Archivos Espanoles De Urologia最新文献

{"title":"A Systematic Review With Meta-Analysis on the Role of Pelvic Floor Muscle Exercises on the Severity of Symptoms and Quality of Life in Women With Urinary Incontinence.","authors":"Reema Joshi, Manisha Rathi","doi":"10.56434/j.arch.esp.urol.20267905.88","DOIUrl":"10.56434/j.arch.esp.urol.20267905.88","url":null,"abstract":"<p><strong>Background: </strong>Involuntary urine loss, also known as urinary incontinence (UI), commonly affects women as a result of pelvic floor weakness or bladder malfunction. Despite conflicting and inconclusive data, pelvic floor muscle training (PFMT) is frequently used to treat individuals with stress urinary incontinence (SUI). This study was designed to investigate the effectiveness of PFMT in females with SUI.</p><p><strong>Methods: </strong>PubMed, the cochrane library, embase, science direct, web of science, scopus, and google scholar databases were searched until 31st October 2023. Included peer reviewed randomized controlled trials (RCTs) published in English language that assessed effect of PFMT in stress-related UI. The I² test and a funnel plot were used to analyze heterogeneity and publication bias. Risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist. Random-effects meta-analysis was performed.</p><p><strong>Results: </strong>14 publications, primarily RCTs, were selected from 8440 citations for the final qualitative analysis. Articles were published between 2010 and 2023, with 2192 total participants ranging from 30 to 600 and aged 18-80 were included. PFMT shows 14% absolute reduction in UI (risk difference (RD) = 0.14; 95% confidence interval (CI): 0.04-0.25; <i>p</i> = 0.01) and significantly improved quality of life (QoL) (RD = 0.17; 95% CI: 0.06-0.29; <i>p</i> < 0.01). Substantial heterogeneity was explored through subgroup and sensitivity analyses.</p><p><strong>Conclusions: </strong>This meta-analysis showed that PFMT reduces UI and improves the QoL in women. The PROSPERO registration: The study was registered at Clinicaltrials.gov (https://www.crd.york.ac.uk/PROSPERO/view/CRD420261339337), registration number: CRD420261339337.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 5","pages":"752-764"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431341","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":"Androgen Deprivation Therapy and Cardiovascular Health: Challenges and Opportunities in Prostate Cancer Care.","authors":"Sandra Fernández Alonso, Fernando López Campos, David Büchser, Sandra Guardado, Jon Andreescu, Walter Vásquez, Ana Castaño, Javier Gil Moradillo, Lucía García González, Andrew Loblaw, Felipe Couñago","doi":"10.56434/j.arch.esp.urol.20267905.87","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267905.87","url":null,"abstract":"<p><strong>Background: </strong>Androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) improve advanced prostate cancer (PCa) outcomes but increase cardiovascular (CV) toxicity, making cardiovascular disease (CVD) a major competing cause of morbidity, and mortality. To review the current evidence on CV toxicity related to ADT and ARPIs in PCa focusing on the magnitude of CV risk, strategies for CV risk assessment and prevention in clinical practice.</p><p><strong>Methods: </strong>A narrative review of the English-language literature was conducted using PubMed, Scopus, the Cochrane Library, and ScienceDirect. The search included studies through December 2025 on ADT- and ARPI-associated cardiovascular toxicity. Search terms combined keywords and Medical Subject Headings (MeSH) terms such as \"prostate cancer\", \"androgen deprivation therapy\", \"androgen receptor pathway inhibitors\", \"cardiovascular toxicity\", and \"cardio-oncology\". Eligible studies included prospective clinical trials, systematic reviews, meta-analyses, and clinically relevant retrospective or real-world studies. Reference snowballing was not performed.</p><p><strong>Results: </strong>ADT induces metabolic, vascular, inflammatory, and endocrine alterations that promote a proatherogenic and prothrombotic state. CV risk appears to vary across hormonal therapies. Gonadotropin-releasing hormone (GnRH) antagonists appear to be associated with lower early rates of major adverse cardiovascular events (MACE)-as defined in each included study-than GnRH agonists, particularly in patients with pre-existing CVD, although evidence from meta-analyses and realworld studies remains heterogeneous. ARPIs show distinct CV safety profiles, with higher rates of hypertension and CV events reported with abiraterone and apalutamide, whereas darolutamide appears to have a more favorable profile.</p><p><strong>Conclusions: </strong>Systematic CV risk assessment, preventive management of modifiable risk factors, and individualized treatment strategies within a multidisciplinary cardio-oncology framework are essential to optimize long-term outcomes in patients with PCa receiving ADT and ARPIs.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 5","pages":"741-751"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431393","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":"Incidence and Spectrum of Adverse Events With Enfortumab Vedotin Therapy in Advanced or Metastatic Urothelial Carcinoma: Evidence From a Systematic Review and Meta-Analysis.","authors":"Xiaoyu Li, Wenyuan Leng, Weimin Hu, Duan Gao, Zhenpeng Zhu, Jian Lin, Chunru Xu","doi":"10.56434/j.arch.esp.urol.20267905.98","DOIUrl":"10.56434/j.arch.esp.urol.20267905.98","url":null,"abstract":"<p><strong>Background: </strong>Systemic treatment options for locally advanced or metastatic urothelial carcinoma (La/mUC), especially for patients resistant to chemotherapy and ineligible for immunotherapy, are a current research focus. Enfortumab vedotin (EV), an antibody-drug conjugate targeting Nectin-4, has recently been introduced, necessitating attention to its potential adverse reactions for patient safety.</p><p><strong>Methods: </strong>Databases were searched for publications up to 12 June 2025. Clinical trials and retrospective studies investigating EV therapy were included in the analysis. Adverse reactions and complications were primary outcomes, analyzed using Stata 14.0.</p><p><strong>Results: </strong>22 studies (including 3 randomized controlled trials (RCTs)) with 1715 patients were included. The most common adverse effect was fatigue (38.41%, 95% confidence interval [CI]: 31.10%-45.99%, I² = 85.2010, <i>p</i> < 0.001). Other common effects included rash, alopecia, peripheral sensory neuropathy, pruritus, dysgeusia, decreased appetite, and decreased weight, and the pooled incidence was 37.20% (95% CI: 30.45%-44.21%, I² = 86.2369, <i>p</i> < 0.001), 37.14% (95% CI: 30.15%-44.40%, I² = 79.0839, <i>p</i> < 0.001), 33.68% (95% CI: 29.44%-38.06%, I² = 59.0190, <i>p</i> = 0.0011), 30.24% (95% CI: 21.26%-40.01%, I² = 91.4944, <i>p</i> < 0.001), 27.50% (95% CI: 20.69%-34.87%, I² = 83.9947, <i>p</i> < 0.001), 27.17% (95% CI: 18.46%-36.81%, I² = 90.4200, <i>p</i> < 0.001) and 26.55% (95% CI: 20.16%-33.45%, I² = 0.0000, <i>p</i> = 0.8935), respectively. The average pooled incidence of grade ≥ 3 adverse events was below 7.0%, with severe complications like rash 6.99% (95% CI: 4.97%-9.28%, I² = 45.9297, <i>p</i> = 0.0267), anemia 5.53% (95% CI: 3.03%-8.60%, I² = 56.9147, <i>p</i> = 0.0132), and neutropenia 4.95% (95% CI: 3.35%-6.80%, I² = 6.7786, <i>p</i> = 0.3788).</p><p><strong>Conclusions: </strong>EV offers a new second-line treatment for La/mUC after chemotherapy and immunotherapy failures. It shows a generally manageable safety profile. However, severe adverse events such as skin complications, peripheral neuropathy, hyperglycemia, fatigue, and decreased appetite require attention. Given the low quality of some included studies, further evidence from larger-scale studies is needed to confirm its long-term tolerability. PROSPERO registration number: The systematic analysis was conducted according to the guidelines of the PRISMA statement and registered on PROSPERO (CRD42022273772). (https://www.crd.york.ac.uk/PROSPERO/view/CRD42022273772).</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 5","pages":"837-846"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431346","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":"Physical Activity During Radiotherapy in Prostate Cancer: Feasibility, Outcomes, and Clinical Integration.","authors":"Ana Maria Serradilla Gil, Aida Tórtola-Navarro, Manuel Luis Blanco-Villar, Raquel Correa Generoso, Antonio Lazo Prados, Nuria Azahara Linares Mesa, Angeles Sanchez Galvez","doi":"10.56434/j.arch.esp.urol.20267905.85","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267905.85","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) is a safe and feasible intervention for prostate cancer (PCa) patients undergoing radiotherapy (RT) and may improve cancer-related fatigue, physical function, and quality of life (QoL). However, evidence specifically addressing PA delivered during RT and the biological mechanisms supporting potential radiosensitisation or normal-tissue protection remains heterogeneous.</p><p><strong>Methods: </strong>We conducted a narrative review of studies published in the last 10 years evaluating PA interventions in men receiving RT for PCa or in survivors previously treated with RT, focusing on feasibility/adherence, safety, treatment-related toxicity, physical function, body composition/metabolic outcomes, and patient-reported QoL.</p><p><strong>Results: </strong>Supervised PA, both cardiovascular and strength-based, is safe and feasible during RT, with high adherence and low risk. Across trials, PA is associated with reduced short-term fatigue, better maintenance of muscle mass and physical performance, and improved QoL, including in men receiving concomitant androgen deprivation therapy. Evidence suggesting positive effects on urinary and bowel symptoms and the therapeutic index is emerging, although mechanistic data in humans during RT are limited and largely indirect.</p><p><strong>Conclusions: </strong>Current evidence supports integrating structured, individualised PA as an adjunct to RT for PCa, given its consistent functional and quality-of-life benefits and favourable safety profile. Future trials should standardise PA dose and outcomes and further clarify dose-response relationships and biological mechanisms during RT.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 5","pages":"719-728"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431404","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":"Age as a Predictor of Prostate Cancer Risk Stratification in Systematic Prostate Biopsy.","authors":"Coskun Bostanci, Kazim Erdem","doi":"10.56434/j.arch.esp.urol.20267905.94","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267905.94","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the correlation between age and prostate pathological outcomes obtained through systematic transrectal prostate biopsy in 50- to 80-year-old patients with prostate-specific antigen levels ranging from 2.5 to 25 ng/mL.</p><p><strong>Methods: </strong>This retrospective study included 1079 patients aged 50-80 years who underwent transrectal ultrasound-guided prostate biopsy. The patients were divided into two primary age groups: 50-65 years and 66-80 years. Additionally, the patients were stratified into six 5-year age subgroups (50-55, 56-60, 61-65, 66-70, 71-75, and 76-80 years). Pathological outcomes were compared between these primary age groups and subgroups.</p><p><strong>Results: </strong>The prostate cancer detection rate increased from 27.6% in patients aged 50-65 years to 46.4% in those aged 66-80 years (<i>p</i> < = 0.001). Clinically significant prostate cancer was more frequent in patients older than 70 years. The International Society of Urological Pathology (ISUP) grade groups 3 and 4 were significantly more common in patients aged 76-80 years than in those under 70 years (<i>p</i> < = 0.001). No significant differences were observed for the ISUP grade groups 2 and 5. For grade group 1, a significant difference was found only between the 61-65 and 66-70-year age groups.</p><p><strong>Conclusions: </strong>This study revealed that the detection rates of clinically significant prostate cancer and higher ISUP grade groups (especially grades 3 and 4) increased notably after age 65 years. These findings highlight the importance of age-adjusted risk assessment and individualized prostate-specific antigen screening and biopsy strategies. Further prospective studies are needed to refine protocols for older patients.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 5","pages":"808-814"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431334","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":"Effect of Evidence-Based Nursing-Guided Optimization of Disinfection Supply Processes on Postoperative Infection Prevention in Patients With Ureteral Calculi.","authors":"Shunqiong Liu, Jin Zhang, Qian Deng, Shiyong Peng","doi":"10.56434/j.arch.esp.urol.20267905.101","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267905.101","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the effects of evidence-based nursing-guided optimization of disinfection supply processes on postoperative infection prevention and patient recovery after surgery for ureteral calculi.</p><p><strong>Methods: </strong>This single-centre retrospective study included 122 patients who underwent ureteral calculi surgery in our hospital between March 2023 and March 2025. Based on the disinfection supply management model used, we divided patients into a control group (routine disinfection supply process) and a study group (evidence-based nursing-guided process optimization). The two group were compared for surgical-related indicators, postoperative recovery outcomes, infection-related outcomes, and inflammatory markers (white blood cell count [WBC], neutrophil percentage [NE], C-reactive protein [CRP] and procalcitonin [PCT]) measured on postoperative days 1 and 5.</p><p><strong>Results: </strong>No statistically significant differences were observed between the two groups in baseline characteristics or operative duration (<i>p</i> > 0.05). Similarly, no statistically significant differences were found in surgeon experience, operative duration, intraoperative irrigation pressure, or ureteral stent placement (<i>p</i> > 0.05). The incidence of urinary tract infection and surgical site infection was significantly lower in the study group than in the control group (<i>p</i> < 0.05), while no significant differences were found in postoperative fever or urine culture positivity rates (<i>p</i> > 0.05). On postoperative day 1, no significant differences were identified in inflammatory markers between the two groups (<i>p</i> > 0.05); however, on postoperative day 5, levels of WBC, NE, CRP, and PCT were significantly lower in the study group than in the control group (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Evidence-based nursing-guided optimization of disinfection supply processes was associated with lower postoperative infection rates, reduced inflammatory marker levels, and improved postoperative recovery in patients with ureteral calculi, suggesting clinical value for perioperative infection prevention and control.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 5","pages":"862-868"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431343","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":"Magnetic Resonance Imaging as a Predictor of Early Discontinuation of Active Surveillance in Patients with Prostate Cancer.","authors":"Raimundo Domínguez Argomedo, Pedro de Pablos-Rodríguez, Paula Pelechano Gómez, María Isabel Martín García, Amaia Arrizabalaga Solano, Victor Rodríguez Part, Manel Beamud Cortés, Ana Calatrava Fons, Cristina Gutiérrez Castañé, Álvaro Gómez-Ferrer Lozano, Ángel García Cortés, José Agustín López Gonzalez, José Luis Domínguez Escrig, Cristian Romero Hinostroza, Eugenio Sánchez Aparisi, Juan Casanova Ramón-Borja","doi":"10.56434/j.arch.esp.urol.20267905.89","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267905.89","url":null,"abstract":"<p><strong>Background: </strong>Active surveillance (AS) is a well-established strategy for managing prostate cancer (PCa); however, available evidence indicates that approximately 28% of patients may experience progression within the first 5 years. Magnetic resonance imaging (MRI) may help optimize patient selection. This study assessed whether the presence of focal lesions (prostate imaging reporting and data system (PI-RADS) ≥ 3) on baseline MRI is associated with an increased risk of histological progression and AS discontinuation.</p><p><strong>Methods: </strong>We conducted a retrospective study of consecutive patients enrolled in AS at a comprehensive cancer center since 2012, recorded in the Urodata platform, based on a prospectively maintained cohort and including patients meeting European Association of Urology (EAU) criteria for low- or favorable intermediate-risk PCa. Inclusion criteria were diagnostic and confirmatory transperineal biopsies performed with the institution's standard technique, available baseline MRI, and a minimum follow-up of one year. Patients with prior treatment were excluded. Histological progression was defined as an increase in Gleason grade group on follow-up biopsy compared with baseline. Progression at 5 years was evaluated using Kaplan-Meier curves and multivariable Cox proportional hazards models. Patients with PI-RADS ≥ 3 were classified as visible lesions on MRI (MRI+), and those with PI-RADS <3 as no visible lesions on MRI (MRI-).</p><p><strong>Results: </strong>A total of 105 patients were included, with a median age of 64 years (interquartile range (IQR) 59-70) and a median prostate-specific antigen (PSA) of 5.8 ng/mL (IQR 4.7-8.9). The median interval between initial and confirmatory biopsy was 24 months, and median follow-up was 6 years. Seventy-one patients were classified as MRI+. Baseline characteristics were similar between groups. Five-year progression-free survival was 41% in MRI+ versus 77% in MRI- groups (hazard ratios (HR) 5.5; 95% confidence interval (CI) 2.3-13). Only 28% of patients with PI-RADS 5 remained free of progression at 5 years. Baseline PSA >6 ng/mL and PSA density >0.2 were independently associated with histological progression.</p><p><strong>Conclusions: </strong>The presence of PI-RADS ≥ 3 lesions on baseline MRI is significantly associated with an increased risk of histological progression and AS discontinuation. MRI may be a key tool for optimizing candidate selection for AS.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 5","pages":"765-772"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431358","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":"Survival in Synchronous Versus Metachronous Bladder and Prostate Cancer.","authors":"Berrin Yalçın, Ebru Tuncay, Serdar Arslan, Hilmi Enes Araci, Hikmet Köseoğlu","doi":"10.56434/j.arch.esp.urol.20267905.93","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267905.93","url":null,"abstract":"<p><strong>Background: </strong>We aim to evaluate the co-occurrence of prostate cancer (Pca) and bladder cancer (Bca). We also aim to identify their clinicopathological characteristics and oncological outcomes in accordance with their status as either synchronous or metachronous during oncological follow-up.</p><p><strong>Methods: </strong>Retrospective data query set to the timeline of 2011-2022 yielded 72 patients with synchronous or metachronous Pca and Bca from the hospital database. Patients with synchronous cancers were assigned to group I, those with metachronous Bca after Pca were assigned to group II and those with metachronous Pca after Bca were assigned to group III.</p><p><strong>Results: </strong>The synchronous group included 33 (45.83%) patients, whereas the metachronous group included 39 (54.17%) patients (29 patients (40.28%) in group II and 10 (13.89%) in group III). The rate of high-grade Bca (71.88%) and presence of carcinoma in situ (CIS) (46.87%) were higher in synchronous tumours than in other tumour types. 5- and 10-year overall and metastasisfree survival rates were lower in the synchronous group than in the metachronous groups. The 10-year survival rates for all three groups were 61%, 89% and 91%. In all groups, the lung was the most common metastatic site and the third most common cancer site.</p><p><strong>Conclusions: </strong>The survival rate in the synchronous group was lower than that in the metachronous groups. In addition, the risk of a third tumour is high in patients with synchronous or metachronous tumours. The occurrence of lung cancer as the third most common tumour in these patients might be related to the common habit of smoking.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 5","pages":"800-807"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430222","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 Urology in Spain: From Technological Promise to Real Clinical Practice.","authors":"Carolina de la Pinta, Alberto Artiles Medina","doi":"10.56434/j.arch.esp.urol.20267905.84","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267905.84","url":null,"abstract":"<p><p>Artificial intelligence (AI) is redefining modern medicine and urology. Its applications range from natural language processing (NLP) systems that streamline clinical documentation and reduce administrative burden to generative AI models capable of producing actionable data to support clinical decision-making and enable precision treatment selection. In Spain, the healthcare system has undergone an accelerated digital transformation, during which AI has evolved from an experimental concept to an operational component of routine clinical practice. This review provides an overview of the current implementation of AI in urology in Spain, highlighting actively deployed AI-based systems across different centers. The review is based on a structured search of publicly available information from news databases, institutional repositories, and independent monitoring initiatives focused on AI adoption in the Spanish healthcare system. These tools demonstrate substantial clinical benefits in areas such as diagnostic imaging, automated coding, digital pathology, radiotherapy planning, and patient follow-up. Their integration has improved diagnostic accuracy, optimized workflow efficiency, reduced reporting times, and facilitated more personalized treatment approaches. At the international level, the steadily growing number of Food and Drug Administration (FDA)- and CE-approved AI tools further illustrates the expanding clinical adoption of AI in urology. Overall, these advances indicate that AI has become a cornerstone of precision medicine, rather than a distant future prospect.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 5","pages":"710-718"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431316","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":"Immunohistochemistry-Based Molecular Subtyping in Muscle-Invasive Bladder Cancer: Predicting Response to Neoadjuvant Chemotherapy.","authors":"Luis Pérez-Bartivas, Fernando Leiva-Cepas, David Ponferrada, Pablo Flores-Paco, Víctor Atance-Morales, Marta Martínez, Ana Armenta-Triviño, Rosa María Rodríguez-Alonso, Juan De La Haba-Rodríguez, Enrique Aranda, María José Méndez-Vidal","doi":"10.56434/j.arch.esp.urol.20267905.90","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.20267905.90","url":null,"abstract":"<p><strong>Background: </strong>Muscle-invasive bladder cancer (MIBC) presents a heterogeneous response to perioperative chemotherapy. Although several molecular classifications of MIBC have been proposed, two main subtypes, namely, luminal and basal, are widely recognised. This study aims to explore the relationship between the molecular subtypes of MIBC, as characterised by GATA binding protein 3 (GATA3) and cytokeratin 5/6 (CK5/6) immunohistochemistry, and treatment response to neoadjuvant chemotherapy.</p><p><strong>Methods: </strong>Patients with nonmetastatic MIBC who were treated with cisplatin-based neoadjuvant chemotherapy at the Reina Sofía University Hospital between 2014 and 2023 were retrospectively analysed. Tumours were classified into luminal (GATA3+, CK5/6-), basal (GATA3-, CK5/6+), double-positive (GATA3+, CK5/6+), or double-negative (GATA3-, CK5/6-) subtypes. Clinical and pathological data, including overall survival (OS), disease-free survival (DFS) and pathological response, were analysed by using Kaplan-Meier curves, log-rank tests and chi-squared tests.</p><p><strong>Results: </strong>Amongst the 69 patients included, 13 were classified as luminal, five as basal, 50 as double positive and one as double negative. Patients with luminal tumours had significantly higher five-year DFS (91.7% vs. 50.7%, <i>p</i> = 0.021) and OS (100% vs. 60.5%, <i>p</i> = 0.016) than those with double-positive tumours. Pathological complete response (ypT0) was observed in 7/13 (53.8%) luminal tumours and in 15/50 (30.0%) double-positive tumours (<i>p</i> = 0.190). Additionally, 9/13 (69.2%) luminal tumours achieved tumour downstaging (<ypT2), whereas 20/50 (40.0%) double-positive tumours (<i>p</i> = 0.060) achieved tumour downstaging. Basal and double-negative subtypes were excluded from analysis because of their low representation in the sample.</p><p><strong>Conclusions: </strong>The luminal subtype showed superior outcomes in terms of DFS and OS compared with double-positive tumours. Higher rates of pathological complete response and tumour downstaging were observed in luminal tumours than in other tumour types. However, these differences did not reach statistical significance.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 5","pages":"773-782"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431332","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}