Archivos Espanoles De Urologia最新文献

{"title":"Risk Factors and Predictive Model for Peripherally Inserted Central Catheter Tip Migration in Patients With Bladder Cancer.","authors":"Keke Zheng, Xiaowan Cui, Yan Liu, Meichun Du, Guanghua Yang","doi":"10.56434/j.arch.esp.urol.20267902.42","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.42","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to construct a predictive model for assessing the risk of peripherally inserted central catheter (PICC) tip migration in patients with bladder cancer, facilitating early detection and tailored management of high-risk cases through comprehensive risk stratification.</p><p><strong>Methods: </strong>A total of 280 patients with bladder cancer who underwent PICC placement for chemotherapy at our institution between January 2021 to May 2023 were retrospectively enrolled and randomly allocated into a training set (n = 196) and a validation set (n = 84) in a 7:3 ratio. Independent risk factors were identified through univariate analysis, variable compression via Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression. Subsequently, random forest, support vector machine and K-nearest neighbour models were constructed. The optimal model was selected based on the area under the curve (AUC), calibration curves and decision curve analysis (DCA). Visualisation and interpretability were further assessed using a nomogram and SHapley Additive exPlanations (SHAP) values.</p><p><strong>Results: </strong>The baseline characteristics were balanced between the training and validation sets (<i>p</i> > 0.05). Multivariate logistic regression analysis further confirmed that body mass index (BMI), abnormal catheter tip position, catheter indwelling duration, number of puncture attempts and range of motion in the limb with the catheter were independent risk factors for PICC tip migration (<i>p</i> < 0.05). The random forest model demonstrated optimal performance, with an AUC of 0.768 in the training set and 0.738 in the validation set. SHAP analysis indicated that the range of motion in the limb with the catheter, BMI and catheter indwelling duration were primary positive contributors.</p><p><strong>Conclusions: </strong>BMI, abnormal catheter tip position, number of puncture attempts, range of motion in the limb with the catheter and catheter indwelling duration were identified as risk factors for PICC tip migration in patients with bladder cancer. The risk prediction model developed in this study, based on these factors, demonstrates substantial clinical predictive value.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"352-361"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628937","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":"Using the Medical Failure Mode and Effect Analysis Nursing Plan to Optimise the Surgical Outcomes of Patients Undergoing Extracorporeal Shock Wave Lithotripsy in the Emergency Department: Retrospective Study.","authors":"Jingyun Ye, Junyan Huang, Guimei Wang, Yanxian Bai, Yalan Yang","doi":"10.56434/j.arch.esp.urol.20267902.32","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.32","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate whether a Healthcare Failure Mode and Effect Analysis (HFMEA)-based nursing plan improves surgical outcomes for patients undergoing emergency extracorporeal shock wave lithotripsy (ESWL) for urinary tract stones.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 127 patients who underwent ESWL between July 2024 and June 2025. According to the nursing protocol received, the patients were divided into a control group (n = 67) receiving routine emergency perioperative care and an observation group (n = 60) receiving HFMEA nursing. Postoperative recovery indicators, pain levels (at 12, 24 and 48 hours), psychological state, follow-up outcomes and disease knowledge were compared.</p><p><strong>Results: </strong>The two groups had comparable baseline characteristics (<i>p</i> > 0.05). Although the time to first flatus was similar between groups (<i>p</i> > 0.05), stone expulsion time was significantly shorter in the observation group (<i>p</i> < 0.05). Regarding pain, Visual Analog Scale (VAS) scores at 12 hours postoperatively were not significantly different (<i>p</i> > 0.05). However, the observation group reported lower VAS scores at 24 and 48 hours (<i>p</i> < 0.05). Hospital Anxiety and Depression Scale scores decreased in both groups after treatment, with lower scores in the observation group (<i>p</i> < 0.05). No significant difference in 1-month stone clearance rate was found (<i>p</i> > 0.05), but the observation group experienced fewer postoperative complications and demonstrated higher disease knowledge (both <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Implementing an HFMEA nursing plan for patients undergoing emergency ESWL may promote recovery, improve mental state, reduce complications and enhance patient education. This strategy warrants clinical promotion.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"265-273"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628942","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":"Controlled Study of Dexmedetomidine and Propofol for Sedation in Transurethral Ureteroscopic Holmium Laser Lithotripsy under Combined Spinal-Epidural Anaesthesia.","authors":"Min Li, Ping Tang, Yang Wan, Hongyi Liu, Rong Li, Xin Xiong","doi":"10.56434/j.arch.esp.urol.20267902.34","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.34","url":null,"abstract":"<p><strong>Objective: </strong>Safety and efficacy were compared between dexmedetomidine and propofol for sedation during transurethral ureteroscopic holmium laser lithotripsy of the renal pelvis under combined spinal-epidural anaesthesia (CSEA).</p><p><strong>Methods: </strong>A total of 200 patients who underwent transurethral ureteroscopic holmium laser lithotripsy of the renal pelvis from March 2022 to March 2025 were selected. According to the administration methods, they were divided into the propofol group (intravenous propofol injection) and dexmedetomidine group (intravenous dexmedetomidine injection), with 100 cases in each group. Depth of sedation (Ramsay score, bispectral index (BIS) and anaesthesia tendency index (NTI)), hemodynamic parameters (heart rate (HR), mean arterial pressure (MAP) and blood oxygen saturation (SpO₂)), postoperative recovery time (respiratory recovery time, eye-opening time and extubation time), doctor satisfaction and incidence of adverse reactions were recorded for the two groups.</p><p><strong>Results: </strong>The dexmedetomidine group had significantly higher Ramsay score at the beginning and 30 minutes after the surgery and significantly lower BIS and NTI indicators than the propofol group (<i>p</i> < 0.001). The fluctuation amplitude of HR and MAP was smaller, and the SpO₂ level was higher (<i>p</i> < 0.05). Recovery time of breathing, eye-opening time and extubation time after the operation were all shorter in the dexmedetomidine group than in the propofol group (<i>p</i> < 0.001). The satisfaction rate of doctors was 96.00%, significantly higher than 82.00% of the propofol group (<i>p</i> < 0.05), and the incidence of adverse reactions was 9.00%, lower than 20.00% of the propofol group (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>In transurethral ureteroscopic holmium laser lithotripsy under CSEA, dexmedetomidine can provide a more satisfactory depth of sedation, maintain more stable hemodynamic and respiratory function, promote rapid postoperative recovery and has higher safety compared with propofol.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"282-289"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628645","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":"Component Analysis of Urinary Calculi in 607 Patients From Jiaxing Region: A Single-Center Study.","authors":"Huijun Ji, Wenhua Jiang","doi":"10.56434/j.arch.esp.urol.20267902.37","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.37","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to analyse the distribution characteristics of urinary calculi components in patients from Jiaxing region and explore their relationship with gender, age and the location of calculi, thereby providing a scientific basis for the prevention and treatment of local urolithiasis.</p><p><strong>Methods: </strong>Clinical data and stone specimens from 607 patients with urinary calculi admitted to a hospital in Jiaxing region between August 2023 and August 2024 were retrospectively collected (the study design is a cross-sectional study). The SUN-3G infrared spectroscopy automatic analysis system was used to determine stone composition. The distribution differences of stone components across different genders, ages and locations were statistically analysed.</p><p><strong>Results: </strong>Amongst the 607 patients, 403 (66.4%) were male and 204 (33.6%) were female, with a male-to-female ratio of 1.95 : 1. The distribution of calcium oxalate, carbapatite and uric acid stones did not show statistically significant differences between male and female patient groups (<i>p</i> > 0.05). However, the distribution of other stone components showed statistically significant differences between genders (<i>p</i> < 0.05). Calcium oxalate stones were the most prevalent, found in 427 cases (70.35%). Amongst them, mixed-component stones accounted for 268 cases (44.15%), primarily characterised by calcium oxalate monohydrate + carbapatite, followed by calcium oxalate monohydrate + calcium oxalate dihydrate + carbapatite. Pure-component stones accounted for 339 cases (55.85%), predominantly composed of calcium oxalate monohydrate. The 41-60 years age group had the highest incidence (297 cases, 48.93%), and stone component distribution varied significantly by age. Upper urinary tract stones accounted for 99.18% (602 cases), with no significant difference in component distribution by location (<i>p</i> > 0.05). Seasonal analysis showed calcium oxalate monohydrate being the dominant component in all seasons, with male cases predominating, and significant seasonal differences in stone occurrence (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Urinary calculi in Jiaxing region are predominantly calcium oxalate stones, with mixed-component stones as the main subtype, most commonly found in the upper urinary tract. Gender, age and season are associated with the distribution of stone components. Targeted dietary adjustments and health-related suggestions based on stone composition may potentially help reduce the risk of stone formation.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"306-314"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628684","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":"Pelvic Power, Steady Steps: Association Between Pelvic Floor Muscle Function, Urinary Incontinence and Balance in Community-Dwelling Older Women: A Cross-Sectional Study.","authors":"Esther Ramos-Castellano, Cinta Gómez-Tomás, Iván Chulvi-Medrano, Carlos Guillamó-Minguez, Teresa Mayordomo-Rodríguez, Pedro Gargallo-Bayo","doi":"10.56434/j.arch.esp.urol.20267902.25","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.25","url":null,"abstract":"<p><strong>Background: </strong>Urinary incontinence (UI) is highly prevalent in older women and is closely associated with pelvic floor muscle (PFM) dysfunction. Impaired pelvic-trunk control may affect postural stability and increase fall risk. However, evidence directly relating PFM strength to balance in this population remains limited. The purpose of this study was to determine the association among PFM strength, UI severity and balance in community-dwelling older women.</p><p><strong>Methods: </strong>A cross-sectional study was conducted including 92 older women aged ≥ 60 years. Data were collected prospectively between January and February 2025 at a single time point. The strength and function of PFM were assessed using the modified Oxford scale and the PERFECT scheme. UI severity and impact were measured with the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Balance and mobility were evaluated using the Romberg test, One-Leg Standing, Functional Reach and Timed Up and Go (TUG) tests. Gait speed and fear of falling were assessed with 4-Meters Walk Test and the Short Falls Efficacy Scale (Short FES). Descriptive and correlation analyses (Pearson or Spearman) were performed.</p><p><strong>Results: </strong>Women (mean age 70.23 ± 5.75 years) with high maximal PFM strength exhibited significantly reduced UI severity and impact across all ICIQ-SF domains (<i>p</i> < 0.05). Within the PERFECT scheme, endurance strength was related to low UI severity (frequency: ρ = -0.339; <i>p</i> = 0.001; quantity: ρ = -0.271; <i>p</i> = 0.010; impact on daily life), whereas fast contractions showed no association. In addition, increased PFM strength and endurance were correlated with improved balance, with more consistent links for dynamic tests (notably TUG: ρ = -0.254, <i>p</i> = 0.008; ρ = -0.229, <i>p</i> = 0.028, respectively) than for static outcomes. No association was observed between strength and gait speed, but increased endurance strength was linked to reduced fear of falling (ρ = -0.506, <i>p</i> = 0.016).</p><p><strong>Conclusions: </strong>In community-dwelling older women with mild UI, enhanced PFM function, especially endurance, is associated with diminished UI severity, improved dynamic balance and reduced fear of falling. Clinically, this supports routine PFM assessment alongside ICIQ-SF and simple balance tests, as well as combining integrated PFM strength training interventions with lower-limb and balance exercises. Incorporating continence assessment into fall-risk evaluations may reduce leakage and falls, but prospective trials should test causality of the present study.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"210-218"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628987","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":"Multi-Omics Integration in Urological Cancers: Unlocking Precision Diagnosis and Therapy Through Big Data.","authors":"Charlotte Delrue, Marijn M Speeckaert","doi":"10.56434/j.arch.esp.urol.20267902.21","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.21","url":null,"abstract":"<p><strong>Background: </strong>Urological cancers, such as prostate, bladder and renal cell carcinoma, contribute substantially to the global cancer burden. Their management remains challenging due to extensive molecular and clinical heterogeneity. Conventional single-omics approaches (e.g., genomics and transcriptomics) have led to important discoveries but provided only partial views of tumour biology, which limit the robustness of biomarkers and therapeutic precision. Multi-omics integration offers a systems-level perspective that captures the complex regulatory networks underlying tumour initiation, progression and treatment resistance.</p><p><strong>Methods: </strong>We conducted a comprehensive narrative review of recent literature on multi-omics integration in urological cancers. Sources included PubMed, Scopus and Web of Science, and only English-language peer-reviewed studies published before September 2025. We synthesised findings from studies employing genomics, transcriptomics, proteomics, metabolomics and epigenomics, alongside computational integration frameworks, such as machine learning, graph neural networks, stemnessbased classifiers and spatial multi-omics.</p><p><strong>Results: </strong>Multi-omics integration enables the refinement of molecular subtypes, identification of prognostic and predictive biomarkers and discovery of therapeutic targets across prostate, bladder and renal cancers. Examples include stemness-based classifiers in prostate cancer that stratify patients by prognosis and therapy sensitivity, consensus molecular subtypes of bladder cancer with differential therapeutic vulnerabilities and programmed cell death-based signatures in renal cancer linked to prognosis and immune responses. However, key challenges persist, including data heterogeneity, limited cohort sizes, lack of standardised analytical pipelines and translational gaps between discovery and clinical implementation.</p><p><strong>Conclusions: </strong>Multi-omics integration is rapidly evolving from an exploratory research tool into a cornerstone of precision urology. Through mechanistically grounded, clinically interpretable models of disease, multi-omics holds the potential to improve individualised diagnosis, prognostication and therapy selection. Translation of multi-omics into routine clinical practice will hinge on overcoming current limitations through standardisation, collaborative consortia and explainable artificial intelligence.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"169-178"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628972","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 Keyhole Limpet Hemocyanin in Bacillus Calmette-Guérin Unresponsive Non-muscle Invasive Bladder Cancer.","authors":"Victor Chernobilsky, Ignacio Tobia Gonzalez, Gabriel Favre","doi":"10.56434/j.arch.esp.urol.20267902.26","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.26","url":null,"abstract":"<p><strong>Background: </strong>Despite undergoing transurethral resection and appropriate Bacillus Calmette-Guérin (BCG) administration for high-risk non-muscle invasive bladder cancer (NMIBC), the non-responder rate is approximately 25%. Although radical cystectomy is the gold standard of treatment recommended by various international guidelines, many patients are either unwilling or ineligible for this therapeutic option. In Argentina, keyhole limpet hemocyanin (immunocyanin KLH) is approved for those patients. The primary objectives of this study were to evaluate the overall treatment response, defined as disease-free survival (recurrence and/or local or distant progression), and adverse events.</p><p><strong>Methods: </strong>A retrospective, two-centre, single-arm clinical study with a quantitative exploratory and documentary approach was designed. Seventy patients diagnosed with NMIBC who were non-responders to appropriate BCG were evaluated between January 2001 and August 2022, with a minimum follow-up duration of one year. All patients completed an induction regimen of KLH and at least three maintenance treatments, which involved the intravesical administration of 20 mg of KLH in 60 mL of physiological saline weekly for six weeks during the induction phase, followed by monthly maintenance with the same dose. Cystoscopic controls were performed every three months during the first year and every three to four months in the second and third years. All suspicious lesions were completely resected, and cytological samples were systematically collected.</p><p><strong>Results: </strong>The mean age of the patients was 69.1 years (SD: 8.1). The mean follow-up duration from the first KLH dose was 60.9 months, with a median of 53 months. The estimated one-, two- and three-year disease-free survival rates were 57.1%, 33.5% and 30.1% (95% CI: 45.5-68.7, 22.3-44.7 and 19.1-41.1), respectively, with a median disease-free survival of 14 months (95% CI: 10.4-17.6). Multifocality, pT1 classification and lymphovascular invasion were identified as adverse factors in multivariate analysis. Toxicity was well tolerated, with six patients (8.6%) experiencing mild urinary infections during treatment (adverse event grade 2).</p><p><strong>Conclusions: </strong>The use of KLH in patients with NMIBC who are non-responders to BCG therapy shows favourable outcomes in terms of disease-free survival and exhibits an excellent safety profile. These findings support KLH as a potential treatment option for this challenging patient population.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"219-223"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628865","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":"Adjuvant Radiotherapy After Cystectomy in Muscle-Invasive Bladder Cancer: Indications, Benefits and Remaining Challenges.","authors":"Patricia Valencia Nieto, Fernando López-Campos, Patricia Diezhandino García, Víctor Duque-Santana, María Antonia Gómez-Aparicio, Abrahams Ocanto, María González de Dueñas, Xavier Maldonado Pijoan, Mohamed Shelan, Mario Álvarez-Maestro, Felipe Couñago","doi":"10.56434/j.arch.esp.urol.20267902.20","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.20","url":null,"abstract":"<p><p>Bladder cancer accounts for nearly 600,000 new cases and over 200,000 deaths annually worldwide. Approximately 25% of diagnoses correspond to muscle-invasive disease, and up to 50% of patients undergoing radical cystectomy experience recurrence within the first two years, with a 5-year overall survival reaching 50%-60%. Despite the use of neoadjuvant chemotherapy, clinical trials have failed to attain a considerable reduction in the risk of locoregional recurrence, which remains a major clinical challenge due to the limited and largely ineffective salvage treatment options. In this context, adjuvant radiotherapy (ART) has re-emerged as a potential strategy for reducing locoregional recurrence and improving metastasis-free survival, supported by advances in delivery techniques and a reassessment of safety concerns following the BART trial. Simultaneously, perioperative immunotherapy is reshaping the therapeutic landscape of muscle-invasive bladder cancer, with recent studies, such as CheckMate 274 and NIAGARA, establishing a new standard of care. The novelty of this review lies in the integration of the evolving role of ART within the immunotherapy era, with critical examination of its complementary value, toxicity profile and patient selection in light of modern systemic strategies. This narrative review provides an updated synthesis of current evidence and ongoing trials and offers a perspective on how ART can be optimally incorporated into multimodal management of high-risk bladder cancer.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"160-168"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628944","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 Retrograde Intrarenal Surgery Combined with Super-Mini Percutaneous Nephrolithotomy versus that of Microchannel Percutaneous Nephrolithotomy in the Treatment of Complex Renal Stones.","authors":"Qingsong Wang, Yongyong Tang","doi":"10.56434/j.arch.esp.urol.20267902.33","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.33","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the efficacy of retrograde intrarenal surgery (RIRS) combined with super-mini percutaneous nephrolithotomy (SMP) versus microchannel percutaneous nephrolithotomy (MPCNL) for complex renal stones (CRSs) and identify prognostic factors.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 156 patients with CRS (January 2022-January 2025), divided into the RIRS + SMP group (n = 85) and MPCNL group (n = 71). Perioperative indicators, inflammatory stress, renal function, postoperative pain and complications were compared. A 60-day follow-up categorised prognosis into poor (n = 23) and normal (n = 133) groups, with logistic regression analysing poor prognosis factors.</p><p><strong>Results: </strong>The RIRS + SMP group had a longer operative time but significantly less intraoperative blood loss, shorter postoperative hospital stay and earlier ambulation (<i>p</i> < 0.05) than the MPCNL group. Stone-free rates were comparable and showed no significant difference (<i>p</i> > 0.05). At 3 days postoperatively, inflammatory markers (procalcitonin (PCT), high-sensitivity Creactive protein (hs-CRP), cortisol (Cor) and malondialdehyde (MDA)) and renal function indicators (blood urea nitrogen (BUN), urinary creatinine (UCr) and cystatin C (Cys-C)) were lower in the RIRS + SMP group (<i>p</i> < 0.05) than in the MPCNL group. Visual Analog Scale (VAS) scores were consistently lower at 6, 12, 24 and 48 h postoperatively (<i>p</i> < 0.05), with a reduced overall complication rate (<i>p</i> < 0.05). Multivariate logistic regression identified surgical approach, diabetes mellitus and indwelling catheterisation time as independent poor prognosis risk factors (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>For CRS, SMP combined with RIRS provides comparable stone clearance rates with superior recovery and fewer complications than MPCNL, whereas diabetes and catheter duration warrant attention as prognostic factors.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"274-281"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628872","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 Ureteral Stone Volume and Maximum Stone Length in Predicting Shock Wave Lithotripsy Success.","authors":"Yavuz Karaca, Orhun Sinanoglu, Didar Ilke Karaca, Goksu Sarica, Kemal Sarica","doi":"10.56434/j.arch.esp.urol.20267902.29","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.29","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare maximum stone length and stone volume as predictors of stone-free (SF) status after extracorporeal shock wave lithotripsy (SWL) for ureteral stones.</p><p><strong>Methods: </strong>Data from 236 patients treated with SWL for solitary radiopaque ureteral stone (5-15 mm) between January 2022 and March 2024 were retrospectively analysed. Stone length and volume were measured on noncontrast computed tomography. SF status was determined on radiography and ultrasonography 4 weeks after the last SWL session and defined as no residual stone or < 4 mm residual fragments. Binary logistic regression models were used to evaluate potential predictors of SWL outcome in univariable and multivariable analyses.</p><p><strong>Results: </strong>The overall SF rate was 68%. The non-SF group had significantly higher body mass index (BMI), Hounsfield unit, maximum stone length, stone volume, skin-to-stone distance and proximal ureteral diameter (all <i>p</i> < 0.05) compared with the SF group. Multivariate analysis revealed maximum stone length (<i>p</i> = 0.004) and BMI (<i>p</i> = 0.009) as independent predictors of SWL outcome, whilst stone volume lost statistical significance (<i>p</i> = 0.2).</p><p><strong>Conclusions: </strong>Simple linear stone measurement without routine reliance on computed tomography (CT)-based volumetric assessment appears sufficient for predicting SWL outcomes in ureteral stones. This approach may help avoid the time-consuming nature and potential radiation exposure associated with volumetric analysis. Further prospective, multicentre studies with standardised imaging and large patient cohorts are warranted to confirm these results.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"241-246"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628607","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}