Archivos Espanoles De Urologia最新文献

{"title":"Role of CT Scan in Prognosticating the Outcome of Medical Expulsive Therapy for Distal Ureteric Stone.","authors":"Mohammad Shazib Faridi, Sanika Deshpande","doi":"10.56434/j.arch.esp.urol.20257807.110","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257807.110","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the correlation of Hounsfield unit (HU) to the success rate of medical expulsive therapy (MET) for distal ureteric calculus of size 4-10 mm.</p><p><strong>Methods: </strong>All recruited patients were divided into two groups: Group A, who successfully passed the stone, and group B, who failed to expel the stone. All patients were prescribed with silodosin for a maximum period of 4 weeks. The stone expulsion rate, mean stone area, mean HU, stone expulsion time, number of pain episodes, grades of hydronephrosis (HDN) and laterality of stone were studied.</p><p><strong>Results: </strong>Out of 87 patients, eight patients were excluded from the study: Four patients had adverse drug reactions, and other four patients were lost to follow up. Hence, 79 patients were finalised for the study. Group A comprised 57 patients, and group B comprised 22 patients. No statistical difference was found between the two groups in terms of mean age, gender, stone density (HU) and side or grade of HDN (<i>p</i> > 0.05). The mean stone area (<i>p</i> = 0.001) and number of pain episodes per day (<i>p</i> = 0.0004) were significantly less in patients who successfully passed stone. The HU was lower in the MET success group (816.04) than in the failure group (900.86), but the difference was not statistically significant (<i>p</i> = 0.123). Receiver operating characteristic analysis showed that the cut off values for stone area and stone density were ≤38 mm² and ≤992 HU, respectively.</p><p><strong>Conclusions: </strong>MET is undoubtedly a treatment modality for lower ureteric stones of size 10 mm. On computed tomography (CT) scan, stone area can be used as an effective parameter, but stone density (HU) cannot determine MET success. Further studies that include more patients and an evaluation of stone composition are required.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 7","pages":"829-835"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024599","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":"Comparison of Efficacy and Safety of Five Categories of Intracorporeal Lithotripsy Devices in Percutaneous Nephrolithotomy: A Systematic Review and Network Meta-Analysis of Randomised Control Trials.","authors":"Wenzhuo Zhang, Ziyu Ye, Shoule Wang, Baorong Feng, Wen Zhong","doi":"10.56434/j.arch.esp.urol.20257807.117","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257807.117","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to assess the efficacy and safety of five categories of intracorporeal lithotripsy devices in percutaneous nephrolithotomy (PCNL): Pneumatic lithotripters, ultrasonic lithotripters, double-probe dual-energy lithotripters, single-probe dual-energy (SPDE) lithotripters and lasers.</p><p><strong>Methods: </strong>A network meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, Embase and Cochrane were utilised to search for randomised controlled trials (RCTs) up to 10 August 2024. Surface under cumulative ranking area technique was used to rank interventions. Outcomes of interest included baseline characteristics, stone-free rate (SFR), complications, operative time and fragmentation time.</p><p><strong>Results: </strong>Fourteen RCTs comprising 1516 procedures were included. No statistically significant difference was found in complications after using the devices. SPDE lithotripters (ratio of ratios (RR) = 1.90, 95% confidence interval (CI) = (1.11 to 3.28)) and lasers (RR = 1.76, 95% CI = 1.09 to 2.84) were associated with significantly higher SFR than pneumatic lithotripters. SPDE lithotripters significantly outperformed in decreasing operation time and fragmentation time. Based on the surface under the cumulative ranking curve (SUCRA) value, lasers and SPDE lithotripters performed better in SFR. In addition, SPDE lithotripters exhibited superior performance in terms of few complications and shortest fragmentation time and operative time.</p><p><strong>Conclusions: </strong>All five categories of devices were found to be equally safe for PCNL. SPDE lithotripters and lasers had higher efficacy. Moreover, SPDE lithotripters exhibited the shortest fragmentation time and operative time. These findings suggest that SPDE lithotripters have potential to be next-generation efficient lithotripsy devices.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 7","pages":"884-895"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024560","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":"Efficacy of Qianlie Shutong Capsule in the Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Single-Centre Retrospective Study.","authors":"Chaofei Zhao, Zhonggui Hu, Xinglin Ping","doi":"10.56434/j.arch.esp.urol.20257807.116","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257807.116","url":null,"abstract":"<p><strong>Background: </strong>Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent urological condition affecting men's health. This study aims to investigate the clinical efficacy of Qianlie Shutong (QLST) capsule in the treatment of CP/CPPS.</p><p><strong>Methods: </strong>The medical records of patients with CP/CPPS who were admitted to our hospital from January 2023 to January 2024 were retrospectively analysed. They were divided into observation and control groups according to treatment modality received. The control group received levofloxacin (0.5 g, qd) in combination with tamsulosin hydrochloride (0.2 mg, qd). The observation group received an additional supplementation of QLST capsule (0.4 g, tid) alongside the treatment administered to the control group. Both groups underwent treatment for 28 days. Baseline data and clinical outcomes were compared between the groups, including the National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), maximum urine flow rate (Qmax), urine volume (UV), prostate-specific extracellular vesicle protein (PSEP) and International Index of Erectile Function-15 (IIEF-15).</p><p><strong>Results: </strong>A total of 117 patients were enrolled in this study, comprising 60 in the observation group and 57 in the control group. No significant differences in baseline characteristics were found between the two groups (<i>p</i> > 0.05). Before intervention, no significant differences in NIH-CPSI, Qmax, UV, PSEP and IIEF-15 were found between the two groups (<i>p</i> > 0.05). Following intervention, both groups exhibited significant reductions in NIH-CPSI and PSEP, and the levels in the observation group were lower than those in the control group (<i>p</i> < 0.05). Qmax, UV and IIEF-15 increased in both groups, and the levels in the observation group were higher than those in the control group (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>This study demonstrates that QLST effectively alleviates the clinical symptoms in patients with CP/CPPS, reduces PSEP levels and improves erectile function, supporting its clinical application.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 7","pages":"877-883"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024584","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":"Efficacy and Safety of Combination Tamsulosin and Dutasteride versus Tamsulosin Monotherapy for Benign Prostatic Hyperplasia: A Meta-Analysis.","authors":"Hao Yu, Hongying Chen, Xuejun Wang, Jiakuan Li, Xiaomei Shen, Xuerong Ye","doi":"10.56434/j.arch.esp.urol.20257807.115","DOIUrl":"10.56434/j.arch.esp.urol.20257807.115","url":null,"abstract":"<p><strong>Background: </strong>We conducted a meta-analysis to compare the efficacy and drug-related adverse events (AEs) of the combination of tamsulosin and dutasteride versus tamsulosin monotherapy for the treatment of benign prostatic hyperplasia (BPH).</p><p><strong>Methods: </strong>Relevant articles published in PubMed, Embase and Cochrane from 2004 to 2024 were searched and downloaded. These studies were screened following pre-established inclusion criteria, and data were extracted. Review Manager software was used for methodological quality assessment of randomised controlled trials and statistical analysis.</p><p><strong>Results: </strong>Eight studies containing 8793 patients were included in the meta-analysis. Combined dutasteride and tamsulosin more significantly improved symptoms (mean difference (MD): -1.55; 95% confidence interval (CI): -2.27, -0.84; <i>p</i> < 0.001), increased maximum urine flow (MD: 1.54; 95% CI: 1.18, 1.91; <i>p</i> < 0.001) and decreased prostate volume (MD: -14.42; 95% CI: -20.62, -8.22; <i>p</i> < 0.001) and prostate-specific antigen (MD: -2.32; 95% CI: -3.03, -1.61; <i>p</i> < 0.001) in patients with BPH than tamsulosin monotherapy. The combined drug also reduced the negative effect on patients' living status (MD: -0.68; 95% CI: -1.02, -0.33; <i>p</i> < 0.001), acute urinary retention or BPH-related surgeries (odds ratio (OR): 0.33; 95% CI: 0.25, 0.44; <i>p</i> < 0.001) and clinical progression of BPH (OR: 0.52; 95% CI: 0.44, 0.61; <i>p</i> < 0.001). However, the combination of dutasteride and tamsulosin significantly increased the incidence of drug-related AEs (OR: 2.13; 95% CI: 1.67, 2.73; <i>p</i> < 0.001) in patients with BPH.</p><p><strong>Conclusions: </strong>In patients with BPH, the combination of dutasteride and tamsulosin is a beneficial treatment option, but the impact on drug-related AEs events needs to be considered on an individual basis.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 7","pages":"866-876"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024535","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":"Bipolar Radiofrequency Ablation Treatment for Benign Prostatic Hyperplasia: A Retrospective Study of Efficacy and Safety in High-Risk Patients.","authors":"Mertcan Dama, Enis Mert Yorulmaz, Serkan Özcan, Osman Köse, Sacit Nuri Görgel, Yiğit Akın","doi":"10.56434/j.arch.esp.urol.20257807.112","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257807.112","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia (BPH) is a common condition, particularly among high-risk patients who are unsuitable for surgical intervention due to comorbidities or anticoagulant use. Bipolar radiofrequency ablation is a minimally invasive technique that has been studied for its potential safety and efficacy. This study aimed to investigate the effectiveness of bipolar radiofrequency ablation in treating BPH and to identify the factors influencing the procedural success in high-risk patients.</p><p><strong>Methods: </strong>Forty-six patients who underwent radiofrequency ablation treatment for prostate between 2018 and 2022 were included in this study. Pre-procedure prostate volume, International Prostate Symptom Score (IPSS), post-voiding residual urine volume (PVR), maximum urine flow rate (Qmax) on uroflowmetric examination, quality of life (QoL) due to urinary symptoms, metabolic syndrome status and bladder wall thickness on ultrasonographic examination were measured and compared with the values at the 3rd month of follow-up.</p><p><strong>Results: </strong>The mean age of the patients was 75.34 ± 10.67 years (55-94 years). Qmax, PVR, QoL and IPSS improved in all the patients after the procedure (<i>p</i> < 0.001). High pre-procedure PVR, low pre-procedure Qmax and prostate volume less than 70 g were found to be statistically significant factors affecting the success of the procedure (<i>p</i> = 0.03, 0.03, 0.04) (odds ratio (OR) = 1.15, 0.75, 1.30).</p><p><strong>Conclusions: </strong>Bipolar radiofrequency ablation for prostate is a safe option with a low incidence of side effects and complications for patients who are at high anaesthetic risk due to comorbidities or anticoagulant/antiplatelet therapy and unsuitable or hesitant to undergo for surgery because of potential surgical complications and side effects.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 7","pages":"842-848"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024577","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":"Urinary Calculi Care Pathways in a French Nationwide Study: The Costs, Lithiasis and Pathways (CLiPs) Study.","authors":"Gauthier Raynal, Annabelle Grabia, Charles Lequeu, Christophe Almeras","doi":"10.56434/j.arch.esp.urol.20257807.109","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257807.109","url":null,"abstract":"<p><strong>Background: </strong>Urinary stone treatment is of interest from a health-economic point of view because of competing technical approaches, high incidence and high recurrence rates. In France, since the release of the activity-based funding called T2A (for Tarification A l'Activité), concerns about possibly induced overactivity have been increasing. A flat-sum-based payment per stone episode has even been proposed. This study aims to describe different parameters, such as reintervention rates.</p><p><strong>Methods: </strong>Using the linkage between different stays of one patient, we studied multiple stays and procedures in the extensive reimbursement database of a group of nationwide private clinics. Patients were identified in 2020, and their procedures and stays were studied in 2019, 2020 and 2021. Demographic data, number of stays and interventions, number of multiple interventions, number of ureteral stentings without other procedures and the rate of outpatient stays were collected.</p><p><strong>Results: </strong>We obtained 50,295 stays from 31,209 patients (0.52 female/male). The median age of the patients was 54 years. The average number of stays was 1.6. No intervention was performed in 16% of the patients. Shockwave lithotripsy (SWL) and ureteroscopy (URS) were performed in 24.7% and 63.3% of the patients, respectively. After one primary URS, 3.2% of the patients were treated with 1.3 SWL on the average, and 24.2% were treated with 1.3 URS on the average. Percutaneous nephrolithotomy with first intent was marginal in the sample, and local disparities were rare.</p><p><strong>Conclusions: </strong>In this representative sample, despite true limitations, repeated procedures were less frequent than expected.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 7","pages":"823-828"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024537","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":"Combining Erection Restoration and Factual Penile Enhancement Based on Revolutionary Penile Fibro-Vascular Assembly.","authors":"Cho-Hsing Chung, Ko-Shih Chang, Heng-Shuen Chen, Yi-Ying Hsieh, Yu-Hsiang Chang, Geng-Long Hsu, Mang-Hung Tsai, Jeff Sc Chueh","doi":"10.56434/j.arch.esp.urol.20257807.113","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257807.113","url":null,"abstract":"<p><strong>Objective: </strong>Conventional penile venous surgery for erection restoration and surgery for penile augmentation have been controversial. Based on de novo penile fibrovascular assembly, we report innovative penile venous stripping (PVS) and factual penile girth enhancement (FPGE).</p><p><strong>Methods: </strong>From 2013 to 2023, refractory impotence and dysmorphia prompted 31 patients to seek PVS and FPGE, and all of them were confirmed with veno-occlusive dysfunction. PVS involves stripping erection-related veins, primarily one deep dorsal vein and two cavernosal veins, after the ligation of each emissary vein closest to the outer tunica albuginea using 6-0 nylon. FPGE was performed bilaterally along the tunica albuginea. Then, two tunic defects were fashioned with a 70.0 × 30.0 mm² venous stripe and covered with either autologous venous walls (AVW) or Surgiform (SF). Penile girth was measured, and radio-opaque contrast was used to compare intracorporeal retention. Patients resorted to follow-up if there was no surgery. The abridged 5-item version of the International Index of Erectile Function (IIEF-5) score and Erection Hardness Scale (EHS) were used yearly during follow-up via the Internet.</p><p><strong>Results: </strong>Overall, among 31 patients, 18 underwent PVS and FPGE, and they were allocated to the surgery group; The remaining 13 were categorised as the control group. The follow-up period was 0.2-10.0 (5.5 ± 1.6) years. In the surgery group, the radiopacity of the postoperative cavernosogram was consistently enhanced. Although indifference was observed in IIEF-5 and EHS (<i>p</i> ≥ 0.95; 20.8 ± 2.3 vs. 20.7 ± 2.1; 3.1 ± 0.2 vs. 3.3 ± 0.2) between AVW and SF, a significant improvement was detected after surgery (both <i>p</i> ≤ 0.01 in IIEF-5 and EHS scores (9.7 ± 2.8 vs. 20.8 ± 2.3; 1.7 ± 0.6 vs. 3.2 ± 0.2, respectively)). In addition, the diameters of the glans and penile shaft were significantly increased (both <i>p</i> ≤ 0.01; 28.0 ± 2.3 and 28.2 ± 2.1 mm vs. 35.3 ± 2.2 and 36.3 ± 2.1 mm, respectively). The satisfaction rate was 81.3% (13/16) when two inconsistent data were excluded in the AVW subgroup.</p><p><strong>Conclusions: </strong>Although this retrospective study encountered limitations, the combined PVS and FPGE surgery shows promise. Further validation requires a larger sample size and more extended surveillance.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 7","pages":"849-858"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024517","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 Retrospective Study of Pelvic Floor Muscle Training Combined with Biofeedback Stimulation versus Pelvic Floor Muscle Training Alone in the Treatment of Postpartum Stress Urinary Incontinence.","authors":"Lin Tong, Xiufang Li, Junyuan Qiu","doi":"10.56434/j.arch.esp.urol.20257806.92","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257806.92","url":null,"abstract":"<p><strong>Objective: </strong>Stress urinary incontinence (SUI) is a common postpartum complication in women. This study aims to evaluate the clinical efficacy of pelvic floor muscle training (PFMT) combined with biofeedback stimulation (BS) in the treatment of postpartum SUI.</p><p><strong>Methods: </strong>A total of patients with postpartum SUI admitted to our hospital from January 2023 to January 2024 were enrolled in the study. Based on the treatment method, the patients were divided into the following two groups: PFMT + BS group and PFMT group. Both groups received treatment for three months. Pelvic floor muscle strength and pelvic floor ultrasound indices were evaluated at T0 (before treatment) and T2 (three months after treatment). The 1-h pad test, Incontinence Urinary Incontinence Questionnaire Short Form (ICI-Q-SF) and Incontinence Quality of Life Questionnaire (I-QOL) were assessed at T0, T1 (one month after treatment) and T2. Data were analysed using repeated measures analysis of variance (ANOVA).</p><p><strong>Results: </strong>A total of 105 patients were included in the study, with 58 patients in the PFMT + BS group and 47 patients in the PFMT group. After treatment, the PFMT + BS group demonstrated significantly better pelvic floor muscle strength and ultrasound compared to the PFMT group (<i>p</i> < 0.05). Repeated measures ANOVA revealed significant interaction effects between time and group on the 1-h pad test, ICI-Q-SF and I-QOL (<i>p</i> < 0.05), along with significant main effects for time and group (<i>p</i> < 0.001). Simple effects analysis showed no significant differences between groups at T0 (<i>p</i> > 0.05). However, at T1 and T2, the PFMT + BS group had significantly lower 1-h pad test and ICI-Q-SF scores (<i>p</i> < 0.05) and significantly higher I-QOL score (<i>p</i> < 0.05) compared to the PFMT group.</p><p><strong>Conclusions: </strong>PFMT combined with BS is more effective than PFMT alone in treating postpartum SUI and thus warrants clinical implementation.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 6","pages":"684-692"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800690","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":"GnRH Antagonists: Current Evidence and Role in Prostate Cancer.","authors":"Antonio Lazo, Manuel Blanco, Abrahams Ocanto, Victor Duque-Santana, Rocio Del Castillo, Marta Barrado, Juan Zafra, Fernando López-Campos, Felipe Couñago","doi":"10.56434/j.arch.esp.urol.20257806.87","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257806.87","url":null,"abstract":"<p><p>Androgen deprivation therapy (ADT) has been a pillar in the management of prostate cancer (PCa) since the 1940s and remains a standard of care across different clinical scenarios of PCa. Gonadotropin-releasing hormone (GnRH) agonists are the most commonly used form of ADT because they have consistently proven to be effective. The arrival of GnRH antagonists, such as degarelix and relugolix, has introduced an alternative to agonists while offering distinct advantages. Antagonists achieve the rapid suppression of testosterone without the initial flare effect observed with agonists. Relugolix, an oral antagonist, has been reported to result in the rapid recovery of normal testosterone levels after treatment discontinuation and may be associated with a potentially lower cardiovascular (CV) risk than agonists. Moreover, antagonists provide an additional therapeutic option that enables an individualised treatment approach, aligning with the growing emphasis on personalised medicine. However, evidence regarding the superiority of antagonists over agonists in terms of clinical outcomes or side effects remains limited and, in some cases, contradictory. The effectiveness of antagonists, particularly in sustaining long-term testosterone suppression, and their safety profile, especially in relation to CV risks, remain debated. Although early studies indicate potential advantages, current clinical evidence is still evolving and requires further validation. This narrative review of the literature aims to provide a comprehensive update on the role of antagonists in PCa management, highlighting their potential benefits and limitations while addressing existing controversies. Despite the apparent advantages of antagonists, long-term prospective studies must be conducted to confirm their efficacy and safety, particularly when combined with other therapies, and to define their role across different disease stages.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 6","pages":"642-652"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800692","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":"Improvement of Urinary Incontinence after Radical Prostatectomy with Electroacupuncture Combined with Supervised Pelvic Floor Muscle Exercises: A Retrospective Study.","authors":"Yingjia Wu, Yuping Yang, Yingli Guo, Yingdan Kang","doi":"10.56434/j.arch.esp.urol.20257806.100","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257806.100","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the efficacy of electroacupuncture (EA) combined with supervised pelvic floor muscle training (PFMT) in improving post-radical prostatectomy urinary incontinence (PRPUI).</p><p><strong>Methods: </strong>The clinical data and treatment methods of patients with PRPUI admitted to the Third Affiliated Hospital of Zhejiang Chinese Medicine University from January 2023 to December 2023 were retrospectively collected, and they were divided into the PFMT group and PFMT + EA group according to the postoperative treatment methods. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) and Incontinence Quality of Life Questionnaire (I-QOL) of patients before treatment (T0), 6 weeks of treatment (T1) and 12 weeks of treatment (T2) were collected and compared. Pelvic floor electromyography assessment values (maximum systolic electromyography (EMG) value, mean EMG value during isometric contraction and mean EMG value during endurance contraction) in patients at T0 and T2 were collected and compared.</p><p><strong>Results: </strong>A total of 226 patients with PRPUI were included in the study: PFMT group (n = 112) and PFMT + EA group (n = 114). The results from repeated measures Analysis of Variance (ANOVA) indicated a significant interaction between time and group for ICIQ-UI-SF and I-QOL (<i>p</i> < 0.001), as well as a significant main effect for time and group (<i>p</i> < 0.001). The ICIQ-UI-SF in the PFMT + EA group was lower than that in the PFMT group at T1 and T2, but the I-QOL was higher in the PFMT + EA group than in the PFMT group, and there was a significant difference between the two groups (<i>p</i> < 0.001). At the T2 time point, the maximum systolic EMG value, mean isometric contraction EMG value and mean endurance contraction EMG value in the PFMT + EA group were significantly higher than those in the PFMT group (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>EA combined with supervised PFMT can be used as an effective non-surgical treatment for the treatment of PRPUI.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 6","pages":"751-757"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800694","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}