Actas urologicas espanolas最新文献

{"title":"Efecto de la sutura hemostática en los resultados de la prostatectomía abierta suprapúbica: estudio observacional retrospectivo","authors":"A. Utlu ,&nbsp;T. Aksakalli ,&nbsp;F. Çelik ,&nbsp;A. Emre Cinislioğlu ,&nbsp;Ş. Oğuz Demirdöğen","doi":"10.1016/j.acuro.2025.501711","DOIUrl":"10.1016/j.acuro.2025.501711","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of suturing the bladderneck in benign prostatic hyperplasia surgery on bleeding parameter sand surgical outcomes.</div></div><div><h3>Methods</h3><div>The age, comorbidities, preoperative findings, surgical treatment techniques, peroperative and postoperative bleedingrates, blood transfusion rates, complication rates, surgery note sand postoperative patient follow-ups of the patients operated on for benign prostatic hyperplasia were taken from the patient files. Patients who were sutured to the bladder neck and those who were not were divided into two groups and compared in terms of bleeding and surgical results.</div></div><div><h3>Results</h3><div>A total of 170 patients were included in the study, 106 patients whounder went bladder neck suturing and 64 patients who did not undergo bladder neck suturing. While the mean operation time in hemostatic suture applied group 84.2<!--> <!-->±<!--> <!-->7.8<!--> <!-->minutes, this time was 61.4<!--> <!-->±<!--> <!-->6.3<!--> <!-->minutes hemostatic suture not applied group (<em>P</em>&lt;.001). The mean decrease in hemoglobin levels at the 2<!--> <!-->nd postoperative hour in the suturing group was observed to be greater than in the non-suturing group (2.1, 2<!--> <!-->g/dl, respectively). There was no statistical difference in postoperative blood transfusion rates (15.1, 15.6%, respectively; <em>P</em>=.137). Postoperative complications and follow-updata were similar for bothgroup. Bladder neck contracture was higher rate (7.5 vs. 3.1%) in hemostatic suture applied group but ıt was not statistically significant.</div></div><div><h3>Conclusion</h3><div>Application of hemostatic suture prolongs the operation time of open prostatectomy without affecting bleeding parameter sand postoperative results. For this reason, open prostatectomy surgery is a surgical method that can be performed safely without applying sutures.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501711"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143518863","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":"Tendencia temporal y efectos de la edad, el periodo y la cohorte en la mortalidad por cáncer renal en España entre 1983 y 2022","authors":"L. Cayuela ,&nbsp;R. Roldán Testillano ,&nbsp;S. Cabrera Fernández ,&nbsp;L. Rodríguez-Sánchez ,&nbsp;A. Cayuela","doi":"10.1016/j.acuro.2025.501714","DOIUrl":"10.1016/j.acuro.2025.501714","url":null,"abstract":"<div><h3>Objective</h3><div>This study examines trends and disparities in kidney cancer (KC) mortality in Spain from 1983 to 2022, focusing on gender, birth cohort, and age influences.</div></div><div><h3>Methods</h3><div>Data from the Spanish National Institute of Statistics were analyzed using age-standardized mortality rates (ASMRs). Joinpoint regression identified temporal trends and annual percentage changes, while Age-Period-Cohort (A-P-C) analysis assessed the impacts of age, calendar period, and birth cohort on mortality.</div></div><div><h3>Results</h3><div>KC mortality increased significantly for both sexes, with men experiencing a steeper rise (1.2% annually) compared to women (0.6% annually). Joinpoint analysis revealed distinct phases: a sharp increase until the mid-1990s, followed by stabilization for men and a slight decline for women. Men aged over 50, particularly those above 80, showed pronounced increases. A-P-C analysis confirmed age as a significant risk factor, with consistently higher mortality rates observed among men across all age groups. Men born from the early 20th century until the 1960s faced increasing mortality risks, while women's risk, after an increase in the early 20th century, stabilized after the 1933 birth cohort. For those born after 1960, both sexes show a potential decline in KC mortality, with a slight upturn in men from the 1980s onwards. The period effect exhibited an increase during the 1980s-1990s, followed by stabilization for men and a continuous decrease for women.</div></div><div><h3>Conclusion</h3><div>This study reveals significant disparities in KC mortality trends in Spain across genders, birth cohorts, and age groups. Despite advancements in diagnosis and treatment, substantial public health challenges remain.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501714"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143518868","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":"Resultados oncológicos de pacientes con afectación ganglionar tras quimioterapia neoadyuvante y cistectomía radical para el cáncer de vejiga músculo-invasivo: estudio observacional multicéntrico del Grupo de Trabajo de Carcinoma Urotelial de la sección de Jóvenes Urólogos Académicos de la Asociación Europea de Urología (YAU-EAU)","authors":"G. Marcq ,&nbsp;W. Kassouf ,&nbsp;M. Roumiguié ,&nbsp;B. Pradere ,&nbsp;L.S. Mertens ,&nbsp;S. Albisinni ,&nbsp;A. Cimadamore ,&nbsp;J. Yuen-Chun Teoh ,&nbsp;M. Moschini ,&nbsp;E. Laukhtina ,&nbsp;A. Mari ,&nbsp;F. Soria ,&nbsp;A. Gallioli ,&nbsp;F. del Giudice ,&nbsp;D. d’Andrea ,&nbsp;W. Krajewski ,&nbsp;J.B. Beauval ,&nbsp;E. Xylinas ,&nbsp;D. Pouessel ,&nbsp;P. Sargos ,&nbsp;G. Ploussard","doi":"10.1016/j.acuro.2025.501701","DOIUrl":"10.1016/j.acuro.2025.501701","url":null,"abstract":"<div><h3>Introduction</h3><div>Until recently there was no recommended adjuvant therapy for patients with lymph nodes metastasis (ypN+) following neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). The aim of the study was to describe the oncological outcomes of ypN+ patients following NAC and RC for MIBC.</div></div><div><h3>Methods</h3><div>This collaborative retrospective study included 195 patients with ypN+ disease after NAC followed by RC and bilateral pelvic lymph node dissection for MIBC between 2000 and 2019 in seven centers. Patients’ demographics, clinical and pathological features were collected. Survival analyses were carried out with Kaplan-Meier estimates and a Cox model was generated.</div></div><div><h3>Results</h3><div>A total of 120 patients (62%) were pN1, 51 pN2 (26%) and 24 pN3 (12%). Adjuvant radiation therapy was performed in 18 (9%), adjuvant chemotherapy in 40 (21%) and the remaining 137 (70%) patients were observed. The median follow-up time was 51 months (95%<!--> <!-->CI: 44-62). Median times for recurrence-free survival, cancer-specific survival and overall survival (OS) were 18 months (95%<!--> <!-->CI: 16-21), 47 months (95%<!--> <!-->CI: 31-70) and 28 months (95%<!--> <!-->CI: 22-34) respectively. On multivariable analysis, female gender (HR: 1.5, 95%<!--> <!-->CI: 1.002-2.21, <em>P</em> <!-->=<!--> <!-->.049) and positive surgical margins (HR: 1.6, 95%<!--> <!-->CI: 1.06-2.38, <em>P</em> <!-->=<!--> <!-->.026) were the only independent predictor of OS. The type of adjuvant therapy did not impact OS (adjuvant chemotherapy, <em>P</em> <!-->=<!--> <!-->.44; adjuvant radiotherapy, <em>P</em> <!-->=<!--> <!-->.40).</div></div><div><h3>Conclusion</h3><div>MIBC patients with residual node positive disease following NAC and RC have poor survival outcomes. Females and patients with positive margin status at RC carry a poorer prognosis. These results may be beneficial for clinical trial design.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501701"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519470","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":"Alfabetización en salud en cáncer de próstata: ¿qué saben los varones españoles sobre el cáncer de próstata? Estudio descriptivo transversal. Respuesta de los autores","authors":"C. Romojaro-Pérez ,&nbsp;B. Navarro-Brazález ,&nbsp;J. Bailón-Cerezo ,&nbsp;M. Torres-Lacomba","doi":"10.1016/j.acuro.2025.501697","DOIUrl":"10.1016/j.acuro.2025.501697","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 2","pages":"Article 501697"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143518872","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 uso de la cirugía robótica para el tratamiento de estenosis uretrales y contracturas del cuello vesical: una revisión sistemática","authors":"G. Mantica ,&nbsp;F. Chierigo ,&nbsp;Ł. Białek ,&nbsp;F.X. Madec ,&nbsp;M. Frankiewicz ,&nbsp;W. Verla ,&nbsp;E.J. Redmond ,&nbsp;C.M. Rosenbaum ,&nbsp;A. Cocci ,&nbsp;F. Campos-Juanatey ,&nbsp;M. Oszczudłowski ,&nbsp;J. Adamowicz ,&nbsp;C. Terrone ,&nbsp;M.W. Vetterlein ,&nbsp;en representación del Grupo de Trabajo de Urología Reconstructiva y Trauma Urológico de la Sección de Jóvenes Urólogos Académicos - Asociación Europea de Urología","doi":"10.1016/j.acuro.2024.10.003","DOIUrl":"10.1016/j.acuro.2024.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this systematic review is to offer a comprehensive view of the current use of robotic surgery for the treatment of urethral strictures and bladder neck contractures.</div></div><div><h3>Methods</h3><div>A systematic review of the current literature was conducted through the Medline and NCBI PubMed, Embase databases in December 2023. Keywords used were ‘robotic’ and ‘robotic-assisted’ combined with ‘urethroplasty’, ‘urethral stricture’, and ‘bladder neck contracture’. All papers published after 2000, concerning studies conducted on humans for urethral strictures and bladder neck contractures managed with robotic surgery were considered for the review. Only procedures involving a direct approach to urethra/bladder neck and/or graft harvesting for urethroplasty have been included.</div></div><div><h3>Results</h3><div>A total of 275 articles were evaluated after the strategy search and only 11 articles were considered eligible for the final analysis. The studies included a series of between a minimum of 1 and a maximum of 104 patients, for a total of 203 patients. The robotic surgery was performed mainly for the treatment of bladder neck contracture and posterior urethra. In some reports, the robotic system was used for graft harvesting, subsequently used with an open perineal technique. The follow-up presented in the different studies is very heterogeneous. However, most studies have high success rates, with recurrence and redo surgery rates generally below 20%. Likewise, post-procedure incontinence rates are low.</div></div><div><h3>Conclusions</h3><div>The outcomes presented in the literature, combined with the minimally invasive nature, suggest a possible growing role for robotic surgery in the coming years in the treatment of these diseases.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 11-19"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100799","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":"Resultados a largo plazo de hipospadias no intervenidos: una revisión exploratoria","authors":"E. Bohane ,&nbsp;M. Murphy ,&nbsp;F. Chierigo ,&nbsp;G. Mantica ,&nbsp;J. Adamowicz ,&nbsp;F. Campos-Juanatey ,&nbsp;A. Cocci ,&nbsp;M. Frankiewicz ,&nbsp;C.M. Rosenbaum ,&nbsp;W. Verla ,&nbsp;M. Waterloos ,&nbsp;Ł. Białek ,&nbsp;F.X. Madec ,&nbsp;M. Oszczudłowski ,&nbsp;M.W. Vetterlein ,&nbsp;E.J. Redmond ,&nbsp;en nombre del Trauma and Reconstructive Urology Working Party de la European Association of Urology Young Academic Urologists","doi":"10.1016/j.acuro.2024.10.002","DOIUrl":"10.1016/j.acuro.2024.10.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The goal of hypospadias repair is to optimize urinary and sexual function, improve cosmesis and minimise the psychosocial effects associated with a penile anomaly. However, a lack of clarity exists regarding the role of surgery in milder hypospadias where the anomaly is inconspicuous and there is no anticipated impact on function. The aim of this study was to review the long term functional, cosmetic and psychosocial outcomes in men with uncorrected hypospadias. This information may be helpful for parents who are burdened with deciding the correct treatment for their child's hypospadias.</div></div><div><h3>Methods</h3><div>A scoping review of PubMed, EMBASE, and CINAHL+ databases was performed in adherence with PRISMA guidelines. Eight studies were identified for inclusion in the review.</div></div><div><h3>Results</h3><div>Men with mild uncorrected hypospadias have similar functional outcomes to those without hypospadias, preferring to void standing and reporting similar IPSS scores. However, those with severe untreated hypospadias experience significant urinary difficulties, higher IPSS scores, and are more likely to sit when voiding. They reported worse SHIM scores, more ventral curvature, and greater difficulty with intercourse. Most men with incidentally identified hypospadias are unaware of their condition and are satisfied with their penile appearance. There was no difference in the attainment of psychosocial milestones between men with uncorrected hypospadias versus no hypospadias.</div></div><div><h3>Conclusion</h3><div>There is a lack of research regarding the experiences of adult men with uncorrected hypospadias. However, there is some evidence to support the non-operative management of mild hypospadias. Therefore, the decision to defer surgery in infancy should balance parental wishes and physician guidance, particularly in cases where the risk of functional impairment is low.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 1-10"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100800","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":"Estado actual de la formación en cirugía reconstructiva en España: resultados de una encuesta nacional","authors":"E. Fes Ascanio ,&nbsp;L.E. Ortega Polledo ,&nbsp;M.E. Zegrí de Olivar ,&nbsp;C.A. Muñoz Bastidas ,&nbsp;E. Seguí Moya ,&nbsp;D.M. Carrión Monsalve ,&nbsp;M. Sánchez García ,&nbsp;F. Campos-Juanatey","doi":"10.1016/j.acuro.2024.10.006","DOIUrl":"10.1016/j.acuro.2024.10.006","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Assessment of urethral stricture (US) management in a specific group of professionals, Urology Residents, in a specific region (Spain), seems to be important to determine the quality of the educational program and design educational interventions to improve it. We aim to investigate diagnosis and therapeutics practices among Urology Residents for the US management.</div></div><div><h3>Materials and methods</h3><div>20-question on-line survey was conducted among residents and junior consultants registered on the mailing list of residents and young urologists of the Spanish Association of Urology (RAEU) group of the educational period 2018-2023. We evaluated demographic, educational, surgical technics and experience data during the training period. 290 questionnaires were mailed between May-August 2023. Data was collected in a prospective way between May-December 2023, with 29,6% response rate.</div></div><div><h3>Results</h3><div>The survey obtained 86 responders, with 29,65% (86/290) response rate. Two first sections were answered by all the responders, however, from the assessment section on, only 57 responders completed the survey, which represents 66,28% of them.</div></div><div><h3>Conclusions</h3><div>Educational program in Reconstructive Urology among Urology Residents in Spain has an improvement margin. We must dedicate our efforts to standardize the educational process and facilitate access to formation to and increasing area of interest among residents.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 86-93"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156143","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 de la estenosis anastomótica tras faloplastia: una revisión actualizada de la literatura","authors":"W. Verla ,&nbsp;N. Lumen ,&nbsp;M. Waterloos ,&nbsp;J. Adamowicz ,&nbsp;F. Campos-Juanatey ,&nbsp;A. Cocci ,&nbsp;M. Frankiewicz ,&nbsp;G. Mantica ,&nbsp;C. Rosenbaum ,&nbsp;F.X. Madec ,&nbsp;E. Redmond ,&nbsp;Ł. Białek ,&nbsp;F. Chierigo ,&nbsp;M. Oszczudłowski ,&nbsp;M. Vetterlein ,&nbsp;en representación del Grupo de Trabajo de Urología Reconstructiva y Trauma Urológico de la Sección de Jóvenes Urólogos Académicos - Asociación Europea de Urología","doi":"10.1016/j.acuro.2024.10.005","DOIUrl":"10.1016/j.acuro.2024.10.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Neo-urethral stricture formation frequently occurs after phalloplasty and most commonly affects the anastomosis between the fixed and phallic part of the neo-urethra. This narrative review gives an overview of the existing literature on how to treat these particular strictures.</div></div><div><h3>Methods</h3><div>This narrative review is based on a literature search conducted in June 2024. No restrictions in terms of publication date, language or sample size were applied.</div></div><div><h3>Results</h3><div>Treatment options include direct vision internal urethrotomy, anastomotic repair urethroplasty, augmentation urethroplasty with grafts or flaps, multi-stage urethroplasty and urethrostomy. Overall, outcomes of these treatments are worse in transmen than in cismen, mainly due to the specific challenges posed by the neophallus environment. Generally, limited data are available on the treatment options for patients with anastomotic strictures after phalloplasty and, consequently, no clear recommendations can be made.</div></div><div><h3>Conclusion</h3><div>This narrative review provides a comprehensive and up-to-date overview of the available literature, which may guide future research and help optimize the outcomes for patients with this complex problem after phalloplasty.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 35-41"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156141","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 los factores predictivos tras uretrotomía interna endoscópica para estenosis de uretra bulbar","authors":"A. García Fernández ,&nbsp;F. Campos-Juanatey ,&nbsp;P. Calleja Hermosa ,&nbsp;A. González Fernández ,&nbsp;R. Varea Malo ,&nbsp;J.L. Gutiérrez Baños","doi":"10.1016/j.acuro.2024.10.007","DOIUrl":"10.1016/j.acuro.2024.10.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Direct vision internal urethrotomy (DVIU) is usually the first treatment offered to patients with bulbar urethral strictures (US). Advances in devices and surgical techniques have contributed to reducing associated complications. Despite the favorable success rate of DVIU, various factors predicting better outcomes have been studied, including patient characteristics, stricture features, and procedural aspects. The main aim of our study is to assess predictive factors for success.</div></div><div><h3>Methods</h3><div>We conducted a retrospective descriptive study of patients who underwent endoscopic internal urethrotomy at our hospital over a 30 year period. Out of 788 DVIU performed, we selected 491 (62.3%) conducted for bulbar US with a minimum follow-up of 12 months. We examined clinical outcomes obtained, and assessed the relationship between different patient characteristics, stricture-related factors and procedural aspects related with clinical success -considered as the avoidance of further interventions for stricture recurrence-. Descriptive statistics were calculated and parametrical and non-parametrical comparative tests were applied. Kaplan-Meier survival analysis was used for evaluating time until recurrence.</div></div><div><h3>Results</h3><div>Mean stricture length was 1.2<!--> <!-->cm (SD 0.5), with only 12 patients presenting with more than 1 US in the bulbar area during DVIU<em>.</em> After a median follow-up of 170 months, 67.4% of patients did not experience clinical recurrence. Severe postoperative complications appear in 0.4% of cases, and need for overnight admission was 4.5%. A positive association was observed between clinical recurrence and a history of prior pelvic radiotherapy (OR 2.8, 95%IC 1.3-22.2), active smoking (OR 2.1, 95% IC 1.6-2.4), infectious etiology of stricture (OR 2.3, 95% IC 1.6-8), history of previous urethroplasty (OR 2.5, 95% IC 1.7-3.2), and higher postoperative urinary catheter sizes (OR 1.8 95% IC 1.1-2.9). Median time until recurrence after the first DVIU was 65 months, after the second was 60 months, after the third was 32 months, and after the fourth was 6 months.</div></div><div><h3>Conclusions</h3><div>Bulbar US could be safely managed with DVIU. The best clinical success is achieved in non-irradiated, non-smoker patients, without prior urethroplasties. The repetition of the procedure is significantly associated with a shorter time to clinical recurrence.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 94-101"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100802","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":"Resultado de la preservación de las arterias bulbares durante la uretroplastia anastomótica para la lesión uretral por fractura de pelvis","authors":"R.G. Gómez,&nbsp;L.G. Velarde,&nbsp;R.A. Campos,&nbsp;R. Massouh,&nbsp;V. Humerez,&nbsp;V. Barrientos","doi":"10.1016/j.acuro.2024.11.001","DOIUrl":"10.1016/j.acuro.2024.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>To the present long-term outcomes of the vascular-sparing approach during reconstruction of pelvic fracture urethral injuries (PFUI) described by Gomez et al.</div></div><div><h3>Material and methods</h3><div>Anastomotic reconstruction of PFUI is performed without transecting the bulb of the spongiosum, to preserve the antegrade flow of the bulbar arteries. After exposure of the urethra, the bulbar arteries are located using a Doppler stethoscope. The bulb is mobilized dorsally and unilaterally, sacrificing the artery with the weaker Doppler signal to preserve the best contralateral artery. Occasionally, both arteries can be preserved. Removal of all fibrosis and anastomosis is performed as described in the traditional transecting technique.</div></div><div><h3>Results</h3><div>A total of 60 patients were included, with a mean age of 37<!--> <!-->years (IQR: 22-48). The median time from trauma to urethral reconstruction was 16<!--> <!-->weeks, and the mean stenosis length was 2.5<!--> <!-->cm (IQR: 2-3). The left bulbar artery was preserved in 27<!--> <!-->cases, the right bulbar artery in 8, and both in 24. There were postoperative complications in 14<!--> <!-->cases (23%), but only one of them was Clavien ≥<!--> <!-->III. With a mean follow-up of 56<!--> <!-->months (IQR: 12-87), only one patient failed due to stenosis (98% success).</div></div><div><h3>Conclusion</h3><div>Preservation of antegrade arterial flow to the corpus spongiosum during PFUI reconstruction is feasible and safe. Although slightly more elaborate, this technique could reduce the risk of ischemic failure of reconstruction.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 102-107"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100801","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}