Actas urologicas espanolas最新文献

{"title":"Quimioterapia neoadyuvante intravesical intensiva en el cáncer vesical no músculo invasivo recurrente de grado bajo y riesgo intermedio: ¿una alternativa real a la resección transuretral de vejiga?","authors":"G. Villoldo , A. Kamat , G. Fernández Candia","doi":"10.1016/j.acuro.2025.501829","DOIUrl":"10.1016/j.acuro.2025.501829","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501829"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801968","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 de resonancia magnética y rebiopsia confirmatoria durante la vigilancia activa en pacientes con cáncer de próstata de grupo de grado 2","authors":"F. Sanguedolce ,&nbsp;M. Baboudjian ,&nbsp;A. Redondo Ríos ,&nbsp;R. Leni ,&nbsp;M. Oderda ,&nbsp;A. Peyrottes ,&nbsp;C. Kesch ,&nbsp;M. Al-Nader ,&nbsp;A. Uleri ,&nbsp;T. Long-Depaquit ,&nbsp;C. Dariane ,&nbsp;H. Baud ,&nbsp;J. Olivier ,&nbsp;V. Benard ,&nbsp;O. Windisch ,&nbsp;M. Valerio ,&nbsp;G. Gandaglia ,&nbsp;G. Ploussard","doi":"10.1016/j.acuro.2025.501924","DOIUrl":"10.1016/j.acuro.2025.501924","url":null,"abstract":"<div><h3>Introduction</h3><div>To report the results of confirmatory MRI/biopsy in a European cohort of MRI-selected patients with Gleason Grade Group (GG) 2 prostate cancer (PCa) in active surveillance (AS).</div></div><div><h3>Methods</h3><div>Multicenter study enrolled patients with GG2 PCa managed by AS between 2016-2024. Serial MRI scans were interpreted according to PRECISE recommendations. Diagnostic accuracy of PRECISE score to predict upgrading on confirmatory biopsy was assessed by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with 95% Confident Intervals (CIs).</div></div><div><h3>Results</h3><div>A total of 77 patients with GG2 PCa was included, with a PI-RADS 4-5 in 48 patients (63%). On confirmatory MRI, 32 cases were classified as PRECISE 4-5 (42%). On confirmatory biopsy, 39 patients (51%) were downgraded to GG0-1, 27 patients (35%) were GG 2 and upgrading occurred in 11 cases (14%). Sensitivity, specificity, NPV and PPV of the PRECISE score 4-5 to detect upgrading was 63.6% (95%CI 31–89), 62.1% (95%CI, 49-74), 91.1% (95%CI, 82-96) and 21.8% (95%CI, 14-32), respectively. In multivariable Cox hazards regression analysis, downgrading at confirmatory biopsy was significantly associated with a reduced risk of subsequent GG3 reclassification (HR 0.125, 95%CI, 0.277-0.560, p<!--> <!-->=<!--> <!-->0.002) and definitive treatment (HR 0.409, 95%CI, 0.199-0.839, p<!--> <!-->=<!--> <!-->0.015).</div></div><div><h3>Conclusion</h3><div>MRI selection of patients with GG2 PCa in AS allows better initial characterization of the disease. The absence of progression on MRI indicates a very low risk of grade reclassification, but signs of imaging progression are not always predictive of progression and should not be considered alone for prompting active treatment.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501924"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801969","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":"Disfunción eréctil y variables relacionadas con el uso de esteroides anabólicos. Una revisión de revisiones","authors":"M. García Vidal ,&nbsp;A. Vázquez-Méndez ,&nbsp;I. Mollinedo-Cardalda ,&nbsp;I. de Oliveira","doi":"10.1016/j.acuro.2026.501926","DOIUrl":"10.1016/j.acuro.2026.501926","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Anabolic androgenic steroids are synthetic substances that mimic testosterone, promoting increased strength and muscle mass. Although they were initially used to achieve an increase in sports performance, nowadays most users are not professional athletes. Their use can cause various adverse effects, but despite these, they continue to be used to improve aesthetic and performance aspects. The purpose of this review of reviews was to examine the effects of anabolic androgenic steroids on male erectile function and related variables.</div></div><div><h3>Materials and methods</h3><div>A systematised literature review was carried out in Medline, Scopus, Pubmed, Cinahl, ScienceDirect, SPORTDiscus databases in July 2025. The search terms were ‘Anabolic Androgenic Steroids’, ‘Erectile Dysfunction’ and ‘Adverse effect’. The A Measurement Tool to Assess Systematic Review (AMSTAR-2) was used to assess the methodological quality of the selected reviews.</div></div><div><h3>Results</h3><div>Six systematic reviews were valid. Assessment of methodological quality using the AMSTAR-2 scale revealed that four reviews had critically low confidence, one review had low confidence, and one review had medium confidence. Despite methodological limitations, the reviews showed common findings associating prolonged use of anabolic androgenic steroids with the reduction in hormone levels, testosterone levels and reproductive function, leading to erectile dysfunction, in young adults (28-33 years) involved in weightlifting, powerlifting or bodybuilding.</div></div><div><h3>Conclusions</h3><div>The use of anabolic androgenic steroids appears to have a negative impact on erectile function and male reproductive health, with evidence of hypogonadism and hormonal alterations.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501926"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801967","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":"Factores predictivos del desarrollo de estenosis uretral en pacientes con tumor vesical: el papel de la terapia intravesical con BCG","authors":"İ.E. Ergín ,&nbsp;A. Sanci ,&nbsp;E. Hepşen ,&nbsp;K. Sarıkaya ,&nbsp;M. Yığman ,&nbsp;A.L. Sağnak ,&nbsp;A.N. Karakoyunlu","doi":"10.1016/j.acuro.2025.501908","DOIUrl":"10.1016/j.acuro.2025.501908","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the predictive role of intravesical Bacillus Calmette-Guérin (BCG) therapy on urethral stricture development in male patients undergoing bladder tumor surveillance, while also assessing the impact of repeated urethral instrumentation on stricture risk.</div></div><div><h3>Methods</h3><div>This retrospective study included male patients aged 18–90 with non-muscle invasive bladder tumors followed between 2018 and 2024. Demographics, cystoscopy and TUR procedures, intravesical treatments (BCG and chemotherapy), and urethral stricture diagnosis were recorded. Urethral stricture was confirmed by uroflowmetry, cystoscopy, and urethrography. Patients with prior urethral stricture or incomplete records were excluded. Statistical analyses included logistic regression to identify predictors of stricture development, adjusting for age and comorbidities. Sample size was calculated to ensure adequate power to detect a 15% difference in stricture incidence related to BCG therapy.</div></div><div><h3>Results</h3><div>A total of 187 male patients were analyzed, with a 12.3% urethral stricture incidence. BCG therapy was administered to 32.6% of patients and significantly increased stricture risk (OR: 4.11, p<!--> <!-->=<!--> <!-->0.015). Each additional dose was associated with an increased risk (OR: 2.11, p<!--> <!-->=<!--> <!-->0.001). TURP (OR: 2.95, p<!--> <!-->=<!--> <!-->0.045) and the number of cystoscopies (OR: 1.42 per procedure, p<!--> <!-->=<!--> <!-->0.040) were also significant predictors. Tumor size ≥3<!--> <!-->cm was associated with higher risk (OR: 1.88, p<!--> <!-->=<!--> <!-->0.037). Spearman analysis showed positive correlations between stricture severity and both BCG doses and cystoscopy number.</div></div><div><h3>Conclusion</h3><div>Intravesical BCG therapy, repeated cystoscopies, and TURP increase urethral stricture risk in bladder tumor patients. Preventive measures and careful monitoring are essential to reduce urethral complications.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501908"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801972","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":"Comparación de la mininefrolitotomía percutánea supina guiada por ecografía y por fluoroscopia: estudio retrospectivo unicéntrico basado en la experiencia clínica y la bibliografía actual","authors":"E. Ördek ,&nbsp;S. Toksöz ,&nbsp;K. Gümüş ,&nbsp;İ. Özdoğan","doi":"10.1016/j.acuro.2026.501930","DOIUrl":"10.1016/j.acuro.2026.501930","url":null,"abstract":"<div><h3>Introduction</h3><div>The utilisation of fluoroscopy in percutaneous nephrolithotomy (PCNL) gives rise to concerns regarding radiation exposure, thus necessitating the exploration of alternative methodologies. This study sets out to compare the efficacy and safety of ultrasound-guided supine mini-PCNL and fluoroscopy-guided supine mini-PCNL for renal stone management.</div></div><div><h3>Methods</h3><div>Adult patients with renal stones ≥15<!--> <!-->mm who underwent supine mini-PCNL were retrospectively reviewed. Patients were categorized into ultrasound-guided (US-PCNL, n<!--> <!-->=<!--> <!-->64) and fluoroscopy-guided (FL-PCNL, n<!--> <!-->=<!--> <!-->84) groups. Clinical variables, including operative time, number of puncture attempts, fluoroscopy duration, perioperative hemoglobin change, transfusion requirement, stone-free rate, complication rate, and length of hospital stay, were analysed. Surgical outcomes between the groups were compared using independent t-test or Mann-Whitney U test as appropriate. Wilcoxon test was used for dependent variables, and Chi-square test for categorical data.</div></div><div><h3>Results</h3><div>The US-PCNL group had a significantly shorter operative time and puncture time compared to the FL-PCNL group (<em>P</em>&lt;.05). No significant differences were found between the groups in terms of puncture attempts, tract formation rates, or stone-free rates (<em>P</em>&gt;.05). Postoperative complications, such as fever and the need for additional interventions, were similar between groups (<em>P</em>&gt;.05). Notably, the FL-PCNL group had a mean fluoroscopy duration of 6.3<!--> <!-->minutes, while the US-PCNL group had none.</div></div><div><h3>Conclusions</h3><div>Ultrasound-guided supine mini-PCNL offers a promising, radiation-free alternative to fluoroscopy in renal stone management. This study shows comparable outcomes between the two techniques, emphasizing the potential of ultrasound to improve patient safety in endourology.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501930"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801905","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 las reuniones multidisciplinarias en el manejo del cáncer de próstata metastásico en un centro de referencia","authors":"L.A. Pereira do Nascimento ,&nbsp;R.M. Mariano da Costa Junior ,&nbsp;V. Ramos Machado ,&nbsp;J.J. Saab Filho ,&nbsp;M.H. Bueno Bavaresco ,&nbsp;R. Panhoca ,&nbsp;W. Aparecido França ,&nbsp;L.A. Seabra Rios ,&nbsp;G. Pinheiro Soares","doi":"10.1016/j.acuro.2025.501905","DOIUrl":"10.1016/j.acuro.2025.501905","url":null,"abstract":"<div><h3>Introduction</h3><div>The management of metastatic prostate cancer (MPC) is complex and requires timely, coordinated decision-making across multiple specialties. Multidisciplinary team meetings (MDMs) have been increasingly adopted to optimize treatment planning, yet evidence regarding their impact on objective clinical outcomes in genitourinary cancers remains limited.</div></div><div><h3>Methods</h3><div>This retrospective, single-center cohort study compared two periods of MPC care: before MDM implementation (2018-2019) and after implementation (2021-2022). Patients were identified through institutional records. Demographic data, treatment timelines, therapeutic choices, and follow-up patterns were collected. Primary outcomes included time to clinical oncology consultation, time to treatment initiation, systemic therapy use, and follow-up adherence.</div></div><div><h3>Results</h3><div>One hundred thirty-nine patients were included, 72 in the 2018-2019 period and 67 in the 2021-2022 period. There was a significant reduction in the time taken to consult clinical oncology (<em>P</em>&lt;.05) and to start treatment (<em>P</em>&lt;.05). Systemic therapy started predominantly in the castration-sensitive setting (70.2 vs 14.3%; <em>P</em>&lt;.001). The MDM promoted a higher quality of treatment, with a greater prescription of docetaxel and novel antiandrogens (95.7 vs 64.3%; <em>P</em>=.001) and zoledronic acid in the castration-resistant phase (92.5 vs 79.2%; <em>P</em>=.047). The MDM discussion optimized follow-up, with loss to follow-up observed in only 7.5% of cases (<em>P</em>&lt;.001).</div></div><div><h3>Conclusion</h3><div>The implementation of multidisciplinary team meetings significantly improved the timeliness, quality, and adherence to oncological care for patients with metastatic prostate cancer. MDMs should be incorporated as a standard component of care in institutions managing this population.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501905"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801970","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":"Conducto ileal retrosigmoideo frente a técnicas tradicionales tras cistectomía radical: impacto en la incidencia de estenosis de la anastomosis ureteroileal","authors":"C. Casanova-Martín ,&nbsp;M. Álvarez-Maestro ,&nbsp;A. Rodríguez-Serrano ,&nbsp;A. Gómez-Villanueva ,&nbsp;A. Aguilera-Bazán ,&nbsp;M. Serrano-Liesa ,&nbsp;J.M. Alonso-Dorrego ,&nbsp;M.Á. Ortega-Núñez ,&nbsp;E. Ríos-González ,&nbsp;L. Martínez-Piñeiro Lorenzo","doi":"10.1016/j.acuro.2026.501934","DOIUrl":"10.1016/j.acuro.2026.501934","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Ureteroileal anastomotic stricture (UAS) is a relevant complication after radical cystectomy (RC). The retrosigmoid ileal conduit (RIC) may reduce its incidence by avoiding left ureteral transposition.</div></div><div><h3>Objective</h3><div>To compare the incidence of UAS, perioperative outcomes, and length of stay between RIC and conventional urinary diversions (Bricker / Wallace).</div></div><div><h3>Material and methods</h3><div>Retrospective, single-center observational study. All patients undergoing RC with bilateral urinary diversion were included: RIC between 01/2021-12/2024 and conventional techniques between 01/2018-12/2020. <em>Primary variable:</em> Multivariable logistic regression was performed using: age, body mass index (BMI), prior urinary tract dilation, Charlson Comorbidity Index (CCI), Eastern Cooperative Oncology Group (ECOG) score, and surgical technique. <em>Secondary variables:</em> operative time, 30-day postoperative complications (grouped as minor complications [Clavien 1-2] and major complications [Clavien ≥3]), time to stricture, length of hospital stay, and follow-up time after surgery.</div></div><div><h3>Results</h3><div>Seventy-one patients were analyzed: 36 RIC and 35 controls, with comparable baseline characteristics. UAS presented an incidence of 2.8% in RIC group and 22.9% in controls; the RIC technique was associated with a lower adjusted risk (OR: 0.05; 95% CI: 0.002-0.35; <em>P</em>=.011). Operative time was shorter with RIC (median: 292 [IQR: 274-315] vs. 330 [308-360] min; p<!--> <!-->=<!--> <!-->0.00025). There were no differences in major complications (11.1 vs. 17.1%; <em>P</em>=.51) or minor complications (33.3 vs. 42.9%; <em>P</em>=.41), nor in hospital stay (11.5 vs. 9 days; <em>P</em>=.23). The median follow-up was 18 months (RIC) and 39 months (control).</div></div><div><h3>Conclusions</h3><div>In our series, RIC significantly reduced UAS without increasing morbidity and was associated with a shorter operative time compared with traditional techniques. The results support the anatomical consistency and reproducibility of the technique.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501934"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801973","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 vigilancia activa como tratamiento de elección en el cáncer de próstata de bajo riesgo. Fiabilidad de resultados obtenidos a través de sistemas de procesamiento de lenguaje clínico y big data","authors":"C. García-Fuentes ,&nbsp;V. Hernández ,&nbsp;J. Arias ,&nbsp;M. López ,&nbsp;E. de la Peña ,&nbsp;A. Guijarro ,&nbsp;E. Pérez-Fernández ,&nbsp;C. Llorente","doi":"10.1016/j.acuro.2025.501907","DOIUrl":"10.1016/j.acuro.2025.501907","url":null,"abstract":"<div><h3>Introduction</h3><div>Advances in natural language processing (NLP) technologies have gained prominence for extracting relevant clinical information. Savana is a platform capable of analyzing free-text data and interpreting the content of electronic health records (EHRs).</div></div><div><h3>Objective</h3><div>To validate the results obtained through NLP by Savana from data of patients with prostate cancer (PC) included in active surveillance (AS), compare them with our database, and assess their reliability.</div></div><div><h3>Methods</h3><div>Observational and retrospective study of patients with PC in AS between 2014-2022. The results from our database were blinded to Savana. Information from the EHRs was transformed by Savana into analysis-ready data. After an initial evaluation, it was necessary to refine the preliminary results and readjust the variables and terminology to eliminate discrepancies.</div></div><div><h3>Results</h3><div>Of the 2,865 patients included in our database, 306 met the selection criteria. Savana detected 366 patients with the terms ‘PC’, ‘Gleason’, and ‘AS’. The results were similar regarding Gleason score at diagnosis: 93.4% Gleason 6 in our series vs. 92% in Savana. Likewise, the proportion of patients who received treatment with curative intent, and the type of treatment were comparable: 33.3% in our series (RP: 56.9%; RT: 42.1%) vs. 32.5% in Savana (RP: 59.7%; RT: 40.3%). However, only 24.8% showed Gleason progression in our series vs. 31% in Savana. The mortality rate was 3.2% in our series vs. 7.4% in Savana.</div></div><div><h3>Conclusions</h3><div>NLP represents a promising tool in clinical research, but its implementation should be approached with caution.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501907"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801986","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":"Prostatectomía radical sin biopsia previa en pacientes con imagenología positiva (PET-PSMA y/o mpMRI): una práctica utilizada, pero escasamente documentada. Cohorte multicéntrica retrospectiva","authors":"D.R. Magdaleno Rodríguez ,&nbsp;L. Almazán Treviño ,&nbsp;L. Lamm Wiechers ,&nbsp;R. González Cosió ,&nbsp;L.F. Galicia Belauzaran ,&nbsp;J.A. Herrera Muñoz ,&nbsp;M. Cantellano Orozco ,&nbsp;C. Martínez Arroyo ,&nbsp;G. Fernandez Noyola ,&nbsp;M.E. Ortega González ,&nbsp;I. Navarro Ruesga ,&nbsp;M.A. Ascencio Martínez ,&nbsp;C.A. Silva Mendoza ,&nbsp;H.A. Miranda Blasnich ,&nbsp;R.E. Domínguez Castillo ,&nbsp;A. Haddad Servín ,&nbsp;J.G. Morales Montor","doi":"10.1016/j.acuro.2025.501921","DOIUrl":"10.1016/j.acuro.2025.501921","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer (PCa) is the most common malignancy among men and currently ranks as the second leading cancer worldwide in terms of incidence. In 2021, a total of 35,764 new cases were diagnosed. The development of new imaging tools such as multiparametric magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography (PET-PSMA) has enabled the exploration of less invasive diagnostic strategies in clinically significant prostate cancer. However, performing radical prostatectomy without a prior biopsy remains an exceptional practice, scarcely documented and highly controversial.</div></div><div><h3>Objective</h3><div>To report a series of Mexican cases undergoing radical prostatectomy without prior biopsy, using PET-PSMA and mpMRI as the main diagnostic tools, and to propose a preliminary risk stratification model based on SUVmax values: the “M&amp;M's PSMA SCORE SUVmax”.</div></div><div><h3>Materials and methods</h3><div>Retrospective, observational, multicenter study of 18 patients treated between 2021 and 2024. Clinical variables, imaging findings, and histopathological results were analyzed. Sensitivity, positive predictive value (PPV), and correlation between SUVmax and ISUP grade were calculated.</div></div><div><h3>Results</h3><div>All cases confirmed clinically significant adenocarcinoma. PET-PSMA showed 100% sensitivity and PPV; mpMRI showed 93.3% sensitivity and 100% PPV. A positive correlation was found between SUVmax and ISUP grade (r=.84; <em>P</em>=.038). A preliminary classification based on SUVmax cut-off points was proposed.</div></div><div><h3>Conclusions</h3><div>This series suggests that, in selected contexts, PET-PSMA and mpMRI could support surgical decision-making even without prior biopsy. However, prospective studies are needed to validate both this strategy and the proposed stratification system.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501921"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578568","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":"Jornada urológica UROLATAM bajo el modelo MEDIUVer - UROLATAM para el desarrollo de acciones universitarias con impacto social","authors":"J.C. Viñas Dozal ,&nbsp;R. Edel Navarro ,&nbsp;A.M. Autrán Gómez ,&nbsp;F. Ruiz García ,&nbsp;V.G. Rojas Hernández ,&nbsp;J.M. Hurtado Capetillo ,&nbsp;C. Palmeros Exsome ,&nbsp;E. Castellanos Contreras ,&nbsp;A. Báez Jiménez ,&nbsp;J.E. Villegas Dominguez","doi":"10.1016/j.acuro.2025.501913","DOIUrl":"10.1016/j.acuro.2025.501913","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Urologic health is a global priority, particularly in Latin America, where access to quality services remains limited. This underscores the importance of collaboration among key societal sectors, including the public, private, and academic domains. The MEDIUVer–UROLATAM model emerged as a university-based urological health strategy to promote socially impactful activities, grounded in the university's core functions, collaborative work, and a targeted focus on specific social needs. The objective was to demonstrate the utility of the MEDIUVer – UROLATAM model as a framework to facilitate prostate cancer detection and prevention actions.</div></div><div><h3>Material and methods</h3><div>The MEDIUVer – UROLATAM model was implemented in three stages through a urological outreach program coordinated by the Latin American Institute of Urology (UROLATAM), the Faculty of Medicine of the Universidad Veracruzana, the private sector, government, and civil society, with the aim of timely prostate cancer detection. The initiative involved collaboration with the private sector, government agencies, and the community to facilitate the early detection of prostate cancer. Medical evaluations, diagnostic tests, and educational activities were conducted.</div></div><div><h3>Results</h3><div>A total of 1656 individuals were attended, with 1352 urological evaluations performed. The first stage focused on social action, the second strengthened inter-institutional collaboration, and the third incorporated educational research and healthcare services for the transgender population. This approach led to greater stakeholder integration and an expanded social impact.</div></div><div><h3>Conclusions</h3><div>The MEDIUVer–UROLATAM model is an educational, training, and care-oriented tool for both the general population and healthcare professionals in terms of timely prostate cancer detection and prevention.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501913"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578567","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}