bladder cancer, 10 (1.4%) upper tract urothelial carcinoma, 9 (1.2%) renal cancer and 5 (0.7%) prostate cancer. Increasing age (OR 1.05 (95% CI 1.03−1.06; P < 0.001)), visible hematuria (VH) OR 2.19 (95% CI 1.13–4.24; P = 0.02)) and smoking (ex-smokers: OR 2.11(95% CI 1.30–3.40; P = 0.002); smokers: OR 2.36 (95% CI 1.40–3.95; P = 0.001)) were associated with higher probability of bladder cancer.
Conclusion
This study highlights the risk of bladder cancer in patients with VH and smoking habits. Bladder cancer presented the highest prevalence; higher than the prevalence reported in previous series and presented in the IDENTIFY study. Future work should evaluate other associated factors that allow us to create cancer prediction models to improve the detection of cancer in our patients.
{"title":"Prevalence of urinary tract cancer in the Spanish cohort of the IDENTIFY study","authors":"C. Toribio-Vázquez , J. Gómez Rivas , F. Amigo , D.M. Carrión , Á. Yebes , M. Alonso-Bartolomé , H. Ayllon , A. Aguilera , L. Martinez-Piñeiro , M. Antón-Juanilla , V. Crespo-Atín , H. Otaola-Arca , J.A. Herranz-Yague , M.V. Munoz Rivero , K.R. MacKenzie , T.T. Shah , C. Gao , E. Zimmermann , M. Jefferies , A. Nambiar , V. Kasivisvanathan","doi":"10.1016/j.acuroe.2023.08.001","DOIUrl":"10.1016/j.acuroe.2023.08.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Malignant tumors of the urinary tract are associated with high morbidity and mortality, and their prevalence can vary worldwide. Recently, the IDENTIFY study has published results on the prevalence of urinary tract cancer at a global level. This study evaluates the prevalence of cancer within the Spanish cohort of the IDENTIFY study to determine whether the published results can be extrapolated to our population.</p></div><div><h3>Patients and methods</h3><p>An analysis of the data from the Spanish cohort of patients in the IDENTIFY study was performed. This is a prospective cohort of patients referred to secondary care with suspected cancer, predominantly due to hematuria. Patients were recruited between December 2017 and December 2018.</p></div><div><h3>Results</h3><p>A total of 706 patients from 9 Spanish centers were analyzed. Of these, 277 (39.2%) were diagnosed with cancer: 259 (36.7%) bladder cancer, 10 (1.4%) upper tract urothelial carcinoma, 9 (1.2%) renal cancer and 5 (0.7%) prostate cancer. Increasing age (OR 1.05 (95% CI 1.03−1.06; <em>P</em> < 0.001)), visible hematuria (VH) OR 2.19 (95% CI 1.13–4.24; <em>P</em> = 0.02)) and smoking (ex-smokers: OR 2.11(95% CI 1.30–3.40; <em>P</em> = 0.002); smokers: OR 2.36 (95% CI 1.40–3.95; <em>P</em> = 0.001)) were associated with higher probability of bladder cancer.</p></div><div><h3>Conclusion</h3><p>This study highlights the risk of bladder cancer in patients with VH and smoking habits. Bladder cancer presented the highest prevalence; higher than the prevalence reported in previous series and presented in the IDENTIFY study. Future work should evaluate other associated factors that allow us to create cancer prediction models to improve the detection of cancer in our patients.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10005464","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 : 2024-04-01DOI: 10.1016/j.acuroe.2023.10.005
M.M. Abdelfatah Zaza , A. Farouk Salim , T.A. El-Mageed Salem , A. Mohammed Ezzat , M. Hassan Ali
Objectives
This study evaluates the impact of using an access sheath (AS) during flexible ureteroscopy (fURS) for urolithiasis treatment, focusing on outcomes such as stone-free rate, operation time, and complications.
Methods
This prospective, randomized study was carried out at Badr Hospital, Helwan University, and Ain Shams University hospitals from August 2021 to August 2022. Patients were systematically randomized into two groups (fURS with AS: 33 patients and without AS: 31 patients) and underwent preoperative and postoperative assessments, including lab tests and imaging. Possible procedure-associated risks, such as failed stone access, pain, bleeding, and sepsis, were monitored.
Results
The two groups were found to be comparable in terms of demographic characteristics or preoperative stone findings (p > 0.05 for all). However, operation duration was shorter in the No Sheath group (79.4 ± 15.3 min vs. 90.4 ± 16.7 min in the Sheath group, p = 0.008). Intraoperative complication rates, including failed access, operation termination, ureteric injury, and bleeding, were comparable in both groups (p > 0.05). Postoperative stone-free rates (78.8% vs. 71.0%, p = 0.305) and mean residual stone size (2.7 ± 3.5 mm vs. 3.1 ± 3.1 mm, p = 0.687) showed no significant differences.
Conclusions
The present study suggests that fURS without an access sheath may offer an efficient and equally effective option for managing upper ureteric and renal stones. However, more studies with larger sample sizes and longer follow-up periods are required to validate these findings and to establish more precise indications for this approach.
{"title":"Impact of ureteric access sheath use during flexible ureteroscopy: A comparative study on efficacy and safety","authors":"M.M. Abdelfatah Zaza , A. Farouk Salim , T.A. El-Mageed Salem , A. Mohammed Ezzat , M. Hassan Ali","doi":"10.1016/j.acuroe.2023.10.005","DOIUrl":"10.1016/j.acuroe.2023.10.005","url":null,"abstract":"<div><h3>Objectives</h3><p>This study evaluates the impact of using an access sheath (AS) during flexible ureteroscopy<span> (fURS) for urolithiasis treatment, focusing on outcomes such as stone-free rate, operation time, and complications.</span></p></div><div><h3>Methods</h3><p>This prospective, randomized study was carried out at Badr Hospital, Helwan University, and Ain Shams University hospitals from August 2021 to August 2022. Patients were systematically randomized into two groups (fURS with AS: 33 patients and without AS: 31 patients) and underwent preoperative and postoperative assessments, including lab tests and imaging. Possible procedure-associated risks, such as failed stone access, pain, bleeding, and sepsis, were monitored.</p></div><div><h3>Results</h3><p>The two groups were found to be comparable in terms of demographic characteristics or preoperative stone findings (<em>p</em> > 0.05 for all). However, operation duration was shorter in the No Sheath group (79.4 ± 15.3 min vs. 90.4 ± 16.7 min in the Sheath group, <em>p</em><span> = 0.008). Intraoperative complication rates, including failed access, operation termination, ureteric injury, and bleeding, were comparable in both groups (</span><em>p</em> > 0.05). Postoperative stone-free rates (78.8% vs. 71.0%, <em>p</em> = 0.305) and mean residual stone size (2.7 ± 3.5 mm vs. 3.1 ± 3.1 mm, <em>p</em> = 0.687) showed no significant differences.</p></div><div><h3>Conclusions</h3><p>The present study suggests that fURS without an access sheath may offer an efficient and equally effective option for managing upper ureteric and renal stones. However, more studies with larger sample sizes and longer follow-up periods are required to validate these findings and to establish more precise indications for this approach.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224618","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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