Actas urologicas espanolas最新文献

{"title":"Actualización del consenso sobre el abordaje terapéutico del paciente con hiperactividad neurógena del detrusor","authors":"","doi":"10.1016/j.acuro.2024.04.004","DOIUrl":"10.1016/j.acuro.2024.04.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>A Consensus document on the management of patients with neurogenic detrusor overactivity (NDO) was published in 2018. The present document aims to update its recommendations regarding treatment considering the new evidence available, and to contribute to the standardization of the management of this disorder.</div></div><div><h3>Methods</h3><div>The methodology used was based on a systematic review and the Nominal Group Technique. The clinical coordinator (CC) and the Consensus update group (CUG) defined the questions to be updated and carried out a systematic review to identify the new available evidence. After being evaluated by the expert panel, the relevant recommendations were updated and agreed in a consensus meeting.</div></div><div><h3>Results</h3><div>A total of 3,210 publications were identified and 26 publications that met the inclusion criteria were included. The CUG updated 18 recommendations on the therapeutic approach to NDO. Unanimous consensus was reached on all of them.</div></div><div><h3>Conclusions</h3><div>Previous recommendations need to be revised due to the availability of new drugs, the increasing evidence on the use of botulinum toxin or neuromodulation procedures, and new surgical options.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 674-682"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141028370","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":"Morbilidad acumulada tras la ureteroscopia para el carcinoma urotelial del tracto superior","authors":"G. Basile ,&nbsp;A. Gallioli ,&nbsp;A. Territo ,&nbsp;P. Verri ,&nbsp;J.M. Gaya ,&nbsp;L. Afferi ,&nbsp;P. Diana ,&nbsp;I. Sanz ,&nbsp;L. Dieguez ,&nbsp;A. Uleri ,&nbsp;C. Berquin ,&nbsp;P. Gavrilov ,&nbsp;F. Algaba ,&nbsp;J. Palou ,&nbsp;A. Breda","doi":"10.1016/j.acuro.2024.02.007","DOIUrl":"10.1016/j.acuro.2024.02.007","url":null,"abstract":"<div><h3>Objective</h3><div>To assess complications after ureteroscopy (URS) for upper tract urothelial carcinoma (UTUC) management and to assess its postoperative cumulative morbidity burden using the Comprehensive Complication Index (CCI).</div></div><div><h3>Materials and methods</h3><div>Single center retrospective study including patients submitted to URS for UTUC suspicion. URSs were both diagnostic and operative. Postoperative complications were recorded according to the EAU Guidelines and graded according to Clavien-Dindo Classification (CDC). The cumulative postoperative morbidity burden developed by patients experiencing multiple events was assessed using the CCI. Multivariable logistic regression (MLR) analyses identified factors independently associated with the development of any grade and major postoperative complications.</div></div><div><h3>Results</h3><div>Overall, 360 patients with UTUC suspicion were included with a total of 575 URSs performed. The cumulative number of all postoperative complications recorded was 111. In 86 (15%) procedures, patients experienced at least one postoperative complication, while 25 (4.3%) experienced more than one complication. Of these, 16 (14%) were severe (CDC<!--> <!-->≥<!--> <!-->IIIa). The most frequent type of complications were urinary (34%), bleeding (30%) and infectious (30%). The higher the CDC grade, the higher the median CCI, with a statistically significant increase in median CCI from CDC II to major complications. Patients who experienced intraoperative complications were at higher risk of developing any grade and major postoperative complications at MLR.</div></div><div><h3>Conclusions</h3><div>Complications after ureteroscopy for UTUC are relatively uncommon events. Patients who experience intraoperative complications are at higher risk of developing postoperative complications. The CCI appeared more representative of the cumulative postoperative morbidity rather than the Clavien-Dindo classification.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 665-673"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573476","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":"¿Cuál es la relación entre el cáncer de pene y el microbioma? Una revisión exploratoria","authors":"","doi":"10.1016/j.acuro.2024.01.012","DOIUrl":"10.1016/j.acuro.2024.01.012","url":null,"abstract":"<div><h3>Introduction</h3><div>The microbiota is defined as the microorganisms in a particular environment. Conversely, the term microbiome is less firmly defined and is used to reference the habitat.</div></div><div><h3>Objective</h3><div>To identify the association between the microbiome and the penile cancer.</div></div><div><h3>Evidence Acquisition</h3><div>We performed this scoping review according to the recommendations of the Joanna Briggs Institute. We found five articles that fulfilled the inclusion criteria. We focused on oncogenesis and factors that alter the penile microbiome. We were not limited to language or setting. We searched MEDLINE (Ovid), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and LILACS from inception to the present day.</div></div><div><h3>Evidence Synthesis</h3><div>We found nine studies describing multiple factors that could disturb the microbiome, such as sexual behavior, anatomic alterations including circumcision, and inflammatory factors: lichen sclerosus, poor genital hygiene, compromised immune system, smoking, and HPV infection.</div></div><div><h3>Conclusion</h3><div>Overall, knowledge of the composition of the penile microbiota and its role in penile cancer oncogenesis is minimal.</div></div><div><h3>Patient Summary</h3><div>Future studies should focus on the relationship between the microbiome and penile cancer to broaden this field of knowledge.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 632-641"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139965865","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":"Alfabetización en salud en cáncer de próstata: ¿qué saben los varones españoles sobre el cáncer de próstata? Estudio descriptivo transversal","authors":"C. Romojaro-Pérez ,&nbsp;B. Navarro-Brazález ,&nbsp;J. Bailón-Cerezo ,&nbsp;M. Torres-Lacomba","doi":"10.1016/j.acuro.2024.05.006","DOIUrl":"10.1016/j.acuro.2024.05.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer is the tumor with the highest incidence in Spanish men. The implementation of health literacy and therapeutic education programs adapted to the needs of the population could be a resource to minimize the sequelae derived from the treatments used to combat this pathology. To this end, it would be necessary to know the level of health literacy about prostate cancer<strong>.</strong></div></div><div><h3>Objective</h3><div>To determine the level of health literacy in prostate cancer in the Spanish male population using the validated version of the PCKQ-12 for the Spanish population<strong>.</strong></div></div><div><h3>Methodology</h3><div>Cross-sectional, population-based, descriptive study. Spanish-speaking men of legal age were included. To carry out the study, an ad hoc questionnaire was designed on the Google Forms platform, which was distributed via WhatsApp. Previously, it was necessary to validate the PCKQ-12 to the Spanish population in 2<!--> <!-->phases, a first phase for translation and cross-cultural adaptation and a second phase to test the measurement properties.</div></div><div><h3>Results</h3><div>The Spanish version of the PCKQ-12 showed good language, conceptual, semantic and content equivalence and could be used to assess health literacy in prostate cancer. Three hundred and seventy Spanish men with a mean age of 43.87 (SD 13.65) years responded to the questionnaire. The level of prostate cancer health literacy found was low (6.72 points), being 2 points higher in health men<strong>.</strong></div></div><div><h3>Conclusion</h3><div>Health literacy about prostate cancer in the Spanish male population is low<strong>.</strong></div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 642-650"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573475","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":"Estudio piloto unicéntrico, doble ciego, aleatorizado y controlado con placebo para evaluar el uso de Canoxidin® en la prevención de la incrustación de la sonda en pacientes portadores de sonda permanente","authors":"","doi":"10.1016/j.acuro.2024.05.005","DOIUrl":"10.1016/j.acuro.2024.05.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Long-term use of an indwelling catheter is associated with complications such as catheter encrustation and infection. Canoxidin® is a novel oral treatment that can potentially prevent catheter encrustation, as it contains a urine acidifier and a combination of two crystallization inhibitors. This study aimed to evaluate the effects of Canoxidin® on catheter encrustation in patients with indwelling Foley catheters.</div></div><div><h3>Patients and methods</h3><div>This was a single-center, double-blind, randomized, placebo-controlled study. Neuro-urology patients aged ≥<!--> <!-->18<!--> <!-->years with an indwelling catheter (urethral or suprapubic) were randomized to treatment consisting of either Canoxidin® or placebo for one month. Foley catheters (two per patient, one before treatment and one after treatment) were removed for analysis of the presence and degree of encrustation.</div></div><div><h3>Results</h3><div>A total of 40 patients were enrolled and randomized, 28 of whom had analyzable catheters (13 assigned to Canoxidin® and 15 assigned to placebo). The patients had a mean age of 51.8<!--> <!-->years, and eight (28.6%) were female. Two patients (13.3%) in the placebo group and eight patients (61.5%) in the Canoxidin® group experienced an improvement (less encrustation). There was a significant association between Canoxidin® and improvement (odds ratio: 10.4, 95% confidence interval: 1.6 to 66.9, <em>P</em> <!-->=<!--> <!-->.016). No adverse effects attributable to the treatment were reported.</div></div><div><h3>Conclusions</h3><div>The overall rate of catheter encrustation was high among those with indwelling Foley catheters. One-month treatment with Canoxidin® reduced the formation of these encrustations, with an excellent short-term safety profile.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 658-664"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141395792","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":"Recomendaciones de tratamiento en el cáncer de próstata hormonosensible metastásico: selección de pacientes","authors":"","doi":"10.1016/j.acuro.2024.03.002","DOIUrl":"10.1016/j.acuro.2024.03.002","url":null,"abstract":"<div><div>The standard treatment for metastatic hormone-sensitive prostate cancer (mHSPC) is now a combination of androgen deprivation therapy plus an androgen receptor-targeted therapy (abiraterone, apalutamide, enzalutamide or darolutamide), with or without chemotherapy (docetaxel). The selection of suitable patients for each therapeutic approach has become a determining factor to ensure efficacy and minimize side effects. This article combines recent clinical evidence with the accumulated experience of experts in medical oncology, radiation oncology and urology, to provide a comprehensive view and therapeutic recommendations for mHSPC.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 623-631"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776855","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":"Cornada envainada: la paradoja de un trauma contuso-penetrante. Caso clínico","authors":"","doi":"10.1016/j.acuro.2024.04.003","DOIUrl":"10.1016/j.acuro.2024.04.003","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 9","pages":"Pages 683-684"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141032209","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":"¿Depende el éxito en nefrolitotomía percutánea solo del tamaño litiásico? Análisis de la capacidad predictiva de éxito y complicaciones de los actuales sistemas de puntuación de nefrolitometría y su relación con la superficie litiásica","authors":"","doi":"10.1016/j.acuro.2024.03.005","DOIUrl":"10.1016/j.acuro.2024.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the predictive capacity of the nephrolithometry scoring systems (GSS, STONE, CROES and S-ReSC) and stone surface regarding success and complications following percutaneous nephrolithotomy (PCNL).</div></div><div><h3>Methods</h3><div>We studied 392 patients who had undergone PCNL in our center. Only patients with a non-contrast CT (n<!--> <!-->=<!--> <!-->240) were finally included for analysis. The predictive capacities for success and complications of the different scoring systems were evaluated using ROC curves and their area under the curve (AUC).</div></div><div><h3>Results</h3><div>Regarding success, the S-ReSC system had the highest predictive capacity with an AUC of 0.681 (95% CI 0.610 - 0.751), followed by the CROES with 0.667 (95% CI 0.595 - 0.738), the STONE with 0.654 (95% CI 0.579 - 0.728) and finally the GSS with 0.626 (95% CI 0.555 - 0.698). The stone surface as a single variable had an AUC of 0.641 (95% CI 0.565 - 0.718). As for complications, the S-ReSC had the highest AUC with 0.664 (95% CI 0.57 - 0.758), followed by STONE with 0.663 (95% CI 0.572 - 0.755), GSS with 0.626 (95% CI 0.555). - 0.698) and CROES with 0.614 (95% CI 0.518 - 0.7). The stone surface alone had an AUC of 0.616 (95% CI 0.522 - 0.715).</div></div><div><h3>Conclusion</h3><div>The nephrolithometry scales analyzed show a moderate predictive capacity for success and complications in patients undergoing PCNL in our center. Moreover, stone surface as an independent variable demonstrates moderate predictive capacity for both outcomes.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 603-610"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140791705","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":"Prevalencia de mutaciones en genes de reparación en hombres mexicanos con cáncer de próstata","authors":"","doi":"10.1016/j.acuro.2024.03.003","DOIUrl":"10.1016/j.acuro.2024.03.003","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Mexico reported 26,742 new cases of prostate cancer in 2020. Different risk factors have been identified in the pathogenesis of prostate cancer. Among them, genetic factors and alterations or mutations in specific genes have been described in different ethnic groups worldwide. The aim of our study is to report the prevalence of germline DNA-repair gene mutations in Mexican patients with prostate cancer.</div></div><div><h3>Material and method</h3><div>We performed germline genetic testing in 50 patients with localized prostate cancer and 50 patients with metastatic prostate cancer. Demographic, clinical, and histopathological data were collected.</div></div><div><h3>Results</h3><div>Thirty-seven germline mutations were identified in 32 patients. The most commonly affected genes were <em>ATM</em> in 6%, followed by <em>FANCA</em> (5%), and <em>ATR</em> (4%). <em>BRCA2</em> mutations were identified in 3%. The frequency of mutations was higher in the metastatic group.</div></div><div><h3>Discussion and Conclusion</h3><div>The results of our study show different mutations from those reported in different populations or regions. The use of PARP inhibitors is indicated in patients with germline mutations, specifically BRCA2, showing improvement in overall survival and progression free survival. To our knowledge, this is the first study reporting the prevalence of mutations in DNA-repair genes in Mexican patients with prostate cancer.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 588-595"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776661","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":"Los últimos avances en prostatectomía robótica: ¿cómo lo hacemos en Cataluña, España?","authors":"","doi":"10.1016/j.acuro.2024.02.006","DOIUrl":"10.1016/j.acuro.2024.02.006","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Robotic-assisted laparoscopic prostatectomy (RALP) seems to improve functional outcomes, however there is not a consensus of a standard procedure. The aim of this study was to identify the RALP “state of art” in Catalonia, Spain.</div></div><div><h3>Material and methods</h3><div>This was a cross-sectional survey-based study conducted among urologists across Catalonia. The survey was distributed through online platforms and the professional urology society. All statistical analyses were performed using Stata software, v. 20.</div></div><div><h3>Results</h3><div>Fifty-nine urologists completed the survey, revealing RALP as the most commonly used technique (79.7%). Most urologist (70%) create the pneumoperitoneum using a controlled incision with direct access and 78.3% use the AirSeal® technology. The intraperitoneal approach is performed in more than 90% of cases. Endopelvic fascia preservation is not routinely performed. A percentage of 34.5 of the survey not perform the dorsal vein complex suture. All preserves the bladder neck when oncologically safe. Nerve-vascular bundles bleeding control is performed using standard coagulation or suturing. Thirty-four percent performed posterior reconstruction. Only use hemostatic devices when evident bleeding and 70% does not routinely left a drainage. Multivariable analysis showed that center volume had a significant independent association with dorsal venous complex suturing (OR 0.073, 95% <span>C</span>I 0.07-0.826), nerve-vascular bundles suturing hemostasis (OR 11.67, 95% CI 1.07-127.60) and endopelvic fascia preservation (OR 13.64, 95% CI 1.087-201.27), but there was no correlation with time the bladder catheter or days hospitalized.</div></div><div><h3>Conclusions</h3><div>The study provides an overview of the state of RALP in Catalonia, Spain, showing significant variability and reflecting a commitment to advancing surgical technology and patient care.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 581-587"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140406751","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}