Actas urologicas espanolas最新文献

{"title":"¿Es necesario el estado 100% libre de litiasis en los casos de cálculos coraliformes?","authors":"G. Freschi ,&nbsp;D.P. Resuto ,&nbsp;R.H. Astolfi ,&nbsp;W.R. Molina ,&nbsp;A. Meller","doi":"10.1016/j.acuro.2025.501812","DOIUrl":"10.1016/j.acuro.2025.501812","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To evaluate long-term outcomes in staghorn stone patients with residual fragments following surgical treatment.</div></div><div><h3>Materials and methods</h3><div>A retrospective study of patients who underwent percutaneous nephrolithotripsy for staghorn stones and long term follow up were divided into two groups: residual stones versus non-residual stones. The occurrence of new stones or fragment growth, infectious events, and renal function were evaluated. Patients with a follow-up period of less than one year were excluded.</div></div><div><h3>Results</h3><div>A total of 87 patients (75.9% female) were included in the study. Of these, 21.8% were stone-free, while 78.2% exhibited residual fragments with a median size of 7<!--> <!-->mm (3.5-11.5<!--> <!-->mm). The average follow-up period was 27 months (21-36 months). Only 24.1% experienced recurrence or growth of residual fragments, with a median growth of 10<!--> <!-->mm (6-12<!--> <!-->mm). Additionally, 14.9% of patients developed urinary infections during the follow-up period. No significant differences were observed between stone-free patients and those with residual fragments in terms of recurrence, residual fragments growth, infectious events, or deterioration in renal function. Similarly, no differences were noted when comparing patients with positive or negative cultures.</div></div><div><h3>Conclusions</h3><div>The incidence of recurrence, growth of residual fragments, infectious events, and deterioration of renal function was comparable between patients with and without residual stones. Furthermore, the presence of positive preoperative or intraoperative cultures did not influence these outcomes.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501812"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922097","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":"Mapeo de las disparidades regionales en la mortalidad por cáncer de testículo en España (2004-2023)","authors":"L. Cayuela ,&nbsp;S. Cabrera Fernández ,&nbsp;R. Roldán Testillano ,&nbsp;M. Ortega Calvo ,&nbsp;A. Cayuela","doi":"10.1016/j.acuro.2025.501800","DOIUrl":"10.1016/j.acuro.2025.501800","url":null,"abstract":"<div><h3>Introduction</h3><div>This study investigates testicular cancer (TC) mortality trends and spatial patterns in Spain, utilizing provincial-level spatial analysis to identify high-risk clusters.</div></div><div><h3>Methods</h3><div>An ecological study was conducted using TC mortality data (ICD-10 code C62) from the Spanish National Institute of Statistics (2004-2023). Age-standardized mortality rates were calculated using the direct method. Temporal trends were analyzed with Joinpoint regression. Spatial patterns were assessed using standardized mortality ratios, smoothed relative risk, and posterior probabilities through Bayesian hierarchical models. Spatial clustering was examined with Tango's test and Kulldorff's likelihood ratio test.</div></div><div><h3>Results</h3><div>A total of 909 TC deaths were recorded, with age-standardized mortality rates ranging from 0.14 to 0.26 per 1,000,000 inhabitants. No significant temporal trends were observed. Age-specific mortality showed a bimodal distribution, peaking at ages 35-39 and 85+. The highest standardized mortality ratios were found in Zamora (2.58), Segovia (2.64), and Soria (2.39), while the lowest were in Madrid (0.66) and Barcelona (0.55). Bayesian spatial analysis identified elevated relative risk in Badajoz (1.6), Huelva (1.47), and Sevilla (1.4). Kulldorff's analysis revealed a high-mortality cluster in southwestern Spain (Huelva, Sevilla, Badajoz), with a secondary cluster extending to neighbouring provinces.</div></div><div><h3>Conclusions</h3><div>While TC mortality in Spain remained stable, significant regional disparities exist. High-risk provinces and mortality clusters highlight potential inequalities in healthcare access, socioeconomic conditions, and environmental exposures.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501800"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922085","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":"Competencias quirúrgicas en urología: concordancia entre la percepción de residentes y profesionales en ejercicio en un país latinoamericano","authors":"J. Scherñuk,&nbsp;M.G. Dorsemaine,&nbsp;J.K. Toapanta Ortega,&nbsp;D. Zimmermann,&nbsp;I.P. Tobia,&nbsp;D. Santillán","doi":"10.1016/j.acuro.2025.501794","DOIUrl":"10.1016/j.acuro.2025.501794","url":null,"abstract":"<div><h3>Introduction</h3><div>Consensus remains lacking on which surgeries should be deemed essential for general urologists and which should be reserved for subspecialists. This study aims to compare the perceptions of urology trainees (Trainees) and practicing urologists (PractUrol) regarding the relevance of surgeries for independent practice and subspecialist training.</div></div><div><h3>Methods</h3><div>Cross-sectional comparative study on Trainees and PractUrol from a Latin-American country. Participants completed a Google Forms® questionnaire on 56 urological surgeries in September-October 2023, categorizing each as Essential Index (E-index), Supervised Index (Sup-index), or Subspecialty (Subspec). Statistical comparisons were performed using Chi-square or Fisher's exact tests with Bonferroni correction.</div></div><div><h3>Results</h3><div>Among 138 participants (109 PractUrol, 29 Trainees), 78.6% (44/56) of surgeries showed agreement between groups, with 13 surgeries achieving over 75% concordance. Disagreements were noted for 21.4% (12/56) of surgeries: (1) Microvaricocelectomy, penectomy, DVIU, ureteral reimplantation, and vesicovaginal fístula repair were more often classified as Subspec by Trainees but as E-index by PractUrol. (2) Radical cystectomy with orthotopic diversion and Boari Flap were classified as Subspec by Trainees but as Sup-index by PractUrol. (3) Partial cystectomy, pelvic, and inguinal lymphadenectomy were more frequently deemed Subspec by Trainees. (4) Flexible ureteroscopy was considered E-index by Trainees but Sup-index by PractUrol. (5) Artificial urinary sphincter placement was more often classified as Sup-index by PractUrol.</div></div><div><h3>Conclusion</h3><div>There is substantial agreement on the relevance of urological surgeries between PractUrol and Trainees, including 13 surgeries deemed essential by over 75% of participants. However, differing opinions on 12 surgeries highlight areas for further discussion.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501794"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922098","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":"Duración de la deprivación androgénica con la radioterapia de rescate en los pacientes con cáncer de próstata con recidiva bioquímica tras cirugía: datos iniciales de reclutamiento en el ensayo fase III URONCOR 06-24","authors":"C. González San Segundo ,&nbsp;F. López-Campos ,&nbsp;A. Gómez Iturriaga ,&nbsp;M. Santos ,&nbsp;A. Ocanto ,&nbsp;L. Montezuma ,&nbsp;A.M. Boladeras-Inglada ,&nbsp;L. Glaria ,&nbsp;S. Guardado ,&nbsp;A. Rodríguez ,&nbsp;I. Henríquez ,&nbsp;J. Olivera ,&nbsp;V. Duque-Santana ,&nbsp;J. Garre ,&nbsp;S. Moreno ,&nbsp;J. Valero ,&nbsp;A.J. Conde ,&nbsp;A. Doval ,&nbsp;G. Sancho ,&nbsp;P. Martín Nieto ,&nbsp;F. Couñago","doi":"10.1016/j.acuro.2025.501823","DOIUrl":"10.1016/j.acuro.2025.501823","url":null,"abstract":"<div><h3>Introduction</h3><div>URONCOR 06-24 (NCT05781217) is a prospective, multicenter, randomized, open-label, phase III trial evaluating the impact on distant metastasis-free survival (MFS) of short-term (6 months) versus long-term (24 months) androgen deprivation therapy (ADT) in combination with salvage radiotherapy in high- and intermediate-risk patients after biochemical recurrence (BCR).</div></div><div><h3>Material and method</h3><div>A total of 534 men will be randomized to receive either 6 or 24 months of ADT. Stratification is based on risk group (intermediate vs high) and nodal status (pN0 vs pNx).</div></div><div><h3>Results</h3><div>From March 2023 to November 2024, 122 patients have been enrolled: 34 (28%) with intermediate risk and 88 (72%) with high risk. Fifty-five patients (45%) are pNx. The mean time from surgery to BCR is 25.4 months, and the PSA at inclusion was 0.55 ng/ml. Restaging was performed in 89 patients, 75 of whom underwent PET/CT (97%, PSMA PET/CT). Hypofractionation was used in 68% of cases, and elective pelvic irradiation in 33%. At the time of analysis, all patients had PSA normalization. No severe ADT-related toxicity has been reported</div></div><div><h3>Conclusion</h3><div>URONCOR 06-24 is the first clinical trial comparing long- versus short-term ADT in the setting of BCR after prostatectomy, with stratification by risk group. Initial recruitment data show a balanced distribution of prognostic factors between both arms and no serious adverse events related to ADT.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501823"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922082","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":"Comparación del P-score de Prostatype® y los modelos de riesgo tradicionales para predecir los resultados del cáncer de próstata en España","authors":"P. González-Peramato ,&nbsp;M. Álvarez-Maestro ,&nbsp;V. Heredia-Soto ,&nbsp;M. Mendiola Sabio ,&nbsp;E. Linares ,&nbsp;Á. Serrano ,&nbsp;J.L. Álvarez-Ossorio ,&nbsp;E. López Alcina ,&nbsp;L. Prieto ,&nbsp;F. Vázquez Alonso ,&nbsp;M. Aller Rodríguez ,&nbsp;E. Berglund","doi":"10.1016/j.acuro.2025.501788","DOIUrl":"10.1016/j.acuro.2025.501788","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer (PCa) shows varied aggressiveness, complicating personalised treatment decisions. Traditional risk stratification systems rely on clinical parameters but may miss crucial genetic insights. The Prostatype® score (P-score) integrates gene expression with clinical data to improve PCa risk assessment precision.</div></div><div><h3>Objectives</h3><div>To validate the P-score's predictive performance for prostate cancer-specific mortality (PCSM) and metastasis in a Spanish cohort, comparing it with NCCN, D’Amico, and EAU systems.</div></div><div><h3>Materials and Methods</h3><div>This study was multicentre, retrospective and included seven Spanish hospitals. Of 154 core needle biopsies, 93 met RNA criteria, and for those, P-score was calculated based on <em>IGFBP3</em>, <em>VGLL3</em>, and <em>F3</em> genes expression and clinical data.</div><div>The primary endpoint was PCa-specific mortality (PCSM), with secondary endpoints being development of metastasis, adverse pathology (AP), and International Society of Urological Pathology (ISUP) grading.</div></div><div><h3>Results</h3><div>The P-score demonstrated superior accuracy in predicting 10-year PCSM, with an AUC of 0.81 and a C-index of 0.75, outperforming NCCN (AUC 0.77, C-index 0.69) and D’Amico/EAU (AUC 0.70, C-index 0.62). For metastasis prediction, the P-score achieved a C-index of 0.77, significantly higher than NCCN, D’Amico, and EAU (0.58). Kaplan-Meier analysis underscored the P-score's ability to better stratify patients by risk, especially high-risk groups. Additionally, the P-score correlated with tumour burden, showing significant associations with positive biopsy cores (p<!--> <!-->=<!--> <!-->0.017) and ISUP grade at radical prostatectomy (p<!--> <!-->=<!--> <!-->0.0028).</div></div><div><h3>Conclusions</h3><div>In this Spanish cohort, the P-score outperformed traditional clinicopathological systems in predicting PCSM, development of metastasis, and pathological markers, supporting its clinical utility for more personalised PCa management.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501788"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517658","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":"La influencia de la invasión linfovascular en la recurrencia y progresión del cáncer vesical no músculo invasivo tratado con bacilo de Calmette-Guérin","authors":"U. Aydin ,&nbsp;S. Cetin ,&nbsp;M. Yavuz Koparal ,&nbsp;C. Coskun ,&nbsp;I.I. Gonul ,&nbsp;S. Yesil ,&nbsp;T.S. Sozen","doi":"10.1016/j.acuro.2025.501785","DOIUrl":"10.1016/j.acuro.2025.501785","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To investigate whether lymphovascular invasion (LVI) could be a factor in predicting recurrence and progression in patients with high and very high-risk non-muscle-invasive bladder cancer (NMIBC) who received Bacillus Calmette-Guérin (BCG) treatment.</div></div><div><h3>Methods</h3><div>Ninety-three patients with high and very high-risk NMIBC, diagnosed initially in our clinic, were treated with at least 1 year of BCG therapy, and they were followed up to assess recurrence and progression, comparing those with and without LVI at the time of diagnosis.</div></div><div><h3>Results</h3><div>In the entire cohort, LVI was present in 33 (35.5%) patients while absent in 60 (64.5%) patients. Among patients with LVI, 17 (51.5%) showed recurrence, and 11 (33.3%) showed progression. Statistically significant differences were observed in both recurrence and progression in patients with LVI compared to those without LVI (<em>P</em> <!-->&lt;<!--> <!-->.001 and .04, respectively). Additionally, univariate and multivariate regression analysis revealed that the presence of LVI was an independent factor predicting recurrence (<em>P</em> <!-->=<!--> <!-->.001).</div></div><div><h3>Conclusion</h3><div>In our study, we demonstrated the importance of being cautious regarding recurrence and progression in patients with high and very high-risk NMIBC who also have LVI despite receiving standard treatment. We found that approximately one-third of these patients may experience recurrence within one year.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501785"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517662","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 síndrome de burnout en urólogos españoles: prevalencia, factores de riesgo e implicaciones para la salud mental","authors":"B. Nakdali Kassab ,&nbsp;J.V. Segura Heras ,&nbsp;M. Gómez Garberí ,&nbsp;J.J. Pacheco Bru ,&nbsp;M.A. Ortiz Gorraiz ,&nbsp;J.J. Mira Solves","doi":"10.1016/j.acuro.2025.501793","DOIUrl":"10.1016/j.acuro.2025.501793","url":null,"abstract":"<div><h3>Introduction</h3><div>Burnout syndrome is a significant occupational phenomenon among healthcare professionals, characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. Urologists, due to the demands of their specialty, are particularly vulnerable. This study aims to assess the prevalence and risk factors for burnout syndrome among urologists in Spain.</div></div><div><h3>Method</h3><div>A cross-sectional survey was conducted among 257 practicing urologists in Spain. Data were collected using the Maslach Burnout Inventory and additional demographic and occupational questions. Burnout was defined based on high emotional exhaustion combined with either high depersonalization or low personal accomplishment. Statistical analyses included univariate and multivariate logistic regression to identify significant predictors.</div></div><div><h3>Results</h3><div>In the study, the prevalence of burnout among Spanish urologists was 54.9%. Fewer years of experience and female gender were associated with higher burnout rates. Significant stressors included workload and work schedule. Despite the high prevalence, only one third of affected professionals sought psychological support.</div></div><div><h3>Conclusions</h3><div>Burnout is highly prevalent among Spanish urologists and poses serious risks to both healthcare professionals and patients. Its impact on patient care includes increased likelihood of medical errors, reduced quality of care and patient satisfaction. Targeted interventions and psychological support are urgently needed to address this issue.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501793"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517904","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 la supervivencia del dispositivo y los factores predictivos de la misma en una cohorte de pacientes intervenidos de esfínter urinario artificial masculino","authors":"C. Mínguez Ojeda,&nbsp;A. Artiles Medina,&nbsp;A. Fraile Poblador,&nbsp;Á. Sánchez González,&nbsp;J.D. Subiela Henríquez,&nbsp;J. Brasero Burgos,&nbsp;I. de la Parra Sánchez,&nbsp;D. López Curtis,&nbsp;P. del Olmo Durán,&nbsp;A. Fernández-Mardomingo Díaz,&nbsp;M.Á. Jiménez Cidre,&nbsp;V. Gómez Dos Santos,&nbsp;F.J. Burgos Revilla","doi":"10.1016/j.acuro.2025.501786","DOIUrl":"10.1016/j.acuro.2025.501786","url":null,"abstract":"<div><h3>Introduction</h3><div>Stress urinary incontinence (SUI) affects between 2.5% and 40% of patients after radical prostatectomy. Although the implantation of an artificial urinary sphincter (AUS) offers continence rates of 70-80%, its failure rate reaches 25% in some series. This single-center retrospective study analyzed the survival of AUS and the factors associated with its failure.</div></div><div><h3>Materials and methods</h3><div>A total of 145 patients treated with the AMS 800® device (Boston Scientific) between 2010 and 2023 were included. Kaplan-Meier analysis and the Cox proportional hazards model were used to evaluate device survival and identify predictive factors for failure.</div></div><div><h3>Results</h3><div>The mean age was 68.6 years; 28% of patients were smokers, 43.7% had diabetes, and 26.2% had undergone prior radiation therapy. Radical prostatectomy was the main cause of SUI (86.9%). In the majority of cases (91.5%), the artificial urinary sphincter was implanted around the bulbar urethra. During follow-up, 25.5% of patients required revision surgery. The probability of functional sphincter survival was 89% at 1 year, 78% at 2 years, 64% at 5 years, and 51% at 10 years. On multivariate analysis, prior radiation therapy (HR: 2.06; <em>P</em>=.029) and diabetes (HR: 2.24; <em>P</em>=.04]) were associated with poorer device survival.</div></div><div><h3>Conclusions</h3><div>The AUS is an effective and safe treatment for severe SUI, although radiotherapy and diabetes may adversely affect its durability.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501786"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517660","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":"Phyllanthus niruri en el manejo de las litiasis urinarias: revisión sistemática de la literatura","authors":"J. Iregui-Parra ,&nbsp;V. Rojas Ossa ,&nbsp;C.M. Arias Salazar ,&nbsp;A.D. López Estupiñán ,&nbsp;D. Díaz Varela ,&nbsp;L.M. Sinisterra Parra ,&nbsp;L. Diéguez ,&nbsp;E. Emiliani","doi":"10.1016/j.acuro.2025.501791","DOIUrl":"10.1016/j.acuro.2025.501791","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Nephrolithiasis is one of the most prevalent urological pathologies worldwide, with an increasing incidence and multifactorial etiology, particularly influenced by diet. Surgical interventions or extracorporeal shock wave lithotripsy (ESWL) are the cornerstone treatments. However, as emphasized by the EAU and AUA guidelines, post-surgical medical management is recommended to reduce recurrence risk. Phyllanthus niruri (PN), widely used in traditional medicine, has been extensively researched, yielding mixed results and presenting an opportunity to explore its role further. This review aims to evaluate PN's potential in enhancing treatment efficacy and reducing stone recurrence.</div></div><div><h3>Materials and Methods</h3><div>A systematic literature review was conducted, encompassing articles published from January 1994 to September 2022 in English and Spanish. The review included studies on humans and rats accessible through the authors’ institutional affiliations. Titles and abstracts were screened, and relevant studies were selected for in-depth analysis.</div></div><div><h3>Results</h3><div>Out of the 16 selected studies, various mechanisms of action for PN were identified, such as promoting glycosaminoglycan (GAG) aggregation, inhibiting nucleation processes, and altering stone density to favor a stone-free state (SFR). Evidence consistently supports PN's long-term safety, confirmed by serial measurements of serum electrolytes and liver function. Novel applications, such as PN as an adjuvant to ESWL, show benefits for lower renal pole stones.</div></div><div><h3>Conclusions</h3><div>Growing evidence suggests that PN, when used alongside traditional interventions, is safe, without significant adverse effects, and may improve SFR outcomes after ESWL.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501791"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517903","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":"Perfil de los pacientes con cateterismo intermitente limpio y consumo de recursos asociados. Estudio multicéntrico en España","authors":"C. Muller-Arteaga ,&nbsp;L. Resel Folkersma ,&nbsp;J. Medina-Polo ,&nbsp;A.M. López García-Moreno ,&nbsp;R. González López ,&nbsp;C. García Sánchez ,&nbsp;B. Madurga Patuel ,&nbsp;C. Zubiaur Libano ,&nbsp;P. Blasco Hernández ,&nbsp;en representación del Grupo Registro de Cateterismo Limpio Intermitente en España (CILREG) (AEU-PIEM/2017/001)","doi":"10.1016/j.acuro.2025.501756","DOIUrl":"10.1016/j.acuro.2025.501756","url":null,"abstract":"<div><h3>Introduction</h3><div>Clean intermittent catheterization (<span>C</span>I<span>C</span>) is a technique used for bladder emptying in patients with neurogenic or non-neurogenic lower urinary tract dysfunction. CIC is considered the best option for most patients with dysfunctional voiding, as it improves their quality of life with a low complication rate. However, there is considerable variability in the management of CIC across regions and countries, as well as a lack of standardized guidelines. This study aims to determine the patient profile, associated complications and resource utilization related to the procedure.</div></div><div><h3>Methods</h3><div>This descriptive, multicenter, cross-sectional study was conducted in the functional urology and urodynamics units of 23 hospitals across Spain between April 2019 and April 2021. Patient characteristics were collected and stored in the Multicenter Studies Research Platform of the Spanish Urology Association.</div></div><div><h3>Results</h3><div>This study included 573 CIC users, with a mean age of 54.1 years (SD 19.1). Of the participants, 78.6% lived in urban areas, and 53.9% had additional comorbidities. The primary indication for CIC was spinal cord injury (29.5%), followed by hypocontractile neurogenic bladder (20.8%). Most patients performed one CIC per day (87.3%), with a median of 3. The most common complication observed was urinary tract infection (51.8%). Additionally, 95.3% of patients attended at least one urology consultation in the past year.</div></div><div><h3>Conclusions</h3><div>CIC is mostly indicated for neurological pathologies, and urinary tract infection is the most common associated complication. CIC is a fundamental procedure in functional urology units and is linked to significant healthcare resource consumption. Knowledge on the patient profile and the characteristics associated with CIC is crucial for comprehensive patient management, as it helps reduce and prevent potential complications while also informing healthcare strategies for more efficient resource management.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501756"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517661","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}