Actas urologicas espanolas最新文献

{"title":"Biopsias prostáticas dirigidas por RM cognitiva y por fusión: un análisis comparativo multicéntrico en 485 pacientes","authors":"Emre Hepşen,&nbsp;Furkan Çapar,&nbsp;İsmail Emre Ergin,&nbsp;Ahmet Emin Doğan,&nbsp;Ahmet Nihat Karakoyunlu,&nbsp;Uğur Kesimal","doi":"10.1016/j.acuro.2026.501983","DOIUrl":"10.1016/j.acuro.2026.501983","url":null,"abstract":"<div><h3>Objectives</h3><div>This multicenter study aimed to compare the diagnostic performance of cognitive registration targeted biopsy (Cog-Tb) and MRI–transrectal ultrasound fusion targeted biopsy (Fus-Tb) in men with Prostate Imaging Reporting and Data System (PI-RADS) ≥3 lesions.</div></div><div><h3>Materials and methods</h3><div>Men with PSA ≥3 ng/mL and/or abnormal digital rectal examination findings who had mpMRI lesions scored as PI-RADS ≥3 were included. This was a retrospective multicenter study, and the Cog-Tb and Fus-Tb groups were obtained from non-contemporary time periods and from different operators (Cog-Tb performed by urologists, Fus-Tb by a dedicated interventional radiologist). Atotal of 267 patients who underwent Cog-Tb and 218 who underwent Fus-Tb were retrospectively analyzed. At least two targeted cores were obtained from each mpMRI-defined lesion, in addition to 10-12 systematic cores. csPCa was defined as International Society of Urological Pathology (ISUP) Grade Group ≥2. Patients were stratified using a PSAd cutoff value of 0.15. In addition, a predefined stratified analysis by PI-RADS category (3 vs. 4-5) was performed, and odds ratios with 95% confidence intervals were calculated to assess independent predictors of csPCa.</div></div><div><h3>Results</h3><div>There was no significant difference between Cog-Tb and Fus-Tb in the detection of ISUP ≥2 prostate cancer (<em>P</em>=.91). In the PI-RADS 3 subgroup, PSAd values were significantly higher in patients with ISUP ≥2 compared with those with benign or ISUP 1 pathology for both Cog-Tb (<em>P</em>=.02) and Fus-Tb (<em>P</em>=.04). Similarly, in the PI-RADS 4-5 subgroup, PSAd levels were significantly higher in patients with ISUP ≥2 disease for both biopsy techniques (<em>P</em>=.01). Multivariate logistic regression showed that biopsy modality was not an independent predictor of csPCa (OR: 1.4; 95% CI: 0.8-2.5). In contrast, both PSAd (OR: 5.9; 95% CI: 2.6-13.1) and PI-RADS category (OR: 6.8; 95% CI: 3.4-13.4) were strong independent predictors of csPCa.</div></div><div><h3>Conclusion</h3><div>Cog-Tb and Fus-Tb demonstrated comparable effectiveness in detecting csPCa in patients with PI-RADS ≥3 lesions, particularly when PSAd ≥0.15. In settings lacking fusion technology, Cog-Tb performed by experienced clinicians remains a reliable and cost-effective alternative.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501983"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530608","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 funcionales de la pieloplastia en niños con función renal preoperatoria reducida: estudio multicéntrico","authors":"S. Tobía González,&nbsp;A. Bujons-Tur,&nbsp;J.P. Corbetta,&nbsp;J.L. Fadil-Iturralde,&nbsp;L.I. Smith-Harrison,&nbsp;I. Tobía-González,&nbsp;J. Ruiz,&nbsp;Y. Quiroz,&nbsp;A. Maiolo,&nbsp;J.C. Contardi,&nbsp;S. Weller,&nbsp;T. Rosito","doi":"10.1016/j.acuro.2026.501990","DOIUrl":"10.1016/j.acuro.2026.501990","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate functional outcomes after dismembered pyeloplasty in children with unilateral ureteropelvic junction obstruction (UPJO) and preoperative differential renal function (DRF) ≤<!--> <!-->40%.</div></div><div><h3>Materials and methods</h3><div>Retrospective multicenter review (2003–2022) including 74 children with primary unilateral UPJO and DRF ≤<!--> <!-->40%. Exclusions: bilateral UPJO, solitary kidney, secondary causes, prior surgery, and &lt;<!--> <!-->1-year follow-up. Group 1: DRF &lt;<!--> <!-->20%; Group 2: 20–40%.</div></div><div><h3>Results</h3><div>Median age 9 years; 50% right-sided obstruction; 20.3% prenatal hydronephrosis. DRF improved from median 26% preoperatively to 36.9% postoperatively (<em>p</em> <!-->&lt;<!--> <!-->0.001). Functional improvement &gt;<!--> <!-->5% occurred in 58.1% overall (73.9% G1 vs. 51.0% G2, <em>p</em> <!-->=<!--> <!-->0.06). DRF was stable or improved in 93.2%. Prenatal hydronephrosis predicted postoperative deterioration (OR 7.12, 95% CI 1.7–47.3). The median follow-up duration was 48 months (IQR 13–64).</div></div><div><h3>Conclusions</h3><div>Pyeloplasty was associated with stabilization or improvement of renal function in children with UPJO and reduced preoperative DRF, including those with DRF &lt;<!--> <!-->20%. Prenatal hydronephrosis identifies a subgroup at higher risk of postoperative decline.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501990"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530610","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":"i-NLP: nueva aplicación de un catéter ureteral para generar irrigación continua, unidireccional y de alto flujo durante la nefrolitotomía percutánea. Descripción de la técnica y resultados preliminares","authors":"A. Servera Ruiz de Velasco,&nbsp;B. Ballesta Martínez,&nbsp;C. Barrera Rodríguez,&nbsp;J. Benejam Gual","doi":"10.1016/j.acuro.2026.501988","DOIUrl":"10.1016/j.acuro.2026.501988","url":null,"abstract":"<div><h3>Introduction</h3><div>Percutaneous nephrolithotomy (PCNL) remains the technique of choice for the treatment of complex renal stones. Despite technical advances, limitations remain in terms of visibility, fragment migration, and effective evacuation of the material. Optimizing irrigation is the key to improve the efficiency and safety of the procedure.</div></div><div><h3>Materials and methods</h3><div>A prospective observational study was done at one referral center, including 14 patients undergoing supine PCNL. A continuous retrograde irrigation technique directed at the upper renal pole was evaluated by adapting commercially available ureteral devices of a specific caliber. Irrigation was performed using a passive system based on hydrostatic pressure dependent on the height of the irrigation bags. Demographic variables, stone characteristics, operative and postoperative parameters, complications, stone-free rate (SFR), and a subjective evaluation of the system using a Likert scale were analyzed.</div></div><div><h3>Results</h3><div>The technique was performed in all cases without incident. No migration of fragments to the upper pole was observed. The mean effective lithotripsy time was 10.07<!--> <!-->minutes. No relevant complications were recorded, except for one case of postoperative anemia. The SFR was 100% in the tomographic control at 4 weeks. The subjective assessment showed high scores for irrigation efficacy, vision quality, and fragment evacuation.</div></div><div><h3>Conclusions</h3><div>Continuous retrograde irrigation during PCNL is a simple and reproducible technique that, in this preliminary series, showed favorable results, making it a promising option.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501988"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530545","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":"Documento de posicionamiento de la Sociedad Española de Oncología Radioterápica (SEOR) y su grupo de tumores genitourinarios (URONCOR) sobre la prescripción de inhibidores de PARP en cáncer de próstata avanzado","authors":"P. Diezhandino,&nbsp;F. Couñago,&nbsp;A. Ocanto,&nbsp;A. Gómez de Iturriaga,&nbsp;A. Conde,&nbsp;X. Maldonado,&nbsp;J. Serrano,&nbsp;F. López-Campos","doi":"10.1016/j.acuro.2026.501991","DOIUrl":"10.1016/j.acuro.2026.501991","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501991"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530546","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":"Predicción del fracaso de la ureteroscopia mediante tomografía computarizada en cálculos ureterales impactados: papel del volumen del cálculo y la anatomía ureteral","authors":"M. Dinckal,&nbsp;K.E. Ergun,&nbsp;A. Akyol,&nbsp;M.S. Kalemci,&nbsp;A. Simsir,&nbsp;A.B. Altay,&nbsp;F. Kizilay","doi":"10.1016/j.acuro.2026.501992","DOIUrl":"10.1016/j.acuro.2026.501992","url":null,"abstract":"<div><h3>Introduction</h3><div>Impacted ureteral stones are associated with lower ureteroscopic success and increased procedural complexity. Although ureteroscopy is the standard treatment, reliable preoperative predictors of failure are limited, and decision-making often depends on intraoperative findings. This study evaluated the association between preoperative CT-based stone and ureteral anatomical parameters and ureteroscopic failure among patients with endoscopically confirmed impacted ureteral calculi.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 123 patients with impacted ureteral calculi who underwent URS. Preoperative non-contrast computed tomography images were evaluated for stone characteristics, ureteral wall thickness (UWT), and ureteral anatomical features, including <em>kinking</em>. URS success was defined as stone-free status after the initial procedure, and the predictive value of CT parameters was assessed using receiver operating characteristic analysis and univariate and multivariate logistic regression models.</div></div><div><h3>Results</h3><div>The overall URS success rate was 68.3%. In univariate analysis, stone volume, proximal kink width, and proximal kink length were significantly larger in the failed group. Multivariate logistic regression analysis identified stone volume as the sole independent predictor of URS failure (OR: 3.05; 95% CI: 1.06–8.78; p<!--> <!-->=<!--> <!-->0.039). A stone volume ≥451.28 mm³ demonstrated modest predictive power (AUC<!--> <!-->=<!--> <!-->0.615). Although proximal kink parameters showed promising results in univariate analysis and ROC curves, these associations were not independent of other factors. UWT showed no significant differences between the groups.</div></div><div><h3>Conclusions</h3><div>Stone volume is the only independent predictor of ureteroscopic failure in impacted ureteral stones, while ureteral anatomy may provide complementary information regarding procedural complexity.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501992"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530611","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":"pH urinario y resultados oncológicos tras el tratamiento con bacilo de Calmette–Guérin en el cáncer de vejiga no músculo invasivo: un estudio de cohorte retrospectivo","authors":"K. Kayar,&nbsp;R. Kayar,&nbsp;B.B. Ozdemir,&nbsp;E. Karabay,&nbsp;C. Tosun,&nbsp;M.I. Ozturk,&nbsp;O.E. Yucebas","doi":"10.1016/j.acuro.2026.501995","DOIUrl":"10.1016/j.acuro.2026.501995","url":null,"abstract":"<div><h3>Introduction</h3><div>Urinary pH may influence intravesical Bacillus Calmette–Guérin (BCG) efficacy by modulating the local immune microenvironment. We evaluated baseline urinary pH as a continuous variable and its association with oncologic outcomes in BCG-treated non–muscle invasive bladder cancer (NMIBC).</div></div><div><h3>Methods</h3><div>In this retrospective cohort, 248 NMIBC patients receiving adequate BCG therapy were analyzed. Recurrence-free survival (RFS) and progression-free survival (PFS) were assessed using Cox proportional hazards models. Given limited progression events, ridge (L2-penalized) multivariable regression was applied. Urinary pH was modeled per 1-unit increase and age per 10-year increment. Model discrimination was evaluated using Harrell's concordance index.</div></div><div><h3>Results</h3><div>During follow-up, 43 patients (17.3%) developed recurrence and 28 (11.3%) experienced progression. In multivariable analysis, urinary pH was independently associated with improved RFS (HR 0.53, 95% CI 0.29–0.96, p<!--> <!-->=<!--> <!-->0.035). For PFS, urinary pH showed a similar inverse direction but borderline significance after ridge adjustment (HR 0.69, 95% CI 0.48–1.00, p<!--> <!-->=<!--> <!-->0.052). Concomitant carcinoma <em>in situ</em> and tumor stage remained independent predictors of progression. Model discrimination was good for RFS (C-index 0.713) and strong for PFS (C-index 0.841).</div></div><div><h3>Conclusions</h3><div>Baseline urinary pH demonstrated an independent association with recurrence and a consistent directional association with progression in BCG-treated NMIBC. While dominant pathological features primarily determine progression risk, urinary pH may represent an accessible microenvironmental modifier of BCG responsiveness. Prospective validation is warranted.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501995"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530493","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":"Efectividad de los recordatorios por correo electrónico para reducir el absentismo en consultas ambulatorias: un estudio cuasi-experimental en un servicio de urología","authors":"D. Santillan,&nbsp;D.H. Giunta","doi":"10.1016/j.acuro.2026.501986","DOIUrl":"10.1016/j.acuro.2026.501986","url":null,"abstract":"<div><h3>Introduction</h3><div>Non-attendance at scheduled medical appointments implies negative consequences for both healthcare systems and individual patient health. An email reminder system that includes a link to easily cancel appointments was implemented. The objective of this study is to evaluate the effectiveness of this tool to reduce non-attendance.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, quasi-experimental before-and-after study using two complementary analytical approaches: an individual-level analysis of scheduled appointments and an aggregated interrupted time series (ITS) analysis by epidemiological weeks. All consecutive adult urology appointments from twelve months before the implementation (July 2021) to twelve months after (March 2024) were included. Appointments scheduled before the intervention were considered unexposed, while those scheduled afterward were considered exposed. We used logistic regression for individual-level and segmented Poisson regression for aggregated ITS analysis.</div></div><div><h3>Results</h3><div>A total of 272,331 appointments corresponding to 73,387 individuals were analyzed over 144 epidemiological weeks. In the main individual-level analysis, the non-attendance percentage was nearly 3% lower in the exposed group. The adjusted odds ratio for the effect of the reminder on non-attendance was 0.76 (95%<!--> <!-->CI: 0.73-0.81). In the ITS analysis, segmented regression confirmed an immediate 13% drop at intervention (Relative Risk [RR]: 0.868), and a post-intervention decline of 0.4% per week (RR: 0.996). Sensitivity and subgroup analyses yielded similar results.</div></div><div><h3>Conclusions</h3><div>We observed a consistent association between the reminders and the reduction in non-attendance percentages for urology appointments, both in the individual-level and aggregated analyses.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501986"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La citología urinaria preoperatoria mejora la selección de pacientes candidatos a instilación única de mitomicina C","authors":"C. Gómez del Cañizo ,&nbsp;N. Fernández Sánchez ,&nbsp;I. González Ginel ,&nbsp;M. Hernández Arroyo ,&nbsp;C. Martín-Arriscado Arroba ,&nbsp;A. de la Calle Moreno ,&nbsp;A. Rodríguez Antolín ,&nbsp;F. Guerrero Ramos","doi":"10.1016/j.acuro.2025.501904","DOIUrl":"10.1016/j.acuro.2025.501904","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess whether adding voided urine cytology to the European Organisation for Research and Treatment of Cancer (EORTC) score improves the indication for a single instillation of mitomycin C following transurethral resection of the bladder and whether this approach improves mitomycin C instillation rate.</div></div><div><h3>Materials and methods</h3><div>A retrospective observational study was conducted on 272 bladder cancer patients treated at a tertiary center from March 2020 to March 2022. After applying the exclusion criteria, 123 patients were included in the analysis. Voided urine cytology results and EORTC scores, with and without pathological data, were compared to the full EORTC 2006 score (gold standard) to evaluate the need for mitomycin C. Statistical analyses included sensitivity, specificity, receiver operating characteristic curves, and the Kappa index to measure test concordance. The method's application in our center was also compared with existing literature.</div></div><div><h3>Results</h3><div>Combining urine cytology with the EORTC score without pathological data improved the accuracy of mitomycin C indications, increasing the area under the curve from 0.62 to 0.79. This approach reduced unnecessary mitomycin C administration in 53 patients, with only 6 patients missing beneficial treatment, none of whom were low-risk. Only 6 cases lacked documented reasons for not receiving the instillation, a better rate than reported in the literature.</div></div><div><h3>Conclusions</h3><div>Adding urine cytology to the EORTC score enhances the accuracy of mitomycin C indications, reducing unnecessary treatments while ensuring appropriate therapy for low-risk patients. Further studies are needed to validate these findings across different populations.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 5","pages":"Article 501904"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148060285","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 de los pacientes con cateterismo intermitente limpio y consumo de recursos asociados. Estudio multicéntrico en España»","authors":"R. Mehta ,&nbsp;R. Sah","doi":"10.1016/j.acuro.2025.501795","DOIUrl":"10.1016/j.acuro.2025.501795","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 5","pages":"Article 501795"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148060226","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":"Pasado y presente del cribado del cáncer de próstata en la Unión Europea","authors":"J. Gómez Rivas ,&nbsp;P. Gómez Dávila ,&nbsp;A.M. Tarrazo Antelo ,&nbsp;M. Corujo Quinteiro ,&nbsp;A. Gómez Amorín ,&nbsp;A. Rodríguez Alonso ,&nbsp;J.M. Vilaseca ,&nbsp;H. López ,&nbsp;J.P. Salazar ,&nbsp;A. Borque-Fernando ,&nbsp;J. Moreno-Sierra ,&nbsp;S. Collen ,&nbsp;K. Beyer ,&nbsp;J. Helleman ,&nbsp;M.J. Roobol ,&nbsp;H. van Poppel ,&nbsp;en representación de PRAISE-U Consortium","doi":"10.1016/j.acuro.2025.501897","DOIUrl":"10.1016/j.acuro.2025.501897","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer (PCa) screening based on prostate-specific antigen (PSA) testing has represented a major milestone in early detection; however, it has also prompted considerable debate due to the risks of overdiagnosis and overtreatment. This review examines the evolution of PCa screening, highlighting its main challenges and emerging approaches aimed at achieving more accurate and individualized detection.</div></div><div><h3>Methods</h3><div>A narrative review of the literature was conducted using databases such as PubMed and Google Scholar, applying MeSH terms related to screening, overdiagnosis, and prostate cancer. Clinical studies, systematic reviews, and recent guidelines pertinent to the topic were included.</div></div><div><h3>Results</h3><div>The PLCO, ERSPC, and Göteborg trials provide complementary insights into the impact of PSA-based screening, with outcomes ranging from limited benefit to significant reductions in PCa-specific mortality. Based on these this findings, a paradigm shift toward risk-stratified screening strategies has been advocated. The incorporation of new tools such as magnetic resonance imaging, blood and urine biomarkers, risk calculators, and artificial intelligence-based algorithms has improved diagnostic accuracy. These strategies reduce unnecessary biopsies and focus on the detection of clinically significant disease. Current guidelines recommend individualized assessment based on factors such as age, baseline PSA levels, family history, and comorbidities.</div></div><div><h3>Conclusion</h3><div>The future of PCa screening resides in personalized medicine, in which the integration of clinical, imaging, and molecular parameters will enable a more efficient approach, minimizing unnecessary interventions and improving overall patient outcomes.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 5","pages":"Article 501897"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148060290","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}