Actas urologicas espanolas最新文献

{"title":"Documento de posicionamiento de la Asociación Española de Urología (AEU) y su Grupo de Urología Oncológica (GUO) sobre la prescripción de inhibidores de PARP (iPARP) en el cáncer de próstata resistente a la castración metastásico","authors":"C. González Enguita ,&nbsp;D. Pérez Fentes ,&nbsp;A. Budía Alba ,&nbsp;M.F. Lorenzo Gómez ,&nbsp;J. Gómez Rivas ,&nbsp;C. Manso Aparicio ,&nbsp;T. Fernández Aparicio ,&nbsp;J.L. Alvárez-Ossorio Fernández ,&nbsp;en representación de la Junta Directiva AEU (Asociación Española de Urología), del GUO (Grupo de Urología Oncológica) y del Patronato Rector de la FIU (Fundación para la Investigación en Urología)","doi":"10.1016/j.acuro.2025.501898","DOIUrl":"10.1016/j.acuro.2025.501898","url":null,"abstract":"<div><div>In recent months, restrictions have been proposed on the prescription of PARP inhibitors (iPARP) by urologists in metastatic castration-resistant prostate cancer (mCRPC). The Spanish Association of Urology (AEU), its Uro-Oncology Group (GUO), and the presidents of the Regional Urology Associations consider these limitations unjustified from clinical, organizational, legal, or professional perspectives. They unduly restrict the exercise of competencies recognized in the interdisciplinary management of prostate cancer, in line with the training, experience, and current regulations of the specialty. This document argues, from scientific, clinical, and legal standpoints, that urologists are qualified and legally authorized to prescribe and administer iPARP according to current legislation and the official training program. It also advocates a collaborative model centred on the patient's care pathway and based on mutual respect among specialties, ensuring professional autonomy, continuity of care, and equitable access to therapeutic innovation.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501898"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415030","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":"Manejo actual del carcinoma de células renales en estadio T1 en España: resultados de un registro nacional multicéntrico","authors":"V. Hevia-Palacios ,&nbsp;D. Pérez Fentes ,&nbsp;A. Vilaseca Cabo ,&nbsp;A. Jalón Monzón ,&nbsp;I. Rivero Belenchón ,&nbsp;E. Tolosa Eizaguirre ,&nbsp;S.F. Morales Pinto ,&nbsp;D. Vázquez Martul ,&nbsp;M.Á. Arrabal Polo ,&nbsp;V. Gómez dos Santos ,&nbsp;L. Cogorno Wasylkowski ,&nbsp;P.I. Ortiz de Urbina ,&nbsp;R. Ballestero Diego ,&nbsp;I. Testa Sklofsky ,&nbsp;S. Fernández-Pello","doi":"10.1016/j.acuro.2025.501922","DOIUrl":"10.1016/j.acuro.2025.501922","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The management of stage T1 renal cell carcinoma (RCC) has shifted toward nephron-sparing surgery (NSS) and minimally invasive surgery (MIS), but contemporary, country-level data from Spain are scarce. We sought to describe real-world treatment patterns for T1 RCC across Spanish centres.</div></div><div><h3>Material and methods</h3><div>Multicentre retrospective descriptive study using the Spanish National Registry of Localized Renal Cancer during 2024. Adults with clinical stage T1 renal masses treated with surgery, ablation or active surveillance (AS) were included. Descriptive statistics were applied. Primary outcomes were management strategy, surgical approach, type of procedure and pathological results; secondary outcomes included intraoperative details.</div></div><div><h3>Results</h3><div>A total of 1,121 patients were analysed (71.5% cT1a). Management consisted of surgery in 82.6%, ablation in 9.5% and AS in 7.3%. Among operated patients, partial nephrectomy (PN) accounted for 65.0% overall (74.5% in cT1a; 46.7% in cT1b). MIS predominated (92.3%: 58.4% laparoscopic, 33.9% robotic). The leading reason to perform radical nephrectomy (RN) was technical infeasibility (56.8%). Median warm ischaemia time was 16<!--> <!-->min (IQR 0-23). Histology showed clear cell RCC 61.1% and benign lesions 12.4%. Final pathology was pT1a 66.1%, pT1b 25.2%; upstaging occurred in 8.6% (mainly pT3a), more frequently in cT1b.</div></div><div><h3>Conclusions</h3><div>In Spain, most T1 RCCs are treated surgically with a high adoption of PN for cT1a and widespread MIS. RN remains common in cT1b primarily for anatomical/technical reasons, suggesting variability in access to robotic platforms and subspecialised teams. These data provide a national benchmark and support initiatives to optimise NSS access, resource allocation, and referral pathways.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501922"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415023","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». Respuesta de los autores","authors":"G. Sánchez-Villaseñor ,&nbsp;J.P. Gómez-Sierra ,&nbsp;A. González-Ojeda ,&nbsp;C. Fuentes-Orozco","doi":"10.1016/j.acuro.2025.501867","DOIUrl":"10.1016/j.acuro.2025.501867","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501867"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415025","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":"Eficacia y seguridad de la vigilancia activa y la quimioablación en el tratamiento del cáncer de vejiga no musculoinvasivo (CVNMI): revisión sistemática y análisis conjunto del Grupo de trabajo de carcinoma urotelial de la Sección de jóvenes urólogos académicos-Asociación Europea de Urología (YAU-EAU)","authors":"A. Saouli ,&nbsp;R. Contieri ,&nbsp;F. Quhal ,&nbsp;R. Hurle ,&nbsp;M. Guenouni ,&nbsp;G. Ploussard ,&nbsp;K. Mori ,&nbsp;T. Yanagisawa ,&nbsp;B. Pradere ,&nbsp;E. Laukhtina ,&nbsp;P. Rajwa ,&nbsp;S. Albisinni ,&nbsp;W. Krajewski ,&nbsp;A. Cimadamore ,&nbsp;F. del Giudice ,&nbsp;J. Gómez Rivas ,&nbsp;F. Soria ,&nbsp;S.F. Shariat ,&nbsp;P. Gontero ,&nbsp;L.S. Mertens ,&nbsp;M. Moschini","doi":"10.1016/j.acuro.2025.501917","DOIUrl":"10.1016/j.acuro.2025.501917","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the oncological outcomes and safety of chemoablation and Active Surveillance for non-muscle invasive bladder cancer.</div></div><div><h3>Methods</h3><div>A systematic review was performed by accessing the following bibliographic databases: PubMed, Scopus, Embase and the Cochrane central register of controlled trials were searched.</div></div><div><h3>Results</h3><div>A total of 29 studies (1847 patients) met the inclusion criteria. The vast majority of patients included had Active Surveillance (n<!--> <!-->=<!--> <!-->7, 582) and chemoablation (n<!--> <!-->=<!--> <!-->21, 1265).</div><div>Regarding chemoablation, Mitomycine C (MMC) was used in 14 studies, Epirubicin in 2 studies, Bacillus Calmette-Guerin (BCG) in one study and Gemcitabine in 5 studies (weekly or single dose).</div><div>Follow-up ranged from 2 weeks to 39 months (Mean 16.8 months). The mean timing of initial assessment was 4.2 (range: 1 day to 27 weeks), and the pooled complete response (CR) rate was 52.3%.</div><div>For the AS protocol, the pathological findings before observation were Ta (n<!--> <!-->=<!--> <!-->583, 86%), low (n<!--> <!-->=<!--> <!-->462, 60.1%) and high grade (n<!--> <!-->=<!--> <!-->138, 42.1%). Mean follow up was 47 months ranged from 25 to 72 months, the mean duration of AS was 13.4 months. The mean AS failure rate was 64%. Grade progression, stage progression and progression to muscle-invasive bladder cancer (MIBC) were 68 (16.5%), 35 (8.5%) and 5 (1%) of cases, respectively.</div></div><div><h3>Conclusions</h3><div>Patients with selected inclusion criteria based on the review can be referred for active Surveillance or chemoablation protocol, with a minimal risk of progression in either grade or stage for AS and a good complete response for chemoablation.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 2","pages":"Article 501917"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415027","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":"A propósito de un caso: tumor mixto epitelial y estromal del riñón con evolución sarcomatosa","authors":"A.C. Jiménez Domínguez ,&nbsp;A.J.G. Álvarez Lucena ,&nbsp;P. Vila Braña ,&nbsp;F. Vázquez Alonso","doi":"10.1016/j.acuro.2025.501692","DOIUrl":"10.1016/j.acuro.2025.501692","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 1","pages":"Article 501692"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898167","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":"Técnicas ablativas para tumores renales en pacientes inoperables: un paso adelante en la SBRT","authors":"A. Ocanto ,&nbsp;R. Ciérvide ,&nbsp;V. Hevia-Palacios ,&nbsp;R. García ,&nbsp;V. Gómez ,&nbsp;P. Cruz ,&nbsp;A. Olavarría ,&nbsp;F. Couñago ,&nbsp;F. López-Campos","doi":"10.1016/j.acuro.2025.501857","DOIUrl":"10.1016/j.acuro.2025.501857","url":null,"abstract":"<div><h3>Introduction</h3><div>The localized renal cell carcinoma (RCC) is the eighth most common tumour in Spain. While surgical resection remains the gold standard for treatment, some elderly and frail patients may not be suitable candidates for this procedure. In selected cases, ablative therapies provide less invasive alternatives. Recent research has highlighted the potential of Stereotactic Body Radiotherapy (SBRT) as a non-invasive, well-tolerated, and effective treatment for RCC. This review aims to examine recent advances in SBRT for localized RCC, focusing on patient selection, treatment modalities and delivery, as well as efficacy and tolerance assessment.</div></div><div><h3>Material and methods</h3><div>A narrative literature review of English articles using Pubmed, Scopus, Cochrane, Google Scholar and Science Direct databases was performed focusing on prospective and relevant retrospective studies. Search terms included “kidney cancer”, “renal cell carcinoma”, “stereotactic radiotherapy”, “radiofrequency ablation”, “cryoablation”, “microwave ablation”, “SBRT” and “SABR”.</div></div><div><h3>Results</h3><div>Studies have reported local control rates ranging from 80% to 100% with SBRT. The decline in glomerular filtration rate following SBRT is approximately -10 to -13<!--> <!-->mL/min over the years. Common toxicities are rare and are mostly classified as CTCAE grade I.</div></div><div><h3>Conclusion</h3><div>Based on available evidence, SBRT appears to be a viable option for patients with localized RCC who are not surgical candidates, given its high local control rate and favorable safety profile. Therefore, some indications for its use in clinical practice have been purposed according to the available evidence and recommending a case by case discussion in a uro-oncology multidisciplinary setting to optimize patient selection and treatment planning.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 1","pages":"Article 501857"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898162","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":"Impacto de los parámetros demográficos y los métodos de drenaje en el pronóstico de la pielonefritis enfisematosa. Estudio unicéntrico retrospectivo de 10 años","authors":"E. Gokmen,&nbsp;M.U. Kutukoglu,&nbsp;T. Altuntas,&nbsp;M. Kars,&nbsp;T.E. Sener,&nbsp;Y. Tanidir","doi":"10.1016/j.acuro.2025.501860","DOIUrl":"10.1016/j.acuro.2025.501860","url":null,"abstract":"<div><h3>Objective</h3><div>To demonstrate the impact of demographic data on the clinical outcomes of patients with emphysematous pyelonephritis (EPN) treated at our center, and to present the results obtained—particularly through the comparison of drainage methods—in the largest patient group possible.</div></div><div><h3>Materials and methods</h3><div>This retrospective single-center study included 54 EPN patients treated at a tertiary care hospital. Inclusion required symptoms of upper urinary tract infection and gas in the renal parenchyma, collecting system, or perinephric space on abdominal CT. Data on demographics, urinary tract stones, labs, imaging (Huang and Tseng classification), hospital and intensive care unit (ICU) stay, and mortality were analyzed by initial treatment, drainage method, and platelet count. Patients with at least 6 months of follow-up were assessed for infection recurrence, renal function loss, and delayed nephrectomy.</div></div><div><h3>Results</h3><div>Advanced age was associated with increased ICU need and mortality (respectively p<!--> <!-->=<!--> <!-->0.047, p<!--> <!-->=<!--> <!-->0.039). Diabetes was associated with longer hospital stays compared to those without DM (14 vs. 7.5 days, p<!--> <!-->=<!--> <!-->0.015). Thrombocytopenia was linked to higher rates of non-functioning kidneys (66.7%) and delayed nephrectomy (33.3%). No significant differences in morbidity or mortality were found between drainage methods (percutaneous vs. DJ stent). More male patients had advanced-stage disease, though this did not impact outcomes.</div></div><div><h3>Conclusion</h3><div>EPN is an emergency urological situation with high rate of mortality. Therefore, early diagnosis and appropriate management are crucial to decrease morbidity and mortality. Patient management approaches can be improved with growing evidence and prospective data with future studies.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 1","pages":"Article 501860"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898163","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":"Adjuntos frente a residentes supervisados: resultados de la formación en resección transuretral de tumores de vejiga y perspectivas a futuro","authors":"P. Diana ,&nbsp;A. Gallioli ,&nbsp;A. Uleri ,&nbsp;L. Mas ,&nbsp;R. Pujol ,&nbsp;A. Territo ,&nbsp;O. Rodriguez-Faba ,&nbsp;J.M. Gaya ,&nbsp;F. Sanguedolce ,&nbsp;J. Huguet ,&nbsp;R. Parada ,&nbsp;F. Algaba ,&nbsp;J. Palou ,&nbsp;A. Breda","doi":"10.1016/j.acuro.2025.501830","DOIUrl":"10.1016/j.acuro.2025.501830","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Urology residents training programs across Europe are uneven and often unsatisfactory. The significance of resident mentoring should not be overstated and trainees should be mentored by training-trained attending urologist even in case of common procedures such transurethral resection of bladder tumor (TURBT). The goal of this study is to demonstrate the comparability in TURBT performance between supervised urology residents and attendings.</div></div><div><h3>Materials and methods</h3><div>This study is a subanalysis of a prospective, randomized trial enrolling patients diagnosed with BC and undergoing endoscopic intervention. The trial (NCT04712201) was approved by the Institutional Review Board (2017/09c). Surgeons were either urology attendings or supervised residents of the 3rd-5th year. Primary outcome was to compare surgical and post-operative outcomes in both groups.</div></div><div><h3>Results</h3><div>From 04/2018 to 06/2021, 300 patients met inclusion criteria and 248 (83%) of these underwent the assigned intervention. 200 (80.6%) patients were males and median (SD) age was 72.2 (11.2). No statistical differences were found in terms of intra and post-operative outcomes (all <em>P</em> <!-->&gt;<!--> <!-->.05). Linear and logistic regression analysis resulted comparable for all variables (all <em>P</em> <!-->&gt;<!--> <!-->.05).</div></div><div><h3>Conclusion</h3><div>Supervised urology residents do not put the patient at an increased risk of complications neither perform a suboptimal procedure. Resident mentoring is fundamental in order to reach comparable results in surgical outcomes and pathological diagnosis. A structured standardized program with trained trainers and proficiency evaluations are warranted to gain and maintain these outcomes across Europe.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 1","pages":"Article 501830"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898164","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 «Nuevos factores de riesgo de tromboembolismo venoso (TEV) después de la resección transuretral de tumor vesical (RTU): modelos de regresión multivariable escalonada y LASSO basados en datos de reclamaciones de seguros de EE.UU.»","authors":"S. Kumar ,&nbsp;R. Mehta ,&nbsp;R. Sah","doi":"10.1016/j.acuro.2025.501787","DOIUrl":"10.1016/j.acuro.2025.501787","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 1","pages":"Article 501787"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898171","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 «Comparación del P-score de Prostatype® y los modelos de riesgo tradicionales para predecir los resultados del cáncer de próstata en España»","authors":"S. Kumar ,&nbsp;R. Sah","doi":"10.1016/j.acuro.2025.501827","DOIUrl":"10.1016/j.acuro.2025.501827","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 1","pages":"Article 501827"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897848","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}