Archivos Espanoles De Urologia最新文献

{"title":"Effect of Tamsulosin Combined With Flexible Ureteroscopic Holmium Laser Lithotripsy on Renal Function and Postoperative Inflammatory Response in Patients With Renal Calculi.","authors":"Xiaoxiang Jiang, Lihong Ying","doi":"10.56434/j.arch.esp.urol.aeu012","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu012","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between perioperative tamsulosin use and outcomes of flexible ureteroscopic holmium laser lithotripsy (FURL).</p><p><strong>Methods: </strong>This retrospective cohort study was performed on 122 patients who underwent FURL at Cixi People's Hospital, Wenzhou Medical University. Patients were divided into an observation group (perioperative tamsulosin + FURL, n = 62) and a control group (FURL alone, n = 60) according to routine clinical protocols and patient preference. Operation time, stone clearance rate at 4 weeks postoperatively, renal function indicators, inflammatory markers, and complication rates were compared between the two groups.</p><p><strong>Results: </strong>Compared with the control group, the observation group had shorter operation time (51.34 ± 9.28 vs. 58.62 ± 10.35 min, <i>p</i> < 0.001), shorter postoperative hospital stay (3.62±1.05 vs. 4.85±1.23 days, <i>p</i> < 0.001), and a higher stone clearance rate (93.55% vs. 75.00%, <i>p</i> = 0.005). On postoperative day 1 and at week 1, renal function indicators were significantly lower in the observation group (all <i>p</i> < 0.05). Serum inflammatory marker levels on postoperative days 1 and 3 were also significantly lower in the observation group (all <i>p</i> < 0.001). The total complication rate was lower in the observation group (8.06% vs. 21.66%, <i>p</i> = 0.036).</p><p><strong>Conclusions: </strong>In this retrospective study, perioperative tamsulosin combined with FURL was associated with shorter operation times, higher stone clearance, and lower renal function, inflammatory, and complication markers. However, due to potential selection bias, these associations require confirmation via prospective randomized controlled trials.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1214-1221"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extra-Anatomical Urinary Stent for Complex Ureteral Strictures: A Systematic Review and Narrative Synthesis.","authors":"Konstantinos Kotrotsios, Napoleon Moulavasilis, Konstantinos Douroumis, Vasileios Tatanis, Panagiotis Levis, Stamatios Katsimperis, Ioannis Anastasiou","doi":"10.56434/j.arch.esp.urol.aeu010","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu010","url":null,"abstract":"<p><strong>Background: </strong>Complex ureteral strictures, irrespective of their aetiology, constitute a therapeutic challenge in everyday clinical practice. They are usually managed with antegrade or retrograde ureteral stent or double-J stent insertion, or the placement of a nephrostomy tube. The Detour® extra-anatomical stent (EAS) is a subcutaneous pyelovesical bypass proposed as an alternative solution for urinary diversion. The aim of this systematic review and narrative synthesis was to evaluate the safety and effectiveness of Detour EAS.</p><p><strong>Methods: </strong>A literature search of MEDLINE, Scopus and Web of Science databases was performed using the following terms: Ureter* AND (\"Subcutaneous pyelovesical bypass\" OR \"Extra-anatomical stent*\" OR \"Detour\" OR \"Artificial ureter\" OR \"Nephrovesical bypass\"). Published observational and interventional studies evaluating the efficacy of Detour subcutaneous pyelovesical bypass placement in the management of complex ureteral stenosis were included. The primary outcome was functional stent success, whereas secondary outcomes included complications.</p><p><strong>Results: </strong>Of 182 records identified, 25 studies including 344 unique patients were analysed. Functional success rate in most of the studies exceeded 85% at follow-up, ranging from 0% in a cohort of patients with ileal conduits to 100% in case reports and poor-quality case series. The most common complications included urinary tract infections, encrustation, infection of the overlying skin and dislodgement of the stent's vesical end. The EAS had to be removed in a total of 50 patients, while five deaths occurred, three due to prosthesis-related septic events, one due to palliative care cessation and one due to abdominal abscess-related sepsis. Despite these risks, Detour placement seemed to improve both renal function and quality of life in most cases.</p><p><strong>Conclusions: </strong>In selected patients Detour EAS might be considered as an alternative but its safety and efficacy need further investigation. Careful patient selection and surgical procedure optimisation are essential to improve its safety-related results.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1078-1090"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Treatment of Male Genital Lymphedema: A Case Report.","authors":"Lorenzo Giunco, David Hernández-Hernández, María Yanira Ortega-González","doi":"10.56434/j.arch.esp.urol.aeu008","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu008","url":null,"abstract":"<p><strong>Unlabelled: </strong>Male genital lymphedema is a rare condition characterized by progressive enlargement of the scrotal and penile tissues. It is associated with substantial physical and psychological morbidity, frequently impairing urinary and sexual function, hygiene, and ambulation. Genital lymphedema may result from secondary lymphatic obstruction to infectious, inflammatory, neoplastic, congenital, or iatrogenic causes. Despite its clinical impact, no standardized diagnostic or therapeutic algorithm has been established to date.</p><p><strong>Unlabelled: </strong>Herein, we present our diagnostic approach and describe a surgical technique involving excision of penoscrotal lymphedematous tissue followed by genital reconstruction using local flaps.</p><p><strong>Unlabelled: </strong>The management of massive genital lymphedema remains surgically challenging, with multiple reconstructive options available depending on the extent of the disease and patient characteristics. Reconstructive surgery is generally associated with favorable functional and aesthetic outcomes, leading to significant improvements in quality of life.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1259-1263"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turkish Translation, Validation, and Clinical Utilization of the Peyronie's Disease Questionnaire.","authors":"Burak Citamak, Cagri Dogan, Muhammed Sencer Koroglu, Aykut Baser, Orkunt Ozkaptan, Alkan Cubuk","doi":"10.56434/j.arch.esp.urol.aeu007","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu007","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to adapt the peyronie's disease (PD) questionnaire into Turkish, psychometrically evaluate its validity, and explore its correlations with patient demographics and disease-specific characteristics.</p><p><strong>Methods: </strong>The PD questionnaire (PDQ) is a 15-item, self-administered, disease-specific, and multidimensional tool developed to quantify the psychosexual symptoms of PD. This observational study enrolled 95 patients from four healthcare centers in Türkiye. Following translation according to the consensus-based standards for the selection of health measurement instruments, all participants were asked to complete the PDQ during two separate visits. The test-retest reliability of the PDQ and the internal consistency of its subscales were assessed.</p><p><strong>Results: </strong>The intraclass correlation coefficients were 0.96, 0.95, and 0.98 for the psychological and physical symptoms, symptom bother, and penile pain subscales, respectively. Exploratory factor analysis was conducted to evaluate construct validity. The factor analysis revealed a three-factor structure, explaining 70.34% of the total variance. A penile curvature angle >60° was associated with PDQ symptom scores and International Index of Erectile Function-5 scores (<i>p</i> = 0.047 and <i>p</i> = 0.001, respectively). A body mass index <25 kg/m² and the absence of comorbidities were also associated with PDQ scores.</p><p><strong>Conclusions: </strong>The Turkish translation and validation of the PDQ were found to be a reliable and useful assessment tool for Turkish individuals with PD. The introduction of the Turkish PDQ may facilitate treatment initiation and follow-up by providing a more reliable and comprehensive evaluation of patients with PD.</p><p><strong>Clinical trial registration: </strong>The study was registered at clinicaltrials.gov after ethical approval (NCT06621420; https://clinicaltrials.gov/study/NCT06621420).</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1115-1122"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Preoperative Neutrophil-to-Lymphocyte Ratio, Leukocyte Count, and Platelet Count With Postoperative Urosepsis in Older Diabetic Patients With Ureteral Calculi.","authors":"Jinyu Qiu","doi":"10.56434/j.arch.esp.urol.aeu013","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu013","url":null,"abstract":"<p><strong>Background: </strong>To investigate the associations of preoperative neutrophil-to-lymphocyte ratio (NLR), leukocyte count, and platelet count with postoperative urosepsis in older adults with type 2 diabetes mellitus (T2DM) and ureteral calculi, and to explore their within-sample discriminative performance.</p><p><strong>Methods: </strong>This retrospective matched case-control study included 85 older adults with T2DM and ureteral calculi who developed urosepsis after laser lithotripsy between January 2021 and December 2025. From 1530 eligible surgical patients without postoperative urosepsis, 85 controls were selected by 1:1 matching on age and sex. Conditional logistic regression was used to evaluate factors associated with urosepsis. Receiver operating characteristic (ROC) analysis, pairwise DeLong tests, and 1000-resample bootstrap validation were used to assess the discriminative performance of NLR, leukocyte count, platelet count, and a combined indicator derived from a binary logistic regression model including all three markers.</p><p><strong>Results: </strong>Age and sex were balanced between the two groups after matching (both <i>p</i> > 0.05). Compared with the control group, the urosepsis group had higher NLR, leukocyte count, platelet count, stone computed tomography (CT) value, and urinary leukocyte positivity, and a higher prevalence of staghorn calculi (all <i>p</i> < 0.05). Conditional logistic regression showed that stone CT value, NLR, leukocyte count, platelet count, and staghorn calculus were associated with postoperative urosepsis (all <i>p</i> < 0.05). The areas under the curve (AUCs) for NLR, leukocyte count, platelet count, and the combined indicator were 0.742, 0.811, 0.681, and 0.872, respectively. The AUC of the combined indicator was larger than that of each individual marker by pairwise DeLong testing (<i>p</i> = 0.028 for leukocyte count; <i>p</i> < 0.001 for the other comparisons), and its optimism-corrected bootstrap AUC was 0.854.</p><p><strong>Conclusions: </strong>Preoperative NLR, leukocyte count, and platelet count were associated with postoperative urosepsis in older adults with T2DM and ureteral calculi. Their combination showed improved discrimination within the matched sample; however, the sample-derived cut-off values and performance measures should not be interpreted as universal screening thresholds without external validation.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1240-1248"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressive Symptoms and Cognitive Function in Late-Stage Prostate Cancer: Transformer-Based Survival Modeling From the CHARLS 2011-2015 Big Data Cohort.","authors":"Wen Li, Zhou Sun, Yangyiyan Song, Jie Wang, Qing Huang, Jun Xiong","doi":"10.56434/j.arch.esp.urol.aeu001","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu001","url":null,"abstract":"<p><strong>Background: </strong>To examine whether depressive symptoms and multi-domain cognition predict 4-year all-cause mortality among men with survey-defined late-stage prostate cancer (PCa), and to evaluate an attention-based discrete-time survival model for short-horizon risk stratification in this urologic oncology setting.</p><p><strong>Methods: </strong>Men ≥ 45 years in China Health and Retirement Longitudinal Study (CHARLS) 2011-2015 were assembled; incident PCa with ≥1 survey-available systemic/palliative indicator was used to approximate a late-stage phenotype (n = 21) and compared with cancer-free controls frequency-matched by age band and province (n = 600; N = 621). Exposures were the 10-item Center for Epidemiologic Studies Depression Scale (CES-D) and a global cognitive z-score. A tabular transformer modeled discrete-time hazards with isotonic calibration and was compared with discrete-time logistic survival and Cox models. Province-blocked internal-external validation and decision-curve analysis evaluated discrimination, calibration, transportability, and clinical utility.</p><p><strong>Results: </strong>Over four years, 51 deaths occurred (late-stage PCa 33.3% vs controls 7.3%). The calibrated transformer achieved an area under the receiver operating characteristic curve (AUC) at 4 years of 0.828 (Integrated Brier Score (IBS) 0.057) and outperformed benchmarks (AUC ≤ 0.774). Leave-one-province-out testing showed median AUC at 4 years 0.832 with stable error. Higher CES-D and lower cognition were associated with higher discrete-time mortality hazard; estimates among late-stage cases were directionally similar but imprecise.</p><p><strong>Conclusions: </strong>Depressive symptoms and cognition may provide urology-relevant prognostic signal for near-term mortality among men with late-stage PCa. An attention-based discrete-time survival model demonstrated good discrimination and calibration in CHARLS; external validation in clinically staged advanced PCa cohorts is needed before clinical use.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1153-1161"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erectile Function and Genital Self-Perception in Young Adults After Childhood Hypospadias Repair: A Case-Control Study.","authors":"Lucas Diéguez-Álvarez, Sara Sánchez Caballero, Jorge Panach-Navarrete, Lorena Valls-González, Daniel Ortiz-Seller, José María Martínez-Jabaloyas","doi":"10.56434/j.arch.esp.urol.aeu011","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu011","url":null,"abstract":"<p><strong>Background: </strong>Long-term evidence on sexual function and genital self-perception in men operated for hypospadias in childhood remains heterogeneous. This exploratory study evaluated erectile function, genital self-perception, and sexual quality of life in young adults with prior hypospadias repair compared with healthy male volunteers.</p><p><strong>Methods: </strong>Exploratory case-control study compared 17 adult men who underwent hypospadias repair before the age of 4 years between 1995 and 2005 with 19 healthy male volunteers of similar age, without known urogenital anomalies, sexual dysfunction, or relevant cardiometabolic disease. Participants anonymously completed the five-item International Index of Erectile Function (IIEF-5), the Hypospadias Objective Penile Evaluation (HOPE), administered as a self-report measure of perceived penile appearance, and the Sexual Quality of Life-Male (SQoL-M) questionnaire. Multivariable regression analyses were adjusted for age and relationship status.</p><p><strong>Results: </strong>Most cases had distal hypospadias (82.3%). Age did not differ significantly between groups (25.6 ± 3.8 vs 27.0 ± 1.6 years; <i>p</i> = 0.288). IIEF-5 scores were lower in cases (21.8 ± 3.1 vs 24.5 ± 0.7; <i>p</i> = 0.002), though both groups remained within ranges consistent with absent or mild erectile dysfunction. HOPE scores were also lower in cases (48.5 ± 6.1 vs 58.1 ± 2.4; <i>p</i> < 0.001), driven by differences in meatal configuration, skin coverage, and torsion. SQoL-M did not differ significantly. Group status was the sole independent predictor of IIEF-5 and HOPE scores.</p><p><strong>Conclusions: </strong>In a predominantly distal cohort, men after childhood hypospadias repair showed statistically significant but clinically modest differences in erectile function scores and lower perceived penile appearance compared with healthy controls, with sexual quality of life preserved. These findings should be interpreted in the context of the small sample size and predominance of distal forms and support consideration of psychosexual assessment within transitional urology programmes. Larger multicentre studies are warranted to further clarify long-term outcomes and risk factors.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1249-1258"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-Plane AI-Assisted Renal Ultrasound for Grading Unilateral Hydronephrosis in Infants: A Single-Center Proof-of-Concept Internal Validation Study.","authors":"Yusuf Atakan Baltrak, Hasan Deliağa","doi":"10.56434/j.arch.esp.urol.aeu002","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu002","url":null,"abstract":"<p><strong>Background: </strong>Renal ultrasound is the first-line imaging method for postnatal hydronephrosis, but its severity grading remains partly reader dependent. Although previous studies have applied artificial intelligence (AI) to pediatric hydronephrosis assessment, the clinical feasibility of a simplified two-still-image workflow in a homogeneous infant cohort remains insufficiently defined.</p><p><strong>Methods: </strong>This retrospective single-center proof-of-concept diagnostic accuracy study was conducted among 186 infants younger than 12 months with unilateral hydronephrosis who had one protocol-compatible transverse and one sagittal renal ultrasound image. The AI workflow classified hydronephrosis as mild, moderate, or severe using a two-branch convolutional neural network (CNN). Model performance was assessed using stratified patient-level five-fold internal validation. The reference standard was expert consensus based on the complete ultrasound examination. Study categories were aligned descriptively with accepted Society for Fetal Urology (SFU) and Urinary Tract Dilation (UTD) severity concepts but were not intended to replace these systems.</p><p><strong>Results: </strong>A total of 186 infants were included. Expert consensus classified 79 cases as mild, 62 as moderate, and 45 as severe. The AI-assisted workflow showed exact agreement with expert consensus in 159 of 186 infants, corresponding to 85.5%, with a linear weighted kappa of 0.83. For clinically significant hydronephrosis, defined as moderate or severe disease, the AI workflow showed a sensitivity of 92.5%, a specificity of 86.1%, an accuracy of 89.8%, a positive predictive value of 90.0%, and a negative predictive value of 89.5%. The ordinal-score area under the curve (AUC), which is based on class labels rather than calibrated probability outputs, was 0.92 for clinically significant hydronephrosis and 0.96 for severe hydronephrosis. Because patient-level probability outputs were unavailable, formal calibration, decision curve analysis, threshold adjustment, and individualized risk estimation could not be performed.</p><p><strong>Conclusions: </strong>This single-center proof-of-concept internal validation study suggests that a simplified two-plane AI-assisted workflow could closely match expert consensus grading in selected infants with unilateral hydronephrosis. The workflow should be considered a research-only ordinal class assignment tool. This study does not establish clinical readiness, external generalizability, calibrated risk prediction, or diagnostic superiority over routine reporting. Prospective multicenter validation with preserved probability outputs and formal calibration is needed before any clinical implementation.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1132-1141"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transperineal Ultrasound for Preoperative Pelvic Floor Assessment Prior to Radical Prostatectomy: Inter-Operator Reliability and Concordance With Magnetic Resonance Imaging.","authors":"Belén Carrero-García, Miguel Ángel Gómez-Luque, Carmen Muñoz-Calahorro, Reyes Chaves-Marcos, Cristina García-Sánchez, Rafael Antonio Medina-López","doi":"10.56434/j.arch.esp.urol.aeu003","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu003","url":null,"abstract":"<p><strong>Background: </strong>Post-prostatectomy urinary incontinence (UI) is a major functional complication of radical prostatectomy (RP), and preoperative membranous urethral length (MUL) has been established as an independent predictor of recovery. Magnetic resonance imaging (MRI) remains the standard for MUL measurement; however, access constraints and operator dependency limit its applicability. Transperineal ultrasound (TPUS) represents a promising alternative. This study aimed to evaluate the inter-operator reliability of TPUS-based pelvic floor measurements performed by urologists and their concordance with preoperative MRI in patients scheduled for robot-assisted radical prostatectomy (RARP).</p><p><strong>Methods: </strong>A prospective observational cohort study was conducted. Fifty-one patients scheduled for RARP underwent preoperative TPUS performed by two urologists, blinded to each other's measurements. Eight pelvic floor parameters were recorded: MUL, prostatic height (PH), prostatic width (PW), prostatic depth (PD), urethral width (UW), urethra-prostate angle (UPA), prostatic urethral length (PUL), and total urethral length (TUL). Preoperative MRI served as the reference standard. Interoperator reliability and transperineal ultrasound-magnetic resonance imaging (TPUS-MRI) concordance were assessed.</p><p><strong>Results: </strong>Inter-operator reliability for TPUS ranged from moderate to substantial across all variables (intraclass correlation coefficient (ICC) range 0.57 to 0.74), with the strongest agreement observed for PD (ICC 0.74; 95% confidence interval (CI) 0.59 to 0.84) and MUL (ICC 0.73; 95% CI 0.57 to 0.84). Concordance between TPUS and MRI was strongest for MUL (ICC 0.47; 95% CI 0.23 to 0.66) and PH (ICC 0.47; 95% CI 0.22 to 0.66), both in the moderate range; UW and TUL showed statistically significant but only fair concordance, whereas the remaining four parameters showed no significant concordance.</p><p><strong>Conclusions: </strong>TPUS performed by urologists demonstrates reproducible inter-operator agreement for pelvic floor parameters, particularly MUL. Significant, though modest, concordance with MRI (moderate for MUL and PH and fair for UW and TUL) together with small absolute mean differences for the key parameters, suggests that TPUS provides clinically reasonable estimates despite limited individual-level interchangeability with MRI. TPUS is a reproducible tool with acceptable inter-operator reliability for key pelvic floor parameters, particularly MUL, and may serve as a complement to MRI or an accessible alternative. However, its individual-level interchangeability with MRI remains limited, and its predictive value for post-prostatectomy urinary continence has not yet been established and requires confirmation in prospective studies.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1123-1131"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research on Ultrasound Image-Assisted Diagnosis of Prostate Cancer Based on Machine Learning.","authors":"Qinghua Liu, Xueping Liu, Yuwang Zhou, Lulu Jiang, Xinkuan Wu, Qunyan Zheng, Kaili Wu","doi":"10.56434/j.arch.esp.urol.aeu019","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu019","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the diagnostic value of a machine learning model based on ultrasound image features for prostate cancer.</p><p><strong>Methods: </strong>600 patients with prostate tumours detected by transrectal ultrasound (TRUS) at Quzhou People's Hospital between July 2023 and June 2025, and with corresponding pathological results, were selected. Based on these results, the patients were divided into prostate cancer and benign lesion groups. Stratified random sampling was then used to divide these groups into a training group (n = 420) and a validation group (n = 180) at a ratio of 7:3. Regions of interest were manually delineated by sonographers and radiomics features were extracted using Pyradiomics software. Using pathological results as the gold standard, the radiomics features with the highest diagnostic value in differentiating between benign and malignant lesions were selected. Based on the selected features, a support vector machine (SVM) algorithm model was then constructed, and the efficacy of the SVM and fusion models in diagnosing prostate cancer was evaluated using receiver operating characteristic curves.</p><p><strong>Results: </strong>In the validation group, the SVM model based solely on ultrasound features achieved an accuracy of 73.06%, a sensitivity of 82.59%, a specificity of 65.50% and the area under the curve (AUC) of 0.729 [95% confidence interval (CI): 0.666-0.792] in diagnosing prostate cancer. After incorporating clinical features such as age, total prostate-specific antigen and prostate volume, the combined model improved the accuracy to 85.00%, sensitivity to 86.61%, specificity to 82.35%, and the AUC to 0.824 (95% CI: 0.785-0.863). Calibration and decision curve analyses further confirmed the model's good calibrability and net clinical benefit.</p><p><strong>Conclusions: </strong>A machine learning fusion model based on whole-gland TRUS radiomics features and combined with clinical indicators demonstrates good performance in estimating patient-level risk for prostate cancer. It may serve as a potential non-invasive decision support tool for risk stratification, but its clinical utility requires further external validation.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1142-1152"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}