Archivos Espanoles De Urologia最新文献

{"title":"Assessing ChatGPT on Male HPV Disorders: Repeated Assessments of Urological and Dermatological Accuracy Using Evidence-Based Guidelines.","authors":"Kemal Turker Ulutas, Mesut Cilli","doi":"10.56434/j.arch.esp.urol.20257809.152","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257809.152","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) is a prevalent viral infection that poses considerable health risks to males, including genital warts and various cancers. The epidemiology of HPV in the male population requires novel approaches for effective patient education. This study investigated the efficacy of Chat Generative Pre-trained Transformer-4 (ChatGPT-4), a sophisticated artificial intelligence model, in disseminating accurate information about HPV-induced genital warts in men.</p><p><strong>Methods: </strong>A meticulously designed questionnaire comprising 240 items, spanning multiple-choice and true/false formats, was administered to ChatGPT-4 from October 2024 to January 2025. The questionnaire covered HPV transmission, clinical manifestations, diagnostic approaches, treatment options and preventive strategies. The responses were evaluated for accuracy and completeness using Likert scales, with repeated questioning sessions to assess the potential for response improvement over time.</p><p><strong>Results: </strong>ChatGPT-4 initially provided accurate and/or highly rated responses for 191 out of 240 questions. Subsequent rounds of questioning for inaccurately answered or low-scoring questions showed a progressive improvement, with 14 and 15 questions answered correctly or receiving higher accuracy scores in the second and third rounds, respectively. The overall accuracy rate was 79.60%, with specific subgroup analyses revealing strengths in general information and protection but challenges in questions about HPV-induced genital warts in men.</p><p><strong>Conclusions: </strong>ChatGPT-4 demonstrates preliminary medical value and potential for patient education in urology. However, variable subgroup accuracy suggests that further optimisation and validation are needed before clinical deployment. Its ability to accurately address a wide range of queries, combined with the potential for an improvement in response accuracy over time, highlights its value in enhancing health communication.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 9","pages":"1164-1170"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670491","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":"Retrograde Intrarenal Surgery Combined with Tamsulosin Hydrochloride for Renal Calculi ≤2 cm: Single-Center Study.","authors":"Lin Sun, Jinbao Wang, Quanxin Liu, Qiuhui Liang, Jia Guo, Jinming Wang, Weiwei Jiao","doi":"10.56434/j.arch.esp.urol.20257809.158","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257809.158","url":null,"abstract":"<p><strong>Background: </strong>Retrograde intrarenal surgery (RIRS) is minimally invasive with rapid recovery, whereas tamsulosin hydrochloride promotes stone expulsion and reduces pain. Whether their combination has a synergistic effect on treating renal calculi ≤2 cm remains unclear. This study aims to explore the efficacy and safety of RIRS combined with tamsulosin in such patients using single-centre data.</p><p><strong>Methods: </strong>The clinical data of patients with renal calculi ≤2 cm treated in The First Hospital of Fangshan District, China from January 2021 to January 2024 were retrospectively collected. The patients were divided into a combination therapy group (RIRS + oral tamsulosin) and a control group (RIRS alone). Clinical efficacy, stone-free rate and adverse event incidence were compared between the groups. Renal function changes, pain intensity and quality of life before and after treatment were evaluated.</p><p><strong>Results: </strong>After propensity score matching, 53 patients were included in the combination therapy group and 53 in the control group. The total effective rate in the combination therapy group was 96.22% (51/53), which was higher than that (81.13%, 43/53) in the control group (χ² = 6.014, <i>p</i> = 0.014). The stone-free rate in the combination therapy group was also significantly higher than that in the control group (94.34% vs. 79.25%, χ² = 5.267, <i>p</i> = 0.022), whereas the scores of expulsive pain, first stone expulsion time and complete stone expulsion time were significantly lower (t = 2.165, 7.142, 4.538; All <i>p</i> < 0.05). After treatment, the levels of serum creatinine, blood urea nitrogen, uric acid, β2-microglobulin, interleukin-6, tumour necrosis factor-α and C-reactive protein decreased in both groups. The glomerular filtration rate and scores of physical function, psychological status, social function and symptoms/discomfort improved. The enhancements in the combination therapy group were more significant than those in the control group (all <i>p</i> < 0.05). No difference in the incidence of postoperative complications was found between the two groups (13.21% vs. 11.32%, χ² = 0.088, <i>p</i> = 0.767).</p><p><strong>Conclusions: </strong>RIRS combined with tamsulosin demonstrates remarkable short-term clinical efficacy, stone clearance and renal function protection in patients with renal calculi ≤2 cm, showing promising clinical application.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 9","pages":"1218-1226"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670205","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":"Relationship between Serum Adropin Levels and Erectile Dysfunction.","authors":"Serdar Duvar, Levent Verim, Cagatay Tosun, Emre Tokuc, Omer Ergin Yucebas","doi":"10.56434/j.arch.esp.urol.20257809.153","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257809.153","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to assess the relationship between serum adropin levels and the severity of erectile dysfunction (ED) and to investigate serum adropin levels as a potential biomarker of ED severity.</p><p><strong>Material and methods: </strong>This prospective case-control study was conducted amongst patients who applied to our outpatient clinic. Patients' medical histories were obtained, and comprehensive systemic examinations were conducted. Fasting glucose levels, lipid profiles, total testosterone levels, adropin levels and International Index of Erectile Function (IIEF) scores were measured and analysed through logistic regression and receiver-operating characteristic curve analysis.</p><p><strong>Results: </strong>Of the 89 patients, 45 complained of ED and matched with 44 patients without ED. Adropin levels were significantly lower in the ED group (<i>p</i> = 0.001; <i>p</i> < 0.05). Using a cut-off value of 2.1 for adropin, the sensitivity was 91.11%, and the specificity was 45.45% with a positive predictive value of 63.08%, negative predictive value of 83.33% and accuracy of 68.54%. The area under curve was 0.711. Logistic regression analysis revealed that adropin values below 2.1 were associated with a 6.31-fold increased risk of developing ED. Furthermore, a significant relationship was observed between serum adropin levels and IIEF scores.</p><p><strong>Conclusions: </strong>Adropin levels below 2.1 may serve as an independent risk factor of developing ED. This finding may contribute to the development of possible predictive models for individualising andrological patient management.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 9","pages":"1171-1177"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670258","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":"Infarcted Adenomatoid Tumour of Paratesticular Tissue: Case Report.","authors":"Marco Tozzi, Elena Di Blasi, Letizia Maria Ippolita Jannello, Sara Nardini, Andrea Marmiroli, Giuseppe Renne, Matteo Ferro","doi":"10.56434/j.arch.esp.urol.20257809.169","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257809.169","url":null,"abstract":"<p><strong>Background: </strong>Although rare, testicular adenomatoid tumours are the most common benign neoplasms of the paratesticular region, particularly affecting the epididymis and spermatic cord. These benign mesothelial-derived tumours rarely undergo malignant transformation and are typically managed with surgical excision. However, their clinical presentation may mimic the tumours arising from the testis, either benign or malignant, leading to grave consequences.</p><p><strong>Case presentation: </strong>We report the challenging case of a 49-year-old man who presented with a painful mass in the left scrotal lower pole. Owing to the suspicious imaging features, malignancy was initially considered. Histopathological examination revealed an infarcted adenomatoid tumour. This finding is rare and emphasises the importance of accurate diagnosis to avoid overtreatment. This case report describes the microscopic and macroscopic aspects of an infarcted adenomatoid tumour of the paratesticular area, focusing on the diagnostic and therapeutic approaches.</p><p><strong>Conclusions: </strong>This case underscores the necessity for the careful clinical and imaging evaluation of paratesticular masses. In settings where intraoperative frozen-section analysis or advanced imaging modalities are available, the application of a conservative, testis-sparing approach may be feasible. Awareness of this rare presentation can help avoid overtreatment and guide tailored surgical decision-making. Multidisciplinary collaboration is essential to balance oncological safety with the preservation of testicular function in benign conditions that mimic malignant diseases.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 9","pages":"1312-1318"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670294","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":"Effect of Nutritional-Psychological Dual-Wheel-Driven Enhanced Recovery after Surgery Nursing on the Prognosis of Patients with Bladder Cancer: A Retrospective Cohort Study.","authors":"Juan Guo, Jiao Xue, Zhongzhen Yu, Jie Dong, Mei Liu","doi":"10.56434/j.arch.esp.urol.20257809.168","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257809.168","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer has a high recurrence rate and presents postoperative challenges that impact patient recovery. Enhanced recovery after surgery (ERAS) programs, which incorporate nutritional and psychological strategies, have demonstrated benefits in perioperative care. This study evaluates the effect of a novel nutritional-psychological dual-wheel-driven ERAS protocol on postoperative outcomes in patients undergoing bladder cancer surgery.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on patients with bladder cancer treated between January 2021 and June 2024. Participants were divided into a routine ERAS group and an enhanced support group receiving enhanced nutritional and psychological support. Perioperative outcomes, including postoperative recovery time, anxiety, nutritional status, complications and patient satisfaction were assessed between groups.</p><p><strong>Results: </strong>The enhanced support group (n = 121) demonstrated significant improvements in postoperative recovery metrics compared with the routine group (n = 124), that is, they had reduced intensive care unit stay, faster nasogastric tube removal and earlier time to flatus, defecation and full oral diet (<i>p</i> < 0.05). Repeated-measures analysis of variance (ANOVA) revealed a significant interaction effect of time and group on Nutritional Risk Screening (NRS) 2002 scores (<i>p</i> = 0.010). The main effects of time and group were significant for NRS 2002, Self-Rating Anxiety Scale (SAS) and visual analogue scale (VAS) scores (all <i>p</i> < 0.05). Simple effects analysis showed lower NRS 2002 and SAS scores in the enhanced support group than in the routine group at 24 hours before surgery and 1 day after surgery (<i>p</i> < 0.05) but higher VAS scores (<i>p</i> < 0.05). Fewer wound leakage complications occurred in the enhanced support group (<i>p</i> = 0.031), and patient satisfaction rates were significantly higher (<i>p</i> = 0.003).</p><p><strong>Conclusions: </strong>The nutritional-psychological dual-wheel-driven ERAS protocol is associated with improved postoperative recovery, reduced complications and increased patient satisfaction in patients with bladder cancer.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 9","pages":"1302-1311"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670478","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":"Segmental Testicular Infarction: Clinical Course and Added Value of Contrast-Enhanced Ultrasound Findings-Case Report.","authors":"Irene Ferri, Vito Lorusso, Francesco Bombaci, Antonio Maria Granata, Andrea Gregori, Franco Palmisano","doi":"10.56434/j.arch.esp.urol.20257809.173","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257809.173","url":null,"abstract":"<p><strong>Introduction: </strong>Segmental testicular infarction (STI) is a rare, benign condition that often mimics testicular tumours, leading to diagnostic challenges and, at times, unnecessary orchiectomies. The clinical challenge is the lack of a consensus regarding which imaging tools should be used to characterise the testicular lesions and which one is the most reliable.</p><p><strong>Case presentation: </strong>We report the case of a 34-year-old man presenting at the emergency department with right testicular pain and swelling. Contrast-enhanced ultrasound (CEUS) performed at our hospital revealed a poorly defined, hypoechoic lesion with peripheral rim enhancement, consistent with subacute infarction. Follow-up CEUS 1 month later showed reduction in lesion size and absence of enhancement, supporting a benign evolution. However, surgical exploration was performed because of the impossibility to fully exclude malignancy. Intraoperative frozen-section analysis confirmed haemorrhagic infarction with no signs of malignancy.</p><p><strong>Conclusions: </strong>CEUS plays a central role in guiding diagnosis and follow-up, offering detailed assessment of testicular perfusion. Compared with conventional ultrasound and magnetic resonance imaging, CEUS is faster, safer, more cost-effective and highly accurate in differentiating infarction from hypovascular tumours. This case study supports the growing use of CEUS as a first-line imaging modality in the evaluation of testicular lesions, promoting conservative management and avoiding overtreatment in appropriate clinical settings.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 9","pages":"1334-1338"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670210","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":"Comparative Analysis of Supine and Prone Percutaneous Nephrolithotomy for Efficacy and Safety in Complex Renal Stones and Anatomical Anomalies.","authors":"Kubilay Sarıkaya, Emre Hepşen, Furkan Capar, Metin Yığman, Ahmet Nihat Karakoyunlu","doi":"10.56434/j.arch.esp.urol.20257809.155","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257809.155","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the efficacy and safety of prone and supine percutaneous nephrolithotomy (PCNL) in patients with complex renal stones and anatomical abnormalities.</p><p><strong>Methods: </strong>This retrospective study analysed the data of patients with complex renal stones and anatomical anomalies who underwent PCNL between December 2022 and June 2024. Inclusion criteria encompassed adult patients with complex renal stones (Guy's score 3 or 4), staghorn calculi, diverticular stone, obesity, kyphoscoliosis and solitary kidney or renal anomalies (horseshoe kidney, autosomal dominance polycystic kidney, malrotated kidney, and pelvic kidney). Patients were divided into prone (group P) and supine (group S) groups on the basis of PCNL positioning. Efficiency was evaluated on the basis of stone-free rates (SFRs), and safety was assessed using the Clavien-Dindo complication classification.</p><p><strong>Results: </strong>A total of 222 patients were included in the study, with 118 patients in group P and 104 patients in group S. No significant differences were observed in stone burden, Hounsfield unit (HU) density or other demographic parameters. Group S had a shorter operative time (105.78 ± 15.71 min) and time to positioning (14.83 ± 12.44 min, <i>p</i> < 0.001) but a longer scopy time (8.13 ± 2.88 min, <i>p</i> < 0.001). The overall SFRs were 77.11% for group P and 75.00% for group S (<i>p</i> = 0.713). Postoperative complications, assessed using the Clavien-Dindo classification, were similar between the groups, with 4.23% major complications in group P and 5.76% in group S.</p><p><strong>Conclusions: </strong>Supine and prone PCNL demonstrated similar success rates and complication profiles, with supine PCNL offering the advantage of shorter operative times while effectively managing complex cases.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 9","pages":"1188-1194"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670469","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":"Case Report of Rare Metastasis of Renal Cell Carcinoma to the Bladder: A New Hypothesis and Literature Review.","authors":"Alper Nesip Manav","doi":"10.56434/j.arch.esp.urol.20257809.172","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257809.172","url":null,"abstract":"<p><strong>Introduction: </strong>Metastatic renal cell carcinoma (RCC) to the bladder is extremely rare. A total of 1.6% of the patients were found via autopsy reports.</p><p><strong>Case presentation: </strong>A 44-year-old male patient presented with left flank pain and hematuria. A 40 mm tumor extending into the pelvis was detected in contrast-enhanced computed tomography (CECT). After benign urine cytology and transurethral-resection (TUR) biopsy from the bladder, left nephroureterectomy and ureteral cuff resection were performed because of a left endophytic renal mass and suspected upper tract urothelial carcinoma. Pathology analysis revealed papillary RCC. In the patient with hematuria, a 16mm mass was detected in the bladder 2 years after nephrectomy. Papillary type RCC was detected after complete TUR of the bladder tumor. Left iliac-lymph-node metastasis was detected via postoperative positron emission tomography-computed tomography (PET-CT). After six months of sunitinib treatment, the metastatic lymphadenopathy was found to regress on PET-CT.</p><p><strong>Discussion: </strong>Solitary resectable intravesical metastatic RCC is a good prognostic factor. Late-onset systemic metastasis may be observed and should be considered during follow-up. PET-CT scanning should be performed if necessary, and the patient can be treated with sunitinib.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 9","pages":"1329-1333"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670396","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":"A Rare Case of Primary Bladder Lymphoepithelial Carcinoma.","authors":"Yongwei Shan, Yiru Hou, Xuan Peng, Nan Wang, Kaili Wei, Yaling Liu, Xue Han, Haiqi Yang, Jiaxi Yao","doi":"10.56434/j.arch.esp.urol.20257809.175","DOIUrl":"10.56434/j.arch.esp.urol.20257809.175","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer is a common malignant tumor of the urinary system. Although lymphoepithelial carcinoma can occur in the liver, breast, thymus, lungs, skin, and other organs, its presence in the urinary system is exceptionally rare.</p><p><strong>Methods: </strong>We report the case of a 50-year-old man who presented to our hospital with hematuria. Urinary tract computed tomography revealed a malignant bladder tumor, with an enhancing nodule measuring 9 mm in the posterior wall of the bladder. The patient received transurethral resection of the bladder tumor, followed by arterial embolization chemotherapy and intravenous chemotherapy combined with immunotherapy successively, and finally underwent cystoscopy follow-up to monitor the condition.</p><p><strong>Results: </strong>After transurethral resection of the bladder tumor, immunohistochemistry revealed tumor cells appearing as syncytial bodies with unclear boundaries. The nuclei were large and vacuolated, with marked infiltration of lymphoplasmacytes observed both between and within the tumor islands. The markers were as follows: cytokeratin 7 (CK7) (+), CK20 (-), S-100 (-), prostate-specific antigen (PSA) (-), Desmin (-), Melanoma (-), Epstein-Barr virus-encoded RNA (EBER) (-), spalt like transcription factor 4 (SALL4) (-), P63 (-), CKpan (+), GATA binding protein 3 (GATA-3) (-), epithelial membrane antigen (EMA) (+), P40 (-), cluster of differentiation (CD)117 (+), CD20 (-), CD3 (-), CD30 (-), placental alkaline phosphatase (PLAP) (-), CD15 (small weak+), and Ki67 (35%+). The patient was diagnosed with lymphoepithelial carcinoma.</p><p><strong>Conclusions: </strong>The patient remained recurrence-free at 11 months of follow-up after gemcitabine bladder infusion chemotherapy, arterial drug-infusion embolization, systemic chemotherapy, and immunotherapy.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 9","pages":"1345-1350"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670424","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":"Impact of Referral Pathways on Paediatric Testicular Torsion Outcomes in Southern Chile.","authors":"Albert Pasten, Lucas Alvarado, Sebastian Dubo, Carolina Bastias, Sonia Pérez-Bertólez","doi":"10.56434/j.arch.esp.urol.20257809.149","DOIUrl":"10.56434/j.arch.esp.urol.20257809.149","url":null,"abstract":"<p><strong>Background: </strong>Testicular torsion (TT) is a critical condition caused by spermatic cord twisting, which can result in irreversible testicular damage without timely intervention. In Chile, centralised healthcare and significant geographic barriers can delay treatment for TT, which potentially worsens outcomes. This study evaluates the impact of referral status on orchiectomy rates among paediatric TT cases treated at two hospitals in Southern Chile.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted on TT cases in patients under 15 years. These patients were treated at Hospital Guillermo Grant Benavente and Hospital Las Higueras between January 2018 and January 2024. Data on demographics, symptom duration, referral status and treatment timelines were analysed using Wilcoxon rank-sum and Pearson's Chi-squared tests, with significance set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>Among 144 patients, 71% were referred from other facilities. Orchiectomy was performed in 44 cases, with a median symptom duration of 48 h, which was significantly longer than that of non-orchiectomy cases (5 h, <i>p</i> < 0.001). Referred patients showed a higher crude orchiectomy rate (35% vs. 20%; <i>p</i> = 0.064). However, in the multivariable analysis with adjusted age, hospital and symptom onset time, referral emerged as an independent predictor of orchiectomy (odds ratio (OR) = 3.68; 95% confidence interval (CI): 1.15-13.1; <i>p</i> = 0.035).</p><p><strong>Conclusions: </strong>Referral delays in TT management correlate with increased orchiectomy rates. Enhancing specialist access and referral protocols is crucial to reducing treatment delays and improving outcomes in regions with dispersed healthcare services.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 9","pages":"1143-1148"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670209","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}