Actas urologicas espanolas最新文献

{"title":"Estudio de evaluación de satisfacción en pacientes con/sin enfermedad de Peyronie e implante de prótesis de pene, y sus parejas","authors":"E. Lledó García ,&nbsp;F.J. González García ,&nbsp;J. Jara Rascón ,&nbsp;J. García Muñoz ,&nbsp;E. Lledó Graell ,&nbsp;M.A. Sánchez Ochoa ,&nbsp;C. Hernández Fernández","doi":"10.1016/j.acuro.2023.08.008","DOIUrl":"https://doi.org/10.1016/j.acuro.2023.08.008","url":null,"abstract":"<div><h3>Introduction and objective</h3><p>Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. However, patients with coexistent Peyronie's disease (PD) and refractory erectile dysfunction and/or severe deformities may show different results. The aim of our study was to assess and to compare the level of satisfaction, with an inflatable penile prosthesis (IPP), in men with/without coexistent PD.</p></div><div><h3>Material and methods</h3><p>A survey study based on a 5-item satisfaction questionnaire was submitted to all those live patients implanted in the period 1992-2022 at our center (n<!--> <!-->=<!--> <!-->570) and their partners. Ninety-two percent of implants were three component inflatable devices. Surgeries were mainly performed by 2 surgeons. The main outcome measure used was the level of patient and partner satisfaction with sexual intercourse after IPP.</p></div><div><h3>Results</h3><p>Of the 570 eligible patients, 479 (84%) completed the survey (393 non-PD: group 1; 70 non-complex PD: group 2; 16 complex PD: group 3). Eighty-six percent of patients in group 1 reported satisfactory sexual intercourse (very or moderately satisfied). Non-complex PD implanted patients (group 2) reported a global 81% satisfactory sexual intercourse (very or moderately satisfied) (p<!--> <!-->&gt;<!--> <!-->0.05). However, when we evaluated the PD subgroup of patients with severe PD who require incision/excision/grafting at the time of implant (group 3, n<!--> <!-->=<!--> <!-->20), only 61% reported satisfactory sexual intercourse (p<!--> <!-->&lt;<!--> <!-->0.01) with predominance of moderately satisfied patients over very satisfied: 78 vs. 22%). Additionally, 84% (group 1), 80% (group 2) and 54% (group 3) of partners reported satisfactory intercourses, respectively (p<!--> <!-->&lt;<!--> <!-->0.01). Overall, 84% of group 1 implants and 79% of group 2 reported that they would undergo the procedure again if the IPP failed (p<!--> <!-->&gt;<!--> <!-->0.05; ns). Only 50% of group 3 patients would do it again. With regard to cosmetic aspects, 48% of the group 3 implant reported penile shortness or soft glans as the main causes of their dissatisfaction. Only 2.4% of total IPP patients expressed difficulty in manipulating the device.</p></div><div><h3>Conclusions</h3><p>The presence of PD alone may not impact IPP patient and partner satisfaction, but patients with more severe baseline deformity who require incision/grafting may be less satisfied with outcomes including penile length and glans sensation.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 5","pages":"Pages 392-397"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141242723","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":"El efecto del vídeo informativo preoperatorio sobre los niveles de ansiedad en pacientes que serán intervenidos para extracción del stent ureteral bajo anestesia local","authors":"O. Can ,&nbsp;M. Bozkurt ,&nbsp;E. Danış ,&nbsp;E. Taha Keskin ,&nbsp;E. Kandemir ,&nbsp;H. Lutfi Canat","doi":"10.1016/j.acuro.2023.12.004","DOIUrl":"10.1016/j.acuro.2023.12.004","url":null,"abstract":"<div><h3>Objective</h3><p>Our objective was to assess the impact of video-animated information on the anxiety levels of patients undergoing ureteral stent removal under local anesthesia.</p></div><div><h3>Method</h3><p>The study was designed as a randomized prospective trial. The one group received only verbal and written information before the surgery, while the other group received video-animated information in addition to the written and verbal instructions. The patients’ anxiety levels were assessed using the STAI-S and STAI-T questionnaires, while their pain scores were evaluated using VAS scores. Tolerability and satisfaction scores were also evaluated on a 5-point likert scale.</p></div><div><h3>Results</h3><p>The video-group (Group 1) consisted of 74 patients, while the non-video group (Group 2) consisted of 82 patients. The mean pre-information STAI-T score was 34.4<!--> <!-->±<!--> <!-->3.7 in Group 1 and 35.2<!--> <!-->±<!--> <!-->3 in the Group 2 (p<!--> <!-->=<!--> <!-->0.113). In the video group, pre-information STAI-S scores was 34.8<!--> <!-->±<!--> <!-->3.3 and post-information STAI-S scores was 33.8<!--> <!-->±<!--> <!-->3 (p<!--> <!-->&lt;<!--> <!-->0.001). In the non-video group, pre-information STAI-S score was 35.6<!--> <!-->±<!--> <!-->2.6 and post-information STAI-S score was 35.5<!--> <!-->±<!--> <!-->2.7 (p<!--> <!-->=<!--> <!-->0.260). The mean VAS score of Group 1 is 5.7<!--> <!-->±<!--> <!-->1.2 and Group 2 is 5.7<!--> <!-->±<!--> <!-->1.4 (p<!--> <!-->=<!--> <!-->0.608). The mean tolerability scores of Group 1 and Group 2 were 3.7<!--> <!-->±<!--> <!-->0.9 and 2.7<!--> <!-->±<!--> <!-->1, respectively. The mean satisfaction scores of Group 1 and Group 2 were 4.1<!--> <!-->±<!--> <!-->0.9 and 2.6<!--> <!-->±<!--> <!-->1, respectively. Both tolerability score and satisfaction score improved statistically significantly after video information (p<!--> <!-->&lt;<!--> <!-->0.001).</p></div><div><h3>Conclusion</h3><p>Providing video-animated information in addition to written and verbal information before removing the ureteral stent reduces patients’ preoperative anxiety. Furthermore, patient tolerance and satisfaction are higher when informative videos are included.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 5","pages":"Pages 377-383"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139632792","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 de la telemedicina en la gravedad de la incontinencia urinaria en mujeres: revisión sistemática y metaanálisis de ensayos controlados aleatorizados","authors":"A.Y. Karaahmet ,&nbsp;F.Ş. Bilgiç ,&nbsp;N. Kızılkaya Beji","doi":"10.1016/j.acuro.2024.01.004","DOIUrl":"10.1016/j.acuro.2024.01.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Although urinary incontinence (UI) does not cause mortality, it is a global health problem that adversely affects the quality of life and health of women.</p></div><div><h3>Objective</h3><p>The aim of this study was to conduct a systematic review and meta-analysis of the studies investigating the effect of telehealth given to women with UI on the severity of incontinence.</p></div><div><h3>Method</h3><p>The literature review for this systematic review was conducted between August-Semptember 2023 using 5 electronic databases. Y-based articles were scanned using MeSH-based keywords. Randomized controlled trials conducted over the last decade were included in the screening.</p></div><div><h3>Results</h3><p>The analysis included 6 studies involving 826 women with UI. After telehealth intervention, there was a significant difference in UI symptom severity (MD: −2.14; 95% CI: −2.67 to −1.62; Z<!--> <!-->=<!--> <!-->8.03; p<!--> <!-->&lt;<!--> <!-->0.00001) and quality of life (SMD: −2.14; 95% CI: −2.67 to 1.62; Z<!--> <!-->=<!--> <!-->8.03; p<!--> <!-->&lt;<!--> <!-->0.00001) compared to the control groups. It had no effect on sexuality (SMD: −4.65; 95% CI: −9.60 to 0.30; Z<!--> <!-->=<!--> <!-->1.84; p<!--> <!-->=<!--> <!-->0.07), and anxiety (SMD: −0.15; 95% CI: −0.38 to 0.08; Z<!--> <!-->=<!--> <!-->1.27; p<!--> <!-->=<!--> <!-->0.21).</p></div><div><h3>Conclusion</h3><p>In this analysis, it was found that telehealth interventions performed on women with UI increased the quality of life while reducing the severity of incontinence in women, but had no effect on sexuality, and anxiety.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 5","pages":"Pages 384-391"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139832785","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":"Terapia trimodal para el cáncer de vejiga: ¿es ahora el estándar para la enfermedad músculo-invasiva?","authors":"M. López Valcárcel ,&nbsp;M. Barrado Los Arcos ,&nbsp;M. Ferri Molina ,&nbsp;I. Cienfuegos Belmonte ,&nbsp;V. Duque Santana ,&nbsp;P. Gajate Borau ,&nbsp;J. Fernández Ibiza ,&nbsp;M. Álvarez Maestro ,&nbsp;P. Sargos ,&nbsp;F. López Campos ,&nbsp;F. Couñago","doi":"10.1016/j.acuro.2024.01.005","DOIUrl":"10.1016/j.acuro.2024.01.005","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this review is to summarize the current evidence and future perspectives of bladder-sparing treatment for MIBC.</p></div><div><h3>Methods</h3><p>A non-systematic literature search in Medline/Pubmed was performed in October 2023 with the following keywords ‘bladder cancer’, ‘bladder-sparing’, ‘trimodal therapy’, ‘chemoradiation’, ‘biomarkers’, ‘immunotherapy’, ‘neoadjuvant chemotherapy’, ‘radiotherapy’.</p></div><div><h3>Results</h3><p>Urology guidelines recommend radical cystectomy as the standard curative treatment for muscle-invasive urothelial bladder cancer, reserving radiotherapy for patients who are unfit or who want to maintain their bladder. Given the morbidity and mortality of cystectomy and its impact on quality of life and bladder function, modern oncologic therapies are increasingly geared toward organ preservation and maximizing functional outcomes while maintaining treatment efficacy. Trimodal therapy, which incorporates maximal transurethral resection followed by radiotherapy with concurrent radiosensitizing chemotherapy, is an effective regimen for bladder function preservation in well-selected patients. Despite the absence of comparative data from randomized trials, the two approaches seem to provide comparable oncologic outcomes.</p><p>Studies are evaluating the expansion of eligibility criteria for trimodal therapy, the optimization of radiotherapy and immunotherapy delivery to further improve outcomes, and the validation of biomarkers to guide bladder preservation.</p></div><div><h3>Conclusions</h3><p>Trimodal therapy has shown acceptable outcomes for bladder preservation; therefore, it provides a valid treatment option in well-selected patients.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 5","pages":"Pages 345-355"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139823055","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":"Influencia de la cirugía laparoscópica dentro de un protocolo de rehabilitación multimodal en cistectomía radical","authors":"L. Muñiz Suárez ,&nbsp;J. Subirá Ríos ,&nbsp;P. Gayarre Abril ,&nbsp;A. Montero Martorán ,&nbsp;J.I. Hijazo Conejos ,&nbsp;J. García Alarcón ,&nbsp;J. García-Magariño Alonso ,&nbsp;P. Medrano Llorente ,&nbsp;M. Ramírez Fabián ,&nbsp;F.X. Elizalde Benito ,&nbsp;C. Murillo Pérez ,&nbsp;M. Utrilla Ibuarben ,&nbsp;A. Asensio Matas ,&nbsp;C. Marín Zaldívar ,&nbsp;R. Casans Francés ,&nbsp;J.M. Ramírez Rodríguez ,&nbsp;B. Blasco Beltrán ,&nbsp;P. Carrera-Lasfuentes","doi":"10.1016/j.acuro.2023.11.003","DOIUrl":"https://doi.org/10.1016/j.acuro.2023.11.003","url":null,"abstract":"<div><h3>Introduction and objective</h3><p>The implementation of Enhanced Recover After Surgery (ERAS) multimodal rehabilitation protocols in radical cystectomy has shown to improve outcomes in hospital stay and complications. The aim of this analysis is to evaluate the impact of laparoscopic surgery on radical cystectomy within a Multimodal Rehabilitation program.</p></div><div><h3>Material and methods</h3><p>The study was carried out in a third level center between 2011 and 2020 including patients with bladder cancer submitted to radical cystectomy according to an ERAS (Enhanced Recovery After Surgery) protocol and the Spanish Multimodal Rehabilitation Group (GERM) with 20 items to be fulfilled.</p></div><div><h3>Results</h3><p>A total of 250 radical cystectomies were performed throughout the study period, 42.8% by open surgery (OS) and 57.2% by laparoscopic surgery (LS). The groups are comparable in demographic and clinical variables (<em>P</em>&gt;.05).</p><p>Operative time was longer in the LS group (248.4<!--> <!-->±<!--> <!-->55.0 vs. 286.2<!--> <!-->±<!--> <!-->51.9<!--> <!-->minutes; <em>P</em>&lt;.001). However, bleeding was significantly lower in the LS group (417.5<!--> <!-->±<!--> <!-->365.7 vs. 877.9<!--> <!-->±<!--> <!-->529.7 cc; <em>P</em>&lt;.001), as was the need for blood transfusion (33.6% vs. 58.9%; <em>P</em>&lt;.001). Postoperative length of stay (11.5<!--> <!-->±<!--> <!-->10.5 vs. 20.1<!--> <!-->±<!--> <!-->17.2 days; <em>P</em>&lt;.001), total and major complications were also significantly lower in this group (LS). The readmission rate was lower in the LS group but not significantly (36.4% vs. 29.4%; <em>P</em>=.237). The difference between 90-day mortality in both groups was not statistically significant (2.8% LS vs. 4.3% OS; <em>P</em>=.546). The differences were maintained in the multivariate models.</p></div><div><h3>Conclusions</h3><p>Laparoscopic surgery within a multimodal rehabilitation program increases operative time but significantly decreases intraoperative bleeding, transfusion requirements, postoperative length of stay, and complications.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 5","pages":"Pages 364-370"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141242715","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":"Tislelizumab, un nuevo anticuerpo monoclonal anti-PD-1 para el cáncer urotelial: estudio de vida real","authors":"Z. Wang,&nbsp;H. Bi,&nbsp;Y.D. Wang,&nbsp;Q. Liu,&nbsp;B. Shao,&nbsp;C.Q. Li,&nbsp;C. Fu,&nbsp;S. Fu,&nbsp;G.Y. Shan,&nbsp;A. Chen,&nbsp;C.C. Lv,&nbsp;Y. Zeng","doi":"10.1016/j.acuro.2023.10.010","DOIUrl":"10.1016/j.acuro.2023.10.010","url":null,"abstract":"<div><h3>Objective</h3><p>Tislelizumab, a monoclonal antibody against programed death protein-1 (PD-1), has shown encouraging antitumor activity in urothelial cancer. This study was designed to assess the efficacy and safety of tislelizumab in urotelial cancer in a real-world setting.</p></div><div><h3>Methods</h3><p>The study was a real-world retrospective study undertaken at Liaoning Cancer Hospital &amp; Institute, China. Eligible patients were ≥18 years. Patients received 200-mg tislelizumab monotherapy intravenously every 3 weeks until the disease progressed to intolerable toxicity. Outcomes included an objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and safety.</p></div><div><h3>Results</h3><p>Between March 2020 and December 2022, 33 patients were enrolled. The median follow-up was 10.17 (IQR 5.73-12.47) months. Of all 33 patients, ORR and DCR were 30.30% (95% CI 15.6-48.7%) and 42.42% (95% CI 25.48-60.78%), respectively. The median PFS was 5.73 (95% CI 3.27-13.00) months, with a 12-month PFS rate of 31.90% (95% CI 19.20-53.00%). The median OS was 17.7 (95% CI 12.80-not reach) months, with a 12-month OS rate of 67.50% (95% CI 52.70-86.40%). Eleven (33.33%) and 8 (24.24%) experienced ≥grade 3 treatment-related adverse events (TRAEs) and immune-related Aes, respectively. No treatment-related deaths occurred.</p></div><div><h3>Conclusion</h3><p>The excellent efficacy and controllable safety of tislelizumab in locally advanced or metastatic urothelial cancer suggest that it may be a promising therapeutic option for this population.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Pages 295-303"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139291900","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":"Infertilidad masculina y la calidad del sueño: otro punto clave a evaluar durante la consulta","authors":"W.F. Fernández-Zapata,&nbsp;W.D. Cardona-Maya","doi":"10.1016/j.acuro.2023.10.002","DOIUrl":"10.1016/j.acuro.2023.10.002","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Page 335"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136094470","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":"Implementación de los nuevos tratamientos para el tumor vesical no músculo invasivo que no responde al tratamiento con BCG. Aspectos a considerar en Latinoamérica","authors":"M.I. Fernández","doi":"10.1016/j.acuro.2024.03.001","DOIUrl":"https://doi.org/10.1016/j.acuro.2024.03.001","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Pages 257-259"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140815548","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":"Priapismo isquémico asociado al consumo de cocaína. Revisión sistemática y presentación de una serie de casos de un solo centro","authors":"C. Altez-Fernandez ,&nbsp;L. Lamas ,&nbsp;M. Bohorquez ,&nbsp;V. Chantada ,&nbsp;D. Ralph","doi":"10.1016/j.acuro.2023.10.006","DOIUrl":"10.1016/j.acuro.2023.10.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Ischemic priapism is a medical emergency that, if not treated, could lead to permanent erectile dysfunction. The association between cocaine and priapism is well-known; however, data on patient characteristics, treatment, and outcomes is missing.</p><p>This work aimed to answer the research question: What are the characteristics, management strategies, and erectile prognosis of patients consuming cocaine and presenting with priapism?</p></div><div><h3>Methods</h3><p>We conducted a systematic review according to PRISMA guidelines and described our case series.</p></div><div><h3>Results</h3><p>Eight studies were selected for qualitative synthesis, presenting information on ten patients. In our case series, we showed information regarding four patients. From the systematic review, the mean presentation time was 42.6<!--> <!-->hours, and the mean number of procedures to solve priapism was 2,4; in our case series was 42.75<!--> <!-->hours and 2, respectively.</p></div><div><h3>Conclusion</h3><p>Cocaine-related priapism might present with a delayed diagnosis, need more procedures to be managed, and have a worse prognosis. More extensive and prospective studies are required.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Pages 281-288"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135410469","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 coste de pruebas de nueva generación en estadificación de pacientes con cáncer de próstata de alto riesgo","authors":"J.J. Szczesniewski ,&nbsp;C. Tellez Fouz ,&nbsp;A. García Tello ,&nbsp;M. de la Rubia Marcos ,&nbsp;M.P. García Alonso ,&nbsp;L. Llanes González","doi":"10.1016/j.acuro.2023.10.008","DOIUrl":"10.1016/j.acuro.2023.10.008","url":null,"abstract":"<div><h3>Introduction and objective</h3><p>Next-generation imaging tests, such as choline PET/CT and PSMA PET, have shown to increase sensitivity in the detection of nodal and metastatic disease in prostate cancer. However, their use implies an increase in diagnostic costs compared to conventional imaging (CI) tests such as CT and bone scan. The aim of our study was to determine which diagnostic pathway is more cost-effective in high-risk prostate cancer.</p></div><div><h3>Material and method</h3><p>Cost-effectiveness analysis of the available imaging tests (CI, Choline/PSMA PET) for the staging of high-risk prostate cancer. Sensitivity and specificity were estimated based on published evidence, and costs were collected from the Management Department. In order to carry out a cost-effectiveness analysis, five diagnostic pathways were proposed estimating the accurate diagnoses.</p></div><div><h3>Results</h3><p>PSMA PET was the most accurate diagnostic option. The CI diagnostic workup was the most economical and CI<!--> <!-->+<!--> <!-->PSMA the most expensive. Analyzing the diagnostic cost-effectiveness ratio, CI<!--> <!-->+<!--> <!-->PSMA proved to be the most expensive (€5627.30 per correct diagnosis) followed by PET PSMA (€4987.11), choline (€4599.84) and CI (€4444.22).</p></div><div><h3>Conclusions</h3><p>PSMA PET is the most accurate strategy in staging distant disease in patients with high-risk prostate cancer. Radiotracer uptake tests such as CI have been shown to be the most cost-effective option, followed by choline and PSMA.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Pages 328-334"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139291749","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}