Actas urologicas espanolas最新文献

{"title":"Seguridad y viabilidad de la cirugía retrógrada intrarrenal sin fluoroscopia para la litiasis ureteral y renal no complicada: estudio unicéntrico en una serie amplia de pacientes","authors":"S. Bürlukkara,&nbsp;Ö. Baran,&nbsp;M. Cemre Cevrin","doi":"10.1016/j.acuro.2025.501709","DOIUrl":"10.1016/j.acuro.2025.501709","url":null,"abstract":"<div><h3>Introduction</h3><div>Aimed to investigate the feasibility and availability of fluoroless retrograde intrarenal surgery (fRIRS) in a large patient population.</div></div><div><h3>Methods</h3><div>Patients who underwent fRIRS for ureteral or renal calculi in our center between June 2019 and June 2024 were reviewed. Demographic data, stone characteristics, operation time, perioperative-postoperative complications, perioperative complications, and stone-free rates of patients who underwent fRIRS for ureteral or renal calculi were evaluated. Clavien-Dindo classification was used for complications. All procedures were performed under spinal or general anesthesia.</div></div><div><h3>Results</h3><div>1079 patients were included in the study. Of the 1079 patients, 352 (32.6%) were female and 727 (67.4%) were male. The mean age was 47.33<!--> <!-->±<!--> <!-->14.31 years. The mean size of the stones was 13.1<!--> <!-->±<!--> <!-->6.33 mm3. Of the patients, 208 (19.27%) received general anesthesia and 871 (80.73%) received spinal anesthesia. The mean operation time was 37.14<!--> <!-->±<!--> <!-->17.65<!--> <!-->minutes. All patients received a Double J (DJ) stent postoperatively. The rate of complications was 8% overall. The complications observed in general were minor; postoperative colic pain and hematuria were observed in 36 (3.3%) patients and 26 (2.4%) patients, respectively. Stone-free rate was 86.4%.</div></div><div><h3>Conclusion</h3><div>The fRIRS is a safe and feasible method for the treatment of uncomplicated ureteral and renal calculi. In uncomplicated patients, it has similar complication and success rates to conventional methods and eliminates radiation exposure.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501709"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737969","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":"Suprarrenalectomía retroperitoneal por puerto único: el abordaje del presente","authors":"D. Vazquez-Martul","doi":"10.1016/j.acuro.2025.501694","DOIUrl":"10.1016/j.acuro.2025.501694","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501694"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738362","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":"Impacto oncológico de la resección transuretral de vejiga completa antes de la quimioterapia neoadyuvante en el cáncer de vejiga músculo invasor","authors":"C. Fernandes ,&nbsp;I. Baptista ,&nbsp;M. Manso ,&nbsp;C. Ferreira ,&nbsp;F. Botelho ,&nbsp;J. Silva ,&nbsp;C. Silva ,&nbsp;L. Vale","doi":"10.1016/j.acuro.2025.501712","DOIUrl":"10.1016/j.acuro.2025.501712","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the impact of cTURBT on pathologic response. Secondary endpoints involved survival and oncologic outcomes.</div></div><div><h3>Methods</h3><div>Tertiary centre data from patients with MIBC submitted to NAC and radical cystectomy between March 2010 and November 2022 was retrospectively analysed. Patients with complete resection (cTURBT) before NAC were compared to those with incomplete (iTURBT).</div></div><div><h3>Results</h3><div>Thirty-seven patients were included in this study. NAC regime was identical between groups. cTURBT group demonstrated a higher rate of downstaging than the iTURBT group (50% vs 20%, <em>p</em> <!-->=<!--> <!-->0.022). During the mean 49-month follow-up period, overall survival (86.4% vs. 40%, <em>p</em> <!-->=<!--> <!-->0.005), relapse-free survival (81.8% vs. 46.7% <em>p</em> <!-->=<!--> <!-->0.036), and cancer-specific survival (90.9% vs 60%, <em>p</em> <!-->=<!--> <!-->0.042) were higher in the cTURBT group. Furthermore, we observed significantly fewer relapses, higher survival rates, and lower oncological-related deaths in patients who exhibited downstaging.</div></div><div><h3>Conclusion</h3><div>cTURBT demonstrated a favourable impact on patients with MIBC undergoing NAC, enhancing pathologic downstaging and improving survival outcomes. Our results can be confounded by cTURBT being a proxy for less aggressive disease.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501712"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737900","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":"Diagnóstico precoz del cáncer de próstata en los varones sanos portadores de mutaciones germinales en las vías de respuesta al daño del ADN (vías DNA Damage Response [DDR]). Revisión de la literatura y propuesta de protocolo","authors":"A. Rosino Sánchez ,&nbsp;E. García Torralba ,&nbsp;E. Girela Baena ,&nbsp;J.A. Macías Cerrolaza ,&nbsp;J. Tudela Pallares ,&nbsp;M. Zafra Povés ,&nbsp;I. Barceló Bayonas ,&nbsp;V. Muñoz Guillermo ,&nbsp;T. Fernández Aparicio","doi":"10.1016/j.acuro.2025.501686","DOIUrl":"10.1016/j.acuro.2025.501686","url":null,"abstract":"<div><h3>Introduction</h3><div>Men with mutations in DNA damage response (DDR) pathways have a higher risk of developing prostate neoplasia compared to the general population. The best studied alterations are mutations in BRCA1/2, ATM and MMR-Lynch s.</div></div><div><h3>Material and methods</h3><div>A review of the clinical and prognostic implications of mutations in DDR pathways, as well as an evaluation of the different screening strategies available for affected patients.</div></div><div><h3>Objective</h3><div>To propose an early diagnostic strategy for men with mutations in DDR pathways.</div></div><div><h3>Results</h3><div>Current guidelines do not provide clear, specific recommendations for this subgroup of men. Among mutations in the MMR pathway, the germline MSH2 mutation is most strongly associated with prostate cancer. Men with germline mutations in BRCA1/2, ATM, and MSH2 have a higher incidence of prostate neoplasia, tend to develop the disease at a younger age, and are more likely to have aggressive forms of the disease. Furthermore, men with BRCA1/2 mutations have a lower cancer-specific survival rate compared to the general population. In these patients, PSA levels have important limitations in detecting prostate cancer. Multiparametric MRI of the prostate may be more effective than periodic PSA testing.</div></div><div><h3>Conclusions</h3><div>Patients with mutations in DDR pathways are at increased risk for aggressive prostate neoplasms and require earlier and more intensive screening. PSA-based screening has notable limitations. A screening strategy incorporating multiparametric MRI could offer a more effective strategy for this patient group.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501686"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737859","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":"Rabdomiólisis inducida por abiraterona y rosuvastatina","authors":"Ó. Porto Fuentes ,&nbsp;S. Penado Nadela ,&nbsp;S. Martínez Breijo ,&nbsp;B. San Millán Tejado","doi":"10.1016/j.acuro.2025.501689","DOIUrl":"10.1016/j.acuro.2025.501689","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501689"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737860","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":"Cáncer de pene y testículo en receptores de trasplante renal: revisión sistemática sobre la epidemiología, las opciones de tratamiento y los resultados oncológicos realizada por el grupo de trabajo de cáncer de pene y testículo de la Asociación Europea de Urología (EAU-YAU)","authors":"G. Basile ,&nbsp;G. Fallara ,&nbsp;M. Bandini ,&nbsp;W. Cazzaniga ,&nbsp;F. Negri ,&nbsp;L. Dieguez ,&nbsp;F. Montorsi ,&nbsp;A. Salonia ,&nbsp;A. Breda ,&nbsp;C. Fankhauser ,&nbsp;A. Territo","doi":"10.1016/j.acuro.2025.501683","DOIUrl":"10.1016/j.acuro.2025.501683","url":null,"abstract":"<div><h3>Introduction</h3><div>Kidney transplant (KT) recipients are at an elevated risk of developing de novo cancers. However, penile (PeCa) and testis cancers have received limited attention in this setting.</div></div><div><h3>Objective</h3><div>To summarize the epidemiology, treatment options, and oncological outcomes of penile and testis cancer in KT recipients.</div></div><div><h3>Evidence acquisition</h3><div>We conducted a systematic review of prospective, retrospective and national transplant registries studies published up to December 2023. Data on the incidence of penile and testis cancers among KT recipients, diagnostic protocols, screening recommendations, and therapeutic strategies tailored for KT recipients were collected. The risk of bias (RoB) of included studies was determined using the Newcastle and Ottawa scale.</div></div><div><h3>Evidence synthesis</h3><div>Overall, 21 studies involving 67924 KT male recipients were included. PeCa was diagnosed in 33 patients, yielding an incidence ranging from 0.04% to 0.3%. Additionally, 67 cases of testicular cancer were recorded, with an incidence ranging from 0.03% to 0.55%. Most tumors were localized, and histology variants were uncommon. While the surgical treatment of the primary tumor remains consistent with that of the general population, the use of radiotherapy and cytotoxic treatments are less frequently reported in this setting. These therapies should be considered on an individualized basis to minimize the risk of graft injury.</div></div><div><h3>Conclusions</h3><div>Penile and testis cancers are relatively uncommon among KT recipients. General screening protocols and deviation from current treatment guidelines are not recommended in localized diseases. Given the risk of graft damage, any non-cytotoxic option should be preferred in locally advanced cases.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501683"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737902","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":"Derivación urinaria y calidad de vida: 6 años de seguimiento después de la cirugía para el cáncer de vejiga","authors":"N. Pyrgidis ,&nbsp;J. Hermans ,&nbsp;P. Keller,&nbsp;D. Karatas,&nbsp;B. Ebner,&nbsp;G. Schulz,&nbsp;C. Stief,&nbsp;Y. Volz","doi":"10.1016/j.acuro.2025.501699","DOIUrl":"10.1016/j.acuro.2025.501699","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate health-related quality of life (HRQOL) six years post-radical cystectomy in patients with muscle-invasive bladder cancer, comparing orthotopic ileal neobladder (ONB) and ileal conduit (IC). Therefore, the study aims to analyze the under-investigated long-term impact of standard bladder cancer treatments on HRQOL and provide insights into the HRQOL differences associated with these two common urinary diversion methods.</div></div><div><h3>Patients and methods</h3><div>This prospective study included 39 patients with urothelial carcinoma treated with ONB or IC at our center between 03/2013 and 01/2023. Patients with variant histology, metastasis, neoadjuvant chemotherapy, or benign indications for cystectomy were excluded. HRQOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire preoperatively, at four and six years postoperatively. Statistical analyses included Chi-square tests, T-tests, and logistic regression models.</div></div><div><h3>Results</h3><div>Of the patients, 64% (25/39) underwent ONB, and 76.9% (30/39) were male, with an average age of 69 years. No significant differences in overall good HRQOL (GHS<!--> <!-->&gt;70) were observed between ONB and IC at six years (IC: 60<!--> <!-->±<!--> <!-->22; ONB: 69<!--> <!-->±<!--> <!-->23, p<!--> <!-->=<!--> <!-->0.2). Patients with IC reported higher insomnia at both follow-ups (4 years: p<!--> <!-->=<!--> <!-->0.01; 6 years: p<!--> <!-->=<!--> <!-->0.03). Emotional function remained stable in ONB patients but declined in IC patients from the fourth to sixth years (p<!--> <!-->=<!--> <!-->0.04).</div></div><div><h3>Conclusions</h3><div>Long-term HRQOL did not significantly differ between ONB and IC up to six years post-radical cystectomy. Both urinary diversion methods can be offered to patients, with tailored discussions in terms of HRQOL.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501699"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eficacia de los ejercicios de suelo pélvico guiados pre-prostatectomía radical robótica en la incontinencia urinaria y calidad de vida","authors":"C. García-Sánchez ,&nbsp;I. García-Obrero ,&nbsp;C. Muñoz-Calahorro ,&nbsp;A.J. Rodríguez-Pérez ,&nbsp;R.A. Medina-López","doi":"10.1016/j.acuro.2025.501702","DOIUrl":"10.1016/j.acuro.2025.501702","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Radical prostatectomy has a great impact on urinary continence, although it is a multifactorial aspect. The aim of the study was to evaluate the effect of guided Pelvic Floor Exercises (PFE) versus written information prior to robotic radical prostatectomy (RRP) on the rate of urinary incontinence, and their effect on patients’ quality of life.</div></div><div><h3>Material and method</h3><div>62 patients were randomized to an experimental (physiotherapist-guided exercises) or control (written information) group. The primary outcome was incontinence rate (measured by pad test). Secondary outcomes were incontinence severity, quality of life (measured by the 36-Item Short Form Survey Instrument (SF-36) and the King's Health Questionnaire (KHQ)), voiding dynamics, correlation between incontinence and quality of life, and other incontinence-related factors.</div></div><div><h3>Results</h3><div>We found no differences in the incontinence rate between groups in the months of follow-up (82.61% vs 84.62%, month 1; 61.54% vs 75.86%, month 3; 50% vs 53.33%, month 6; 30.77% vs 40%, month 12) nor in the severity of incontinence between groups. There were significant differences in the quality of life related to “emotional problems” and “personal relationships”, in favor of the control group. We found correlations between incontinence severity and age, severity and quality of life, urgency/frequency and quality of life.</div></div><div><h3>Conclusions</h3><div>Guided exercises prior to RRP do not seem to offer benefits over written information in either the rate or severity of incontinence. Urinary incontinence correlates with age and quality of life. Quality of life correlates with urgency and voiding frequency.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501702"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737966","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":"Factores de riesgo y modelos predictivos de litiasis renal en la población estadounidense: estudio de cohortes emparejadas mediante puntuación de propensión","authors":"Y. Sun,&nbsp;F. Xu,&nbsp;Z. Xiao,&nbsp;Y. An,&nbsp;H. Zhao","doi":"10.1016/j.acuro.2025.501715","DOIUrl":"10.1016/j.acuro.2025.501715","url":null,"abstract":"<div><h3>Objective</h3><div>This study sought to identify risk factors and develop predictive models for kidney stone disease in the U.S. population using data from the National Health and Nutrition Examination Survey (NHANES).</div></div><div><h3>Methods</h3><div>In a propensity score–matched cohort study, we examined the association of serum α-Klotho, hemoglobin levels, serum creatinine, and the urinary albumin-to-creatinine ratio (uACR) with kidney stone disease.</div></div><div><h3>Results</h3><div>Initially, 216,560 participants were screened; following propensity matching, 28,370 adults aged 40 to 79 years were included in the final analysis. Serum α-Klotho levels were inversely associated with kidney stone disease, particularly among individuals with chronic kidney disease and those who consumed alcohol. Hemoglobin levels demonstrated an inverse association with kidney stone disease risk, whereas serum creatinine levels exhibited a U-shaped relationship. No significant trend was observed for uACR overall. Low hemoglobin and α-Klotho levels, as well as elevated serum creatinine and uACR, were significantly associated with increased all-cause mortality.</div></div><div><h3>Conclusion</h3><div>Our findings underscore the significance of serum α-Klotho, hemoglobin, serum creatinine, and uACR levels in assessing the risk of kidney stone disease and all-cause mortality, suggesting these markers as potential targets for prevention and management strategies. Further research is warranted to clarify the mechanisms underlying these associations.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501715"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737901","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":"Análisis prospectivo de la curva de aprendizaje en enucleación prostática con láser de holmio: serie de 125 casos","authors":"L.E. Ortega Polledo ,&nbsp;E. García Rico ,&nbsp;A. Sánchez Pellejero ,&nbsp;G.F.J. Bianchini Hernández ,&nbsp;A. Sanchís Bonet ,&nbsp;J. Gómez Rivas ,&nbsp;I. Galante Romo ,&nbsp;J. Moreno Sierra ,&nbsp;B. Miñana ,&nbsp;S. Ahyai ,&nbsp;S. Alonso y Gregorio","doi":"10.1016/j.acuro.2025.501705","DOIUrl":"10.1016/j.acuro.2025.501705","url":null,"abstract":"<div><h3>Objective</h3><div>The objective is to evaluate the effectiveness and safety of a surgeon's learning curve for holmium laser enucleation of the prostate in 125 consecutive cases.</div></div><div><h3>Materials and methods</h3><div>Preoperative baseline characteristics, functional outcomes, surgical times, and complications of the first 125 patients treated by holmium laser enucleation of the prostate were recorded. The sample was divided into quintiles (25 cases/group), and statistical analysis was carried out using the ANOVA test, Kruskal-Wallis H test, Chi-squared test, and likelihood-ratio test.</div></div><div><h3>Results</h3><div>Surgical time decreased progressively: 92<!--> <!-->min (Q1), 65<!--> <!-->min (Q2), 54<!--> <!-->min (Q3), 45<!--> <!-->min (Q4) and 50<!--> <!-->min (Q5) (p<!--> <!-->&lt;<!--> <!-->0.001). Enucleation rate gradually increased: 1.08<!--> <!-->g/min (Q1), 1.65<!--> <!-->g/min (Q2), 1.82<!--> <!-->g/min (Q3), 1.96<!--> <!-->g/min (Q4) and 2.74<!--> <!-->g/min (Q5) (p<!--> <!-->&lt;<!--> <!-->0.001). There were no differences in enucleated weight (Q1: 51<!--> <!-->g, Q2: 57<!--> <!-->g, Q3: 51<!--> <!-->g, Q4: 53<!--> <!-->g, Q5: 65<!--> <!-->g) (p<!--> <!-->=<!--> <!-->0.21), length of hospital stay (median 1.12 days), bladder catheterization (mean 1.51 days), intra- and postoperative complications or urethral stricture (5.6%) (p<!--> <!-->&gt;<!--> <!-->0.05). Time to continence recovery was similar in quintiles 1 to 4 (23, 27, 21 and 20 days, respectively) and shorter in quintile 5 (3.5 days) (p<!--> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>The initiation of a holmium laser enucleation of the prostate program following the completion of training demonstrates a low morbidity rate and highly favorable functional outcomes. The efficiency of the technique demonstrates a linear and consistent increase from the outset of the learning curve, with significantly reduced surgical times achieved after 25 cases.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501705"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737967","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}