Actas urologicas espanolas最新文献

{"title":"Influencia de la cirugía laparoscópica dentro de un protocolo de rehabilitación multimodal en cistectomía radical","authors":"L. Muñiz Suárez ,&nbsp;J. Subirá Ríos ,&nbsp;P. Gayarre Abril ,&nbsp;A. Montero Martorán ,&nbsp;J.I. Hijazo Conejos ,&nbsp;J. García Alarcón ,&nbsp;J. García-Magariño Alonso ,&nbsp;P. Medrano Llorente ,&nbsp;M. Ramírez Fabián ,&nbsp;F.X. Elizalde Benito ,&nbsp;C. Murillo Pérez ,&nbsp;M. Utrilla Ibuarben ,&nbsp;A. Asensio Matas ,&nbsp;C. Marín Zaldívar ,&nbsp;R. Casans Francés ,&nbsp;J.M. Ramírez Rodríguez ,&nbsp;B. Blasco Beltrán ,&nbsp;P. Carrera-Lasfuentes","doi":"10.1016/j.acuro.2023.11.003","DOIUrl":"https://doi.org/10.1016/j.acuro.2023.11.003","url":null,"abstract":"<div><h3>Introduction and objective</h3><p>The implementation of Enhanced Recover After Surgery (ERAS) multimodal rehabilitation protocols in radical cystectomy has shown to improve outcomes in hospital stay and complications. The aim of this analysis is to evaluate the impact of laparoscopic surgery on radical cystectomy within a Multimodal Rehabilitation program.</p></div><div><h3>Material and methods</h3><p>The study was carried out in a third level center between 2011 and 2020 including patients with bladder cancer submitted to radical cystectomy according to an ERAS (Enhanced Recovery After Surgery) protocol and the Spanish Multimodal Rehabilitation Group (GERM) with 20 items to be fulfilled.</p></div><div><h3>Results</h3><p>A total of 250 radical cystectomies were performed throughout the study period, 42.8% by open surgery (OS) and 57.2% by laparoscopic surgery (LS). The groups are comparable in demographic and clinical variables (<em>P</em>&gt;.05).</p><p>Operative time was longer in the LS group (248.4<!--> <!-->±<!--> <!-->55.0 vs. 286.2<!--> <!-->±<!--> <!-->51.9<!--> <!-->minutes; <em>P</em>&lt;.001). However, bleeding was significantly lower in the LS group (417.5<!--> <!-->±<!--> <!-->365.7 vs. 877.9<!--> <!-->±<!--> <!-->529.7 cc; <em>P</em>&lt;.001), as was the need for blood transfusion (33.6% vs. 58.9%; <em>P</em>&lt;.001). Postoperative length of stay (11.5<!--> <!-->±<!--> <!-->10.5 vs. 20.1<!--> <!-->±<!--> <!-->17.2 days; <em>P</em>&lt;.001), total and major complications were also significantly lower in this group (LS). The readmission rate was lower in the LS group but not significantly (36.4% vs. 29.4%; <em>P</em>=.237). The difference between 90-day mortality in both groups was not statistically significant (2.8% LS vs. 4.3% OS; <em>P</em>=.546). The differences were maintained in the multivariate models.</p></div><div><h3>Conclusions</h3><p>Laparoscopic surgery within a multimodal rehabilitation program increases operative time but significantly decreases intraoperative bleeding, transfusion requirements, postoperative length of stay, and complications.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 5","pages":"Pages 364-370"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141242715","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":"Tislelizumab, un nuevo anticuerpo monoclonal anti-PD-1 para el cáncer urotelial: estudio de vida real","authors":"Z. Wang,&nbsp;H. Bi,&nbsp;Y.D. Wang,&nbsp;Q. Liu,&nbsp;B. Shao,&nbsp;C.Q. Li,&nbsp;C. Fu,&nbsp;S. Fu,&nbsp;G.Y. Shan,&nbsp;A. Chen,&nbsp;C.C. Lv,&nbsp;Y. Zeng","doi":"10.1016/j.acuro.2023.10.010","DOIUrl":"10.1016/j.acuro.2023.10.010","url":null,"abstract":"<div><h3>Objective</h3><p>Tislelizumab, a monoclonal antibody against programed death protein-1 (PD-1), has shown encouraging antitumor activity in urothelial cancer. This study was designed to assess the efficacy and safety of tislelizumab in urotelial cancer in a real-world setting.</p></div><div><h3>Methods</h3><p>The study was a real-world retrospective study undertaken at Liaoning Cancer Hospital &amp; Institute, China. Eligible patients were ≥18 years. Patients received 200-mg tislelizumab monotherapy intravenously every 3 weeks until the disease progressed to intolerable toxicity. Outcomes included an objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and safety.</p></div><div><h3>Results</h3><p>Between March 2020 and December 2022, 33 patients were enrolled. The median follow-up was 10.17 (IQR 5.73-12.47) months. Of all 33 patients, ORR and DCR were 30.30% (95% CI 15.6-48.7%) and 42.42% (95% CI 25.48-60.78%), respectively. The median PFS was 5.73 (95% CI 3.27-13.00) months, with a 12-month PFS rate of 31.90% (95% CI 19.20-53.00%). The median OS was 17.7 (95% CI 12.80-not reach) months, with a 12-month OS rate of 67.50% (95% CI 52.70-86.40%). Eleven (33.33%) and 8 (24.24%) experienced ≥grade 3 treatment-related adverse events (TRAEs) and immune-related Aes, respectively. No treatment-related deaths occurred.</p></div><div><h3>Conclusion</h3><p>The excellent efficacy and controllable safety of tislelizumab in locally advanced or metastatic urothelial cancer suggest that it may be a promising therapeutic option for this population.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Pages 295-303"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139291900","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":"Infertilidad masculina y la calidad del sueño: otro punto clave a evaluar durante la consulta","authors":"W.F. Fernández-Zapata,&nbsp;W.D. Cardona-Maya","doi":"10.1016/j.acuro.2023.10.002","DOIUrl":"10.1016/j.acuro.2023.10.002","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Page 335"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136094470","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":"Implementación de los nuevos tratamientos para el tumor vesical no músculo invasivo que no responde al tratamiento con BCG. Aspectos a considerar en Latinoamérica","authors":"M.I. Fernández","doi":"10.1016/j.acuro.2024.03.001","DOIUrl":"https://doi.org/10.1016/j.acuro.2024.03.001","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Pages 257-259"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140815548","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":"Priapismo isquémico asociado al consumo de cocaína. Revisión sistemática y presentación de una serie de casos de un solo centro","authors":"C. Altez-Fernandez ,&nbsp;L. Lamas ,&nbsp;M. Bohorquez ,&nbsp;V. Chantada ,&nbsp;D. Ralph","doi":"10.1016/j.acuro.2023.10.006","DOIUrl":"10.1016/j.acuro.2023.10.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Ischemic priapism is a medical emergency that, if not treated, could lead to permanent erectile dysfunction. The association between cocaine and priapism is well-known; however, data on patient characteristics, treatment, and outcomes is missing.</p><p>This work aimed to answer the research question: What are the characteristics, management strategies, and erectile prognosis of patients consuming cocaine and presenting with priapism?</p></div><div><h3>Methods</h3><p>We conducted a systematic review according to PRISMA guidelines and described our case series.</p></div><div><h3>Results</h3><p>Eight studies were selected for qualitative synthesis, presenting information on ten patients. In our case series, we showed information regarding four patients. From the systematic review, the mean presentation time was 42.6<!--> <!-->hours, and the mean number of procedures to solve priapism was 2,4; in our case series was 42.75<!--> <!-->hours and 2, respectively.</p></div><div><h3>Conclusion</h3><p>Cocaine-related priapism might present with a delayed diagnosis, need more procedures to be managed, and have a worse prognosis. More extensive and prospective studies are required.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Pages 281-288"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135410469","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":"Análisis de coste de pruebas de nueva generación en estadificación de pacientes con cáncer de próstata de alto riesgo","authors":"J.J. Szczesniewski ,&nbsp;C. Tellez Fouz ,&nbsp;A. García Tello ,&nbsp;M. de la Rubia Marcos ,&nbsp;M.P. García Alonso ,&nbsp;L. Llanes González","doi":"10.1016/j.acuro.2023.10.008","DOIUrl":"10.1016/j.acuro.2023.10.008","url":null,"abstract":"<div><h3>Introduction and objective</h3><p>Next-generation imaging tests, such as choline PET/CT and PSMA PET, have shown to increase sensitivity in the detection of nodal and metastatic disease in prostate cancer. However, their use implies an increase in diagnostic costs compared to conventional imaging (CI) tests such as CT and bone scan. The aim of our study was to determine which diagnostic pathway is more cost-effective in high-risk prostate cancer.</p></div><div><h3>Material and method</h3><p>Cost-effectiveness analysis of the available imaging tests (CI, Choline/PSMA PET) for the staging of high-risk prostate cancer. Sensitivity and specificity were estimated based on published evidence, and costs were collected from the Management Department. In order to carry out a cost-effectiveness analysis, five diagnostic pathways were proposed estimating the accurate diagnoses.</p></div><div><h3>Results</h3><p>PSMA PET was the most accurate diagnostic option. The CI diagnostic workup was the most economical and CI<!--> <!-->+<!--> <!-->PSMA the most expensive. Analyzing the diagnostic cost-effectiveness ratio, CI<!--> <!-->+<!--> <!-->PSMA proved to be the most expensive (€5627.30 per correct diagnosis) followed by PET PSMA (€4987.11), choline (€4599.84) and CI (€4444.22).</p></div><div><h3>Conclusions</h3><p>PSMA PET is the most accurate strategy in staging distant disease in patients with high-risk prostate cancer. Radiotracer uptake tests such as CI have been shown to be the most cost-effective option, followed by choline and PSMA.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Pages 328-334"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139291749","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":"Entrenamiento del suelo pélvico para prevenir la incontinencia urinaria de esfuerzo: revisión sistemática","authors":"S.C. Mantilla Toloza,&nbsp;A.F. Villareal Cogollo,&nbsp;K.M. Peña García","doi":"10.1016/j.acuro.2024.01.007","DOIUrl":"10.1016/j.acuro.2024.01.007","url":null,"abstract":"<div><h3>Introduction</h3><p>Stress urinary incontinence (SUI) is a common disorder in women that has a negative impact on quality of life. Pregnancy and childbirth are considered important risk factors that directly affect the pelvic floor during pregnancy and labour, increasing the risk of pelvic floor dysfunction, with prevalence rates of SUI in the pospartum period ranging from 30 to 47% during the first 12 months.</p></div><div><h3>Objective</h3><p>To determine the effectiveness of pelvic floor muscle training (PFMT) in the prevention of SUI in women during the antenatal and posnatal period by reviewing and evaluating the available scientific literature.</p></div><div><h3>Methods</h3><p>This is a systematic review, using only randomised controlled trials. We searched the databases Pubmed, Scopus, Cochrane and PEDro. We reviewed 7 prospective studies in English and Portuguese, which included 1,401 pregnant women of legal age who underwent PFMT to prevent SUI.</p></div><div><h3>Results</h3><p>The results allowed us to establish that PFMT is used for pelvic floor muscles and that this intervention, applied with the appropriate methodology, can prevent or cure SUI.</p></div><div><h3>Conclusions</h3><p>The application of PFMT in an early stage of pregnancy has positive effects on the continence capacity after delivery.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Pages 319-327"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0210480624000135/pdfft?md5=723d9af0125102f942a47e0ca4de312c&pid=1-s2.0-S0210480624000135-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139818301","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":"La SBRT es una nueva opción de tratamiento en el cáncer renal","authors":"F. Couñago ,&nbsp;F. López-Campos","doi":"10.1016/j.acuro.2023.10.005","DOIUrl":"10.1016/j.acuro.2023.10.005","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Pages 260-261"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135221338","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":"Calidad de la consulta externa urológica en un hospital público de tercer nivel en México","authors":"R. Cortés-Ramírez ,&nbsp;C.B. Ruíz-Velasco ,&nbsp;A. González-Ojeda ,&nbsp;R.A. Ramírez-Aguado ,&nbsp;N.G. Barrera-López ,&nbsp;E. Gómez-Mejía ,&nbsp;K. Toala-Díaz ,&nbsp;G. Delgado-Hernández ,&nbsp;N.E. López-Bernal ,&nbsp;J.A. Tavares-Ortega ,&nbsp;J.M. Chejfec-Ciociano ,&nbsp;G. Cervantes-Guevara ,&nbsp;G. Cervantes-Cardona ,&nbsp;E. Cervantes-Pérez ,&nbsp;S. Ramírez-Ochoa ,&nbsp;A. Nápoles-Echauri ,&nbsp;A.S. Álvarez-Villaseñor ,&nbsp;A.O. Cortés-Flores ,&nbsp;C. Fuentes-Orozco","doi":"10.1016/j.acuro.2023.10.009","DOIUrl":"10.1016/j.acuro.2023.10.009","url":null,"abstract":"<div><h3>Introduction</h3><p>Patient satisfaction is the degree of conformity with the healthcare they receive. It is real evidence and one of the most important factors in determining the effectiveness and quality of healthcare systems.</p></div><div><h3>Objective</h3><p>To identify the quality of care in the Urology outpatient department of a third-level hospital.</p></div><div><h3>Materials and methods</h3><p>The NHS (National Health Service) 2018 quality of care questionnaire with 11 sections, 133 items, and duration of approximately 25<!--> <!-->minutes was randomly administered to 250 patients attending Urology outpatients at a third-level public hospital in Mexico.</p></div><div><h3>Results</h3><p>According to responses, 92% (n<!--> <!-->=<!--> <!-->230) knew the reason for the consultation. 64.8% (n<!--> <!-->=<!--> <!-->162) had a consultation with the same physician by whom they were initially seen. The longest reported hospital wait time before being seen was more than 2<!--> <!-->hours in 29.6% (n<!--> <!-->=<!--> <!-->74). As for consultation time, 212 patients responded and the duration was 11 to 20<!--> <!-->minutes in 52.8% (n<!--> <!-->=<!--> <!-->112). Finally, 33.2% (n<!--> <!-->=<!--> <!-->83) considered the quality of service to be good.</p></div><div><h3>Conclusions</h3><p>The use of the NHS 2018 survey in the Urology service at a third-level public hospital in Mexico is feasible, since we managed to obtain a significant and continuous improvement in all its indicators which is satisfactory for all.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Pages 289-294"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139294863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Documento multidisciplinar de consenso sobre el tratamiento actual del tumor vesical no-músculo invasor que no responde al tratamiento con bacilo Calmette-Guérin","authors":"F. Guerrero-Ramos ,&nbsp;M. Álvarez-Maestro ,&nbsp;Á. Pinto Marín ,&nbsp;J.L. Domínguez Escrig ,&nbsp;Ó. Rodríguez Faba","doi":"10.1016/j.acuro.2024.01.008","DOIUrl":"10.1016/j.acuro.2024.01.008","url":null,"abstract":"<div><p>Radical cystectomy is the current treatment of choice for patients with BCG-unresponsive non-muscle invasive bladder cancer (NMIBC). However, the high comorbidity of this surgery and its effects on the quality of life of patients require the investigation and implementation of bladder-sparing treatment options. These must be evaluated individually by the uro-oncology committee based on the characteristics of the BCG failure, type of tumor, patient preferences and treatment options available in each center. Based on FDA-required oncologic outcomes (6-month complete response rate for CIS: 50%; duration of response in responders for CIS and papillary: 30% at 12 months and 25% at 18 months), there is not currently a strong preference for one treatment over another, although the intravesical route seems to offer less toxicity. This work summarizes the evidence on the management of BCG-unresponsive NMIBC based on current scientific evidence and provides consensus recommendations on the most appropriate treatment.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 4","pages":"Pages 262-272"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139891453","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}