Archivos Espanoles De Urologia最新文献

{"title":"Counter-Irrigation as a Novel Technique in Mini-PCNL: Results from a Prospective Clinical Trial.","authors":"Ahmad El-Sakka, Mostafa El-Gendy, Abdelnaser El-Gamasy, Abdelhamid El-Bahnasy, Mohammed Lotfi Amer","doi":"10.56434/j.arch.esp.urol.20257801.2","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257801.2","url":null,"abstract":"<p><strong>Objective: </strong>To assess the stone-free rate (SFR) and safety of our new modified technique of mini-percutaneous nephrolithotomy (mini-PCNL) using counter-irrigation through a separate upper pole access.</p><p><strong>Methods: </strong>The medical data of 40 patients with kidney stones (<30 mm) and a dilated upper calyx treated with our novel modification of mini-PCNL between August 2020 and October 2021 were prospectively collected and analysed. Stone-free status of the patients was evaluated at 3 days and 1 month post-operatively via abdominal and pelvic non-contrast computed tomography (NCCT).</p><p><strong>Results: </strong>The mean stone size was 24.68 ± 2.86 mm, and the mean stone density was 931.38 ± 308.92 hounsfield unit (HU). The mean total operative time was 78.8 ± 13.62 min, while the mean time required for placing the upper calyceal nephrostomy tube was 3.76 ± 1.25 min. Immediate overall SFR was 90%, which reached 95% at the 1-month follow-up. The overall complication rate was 10% (four patients), including fever (38 °C) that required antipyretics in two (5%), fever (38 °C) that necessitated hydration and IV antibiotics in one (2.5%), and persistent mild haematuria that improved with coagulants and excess fluid intake in one (2.5%).</p><p><strong>Conclusions: </strong>Counter-irrigation in mini-PCNL for a renal pelvic stone with a dilated upper calyx is an encouragingly safe and effective option. This novel technique provides a potentially high SFR and acceptable safety profile via enhanced intra-operative visualisation, decreased stone migration, and better washout of stone fragments.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 1","pages":"10-17"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410703","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":"Letter to the Editor Re: Impact of Cost-Benefit Analysis on the Selection of Therapeutic Drugs for Patients with Overactive Bladder.","authors":"Xiuyan Tan, Ying Wang, Shuzhen Cai, Chunquan Song","doi":"10.56434/j.arch.esp.urol.20257801.15","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257801.15","url":null,"abstract":"","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 1","pages":"113-114"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411062","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":"Utilisation of Peplau's Interpersonal Relationship Theory in Nursing Enhances the Recovery Outcomes of Patients with Renal Cancer Undergoing Laparoscopic Radical Nephrectomy.","authors":"Xiaoting Sun, Chunlei Zhang, Ying Hu","doi":"10.56434/j.arch.esp.urol.20257801.10","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257801.10","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing laparoscopic radical nephrectomy (LRN) for renal cancer face multifaceted challenges that can affect their physical, psychological, and emotional well-being. This study aimed to evaluate the impact of nursing based on Peplau's theory on the recovery outcomes of patients treated with LRN for renal cancer, focusing on their nutritional status, spiritual well-being, and quality of life (QOL) after the surgical procedure.</p><p><strong>Methods: </strong>A total of 148 patients with renal cancer who underwent LRN at our hospital between January 2023 and January 2024 were initially selected and grouped according to the type of postoperative nursing approach. Among the 75 patients receiving routine nursing, three with thrombosis of the renal vein or inferior vena cava and two with multiple renal tumours were excluded. Ultimately, 70 patients were included in the control group. Along with the routine nursing interventions, 73 patients received nursing care based on Peplau's interpersonal relationship theory. A total of 70 patients were categorised in the Peplau nursing group after excluding two with multiple renal tumours and one with a history of laparoscopic partial nephrectomy (LPN). Data on demographic characteristics, disease features, nutritional indices, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp) scores, and QOL scores were collected and analysed using statistical tests.</p><p><strong>Results: </strong>The haemoglobin (<i>p</i> < 0.001), albumin (<i>p</i> = 0.002), prealbumin (<i>p</i> = 0.013), and transferrin levels (<i>p</i> < 0.001) after nursing in the Peplau nursing group showed a significant increase compared to those in the control group. Moreover, the Peplau nursing group demonstrated significantly higher FACIT-Sp (<i>p</i> < 0.001) and QOL scores (<i>p</i> < 0.001) after nursing than the control group.</p><p><strong>Conclusions: </strong>Nursing grounded in Peplau's interpersonal relationship theory may have a beneficial effect on the nutritional status, spiritual well-being, and QOL of patients undergoing LRN for renal cancer.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 1","pages":"77-83"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411251","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":"Predictive Nomographic Model for Tumour Recurrence in Children with Wilms' Tumour.","authors":"Xinxin Wang, Jie Luan, Yanyan Yuan, Lu Gao","doi":"10.56434/j.arch.esp.urol.20257801.5","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257801.5","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to retrospectively analyse factors affecting recurrence in children with Wilms' tumour (WT) and establish a nomographic model for predicting WT recurrence 12 months after operation.</p><p><strong>Methods: </strong>Children with Wilms' tumour admitted to our hospital from January 2020 to January 2022 were retrospectively analysed. According to the recurrence of children recorded in the medical record system, they were divided into case group and control group. General demographic data and disease characteristics were collected, and multivariate logistics regression analysis was used to evaluate recurrence factor 12 months after operation. A nomogram model was constructed to predict the recurrence factors of WT, and an ROC (receiver operating characteristic) curve was drawn to verify the predictive efficacy of the nomogram model. Calibration and decision curves were constructed.</p><p><strong>Results: </strong>A total of 119 children with WT were selected and divided into case group (25 children with recurrence) and control group (94 children without recurrence). Multivariate logistic regression analysis showed that clinical stage, histological risk group, Ki-67, tumour volume, capsule rupture and incomplete resection were all risk factors for the recurrence of WT (odds ratio (OR) >1, <i>p</i> < 0.05). The R package rms was used to draw a nomogram for the risk of recurrence. The C-index of clinical stage, histological risk group, Ki-67, tumour volume, capsule rupture and incomplete resection was 0.885 (95% CI: 0.810-0.956). The accuracy of the nomogram model in predicting the risk of recurrence was verified. The ROC curve showed that the Area Under Curve (AUC) value of the model was 0.911 (95% CI: 0.854-0.969; <i>p</i> < 0.05). The calibration and reference curves of the risk prediction model were similar, which proved the high consistency between the predicted risk and the actual risk of the recurrence of WT. The net benefit rate of the prediction model in the threshold range was high.</p><p><strong>Conclusions: </strong>Clinical stage, histological risk group, Ki-67, tumour volume, capsule rupture and incomplete resection were risk factors for the recurrence of WT. A predictive nomogram model was constructed using these factors to screen children with WT with a high risk of recurrence for early intervention.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 1","pages":"37-45"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411176","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":"Prevalence and Determinants of Stress Urinary Incontinence in Middle-Aged and Older Women: A Systematic Review and Meta-Analysis.","authors":"Chuhan Wang, Wei Wei, Danli Ma, Huimin Yu, Lingzhi Yu","doi":"10.56434/j.arch.esp.urol.20257801.6","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20257801.6","url":null,"abstract":"<p><strong>Background: </strong>Stress urinary incontinence (SUI) is a prevalent chronic condition that significantly impacts the quality of life in middle-aged and older women. However, controversy persists regarding the factors influencing SUI in this population. This study aimed to investigate the prevalence and determinants of SUI in middle-aged and older women through a meta-analysis.</p><p><strong>Methods: </strong>Cross-sectional, case-control, and cohort studies related to the prevalence and determinants of SUI in women aged ≥40 years were meticulously retrieved from databases such as Public Medical Database (PubMed), Web of Science, Excerpta Medica Database (Embase), Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and Viper Information Products (VIP), covering data until March 31, 2024. Two researchers independently conducted literature screening, data extraction, and quality assessment. Meta-analysis was conducted utilising Review Manager (RevMan) 5.3 software.</p><p><strong>Results: </strong>Thirteen studies with a total sample size of 19,283 were included. The meta-analysis indicated that the prevalence of SUI among middle-aged and older women was 27%. Identified risk factors for SUI included age ≥50 years, body mass index (BMI) ≥24 kg/m², low educational attainment, history of pelvic organ prolapse, previous pelvic surgery, constipation, urinary tract infections, hypertension, vaginal delivery, parity ≥2, and menopause.</p><p><strong>Conclusions: </strong>SUI is prevalent among middle-aged and older women, affecting over a quarter of this population. Recognising the risk factors associated with SUI is crucial for strengthening the assessment, intervention, and overall quality of life in these women.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"78 1","pages":"46-55"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411230","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 Neurotrophin Levels as Potential Biomarkers for Overactive Bladder: A Prospective Study.","authors":"Ozgur Ekici, Murat Gunay, Abdullah Gul, Ozlem Admıs, Ali Seydi Bozkurt, Ercument Keskin","doi":"10.56434/j.arch.esp.urol.20247709.138","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20247709.138","url":null,"abstract":"<p><strong>Background: </strong>Overactive bladder (OAB) is an issue in the field of urology that is known for causing symptoms like urges to urinate frequently during the day and even at night (known as nocturia). Nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) play a vital role in the growth and operation of nerve cells in the body. New studies are indicating a connection between these neurotrophins and OAB; As such this research project was undertaken to explore how levels of NGT and BDNF in urine might be related to the presence of OAB in individuals.</p><p><strong>Methods: </strong>This investigation employed a case-control design, enrolling 44 individuals with a confirmed diagnosis of OAB and an equal number of healthy participants as the control group. Urine samples were collected from all participants, and levels of NGF and BDNF were quantified. To account for fluctuations in urine concentration, NGF/creatinine (Cr) and BDNF/Cr ratios were also determined.</p><p><strong>Results: </strong>Our research findings revealed that individuals experiencing bladder (OAB) showed increased urinary NGF levels (statistically significant, at <i>p</i> < 0.001). This disparity remained consistent after adjusting for creatinine levels; There were higher NGF/Cr (statistically significant, at <i>p</i> = 0.001) and BDNF/Cr (statistically significant, at <i>p</i> < 0.001) ratios in the OAB group compared to the control group. Additionally we noted a relationship between urine NGF/Cr levels and the presence of OAB (statistically significant, at <i>p</i> < 0.001; Correlation coefficient: +0.686). Urine BDNF/Cr levels showed a correlation with OAB (correlation coefficient of +0.461; <i>p</i> value < 0.001). In OAB prediction, the NGF/Cr cutoff value was found to be 0.87, the NGF cutoff value was 180.02 pg/mL, and the BDNF/Cr ratio was 0.19.</p><p><strong>Conclusions: </strong>Elevated urinary NGF and BDNF levels are associated with OAB, suggesting a potential role for these neurotrophic factors in the pathogenesis of the condition. Further research is warranted to explore their potential as diagnostic or prognostic biomarkers and to elucidate the underlying molecular mechanisms.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"77 9","pages":"971-977"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781646","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":"Deep Learning for the Study of Urinary Stone Composition from Computed Tomography Images.","authors":"Yuanchao Cao, Hang Yuan, Yang Guo, Bin Li, Xinning Wang, Xinsheng Wang, Yanjiang Li, Wei Jiao","doi":"10.56434/j.arch.esp.urol.20247709.144","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20247709.144","url":null,"abstract":"<p><strong>Objectives: </strong>Urinary stones composed of uric acid can be treated with medicine. Computed tomography (CT) can diagnose urinary stone disease, but it is difficult to predict the type of uric stones. This study aims to develop a method to distinguish pure uric acid (UA) stones from non-uric acid (non-UA) stones by describing quantitative CT parameters of single-energy slices of urinary stones related to chemical stone types.</p><p><strong>Methods: </strong>Clinical data, CT images, and stone composition analysis results of patients with urinary stones clinically diagnosed at The Department of Urology, Affiliated Hospital of Qingdao University between 1 January 2018 and 31 December 2020 were collected and retrospectively analyzed. The above data were preprocessed and fed into a convolutional neural network to perform deep learning (DL) of the model, and the dataset was validated at a ratio of 4:1. The area under the curve (AUC) value of the receiver operating characteristic (ROC) curve and the confusion matrix were utilized to evaluate the predictive effect of the model.</p><p><strong>Results: </strong>A retrospective analysis of 918 non-enhanced thin-slice single-energy CT images of known chemical stone types (124 with UA stones and 794 with non-UA stones) was conducted using a DL model. Compared with the results of <i>ex vivo</i> analysis by infrared spectroscopy, the prediction model obtained an AUC of 0.83 for the dichotomous classification of UA stones and non-UA stones. The accuracy of the model was 97.01%, with an F1 score of 89.04%, sensitivity of 84.62%, and specificity of 82.28%.</p><p><strong>Conclusions: </strong>This DL model constructed based on convolutional neural network analysis of thin-slice single-energy CT images is highly accurate in predicting the composition of pure UA and non-UA stones, providing a simple and rapid diagnosis method.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"77 9","pages":"1017-1025"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781487","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":"Necrosis-Related lncRNAs: Biomarker Screening and Prognostic Prediction for Hot and Cold Tumours of Prostate Cancer.","authors":"Kai Li, Kaiyu Lu, Fei Wang, Chunchun Zhao, Hua Shen, Caibin Fan","doi":"10.56434/j.arch.esp.urol.20247709.151","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20247709.151","url":null,"abstract":"<p><strong>Background: </strong>The objectives of this work were the search for novel prognostic biomarkers for the diagnosis of prostate cancer (PCa) and the improvement of therapy outcomes in cases with a poor prognosis and the failure of immunotherapy.</p><p><strong>Methods: </strong>The GTEx (Genotypic Tissue Expression Project) and TCGA (The Cancer Genome Atlas) databases were used to find out the co-expressed long non-coding RNAs (lncRNAs) associated with necrosis status based on statistics and univariate Cox regression tests. IncRNA associated with necrosis was screened by least absolute shrinkage and selection operator (Lasso) analysis, and the predictive model was further verified by Kaplan-Meier analysis, Receiver Operating Characteristic (ROC) curve analysis, Cox regression, nomogram and calibration curve. Also, immune analysis, principle component analysis, gene set enrichment analysis and prediction of semi-maximum inhibitory concentration in risk groups were conducted.</p><p><strong>Results: </strong>The model successfully identified 16 necrosis-related lncRNA models, demonstrating good consistency among the calibration map and prognosis expectation. The ROC curve's area under the curve (AUC) for 1-year overall survival was 0.726, 0.763 and 0.770. The risk groups identified by the model could guide systematic treatment due to significant differences in semi-inhibitory concentrations. The study also demonstrated that the model could differentiate amongst hot and cold tumours and provide accurate mediation, with cluster 2 recognised as a hot tumour and likely to benefit from immunotherapy drugs.</p><p><strong>Conclusions: </strong>In conclusion, the given study supports the potential of necrosis-related lncRNAs as a biomarker for predicting the prognosis and personalised treatment for PCa.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"77 9","pages":"1078-1088"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781625","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 Outcomes and Renal Function Impact of Retrograde Intrarenal Surgery for Renal Stones: A Comparison of General Anaesthesia and Continuous Epidural Anaesthesia in a Retrospective Study.","authors":"Ying Chen, Li Yang, Yin Huang, Huaxin Lu","doi":"10.56434/j.arch.esp.urol.20247709.147","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20247709.147","url":null,"abstract":"<p><strong>Background: </strong>Choosing the appropriate anaesthesia for retrograde intrarenal surgery (RIRS) is crucial due to its potential impact on surgical outcomes, postoperative recovery, and renal function. This retrospective study aimed to compare surgical outcomes and renal function impacts between general anaesthesia and continuous epidural anaesthesia for RIRS.</p><p><strong>Methods: </strong>Clinical data from patients who underwent RIRS for renal stones at our hospital from January 2023 to December 2023 were retrospectively analysed. Patients were categorised into two groups: Those receiving general anaesthesia and those receiving continuous epidural anaesthesia. General patient information, surgical outcomes, renal function parameters, and postoperative pain scores were evaluated.</p><p><strong>Results: </strong>The study included 110 patients: 51 in the general anaesthesia group and 59 in the continuous epidural anaesthesia group. Operation duration and stone clearance rates were similar across both groups. However, the epidural group had a significantly shorter hospital stay (1.28 ± 0.39 days vs 1.73 ± 0.42 days) and required less analgesia (25.86 ± 5.26 mg vs 29.56 ± 5.63 mg) (<i>p</i> < 0.001). Although the epidural group had higher preoperative creatinine levels, these levels significantly decreased postoperatively (0.99 ± 0.12 mg/dL vs 1.07 ± 0.11 mg/dL, <i>p</i> < 0.001). Pain scores at 2 hours (3.95 ± 1.28 vs 3.18 ± 1.42, <i>p</i> = 0.004) and 24 hours (3.75 ± 1.67 vs 3.08 ± 1.45, <i>p</i> = 0.027) were lower in the epidural group.</p><p><strong>Conclusions: </strong>Continuous epidural anaesthesia may offer advantages over general anaesthesia for RIRS, including reduced hospital stays, lower analgesic requirements, potential renoprotection, and improved early postoperative pain management.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"77 9","pages":"1047-1053"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781644","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 Single Center Experience of Special Cases: Isolated Adrenal Myelolipoma and Adrenocortical Adenoma with Myelolipomatous Component.","authors":"Serhat Çetin, Kadir Şerefhan Erten, Metin Onaran, İlker Şen, Mustafa Özgür Tan, İpek Işık Gönül, Ethem Turgay Cerit, Tevfik Sinan Sözen","doi":"10.56434/j.arch.esp.urol.20247709.136","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20247709.136","url":null,"abstract":"<p><strong>Objective: </strong>Isolated adrenal myelolipoma (IAM) is an uncommon, nonfunctioning tumour of the adrenal gland, primarily composed of adipose tissue and hematopoietic trilinear cells. The etiopathogenesis and clinical relevance of this neoplasm remain poorly understood. However, similar myelolipomatous alterations can also occur within adrenocortical adenomas. This report presents our findings on IAM and adrenocortical adenomas with a myelolipomatous component (AMC), focusing on comparing these cases' clinical, demographic, and pathological characteristics.</p><p><strong>Methods: </strong>Data from twenty patients were retrospectively analyzed, including twelve diagnosed with IAM and eight with AMC, all of whom underwent adrenalectomy. In the IAM cohort, surgical intervention was primarily indicated based on tumour size and/or related symptoms, while in AMC cases, the indication was often driven by hormonal activity.</p><p><strong>Results: </strong>Patients with IAM had an average age of 52.5 years, with a predominance of female patients (75%). A significant proportion of this group was obese, with concomitant hypertension (HT) and/or type 2 diabetes mellitus (DM). The tumours were predominantly right-sided, with a median size of 69.0 ± 40.0 mm. Notably, 58% of patients with IAM presented with flank or abdominal pain attributed to the mass effect. None of the IAM cases exhibited hormonal activity. Conversely, the AMC group had a younger average age of 46 years, with a high prevalence also in female patients (63%). The tumours were generally smaller, with a median size of 40.0 ± 16.0 mm, and were mostly left-sided. All patients in this group had a history of HT and/or DM, with six exhibiting hormonally active tumours, which manifested as various clinical syndromes, including Cushing syndrome, pheochromocytoma, and Conn syndrome.</p><p><strong>Conclusions: </strong>While IAM and AMC share several common features, they also demonstrate distinct differences. The presence of endocrinological syndromes was more frequent in AMC cases, whereas IAM cases rarely showed hormonal activity. The most pronounced difference between the two groups was the tumour size at diagnosis, which contributed to the varying clinical presentations upon hospital admission. Furthermore, the high prevalence of obesity, HT, and DM in both groups suggests that these comorbidities may play a role in the development of myelolipomatous patterns observed in these tumours.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"77 9","pages":"955-964"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781250","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}