Archivos Espanoles De Urologia最新文献

{"title":"Outcomes of Multichannel Urodynamic Study-Guided Concomitant Burch Colposuspension During Abdominal Sacrocolpopexy: A Retrospective Cohort Study.","authors":"Göktuğ Kalender, Bülent Çetinel, Muhammet Demirbilek, Emre Akkus, Sinharib Çitgez","doi":"10.56434/j.arch.esp.urol.20267906.108","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.108","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate outcomes following a preoperative strategy in which invasive multichannel urodynamic testing guided the decision to perform concomitant Burch colposuspension during abdominal sacrocolpopexy. A secondary objective was to assess whether a non-invasive diagnostic test could predict urodynamic stress urinary incontinence (USUI) in patients with severe apical pelvic organ prolapse scheduled for abdominal sacrocolpopexy.</p><p><strong>Methods: </strong>A retrospective review of medical records was performed for patients who underwent abdominal sacrocolpopexy. Patients with USUI underwent concomitant Burch colposuspension (Group 1), while those without underwent abdominal sacrocolpopexy alone (Group 2). Both groups were assessed for postoperative satisfaction, pre- and postoperative stress urinary incontinence status and changes in symptom questionnaire scores. In addition, non-invasive parameters were identified to predict the presence of USUI, as detected by multichannel urodynamic study across the entire cohort.</p><p><strong>Results: </strong>Groups 1 and 2 consisted of 53 (48.6%) and 56 (51.4%) patients, respectively. The median follow-up time was 16 months (interquartile range: 12-21). Based on the Patient Global Impression of Improvement, satisfaction rates (defined as responses of \"a little better\" or greater) were 92.5% and 94.6% in Groups 1 and 2, respectively. Postoperative symptom questionnaire scores significantly improved in both groups; notably, postoperative stress urinary incontinence (SUI) status significantly improved only in Group 1 (<i>p</i> < 0.001). Multivariable logistic regression and modified Poisson regression analyses demonstrated that a positive provocative stress test with prolapse reduction was independently associated with USUI.</p><p><strong>Conclusions: </strong>When preoperative multichannel urodynamic study identified USUI, combining abdominal sacrocolpopexy with Burch colposuspension yielded favorable surgical outcomes. Although the provocative stress test with prolapse reduction may serve as a screening tool for predicting preoperative USUI in patients with severe apical pelvic organ prolapse undergoing abdominal sacrocolpopexy, it cannot yet be considered a substitute for multichannel urodynamic study.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"922-929"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800417","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 Outcomes of CTA-Assisted Transarterial Embolization in Emergency Patients With Urologic Tumours Complicated by Gross Haematuria: A Retrospective Cohort Study.","authors":"Yunfeng Lu, Guangliang Gu, Shoulei Liu, Xisheng Zhou","doi":"10.56434/j.arch.esp.urol.20267906.118","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.118","url":null,"abstract":"<p><strong>Background: </strong>Gross haematuria constitutes a life-threatening complication of urologic tumours, demanding urgent and precise identification of the responsible bleeding vessels, along with immediate and effective haemostatic intervention to avert hemodynamic collapse.</p><p><strong>Methods: </strong>This retrospective cohort study included 120 emergency patients with urologic tumours and gross haematuria between January 2020 and December 2023. All patients underwent preprocedural computed tomography angiography (CTA) to evaluation bleeding vessels and tumour blood supply, followed by transarterial embolization (TAE). Clinical characteristics, procedural outcomes, and follow-up data were analysed.</p><p><strong>Results: </strong>Preprocedural CTA identified target vessels in 112 of 120 patients (93.3%). Postoperative complications occurred in 23 patients (19.2%) and were predominantly Clavien-Dindo grade I-II, including embolization syndrome (9.2%), transient recurrent haematuria (5.0%), and urinary tract infection (3.3%), all of which were managed conservatively. Multivariate Cox regression analysis identified tumour node metastasis (TNM) stage III-IV, multiple tumour foci, and hypovascular supply as independent risk factors for haematuria recurrence and poor overall survival rate (all <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>CTA-assisted TAE shows high immediate haemostatic efficacy and acceptable short-term safety, supporting its clinical feasibility as a rescue approach for urologic tumour-related gross haematuria. TNM stage III-IV, multiple foci, and hypovascular supply predict poorer outcomes. Prospective multicentre controlled studies are warranted.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"1027-1037"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800426","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":"Research Progress on the Prevention and Treatment of Postoperative Complications of Benign Prostatic Hyperplasia in Elderly Patients: A Narrative Review.","authors":"Zewei Sun, Mingfa Wan","doi":"10.56434/j.arch.esp.urol.20267906.104","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.104","url":null,"abstract":"<p><p>Benign prostatic hyperplasia (BPH) is a leading cause of lower urinary tract symptoms in middle-aged and elderly men. Surgery remains an important treatment option for BPH with moderate-to-severe symptoms, yet postoperative complications adversely affect patients' quality of life. With an aging patient population and the emergence of new surgical technologies, traditional prevention strategies face new challenges. This review examines how the rising complexity of the elderly cohort is reshaping postoperative care paradigms, and how two key drivers-Enhanced Recovery After Surgery (ERAS) and laser technology evolution-are responding to this challenge. First, it analyses the unique risk spectrum of the elderly compared with younger patients, underscoring the need for individualized pathways integrating comprehensive geriatric assessment. Second, it elucidates how ERAS, through optimized perioperative care, directly mitigates specific postoperative complications. Third, it explores how laser techniques have transformed the complication profile and how technique-specific risks are managed in the context of the aging population. Finally, this narrative review synthesizes these dimensions into a cross-dimensional framework for risk prediction, targeted prevention, and personalized care, aiming to provide new ideas for clinical practice and future research. By integrating geriatric assessment, ERAS principles, and laser-specific considerations, this framework aims to provide new ideas for clinical practice and guide future research toward safer, outcome-driven BPH surgery in the aging population.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"888-896"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800337","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":"Preoperative Systemic Immune-Inflammation Index Combined With Multiphasic Enhanced CT Features for Predicting Fuhrman Grade in Clear Cell Renal Cell Carcinoma: An Internally Validated Proof-of-Concept Nomogram.","authors":"Leikang Zhang, Yize Yao, Xuerong Ye, Lei Qu, Dongdong Li","doi":"10.56434/j.arch.esp.urol.20267906.116","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.116","url":null,"abstract":"<p><strong>Background: </strong>Accurate preoperative estimation of tumour grade may guide management decisions for clear cell renal cell carcinoma (ccRCC); however, grade is typically confirmed only postoperatively. This study evaluated whether an internally validated proof-of-concept model combining the systemic immune-inflammation index (SII) with multiphasic computed tomography (CT) features could identify high Fuhrman grade preoperatively, while acknowledging that this endpoint is not interchangeable with World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade without revalidation.</p><p><strong>Methods: </strong>This study retrospectively analysed 286 surgically treated patients with pathologically proven ccRCC between January 2018 and December 2023. Patients were randomly assigned to training (n = 200) and internal validation (n = 86) cohorts. SII was calculated from preoperative platelet, neutrophil, and lymphocyte counts and modelled continuously; the SII cutoff of 530 was used only for sensitivity analysis and nomogram display. Variables with <i>p</i> < 0.10 in univariable logistic regression and variables considered clinically important were entered into multivariable logistic regression with backward stepwise selection. Collinearity diagnostics, area under the curve (AUC) comparison, calibration, decision curve analysis, bootstrap resampling, and risk stratification were performed.</p><p><strong>Results: </strong>High-grade ccRCC (Fuhrman III/IV) accounted for 31.1% of cases. In multivariable analysis, continuous SII (odds ratio (OR) = 1.39 per 100-unit increase, 95% confidence interval (CI): 1.18-1.63, <i>p</i> < 0.001), tumour size >4 cm (OR = 3.06, 95% CI: 1.44-6.52, <i>p</i> = 0.004), intratumoral necrosis (OR = 4.71, 95% CI: 2.26-9.83, <i>p</i> < 0.001), and corticomedullary phase (CMP) enhancement ≤84 Hounsfield unit (HU; OR = 2.11, 95% CI: 1.10-4.04, <i>p</i> = 0.024) were independently associated with high-grade disease. The nomogram achieved AUCs of 0.891 (95% CI: 0.846-0.936) and 0.867 (95% CI: 0.793-0.941) in the training and validation cohorts. Adding SII to CT features improved the validation AUC by 0.036 and improved reclassification metrics.</p><p><strong>Conclusions: </strong>This internally validated proof-of-concept nomogram integrates continuous SII and routine enhanced CT features to estimate the probability of high Fuhrman grade in surgically treated ccRCC. It may facilitate preoperative discussions in similar clinical settings, but external validation using centralized WHO/ISUP grading is required before broad implementation.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"1004-1013"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800401","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 Disease Burden and Risk Factor Attribution for Urological Cancers in Six High-Growth GBD Regions.","authors":"Yang Liu, Yunfan Li, Tingjia Wu, Hongyu Hu, Haiyang Hu","doi":"10.56434/j.arch.esp.urol.20267906.117","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.117","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa), bladder cancer (BCa), and kidney cancer (KC) are the predominant urological cancers in older adults, posing substantial global health burdens. This study aimed to identify regions with the most rapid growth in combined urological cancer burden and characterize their distinct epidemiological profiles, risk factor attributions, and future trajectories.</p><p><strong>Methods: </strong>We aggregated age-standardized incidence rates (ASIRs) for PCa, BCa, and KC across 21 Global Burden of Disease (GBD) regions (1990-2021), identifying six high-growth regions using the estimated annual percentage change (EAPC) of the combined ASIR. We analysed mortality-to-incidence ratios (MIRs), risk factor-attributable mortality, disability-adjusted life year (DALY) decomposition, and autoregressive integrated moving average (ARIMA) projections to 2036. DALYs were further decomposed into years of life lost (YLLs) and years lived with disability (YLDs).</p><p><strong>Results: </strong>Six high-growth regions were identified: Eastern Europe, Central Europe, North Africa and Middle East (NAME), High-income Asia Pacific (HIAP), Southeast Asia (SEA), and Andean Latin America (ALA). High body mass index (BMI) has surpassed tobacco as the leading attributable risk factor for KC mortality globally (2021 male age-standardized mortality rate [ASMR] in Eastern Europe: 2.91 [95% uncertainty interval (UI): 2.07-3.74] vs. 1.88 [1.15-2.62] per 100,000 for tobacco). Tobacco use remains the leading attributable risk factor for BCa mortality, though declining in most regions, except Central European women (EAPC 1.23 [0.78-1.69]). Eastern and Central Europe showed the steepest increases in PCa DALY rates (Central Europe: from 145.54 to 301.56 per 100,000). Decomposition analyses revealed that epidemiological changes were associated with burden increases in high-human development index (HDI) regions, whereas population growth and aging predominated in NAME, SEA, and ALA. ARIMA projections indicate rising PCa incidence and mortality in Eastern Europe through 2036.</p><p><strong>Conclusions: </strong>Eastern and Central Europe require urgent, evidence-based interventions targeting rapid disease burden growth and high baseline rates. Low-to-middle HDI regions should implement proactive policies to reduce future risks driven by demographic transitions and the adoption of westernized lifestyle.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"1014-1026"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800362","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":"Evidence-Based Pain Management and Rehabilitation Nursing is Associated With Reduced Early Postoperative Biochemical Stress Markers and Improved Recovery After Mini-PCNL for Complex Renal or Ureteral Stones: A Retrospective Cohort Study.","authors":"Dan Sun, Yang Song, Jinzhou Xiong, Ting Hu","doi":"10.56434/j.arch.esp.urol.20267906.113","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.113","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether an evidence-based pain management and rehabilitation nursing pathway improves early recovery after mini-percutaneous nephrolithotomy (mini-PCNL) for complex renal or ureteral stones.</p><p><strong>Methods: </strong>This retrospective cohort study included 148 patients undergoing mini-PCNL from January 2023 to December 2025. The control group received routine perioperative nursing care (January 2023-June 2024), and the observation group received an evidence-based pain and rehabilitation nursing pathway (July 2024-December 2025), with 74 patients in each group. Stress indicators, pain, renal function, recovery milestones, and complications were compared.</p><p><strong>Results: </strong>Heart rate and mean arterial pressure changed over time, but did not differ between-group. Compared with the control group, the observation group had lower cortisol levels at 6 h (888.5 ± 159.3 vs 1074.1 ± 258.2 nmol/L) and 24 h postoperatively (522.7 ± 97.5 vs 868.0 ± 215.9 nmol/L), and lower adrenocorticotropic hormone levels at 6 h (20.7 ± 5.4 vs 26.9 ± 7.6 pmol/L) and 24 h postoperatively (12.6 ± 3.5 vs 21.4 ± 6.2 pmol/L). Median Visual Analogue Scale (VAS) pain scores were lower at 6, 12, and 24 h postoperatively (5, 4, 3 vs 7, 6, 5). At 24 h postoperatively, serum creatinine (87.5 ± 14.7 vs 96.4 ± 15.0 µmol/L) and blood urea nitrogen levels (5.59 ± 0.94 vs 6.36 ± 1.34 mmol/L) were lower. The observation group also had earlier first ambulation (13.3 vs 15.4 h), lower VAS scores at first voiding (3 vs 5), and shorter hospital stay (4 vs 6 days). Nephrostomy tube duration, catheter duration, urinary tract infection, and haematuria were similar.</p><p><strong>Conclusions: </strong>Evidence-based pain management and rehabilitation nursing was associated with reduced early biochemical stress markers, improved pain control and short-term renal function, and accelerated early recovery after mini-PCNL.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"969-979"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800431","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":"Recurrent Invasive Clear Cell Subtype of Upper Tract Urothelial Carcinoma Responding to Enfortumab Vedotin and Pembrolizumab After Chemotherapy: A Case Report.","authors":"Kota Kawase, Keita Nakane, Koji Iinuma, Tomoki Taniguchi, Masayuki Tomioka, Yuki Tobisawa, Chiemi Saigoh, Tatsuhiko Miyazaki, Takuya Koie","doi":"10.56434/j.arch.esp.urol.20267906.122","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.122","url":null,"abstract":"<p><strong>Introduction: </strong>Urothelial carcinoma (UC) with clear cell subtype is a malignant neoplasm characterized by a distinctive morphological pattern featuring a glycogen-rich cytoplasm. Due to its extremely rare occurrence in the upper urinary tract, an optimal treatment has not yet been established.</p><p><strong>Case presentation: </strong>This study reports the case of an 81-year-old woman diagnosed with upper tract urothelial carcinoma (UTUC) with clear cell subtype located in the right renal pelvis. The patient underwent laparoscopic radical nephroureterectomy, and pathological findings showed that clear-cell morphology accounted for more than 90% of the tumor. Gemcitabine and carboplatin were administered as adjuvant chemotherapy. However, 3 months after completing adjuvant chemotherapy, the patient developed severe pain, and imaging examinations revealed metastasis to the para-aortic lymph nodes and retroperitoneum. Subsequently, the patient underwent systemic therapy with enfortumab vedotin (EV) and pembrolizumab (EV-P). Following a single cycle of EV-P, the patient exhibited substantial improvement in symptoms, and metastatic lesions decreased notably. Immunohistochemical testing confirmed strong expression of Nectin-4 in the tumor tissue.</p><p><strong>Conclusions: </strong>This is the first report to demonstrate the efficacy of EV-P for recurrent UTUC with clear cell subtype. In tumors exhibiting rare histological variants, the identification of biomarkers such as nectin-4 suggests their potential to guide effective treatment selections.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"1072-1077"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800355","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 and Validation of A Nomogram for Prostate Cancer Diagnosis Based on Inflammatory Ratios and PSA Derived Indicators.","authors":"Yong Wang, Jie Chen, Jilin Kuang, Xuefen Wang","doi":"10.56434/j.arch.esp.urol.20267906.121","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.121","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the diagnostic value of the C-reactive protein/albumin ratio (CAR) and platelet/albumin ratio (PAR) combined with prostate-specific antigen (PSA)-derived indicators for prostate cancer (PCa) and to develop a visualised nomogram for PCa diagnosis.</p><p><strong>Methods: </strong>This retrospective study included 354 patients undergoing initial prostate biopsy between January 2023 and December 2025. Patients were randomly assigned to a training set (n = 248, 70%) and a validation set (n = 106, 30%). The training set included 106 patients with PCa and 142 patients with benign prostatic hyperplasia (BPH). Clinical characteristics and laboratory data were collected to calculate CAR, PAR and PSA-derived indicators. Independent risk factors of PCa were identified using univariate and multivariate logistic regression analyses and incorporated into a nomogram. Model performance was assessed by receiver operating characteristic (ROC) curves, calibration curves, bootstrap internal validation (1000 resamples) and decision curve analysis (DCA).</p><p><strong>Results: </strong>Compared with patients with BPH, those with PCa had older age, lower free/total prostate-specific antigen ratio (f/tPSA), and higher prostate-specific antigen density (PSAD), CAR and PAR (all <i>p</i> < 0.05). Multivariate analysis confirmed these five indicators as independent predictors of PCa (all <i>p</i> < 0.05). The combined model yielded an area under the curve (AUC) of 0.882, significantly outperforming single indicators (<i>p</i> < 0.05), with a sensitivity of 92.45% and a specificity of 73.94%. The nomogram achieved AUCs of 0.886 (training) and 0.850 (validation), with an AUC difference of 0.036 and no significant overfitting. Patients with intermediate- to high-risk PCa (Gleason score ≥ 7) showed lower f/tPSA and higher PSAD, CAR, PAR than those with low-risk PCa (all <i>p</i> < 0.05). Calibration curves showed good agreement between predicted and actual observed probabilities, and DCA indicated favourable clinical net benefit.</p><p><strong>Conclusions: </strong>Age, f/tPSA, PSAD, CAR and PAR are independent risk factors of PCa. Internal validation of the nomogram incorporating these variables showed no significant overfitting and high preoperative diagnostic value. The nomogram may assist in tumour malignancy assessment, but external multicentre validation is needed to confirm its generalisability.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"1060-1071"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800411","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":"Cancer-Associated Thrombosis in Genitourinary Malignancies: A Real-World Analysis From the TESEO Registry.","authors":"Francisco José Pelegrín-Mateo, Beatriz Grau Mirete, Federico Vázquez Mazón, Álvaro Rodríguez Lescure, Paula Jiménez Fonseca, Alberto Carmona Bayonas, Isaura Fernández Pérez, Jaime Rubio Pérez, Laura Ortega Morán, Diego Cacho Lavin, Purificación Martínez Del Prado, Mariano Martínez Marín, Marta García de Herreros, Marta Carmona Campos, Andrés Muñoz Martín","doi":"10.56434/j.arch.esp.urol.20267906.106","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.106","url":null,"abstract":"<p><strong>Background: </strong>Cancer-associated thrombosis (CAT) is a frequent and clinically relevant complication in patients with genitourinary (GU) malignancies, but real-world data focused on this population are limited. We describe the clinical characteristics, management, and outcomes of venous thromboembolism (VTE) in patients with GU cancers.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients with GU malignancies included in the registry of Thrombosis and nEoplasia of SEOM (TESEO). Adult patients with histologically confirmed GU cancer and radiologically proven VTE were included.</p><p><strong>Results: </strong>Data on a total of 337 patients were analyzed; most of the patients (75.4%) had advanced disease. Pulmonary embolism was the most frequent presentation (56.2%), and 51.2% of events were incidentally diagnosed. Median time from cancer diagnosis to VTE was 9 months, with shorter intervals observed in germ cell tumors. Low-molecular-weight heparin was the most commonly used anticoagulant (88.2%). Bleeding complications occurred in 11.3% of patients, mainly during the first month of treatment, with GU bleeding being the most frequent. Recurrent VTE was observed in 4.1% of patients. Median overall survival was 59 months and did not differ according to thrombotic characteristics. However, among patients with bladder cancer, bleeding events were associated with worse overall survival (adjusted hazard ratio 2.82; 95% confidence interval, 1.13-7.04; <i>p</i> = 0.019 by log-rank test).</p><p><strong>Conclusions: </strong>In this real-world cohort, CAT in GU malignancies predominantly occurred in advanced disease and was frequently diagnosed incidentally. Overall survival was mainly influenced by tumor-related factors, although bleeding events negatively affected outcomes in patients with bladder cancer, underscoring the need for individualized anticoagulation strategies.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"905-914"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800347","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":"Machine Learning Analysis of CT Images for the Prediction of Extracorporeal Shock Wave Lithotripsy Efficacy.","authors":"Yuanchao Cao, Hang Yuan, Yi Qiao, Yuting Guo, Xinning Wang, Bin Li, Xinsheng Wang, Yanjiang Li, Wei Jiao","doi":"10.56434/j.arch.esp.urol.20267906.111","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267906.111","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to evaluate the use decision support analysis for the prediction of extracorporeal shock wave lithotripsy (ESWL) efficacy and to analyze the factors influencing outcomes in patients who underwent ESWL using machine learning (ML) methods.</p><p><strong>Methods: </strong>This retrospective study analyzed the clinical data, including preoperative computed tomography (CT) images, of 302 patients who received a single ESWL session treatment for urinary stone between May and October 2022 in the Department of Urology. The data was preprocessed and incorporated into an ML model, and the dataset was validated at a ratio of 4:1. The area under the curve (AUC) and the confusion matrix were used to evaluate the predictive efficacy of the model.</p><p><strong>Results: </strong>The CT image-based ML model predicting ESWL efficacy for urinary stone removal achieved an AUC of 0.86, precision of 88.33%, F1 score of 86.57%, sensitivity of 82.86%, and specificity of 88.89%. The model achieved an AUC of 0.95 for kidney stones, with 95.45% precision, 96.00% F1 score, 100.00% sensitivity, and 90.00% specificity. The AUC value for upper ureteral stones was 0.89, with 89.14% precision, 88.05% F1 score, 83.33% sensitivity, and 94.51% specificity, while that for mid-ureteral stones was 0.85, with 82.93% precision, 84.09% F1 score, 74.00% sensitivity, and 96.88% specificity, and the success rate of ESWL for lower ureteral stones was 100.00%, with an AUC of 1.00.</p><p><strong>Conclusions: </strong>ML analysis was used to predict outcomes following ESWL treatment for urinary stone. The ML-based model achieved an AUC of 0.86. The use of ML algorithms can provide matched insights to domain knowledge on effective and influential factors for the prediction of ESWL outcomes.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 6","pages":"950-957"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800367","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}