Archivos Espanoles De Urologia最新文献

{"title":"Comparison of Thulium Fibre Laser and Holmium:YAG Laser in Flexible Ureteroscopic Lithotripsy for 1-2 cm Lower Pole Kidney Stones.","authors":"Jiacheng Zhang, Jinguo Xiong, Zhonghao Zhao, Zhihua Cao","doi":"10.56434/j.arch.esp.urol.aeu020","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu020","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of thulium fibre laser (TFL) and holmium:yttrium aluminum garnet (Ho:YAG) laser in flexible ureteroscopic lithotripsy for 1-2 cm lower pole kidney stones.</p><p><strong>Methods: </strong>This retrospective analysis included 160 patients with 1-2 cm lower pole stones (LPSs) admitted to our hospital between January 2024 and December 2025. Patients were assigned to a TFL group and a Ho:YAG group according to the surgical technique used. After applying propensity score matching (PSM), two matched groups with 60 cases each were obtained. Outcome variables included surgery-related indicators, postoperative recovery indicators, stone-free rate (SFR), and postoperative complications.</p><p><strong>Results: </strong>The operation time, lithotripsy time, hospital stay, first ambulation time, and urethral catheter indwelling time in the TFL group were significantly shorter than those in the Ho:YAG group (all <i>p</i> < 0.05). The incidence of intraoperative stone retropulsion and the visual analogue scale (VAS) score at 24 h postoperatively were significantly lower in the TFL group than in the Ho:YAG group (both <i>p</i> < 0.05). At 4 weeks postoperatively, the SFR was significantly higher in the TFL group than in the Ho:YAG group (93.33% vs. 80.00%; <i>p</i> < 0.05), and the overall complication rate was significantly lower in the TFL group than in the Ho:YAG group (6.67% vs. 20.00%; <i>p</i> < 0.05). Stratified analysis showed that TFL was associated with shorter operation time and lithotripsy time across different stone sizes and densities. Furthermore, in patients with a diameter ≥1.5 cm, the SFR was higher in the TFL group than in the Ho:YAG group. The SFR in the Ho:YAG group was significantly lower in large-diameter stones than in small-diameter stones, whereas the TFL group showed consistently high SFR (>90%) across all subgroups.</p><p><strong>Conclusions: </strong>Compared with Ho:YAG laser, TFL was associated with better efficiency and perioperative outcomes in flexible ureteroscopic lithotripsy for 1-2 cm LPSs. TFL may provide more consistent fragmentation efficacy in larger stones and may reduce the risk of stone retropulsion and postoperative complications.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1207-1213"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882498","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 Modifiable Factors of Urinary Tract Infections in Infants and Toddlers: A Case-Control Study.","authors":"Jijuan Dou, Jinling Zhao, Hongliang Jia","doi":"10.56434/j.arch.esp.urol.aeu004","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu004","url":null,"abstract":"<p><strong>Background: </strong>To investigate the clinical characteristics and associated factors of urinary tract infections (UTIs) in infants and toddlers from a paediatric urological perspective.</p><p><strong>Methods: </strong>This single-centre retrospective case-control study included 54 children with UTI and 54 hospital-based unmatched controls treated between January 2023 and December 2025. Perinatal factors, feeding patterns, constipation, clinically relevant external genital abnormalities, diaper changing, and perineal hygiene were compared between groups. Clinical manifestations, pathogens, antimicrobial susceptibility, recurrence, and ultrasound findings were analysed in the UTI group. Firth-corrected logistic regression was used to reduce small-sample estimation bias.</p><p><strong>Results: </strong>The UTI group had higher proportions of low birth weight, non-exclusive breastfeeding, constipation, clinically relevant external genital abnormalities, infrequent diaper changing, and improper perineal hygiene than the control group (all <i>p</i> < 0.05). Multivariate analysis showed that low birth weight, non-exclusive breastfeeding, constipation, and improper perineal hygiene were independently associated with UTI (all <i>p</i> < 0.05). Fever, irritability, poor feeding, and voiding abnormalities were common presentations. <i>Escherichia coli</i> was the predominant pathogen, with high resistance to ampicillin, whereas susceptibility to nitrofurantoin, amikacin, and imipenem exceeded 95%. Ultrasound-detected urinary tract structural abnormalities may be associated with recurrence, but this result should be interpreted cautiously because of the small sample size.</p><p><strong>Conclusions: </strong>UTIs in infants and toddlers often present with non-specific symptoms; therefore, standardised urine specimen collection combined with comprehensive testing is crucial for early identification. Low birth weight, non-exclusive breastfeeding, constipation, and improper perineal hygiene were associated with UTI, among which feeding pattern, bowel habits, and perineal care are potentially modifiable. For empirical anti-infective therapy, cephalosporins or nitrofurantoin may be preferred. Further imaging evaluation should be individualised, with ultrasonography as the first-line assessment and voiding cystourethrography or dimercaptosuccinic acid scintigraphy reserved for selected children with recurrent febrile UTI, abnormal ultrasound findings, poor treatment response, or suspected renal scarring. Strengthening breastfeeding, constipation management, and perineal care may help reduce UTI occurrence.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1199-1206"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882483","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":"Effects of General Versus Regional Anaesthesia on Surgical Outcomes and Early Postoperative Sequelae in Minimally Invasive Surgery for Urinary Calculi: A Meta-analysis of Randomized Controlled Trials.","authors":"Honghong Du, Xiuxiu Xie, Min Chen, Siren Shi, Fangtong Zhai, Jianyong Zhao","doi":"10.56434/j.arch.esp.urol.20267906.119","DOIUrl":"10.56434/j.arch.esp.urol.20267906.119","url":null,"abstract":"<p><strong>Background: </strong>To systematically compare general anaesthesia (GA) and regional anaesthesia in patient undergoing minimally invasive surgery for urinary calculi, focusing on operative outcomes (e.g., operative time, length of hospital stay, stone-free rate [SFR]) and early postoperative outcomes (e.g., pain measured by the visual analog scale [VAS] and complication rate), and to provide evidence to guide anaesthetic selection.</p><p><strong>Methods: </strong>PubMed, Embase, and the Cochrane Library were searched from database inception to December 2025 for randomized controlled trials (RCTs) comparing GA with regional anaesthesia in minimally invasive urinary stone procedures. Study quality was assessed using the Cochrane Risk of Bias tool. Meta-analyses were conducted using RevMan 5.4. Heterogeneity was quantified using the I² statistic; fixed-effects models were used when I² < 50% and random-effects models when I² ≥ 50%. Sensitivity analyses were conducted to evaluate the robustness of pooled estimates. The analysis included seven RCTs (525 participants) with regional anaesthesia administered to n = 257 and GA to n = 268.</p><p><strong>Results: </strong>Regional anaesthesia was associated with a shorter operative time compared with GA (weighted mean difference [WMD] = -8.90 minutes, 95% confidence interval [CI] = -14.53 to -3.27; <i>p</i> = 0.002). After excluding studies that contributed to heterogeneity, the effect remained consistent (I2= 43%; <i>p</i> = 0.004). No statistically significant between-group differences were observed for length of hospital stay or SFR (<i>p</i> > 0.05). In the primary analyses, postoperative 4-8 hours VAS scores and complication rates showed no significant differences (<i>p</i> > 0.05). Sensitivity analyses suggested that, after exclusion of influential studies, regional anaesthesia was associated with higher VAS scores (WMD = 1.11, 95% CI: 0.59 to 1.64; <i>p</i> < 0.001), and one sensitivity model suggested a higher complication rate in the regional anaesthesia group (odds ratio [OR] = 2.79, 95% CI = 1.49 to 5.20; <i>p</i> = 0.001). Risk-of-bias assessment varied across domains, with concerns mainly related to performance bias and incomplete reporting in some trials.</p><p><strong>Conclusions: </strong>Regional anaesthesia may shorten overall procedure-related time in minimally invasive surgery for urinary calculi. However, its effects on postoperative pain and complications remain uncertain, and the complication outcome was sensitive to individual studies. Length of hospital stay and SFR do not appear to substantially differ between anaesthesia strategies. The PROSPERO Registration: The protocol for this meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD420261326142, https://www.crd.york.ac.uk/PROSPERO/view/CRD420261326142).</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"1038-1049"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800372","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":"Short-Course Versus Standard-Course Antibiotics for Neonatal Urinary Tract Infection: Implications for Urological Referral, Structural Follow-Up and Surgical Decision-Making.","authors":"Yunge Hu, Jun Zou, Wenping Wang, Li Chen, Yuling Huang","doi":"10.56434/j.arch.esp.urol.20267906.109","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.109","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the effects of short-course (5-7 days) versus standard-course (10-14 days) antibiotics on the incidence and recurrence of renal cortical defects and urological management outcomes in neonates with urinary tract infection (UTI), particularly in those with underlying urinary malformations.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 196 neonates with UTIs (98 in the short-course group and 98 in the standard-course group) admitted to our centre between February 2021 and December 2024. The co-primary outcomes were the incidence of renal cortical defects on Technetium-99m dimercaptosuccinic acid (99mTc-DMSA) imaging at 6-12 months and 30-day UTI recurrence. Prespecified secondary outcomes included treatment-related indicators, short-term efficacy, renal function, safety and health-economic endpoints. Structural follow-up, urological referral, urological intervention and subgroup outcomes according to urinary malformation status were analysed as exploratory outcomes. Subsequently, 1:1 propensity score matching was performed to mitigate confounding by indication.</p><p><strong>Results: </strong>The short-course group had a significantly shorter antibiotic duration and hospital stay, with lower total hospitalisation and antibiotic costs (all <i>p</i> < 0.001), than the standard-course group. 30-day UTI recurrence was higher in the short-course group than in the standard-course group, whereas the incidence of renal cortical defects at 6-12 months did not differ significantly. Structural follow-up and urological subgroup findings, particularly in neonates with urinary malformations, showed nominal between-group differences but were interpreted as exploratory after correction for multiple comparisons.</p><p><strong>Conclusions: </strong>In this single-centre retrospective cohort study, short-course antibiotics yielded comparable renal cortical defect outcomes but a higher 30-day UTI recurrence rate compared with standard-course antibiotics in neonates with UTIs. Short-course therapy was associated with shorter hospitalisation and lower overall costs than standard-course therapy. Structural and urological follow-up findings, particularly in neonates with urinary malformations, should be interpreted as exploratory and require prospective validation.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"930-938"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799914","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":"Bone Health in Patients With Prostate Cancer Treated With Androgen Deprivation Therapy: Risk Assessment and Practical Recommendations.","authors":"Sandra Guardado González, Fernando López-Campos, Miren Gaztañaga Boronat, Sandra Fernández Alonso, Laura Zaragoza Cocero, Luis Alberto Glaría Enríquez, María Antonia Gómez-Aparicio, Marta Rodríguez-Izquierdo Jiménez, Ana García Tello, Jennifer Le Guévelou, Felipe Couñago","doi":"10.56434/j.arch.esp.urol.20267906.103","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.103","url":null,"abstract":"<p><p>Androgen deprivation therapy (ADT) represents a cornerstone in the treatment of prostate cancer (PC); however, its use is associated with an accelerated deterioration of bone health as a consequence of treatment-induced hypogonadism. Patients receiving ADT experience a rapid loss of bone mineral density (BMD), especially during the first year of therapy, leading to a clinically significant increase in the risk of osteoporosis and fragility fractures. These bone complications are associated with a significant negative impact on quality of life, morbidity and mortality, and healthcare costs. This article aims to provide a critical and practical review of pathophysiology, risk factors, assessment methods, and strategies for the prevention and treatment of ADT-induced bone loss in patients with prostate cancer. Current recommendations from major clinical guidelines are analyzed, highlighting the importance of systematic bone risk assessment using bone densitometry and risk stratification tools like Fracture Risk Assessment Tool (FRAX®). Evidence-based interventions are also reviewed, ranging from lifestyle modifications and calcium and vitamin D supplementation to the use of antiresorptive therapies in selected patients, to provide a comprehensive and clinically applicable approach for daily practice.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"876-887"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800239","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":"Hypofractionated Postoperative Radiotherapy in Prostate Cancer: A Real-World Single-Center Experience.","authors":"Inmaculada Navarro-Domenech, Rafael Ordoñez-Marmolejo, Antonio Lazo-Prados, Ana Otero-Romero, Angel Calvo-Tudela, Herminda Jiménez-Rodríguez, Valery Tarazona-Vera, Martina Álvarez-Pérez, Raquel Correa-Generoso","doi":"10.56434/j.arch.esp.urol.20267906.105","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.105","url":null,"abstract":"<p><strong>Background: </strong>Postoperative radiotherapy (RT) is an established treatment for biochemical recurrence (BR) after prostatectomy. Moderate hypofractionation offers potential radiobiological and logistical advantages, although evidence for non-escalated postoperative RT schedules remains limited. This study evaluated oncological outcomes in patients with a hypofractionated postoperative RT.</p><p><strong>Methods: </strong>We retrospectively analyzed 189 patients with prostate cancer treated with postoperative hypofractionated RT to the prostate bed (55 Gy in 20 fractions). RT was delivered as salvage or adjuvant treatment according to pathological and biochemical findings. Survival outcomes and predictive factors were assessed using Kaplan-Meier and multivariable analyses.</p><p><strong>Results: </strong>Most patients received salvage RT, with a median pre-RT prostate-specific antigen (PSA) of 0.61 ng/mL. High-risk pathological features were common, and 26.3% developed BR after treatment. 5-year disease-free survival reached 93.8%, while 5-year overall survival (OS) was 96.6%. Postsurgical grade, pre-RT PSA, nodal involvement, and androgen deprivation therapy (ADT) were associated with outcomes.</p><p><strong>Conclusions: </strong>Non-escalated hypofractionated postoperative RT yields favorable local disease control accompanied by acceptable safety toxicity profiles, supporting its application as an effective and practical alternative to conventional fractionation regimens. Further prospective clinical studies are needed to clarify the potential therapeutic role of dose escalation in routine postoperative treatment setting.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"897-904"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800334","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":"Oncological Outcomes of Intravesical Bacillus Calmette-Guérin Versus Early Radical Cystectomy in Very High-Risk Non-Muscle-Invasive Bladder Cancer: A Retrospective Cohort From a Latin American Referral Center.","authors":"Andres German Alfieri, Florencia Ramirez, Gabriel Favre, Ignacio Tobia Gonzalez, Denise Zimmermann, Matias Gonzalez","doi":"10.56434/j.arch.esp.urol.20267906.107","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.107","url":null,"abstract":"<p><strong>Background: </strong>Very high-risk (VHR) bladder tumors represent a subcategory of non-muscle-invasive bladder cancer (NMIBC) with a high potential for progression to muscle-invasive bladder cancer (MIBC). Early radical cystectomy (ERC) is the standard treatment. However, for patients unfit for or refusing surgery, intravesical Bacillus Calmette-Guérin (BCG) immunotherapy remains a commonly used bladder-preserving approach. This study aimed to assess oncological outcomes in patients with VHR NMIBC treated with intravesical BCG or ERC.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study, including patients with VHR NMIBC treated with BCG or ERC between July 2008 and May 2023. Data were collected from an institutional electronic database. Only patients who received adequate BCG treatment, according to predefined induction and early maintenance criteria, were included in the BCG group. We analyzed clinical and pathological features, overall survival (OS), and cancer‑specific survival (CSS). Secondary objectives included progression and high-grade intravesical recurrence rates among BCG-treated patients.</p><p><strong>Results: </strong>Among 112 patients included, 99 received BCG and 13 underwent ERC. Patients undergoing ERC were younger and more frequently presented with adverse pathological features, including lymphovascular invasion and variant histology. No statistically significant differences in OS or CSS were observed between the groups. The estimated 60-month CSS was 91.1% in the BCG group and 100% in the ERC group. In the BCG cohort, 48 patients (48.5%) experienced recurrence and 15 progressed to muscle-invasive disease.</p><p><strong>Conclusions: </strong>In this retrospective cohort of patients with VHR NMIBC, intravesical BCG was associated with acceptable oncological outcomes in selected cases. However, due to significant baseline imbalances and the small size of the ERC group, these findings should be interpreted with caution, and cannot be considered evidence of equivalence between treatment strategies. Further prospective multicenter studies are needed to refine patient selection and optimize treatment strategies in this population.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"915-921"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800381","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":"Risk Factors and Nomogram for Predicting Urosepsis Following Laparoscopic Urological Surgery and Its Association With Acute Kidney Injury.","authors":"Junwei Zhang, Yuting Zhang, Yan Su, Kang Jia, Yi Yang","doi":"10.56434/j.arch.esp.urol.20267906.120","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.120","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the incidence and risk factors of urosepsis following laparoscopic urological surgery, develop a predictive nomogram, and evaluate the association between postoperative urosepsis and acute kidney injury (AKI).</p><p><strong>Methods: </strong>This retrospective analysis was performed on 426 consecutive patients who underwent laparoscopic urological surgery between March 2020 and August 2025. Patients were divided into a sepsis group (n = 42) and a non-sepsis group (n = 384) based on the occurrence of postoperative urosepsis. Demographics, disease and surgical characteristics, laboratory parameters, and the incidence of AKI were compared between the two group. Independent risk factors were identified using multivariable logistic regression and incorporated into a predictive nomogram. Model performance was assessed by receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Postoperative urosepsis occurred in 9.86% (42/426) of patients, of whom 83.33% (35/42) had positive urine cultures. Independent risk factors included positive preoperative urine culture, prolonged operative time, elevated urinary heparin-binding protein (HBP), and elevated white blood cell (WBC) count (all <i>p</i> < 0.05). The nomogram achieved an area under the ROC curve of 0.812 (95% confidence interval [CI]: 0.739-0.885), sensitivity of 0.810, specificity of 0.677, accuracy of 0.690, good calibration (Hosmer-Lemeshow test, <i>p</i> = 0.388), and net clinical benefit on DCA. The incidence of AKI was higher in the sepsis group than in the non-sepsis group (30.95% vs. 6.25%, <i>p</i> < 0.05), with greater severity observed in the sepsis group. After adjustment for age, diabetes mellitus, intraoperative blood loss, and baseline creatinine, urosepsis remained an independent risk factor for AKI (odds ratio [OR] = 5.623, 95% CI: 2.847-11.106; <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Urosepsis after laparoscopic urological surgery is an independent risk factor for AKI. The developed nomogram, incorporating preoperative urine culture, operative time, urinary HBP, and WBC count, demonstrated good performance in identifying patients at high risk of postoperative urosepsis.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"1050-1059"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800388","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":"Development of a Nomogram Incorporating Multiparametric MRI and Clinical Indicators for Predicting Positive Surgical Margins After Radical Prostatectomy.","authors":"Juan Ma, Xinyue Qiu, Fei Ren, Yanting Hu, Qi Cui, Xuan Zhou","doi":"10.56434/j.arch.esp.urol.20267906.110","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.110","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop a nomogram integrating multiparametric magnetic resonance imaging (mpMRI) features and clinical indicators for the preoperative prediction of positive surgical margins (PSM) after radical prostatectomy (RP).</p><p><strong>Methods: </strong>This retrospective study enrolled 304 patients who underwent RP for prostate cancer (PCa). The patients were divided into PSM (n = 98) and negative surgical margin (NSM, n = 206) groups based on histopathological results. Preoperative clinical variables, including prostate-specific antigen (PSA), PSA density (PSAD), biopsy Gleason Grade Group and clinical T-stage, were collected. The mpMRI parameters assessed included Prostate Imaging Reporting and Data System (PI-RADS) v2.1 score, tumour location, extracapsular extension (ECE), tumour maximum diameter, capsule contact length (CCL) and apparent diffusion coefficient (ADC) value.</p><p><strong>Results: </strong>Compared with the NSM group, the PSM group had significantly higher preoperative PSA, higher PSAD, a higher proportion of biopsy Gleason Grade Group 4-5, and a higher clinical T-stage proportion. On mpMRI, the PSM group exhibited a higher proportion of PI-RADS v2.1 score 5 lesions, more frequent transition zone tumours, higher suspicion of ECE, larger tumour maximum diameter, longer CCL and lower ADC value. Multivariate analysis identified PSAD, PI-RADS v2.1 score, suspected ECE, tumour maximum diameter, CCL, ADC value, and biopsy Gleason Grade Group as independent predictors of PSM (all <i>p</i> < 0.05). The nomogram achieved an area under the curve of 0.907 (95% confidence interval (CI): 0.873-0.941).</p><p><strong>Conclusions: </strong>A nomogram combining mpMRI and clinical indicators may aid preoperative prediction of PSM after RP, potentially facilitating patient risk stratification.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"939-949"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800357","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":"Xia Li Qi Capsules Improve Symptoms and Urodynamic Parameters in Patients With Benign Prostatic Hyperplasia: A Randomised Controlled Trial With Evidence of p38-JAK/STAT Axis Inhibition.","authors":"Pushen Yang, Hao Wang, Jianyang Lv, Jianwen Wang","doi":"10.56434/j.arch.esp.urol.20267906.115","DOIUrl":"10.56434/j.arch.esp.urol.20267906.115","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of Xia Li Qi capsules (XLQ) for benign prostatic hyperplasia (BPH) and explore its mechanisms of action involving the p38-Janus kinase/signal transducer and activator of transcription (p38-JAK/STAT) pathway.</p><p><strong>Methods: </strong>In this randomised controlled trial, 115 patients with BPH received XLQ (n = 58) or placebo (n = 57) for 8 weeks. The primary endpoint was change in International Prostate Symptom Score (IPSS) from baseline to Week 8; secondary endpoints included the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), maximum urinary flow rate (Qmax), mean urinary flow rate (Qave), prostate volume, post-void residual urine volume, quality of life (QOL), and the International Index of Erectile Function-5 (IIEF-5). Baseline-adjusted analysis of covariance (ANCOVA) was performed for between-group comparisons. <i>In vitro</i>, experiments using BPH-1 cells were conducted to assess cell proliferation, inflammatory cytokines levels, androgen receptor (<i>AR</i>)-related genes, and p38-JAK1-STAT3 signalling.</p><p><strong>Results: </strong>Both groups showed significant improvements in IPSS, NIH-CPSI, Qmax, Qave, and QOL (all <i>p</i> < 0.001). No significant between-group differences in IPSS or NIH-CPSI after adjustment. At Week 8, Qmax and Qave were significantly higher in the XLQ group (both <i>p</i> < 0.001), with reduced residual urine volume (<i>p</i> = 0.010). QOL improvement favoured XLQ before correction (<i>p</i> = 0.018) but did not survive multiple-comparison correction; prostate volume and IIEF-5 were unchanged. <i>In vitro</i>, XLQ inhibited BPH-1 proliferation, reduced interleukin (IL)-6, IL-1β, and tumour necrosis factor-α (TNF-α), suppressed AR-related gene expression, and decreased the phosphorylation of p38, JAK1, and STAT3 phosphorylation; these effects were partially reversed by p38 activation.</p><p><strong>Conclusions: </strong>XLQ improves urinary function in BPH patients, potentially by the inhibiting of inflammation and AR signalling via the p38-JAK/STAT axis.</p><p><strong>Clinical trial registration: </strong>The study was registered at Clinicaltrial.gov (https://www.chictr.org.cn/showproj.html?proj=14405), registration number: (ChiCTR1900022393).</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"992-1003"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799985","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}