Actas urologicas espanolas最新文献

{"title":"Enucleación prostática con láser holmium (HoLEP) En-bloc: experiencia inicial y consolidación de la técnica","authors":"J. Pineda-Murillo,&nbsp;O. Hernández-León,&nbsp;J.S. Cuéllar del Río,&nbsp;J.R. Arellano-Cuadros,&nbsp;G. Martínez-Carrillo,&nbsp;G.A. Quintero-Cortés,&nbsp;S.P. de la Paz-Martínez,&nbsp;J.C. Ávalos-Ramón,&nbsp;J.A. Lugo-García","doi":"10.1016/j.acuro.2025.501745","DOIUrl":"10.1016/j.acuro.2025.501745","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Benign prostatic enlargement has a prevalence of approximately 60% in 60-year-old men. En bloc enucleation and its variants, which emerged in 2010, are methods to enucleate the 3<!--> <!-->lobes of the prostatic capsule completely, maintaining the capsular plane and the urethral sphincter while removing the prostate. The aim of the present study is to analyze the implementation of the surgical technique, considering the learning curve and the experience accumulated in a group of patients before and after its development.</div></div><div><h3>Material and methods</h3><div>Retrospective study from July 2022 to November 2024, in which 136 patients with lower urinary tract symptoms due to prostate growth with indication for surgical treatment were included. Bleeding, surgical time, hospital stay, enucleated prostate volume, as well as enucleation, morcellation, time and laser energy efficiencies were analyzed.</div></div><div><h3>Results</h3><div>The efficacy of the procedure was higher in the post-curve group with a <em>P</em> <!-->&lt;<!--> <!-->0.0001 compared to the pre-curve group with a coefficient of determination R² <!-->=<!--> <!-->0.8091. Enucleation efficiencies, laser time and energy showed a statistically significant difference (<em>P</em> <!--> <!-->0.05) in favor of the post-curve group.</div></div><div><h3>Conclusions</h3><div>Holmium laser enucleation of the prostate has proven to be an effective and safe surgical treatment, even during the learning curve. The turning point of the procedure depends on proper mentoring and the appropriate selection of cases during the training process.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501745"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891111","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":"Precisión de Bladder EpiCheck en el diagnóstico del carcinoma urotelial del tracto urinario superior: un metaanálisis","authors":"S. Artero Fullana ,&nbsp;J. Caño Velasco ,&nbsp;A. Lafuente Puentedura ,&nbsp;L. Polanco Pujol ,&nbsp;V. Bataller Monfort ,&nbsp;M. Moralejo Gárate ,&nbsp;J.D. Subiela ,&nbsp;A. Gallioli ,&nbsp;M. Moschini ,&nbsp;R. Pichler ,&nbsp;F. del Giudice ,&nbsp;G. Marcq ,&nbsp;J. Teoh ,&nbsp;F. Soria ,&nbsp;L. Mertens ,&nbsp;W. Krajewski ,&nbsp;E. Laukhtina ,&nbsp;K. Mori ,&nbsp;B. Pradere ,&nbsp;L. Afferi ,&nbsp;C. Hernández Fernández","doi":"10.1016/j.acuro.2025.501720","DOIUrl":"10.1016/j.acuro.2025.501720","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Current upper tract urothelial carcinoma (UTUC) diagnosis and disease management rely on the combination of CT Urography (CTU), cytology and ureteroscopy (URS). The limited accuracy and complications associated with these tools have led to the search for non-invasive and reliable biomarkers. Our aim was to review and analyse the existing data on the use of Bladder EpiCheck® to assess its performance as a diagnostic tool for UTUC.</div></div><div><h3>Material and methods</h3><div>A literature search on the diagnostic value of Bladder EpiCheck® as a urinary biomarker in UTUC was conducted through PubMed, Web of Science and Scopus until February 2024. Pooled sensitivity (Se), specificity (Sp), negative predictive value (NPV) and positive predictive value (PPV) of the biomarker were calculated. Diagnostic performance was assessed through the area under the curve (AUC).</div></div><div><h3>Results</h3><div>Four studies, including 334 patients, were included in the quantitative analysis. Bladder EpiCheck® showed promising pooled diagnostic values with Se of 0.85 (95%<!--> <!-->CI: 0.55-0.96), Sp of 0.93 (95%<!--> <!-->CI: 0.56-0.99), PPV of 0.74 (95%<!--> <!-->CI: 0.54-0.87) and NPV of 0.84 (95%<!--> <!-->CI: 0.77-0.89). The exact AUC obtained was 0.912.</div></div><div><h3>Conclusions</h3><div>Bladder EpiCheck® is an effective diagnostic tool in UTUC, showing a promising diagnostic accuracy, with a Se and NPV of 85% and 84%, respectively. Its use in UTUC diagnosis and follow-up could reduce or postpone the need for more invasive procedures, such as URS, thereby reducing the procedure-associated risks and improving patients’ quality of life. Although further research and large prospective studies are needed, the current results indicate that Bladder EpiCheck® is a promising tool in UTUC diagnosis, treatment decision-making, and follow-up.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501720"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891178","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":"Biopsia dinámica de ganglio centinela en cáncer de pene: 25 años de experiencia en un centro oncológico terciario","authors":"C. Rodríguez ,&nbsp;M. Hassi ,&nbsp;Á. García ,&nbsp;A. Calatrava ,&nbsp;P. De Pablos-Rodríguez ,&nbsp;J. Casanova ,&nbsp;Á. Gómez-Ferrer","doi":"10.1016/j.acuro.2025.501721","DOIUrl":"10.1016/j.acuro.2025.501721","url":null,"abstract":"<div><h3>Introduction</h3><div>Penile cancer lymph node (LN) metastases are critical prognostic factors. The European Association of Urology (EAU) guidelines recommend dynamic sentinel node biopsy (DSNB) as a less invasive alternative for cN0 patients with intermediate- to high-risk tumors. Due to the rarity of penile cancer, lymph node staging tends to be underutilized, and few centers have a significant number of patients to develop the DSNB technique and observe its evolution over time. Previously, our series reported a sensitivity of 66%, and our aim is to contribute to the available evidence, based on 25 years of real-world experience.</div></div><div><h3>Materials and methods</h3><div>Retrospective single-center study involving 95 groins of 51 patients with intermediate or high-risk penile squamous carcinoma, who underwent DSNB between November 1999 and July 2024. Clinical data, including histology, surgical treatment, and complications, were analyzed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Complications were registered using the Clavien-Dindo system.</div></div><div><h3>Results</h3><div>The median age of patients was 60 (range 30 – 84) years. 10/51 patients (21%) had metastatic sentinel node. DSNB successfully identified sentinel nodes in 95.7% for right and 89.5% for left groins. The false-negative rate was 8.1%, with a sensitivity of 77%, specificity of 100%, PPV of 100%, and NPV of 92%. 18% (9/51) of patients suffered complications being most of them minor (6/9), 3 patients experimented major complications.</div></div><div><h3>Discussion and conclusion</h3><div>The updated DSNB outcomes show improved diagnostic accuracy compared to previous reports, reflecting enhanced techniques and learning curves. The study highlights the accuracy and the low morbidity of DSNB.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501721"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891109","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":"Valor de HCY, c-sdLDL, creatinina, IL-6 y PSA en el diagnóstico de la hiperplasia prostática benigna en el anciano","authors":"W. Qin,&nbsp;S. Liu,&nbsp;L. Liu,&nbsp;M. Liu,&nbsp;J. Chen,&nbsp;P. Dai","doi":"10.1016/j.acuro.2025.501744","DOIUrl":"10.1016/j.acuro.2025.501744","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the diagnostic value of serum metabolic markers such as HCY, sdLDL-C, Crea, inflammatory factor IL-6 and prostate-specific antigen in elderly patients with prostatic hyperplasia (BPH).</div></div><div><h3>Methods</h3><div>150 senile patients with hyperplasia of prostate were selected as observation group and 169 healthy senile patients were selected as control group. The tPSA, fPSA, fPSA/tPSA and prostate size data of the two groups were collected, and serum samples of the subjects were collected for the detection of HCY, sdLDL, Crea, IL-6 and other indicators. Univariate analysis, correlation analysis and logistic regression analysis were conducted to analyze the relationship between each index and senility prostatic hyperplasia. The diagnostic efficiency of each serum metabolite was analyzed by receiver operating characteristic curve (ROC).</div></div><div><h3>Results</h3><div>Serum levels of tPSA, fPSA, Crea, HCY, sdLDL-C and IL-6 were significantly increased, fPSA/tPSA ratio and HDL were significantly decreased, and TCHO, TG and LDL had no statistical significance. Serum tPSA and fPSA levels were positively correlated with prostate size, serum IL-6, Crea and HCY levels were positively correlated with tPSA and fPSA levels, and serum sdLDL-C levels were negatively correlated with fPSA levels. Logistic regression analysis showed that tPSA, fPSA, prostate size, HCY, Crea and IL-6 were risk factors for prostate hyperplasia. HDL and fPSA/tPSA are protective factors for benign prostatic hyperplasia. ROC curve analysis showed that the sensitivity and specificity of fPSA/tPSA and IL-6 were 82.7% and 72%, 83.4% and 80.5%, and the area under ROC curve were 0.840 and 0.825, respectively. tPSA and fPSA combined with HCY, IL-6 and Crea had the best diagnostic efficiency, with the area under ROC curve reaching 0.881, specificity and sensitivity reaching 84% and 77.3%, respectively.</div></div><div><h3>Conclusion</h3><div>The combined detection of prostate-specific antigen, HCY, Crea and IL-6 can significantly improve the diagnostic efficiency of senile prostatic hyperplasia, and optimize the diagnosis and treatment scheme can even be used as a major screening index to evaluate and predict the incidence of BPH in senile prostatic hyperplasia.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501744"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891110","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":"ADN tumoral circulante en el cáncer de vejiga músculo invasivo: una revisión sistemática","authors":"A.A. Grosso ,&nbsp;A. Cadenar ,&nbsp;S. Pillozzi ,&nbsp;G. Carli ,&nbsp;F. Lipparini ,&nbsp;F. Di Maida ,&nbsp;R. Pichler ,&nbsp;W. Krajewski ,&nbsp;S. Albisinni ,&nbsp;E. Laukhtina ,&nbsp;S. Mancon ,&nbsp;F. del Giudice ,&nbsp;M.C. Mir ,&nbsp;F. Soria ,&nbsp;M. Moschini ,&nbsp;S.F. Shariat ,&nbsp;M. Roupret ,&nbsp;J. Yuen-Chun Teoh ,&nbsp;L. Antonuzzo ,&nbsp;A. Breda ,&nbsp;A. Mari","doi":"10.1016/j.acuro.2025.501717","DOIUrl":"10.1016/j.acuro.2025.501717","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the role of circulating tumor DNA (ctDNA) as a prognostic and predictive biomarker in the perioperative management of muscle-invasive bladder cancer (MIBC).</div></div><div><h3>Methods</h3><div>We conducted a systematic literature review using PubMed, Medline, and Embase, following PRISMA guidelines. Studies from January 2013 to March 2024 were included if they examined ctDNA in MIBC patients undergoing radical cystectomy (RC) and perioperative chemotherapy or immunotherapy.</div></div><div><h3>Results</h3><div>Eight studies were included. ctDNA detected before RC was associated with poor recurrence-free survival and higher risk of nodal and locally advanced disease. Postoperative ctDNA levels correlated with shorter disease-free survival and higher recurrence rates. ctDNA clearance during neoadjuvant chemotherapy was predictive of treatment response. ctDNA status post-neoadjuvant immunotherapy correlated with pathological outcomes and recurrence rates.</div></div><div><h3>Conclusions</h3><div>ctDNA is a promising biomarker for predicting oncological outcomes in MIBC, with potential to guide perioperative treatment decisions. Further randomized controlled trials are needed to validate these findings.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501717"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890638","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":"Percepción real de los informes de anatomía patológica en urología","authors":"A. Cimadamore ,&nbsp;M. Moschini ,&nbsp;J. Teoh ,&nbsp;S. Albisinni ,&nbsp;Z. Adwin ,&nbsp;W. Shen Tan ,&nbsp;K. Mori ,&nbsp;M. Wroclawski ,&nbsp;F. Soria ,&nbsp;A. Aziz ,&nbsp;E. Laukhtina ,&nbsp;D.M. Carrión ,&nbsp;W. Krajewski ,&nbsp;M. Karavitakis ,&nbsp;M. Abufaraj ,&nbsp;A. Uleri ,&nbsp;A. Gallioli ,&nbsp;B. Pradere ,&nbsp;en representación del Grupo de Trabajo de Carcinoma Urotelial de la Sección de Jóvenes Urólogos Académicos - Asociación Europea de Urología (EAU-YAU)","doi":"10.1016/j.acuro.2025.501751","DOIUrl":"10.1016/j.acuro.2025.501751","url":null,"abstract":"<div><h3>Introduction</h3><div>Collaboration between pathologists and urologists is crucial for accurate diagnostic reporting and patient management, particularly in urology. This study aims to evaluate international practices regarding pathology reporting of bladder specimens to identify areas for improvement.</div></div><div><h3>Materials and methods</h3><div>A web-based survey with 32 questions was developed in collaboration with the EAU Young Academic Urologists Urothelial Cancer Working Party. It was sent to urologists with more than 5<!--> <!-->years of experience across different institutions globally. Descriptive statistics were used to evaluate the responses.</div></div><div><h3>Results</h3><div>A total of 157 responses were received from urologists, representing a response rate of 65%. Most respondents (64.3%) found pathological reports comprehensive, although 36% reported unclear reports in some cases. Pathologists were contacted for clarification in less than 20% of cases. Notably, the reporting of pathological subtypes and depth of invasion was inconsistent among institutions.</div></div><div><h3>Conclusion</h3><div>The survey highlights variability in pathology report quality across centers. Standardized reporting, increased pathologist involvement in multidisciplinary teams, and adherence to international guidelines are necessary to improve the accuracy and clarity of pathology reports in urology.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501751"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891179","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 de satisfacción de las parejas femeninas de pacientes con implante de prótesis de pene","authors":"C. Calzas Montalvo ,&nbsp;M. Alonso Isa ,&nbsp;M. Lo Re ,&nbsp;M.P. Caro González ,&nbsp;S. Juste Álvarez ,&nbsp;A. de la Calle Moreno ,&nbsp;C. García-Rayo Encina ,&nbsp;I. González Ginel ,&nbsp;J. Romero Otero ,&nbsp;A. Rodríguez Antolín ,&nbsp;B. García Gómez","doi":"10.1016/j.acuro.2025.501713","DOIUrl":"10.1016/j.acuro.2025.501713","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>There is limited evidence regarding sexual satisfaction among female partners of patients with penile prosthesis (PP) and factors influencing it.</div></div><div><h3>Materials and methods</h3><div>Single-center, retrospective, observational study including all patients aged ≥18 years who underwent PP implantation (inflatable and malleable types) between October 2007-December 2022 at Hospital 12 de Octubre, Madrid, Spain. 73 female partners completed the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire (5-item partner version). Each question was scored from 0 (lowest satisfaction) to 4 (highest satisfaction), resulting in an overall EDITS score ranging from 0 to 100. Variables collected: time since surgery, monthly intercourse frequency, type and brand of PP, initial placement rationale, new versus replacement surgery, total and inflatable PP part length.</div></div><div><h3>Results</h3><div>Average (standard deviation) scores were: 3.3 (0.9), 3.19 (0.9), 2.42 (0.8), 3.45 (0.9), and 3.67 (0.8). The overall average satisfaction score was 80 (12.4). Statistical analysis revealed no significant correlations between female partners’ satisfaction and their age (r<!--> <!-->=<!--> <!-->-0.128), actual age of the patient (r<!--> <!-->=<!--> <!-->-0.041), time since surgery (r<!--> <!-->=<!--> <!-->-0.072), monthly intercourse frequency (r<!--> <!-->=<!--> <!-->0.164), type of PP (p<!--> <!-->=<!--> <!-->0.521), brand of inflatable PP (p<!--> <!-->=<!--> <!-->0.582), causes of erectile dysfunction (p<!--> <!-->=<!--> <!-->0.174), number of replacements (p<!--> <!-->=<!--> <!-->0.705), total (r<!--> <!-->=<!--> <!-->0.167) or inflatable PP part length (r<!--> <!-->=<!--> <!-->0.134).</div></div><div><h3>Conclusions</h3><div>Sexual satisfaction among female partners in our cohort is high but we did not demonstrate any predictors of couple satisfaction.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501713"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891215","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":"Dominando la curva: avances y desafíos en la enseñanza de la enucleación endoscópica de la próstata","authors":"I. Schwartzmann","doi":"10.1016/j.acuro.2025.501695","DOIUrl":"10.1016/j.acuro.2025.501695","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501695"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890719","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":"Nuevos factores de riesgo de tromboembolismo venoso después de la resección transuretral de tumor vesical: modelos de regresión multivariable escalonada y LASSO basados en datos de reclamaciones de seguros de EE. UU.","authors":"J. Łaszkiewicz ,&nbsp;F. del Giudice ,&nbsp;S. Li ,&nbsp;W. Krajewski ,&nbsp;Ł. Nowak ,&nbsp;T. Szydełko ,&nbsp;S. Basran ,&nbsp;E. De Berardinis ,&nbsp;D. Carino ,&nbsp;R. Corvino ,&nbsp;V. Santerelli ,&nbsp;M. Ferro ,&nbsp;B. Rocco ,&nbsp;M.C. Sighinolfi ,&nbsp;F. Crocetto ,&nbsp;B. Barone ,&nbsp;F. Dinacci ,&nbsp;R. Pichler ,&nbsp;J.D. Subiela ,&nbsp;B. Pradere ,&nbsp;B.I. Chung","doi":"10.1016/j.acuro.2025.501738","DOIUrl":"10.1016/j.acuro.2025.501738","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Transurethral resection of the bladder tumor (TURBT) is a standard procedure in bladder cancer (BC), which is associated with low risk of venous thrombo-embolism (VTE). The aim of this study was to find the predictors of postoperative VTE in patients undergoing TURBT for BC.</div></div><div><h3>Materials and Methods</h3><div>In this retrospective cohort analysis, patients aged ≥18 years with BC diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de-identified databases in 2007-2021. Patients with prior VTE events were excluded. Preoperative diagnostic codes and outpatient prescriptions present in at least 1% of the cohort were recorded (205 variables). Then, logistic regressions were performed including each variable separately, all variables together, as well as variables selected by stepwise and Least Absolute Shrinkage and Selection Operator (LASSO) selection methods. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated.</div></div><div><h3>Results</h3><div>In total, 132,425 patients were included in this study, with 1,959 (1.5%) individuals diagnosed with postoperative VTE. Various malignant neoplasms diagnosed before BC were significant risk factors of postoperative VTE, with aOR reaching up to 2.26 (95% CI: 1.96-2.61). Another strong predictor of VTE was a diagnosis of nephritis, nephrotic syndrome, and nephrosis (aOR: 1.67; 95% CI: 1.48-1.87 stepwise; aOR: 1.65; 95% CI: 1.46-1.85 LASSO). Also, patients with diseases of the urinary system, non-specific symptoms, diseases of the respiratory system, anemias, and other cardiovascular diseases were associated with increased VTE risk. Regarding drugs, antidiabetic agents and gastrointestinal drugs reduced the probability of VTE.</div></div><div><h3>Conclusions</h3><div>Numerous preoperative factors have influence on the risk of VTE after TURBT. These findings might facilitate the clinical decision about the implementation of thromboprophylaxis in the appropriate patients.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501738"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891177","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":"Cirugía laparoscópica oncológica renal en pacientes de 85 años o mayor edad","authors":"P. Izquierdo ,&nbsp;J. Huguet ,&nbsp;A. Bravo-Balado ,&nbsp;S. Fontanet ,&nbsp;A. Farré ,&nbsp;R. Sánchez ,&nbsp;J.M. Gaya ,&nbsp;Ó. Rodríguez-Faba ,&nbsp;J. Palou ,&nbsp;A. Breda","doi":"10.1016/j.acuro.2025.501688","DOIUrl":"10.1016/j.acuro.2025.501688","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze our series of radical nephrectomies and laparoscopic nephroureterectomies in elderly patients.</div></div><div><h3>Materials and methods</h3><div>A retrospective review of patients aged 85 years and older who underwent major laparoscopic surgery for renal tumors at our center between April 2005 and March 2022 was conducted. Clinical-pathological characteristics, complications, and postoperative outcomes were analyzed.</div></div><div><h3>Results</h3><div>Forty-seven patients were included, with a median age of 87 years. Fifteen nephrectomies for renal tumors (Group 1), and 32 nephroureterectomies for urinary tract tumors (Group 2) were performed. In Group 1, 4<!--> <!-->postoperative complications were observed: 2<!--> <!-->Clavien 1, one Clavien 2, and one Clavien 4a. The most common histology was clear cell carcinoma; 9 patients had locally advanced tumors (TNM<!--> <!-->≥<!--> <!-->T3) at diagnosis. Five-year cancer-specific survival and overall survival rates were 73% and 40%, respectively. In Group 2, 14 postoperative complications occurred: 6<!--> <!-->(18.8%) Clavien 1, 4<!--> <!-->(12.5%) Clavien 2, and 5<!--> <!-->(15.6%) Clavien 5. All patients had urothelial carcinoma in their pathology reports. Twenty (62.5%) had invasive tumors (TNM<!--> <!-->≥<!--> <!-->T2) at diagnosis. Five-year cancer-specific survival and overall survival rates were 45% and 30%, respectively.</div></div><div><h3>Conclusion</h3><div>Laparoscopic renal oncologic surgery in elderly patients is feasible, although it is associated with a high morbimortality rate, particularly in those with urinary tract tumors. It is essential to provide this patient group with adequate information regarding the elevated surgical risks associated with the procedure.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501688"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891112","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}