Actas urologicas espanolas最新文献

{"title":"Principales diferencias farmacológicas entre mirabegrón y vibegrón para el tratamiento de la vejiga hiperactiva","authors":"A. Alcántara Montero","doi":"10.1016/j.acuro.2025.501868","DOIUrl":"10.1016/j.acuro.2025.501868","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501868"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859164","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":"Cuando la evidencia no es intercambiable: límites de la equivalencia terapéutica en la recidiva bioquímica de alto riesgo en cáncer de próstata","authors":"D. Pérez Fentes, A. Gómez Iturriaga, M. Ramírez Backhaus, J. Gómez Rivas, F. López Campos","doi":"10.1016/j.acuro.2026.501989","DOIUrl":"10.1016/j.acuro.2026.501989","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501989"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859338","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 predictores de recurrencia bioquímica tras prostatectomía radical en cáncer de próstata ISUP 1: cohorte retrospectiva con seguimiento prolongado","authors":"L. Diéguez-Álvarez,&nbsp;A.I. Hernández Álvarez,&nbsp;J. Panach-Navarrete,&nbsp;A. Castelló-Porcar,&nbsp;L. Esteban-Igual,&nbsp;J.M. Martínez-Jabaloyas","doi":"10.1016/j.acuro.2026.501979","DOIUrl":"10.1016/j.acuro.2026.501979","url":null,"abstract":"<div><h3>Introduction</h3><div>The clinical relevance of biochemical recurrence (BCR) after radical prostatectomy (RP) in ISUP Grade Group 1 prostate cancer is unclear. We evaluated the incidence of BCR, its pathological predictors, and long-term oncologic outcomes in this population.</div></div><div><h3>Materials and methods</h3><div>Retrospective observational study of consecutive patients who underwent RP between 1999 and 2012 with ISUP GG 1 adenocarcinoma in the specimen. BCR was defined as prostate-specific antigen<!--> <!-->≥<!--> <!-->0.2 ng/ml in two consecutive measurements after postoperative nadir. BCR-free survival and overall survival were estimated using Kaplan-Meier analysis, and predictors of BCR were identified using Cox regression. Salvage treatments, events of radiologic progression, and mortality were described.</div></div><div><h3>Results</h3><div>A total of 208 patients were included. The median follow-up was 12.1 years. BCR was observed in 45 (21.6%), with a median time to BCR of 5.2 years (IQR: 2.3-7.5). Five-year BCR-free survival was 92%, 81% at 10 years, and 78% at 15 years. Positive surgical margins were the only independent predictor of BCR (HR: 3.27; 95% CI: 1.64-6.53; <em>P</em>&lt;.001). Eleven patients with BCR (24.4%) received salvage radiotherapy. Only 3 patients developed radiologic progression (1.4%); 42 deaths (20.2%) were recorded; none of them were cancer-specific deaths.</div></div><div><h3>Conclusions</h3><div>In ISUP grade group 1 prostate cancer treated with RP, BCR is relatively common but rarely associated with radiologic progression; no cancer-specific deaths were observed during long-term follow-up. Positive margins were associated with a higher risk of BCR.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501979"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859163","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":"Estudio prospectivo aleatorizado de la concordancia en la valoración del dolor referida por el paciente y el médico en la cistoscopia flexible: impacto de la experiencia del médico y la ansiedad del paciente","authors":"G. Ozgur,&nbsp;C. Ozdemiroglu,&nbsp;M. Kars,&nbsp;Y. Senoglu,&nbsp;H. Kamil Cam","doi":"10.1016/j.acuro.2026.501982","DOIUrl":"10.1016/j.acuro.2026.501982","url":null,"abstract":"<div><h3>Introduction</h3><div>Flexible cystoscopy is commonly performed under local anesthesia. This study explores the effects of pre-procedural anxiety, depression, and physician experience on both patient pain and the physician's perception of it.</div></div><div><h3>Methods</h3><div>This prospective, randomized study included 120 male patients (≥18 years), scheduled for flexible cystoscopy under intraurethral 2% lidocaine. Patients were randomly assigned to four groups based on the experience level of the physician. Pain perception was assessed using the Visual Analog Scale (VAS), while pre-procedural anxiety and depression were measured with the Hospital Anxiety and Depression (HAD) scale.</div></div><div><h3>Results</h3><div>Postoperative VAS-pain scores were slightly higher than preoperative values (2 vs. 1.5; p&lt;<!--> <!-->0.001), but this difference was considered clinically negligible due to the overall low pain levels observed. Although doctors tended to underestimate patients’ pain, a correlation was observed between patient- and physician-reported postoperative VAS-pain (r<!--> <!-->=<!--> <!-->0.487, p&lt;<!--> <!-->0.01). Physician experience did not significantly affect pain perception (p<!--> <!-->=<!--> <!-->0.585). Interestingly, although the differences in VAS-scores are not clinically important, the correlation analysis revealed that less experienced physicians -residents- demonstrated a stronger concordance between their perception of patient pain and the patients’ self-reported pain (r<!--> <!-->=<!--> <!-->0.798 and r<!--> <!-->=<!--> <!-->0.633). HADS-anxiety scores correlated positively with both preoperative and postoperative pain and anxiety levels (r<!--> <!-->=<!--> <!-->0.194–0.404, p&lt;<!--> <!-->0.05), while HADS-depression showed no association.</div></div><div><h3>Conclusion</h3><div>Flexible cystoscopy performed under local anesthesia is a well-tolerated procedure, irrespective of the physician's level of experience. The correlation between patient and physician pain scores suggests that physicians can reliably assess patient discomfort. Managing preoperative anxiety is essential to enhance patient comfort during the procedure.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501982"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859341","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":"Mejora del seguimiento a largo plazo del cáncer de vejiga no músculo-invasivo (CVNMI): Digital Uromonitor® (dUM) como herramienta complementaria a la cistoscopia para la estratificación del riesgo de recurrencia a dos años","authors":"J. Rubio-Briones,&nbsp;F. Guerrero Ramos,&nbsp;A. Mercadé Sánchez,&nbsp;I. Bezana Abadía,&nbsp;R. Martín Rodríguez,&nbsp;A. Alcaraz,&nbsp;M. Miqueleiz Legaz,&nbsp;F. Lozano,&nbsp;M. Arrabal Martín,&nbsp;A.L. Cardo,&nbsp;V. Gonzalo Rodríguez,&nbsp;J. Caño Velasco,&nbsp;M. Serrano Liesa,&nbsp;C. Ferreiro Pareja,&nbsp;R. Espílez Ortiz,&nbsp;I. González-Valcárcel de Torres,&nbsp;D. Sánchez Zalabardo,&nbsp;A. Guijarro,&nbsp;L. Mengual,&nbsp;A. Borque-Fernando,&nbsp;L. Martínez Piñeiro","doi":"10.1016/j.acuro.2026.501994","DOIUrl":"10.1016/j.acuro.2026.501994","url":null,"abstract":"<div><h3>Objective</h3><div>Non-muscle-invasive bladder cancer (NMIBC) has a high risk of recurrence and requires intensive long-term surveillance. Existing clinical risk models offer limited prognostic accuracy. Molecular urine-based assays may improve prognostic assessment accuracy of future recurrence. This study evaluated whether Digital Uromonitor® (dUM), detecting TERT and FGFR3 mutations via ddPCR, enhances prognostic assessment of two-year recurrence beyond cystoscopy and cytology in a prospective multicenter cohort.</div></div><div><h3>Methods</h3><div>This prospective, multicenter observational study (EVALUATION-CUETO; NCT05864599) enrolled consecutive NMIBC patients from 26 institutions. Eligible participants had an index tumor diagnosed 3<!--> <!-->months-2<!--> <!-->years before recruitment and completed two years of follow-up with sufficient DNA for dUM analysis. Clinical, pathological, and biomarker variables (cystoscopy, cytology, dUM) were collected. Recurrence rate was defined as events per year and classified as high (R<!--> <!-->&gt;<!--> <!-->0.5) or low (R<!--> <!-->≤<!--> <!-->0.5).</div></div><div><h3>Results</h3><div>Of 201 included patients, 75 (37%) were dUM-positive; TERT promoter mutations accounted for 88% of these cases. dUM showed prognostic value, correctly identifying 59% of recurrences over two years of standardized FU, outperforming cystoscopy alone (42%), with specificity of 74% and NPV of 78%. Combining dUM with cystoscopy increased sensitivity to 71%. Patients negative for both cystoscopy and TERT had the lowest recurrence risk (14%), whereas dual-positive patients exceeded 80%. High baseline recurrence rate consistently increased risk across all biomarker categories.</div></div><div><h3>Conclusions</h3><div>dUM provides robust, reproducible prognostic information and significantly improves molecular risk stratification in NMIBC. These findings support its potential integration into risk-adapted surveillance strategies, pending validation in larger populations.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501994"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859343","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 asociados a la incontinencia urinaria tras la enucleación endoscópica de la próstata: una revisión exploratoria","authors":"N. Rodríguez Caicedo,&nbsp;H.E. López Ramos,&nbsp;J.M. Huertas,&nbsp;N. Vivas Ramírez,&nbsp;J. González-Nieto","doi":"10.1016/j.acuro.2026.501985","DOIUrl":"10.1016/j.acuro.2026.501985","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Endoscopic enucleation of the prostate is an established treatment for benign prostatic obstruction, providing substantial improvement in lower urinary tract symptoms and urinary flow. However, postoperative urinary incontinence (UI), typically transient, remains a relevant concern. Evidence regarding factors associated with postoperative UI remains heterogeneous. This scoping review aimed to synthesize available literature describing variables associated with urinary incontinence following endoscopic prostate enucleation.</div></div><div><h3>Materials and methods</h3><div>A scoping review was conducted using PubMed and Embase. The search identified 490 records; after duplicate removal and screening by three independent reviewers, 52 studies were included. Most were retrospective cohort studies with heterogeneous designs, follow-up intervals, and definitions of UI. Data analyzed descriptively in accordance with PRISMA-ScR guidelines.</div></div><div><h3>Results</h3><div>Reporting of postoperative UI varied across studies, including differences in subtype classification and outcome measurement methods. Early postoperative UI was commonly reported (15-35%), with most cases resolving within 6<!--> <!-->months and persistent incontinence generally below 3% at one year. Advanced age, diabetes mellitus, obesity, larger prostate volume, greater resected tissue weight, and elevated preoperative post-void residual were described as associated with early UI. However, variability in outcome definitions and inconsistent multivariable adjustment limited identification of definitive independent predictors.</div></div><div><h3>Conclusions</h3><div>Postoperative urinary incontinence after endoscopic prostate enucleation is transient and resolves over time. Although several patient and surgical factors are repeatedly linked to early UI, heterogeneity of existing evidence precludes firm conclusions regarding independent predictors. Standardized outcome definitions and prospective studies are needed to improve risk stratification and guide perioperative counseling.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501985"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530628","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: «Factores predictivos del desarrollo de estenosis uretral en pacientes con tumor vesical: el papel de la terapia intravesical con BCG»","authors":"B.Y. Ekenci","doi":"10.1016/j.acuro.2026.501932","DOIUrl":"10.1016/j.acuro.2026.501932","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501932"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530150","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":"Criterios de valoración y evidencia en el cribado del cáncer de próstata","authors":"T. Takahashi","doi":"10.1016/j.acuro.2026.501968","DOIUrl":"10.1016/j.acuro.2026.501968","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501968"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530547","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":"Secuelas endocrinas a largo plazo del cáncer testicular: manifestaciones clínicas, mecanismos y consideraciones para el seguimiento","authors":"C.S. González Beltrán,&nbsp;H.A. García-Perdomo,&nbsp;A.F. García Ramos","doi":"10.1016/j.acuro.2026.501935","DOIUrl":"10.1016/j.acuro.2026.501935","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the main long-term endocrine sequelae in testicular cancer survivors and their clinical relevance.</div></div><div><h3>Material and Methods</h3><div>A narrative review of the clinical literature on the endocrine consequences of curative therapies for TC (orchiectomy, platinum-based chemotherapy, and radiotherapy) was conducted. The impact of these interventions on the hypothalamic-pituitary-gonadal (HPG) axis and other relevant endocrine systems was examined.</div></div><div><h3>Results</h3><div>The most prevalent endocrine finding was hypergonadotropic hypogonadism (primary testicular dysfunction), characterized by elevated FSH and altered testosterone levels. The etiology is multifactorial, involving the direct deficiency following orchiectomy and the toxicity of chemotherapy/radiotherapy on Leydig cells. Hypogonadism is correlated with adverse effects on quality of life, fertility, bone metabolism, and body composition.</div><div>Additionally, an increased risk of osteopenia/osteoporosis and thyroid dysfunction was documented, the latter associated explicitly with mediastinal or cervical irradiation.</div></div><div><h3>Conclusions</h3><div>CT survivors present a significant and persistent risk of chronic endocrine dysfunction. It is imperative to establish systematic endocrine surveillance, especially for symptomatic patients or those with borderline hormonal parameters, to facilitate early identification and initiate interventions such as hormone replacement therapy. This strategy is crucial for preserving functional health and quality of life in this young population.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501935"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530627","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":"Efecto de mirabegrón, tamsulosina y tadalafilo en la calidad de vida de pacientes portadores de catéter ureteral permanente (doble J)","authors":"A. Mahmoud Mohammed,&nbsp;E. Abdellah Ali Mostafa,&nbsp;A.M. Reyad,&nbsp;H. Ali Abdelhaleem,&nbsp;T. Ahmed Mahmoud","doi":"10.1016/j.acuro.2026.501980","DOIUrl":"10.1016/j.acuro.2026.501980","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate and compare the efficacy of mirabegron, tamsulosin, and tadalafil in improving stent-related symptoms and overall quality of life in urological patients following JJ stent insertion.</div></div><div><h3>Methods</h3><div>During the period from January 2022 to December 2022, 131 patients with ureteral double-J stents were randomly assigned two days post-insertion to receive either mirabegron (50<!--> <!-->mg daily), tamsulosin (0.4<!--> <!-->mg daily), or tadalafil (5<!--> <!-->mg daily) for two weeks. Stent-related symptoms and health-related quality of life were assessed at baseline and at two weeks using the validated Ureteral Stent Symptom Questionnaire (USSQ). All groups completed follow-up.</div></div><div><h3>Results</h3><div>The tamsulosin group showed the greatest improvement in total USSQ score (<em>P</em> <!-->≤<!--> <!-->.001), with significantly lower urinary symptoms, general health, and sexual function scores than the mirabegron and tadalafil groups. Specifically, sexual matter scores [median (IQR)] were lowest in the tamsulosin group [5 (1)] versus tadalafil [7 (3.2)] and mirabegron [16.5 (11)] (<em>P</em> <!-->≤<!--> <!-->.001). Differences in work performance and additional problem domains were not significant. Adverse effects were mild: dizziness/hypotension (∼<!--> <!-->6% tamsulosin), palpitations/headache (∼<!--> <!-->4% mirabegron), and flushing/dyspepsia/back pain (∼<!--> <!-->10% tadalafil). No serious events occurred, and no patient discontinued therapy.</div></div><div><h3>Conclusion</h3><div>In conclusion, tamsulosin produced the most comprehensive symptom relief supporting its use as first-line therapy for patients with indwelling JJ stents. Mirabegron demonstrated good safety and modest benefits in pain and storage symptoms, suggesting its use as a viable alternative for patients intolerant to standard treatments. Larger placebo-controlled trials are needed to validate these findings.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501980"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530607","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}