Actas urologicas espanolas最新文献

{"title":"El drenaje de las venas varicosas (vein milking) durante la varicocelectomía microscópica subinguinal: efectos sobre el dolor, el resultado estético y el espermiograma","authors":"B. Kati ,&nbsp;E. Ordek ,&nbsp;I. Demir ,&nbsp;E. Sabri Pelit","doi":"10.1016/j.acuro.2025.501706","DOIUrl":"10.1016/j.acuro.2025.501706","url":null,"abstract":"<div><h3>Introduction</h3><div>Varicocele, defined as abnormal convoluted enlargement of the pampiniform plexus veins, is the most common cause of correctable male infertility. This study aimed to investigate the effect of blood drainage in varicose veins on spermiogram parameters, postoperative pain, cosmetic appearance, and patient satisfaction in patients undergoing subinguinal microscopic varicocelectomy.</div></div><div><h3>Methods</h3><div>Patients diagnosed with clinical varicocele and admitted to our urology outpatient clinic between January 2020 and January 2024 were evaluated. Those with a venous vessel diameter<!--> <!-->≥<!--> <!-->2.5<!--> <!-->mm underwent subinguinal microscopic varicocelectomy. In 75 patients, a small incision was made in the thickest varicose vein, and the veins were ligated after venous blood was drained by hand patting. In another 75 patients, vessels were cut and ligated by the classical method without venous blood drainage. Exclusion criteria included patients younger than 18, those with secondary varicocelectomy history, undescended testis, testicular trauma or tumors, and prior infertility treatment. Preoperative and postoperative spermiogram values, pain scores, cosmetic appearance, and patient satisfaction were recorded and compared.</div></div><div><h3>Results</h3><div>The pain rate was significantly lower (p<!--> <!-->&lt;<!--> <!-->0.05) in the blood-milking varicocelectomy group during postoperative controls (7-10 days) compared to the classical method group. The blood-milking group also showed significantly higher (p<!--> <!-->&lt;<!--> <!-->0.05) sperm count and motility at the 3rd postoperative month. Cosmetic satisfaction was significantly higher (p<!--> <!-->&lt;<!--> <!-->0.05) in the blood-milking group.</div></div><div><h3>Conclusions</h3><div>Blood drainage during subinguinal microscopic varicocelectomy significantly reduces postoperative pain and enhances sperm values, cosmetic outcomes, and patient satisfaction. These findings reveal that vein-milking techniques during varicocelectomy can optimize postoperative outcomes.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501706"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737968","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":"Tratamiento adyuvante en el cáncer renal de células claras de riesgo intermedio-alto. Revisión sistemática","authors":"M.Á. Arrabal-Polo ,&nbsp;L. Gómez-Morón ,&nbsp;F. Gutiérrez-Tejero ,&nbsp;A. Zambudio-Munuera ,&nbsp;I. Millán-Ramos ,&nbsp;M. Arrabal-Martín","doi":"10.1016/j.acuro.2025.501685","DOIUrl":"10.1016/j.acuro.2025.501685","url":null,"abstract":"<div><h3>Introduction</h3><div>Given the lack of comparative studies on adjuvant treatment for clear cell renal cell carcinoma, we present an updated systematic review, exploring the various options for adjuvant therapy. This review is conducted in accordance with the PRISMA guidelines.</div></div><div><h3>Material and method</h3><div>A systematic review was conducted, and 13 clinical trials were included after applying the pre-specified inclusion criteria. The risk of bias and the level of evidence were assessed. Subsequently, the requisite data were extracted in order to present the findings of the studies.</div></div><div><h3>Results and discussion</h3><div>The present systematic review establishes that pembrolizumab can be used as adjuvant therapy in patients with advanced renal cancer at high risk after nephrectomy. This is supported by the KEYNOTE-564 study, which concluded that it increased disease-free survival (DFS) and overall survival. The use of sunitinib is discussed, since the study published in NEJM shows a modest benefit in terms of DFS, but only in an independent and blinded central review. According to the PROTECT study, pazopanib has no overall benefit. The EVEREST study showed no significant benefit over everolimus. Further studies are needed to confirm the use of axitinib, as the ATLAS trial showed statistically significant results in DFS in higher-risk population based on investigator assessment, but not based on independent central review. Therapy with 5-FU, α-IFN and IL-2, atezolizumab, sorafenib, thalidomide, nivolumab<!--> <!-->+<!--> <!-->ipilimumab should not be used in the adjuvant setting.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501685"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143518871","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":"¿Qué saben los varones españoles sobre el cáncer de próstata?","authors":"C. Vargas-Blasco ,&nbsp;J. Arimany-Manso","doi":"10.1016/j.acuro.2025.501698","DOIUrl":"10.1016/j.acuro.2025.501698","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501698"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143518870","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":"Validación inicial lingüística y cultural de una encuesta de satisfacción sobre el uso de la prótesis inflable de pene en español","authors":"B.M. Ljubetic ,&nbsp;S.L. Thorogood ,&nbsp;E.F. Becher ,&nbsp;I. Alvarez de Toledo ,&nbsp;R. Carrion ,&nbsp;A. Carvajal ,&nbsp;E. Fernández-Pascual ,&nbsp;J.I. Martinez-Salamanca ,&nbsp;C. Nelson ,&nbsp;J. Quesada ,&nbsp;C.A. Salter ,&nbsp;J. Torremade ,&nbsp;M. d’Anna ,&nbsp;R. Valenzuela ,&nbsp;J.P. Mulhall ,&nbsp;J.M. Flores","doi":"10.1016/j.acuro.2025.501700","DOIUrl":"10.1016/j.acuro.2025.501700","url":null,"abstract":"<div><h3>Introduction</h3><div>The Satisfaction Survey for Inflatable Penile Implant (SSIPI) is useful tool to assess patient outcomes after inflatable penile prosthesis implant (PPI) surgery. However, this survey is not validated in Spanish. This work aims to report the initial steps carried out for the linguistic validation of the SSIPI translation into Spanish.</div></div><div><h3>Method</h3><div>The linguistic validation process had the following steps: (i)<!--> <!-->SSIPI forward translation; (ii)<!--> <!-->reconciliation; (iii)<!--> <!-->back translation; (iv)<!--> <!-->harmonization, review, and correction of the translation, and (v)<!--> <!-->cognitive interviewing and testing the new translated version. Urologists from Spain, South America, and the United States participated in these steps. The last step was performed in 3 centers: Medellín, Colombia; Florida, United States; and Madrid, Spain.</div></div><div><h3>Results</h3><div>19 Spanish-speaking patients tested the initial translated version of SSIPI. Most patients found the translated SSIPI questionnaire easy to understand; however, of the 16 questions, patients most frequently commented that questions 3, 5, and 7 should be modified. The median number of observations or comments per question was 1 (1, 3). Based on these suggestions, the research group adapted the questionnaire to obtain the final version in Spanish.</div></div><div><h3>Conclusion</h3><div>This study evaluates the initial steps for the translation and linguistic validation of the SSIPI questionnaire into Spanish. The results indicate a remarkable level of readability and comprehension, while some challenges were observed in certain questions. This work demonstrates that a standardized and protocolized process is needed to translate and validate surveys into Spanish.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501700"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519474","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":"Evaluación de la percepción de la imagen corporal y los niveles de dolor, fatiga y ansiedad de pacientes en hemodiálisis a la espera de trasplante renal y de pacientes trasplantados","authors":"F. Hassan ,&nbsp;N. Doğan","doi":"10.1016/j.acuro.2025.501707","DOIUrl":"10.1016/j.acuro.2025.501707","url":null,"abstract":"<div><h3>Objective</h3><div>This study was conducted to evaluate the body image perception, pain, fatigue and anxiety levels of individuals with kidney transplantation and undergoing hemodialysis and waiting for kidney transplantation.</div></div><div><h3>Materials and methods</h3><div>This cross-sectional study was conducted with 240 individuals who applied to the nephrology outpatient clinic and dialysis unit between 29 August 2021 and 20 May 2022. Data in the study were collected using Patient Information Form, LANSS Pain Scale, Visual Similarity Scale for Fatigue, Beck Anxiety Scale and Body Image Scale.</div></div><div><h3>Results</h3><div>The Body Image Scale total score average of individuals undergoing hemodialysis is 104.8<!--> <!-->±<!--> <!-->15.4, the LANSS Pain Scale total score average is 18.7<!--> <!-->±<!--> <!-->5.4, the Visual Similarity Scale total score average for Fatigue is 29.5<!--> <!-->±<!--> <!-->1.2, and the Beck Anxiety Scale total score average is 104.8<!--> <!-->±<!--> <!-->15.4. The total score average is 47.6<!--> <!-->±<!--> <!-->6.8.</div><div>The LANSS Pain Scale total mean score of individuals with kidney transplantation is 8.2<!--> <!-->±<!--> <!-->2.0, the Body Image Scale total score mean is 75.6<!--> <!-->±<!--> <!-->3.5, the Visual Similarity Scale total score mean for Fatigue is 24.3<!--> <!-->±<!--> <!-->1, and the Beck Anxiety Scale total score mean is 24.3<!--> <!-->±<!--> <!-->1. The mean total score of the scale was found to be 25.6<!--> <!-->±<!--> <!-->4.1.</div></div><div><h3>Conclusions</h3><div>It has been determined that hemodialysis patients waiting for a kidney transplant are not satisfied with their body image, experience more pain, and have higher levels of fatigue and anxiety than patients who have had a kidney transplant.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501707"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519477","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":"Relación entre los cultivos intestinales intraoperatorios y la infección urinaria postoperatoria en pacientes sometidos a cistectomía radical y derivación urinaria con conducto ileal","authors":"I.P. Tobia,&nbsp;C. Pedergrana,&nbsp;A.G. Alfieri,&nbsp;J.C. Tejerizo,&nbsp;M.I. González,&nbsp;G.A. Favre","doi":"10.1016/j.acuro.2025.501703","DOIUrl":"10.1016/j.acuro.2025.501703","url":null,"abstract":"<div><h3>Introduction</h3><div>Radical cystectomy (RC) is a preferred treatment for muscle-invasive bladder cancer (T2-T4) and certain non-muscle-invasive tumors. Post-cystectomy, urinary diversions often utilize intestinal segments, which are prone to complications, notably urinary tract infections (UTIs).</div></div><div><h3>Objective</h3><div>To estimate the association between intraoperative cultures of the isolated intestinal loop and urine cultures during UTI episodes in RC patients with urinary diversion. Additionally, to compare urinary cultures from catheters at discharge with UTI cultures and calculate UTI prevalence and readmission rates within three months postoperatively.</div></div><div><h3>Materials and Methods</h3><div>This prospective, observational cohort study included patients who underwent RC with ileal segment diversion our center between April 2021 and January 2024. Intraoperative cultures were obtained by washing the isolated ileal loop, and urine cultures were taken during postoperative UTI episodes. Patients were followed for 90 days post-surgery, and new cultures were performed if UTI symptoms appeared.</div></div><div><h3>Results</h3><div>Among 118 cystectomies, 82 patients were included, with a mean age of 67.8 years. UTI prevalence within the first three months was 43.9%. The kappa concordance index for bacteria between intraoperative and UTI cultures was 0.033 (poor), and for cultures from discharge catheters and UTI episodes, it was 0.251 (fair). UTI readmission rate was 28.9%, with no significant predictors identified.</div></div><div><h3>Conclusion</h3><div>There is no significant association between germs in intraoperative intestinal cultures or discharge catheters and those in UTI cultures in RC patients with urinary diversion. The three-month UTI prevalence is 43.9%, with a 28.9% readmission rate. Continuous epidemiological surveillance is recommended for appropriate antibiotic therapy.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501703"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cirugía robótica, luces y sombras","authors":"A. Aguilera Bazán","doi":"10.1016/j.acuro.2025.501696","DOIUrl":"10.1016/j.acuro.2025.501696","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501696"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519469","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":"Cambio de paradigma en el tratamiento quirúrgico de la fimosis en edad pediátrica. ¿Se ajusta la práctica a las recomendaciones actuales?","authors":"S. Fuentes ,&nbsp;N. Vicente-Sánchez ,&nbsp;M.E. Martín-Castillo ,&nbsp;E. Robert-Gil ,&nbsp;A. Arranz-Martí ,&nbsp;C. Grande-Moreillo","doi":"10.1016/j.acuro.2025.501710","DOIUrl":"10.1016/j.acuro.2025.501710","url":null,"abstract":"<div><h3>Introduction</h3><div>Improving the quality of care is a fundamental issue in medicine. The analysis of routine practice and its adequacy to the available evidence can detect areas for improvement. We have decided to apply these principles to the surgical treatment of phimosis in pediatric age. The aim of this study is to analyze the situation of phimosis surgery for children up to 18 years of age in our environment and its compliance with current recommendations.</div></div><div><h3>Material and methods</h3><div>Retrospective descriptive observational study including surgeries performed for phimosis in children and adolescents up to 18 years of age in 2022 and 2023. Data were compared with the recommendations of the European and British Pediatric Urology Associations.</div></div><div><h3>Results</h3><div>A total of 222 medical records were included. All surgeries were performed on an outpatient basis and with loco-regional anesthesia. The percentage of pathological phimosis was 11%. Among physiological phimosis, 47% were asymptomatic (70% between 3 and 7 years of age).</div></div><div><h3>Discussion</h3><div>According to current European recommendations, phimosis surgery is reserved for cases of symptomatic pathological or physiological phimosis or with increased risk of urinary tract infection. In pediatric patients in our environment, all aspects of phimosis surgery are performed according to current recommendations, but the percentage of asymptomatic phimosis operated on in young children is high. Based on the possibility of spontaneous resolution, the indication and optimal age of intervention in this group of patients should be reviewed.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501710"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143518869","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":"Nota del publisher","authors":"","doi":"10.1016/S0210-4806(25)00058-0","DOIUrl":"10.1016/S0210-4806(25)00058-0","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501740"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renorrafia sin sutura frente a renorrafia convencional con sutura en nefrectomía parcial robóti̇ca sin clampaje: análisis unicéntrico de emparejamiento por puntuación de propensión","authors":"S. Kilic,&nbsp;M. Ates","doi":"10.1016/j.acuro.2025.501704","DOIUrl":"10.1016/j.acuro.2025.501704","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Suture renorrhaphy persists as time-consuming in partial nephrectomy (PN) and carries the risk of renal arterial damage and renal functional loss. This study aims to compare the functional and oncological outcomes of the clampless and sutureless robotic PN (sRPN) with clampless conventional suture renorrhaphy RPN (cRPN).</div></div><div><h3>Patients</h3><div>A total of 173 consecutive patients who underwent RPN between January 2019 and December 2023 were reviewed from our center's database. Seventy six clampless (sutureless: 23; conventional suture renorrhaphy: 53) RPN were identified. A propensity score matched-pair analysis (PSM) was performed to homogenize the ingredients of the groups. Comprehensive evaluations of perioperative variables, functional and oncological results were performed before and after the PSM between the sRPN and cRPN.</div></div><div><h3>Results</h3><div>Before the PSM, median console time was 10<!--> <!-->minutes shorter in the sRPN group but was not statistically significant. Estimated median blood loss was significantly lower in the sRPN group (<em>P</em> <!-->&lt;<!--> <!-->.05). After PSM, 22 patients were matched in each group and all of the preoperative baseline characteristics were similar. Ratio of interpolar lines located tumors was higher in sRPN group (68.2% vs 31.2%) (<em>P</em> <!-->&lt;<!--> <!-->.05). Median tumor diameter was 3 (1.5-7) cm in each group. The trifecta achievement ratios were 90.9% and 77.2% for sRPN and cRPN groups, respectively (<em>P</em> <!-->&gt;<!--> <!-->.05). There were no differences in terms of median console times, estimated blood loss, drain removal times or eGFR changes.</div></div><div><h3>Conclusions</h3><div>In the treatment of small renal masses with clampless RPN, the sutureless technique can be applied with similar complication rates and functional, oncological outcomes as conventional sutured renorophy.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501704"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519476","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}