Actas urologicas espanolas最新文献

{"title":"La vigilancia activa como tratamiento de elección en el cáncer de próstata de bajo riesgo. Fiabilidad de resultados obtenidos a través de sistemas de procesamiento de lenguaje clínico y big data","authors":"C. García-Fuentes ,&nbsp;V. Hernández ,&nbsp;J. Arias ,&nbsp;M. López ,&nbsp;E. de la Peña ,&nbsp;A. Guijarro ,&nbsp;E. Pérez-Fernández ,&nbsp;C. Llorente","doi":"10.1016/j.acuro.2025.501907","DOIUrl":"10.1016/j.acuro.2025.501907","url":null,"abstract":"<div><h3>Introduction</h3><div>Advances in natural language processing (NLP) technologies have gained prominence for extracting relevant clinical information. Savana is a platform capable of analyzing free-text data and interpreting the content of electronic health records (EHRs).</div></div><div><h3>Objective</h3><div>To validate the results obtained through NLP by Savana from data of patients with prostate cancer (PC) included in active surveillance (AS), compare them with our database, and assess their reliability.</div></div><div><h3>Methods</h3><div>Observational and retrospective study of patients with PC in AS between 2014-2022. The results from our database were blinded to Savana. Information from the EHRs was transformed by Savana into analysis-ready data. After an initial evaluation, it was necessary to refine the preliminary results and readjust the variables and terminology to eliminate discrepancies.</div></div><div><h3>Results</h3><div>Of the 2,865 patients included in our database, 306 met the selection criteria. Savana detected 366 patients with the terms ‘PC’, ‘Gleason’, and ‘AS’. The results were similar regarding Gleason score at diagnosis: 93.4% Gleason 6 in our series vs. 92% in Savana. Likewise, the proportion of patients who received treatment with curative intent, and the type of treatment were comparable: 33.3% in our series (RP: 56.9%; RT: 42.1%) vs. 32.5% in Savana (RP: 59.7%; RT: 40.3%). However, only 24.8% showed Gleason progression in our series vs. 31% in Savana. The mortality rate was 3.2% in our series vs. 7.4% in Savana.</div></div><div><h3>Conclusions</h3><div>NLP represents a promising tool in clinical research, but its implementation should be approached with caution.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501907"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801986","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":"Prostatectomía radical sin biopsia previa en pacientes con imagenología positiva (PET-PSMA y/o mpMRI): una práctica utilizada, pero escasamente documentada. Cohorte multicéntrica retrospectiva","authors":"D.R. Magdaleno Rodríguez ,&nbsp;L. Almazán Treviño ,&nbsp;L. Lamm Wiechers ,&nbsp;R. González Cosió ,&nbsp;L.F. Galicia Belauzaran ,&nbsp;J.A. Herrera Muñoz ,&nbsp;M. Cantellano Orozco ,&nbsp;C. Martínez Arroyo ,&nbsp;G. Fernandez Noyola ,&nbsp;M.E. Ortega González ,&nbsp;I. Navarro Ruesga ,&nbsp;M.A. Ascencio Martínez ,&nbsp;C.A. Silva Mendoza ,&nbsp;H.A. Miranda Blasnich ,&nbsp;R.E. Domínguez Castillo ,&nbsp;A. Haddad Servín ,&nbsp;J.G. Morales Montor","doi":"10.1016/j.acuro.2025.501921","DOIUrl":"10.1016/j.acuro.2025.501921","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer (PCa) is the most common malignancy among men and currently ranks as the second leading cancer worldwide in terms of incidence. In 2021, a total of 35,764 new cases were diagnosed. The development of new imaging tools such as multiparametric magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography (PET-PSMA) has enabled the exploration of less invasive diagnostic strategies in clinically significant prostate cancer. However, performing radical prostatectomy without a prior biopsy remains an exceptional practice, scarcely documented and highly controversial.</div></div><div><h3>Objective</h3><div>To report a series of Mexican cases undergoing radical prostatectomy without prior biopsy, using PET-PSMA and mpMRI as the main diagnostic tools, and to propose a preliminary risk stratification model based on SUVmax values: the “M&amp;M's PSMA SCORE SUVmax”.</div></div><div><h3>Materials and methods</h3><div>Retrospective, observational, multicenter study of 18 patients treated between 2021 and 2024. Clinical variables, imaging findings, and histopathological results were analyzed. Sensitivity, positive predictive value (PPV), and correlation between SUVmax and ISUP grade were calculated.</div></div><div><h3>Results</h3><div>All cases confirmed clinically significant adenocarcinoma. PET-PSMA showed 100% sensitivity and PPV; mpMRI showed 93.3% sensitivity and 100% PPV. A positive correlation was found between SUVmax and ISUP grade (r=.84; <em>P</em>=.038). A preliminary classification based on SUVmax cut-off points was proposed.</div></div><div><h3>Conclusions</h3><div>This series suggests that, in selected contexts, PET-PSMA and mpMRI could support surgical decision-making even without prior biopsy. However, prospective studies are needed to validate both this strategy and the proposed stratification system.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501921"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578568","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":"Jornada urológica UROLATAM bajo el modelo MEDIUVer - UROLATAM para el desarrollo de acciones universitarias con impacto social","authors":"J.C. Viñas Dozal ,&nbsp;R. Edel Navarro ,&nbsp;A.M. Autrán Gómez ,&nbsp;F. Ruiz García ,&nbsp;V.G. Rojas Hernández ,&nbsp;J.M. Hurtado Capetillo ,&nbsp;C. Palmeros Exsome ,&nbsp;E. Castellanos Contreras ,&nbsp;A. Báez Jiménez ,&nbsp;J.E. Villegas Dominguez","doi":"10.1016/j.acuro.2025.501913","DOIUrl":"10.1016/j.acuro.2025.501913","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Urologic health is a global priority, particularly in Latin America, where access to quality services remains limited. This underscores the importance of collaboration among key societal sectors, including the public, private, and academic domains. The MEDIUVer–UROLATAM model emerged as a university-based urological health strategy to promote socially impactful activities, grounded in the university's core functions, collaborative work, and a targeted focus on specific social needs. The objective was to demonstrate the utility of the MEDIUVer – UROLATAM model as a framework to facilitate prostate cancer detection and prevention actions.</div></div><div><h3>Material and methods</h3><div>The MEDIUVer – UROLATAM model was implemented in three stages through a urological outreach program coordinated by the Latin American Institute of Urology (UROLATAM), the Faculty of Medicine of the Universidad Veracruzana, the private sector, government, and civil society, with the aim of timely prostate cancer detection. The initiative involved collaboration with the private sector, government agencies, and the community to facilitate the early detection of prostate cancer. Medical evaluations, diagnostic tests, and educational activities were conducted.</div></div><div><h3>Results</h3><div>A total of 1656 individuals were attended, with 1352 urological evaluations performed. The first stage focused on social action, the second strengthened inter-institutional collaboration, and the third incorporated educational research and healthcare services for the transgender population. This approach led to greater stakeholder integration and an expanded social impact.</div></div><div><h3>Conclusions</h3><div>The MEDIUVer–UROLATAM model is an educational, training, and care-oriented tool for both the general population and healthcare professionals in terms of timely prostate cancer detection and prevention.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501913"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578567","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 papel de los índices de inflamación sistémica y los marcadores pronósticos en pacientes diabéticos con cáncer de vejiga no músculo invasivo tratados con BCG","authors":"A. Tunçekin ,&nbsp;Y. Aktaş","doi":"10.1016/j.acuro.2026.501925","DOIUrl":"10.1016/j.acuro.2026.501925","url":null,"abstract":"<div><h3>Introduction</h3><div>Systemic inflammatory and prognostic índices are emerging biomarkers in bladder cancer. Diabetes mellitus (DM), a chronic inflammatory disease, and Bacillus Calmette–Guérin (BCG) therapy may influence these índices in non-muscle invasive bladder cancer (NMIBC).</div></div><div><h3>Objective</h3><div>To evaluate the impact of DM and BCG therapy on inflammatory and prognostic índices in patients with NMIBC.</div></div><div><h3>Material and method</h3><div>A retrospective study of 156 NMIBC patients was conducted. Patients were stratified by DM and BCG status (DM+/DM−; BCG+/BCG−), and into 4<!--> <!-->subgroups (DM−/BCG−, DM+/BCG+, DM−/BCG+, DM+/BCG−). Laboratory and clinical parameters were compared using standard statistical tests (t-test, Chi-square, ANOVA). A p-value &lt;<!--> <!-->0.05 was considered significant.</div></div><div><h3>Results</h3><div>DM+ patients had significantly higher glucose <em>(P</em>=.001), HbA1c <em>(P</em>=.017), GKR <em>(P</em>=.014), and lower PNI <em>(P</em>=.014). Tumor recurrence was more common in DM+ <em>(P</em>=.021). In the BCG comparison, albumin (p<!--> <!-->=<!--> <!-->0.002) and PNI (p<!--> <!-->=<!--> <!-->0.009) differed. Four-group analysis showed significant differences in tumor grade, tumor recurrence, HbA1c, albumin, PNI, and MPR (all <em>P</em>&lt;.05), especially between DM+/BCG+ and DM−/BCG+.</div></div><div><h3>Conclusion</h3><div>DM and BCG therapy are associated with systemic inflammatory and prognostic índices in NMIBC. GKR and PNI may serve as practical, cost-effective markers for recurrence risk stratification.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501925"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578569","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":"Comentario sobre «Resultados oncológicos de pacientes con afectación ganglionar tras quimioterapia neoadyuvante y cistectomía radical para el cáncer de vejiga músculo-invasivo: Estudio observacional multicéntrico del Grupo de Trabajo de Carcinoma Urotelial de la sección de Jóvenes Urólogos Académicos de la Asociación Europea de Urología (YAU-EAU)»","authors":"V.D. Kumar Veldi ,&nbsp;R. Sah","doi":"10.1016/j.acuro.2025.501792","DOIUrl":"10.1016/j.acuro.2025.501792","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501792"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578881","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 futuro del cribado del cáncer de próstata en la Unión Europea: programa PRAISE-U","authors":"J. Gómez Rivas ,&nbsp;P. Gómez Dávila ,&nbsp;A.M. Tarrazo Antelo ,&nbsp;M. Corujo Quinteiro ,&nbsp;Á. Gómez Amorín ,&nbsp;A. Rodríguez Alonso ,&nbsp;J.M. Vilaseca ,&nbsp;H. López ,&nbsp;J.P. Salazar ,&nbsp;Á. Borque-Fernando ,&nbsp;J. Moreno-Sierra ,&nbsp;S. Collen ,&nbsp;K. Beyer ,&nbsp;J. Helleman ,&nbsp;M.J. Roobol ,&nbsp;H. van Poppel ,&nbsp;en representación de PRAISE-U Consortium","doi":"10.1016/j.acuro.2025.501919","DOIUrl":"10.1016/j.acuro.2025.501919","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer (PCa) remains one of the leading public health challenges among European men. Despite technological advances, its early detection continues to be controversial due to the risk of overdiagnosis and the limited adoption of organized screening programs.</div></div><div><h3>Materials and methods</h3><div>A review was conducted of scientific literature, institutional reports, and technical documentation from the PRAISE-U project. We describe the key components of its design, implementation and lessons learned at two pilot sites in Spain (Galicia and Manresa), with a focus on personalized strategies and operational efficiency.</div></div><div><h3>Results</h3><div>Based on the European Union recommendation of 2022, the PRAISE-U project promotes a risk-based screening program that incorporates prostate-specific antigen (PSA), magnetic resonance imaging (MRI) and risk calculators (RC). Galicia and Manresa have developed screening circuits adapted to their health systems. Galicia has managed to invite 7,000 of the 12,000 target men in less than a year, integrating digital tools and direct contact strategies. Manresa, from primary care, has developed a coordinated approach focused on accessibility and traceability. Both models prioritize equity, adherence and minimization of overtreatment.</div></div><div><h3>Conclusions</h3><div>The PRAISE-U project offers an innovative and adaptable framework for PCa screening in Europe. The Spanish experience demonstrates that it is possible to implement effective and risk-focused early detection programs, provided that there is sound planning, technological tools and a collaborative approach between levels of care.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501919"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578566","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 continencia urinaria y estenosis uretral tras enucleación prostática con láser de Holmio (HoLEP): Serie consecutiva de 254 casos","authors":"L.E. Ortega Polledo ,&nbsp;A. Sánchez Pellejero ,&nbsp;G.F.J. Bianchini Hernández ,&nbsp;E. García Rico ,&nbsp;E. Redondo González ,&nbsp;J.D. Subiela Henríquez ,&nbsp;P. Mata Deniz ,&nbsp;M.J. Marugán Álvarez ,&nbsp;J. Gómez Rivas ,&nbsp;I. Galante Romo ,&nbsp;J. Moreno Sierra ,&nbsp;S. Ahyai ,&nbsp;B. Miñana ,&nbsp;S. Alonso y Gregorio","doi":"10.1016/j.acuro.2025.501912","DOIUrl":"10.1016/j.acuro.2025.501912","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the rate of stress urinary incontinence, time to continence recovery, and incidence of urethral stricture in a series of patients who underwent holmium laser enucleation of the prostate (HoLEP) from the beginning of the learning curve of a single surgeon.</div></div><div><h3>Materials and methods</h3><div>Prospective study of 254 patients consecutively operated on by one surgeon between December 2022 and December 2024. Continence was defined as the use of 0 pads. Survival analysis (Kaplan-Meier) was performed to estimate time to continence recovery. Results were stratified according to surgical technique (2- or 3-lobe vs. en bloc), prostate volume, and BMI. Overall and de novo urethral stricture rates were analyzed according to operative time, ultrasound volume, and enucleated weight.</div></div><div><h3>Results</h3><div>The median time to continence was 20 days. The continence rates at 1 month, 2 months, and 4 months were 80.7%, 91.2%, and 98.5%, respectively. Although incontinence decreased progressively, urgency was more frequent in persistent cases. No significant differences were observed in the time to continence according to surgical technique, prostate volume, or BMI. The overall rate of urethral stricture was 3.9%, with 3.65% de novo cases. No associated risk factors were identified.</div></div><div><h3>Conclusions</h3><div>HoLEP showed a low rate of transient incontinence and urethral stricture, and no correlation with surgical technique or patient clinical characteristics.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501912"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578620","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":"Infección e inflamación de la vía seminal: revisión de su vínculo con la fertilidad masculina","authors":"A. Vives Suñé ,&nbsp;M. Cosentino","doi":"10.1016/j.acuro.2025.501899","DOIUrl":"10.1016/j.acuro.2025.501899","url":null,"abstract":"<div><h3>Introduction</h3><div>In 1997, the WHO established the role of genital tract infections in human infertility, currently responsible for 15% of the causes of infertility in men. The WHO classifies urethritis, prostatitis, vesiculitis, orchitis, and epididymitis as infections of the male accessory gland. This paper represents the state of the art on inflammation and infection of seminal tract. Objective of the study is to revise literature and to discuss regarding association to fertility.</div></div><div><h3>Methods</h3><div>A literature search was performed on PubMed database (<span><span>http://www.pubmed.gov</span><svg><path></path></svg></span>) for peer-reviewed journal articles relating to STD, UTI, diagnosis and treatment and fertility. We carefully evaluated the most representative reports published in literature and all papers results were supported by European and American guidelines results on theme.</div></div><div><h3>Results</h3><div>Seminal tract infections may cause infertility by different mechanisms. Traditionally, the most common infectious causes of male infertility were sexually transmitted infections, especially <em>Neisseria gonorrhoeae</em>. However, the most frequent causes of infection of the seminal tract are <em>Chlamydia trachomatis</em>, <em>Mycoplasma</em> spp, especially <em>Ureaplasma urealyticum</em> and the gram-negative bacteria typical of urogenital infections. When classifying seminal tract infections, it must be considered whether or not these are sexually transmitted, and treat both partners for Sexual Transmitted Diesase if necessary (STI). There is evidence that treating STIs leads to improved semen parameters. Although antibiotics can improve sperm quality and reduce DNA fragmentation values, there is no evidence that they increase the probability of natural conception.</div></div><div><h3>Conclusions</h3><div>Taking into account the highly prevalence of infective or inflammatory affections of the male genital tract, it is clearly stablished association with infertility and that a remarkable percentage of sexual transmitted infections (STI) are asymptomatic, we believe that these infections must be ruled out during the initial andrological evaluation in couples seeking fertility.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501899"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578565","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":"Comentario editorial sobre el artículo «Abordaje del tratamiento antitrombótico durante el perioperatorio y el peri-procedimiento: documento de consenso 2025 de SEC, SEDAR, SEACV, SECCE, AEC, SECOM CYC, SECPRE, SEPD, SEGG, SEGO, SEHH, SETH, SEMERGEN, SEMFYC, SEMG, SEMICYUC, SEMI, SEMES, SEN, S.E.N., SENEC, SEPAR, SEO, SEORL-CCC, SEPA, SERVEI, SECOT y AEU»","authors":"L. Ibáñez Vázquez,&nbsp;J.F. Hermida Gutiérrez,&nbsp;J. Moreno Sierra","doi":"10.1016/j.acuro.2026.501931","DOIUrl":"10.1016/j.acuro.2026.501931","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501931"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578564","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":"Adenocarcinoma de uraco: presentación de un caso, revisión bibliográfica y propuesta de algoritmo terapéutico","authors":"P. Guedes Oliva ,&nbsp;P. Jiménez Marrero ,&nbsp;R. Espino Espino ,&nbsp;R. Marrero Domínguez ,&nbsp;E. Perera Gordo","doi":"10.1016/j.acuro.2025.501916","DOIUrl":"10.1016/j.acuro.2025.501916","url":null,"abstract":"<div><div>Urachal adenocarcinoma is an extremely rare malignancy, accounting for less than 1% of all bladder tumors. Diagnosis is often delayed due to nonspecific symptoms and low clinical suspicion. We report the case of a 52-year-old male with no relevant medical history who presented with lower urinary tract symptoms. Cystoscopy revealed a cystic lesion at the bladder dome. Transurethral resection confirmed mucinous urachal adenocarcinoma. CT imaging showed no locoregional or distant spread, and tumor markers were within normal limits. The patient underwent laparoscopic partial cystectomy with en bloc excision of the urachus and umbilicus plus bilateral pelvic lymphadenectomy. Final pathology confirmed a Sheldon stage IIIA mucinous cystadenocarcinoma. At 25 months of follow-up, the patient remains free of disease recurrence. Given its low prevalence and aggressive nature, accurate diagnosis and appropriate surgical management are critical. While surgery remains the cornerstone in localized disease, the role of systemic therapy remains unclear. Immunotherapy and targeted therapies are emerging as promising options in advanced stages. This case illustrates the diagnostic challenges and emphasizes the importance of surgical planning and long-term surveillance in the absence of standardized treatment guidelines. Midline bladder lesions should prompt suspicion of urachal adenocarcinoma. Complete surgical excision is essential, with lymphadenectomy and systemic therapy considered on a case-by-case basis. Long-term follow-up is necessary due to the high risk of recurrence.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501916"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578570","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}