Archivos Espanoles De Urologia最新文献

{"title":"Association of Perioperative Full-Course Nursing Management With Renal Function and Urinary Tract Infections in Patients With Complex Urinary Tract Stones Undergoing Percutaneous Nephrolithotomy.","authors":"Junyan Yu, Ping Hong, Lihua Pan, Jian Wang","doi":"10.56434/j.arch.esp.urol.aeu036","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu036","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association of perioperative full-course nursing management with renal function and the incidence of urinary tract infections in patients with complex urinary tract stones undergoing percutaneous nephrolithotomy (PCNL).</p><p><strong>Methods: </strong>This retrospective cohort study included 200 patients with complex urinary tract stones who received PCNL treatment at The Second People's Hospital of Chun'an County between January 2023 and January 2026. Participants were divided into a control group (100 cases) and a full-course nursing group (100 cases) based on different nursing methods. After 1:1 propensity score matching, 85 patients were retained in each group. The control group received routine perioperative nursing, whereas the full-course nursing group received full-course nursing management based on routine care, including preoperative risk assessment and health education, infection prevention, intraoperative collaborative nursing, postoperative management (drainage tube management, pain management, and early rehabilitation training), and post-discharge follow-up. Preoperative and postoperative renal function indicators [serum creatinine (Scr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR)], inflammatory markers [C-reactive protein (CRP), procalcitonin (PCT)], incidence of urinary tract infections, postoperative complication rates, length of hospital stay, and nursing satisfaction were compared between the two groups.</p><p><strong>Results: </strong>On postoperative day 7, compared with the control group, the full-course nursing group showed significantly lower levels of Scr (87.35 ± 8.99 vs. 95.16 ± 9.89 μmol/L, <i>p</i> < 0.001), BUN (6.57 ± 0.79 vs. 7.25 ± 1.18 mmol/L, <i>p</i> < 0.001), CRP (10.13 ± 2.13 vs. 12.98 ± 2.72 mg/L, <i>p</i> < 0.001), and PCT (0.35 ± 0.08 vs. 0.39 ± 0.07, <i>p</i> < 0.001), significantly higher levels of eGFR (84.87 ± 6.17 vs. 81.01 ± 7.57 mL·min^-1·1.73m^-2, <i>p</i> < 0.001), and significantly shorter hospital stay (8.36 ± 1.18 vs. 10.08 ± 2.13 d, <i>p</i> < 0.001). The overall complication rate was significantly lower (3.5% vs. 20.0%, <i>p</i> < 0.001), as was the urinary tract infection rate (2.4% vs. 16.5%, <i>p</i> = 0.002). Nursing satisfaction was significantly higher (89.4% vs. 75.3%, <i>p</i> = 0.016).</p><p><strong>Conclusions: </strong>Perioperative comprehensive nursing management was associated with better postoperative renal function, lower incidences of urinary tract infection and related complications, and shorter hospital stay in patients with complex urinary tract stones undergoing PCNL, suggesting potential clinical value.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 8","pages":"1429-1439"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185180","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":"Association Between Hemoglobin Glycation Index and Kidney Stone Risk in Non-Diabetic Individuals: The Mediating Effect of Alkaline Phosphatase.","authors":"Nan Wang, Kaihua Zhao, Lei Cui","doi":"10.56434/j.arch.esp.urol.aeu030","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu030","url":null,"abstract":"<p><strong>Objective: </strong>Diabetes and alkaline phosphatase (ALP) may be associated with kidney stone risk. This investigation aimed to assess the relationship between hemoglobin glycation index (HGI) and kidney stone risk in non-diabetic individuals, and evaluate the role of ALP within this association.</p><p><strong>Materials and methods: </strong>Non-diabetic individuals aged 20 and above from the National Health and Nutrition Examination Survey (NHANES) (2007-2020) were incorporated into this cross-sectional study. HGI and ALP values were each stratified into tertiles. The association of HGI and ALP with kidney stone risk was investigated using a logistic regression model. Mediation analysis was performed to examine whether ALP acts as a potential mediator linking HGI to kidney stone risk.</p><p><strong>Results: </strong>The analysis cohort comprised 12,103 non-diabetic individuals, of whom 985 (weighted percentage: 8.53%) had kidney stones, and 11,118 (weighted percentage: 91.47%) did not. HGI values ≥0.092 (vs. <0.092) [odds ratio (OR) = 1.22 (95% confidence interval (CI): 1.01-1.46)] and ALP levels ≥73 U/L (vs. <73) [OR = 1.22 (95% CI: 1.01-1.46)] were associated with a higher kidney stone risk. In the mediation analysis, the β value was 0.0153 (95% CI: 0.0056-0.0262) for the average direct effect (ADE) and 0.0007 (95% CI: 0.0002-0.0013) for the average causal mediation effect (ACME). ALP mediated 4.56% (95% CI: 1.07%-16.6%) (<i>p</i> < 0.001) of the total association between HGI and kidney stone risk.</p><p><strong>Conclusions: </strong>Higher HGI levels were associated with an elevated kidney stone risk in non-diabetic individuals, and ALP partially mediated this association.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 8","pages":"1395-1405"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185198","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":"Real-World Comparative Effectiveness of Lobaplatin Versus Epirubicin and Gemcitabine for Post-TURBT Intravesical Therapy in Non-Muscle-Invasive Bladder Cancer.","authors":"Sujun Han, Xu Li, Limin Ma, Zhiquan Hu, Zhankui Jia, Minhong Wu, Nianzeng Xing","doi":"10.56434/j.arch.esp.urol.aeu037","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu037","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness and safety of lobaplatin versus epirubicin or gemcitabine for intravesical instillation in post-therapy following transurethral resection of bladder tumour (TURBT) non-muscle-invasive bladder cancer (NMIBC) patients in the absence of randomized evidence.</p><p><strong>Methods: </strong>This retrospective study analysed clinical data from 522 NMIBC patients who received postoperative intravesical therapy with lobaplatin (n = 121), epirubicin (n = 128), or gemcitabine (n = 273) at tertiary hospitals in China between 2019 to 2022. Key tumour-specific factors, including T stage (Ta, T1), tumour grade, were collected from medical records. Given the non-randomized nature of real-world data, propensity score matching (PSM) was applied to reduce baseline imbalance. For the lobaplatin vs. epirubicin comparison, PSM included age, sex, smoking history, tumour location, surgical history, surgical method, and need for secondary resection. For the lobaplatin vs. gemcitabine comparison, PSM included sex, tumour location, surgical method, and requirement for re-resection. The study compared 1-year and two-year recurrence-free survival (RFS), progression to muscle-invasive bladder cancer (MIBC), and treatment related dose adjustments.</p><p><strong>Results: </strong>After PSM, 79 patients were in each of the lobaplatin and epirubicin groups, and 119 patients were in each of the lobaplatin and gemcitabine groups. Lobaplatin and epirubicin showed comparable 1-year (100% vs. 98.73%, <i>p</i> = 0.32) and 2-year RFS rates (98.67% vs. 97.45%, <i>p</i> = 0.57). In the lobaplatin versus gemcitabine comparison, the 1-year RFS rates were 97.48% and 90.69%, respectively (<i>p</i> = 0.026), and the 2-year RFS rates were 95.75% and 88.98%, respectively (<i>p</i> = 0.047). Dose adjustments were less frequent with lobaplatin than with epirubicin (31.65% vs. 51.90%, <i>p</i> = 0.010) and comparable between lobaplatin and gemcitabine (24.37% vs. 24.37%, <i>p</i> > 0.999).</p><p><strong>Conclusions: </strong>In this real-world retrospective cohort, lobaplatin instillation showed comparable effectiveness to epirubicin and differences in outcomes compared with gemcitabine in post-TURBT NMIBC, with fewer dose adjustments compared to epirubicin.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 8","pages":"1440-1449"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185368","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":"Reducing Radiation Exposure in Endourology: Practical Recommendations for the Urologist.","authors":"Daniel Campos-Valverde, Gonzalo Bueno-Serrano, Francisco Donis Canet, Paz Castro Fernández, Mercedes Sanchez-Pedreno Jiménez, Miguel Francisco Téllez Martínez-Fornés","doi":"10.56434/j.arch.esp.urol.aeu034","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu034","url":null,"abstract":"<p><p>Radiation exposure remains an unavoidable part of modern stone management. Patients with urolithiasis may receive ionising radiation during diagnosis, surgical treatment and follow-up, particularly when computed tomography, plain radiography and intraoperative fluoroscopy are repeatedly used. In parallel, urologists and operating room staff are exposed to scattered radiation during endourological procedures, especially in complex or prolonged cases. Although the individual risk of radiation-induced malignancy in this setting is difficult to quantify and should not be overstated, cumulative exposure should be actively reduced whenever this can be achieved without compromising safety or surgical efficacy. This narrative review provides practical recommendations for reducing radiation exposure in endourology, with a focus on ureteroscopy, retrograde intrarenal surgery, percutaneous nephrolithotomy and endoscopic combined intrarenal surgery. It is based on current European Association of Urology guidance on urolithiasis and radiation protection in endourology, together with the relevant clinical literature on fluoroscopy use, occupational exposure, low-dose protocols, ultrasound-guided access and fluoroscopy-sparing techniques. The core principles include appropriate justification for imaging, adherence to the as low as reasonably achievable principle, minimisation of fluoroscopy time, maximisation of distance from the radiation source, adequate shielding, collimation, pulsed fluoroscopy, low-dose settings, avoidance of unnecessary magnification and systematic use of last-image hold. Radiation reduction in endourology should be viewed as part of good surgical technique rather than as an administrative requirement. Simple measures, consistently applied, can reduce exposure for both patients and staff. Ultrasound-guided and fluoroscopy-sparing approaches offer additional opportunities, particularly in percutaneous stone surgery, but require training, case selection and awareness of their limitations. A structured radiation safety culture, led by the urologist and shared by the whole operating room team, is essential for safer and more sustainable endourological practice.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 8","pages":"1269-1283"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185385","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":"Influencing Factors of Urinary Continence Recovery and Construction of a Nomogram Prediction Model After Radical Prostatectomy.","authors":"Kang Qian, Wenwen Lu, Guolin Wu, Jialin Gu","doi":"10.56434/j.arch.esp.urol.aeu038","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu038","url":null,"abstract":"<p><strong>Background: </strong>Screening clinical factors related to poor urinary control 3 months after radical prostatectomy and constructing a risk prediction model for early postoperative urinary control dysfunction.</p><p><strong>Methods: </strong>Retrospective inclusion of clinical data from 300 patients undergoing radical prostatectomy, divided into a modeling cohort (n = 210) and a randomized split internal validation cohort (n = 90) in a 7:3 ratio. Extract preoperative demographic, oncology, imaging, and rehabilitation related variables; Using Least Absolute Shrinkage and Selection Operator Regression (LASSO) to screen for factors related to early postoperative urinary control in prostate cancer patients undergoing radical prostatectomy, the statistically significant variables selected by LASSO were included in a multivariate logistic regression analysis to further explore the independent influencing factors of early postoperative urinary control. A nomogram was built, and its discrimination, calibration and clinical net benefit were evaluated via receiver operating characteristic (ROC) analysis, 1000-bootstrap calibration curves and decision curve analysis (DCA), followed by internal validation.</p><p><strong>Results: </strong>Preoperative baselines were comparable between cohorts (<i>p</i> > 0.05). Univariate analysis shows that there are eight variables with differences. LASSO regression screening yielded five variables: age, body mass index (BMI), previous transurethral resection of the prostate (TURP), prostate volume, and regular pelvic floor muscle training. Multivariate logistic regression analysis showed that older age, higher BMI, history of TURP, and larger prostate volume were all associated with a higher risk of urinary incontinence; There is a correlation between regular pelvic floor muscle training and a reduced risk of urinary incontinence (<i>p</i> < 0.05). The nomogram achieved good discrimination in the modeling set [area under the curve (AUC) = 0.849, 95% confidence interval (CI) 0.7904-0.9076], with bootstrap calibration showing consistent predicted and actual risks. DCA confirmed superior net benefit over \"Treat all\" and \"Treat none\" within the 0-0.60 threshold range. Internal validation yielded an AUC of 0.750 (95% CI 0.633-0.868), with acceptable calibration and steady net benefit despite slightly lower discriminative ability.</p><p><strong>Conclusions: </strong>The postoperative early risk stratification nomogram constructed in this study has acceptable discrimination and calibration, and can only be used as a preliminary screening tool to evaluate the risk of poor urinary control recovery 3 months after radical prostatectomy. It can provide auxiliary reference for postoperative rehabilitation decision-making.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 8","pages":"1450-1463"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185363","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":"Diagnostic Value of Artificial Intelligence-Based Multiparametric MRI for Prostate Cancer in Patients With PSA Levels in the Gray Zone.","authors":"Bingqiang Mei, Liya Zhu, Yaojun Li, Xinsheng Mao, Guoqiu Dong","doi":"10.56434/j.arch.esp.urol.aeu027","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu027","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing prostate cancer in patients with prostate-specific antigen (PSA) levels in the gray zone (4-10 ng/mL) remains challenging. In recent years, artificial intelligence (AI) technology has been able to analyse the imaging features of multiparametric MRI (mpMRI). This study aimed to explore the diagnostic value of AI-based mpMRI technology for prostate cancer in patients with PSA levels in the gray zone.</p><p><strong>Methods: </strong>This retrospective study included 213 patients aged 45-85 years who underwent prostate mpMRI between May 2020 and May 2025. A deep learning AI system was used to analyse the mpMRI images to obtain parameters of the primary prostate lesion. Using pathological results as the gold standard, the diagnostic value of mpMRI parameters in prostate cancer was analysed.</p><p><strong>Results: </strong>Among the 213 patients, 72 had prostate cancer (clinically significant prostate group) and 141 did not (non clinically significant prostate group). The mean age was (72.7 ± 7.4) years, and the mean body mass index was (25.7 ± 3.9) kg/m². Compared with the non-clinically significant prostate cancer (non-csPCa) group, the clinically significant prostate cancer group had significantly lower ellipsoid volume and segmented prostate volume (<i>p</i> < 0.05). Pearson analysis showed negative correlation between PSA level and segmented prostate volume in all patients with prostate cancer (r = -0.449, <i>p</i> < 0.01). PSA level, apparent diffusion coefficient (ADC), maximum lesion diameter, peripheral-zone signal intensity, and the prostate-specific antigen density (PSAD) derived from mpMRI exhibited strong predictive value for prostate cancer (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>The AI-based mpMRI can enhance diagnostic value for clinically significant prostate cancer and provide valuable insights into tumour invasiveness, potentially guiding more informed clinical decisions and reducing unnecessary biopsies.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 8","pages":"1363-1372"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185219","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":"Clinical Characteristics and Treatment Outcomes of <i>Brucella</i> Epididymo-Orchitis in an Endemic Region.","authors":"Abuzer Öztürk, Caner Öksüz, Murtaza Öz","doi":"10.56434/j.arch.esp.urol.aeu022","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu022","url":null,"abstract":"<p><strong>Objective: </strong>The most common genitourinary complication of brucellosis is <i>Brucella</i> epididymo-orchitis (BEO), which, if not promptly diagnosed and treated, may lead to severe testicular complications. The present study aimed to evaluate the frequency, clinical characteristics, laboratory findings, and treatment outcomes of BEO in an endemic region.</p><p><strong>Methods: </strong>This retrospective cohort study included male patients diagnosed with brucellosis between August 2017 and October 2022 at a tertiary referral center. We identified patients with BEO based on clinical, laboratory, and ultrasonographic findings and analyzed the demographic characteristics, clinical presentation, laboratory parameters, microbiological findings, treatment regimens, and follow-up outcomes.</p><p><strong>Results: </strong>Among 278 male patients with brucellosis, 16 patients (5.75%) were diagnosed with BEO. The median age was 42 (32-55) years. All patients had scrotal pain and scrotal swelling. The most predominant clinical form was acute brucellosis (68.75%). Bilateral testicular involvement was observed in one patient (6.25%). <i>Brucella</i> Coombs and Rose Bengal tests were positive in all patients, while blood culture positivity was detected in 37.50% of cases. Patients who had BEO had significantly higher white blood cell counts than those who did not have BEO (<i>p</i> = 0.038). All patients received combined antimicrobial therapy. Relapse occurred in five patients (31.25%), all of whom responded favorably to modified antibiotic regimens. No patient required orchiectomy or developed severe complications during the follow-up period.</p><p><strong>Conclusions: </strong>BEO remains a significant complication of brucellosis in endemic regions and should be taken into account in the differential diagnosis of epididymo-orchitis (EO). Early diagnosis and prompt combined antimicrobial therapy appear highly effective in preventing severe complications and unnecessary surgical intervention.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 8","pages":"1302-1310"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185228","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":"Single-Cell-Informed Characterization of A Candidate <i>S100A9</i>-Associated Epithelial Program and Prognostic Signature in Bladder Cancer.","authors":"Gang Li, Jingmin Cui, Xiufang Feng, Wenhan Li, Tao Li, Peilin Chen","doi":"10.56434/j.arch.esp.urol.aeu029","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu029","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer exhibits substantial molecular heterogeneity, and adverse epithelial programs remain incompletely characterized at single-cell resolution. This study aimed to identify candidate epithelial programs and derive genes supporting prognostic modeling.</p><p><strong>Methods: </strong>Single-cell RNA sequencing data were analyzed to annotate epithelial subtypes and infer malignant populations. Bulk transcriptomic cohorts were used for Cox regression, risk-model construction, pathway analysis, immune characterization, and cell-cell communication inference. <i>Stearoyl-CoA desaturase</i> (<i>SCD</i>) was experimentally assessed in bladder cancer cells.</p><p><strong>Results: </strong>We identified 14 epithelial subtypes with cell-level differences across pathological T stages. C05 Epithelial-<i>S100A9</i> showed basal-like features, proliferative signaling, and adverse program-level survival associations. GSE130001 showed broad C05-signature activity but no discrete C05-like subpopulation. From this program, we derived a four-gene signature comprising epoxide <i>EPHX1</i>, <i>SCD</i>, <i>LDLR</i>, and <i>TSPAN8</i>. High-risk tumors were enriched for epithelial-mesenchymal transition, collagen-associated pathways, immune-checkpoint expression, and fibroblast-related signaling. <i>SCD</i> knockdown reduced proliferation and migration.</p><p><strong>Conclusions: </strong>This study characterizes a candidate <i>S100A9</i>-associated epithelial program and a single-cell-informed prognostic framework linked to stromal and immune features. These findings suggest potential prognostic relevance, but independent single-cell analyses, mechanistic studies, and prospective validation remain required.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 8","pages":"1381-1394"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185334","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 Value of Inflammatory Markers Combined With Urinary Biomarkers for 28-Day Outcomes in Patients With Urosepsis: A Retrospective Study.","authors":"Jun Mao, Chao Chen, Jiao He, Lindong Zhou, Junhua Ding, Ting Wang, Xiaoyu Yuan, Yan Shen","doi":"10.56434/j.arch.esp.urol.aeu026","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu026","url":null,"abstract":"<p><strong>Background: </strong>Urosepsis is a life-threatening complication of urinary tract infection (UTI) associated with high mortality. Early identification of patients at high risk of poor outcomes remains challenging due to the limited predictive value of single biomarker.</p><p><strong>Methods: </strong>We retrospectively analysed 148 patients with urosepsis admitted to Tianjin Medical University General Hospital between October 2022 and October 2025. Baseline clinical characteristics, laboratory markers (high-sensitivity C-reactive protein [hsCRP], procalcitonin [PCT], serum creatinine [Scr], β2-microglobulin [β2-MG], and urinary orosomucoid-to-creatinine ratio [u-ORM/u-CREAT]) and 28-day outcomes were collected. Patients were classified into favourable prognosis (n = 102) and poor prognosis (n = 46) groups. Between-group differences were analysed using appropriate parametric, nonparametric, or categorical tests. Prognostic factors were evaluated by univariate and multivariable logistic regression, and predictive performance was assessed by receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>The levels of hsCRP, PCT, Scr, β2-MG, and u-ORM/u-CREAT were significantly higher in the poor prognosis group than in the favourable prognosis group (all <i>p</i> < 0.001). Multivariable analysis identified hsCRP >85.3 mg/L, PCT >5.7 ng/mL, Scr >132 μmol/L, and u-ORM/u-CREAT >18.5 mg/mmol as independent predictors of poor prognosis (all <i>p</i> < 0.05). A combined model of hsCRP, PCT, Scr, and u-ORM/u-CREAT achieved the highest predictive performance, with an area under the ROC curve of 0.923, a sensitivity of 86.9% and a specificity of 84.3%, and outperformed individual marker (all <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Combined assessment of hsCRP, PCT, Scr, and u-ORM/u-CREAT showed high predictive value for poor 28-day clinical outcomes in urosepsis and may support early risk stratification.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 8","pages":"1355-1362"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185347","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":"Ultrasound-Based Prediction of Skin-to-Renal Pelvis Distance for Percutaneous Renal Access.","authors":"Merkourios Kolvatzis, Efstathios Papaefstathiou, Evangelos N Symeonidis, Christos D Karkos, Georgios Tsoulfas, Konstantinos Hatzimouratidis, Kyriakos Moysidis","doi":"10.56434/j.arch.esp.urol.aeu023","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu023","url":null,"abstract":"<p><strong>Background: </strong>Studies examining anatomical changes in the prone position during endourological procedures lack predictive formulas for estimating the renal pelvis-to-skin distance (KSD). Furthermore, existing equations for renal depth-an important parameter for accurate glomerular filtration rate (GFR) assessment-are based on supine measurements. This study aimed to develop predictive formulas for estimating renal depth in the prone position for patients undergoing percutaneous renal access.</p><p><strong>Methods: </strong>A total of 86 healthy volunteers (46 men, 40 women) were enrolled in a prospective study conducted at the 2nd Department of Urology, Papageorgiou General Hospital between June and September 2020. Participants completed a questionnaire on medical history, demographic, and somatometric characteristics. Renal KSD was measured ultrasonographically in the prone position using a convex probe placed parallel and 1 cm below the 12th rib, with the posterior axillary line as a landmark. The biopsy line targeted the midpoint of the renal pelvis. Distances were analyzed in relation to clinical and anthropometric variables, and predictive equations were generated for each kidney.</p><p><strong>Results: </strong>The following equations were derived: left kidney: distance = 1.5 + 0.272 × body mass index (BMI) - 0.452 × gender; right kidney: distance = 1.619 + 0.259 × BMI - 0.457 × gender (BMI: gender coded as 0 = male, 1 = female). Mean renal depth was 7.81 cm for the right kidney and 8.23 ± 1.47 cm for the left. Distances were significantly greater in men (<i>p</i> = 0.004 right; <i>p</i> = 0.005 left). A strong positive correlation was observed between right and left kidney depths (r = 0.859, <i>p</i> < 0.001), as well as with body weight and waist circumference. In men, greater right kidney depth was associated with hypertension, low high-density lipoprotein (HDL), and metabolic syndrome (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>These formulas provide a simple and reliable method for estimating renal depth in the prone position, potentially improving procedural accuracy and patient safety during percutaneous renal access.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 8","pages":"1284-1290"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185401","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}