Actas urologicas espanolas最新文献

{"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}

{"title":"Vías clínicas para el cuidado oral en pacientes sometidos a extracción de injerto de mucosa oral: una revisión sistemática","authors":"M. Frankiewicz ,&nbsp;J. Adamowicz ,&nbsp;L. Białek ,&nbsp;F. Campos-Juanatey ,&nbsp;F. Chierigo ,&nbsp;A. Cocci ,&nbsp;F.X. Madec ,&nbsp;G. Mantica ,&nbsp;M. Oszczudłowski ,&nbsp;E.J. Redmond ,&nbsp;C.M. Rosenbaum ,&nbsp;W. Verla ,&nbsp;M. Waterloos ,&nbsp;M. Jobczyk ,&nbsp;A. Kałużny ,&nbsp;M.W. Vetterlein ,&nbsp;M. Matuszewski ,&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.2024.10.004","DOIUrl":"10.1016/j.acuro.2024.10.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Oral mucosal grafts are essential in reconstructive urology, particularly for urethral and genital defects. Advances in harvesting and implantation techniques have been made, yet perioperative care remains crucial for optimal outcomes. This systematic review explores postoperative care pathways following oral mucosal graft harvesting to consolidate knowledge, identify best practices, and highlight research gaps.</div></div><div><h3>Objective</h3><div>The review aims to identify optimal care pathways, compare different oral care approaches, and address research gaps.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted using PubMed, Scopus, and Web of Science databases without time constraints. Key search terms included «oral mucosal graft», «oral care pathways», «OMG post-operative care», «BMG», «LMG», and «OMG graft harvesting». Selection followed PRISMA guidelines. Inclusion criteria focused on studies addressing oral mucosal grafts in reconstructive urology and associated perioperative care, excluding non-English articles, case reports, and editorials.</div></div><div><h3>Results</h3><div>The review underscores the suitability of oral mucosa for grafting due to properties like excellent vascularization and minimal immunogenicity. Comparisons among graft harvesting sites reveal differences in tissue quality, ease of harvest, and donor site morbidity. Non-closure techniques generally result in less postoperative pain and quicker healing, though closure might better control bleeding and infection. Despite common complications such as mild trismus and altered chewing efficiency, patient satisfaction remains high.</div></div><div><h3>Conclusions</h3><div>Effective management of oral mucosal grafts harvesting emphasizes tailored perioperative care to minimize complications and enhance recovery. Further research should focus on long-term oral morbidity, standardized care protocols, and patient-reported outcomes to improve care pathways and surgical results.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 20-34"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156142","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":"Uretroplastia femenina con injerto de mucosa oral en una etapa: resultados comunicados por las pacientes y tasas de éxito funcional a largo plazo","authors":"J. Klemm,&nbsp;P. Marks,&nbsp;R.J. Schulz,&nbsp;D.K. Filipas,&nbsp;D.R. Stelzl,&nbsp;R. Dahlem,&nbsp;M. Fisch,&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.2024.04.002","DOIUrl":"10.1016/j.acuro.2024.04.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Female urethral strictures are a rare condition that significantly impacts patients’ quality of life. Patient-reported outcomes are crucial, yet data regarding sexual function and treatment satisfaction are scarce. We aimed to provide insights from a reconstructive referral center.</div></div><div><h3>Patients and methods</h3><div>We conducted a retrospective analysis of women treated with ventral onlay one-stage buccal mucosa graft urethroplasty for urethral strictures between 2009–2023. We assessed objective (retreatment-free survival, improvement in maximum flow rate) and subjective outcomes (validated patient-reported outcomes).</div></div><div><h3>Results</h3><div>Of 12 women, 83 and 17% had iatrogenic and idiopathic strictures, respectively. Median number of prior interventions was 6. Strictures were located meatal and mid-urethral in 25 and 75%, respectively, 22% had the bladder neck involved. Median graft length was 2<!--> <!-->cm At median follow-up of 66 months, 33% of patients underwent stricture retreatment, but only one case occurred within the first 2 years postoperatively. The median improvement in maximum flow rate was 10<!--> <!-->ml/s. Median International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ-FLUTS) scores were 8 for filling symptoms, 6 for voiding symptoms, and 3 for incontinence symptoms. Median ICIQ-FLUTSsex score was 4. Higher scores indicate a higher symptom burden. Median ICIQ-Satisfaction outcome and satisfaction scores were 18 and 7, respectively, reflecting high treatment satisfaction.</div></div><div><h3>Conclusions</h3><div>Buccal mucosal graft urethroplasty by ventral onlay for female urethral strictures yields effective, durable, and positively received outcomes. However, larger studies across multiple institutions are necessary to further assess its efficacy, especially regarding patient-reported experiences and sexual function.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 72-79"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141049511","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":"Complicaciones estéticas de la cirugía de uretra anterior: revisión exploratoria y galería de imágenes","authors":"F. Chierigo ,&nbsp;G. Mantica ,&nbsp;G. Drocchi ,&nbsp;F.X. Madec ,&nbsp;W. Verla ,&nbsp;Ł. Białek ,&nbsp;J. Adamowicz ,&nbsp;A. Cocci ,&nbsp;M. Frankiewicz ,&nbsp;J. Klemm ,&nbsp;P. Neuville ,&nbsp;M. Oszczudłowski ,&nbsp;E.J. Redmond ,&nbsp;C.M. Rosenbaum ,&nbsp;M. Waterloos ,&nbsp;M.W. Vetterlein ,&nbsp;F. Campos-Juanatey ,&nbsp;en representación del Grupo de Trabajo de Urología Reconstructiva y Trauma Urológico de la Sección de Jóvenes Urólogos Académicos (YAU) - Asociación Europea de Urología (EAU)","doi":"10.1016/j.acuro.2024.11.002","DOIUrl":"10.1016/j.acuro.2024.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Anterior urethroplasty is the gold standard for treating complex urethral strictures, primarily focusing on restoring urinary function. However, aesthetic complications, including penile curvature, scarring, and meatal deformities, can impact patient satisfaction, self-image, and quality of life. Despite their significance, cosmetic outcomes are underreported in the literature, affecting patient counseling and surgical planning.</div></div><div><h3>Objective</h3><div>This scoping review aims to assess the prevalence, types, and contributing factors of cosmetic complications after anterior urethroplasty. A photographic collection of these complications is also presented to aid in clinical education.</div></div><div><h3>Materials and methods</h3><div>A systematic search of PubMed, Scopus, and Web of Science databases was performed, including studies from 2000 onward that report cosmetic outcomes in male adult patients post-urethroplasty. Following PRISMA guidelines, studies focusing on pediatric cases, case reports with fewer than 10 patients, and those lacking specific cosmetic data were excluded.</div></div><div><h3>Results</h3><div>Of the 493 studies screened, 97 met the inclusion criteria, with only a minority (8 studies) explicitly discussing cosmetic complications. Reported issues varied widely, including penile curvature, skin tethering, hypertrophic scarring, meatal deformities, and penile shortening, underscoring the diversity of aesthetic challenges in urethral reconstruction.</div></div><div><h3>Conclusion</h3><div>This review highlights the need for incorporating aesthetic considerations into surgical planning and patient counseling for anterior urethroplasty. Standardized metrics for evaluating cosmetic outcomes could improve patient satisfaction and the quality of care in urethral reconstruction.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 42-62"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156140","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":"Historia de la cirugía uretral: lecciones aprendidas del pasado","authors":"F.X. Madec ,&nbsp;P. Neuville ,&nbsp;F. Chierigo ,&nbsp;J. Adamowicz ,&nbsp;Ł. Białek ,&nbsp;A. Cocci ,&nbsp;M. Frankiewicz ,&nbsp;G. Mantica ,&nbsp;M. Oszczudłowski ,&nbsp;E.J. Redmond ,&nbsp;C.M. Rosenbaum ,&nbsp;W. Verla ,&nbsp;M. Waterloos ,&nbsp;F. Campos-Juanatey ,&nbsp;J. Klemm ,&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.2024.12.001","DOIUrl":"10.1016/j.acuro.2024.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Although failures are undesirable, they offer valuable learning opportunities that drive progress through necessary changes. This concept holds particularly true in the history of urethral reconstruction.</div></div><div><h3>Methods</h3><div>A comprehensive literature review was conducted using PubMed, focusing on the history of the urethral stricture and current trends based on national and international guidelines for urethral stricture management.</div></div><div><h3>Results</h3><div>Urethral strictures are among the oldest known urological conditions, with initial treatments centred around dilatation. These palliative measures proved disappointing. The advent of reconstructive urology has transformed this pathology into a treatable condition, notably through Excision and Primary Anastomosis (EPA) and one-stage augmentation urethroplasty using buccal grafts.</div></div><div><h3>Conclusion</h3><div>Urethroplasty is the gold standard treatment for urethral strictures, and ongoing refinements aim to further reduce morbidity.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 63-71"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156139","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 del balón de dilatación uretral Optilume® en la práctica clínica real: análisis multicéntrico en España","authors":"C. Ballesteros Ruiz ,&nbsp;F. Campos-Juanatey ,&nbsp;I. Povo Martín ,&nbsp;S. Mitjana Biosca ,&nbsp;Ó. Gorría Cardesa ,&nbsp;J.F. Aguilar Guevara ,&nbsp;N. García Formoso ,&nbsp;E. Fernández Pascual ,&nbsp;J.I. Martínez Salamanca ,&nbsp;S. Martínez Pérez ,&nbsp;J.M. Alonso Dorrego ,&nbsp;E. Ríos González ,&nbsp;S. San Cayetano Talegón ,&nbsp;A.M. Araujo Suarez ,&nbsp;E. Moran Pascual ,&nbsp;M.Á. Bonillo García ,&nbsp;J. Medina Polo ,&nbsp;L. Viver Clotet ,&nbsp;A.J. Vicens Morton ,&nbsp;J. Arce Gil ,&nbsp;L. Martínez-Piñeiro Lorenzo","doi":"10.1016/j.acuro.2024.07.002","DOIUrl":"10.1016/j.acuro.2024.07.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The Optilume® paclitaxel-coated urethral dilatation balloon is an alternative to conventional endoscopic treatments that combines mechanical dilatation with local delivery of paclitaxel.</div></div><div><h3>Objective</h3><div>To describe the success rate and analyze the safety of the device in real clinical practice. To evaluate possible predictors of treatment failure.</div></div><div><h3>Material and methods</h3><div>Retrospective multicenter study in patients diagnosed with urethral stricture and treated with an Optilume® balloon in routine clinical practice. Data were collected from flowmetry, questionnaires (PROM and IPSS) and cystoscopy before surgery, and 3, 6 and 12 months after the procedure, according to standard practice. Surgical success was defined as the absence of subsequent urethral manipulation and a Qmax<!--> <!-->&gt;<!--> <!-->10<!--> <!-->ml/s.</div></div><div><h3>Results</h3><div>238 patients treated with Optilume® in 12 Spanish hospitals between May 2021 and April 2024 were included in the study. Of these, 156 who had a minimum follow-up of 3 months, were analyzed. Median stricture length: 1.5<!--> <!-->cm (0.5 - 5.3), mainly in bulbar urethra (87.7%). Of the total, 12.8% of patients had a history of pelvic radiotherapy, and 81.4% had undergone prior urethral manipulation. Postoperative complications were reported in 14.2% of the total. The treatment success rate was 73.8%, with a median follow-up of 8 months (5-12). No predictors of stricture recurrence were identified. Recurrence rates were higher in strictures located in the posterior versus anterior urethra (42.9% vs. 24.6%, p<!--> <!-->=<!--> <!-->0.126). No significant differences were observed between patients with and without prior urethral manipulation.</div></div><div><h3>Conclusion</h3><div>Treatment with Optilume® has been shown to be safe and effective in short-term routine clinical practice.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 80-85"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156088","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":"Controversias en el abordaje del cáncer de próstata: consenso de recomendaciones de expertos del norte de España","authors":"D. Pérez Fentes ,&nbsp;P. Willisch ,&nbsp;S. Martínez Breijoo ,&nbsp;M. Domínguez ,&nbsp;U. Anido ,&nbsp;C. Álvarez ,&nbsp;A. Gómez Caamaño","doi":"10.1016/j.acuro.2024.06.001","DOIUrl":"10.1016/j.acuro.2024.06.001","url":null,"abstract":"<div><div>In recent years, various aspects of prostate cancer (PC) management have undergone significant changes, including the implementation of therapeutic strategies such as the use of new hormonal agents like abiraterone, apalutamide, enzalutamide or darolutamide and the incorporation of next generation imaging techniques. However, the evidence regarding the role of next generation imaging techniques and the therapeutic decision-making based on their findings is not solid. Following the methodology of the Advanced Prostate Cancer Consensus Conference, a multidisciplinary expert consensus was developed to address controversial questions concerning the use of next generation imaging techniques and clinical management in 4 priority scenarios: localized PC, PC after radical prostatectomy, PC after radiotherapy with curative intent, and metastatic hormone-sensitive PC. This consensus represents the opinions of medical oncology, radiation oncology and urology physicians, and provides useful recommendations for clinical practice.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 739-750"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757290","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":"Relación entre varicocele e hipogonadismo o disfunción eréctil: revisión sistemática y metaanálisis","authors":"S.J. Gonzalez-Daza ,&nbsp;A.M. Díaz-Hung ,&nbsp;H.A. García-Perdomo","doi":"10.1016/j.acuro.2024.05.002","DOIUrl":"10.1016/j.acuro.2024.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the association between varicocele and hypogonadism, or erectile dysfunction.</div></div><div><h3>Methods</h3><div>We searched MEDLINE, EMBASE, LILACS, CENTRAL, and other sources. We included cohort, case-control, and cross-sectional studies. The primary outcome was the association between varicocele and hypogonadism, or erectile dysfunction, and the secondary outcome included semen analysis. We assessed the risk of bias with the Newcastle-Ottawa Scale. We performed statistical analysis in Review Manager® 5.3 and reported information about the odds ratio (OR) with a 95% confidence interval. We produced a forest plot for the primary outcome.</div></div><div><h3>Results</h3><div>We included ten studies in qualitative analysis and six studies in quantitative analysis. Most of the cross-sectional studies showed a low risk of bias, not so for the two case-control studies, which represented a high risk of bias. Most of the reports described a correlation between having varicocele and presenting low testosterone levels: the meta-analysis showed that there is a significant association between varicocele and hypogonadism (OR: 3.27; 95% CI: 1.23-8.68). Regarding varicocele and erectile, only one study showed a significant difference in erectile function in comparison to varicocele patients and men without varicocele.</div></div><div><h3>Conclusion</h3><div>There is an association between varicocele presence and hypogonadism, although more studies are needed. Besides, not much is reported about an association between varicocele and erectile dysfunction, but impairment can occur through hormone disturbances.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 751-759"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757298","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}