{"title":"Aumento de la incidencia del cáncer testicular en España a pesar del descenso de la mortalidad: un análisis edad-periodo-cohorte","authors":"","doi":"10.1016/j.acuro.2024.03.004","DOIUrl":"10.1016/j.acuro.2024.03.004","url":null,"abstract":"<div><h3>Background</h3><div>Testicular cancer, primarily affecting young men, has seen an alarming rise globally. This study delves into incidence and mortality trends in Spain from 1990 to 2019 using the Global Burden of Disease (GBD) database and the Age-Period-Cohort (A-P-C) model.</div></div><div><h3>Methods</h3><div>We analyzed GBD data on testicular cancer cases and deaths in Spain, calculating age-standardized rates (ASIR and ASMR) and employing Joinpoint regression to identify significant shifts. The A-P-C model further dissected the effects of age, period, and birth cohort on these trends.</div></div><div><h3>Results</h3><div>A striking doubling in testicular cancer incidence was observed, from 3.09 to 5.40 per 100,000 men (1.9% annual increase), while mortality rates remained stable and even decreased in younger age groups (0.34 to 0.26 per 100,000, 0.8% annual decrease). Joinpoint analysis revealed four distinct periods of increasing incidence, with a recent slowdown. The A-P-C model highlighted a consistent rise in incidence risk with each successive generation born after 1935, contrasting with a progressive decline in mortality risk across cohorts, particularly marked for those born since the 1960s.</div></div><div><h3>Conclusion</h3><div>While mortality rates are encouraging, Spain reflects the global trend of escalating testicular cancer incidence. The A-P-C analysis suggests a generational influence, but the underlying causes remain elusive. Further research is crucial to understand these trends and implement effective prevention strategies to combat this growing health concern.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 596-602"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765065","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":"Coinfección de viruela del mono, COVID-19 y sífilis en un HSH usuario de PrEP: informe de un caso en Barcelona","authors":"","doi":"10.1016/j.acuro.2024.04.001","DOIUrl":"10.1016/j.acuro.2024.04.001","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 618-619"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140764471","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":"Tendencias de género en el Congreso Anual de la Asociación Española de Urología (AEU): revisión de los programas de la AEU en un periodo de 10 años (2012-2022)","authors":"","doi":"10.1016/j.acuro.2024.02.005","DOIUrl":"10.1016/j.acuro.2024.02.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Gender equity in urological meetings is pivotal for fostering diversity and inclusivity in the field. This study aims to evaluate the representation of Spanish urologist and regional disparities, and to assess its alignment with the demographic composition of the urological community.</div></div><div><h3>Materials and methods</h3><div>All urology meetings organized by the AEU between January 2012 and December 2022 were reviewed, including meeting information and details of the faculty. Additionally, we analysed geographic distribution of speakers across 17 different regions. Gender demographics were obtained disaggregating data by sex and year from the Organización Médica Colegial de España (OMC) and from those urologists affiliated to the AEU.</div></div><div><h3>Results</h3><div>Analysing 52 AEU congresses held from 2012 to 2022, encompassing 3,407 speakers, the study found that 95.25% of speakers were from Spain and 89.6% were male speakers. Over the years, there was a positive trend in female speaker representation, increasing by 1.1% annually, slightly lagging the 1.8% annual rise in the number of female urologists in Spain. In specific subfields like functional, transplantation, and oncology sessions, the study revealed a higher representation of women, indicating focused efforts in these areas. Geographically, Madrid, Catalonia and Andalusia exhibited the highest representation.</div></div><div><h3>Conclusions</h3><div>Although there was a positive trend towards an increased participation of female urologists in Spanish urological meetings, it fails to accurately reflect the proportional increase in the number of women entering the urology profession in recent years. This study underscores the importance of ongoing efforts to ensure diverse and balanced representation in urological forum.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 574-580"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140407819","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}
X. Zhu , C. Peng , Z. Wu , X. Zhang , S. Liu , Y. Luo , L. Yang
{"title":"Elaboración de un modelo experimental en conejos con diferentes grados de torsión testicular","authors":"X. Zhu , C. Peng , Z. Wu , X. Zhang , S. Liu , Y. Luo , L. Yang","doi":"10.1016/j.acuro.2024.04.007","DOIUrl":"10.1016/j.acuro.2024.04.007","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Different degrees of testicular torsion result in varying degrees of testicular damage, which influences treatment options and outcomes. Therefore, establishing a testicular torsion model with different degrees is necessary for clinical diagnosis.</div></div><div><h3>Materials and methods</h3><div>Rabbits were randomly divided into 4<!--> <!-->groups and their spermatic cords were twisted at 0°, 180°, 360°, and 720°, respectively. Color Doppler flow imaging (CDFI) were performed to evaluate the blood supply in testicles. The twisted testicles were surgically removed at 6<!--> <!-->hours post-operation and were evaluated by morphological observation and Hematoxylin and Eosin staining.</div></div><div><h3>Results</h3><div>CDFI signals were gradually decreased as the degree of testicular torsion increased, and scores of CDFI in the 360° and 720° groups were significantly decreased at postoperative 6<!--> <!-->hours compared to pre-surgery. Compared to the sham, the testicle in the 180° group exhibited slight congestion, whereas the testicles in the 360° and 720° groups were dark red in color and had severe congestion and unrecognizable vessels. Hematoxylin and Eosin staining showed mild spermatogenic cell reduction and testicular interstitial hemorrhage in the 180° group. In the 360° and 720° groups, disordered seminiferous tubules, shed spermatogenic cells in tubules, inflammatory cell infiltration, and severe hemorrhage were found. In comparison with the sham, interstitial hemorrhage scores in the 360° and 720° groups were significantly higher, and scores of germinal epithelial cell thickness in the 3<!--> <!-->testicular torsion groups were significantly decreased.</div></div><div><h3>Conclusion</h3><div>Collectively, we successfully constructed a testicular torsion model with different degrees in rabbits.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 565-573"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419845","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":"Colposacropexia robótica para el tratamiento del prolapso de órganos pélvicos en mujeres de edad avanzada: análisis comparativo de la seguridad y eficacia frente a mujeres jóvenes","authors":"","doi":"10.1016/j.acuro.2024.04.005","DOIUrl":"10.1016/j.acuro.2024.04.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Pelvic organ prolapse is a condition with high prevalence in elderly women. With increasing life expectancy and a desire for improved quality of life, a rise in the frequency of surgical treatments for these women is anticipated. The aim is to compare complication, success, and satisfaction rates among elderly patients (aged<!--> <!-->>70 years) in comparison to younger women undergoing robotic sacrocolpopexy, thereby assessing the safety and efficacy of this surgery in this group of patients.</div></div><div><h3>Method</h3><div>A prospective observational comparative study of 123 robotic sacrocolpopexies conducted between December 2016 and June 2022. Patients were stratified by age (cutoff point: 70 years). Baseline characteristics, type, and grade of prolapse, intra and postoperative data, complications, functional and anatomical outcomes, and satisfaction levels were collected.</div></div><div><h3>Results</h3><div>Among the 123 patients, 62.6% were under 70 years old, while 37.4% were 70 years or older, exhibiting similar baseline characteristics, prolapse grade, and type. The percentages of intraoperative (6.5%) and postoperative complications (4.4-9%) were comparable in both age groups. Furthermore, success and satisfaction rates exceeded 90%, with no significant differences between women under and over 70 years during a two-year follow-up.</div></div><div><h3>Conclusion</h3><div>Robotic sacrocolpopexy is at least as effective and safe in women aged 70 years or older as in younger individuals, with no higher rates of intra and postoperative complications and similar rates of anatomical and subjective success.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 611-617"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141041665","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":"El periplo de la determinación de la expresión de PD-L1 en el carcinoma urotelial infiltrante","authors":"","doi":"10.1016/j.acuro.2024.04.006","DOIUrl":"10.1016/j.acuro.2024.04.006","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 553-554"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141041649","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":"Utilidad de Bladder Epicheck® en el seguimiento del tumor de vejiga no músculo infiltrante: revisión sistemática de la literatura","authors":"","doi":"10.1016/j.acuro.2024.02.004","DOIUrl":"10.1016/j.acuro.2024.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent years, different urinary markers such as the Bladder Epicheck® have been developed in an attempt to reduce the number of cystoscopies in the follow-up of non-muscle invasive bladder cancer (NMIBC).</div></div><div><h3>Aim</h3><div>To provide a systematic review of Bladder Epicheck® and its current clinical utility in the follow-up and detection of recurrence of NMIBC.</div></div><div><h3>Material and methods</h3><div>Systematic review based on a literature search of PubMed, Web of Science and Scopus databases until October 2023, according to PRISMA and Quadas-2 criteria. Sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the marker were calculated. Diagnostic performance was evaluated by the area under the curve (AUC).</div></div><div><h3>Results</h3><div>Fifteen studies were analyzed (n<!--> <!-->=<!--> <!-->3761) including 86.7% prospective studies. Of the patient series, 53.2% had received previous intravesical instillations. The mean Se of the biomarker in the detection of recurrence varied according to tumor grade (87.9%-high grade/HG vs. 44.9%-low grade/LG, respectively). Their weighted mean Se and Sp were 71.6% and 84.5%, respectively. The mean recurrence rate was 29.1%. The weighted mean PPV and NPV were 56.4% and 92.8% (97.7% non-LG), respectively. The mean AUC was 85.63%.</div></div><div><h3>Conclusion</h3><div>Bladder Epicheck® is a useful urinary marker in the follow-up of NMIBC, with significantly high Se and NPV in the detection of recurrences, especially in cases of HG disease. Its use can reduce the number of cystoscopies required in the follow-up of NMIBC, improving the quality of life of patients and potentially increasing health economic savings.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 555-564"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140406235","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}
A. Ayranci, U. Caglar, A. Meric, M. Gelmis, O. Sarilar, F. Ozgor
{"title":"Impacto del tamaño de la lesión en las tasas de detección del cáncer de próstata clínicamente significativo en lesiones PI-RADS 3-5","authors":"A. Ayranci, U. Caglar, A. Meric, M. Gelmis, O. Sarilar, F. Ozgor","doi":"10.1016/j.acuro.2024.01.003","DOIUrl":"10.1016/j.acuro.2024.01.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Prostate cancer (PCa) ranks second among prevalent cancers in men, necessitating effective screening tools such as multiparametric magnetic resonance imaging (mpMRI) with the prostate imaging reporting and data system (PI-RADS) classification. This study explores the impact of lesion volume on clinically significant prostate cancer (csPCa) detection rates in PI-RADS 3–5 lesions, aiming to contribute insights into the underexplored relationship between lesion size and csPCa detection.</p></div><div><h3>Materials and methods</h3><p>A retrospective analysis was conducted on data from 754 patients undergoing mpMRI-guided transrectal ultrasound (TRUS) prostate biopsy between January 2016 and 2023. Patients with PI-RADS 3, 4, and 5 lesions were included. Lesion size and PI-RADS categories were assessed through mpMRI, followed by MR fusion biopsy.</p></div><div><h3>Results</h3><p>Of the patients, 33.7%, 52.3%, and 14.1% had PI-RADS 3, 4, and 5 lesions, respectively. Lesion sizes correlated significantly with csPCa detection in PI-RADS 4 and 5 categories. For PI-RADS 3 lesions, no significant differences in csPCa rates were observed based on lesion size. However, in PI-RADS 4 and 5 groups, larger lesions showed higher csPCa rates.</p></div><div><h3>Conclusions</h3><p>This study suggests that subgroup categorizations based on lesion volume could predict clinically significant PCa with high accuracy, potentially reducing unnecessary biopsies and associated overtreatment. Future research should further explore the relationship between lesion size and csPCa, clarifying discussions regarding the inclusion of systematic biopsies in diagnostic protocols.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 7","pages":"Pages 526-531"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142117599","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":"Efecto de la edad, el periodo y la cohorte en la incidencia del cáncer renal en España entre 1990 y 2019: datos del estudio Global Burden of Disease","authors":"","doi":"10.1016/j.acuro.2024.02.003","DOIUrl":"10.1016/j.acuro.2024.02.003","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to assess the influence of age, period, and cohort (A-P-C) factors on kidney cancer (KC) incidence trends in Spain from 1990 to 2019.</p></div><div><h3>Methods</h3><p>Employing data from the Global Burden of Disease Study 2019, we employed joinpoint analysis to determine long-term patterns and A-P-C modelling to quantify net drift, local drift, longitudinal age curves, and rate ratios (RRs) of period and cohort effects.</p></div><div><h3>Results</h3><p>Over the period 1990-2019, an estimated 142,811 cases of KC were diagnosed in Spain. A consistent upward trend in KC incidence was observed for both men and women, with the male-to-female ratio remaining stable at 2.6. Joinpoint analysis identified three distinct periods for men: An initial period (1990-1995) characterised by a significant increase in rates, a subsequent period (1995-2016) characterised by a slowdown in the rate of increase, and a final period (2016-2019) in which rates have plateaued. In women, 2 time periods were observed: an initial period (1990-2007) in which rates increased significantly, followed by a period of stabilization (2007-2019).</p><p>Men born in the early-mid 20th century had a rising KC risk, peaking in the 1960s. Women's risk rose steadily, peaking in the late 1990s.</p></div><div><h3>Conclusion</h3><p>A-P-C analysis reveals steady KC incidence increase in both genders over three decades. This highlights the need for targeted public health policies and effective prevention strategies.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 7","pages":"Pages 538-544"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276048","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":"Ensayo clínico aleatorizado: utilización de la luz IMAGE1S (SPIES) vs. luz blanca durante la resección transuretral de tumores vesicales para la prevención de recurrencias, análisis a los 12 meses de seguimiento","authors":"","doi":"10.1016/j.acuro.2023.10.004","DOIUrl":"10.1016/j.acuro.2023.10.004","url":null,"abstract":"<div><h3>Introduction</h3><p>The improved image resolution of IMAGE1 S technology will increase tumor detection, achieve a greater number of complete resections, and would probably have an impact on the reduction of recurrences.</p></div><div><h3>Aim</h3><p>The primary objective was to compare the recurrence rates of IMAGE1 S vs. white light during transurethral resection of the bladder; the secondary objective was to compare the complication rates according to Clavien-Dindo at 12 months of follow-up.</p></div><div><h3>Methodolgy</h3><p>Prospective, randomized 1:1, blinded clinical trial. Recurrence and complication rates according to Clavien-Dindo were analyzed using chi-square/U Mann-Whitney tests, and recurrence-free survival using Kaplan-Meier curves. The European Association of Urology 2021 scoring model was used.</p></div><div><h3>Results</h3><p>The analysis included 103 participants; 49 were assigned to the IMAGE1 S group and 54 to the white light group. Recurrence rates were 12.2% and 25.9%, respectively (<em>P</em> <!-->=<!--> <!-->.080). The low and intermediate risk group had a lower recurrence rate with IMAGE1 S (7.7% vs. 30.8%, <em>P</em> <!-->=<!--> <!-->.003) and a higher recurrence-free survival with IMAGE1 S (85.2% vs. 62.8% Log Rank: 0.021), with a Hazard Ratio of 0.215 (95% CI: 0.046-0.925). No differences were observed in the high and very high-risk groups. Complications were mostly grade I and rates were similar between both groups (IMAGE1 S 20.4% vs. white light 7.4% <em>P</em> <!-->=<!--> <!-->.083).</p></div><div><h3>Conclusions</h3><p>There were no differences in the recurrence rates between groups. However, the low and intermediate risk group had a lower recurrence rate with IMAGE1 S. In addition, perioperative complication rates were not higher.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 7","pages":"Pages 512-520"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136153985","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}