Archivos Espanoles De Urologia最新文献

{"title":"Clinical and Pathological Features of Renal Cell Carcinoma in Young Adults.","authors":"Abuzer Öztürk, Şeyhmus Kaya","doi":"10.56434/j.arch.esp.urol.20267902.31","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.31","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to describe the clinicopathological characteristics of renal cell carcinoma (RCC) in young adults (≤ 40 years) and reclassify tumour subtypes in accordance with the 2022 World Health Organization (WHO) classification, with exploratory assessment of outcome-related associations.</p><p><strong>Methods: </strong>Individuals aged 40 years or younger who had been diagnosed with RCC were retrospectively evaluated. All cases were re-evaluated using the current WHO 2022 classification criteria and immunohistochemical markers. Demographic data; histological subtypes; surgical treatment methods; and patient outcomes, including recurrence and mortality, were reviewed.</p><p><strong>Results: </strong>Clear-cell RCC was the most common subtype (65.8%), followed by chromophobe RCC (20%) and papillary RCC (11.4%). A rare case of mucinous tubular and spindle cell carcinoma was identified. Tumour size and pathological stage significantly influenced the surgical modality; partial nephrectomy was more frequently performed in smaller tumours. Recurrence and mortality were primarily observed in patients treated with radical nephrectomy and those with adverse histologic features such as tumour necrosis and lymphovascular invasion.</p><p><strong>Conclusions: </strong>This study provides a clinicopathological overview of RCC in young adults on the basis of 2022 WHO classification. Despite the exploratory nature of survival analyses due to limited events, the findings highlight the histological diversity and clinical features of RCC in this population.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"255-264"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628899","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":"Primitive Neuroectodermal Kidney Tumor in Adults. A Systematic Review.","authors":"Eloísa Cabello-Gómez, Inés Rivero-Belenchón, Carmen Belén Congregado-Ruiz, Ignacio Osmán-García, Rafael Antonio Medina-López","doi":"10.56434/j.arch.esp.urol.20267902.19","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.19","url":null,"abstract":"<p><strong>Introduction: </strong>Renal primitive neuroectodermal tumour (rPNET) is a rare entity, typically affecting young adults. The diagnosis is usually confirmed through histopathology. A multidisciplinary approach to treatment is essential due to its poor prognosis.</p><p><strong>Materials and methods: </strong>A systematic literature review was conducted, and a descriptive analysis of significant variables from 128 cases is presented.</p><p><strong>Results and discussion: </strong>The literature review indicated a slightly higher incidence in females (54.2%), with a mean age at presentation of 33 years (range: 16-73 years). The most common symptoms were acute flank pain (46%) and haematuria (33%). Tumour thrombus in the vena cava and metastatic dissemination were frequent (30.5% and 50.4%, respectively). In the systematic review, 98% of cases were cluster of differentiation 99 (CD99)-positive and 62.7% showed EWSR1 rearrangement. Nephrectomy was performed in 90% of cases, and 64.8% received adjuvant chemotherapy (CT). The mean follow-up was 24.8 months (range: 0.5-150 months). The median CSS was 11.5 months (interquartile range (IQR): 6-32.3), and the median OS was 9 months (IQR: 5.25-24).</p><p><strong>Conclusions: </strong>rPNET in adults is a rare, aggressive entity that is frequently diagnosed at an advanced stage. A multimodal strategy of surgery when feasible plus systemic multi-agent CT, with radiotherapy in selected cases, should be planned upfront in specialised centres by a multidisciplinary team.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"152-159"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628951","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":"Postoperative Urinary Tract Infection after Senile Upper Urinary Tract Calculi Surgery: Pathogen Analysis and Construction of Risk Prediction Model.","authors":"Xiuping Zhou, Tingshuai Yan, Jie Jiang, Fangtian Chen, Jing Yang, Changshun Yang","doi":"10.56434/j.arch.esp.urol.20267902.38","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.38","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe the etiological profile of postoperative urinary tract infection (UTI) in elderly patients with upper urinary tract calculi and construct a risk factor prediction model.</p><p><strong>Methods: </strong>The clinical data of elderly patients with upper urinary tract calculi who underwent surgery in our hospital from January 2024 to March 2025 were retrospectively analysed. The patients were divided into an infection group and a control group according to whether they developed UTI. The risk factors for secondary UTI in elderly patients after upper urinary tract calculi surgery were also examined. A multivariate logistic regression analysis was used to establish a risk prediction model, and a receiver operating characteristic (ROC) curve was drawn. All patients were randomly divided into a training set and a validation set at a ratio of 7:3 to evaluate the stability of the prediction model.</p><p><strong>Results: </strong>Among the 233 elderly patients, 54 (23.18%) developed postoperative UTI. Univariate analysis identified hydronephrosis severity, age, hospital stay, preoperative serum albumin and postoperative daily water intake as associated with UTI (<i>p</i> < 0.05). In the multivariate model, age and hydronephrosis severity remained independent risk factors, whilst high postoperative water intake and preoperative albumin were independent protective factors. An ROC model based on these four variables showed an area under the curve (AUC) of 0.85 (95% CI 0.78-0.93) in the training set (specificity 0.820, sensitivity 0.752) and 0.81 (95% CI 0.71-0.91) in the validation set (specificity 0.813, sensitivity 0.762). Hosmer-Lemeshow test indicated good model fit.</p><p><strong>Conclusions: </strong>Age, hydronephrosis severity, preoperative serum albumin and postoperative daily water intake are relevant factors for secondary UTI in patients with upper urinary tract calculi after surgery. Clinicians should intervene early for high-risk populations.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"315-326"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Large Language Models for Pediatric Kidney Stone Patient Education: A Multi-dimensional Assessment of Readability, Quality and Reliability.","authors":"Fesih Ok, Ibrahim Halil Sukur, Zahide Orhan Ok, Tunahan Ates, Mutlu Deger","doi":"10.56434/j.arch.esp.urol.20267902.30","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267902.30","url":null,"abstract":"<p><strong>Background: </strong>Pediatric urolithiasis is an increasingly important health concern, and affected children and their families require information that is both accurate and easily understandable. Artificial intelligence (AI)-powered chatbots have become widely used sources of health information; however, the readability, quality, and reliability of their outputs remain insufficiently evaluated. This study aimed to assess the effectiveness and reliability of AI chatbots in providing patient-oriented information on pediatric kidney stone disease and to identify factors influencing the quality and readability of their responses.</p><p><strong>Methods: </strong>Four AI chatbots (ChatGPT-5, Google Gemini, Claude 3 Opus, and DeepSEEK) were queried with 30 standardized questions related to pediatric kidney stones. Readability was evaluated using the Average Reading Level Consensus (ARLC), Automated Readability Index (ARI), and Simple Measure of Gobbledygook (SMOG). Response quality and reliability were asssessed using the Ensuring Quality Information for Patients (EQIP) tool and Modified DISCERN score. Statistical analyses included one-way analysis of variance ANOVA, Kruskal-Wallis tests, and appropriate post hoc comparisons.</p><p><strong>Results: </strong>Readability differed significantly among the chatbots. Google Gemini demonstrated the highest reading levels across all metrics (ARLC: 14.93, ARI: 16.2, and SMOG: 13.32), whereas ChatGPT, Claude, and DeepSEEK produced less complex test (<i>p</i> < 0.001; large effect sizes, η² = 0.195-0.512). EQIP scores did not differ significantly between models (<i>p</i> = 0.491, ε² = 0.021, negligible effect), indicating comparable informational quality. In contrast, reliability varied significantly: ChatGPT and Google Gemini achieved higher Modified DISCERN scores (median 4.00) than Claude and DeepSEEK (median 3.00; <i>p</i> = 0.001, ε² = 0.318, large effect). Subgroup analyses by question category revealed notable differences in performance, highlighting model-specific strenghts and limitations.</p><p><strong>Conclusions: </strong>Substantial variability exists in the readability and reliability of AI-generated health information on pediatric urolithiasis. Although ChatGPT and Google Gemini provided more reliable information, Google Gemini's responses were consistently more complex and less accessible. These findings emphasize the need for careful validation and language simplification of AI-generated content before its use in patient and caregiver education.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 2","pages":"247-254"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628388","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: Research Progress on Predictive Indicators for the Occurrence of Ureteral Sepsis after Ureteral Stone Surgery.","authors":"Huahui Li, Hongchen Zhou, Xingli Xu, Lei Wang","doi":"10.56434/j.arch.esp.urol.20267901.18","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267901.18","url":null,"abstract":"","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 1","pages":"150-151"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349657","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 Model Integrating Imaging and Inflammatory Biomarkers for Preoperative Urinary Tract Infection in Patients with Ureteral Calculi and Metabolic Syndrome.","authors":"Shaohang Yang, Yangyang Lin, Zhile Chen","doi":"10.56434/j.arch.esp.urol.20267901.13","DOIUrl":"10.56434/j.arch.esp.urol.20267901.13","url":null,"abstract":"<p><strong>Objective: </strong>Urinary tract infection (UTI) frequently occurs in patients with ureteral calculi and metabolic syndrome (MetS). Timely recognition of patients at elevated risk remains a clinical challenge. This study aimed to construct and internally validate a nomogram for assessing the risk of UTI in this population.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed the data of 254 patients diagnosed with ureteral calculi and MetS who were hospitalised between January 2022 and March 2025. Baseline patient characteristics, clinical parameters, laboratory test results and imaging findings were systematically collected. Factors showing significant differences (<i>p</i> < 0.05) between patients with and without UTI were examined for multicollinearity and then entered into a multivariable regression framework to determine independent predictors. A risk-prediction nomogram based on these key determinants was subsequently constructed. The model's performance was assessed through the area under the receiver operating characteristic curve (AUC), calibration plot, Hosmer-Lemeshow goodness-of-fit test, Brier score and decision curve analysis (DCA). Internal validation was conducted using bootstrap resampling.</p><p><strong>Results: </strong>Multivariate analysis identified periureteral fat stranding, tissue rim sign, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio and positive urine nitrite as independent predictors of UTI. The constructed nomogram exhibited robust discriminative ability (AUC = 0.783; 95% confidence interval (CI): 0.702-0.863) and satisfactory calibration (χ²= 6.867, <i>p</i>= 0.551; Brier score = 0.118). Bootstrap validation confirmed model stability (AUC = 0.783). DCA indicated that the nomogram yielded a superior net clinical benefit compared with strategies of treating all or none with a probability threshold of 0.1-0.85.</p><p><strong>Conclusions: </strong>The proposed nomogram accurately predicts the risk of UTI in patients with ureteral calculi and MetS. The integration of imaging features, haematologic inflammatory markers and urinalysis results enables individualised risk assessment,facilitating the early detection of high-risk patients and informing timely preventive and therapeutic interventions.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 1","pages":"105-113"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349568","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 and Functional Outcomes after Perineal Approach for Repair of Vesico-Urethral Anastomotic Stenosis Following Radical Prostatectomy.","authors":"Sandra San Cayetano Talegón, Felix Campos-Juanatey, Paola Calleja Hermosa, Raquel Varea Malo, Jaime García Herrero, Marina Sánchez Gil, Gonzalo Azcárraga Aranegui, María Onrubia Pereira, Sergio Zubillaga Guerrero, Óscar Gorría Cardesa, Eva Mallén Mateo, Ignacio Puche Sanz, Balig Amir Nicolau, Eduardo Barroso Deyne, Ana Gutiérrez Aguilar, José Luis Gutiérrez Baños","doi":"10.56434/j.arch.esp.urol.20267901.2","DOIUrl":"10.56434/j.arch.esp.urol.20267901.2","url":null,"abstract":"<p><strong>Background: </strong>Vesicourethral anastomotic stenosis (VUAS) is a rare but complex complication following radical prostatectomy (RP), with an incidence ranging from 0.5% to 33% depending on surgical approach, surgeon experience and prior radiotherapy. Risk factors include intraoperative bleeding, urinary leakage, infection and adjuvant treatments. Despite advances in minimally invasive and robotic surgery, VUAS remains a significant cause of morbidity, often compromising urinary function and quality of life. Our objective is to evaluate the surgical and functional outcomes of perineal vesicourethral re-anastomosis in patients with recurrent VUAS after radical prostatectomy.</p><p><strong>Methods: </strong>We retrospectively reviewed 12 patients with recurrent VUAS treated between 2017 and 2024 by a single surgeon, with a minimum follow-up period of 6 months. All had at least one failed endoscopic treatment and preoperative incontinence. Anatomic success was assessed by urethrogram or urethroscopy. Descriptive analysis was conducted on demographic, surgical and outcome data.</p><p><strong>Results: </strong>The mean patient age was 71 years, with a median interval of 42-4 months (interquartile range (IQR) 9.5-86.1) from RP to stenosis diagnosis. Minor postoperative complications (Clavien I-II) occurred in three patients. Anatomical success, defined as the atraumatic passage of a 16 Fr cystoscope and/or absence of radiological stenosis, was achieved in 83.3% of cases with a mean follow-up of 39.5 months (standard deviation (SD) 24.7). At follow-up, urinary incontinence persisted in the majority of patients, and seven underwent artificial urinary sphincter implantation with satisfactory functional outcomes. One patient developed a urosymphyseal fistula complicated with pubic osteitis, ultimately requiring cystectomy and pubectomy.</p><p><strong>Conclusions: </strong>Perineal vesicourethral re-anastomosis represents an effective salvage strategy for recurrent VUAS after RP, providing high rates of urethral patency. However, it carries a substantial risk of postoperative incontinence, frequently necessitating subsequent continence surgery. Management should be centralised in reconstructive referral centres to optimise anatomical and functional outcomes.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 1","pages":"13-20"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349660","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":"Artificial Intelligence and Big Data in Urological Oncology: From Radiomics to Real-World Evidence.","authors":"Stamatios Katsimperis, Lazaros Tzelves, Ioannis Kyriazis, Panagiotis Neofytou, Sotirios Kapsalos-Dedes, Georgios Feretzakis, Andreas Skolarikos","doi":"10.56434/j.arch.esp.urol.20267901.1","DOIUrl":"10.56434/j.arch.esp.urol.20267901.1","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) and big data are transforming urological oncology by enhancing diagnostic precision, prognostic assessment and treatment personalisation for prostate, bladder and kidney cancer.</p><p><strong>Methods: </strong>We searched PubMed and MEDLINE up to September 2025 for English-language, peer-reviewed human studies using terms including \"artificial intelligence\", \"deep learning\", \"radiomics\", \"real-world evidence\" and \"urological oncology\".</p><p><strong>Results: </strong>AI-driven radiomics and deep learning models have demonstrated high accuracy in detecting and characterising urological malignancies by using magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET) and histopathology. In prostate, bladder and kidney cancers, AI-driven radiomics and deep learning models have demonstrated high diagnostic performance, with reported area under the curves (AUCs) typically ranging from 0.80 to 0.95 for lesion detection, staging and risk stratification. Sensitivities and specificities in cystoscopic image analysis often exceed 90%, but radiogenomic models for renal cancer achieve mutation prediction accuracies of 85%-95%.</p><p><strong>Conclusions: </strong>AI and big data are reshaping urological oncology by integrating diagnostic imaging, pathology and real-world practice. Their continued integration promises a precise, equitable and adaptive model of cancer care. Despite these robust results, most studies rely on retrospective or single-centre datasets with limited external validation, raising concerns about generalisability. Future progress will depend on multicentre standardisation, federated learning frameworks and incorporation of multimodal real-world data to facilitate clinically robust and implementable AI systems.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 1","pages":"1-12"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349608","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":"Establishment and Validation of a Nomogram Model for Predicting the Risk of Postpartum Stress Urinary Incontinence in Women during the Perinatal Period.","authors":"Shuwen Yu, Fengling Yin, Yihui Fan, Qiuchan Qu","doi":"10.56434/j.arch.esp.urol.20267901.16","DOIUrl":"10.56434/j.arch.esp.urol.20267901.16","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to analyse factors influencing maternal postpartum stress urinary incontinence (SUI) and construct a prediction model using a nomogram.</p><p><strong>Methods: </strong>A retrospective analysis of clinical data was conducted on 500 women who delivered at our hospital between June 2021 and June 2024, of whom 147 developed postpartum SUI. The participants were randomly assigned to the modelling (n = 354) or validation groups (n = 146) in a 7:3 ratio. The modelling group was further subdivided on the basis of postpartum SUI occurrence: SUI (n = 106) and non-SUI groups (n = 248). Relevant factors were identified through logistic regression analysis, and a nomogram was constructed using R software. The nomogram was evaluated through receiver operating characteristic, calibration and decision curves.</p><p><strong>Results: </strong>Significant differences existed between the SUI and non-SUI groups in maternal educational attainment, newborn weight, current address, natural birth and gestation period (<i>p</i> < 0.05). Educational attainment (junior high school and below), increase in newborn weight, rural residence, natural birth and parity (≥ 2) were identified as risk factors for postpartum SUI (<i>p</i> < 0.05). The nomogram showed good predictive performance with area under the curve (AUC) values of 0.778 and 0.754 for the modelling and validation groups, respectively (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Maternal educational attainment, newborn weight, current address, natural birth and gestation period are risk factors for postpartum SUI. Based on these factors, the proposed nomogram model is a potentially reliable tool for predicting postpartum SUI risk.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 1","pages":"134-144"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349634","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":"Mid-Term Follow-Up of the Zephyr 375 Artificial Urinary Sphincter Implanted via a Single Perineal Incision.","authors":"Roberto Molina Escudero, Luís Crespo Martínez, Emilio Ripalda Ferreti, Manuel Álvarez Ardura, Ana Muñoz Rivas","doi":"10.56434/j.arch.esp.urol.20267901.4","DOIUrl":"10.56434/j.arch.esp.urol.20267901.4","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment for severe male stress urinary incontinence (SUI) following surgery refers to the implantation of an artificial urinary sphincter (AUS). Traditionally, the procedure requires two incisions: Perineal and inguinal.</p><p><strong>Objective: </strong>To present a series of patients treated with the Zephyr 375 AUS implanted via a single perineal incision.</p><p><strong>Materials and methods: </strong>We report 14 male patients with SUI following transurethral resection of the prostate (1) and radical prostatectomy (13). Preoperative assessment included a pad test and cystoscopy. Under epidural anaesthesia, bulbar urethra was exposed through a vertical perineal incision via dissection and division of the bulbospongiosus muscle. After catheter removal, the cuff was placed around the urethra and tested to ensure appropriate pressure and then deactivated. The pump-reservoir was positioned by digitally creating a scrotal dartos pouch from the perineum and secured with a 3/0 Vicryl. The perineum was closed, and a urinary catheter was installed.</p><p><strong>Results: </strong>The mean age was 65 years (55-74), and the average operative time was 64 minutes (50-85). All patients were discharged the following day without a catheter. Each one of them can palpate the pump-reservoir in the scrotum. After activation, all patients achieved continence, with five requiring a safety pad. During follow-up, four patients required pressure adjustment due to diminished continence with desirable outcomes. Patient satisfaction was notably high.</p><p><strong>Conclusions: </strong>After a mean follow-up of 19 months, the Zephyr 375 AUS demonstrated good functional outcomes for the treatment of severe male SUI. The system allowed for effective pressure adjustments when efficacy diminished. Implantation via a single perineal approach simplifies the procedure and reduces morbidity associated with dual-incision techniques.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 1","pages":"31-35"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349587","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}