Actas urologicas espanolas最新文献

{"title":"HoLEP en los pacientes con y sin retención aguda de orina que precisa sondaje: resultados quirúrgicos y funcionales","authors":"G. Ozgur ,&nbsp;M. Cetin ,&nbsp;T. Altuntas ,&nbsp;E. Gokmen ,&nbsp;H.K. Cam ,&nbsp;T. Tarcan ,&nbsp;T.E. Sener","doi":"10.1016/j.acuro.2025.501906","DOIUrl":"10.1016/j.acuro.2025.501906","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Holmium Laser Enucleation of the Prostate (HoLEP) is an effective treatment for benign prostatic obstruction; however, data on its outcomes in patients with acute urinary retention (AUR), particularly those who remained catheter-dependent until surgery, remain limited. This study compared HoLEP outcomes in patients with and without AUR.</div></div><div><h3>Methods</h3><div>Data from 140 male patients aged 50-80 who underwent HoLEP were retrospectively and exploratorily analyzed. Patients were grouped as catheter-dependent AUR (group 1) and non-AUR (group 2). The primary comparison was Qmax at 6 months, while secondary comparisons included functional outcomes and perioperative/postoperative complications.</div></div><div><h3>Results</h3><div>Thirty-four patients (24.3%) had catheter-dependent AUR. They were older (68.9<!--> <!-->±<!--> <!-->6.9 vs. 66.2<!--> <!-->±<!--> <!-->6.5 years) and had worse baseline IPSS (25 [22-29] vs. 22 [17-25]), quality of life (QoL; 5 [4-6] vs. 4 [3-5]), Qmax (0 vs. 8 [5.6-10] ml/s), and PVR (400 [197-560] vs. 100 [60-150] ml) (<em>P</em>&lt;.05). Perioperative parameters and complication rates were not significantly different between the groups. Following HoLEP, AUR patients showed greater improvements in Qmax (Δ16 [14-20.3] vs. 10 [7-15] ml/s), IPSS (Δ16.5 [10.8-22.3] vs. 11.5 [6-17.3]), QoL (Δ4 [3-5] vs. 3 [1-3.3]), and PVR (Δ326 [128-502] vs. 62.5 [26-120] ml) (<em>P</em>&lt;.05). Although patients with catheter-dependent AUR demonstrated more pronounced improvements in functional outcomes, this was largely attributable to worse baseline parameters. No statistically significant differences were observed in postoperative outcomes between the groups. Notably, subjective measures (IPSS and QoL) improved more markedly in group 1.</div></div><div><h3>Conclusions</h3><div>HoLEP is an effective treatment option for catheter-dependent AUR patients, providing significant functional improvement. Preoperative catheterization until surgery does not negatively affect surgical efficacy or postoperative outcomes.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501906"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578571","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":"Panorama actual de la formación quirúrgica y la simulación en urología: estudio multinacional de los programas de residencia de la Confederación Americana de Urología","authors":"G. Gentili ,&nbsp;N. Paesano ,&nbsp;M. Barreto ,&nbsp;G. Castillo ,&nbsp;T. Mierzwa ,&nbsp;A. Hernández Méndez ,&nbsp;M. Falcioni ,&nbsp;F. Santomil ,&nbsp;A.M. Autrán Gómez ,&nbsp;I. Tobia-González ,&nbsp;A. Rodríguez ,&nbsp;en nombre del Grupo de Trabajo del Proyecto PRYUS-CAU","doi":"10.1016/j.acuro.2025.501915","DOIUrl":"10.1016/j.acuro.2025.501915","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgical training in urology has undergone significant transformation due to the increasing complexity of procedures and the integration of advanced technologies. Simulation-based education is recognized as a fundamental component of residency programs. This study aimed to evaluate the current status of surgical training and the availability of simulation resources for urology residents and early-career urologists in the countries represented by the American Confederation of Urology.</div></div><div><h3>Methods</h3><div>A descriptive, cross-sectional survey was conducted with 402 participants from 19 countries. The questionnaire included multiple-choice questions addressing demographics, access to surgical procedures, simulation tools, evaluation methods, mentorship, and the impact of the COVID-19 pandemic.</div></div><div><h3>Results</h3><div>The study revealed significant heterogeneity in surgical training. Only 17.9% had access to robotic surgery and 32.8% to prostate enucleation. Over 80% reported the absence of virtual or wet labs at their institutions. Training was based on step-by-step instruction (89.9%), in laparoscopic (45%) and endoscopic (50.7%). However, 15.7% used simulators during surgical procedures. Additionally, 50.6% reported the absence of formal assessment or mentorship. Fellowship training was considered in 84.7%. The COVID-19 pandemic negatively impacted academic (50.3%) and surgical (66.9%) training.</div></div><div><h3>Conclusions</h3><div>The findings highlight considerable variability in surgical training, limited access to simulation resources, and a general absence of standardized evaluation and mentorship systems. These results emphasize the need to implement structured and equitable training that incorporate simulation, these offer a safe and effective environment for developing surgical skills.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501915"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147414557","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":"Nuevo biomarcador para la disfunción eréctil: inductor soluble débil de apoptosis similar al factor de necrosis tumoral","authors":"A. Iplikci ,&nbsp;O. Efiloglu ,&nbsp;A. Kado ,&nbsp;H. Erman ,&nbsp;A. Yildirim","doi":"10.1016/j.acuro.2025.501903","DOIUrl":"10.1016/j.acuro.2025.501903","url":null,"abstract":"<div><h3>Introduction</h3><div>The soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) is a cytokine that modulates inflammatory and atherogenic reactions. In our study, we aimed to determine whether sTWEAK could be a biomarker of erectile dysfunction (ED).</div></div><div><h3>Methods</h3><div>Ninety patients diagnosed with ED and 90 healthy participants were prospectively enrolled during the period of September 2021 - September 2023. Participants were divided into three groups according to International Index of Erectile Function (IIEF) Erectile Function Domain scores; severe disease (1-10), moderate-mild disease (11-21) and healthy control (22-30). All participants filled out Beck Depression Inventory (BDI). Blood samples were collected for complete blood count, biochemical analysis and hormonal assessment.</div></div><div><h3>Results</h3><div>sTWEAK levels were higher in patients and increased with the severity of the disease as well. Healthy participants had lower BDI score (p<!--> <!-->=<!--> <!-->0.001) and erythrocyte sedimentation rate (p<!--> <!-->=<!--> <!-->0.001). Analysis with ROC curve demonstrated good area under curve value for sTWEAK (0.776, p<!--> <!-->=<!--> <!-->0.001) in predicting ED. Optimal threshold level was determined as 5,41 ng/ml (71.1% sensitivity and 71.1% specificity).</div></div><div><h3>Conclusions</h3><div>We revealed that there is a significant association between sTWEAK levels and severity of disease, therefore we belive that sTWEAK pathway has a role in the pathogenesis of atherosclerosis in patients with ED.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501903"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147414556","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 electiva en el cáncer de próstata: el ocaso de una práctica histórica","authors":"A. Ocanto ,&nbsp;F. López-Campos ,&nbsp;P. Ost ,&nbsp;F. Couñago","doi":"10.1016/j.acuro.2025.501923","DOIUrl":"10.1016/j.acuro.2025.501923","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501923"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415031","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":"Índice sistémico de inflamación e inmunidad como predictor independiente de malignidad en incidentalomas adrenales de 4-6 cm","authors":"E.M. Yorulmaz ,&nbsp;A. Gorgel ,&nbsp;S. Ozcan ,&nbsp;O. Kose ,&nbsp;S.N. Gorgel ,&nbsp;Y. Akin","doi":"10.1016/j.acuro.2025.501909","DOIUrl":"10.1016/j.acuro.2025.501909","url":null,"abstract":"<div><h3>Introduction</h3><div>Adrenal incidentalomas (AI) measuring 4–6<!--> <!-->cm present a diagnostic challenge, as size alone inadequately predicts malignancy and creates uncertainty in surgical decisions.</div></div><div><h3>Objective</h3><div>To evaluate the Systemic Immune-Inflammation Index (SII) as a predictor of malignancy in adrenal tumors ≥<!--> <!-->4<!--> <!-->cm, with a focus on the 4–6<!--> <!-->cm “gray zone.”</div></div><div><h3>Methods</h3><div>Retrospective single-center cohort of 91 adrenalectomy patients with AI ≥<!--> <!-->4<!--> <!-->cm (ACC n<!--> <!-->=<!--> <!-->19, ACA n<!--> <!-->=<!--> <!-->72). A predefined subgroup included 46 patients with 4–6<!--> <!-->cm tumors (ACC n<!--> <!-->=<!--> <!-->9, ACA n<!--> <!-->=<!--> <!-->37). SII was calculated from preoperative complete blood counts (CBC) as platelets<!--> <!-->×<!--> <!-->neutrophils / lymphocytes. Predictive performance was assessed using ROC analysis and logistic regression.</div></div><div><h3>Results</h3><div>In the ≥<!--> <!-->4<!--> <!-->cm cohort, SII was higher in ACC vs. ACA (1107.4 vs. 711.3, p<!--> <!-->&lt;<!--> <!-->0.001). SII independently predicted ACC (per 100-unit increase: OR 0.78, 95% CI 0.67–0.90; p<!--> <!-->=<!--> <!-->0.002). SII showed AUC 0.778 with a cut-off of 811 (sensitivity 78.9%, specificity 73.6%). Tumor size was not predictive (AUC ≈ 0.50). In the 4–6<!--> <!-->cm subgroup, SII remained an independent predictor (per 100-unit increase: OR 0.61, 95% CI 0.45–0.82; p<!--> <!-->=<!--> <!-->0.004), with AUC 0.898 at a cut-off of 945 (sensitivity 88.9%, specificity 83.8%).</div></div><div><h3>Conclusions</h3><div>SII—derived from routine CBC—is a low-cost, adjunctive biomarker that improves preoperative malignancy risk stratification beyond size in AI, particularly in 4–6<!--> <!-->cm tumors. External prospective validation is warranted before routine implementation.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501909"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415022","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 «Perfil clínico y factores de riesgo identificados en pacientes con cáncer renal en población mexicana»","authors":"R. Mehta ,&nbsp;R. Sah","doi":"10.1016/j.acuro.2025.501833","DOIUrl":"10.1016/j.acuro.2025.501833","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501833"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415026","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":"Del diagnóstico a la ablación: el papel de la terapia focal para el cáncer de próstata localizado","authors":"R. Roldan-Testillano ,&nbsp;L. Rodriguez-Sanchez ,&nbsp;M.E. Rodríguez Socarrás ,&nbsp;G. de Andrés Boville ,&nbsp;F. Durazo-Ruiz ,&nbsp;J. Gómez Rivas ,&nbsp;H. Alfambra Fernández ,&nbsp;J. Sánchez Macías ,&nbsp;F.J. Bianco ,&nbsp;B. Miñana López ,&nbsp;R. Sanchez-Salas","doi":"10.1016/j.acuro.2025.501918","DOIUrl":"10.1016/j.acuro.2025.501918","url":null,"abstract":"<div><h3>Introduction</h3><div>Focal therapy (FT) has emerged as an intermediate therapeutic strategy between active surveillance (AS) and radical treatments for the management of localized prostate cancer (PCa) in patients with clinically significant disease and a well-defined index lesion (IL). The development of ablative and imaging techniques has enabled the selective treatment of the IL, preserving healthy tissue and reducing adverse effects.</div></div><div><h3>Objectives</h3><div>o review the current evidence on FT in localized PCa, including technological modalities, selection criteria, diagnostic tools, post-treatment surveillance strategies, and barriers to its clinical implementation in the Spanish healthcare setting.</div></div><div><h3>Materials and methods</h3><div>A structured narrative review was conducted through a search in PubMed, Scopus, and Web of Science, including studies published up to April 2025. Original articles, reviews, clinical guidelines, and meta-analyses focusing on FT for localized PCa were selected. Prospective and comparative studies addressing oncological and functional outcomes, as well as associated technologies such as fusion biopsy, multiparametric magnetic resonance imaging (mpMRI), prostate-specific membrane antigen positron emission tomography (PSMA-PET), and artificial intelligence (AI), were prioritized.</div></div><div><h3>Results</h3><div>FT offers encouraging short- and medium-term oncological outcomes, with notable functional preservation. Modalities such as high-intensity focused ultrasound (HIFU) and cryotherapy are currently the most widely used and have the longest clinical trajectory, while irreversible electroporation (IRE) stands out among emerging techniques with results.</div><div>Surveillance after FT should be multifactorial and include serial PSA monitoring, systematic and targeted biopsies, as well as imaging techniques such as mpMRI. Specific tools such as PI-FAB (Prostate Imaging after Focal Ablation) and TARGET (Transatlantic Recommendations for MRI Evaluation after Focal Therapy) systems allow for standardized interpretation of mpMRI after FT. In Spain, its adoption remains limited, reinforcing the need for specific guidelines and multicenter registries.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501918"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415028","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":"Estudio MANCOIT: Estudio piloto sobre la prevención de la infección urinaria postcoital recurrente en mujeres mediante la combinación de D-manosa y proantocianidinas (PAC)","authors":"E. López Pérez ,&nbsp;V. García-Astillero Vallecillo ,&nbsp;J.M. Gómez de Vicente ,&nbsp;S. Bravo Marín ,&nbsp;Á. Yebes ,&nbsp;C. de Castro Guerín ,&nbsp;M.J. García-Matres y Cortés ,&nbsp;J.A. Maínez Rodríguez ,&nbsp;N. Cámara Llorente ,&nbsp;C. Iglesias García ,&nbsp;L. Martínez-Piñeiro Lorenzo","doi":"10.1016/j.acuro.2025.501911","DOIUrl":"10.1016/j.acuro.2025.501911","url":null,"abstract":"<div><h3>Introduction</h3><div>Urinary tract infections (UTIs) are common among women, and approximately 20–30% experience recurrent episodes (rUTIs). The increasing prevalence of antimicrobial resistance highlights the need for non-antibiotic preventive strategies. D-mannose and proanthocyanidins (PAC) have shown potential in reducing rUTIs. The aim of this study was to evaluate the efficacy of a combination of D-mannose and PAC in preventing postcoital UTIs over a 6-month period.</div></div><div><h3>Materials and Methods</h3><div>We conducted a prospective, single-center pilot study including 26 women aged 18–45 years with a history of recurrent postcoital UTIs. Participants received a daily prolonged-release formulation containing D-mannose (2000<!--> <!-->mg) and PAC (140<!--> <!-->mg) for 6 months. The primary outcome was the incidence of postcoital UTI episodes. Secondary outcomes included treatment adherence, episode severity, microbiological findings, safety, quality of life, and patient-reported improvement. Analyses were performed on both the intention-to-treat (ITT) and per-protocol (PP) populations.</div></div><div><h3>Results</h3><div>At 6 months, 53.6% of participants had no new UTI episodes. A total of 24 episodes were recorded in 12 women, with more than two-thirds concentrated in a small subgroup. Overall, UTI incidence decreased significantly (p<!--> <!-->=<!--> <!-->0.01), and 76.2% of participants remained infection-free at the final visit. Adherence was high (90.9% at 3 months and 85.7% at 6 months). Positive urine cultures most frequently identified Klebsiella aerogenes and Escherichia coli. Sexual function remained stable, and 80.9% of women reported subjective improvement. Only one withdrawal occurred due to vaginal dryness.</div></div><div><h3>Conclusions</h3><div>The combination of D-mannose and PAC in a prolonged-release formulation appears to be a promising, safe, and well-tolerated strategy for the prevention of postcoital rUTIs in young women. Larger randomized controlled trials are warranted to confirm these preliminary findings.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501911"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415021","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":"Entrenamiento de habilidades en cirugía abierta: ocho años de formación basada en simulación en urología reconstructiva en el Reino Unido","authors":"S. Rahman ,&nbsp;H. wen Ho ,&nbsp;C. Shekhar Biyani ,&nbsp;M. Hamid Elmamoun ,&nbsp;V. Hanchanale ,&nbsp;S. Jain ,&nbsp;B. Hickerton ,&nbsp;A. Hoyle ,&nbsp;A. Turner","doi":"10.1016/j.acuro.2025.501920","DOIUrl":"10.1016/j.acuro.2025.501920","url":null,"abstract":"<div><h3>Objective</h3><div>The Urology Simulation Bootcamp Course (USBC) was developed to address the lack of a structured national programme for practical urological skills training. Feedback from urology colleagues and trainees highlighted the need for focused procedural teaching, particularly in reconstructive urology. In response, a dedicated reconstructive skills module was established within the USBC in 2015. A descriptive report of a structured educational module is presented.</div></div><div><h3>Methods</h3><div>The module concentrated on four key reconstructive procedures: small bowel anastomosis, stoma formation, uretero-ileal anastomosis, and repair of ureteric and bladder injuries. This hands-on training was delivered with a high faculty-to-trainee ratio, allowing one-to-one mentorship. Faculty recruitment was based on subspecialist expertise and enthusiasm for medical education, ensuring high-quality instruction and one-to-one training. Continuous evaluation and feedback from participants shaped iterative improvements to course content and delivery. Feedback was collated from 2016 onwards, which facilitated the revision of the course over subsequent iterations.</div></div><div><h3>Results</h3><div>Over eight years, 378 trainees participated in the course. Delegates consistently praised the programme, particularly the individualised mentoring and the quality of tissue models used. The evolving curriculum, informed by systematic feedback, ensured relevance and sustainability. One notable adaptation was reducing the time devoted to small bowel anastomosis in order to expand training on ureteric reimplantation and bladder repair, reflecting delegate preferences and clinical relevance.</div></div><div><h3>Conclusion</h3><div>Our simulation-based approach to teaching reconstructive urological skills has demonstrated extremely positive results from the delegates consistently over the eight-year period. Focused mentorship and amendments based on feedback have been vital in ensuring a high degree of satisfaction throughout the evolution of the course.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501920"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415024","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":"Recurrencia local tras radioterapia o braquiterapia en cáncer de próstata: ¿qué hacer? Análisis retrospectivo comparativo entre prostatectomía radical y crioablación de rescate","authors":"C. Martínez Osorio ,&nbsp;P. de Pablos-Rodríguez ,&nbsp;N. Valdés Figueroa ,&nbsp;M. Beamud Cortés ,&nbsp;C. Gutiérrez Castañé ,&nbsp;Á. Gómez-Ferrer Lozano ,&nbsp;A. Wong Gutiérrez ,&nbsp;Y. Murria Pérez ,&nbsp;B. Sanvictor Beneito ,&nbsp;A. Calatrava Fons ,&nbsp;J. Patiño Aliaga ,&nbsp;Á. García Cortés ,&nbsp;J.A. López González ,&nbsp;V. Rodríguez-Part ,&nbsp;P. Pelechano Gómez ,&nbsp;J.L. Casanova Ramón-Borja","doi":"10.1016/j.acuro.2025.501914","DOIUrl":"10.1016/j.acuro.2025.501914","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Local recurrence after radiotherapy for prostate cancer poses a significant clinical challenge, and the lack of robust comparative evidence limits clear therapeutic guidance. This study aimed to assess oncological outcomes of salvage radical prostatectomy (SRP) versus salvage cryoablation (SCA) in patients with localized radio-recurrent disease.</div></div><div><h3>Material and methods</h3><div>A retrospective, single-centre cohort study was conducted including hormone-sensitive prostate cancer patients with local recurrence after external beam radiotherapy or brachytherapy, treated between 2007 and 2024. The primary endpoint was biochemical recurrence-free survival at 3 and 5 years. Secondary endpoints included additional treatment-free survival, metastasis-free survival, and recurrence predictors. Kaplan-Meier and multivariate logistic regression analyses were performed.</div></div><div><h3>Results</h3><div>A total of 56 patients were included: 32 treated with SRP and 24 with SCA. Median follow-up was significantly longer in the SCA group (98 vs. 46 months, p<!--> <!-->&lt;<!--> <!-->0.05). Biochemical recurrence-free survival at 3 and 5 years was 47 and 37% in the SCA group and 43 and 32% in the SRP group (p<!--> <!-->&gt;<!--> <!-->0.05). Five-year additional treatment-free survival was 40% (SCA) vs. 55% (SRP; p<!--> <!-->=<!--> <!-->0.32), and metastasis-free survival was 85 (SCA) vs. 83% (SRP; p<!--> <!-->=<!--> <!-->0.92). A Gleason score<!--> <!-->≥<!--> <!-->8 at recurrence was independently associated with higher risk of recurrence (OR 7.7; 95% CI: 1.3-47; p<!--> <!-->=<!--> <!-->0.02).</div></div><div><h3>Conclusions</h3><div>SRP and SCA showed similar oncological outcomes. Gleason<!--> <!-->≥<!--> <!-->8 was the only factor related to poor outcomes. Given the low chance of cure after salvage therapies, SCA may be an adequate option in these patients.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501914"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415029","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}