Actas urologicas espanolas最新文献

{"title":"Impacto de la terapia intravesical con BCG en la calidad de vida en el cáncer de vejiga no músculo invasivo: una evaluación prospectiva mediante el cuestionario FACT-Bl","authors":"J. Caño-Velasco,&nbsp;A. Luis-Cardo,&nbsp;J.C. Moreno-Cortés,&nbsp;L. Carrasco-Loras,&nbsp;J. Astudillo-Campoverde,&nbsp;J.D. Subiela,&nbsp;F. Lozano-Palacio,&nbsp;M. Campistol-Torres,&nbsp;R. Pichler,&nbsp;A. Partl,&nbsp;F. Lackner,&nbsp;F. Del Giudice,&nbsp;D. Carino,&nbsp;L.A. García-Martín,&nbsp;P. Salamanca-Blanco,&nbsp;A. Bielsa-Carrillo,&nbsp;A.M. Pastor-Cordero,&nbsp;V. Bataller-Monfort,&nbsp;A. Tello-Delsors,&nbsp;L. Polanco-Pujol,&nbsp;C. Hernández-Fernández","doi":"10.1016/j.acuro.2026.501937","DOIUrl":"10.1016/j.acuro.2026.501937","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Intravesical bacillus Calmette-Guérin (BCG) remains the standard treatment for high-risk non-muscle-invasive bladder cancer (NMIBC) and is also considered an option for intermediate and very high-risk groups. Despite over five decades of clinical use, limited information is available regarding patients’ quality of life (QoL) during therapy. The objective was to evaluate QoL patients receiving BCG therapy using the Functional Assessment of Cancer Therapy-Bladder Cancer (FACT-Bl) questionnaire.</div></div><div><h3>Materials and methods</h3><div>Prospective multicentre observational study from February 2022 to June 2024 in patients with NMIBC. Patients completed the FACT-Bl questionnaire before and after the induction course. The results of both questionnaires were compared with Student's t-test for paired data using IBM®SPSS-Statistics-25.</div></div><div><h3>Results</h3><div>A total of 235 patients completed both questionnaires and were analysed. 97% of the series completed BCG induction. A worsening in the physical well-being (PWB) subscale (P&lt;<!--> <!-->0.05) and an improvement in the emotional well-being (EWB) subscale (P&lt;<!--> <!-->0.05) were observed in the total series of cases, without differences in total scores. In BCG-naive patients (90%), significant deterioration was observed in PWB subscale (P&lt;<!--> <!-->0.05) and FACT-Bl Trial Outcome Index (TOI) (P&lt;<!--> <!-->0.05). Patients over 75 years showed a statistically significant improvement in EWB, while those aged ≤<!--> <!-->75 years experienced significant declines in PWB, bladder cancer subscale (BlCS), and three total scores. Limitations include exclusive use of FACT-Bl questionnaire to assess QoL and limited sample size.</div></div><div><h3>Conclusions</h3><div>BCG induction therapy shows no significant impact on overall FACT-Bl scores but declines PWB and improves EWB subscales. Age and prior BCG exposure influence outcomes; notably, patients aged ≤<!--> <!-->75 show marked declines in PWB, BlCS and total FACT-Bl scores.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 8","pages":"Article 501937"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095321","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":"BCG e inmunoterapia sistémica en el cáncer vesical no músculo-invasivo de alto riesgo: luces y sombras","authors":"F. Guerrero-Ramos","doi":"10.1016/j.acuro.2026.501936","DOIUrl":"10.1016/j.acuro.2026.501936","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 8","pages":"Article 501936"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095323","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 pronósticos y resultados oncológicos tras terapia trimodal con preservación vesical en el cáncer de vejiga músculo invasivo: estudio multicéntrico en práctica clínica real","authors":"N. Feltes Benítez,&nbsp;F. Couñago,&nbsp;S. Paredes-Rubio,&nbsp;P. Peleteiro Higuero,&nbsp;J.G. Molina Osorio,&nbsp;A. Folgar Torres,&nbsp;A. Aissati,&nbsp;A. Mera,&nbsp;J.R. Pastor Peidró,&nbsp;M.I. Garrido Botella,&nbsp;M. González de Dueñas,&nbsp;V. Duque-Santana,&nbsp;J. Torices Caballero,&nbsp;A. Pons Sánchez,&nbsp;J. Andreescu Yagüe,&nbsp;A. Rodríguez Pérez,&nbsp;S. Guardado González,&nbsp;S. Fernández Alonso,&nbsp;A. Lazo-Prados,&nbsp;M. Gaztañaga Boronat,&nbsp;E. González del Portillo","doi":"10.1016/j.acuro.2026.501967","DOIUrl":"10.1016/j.acuro.2026.501967","url":null,"abstract":"<div><h3>Introduction</h3><div>Trimodality therapy (TMT), consisting of maximal transurethral resection of the bladder tumor followed by concurrent chemoradiotherapy, is an established bladder-preserving option for selected patients with muscle-invasive bladder cancer (MIBC). However, contemporary multicenter real-world data are needed to better define oncological outcomes and prognostic factors in routine clinical practice.</div></div><div><h3>Methods</h3><div>We conducted a retrospective multicenter cohort study including 369 patients with cT2–T4aN0M0 MIBC treated with definitive TMT between 2010 and 2022. Time-to-event outcomes were measured from radiotherapy completion and estimated using the Kaplan–Meier method. Endpoints included overall survival (OS), cancer-specific survival (CSS), metastasis-free survival (MFS), and progression-free survival (PFS). Bladder-preservation outcomes included complete local response (CLR) at first assessment and salvage cystectomy. Prognostic factors were evaluated using multivariable Cox proportional hazards regression.</div></div><div><h3>Results</h3><div>Median age was 76 years (IQR 66.5–81.0), and 85.1% of patients were male. After a median follow-up of 27.4 months, OS at 1, 2, and 3 years was 85.8%, 75.7%, and 65.7%, respectively, while CSS was 90.5%, 84.7%, and 79.9%. MFS rates at 1, 2, and 3 years were 85.8%, 83.1%, and 80.6%, and corresponding PFS rates were 82.9%, 75.4%, and 71.6%. A complete local response was achieved in 63.7% of patients, and salvage cystectomy was required in 9.7%. On multivariable analysis, increasing age, poorer ECOG performance status, and lymphovascular invasion were independently associated with worse outcomes, whereas the use of modern radiotherapy techniques (IMRT/VMAT) was associated with improved survival compared with three-dimensional conformal radiotherapy.</div></div><div><h3>Conclusions</h3><div>In this large contemporary real-world cohort, trimodality therapy achieved effective cancer control with durable bladder preservation and a low salvage cystectomy rate. While overall survival was influenced by baseline patient fitness, cancer-specific and metastasis-free outcomes remained favourable. These findings support TMT as a robust bladder-preserving strategy in routine clinical practice, provided that appropriate patient selection and high-quality radiotherapy delivery are ensured.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501967"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859168","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":"Mininefrolitotomía percutánea frente a ureteroscopia flexible con litotricia láser de holmio asistida por vaina de acceso ureteral con presión negativa: abordaje mínimamente invasivo de la litiasis renal","authors":"Q. Chen,&nbsp;P. Liu,&nbsp;F. Peng,&nbsp;Y. Zhang","doi":"10.1016/j.acuro.2026.501978","DOIUrl":"10.1016/j.acuro.2026.501978","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal calculi are a common urological condition, and minimally invasive surgical techniques have become the mainstay of treatment. We evaluated and compared the clinical effectiveness of mini-percutaneous nephrolithotomy (mini-PCNL) and flexible ureteroscopic holmium laser lithotripsy (FURL) assisted by a negative-pressure ureteral access sheath (NPUAS) in the management of renal calculi.</div></div><div><h3>Methods</h3><div>A total of 124 patients with renal calculi were assigned to mini-PCNL (n<!--> <!-->=<!--> <!-->62) or NPUAS-FURL (n<!--> <!-->=<!--> <!-->62) groups. Surgical parameters (operative time, blood loss), hospitalization, stone clearance, efficacy, complications, renal function (Scr, BUN, UA), inflammatory markers (IL-6, CRP, PCT), and postoperative pain (VAS at 4/12/24/48<!--> <!-->h) were evaluated.</div></div><div><h3>Results</h3><div>Compared with mini-PCNL, the NPUAS-FURL group demonstrated shorter operative and hospitalization times and reduced intraoperative bleeding (<em>P</em> &lt;<!--> <!-->0.05). Stone clearance and overall efficacy were higher in the NPUAS-FURL group (95.16% each) than in the mini-PCNL group (77.42% and 80.65%; <em>P</em> &lt;<!--> <!-->0.05). The incidence of complications was similar between groups (14.52% vs. 22.58%, <em>P</em> <!-->&gt; 0.05). At 24<!--> <!-->hours postoperatively, Scr, BUN, UA, IL-6, CRP, and PCT increased in both groups but remained significantly lower in the NPUAS-FURL group (<em>P</em> &lt;<!--> <!-->0.05). VAS scores progressively decreased over time, with consistently lower values observed in the NPUAS-FURL cohort (<em>P</em> &lt;<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>NPUAS-assisted FURL outperforms mini-PCNL in renal calculi treatment, offering higher stone clearance, reduced trauma, better renal function preservation, milder inflammation, and less pain, with comparable safety.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501978"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859340","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":"Determinantes clínicos y tumorales de la morbilidad precoz y la estancia hospitalaria prolongada tras la resección transuretral de tumor vesical (RTU-TV)","authors":"Y.M. Aydın,&nbsp;O. Ozdel,&nbsp;N.A. Mungan","doi":"10.1016/j.acuro.2026.501987","DOIUrl":"10.1016/j.acuro.2026.501987","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Transurethral resection of bladder tumor (TUR-BT) morbidity rates vary widely in the literature (4.3%-43.5%), and differences across studies reflect differences in patient populations and definitions of adverse events. We aimed to identify independent risk factors for postoperative complications and prolonged length of hospital stay (LOS) following TUR-BT.</div></div><div><h3>Materials and methods</h3><div>We analyzed data from 803 patients who underwent bipolar TUR-BT between 01/2012 and 10/2024. Demographic, clinical, and pathological variables were evaluated, including age, sex, ASA score, tumor size, number, morphology, grade, stage, resection status, intravesical treatment, history of prior TUR-BT, and reTUR-BT. Complications occurring within 30 days were classified according to the Clavien-Dindo system. A hospital stay exceeding the study's median LOS (&gt;3 days) was defined as prolonged. Logistic regression models were used to identify independent predictors of complications and prolonged LOS.</div></div><div><h3>Results</h3><div>Postoperative complications occurred in 10.6% of cases, most of which were low-grade (Clavien-Dindo I-II, 82.3%). Hematuria and urinary tract infections were the most common events. Independent predictors of complications included higher ASA scores (3-4) (OR<!--> <!-->=<!--> <!-->2.075, <em>P<!--> </em>=<!--> <!-->0.016), tumor multiplicity (OR<!--> <!-->=<!--> <!-->1.878, <em>P<!--> </em>=<!--> <!-->0.021), incomplete resection (OR<!--> <!-->=<!--> <!-->2.247, <em>P<!--> </em>=<!--> <!-->0.018), T2 stage (OR<!--> <!-->=<!--> <!-->3.188, <em>P<!--> </em>=<!--> <!-->0.002), and CIS (OR<!--> <!-->=<!--> <!-->3.476, <em>P<!--> </em>=<!--> <!-->0.017). Prolonged LOS was independently associated with larger tumor size (OR<!--> <!-->=<!--> <!-->1.009, <em>P<!--> </em>=<!--> <!-->0.005), non-papillary morphology (OR<!--> <!-->=<!--> <!-->1.903, <em>P<!--> </em>=<!--> <!-->0.001), incomplete resection (OR<!--> <!-->=<!--> <!-->1.904, <em>P<!--> </em>=<!--> <!-->0.035), reTUR-BT (OR<!--> <!-->=<!--> <!-->1.926, <em>P<!--> </em>=<!--> <!-->0.001), and the presence of complications (OR<!--> <!-->=<!--> <!-->4.777, <em>p</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>TUR-BT is generally safe; however, early morbidity and prolonged LOS are influenced by tumor characteristics, operative factors, and patient comorbidity, informing perioperative risk stratification.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501987"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859342","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":"Tendencias en la mortalidad por cáncer de órganos genitales masculinos de aparición temprana y tardía en España, 1999-2023","authors":"L. Cayuela,&nbsp;R. Roldán-Testillano,&nbsp;A. Rodríguez-Serrano,&nbsp;L. Rodríguez-Sánchez,&nbsp;A. Cayuela","doi":"10.1016/j.acuro.2026.501966","DOIUrl":"10.1016/j.acuro.2026.501966","url":null,"abstract":"<div><h3>Objective</h3><div>To assess long-term mortality trends for male genital organ (MGO) cancers in Spain from 1999 to 2023, stratified by age group and tumour type.</div></div><div><h3>Methods</h3><div>A retrospective, population-based ecological study was conducted using mortality records from the Spanish National Institute of Statistics. Deaths were classified by ICD-10 codes: penile (C60), prostate (C61), testicular (C62), and other/unspecified (C63). Age-standardised mortality rates (ASMRs) were calculated using the 2013 European Standard Population. Temporal trends were evaluated with Joinpoint regression to estimate annual percentage change (APC) and average annual percentage change (AAPC). Analyses were stratified by early-onset (&lt;50 years) and late-onset (≥50 years) disease.</div></div><div><h3>Results</h3><div>From 1999 to 2023, 147,917 MGO-related deaths were recorded; prostate cancer comprised approximately 97%, predominantly in men aged ≥50 years. Crude mortality increased slightly over time due to population ageing, whereas prostate cancer ASMR decreased from 49.61 to 27.26 per 100,000 (AAPC −2.5%; 95% CI −2.7 to −2.3). A joinpoint in 2016 indicated a slowing decline thereafter (APC −1.3%). Testicular cancer mortality remained low and stable (AAPC −0.4%), with a minor reduction in older men but stable or slightly increasing patterns among younger men. Penile cancer mortality showed persistently low and unchanged rates (AAPC −0.8%). Early-onset prostate and penile cancer mortality was rare and exhibited stable trends.</div></div><div><h3>Conclusions</h3><div>MGO cancer mortality in Spain is overwhelmingly driven by prostate cancer, which has declined markedly over 25 years but has plateaued since 2016. Mortality from testicular and penile cancers remains low with limited age-specific variability.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501966"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859167","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":"Nefrectomía parcial robótica de puerto único con la plataforma Da Vinci SP: viabilidad y resultados preliminares de la primera serie española","authors":"V. Hevia-Palacios,&nbsp;R. Brime-Menéndez,&nbsp;C. Cámara-Martínez,&nbsp;R. Guevara,&nbsp;N. Paesano,&nbsp;E. García-Rojo,&nbsp;F. Barrientos,&nbsp;F. Lista-Mateos,&nbsp;J. Justo-Quintas,&nbsp;J. Romero-Otero","doi":"10.1016/j.acuro.2026.501981","DOIUrl":"10.1016/j.acuro.2026.501981","url":null,"abstract":"<div><h3>Introduction</h3><div>Single-port robot-assisted partial nephrectomy (SP-RAPN) is an emerging minimally invasive technique that integrates all instruments through a single multichannel port. Despite its increasing international use, European experience remains limited and no prior clinical series have been reported in Spain. This study aims to assess the feasibility, perioperative safety, and early outcomes of SP-RAPN in the first Spanish institutional experience.</div></div><div><h3>Materials and Methods</h3><div>Prospective observational study including the first eight consecutive patients undergoing SP-RAPN at a high-volume RAPN centre. Surgical approach was selected according to tumour location. Perioperative parameters, postoperative recovery, renal function at 3 months, and pathological outcomes were collected.</div></div><div><h3>Results</h3><div>All procedures were completed successfully without conversion. Mean tumour size was 33<!--> <!-->mm and mean RENAL score 7. Access was transperitoneal in 50%, pure retroperitoneal in 25%, and SARA/LAA in 25% of cases. Mean warm ischemia time was 19<!--> <!-->minutes and mean operative time 123<!--> <!-->minutes. Estimated blood loss was low (125<!--> <!-->mL), and no transfusions were required. Only one minor complication (Clavien I) occurred. Serum creatinine remained stable postoperatively and at 3 months. Final pathology confirmed renal cell carcinoma in 7 patients, with negative surgical margins in 87.5%. Early recurrence-free survival was 100%.</div></div><div><h3>Conclusions</h3><div>SP-RAPN is a feasible, reproducible, and safe procedure for localized T1 renal tumours. Perioperative, functional, and oncologic outcomes were favourable and within the ranges reported for RAPN in contemporary series. The versatility of transperitoneal, retroperitoneal, and SARA/LAA approaches may further expand its indications. Future multicentre studies with larger cohorts and long-term follow-up will be essential to confirm the durability and clinical benefits of this promising technique.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501981"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859231","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":"Radioterapia pélvica en el cáncer de próstata de alto riesgo: más allá del volumen irradiado","authors":"I. Henríquez,&nbsp;Ó. Abuchaibe","doi":"10.1016/j.acuro.2026.501933","DOIUrl":"10.1016/j.acuro.2026.501933","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501933"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859165","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":"Profilaxis antibiótica en estudios urodinámicos: revisión sistemática de estudios secundarios","authors":"L. Castillo Carvajal,&nbsp;C.A. Zapata,&nbsp;E. Corrales Acosta,&nbsp;C. Errando Smet,&nbsp;M. Przydacz,&nbsp;S. de Cillis,&nbsp;C.G. Tantay,&nbsp;P. Geretto,&nbsp;A.L. Caceres","doi":"10.1016/j.acuro.2026.501984","DOIUrl":"10.1016/j.acuro.2026.501984","url":null,"abstract":"<div><div>Urodynamics is the functional study of the urinary tract and an invasive diagnostic test that involves inserting a catheter into the bladder to assess bladder-related symptoms. One major risk is the development of urinary tract infections (UTI) following the procedure. Currently, there is no global consensus on the use of antibiotic prophylaxis. This study aims to identify key recommendations regarding prophylactic antibiotic therapy associated with urodynamic procedures. A systematic review of clinical practice guidelines (CPG), systematic reviews, and meta-analyses was conducted with subsequent quality evaluation. Out of 320 references, four clinical practice guidelines, one meta-analysis, and one systematic review were selected. Three clinical practice guidelines had acceptable global quality, and one was a «Best Practice Statement».</div><div>All guidelines agree that antibiotic prophylaxis is not recommended for low-risk patients but should be used in those at high risk of postoperative infection. The meta-analysis concluded that prophylactic antibiotics could reduce the risk of asymptomatic bacteriuria and symptomatic UTI post-urodynamics without increasing the incidence of adverse events. For high-risk patients, the recommended antimicrobials include trimethoprim-sulfamethoxazole or fluoroquinolones, considering the institution's resistance profile. These recommendations are based on expert panel opinions following a systematic literature review. Current evidence indicates that routine antibiotic prophylaxis prior to urodynamic studies is not warranted, as its primary benefit lies in reducing asymptomatic bacteriuria without significantly decreasing the incidence of symptomatic urinary tract infections. Prophylactic antibiotics should be reserved for patients at high risk of infection, with antimicrobial selection guided by local resistance patterns and an individualized assessment of risk and benefit.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501984"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859339","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":"Nueva herramienta complementaria para la elección del tratamiento de masas renales sólidas en estadio clínico T1a","authors":"T. Asi,&nbsp;M. Altan,&nbsp;E. Karabulut,&nbsp;M.S. Yazici,&nbsp;B. Akdogan,&nbsp;H. Ozen","doi":"10.1016/j.acuro.2026.501927","DOIUrl":"10.1016/j.acuro.2026.501927","url":null,"abstract":"<div><h3>Objectives</h3><div>To present a new nomogram that uses preoperative clinical features to predict benign pathology in clinical T1a solid renal masses.</div></div><div><h3>Materials and methods</h3><div>Demographic, clinical and pathologic data related to 579 patients diagnosed with clinical solid T1a renal mass were retrospectively collected. Univariate and multivariable logistic regression analyses were used to determine the variables related to benign pathology. Variables with statistical significance were used to develop a nomogram.</div></div><div><h3>Results</h3><div>The female-to-male ratio was 240/339, with a median age of 56 (47-64) years. 40% (232/579) of all patients had a diagnosis of hypertension or diabetes mellitus or both. All patients had solitary renal lesion with a median size of 3.0 (23-35) cm. Cystic component was noticed in 20.7% (119/579) of the lesions.</div><div>Benign pathology was detected in 19.9% (115/579) of cases. On univariate analysis, female gender, age less than 60 years, absence of hypertension or diabetes mellitus, symptomatic presentation, smaller tumor size and absence of cystic component were all related to benign pathology. Female gender, age less than 60 years, smaller tumor size and absence of cystic component kept their significance on multivariable analysis. A nomogram was built depending on these variables. The model was close to the ideal and had a c-index value of 0.79.</div></div><div><h3>Conclusion</h3><div>The nomogram in the present study has good predictive ability for benign pathology in T1a solid renal masses. This will help physicians and patients while making decisions related to the management paradigm.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501927"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859166","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}