Actas urologicas espanolas最新文献_第9页

Estado de la formación robótica en la residencia de urología: resultados de una encuesta nacional en España 泌尿外科住院医师机器人培训现状：西班牙全国调查结果

IF 1.2 4区医学

Actas urologicas espanolas Pub Date : 2024-09-01 DOI: 10.1016/j.acuro.2024.01.015

N. García-Formoso , R. Ballestero Diego , E. Seguí-Moya , E. Herrero Blanco , C. Mercader Barrull , D.A. González-Padilla , J.M. Benejam Gual

{"title":"Estado de la formación robótica en la residencia de urología: resultados de una encuesta nacional en España","authors":"N. García-Formoso , R. Ballestero Diego , E. Seguí-Moya , E. Herrero Blanco , C. Mercader Barrull , D.A. González-Padilla , J.M. Benejam Gual","doi":"10.1016/j.acuro.2024.01.015","DOIUrl":"10.1016/j.acuro.2024.01.015","url":null,"abstract":"<div><h3>Introduction and objective</h3><p>The increasing number of robotic urological procedures observed in recent years highlights the need to expand training opportunities in robotic surgery. Our objective is to investigate the state of robotic training during urology residency in Spain in order to identify significant deficiencies.</p></div><div><h3>Materials and methods</h3><p>A 20-item online survey was conducted among urology residents in Spain who were registered in the database of the Residents and Young Urologists Group of the Spanish Association of Urology. The survey assessed subjective opinions, institutional aspects, training resources, and experience regarding robotic surgery. A total of 455 email invitations were sent throughout the year 2021. Descriptive analysis of the responses was performed.</p></div><div><h3>Results</h3><p>The participation rate reached 30%, with a total of 135 residents. The 52% of respondents lacked access to a robotic system in their institution, of which only 48% could compensate for this deficiency through external rotations. Among those with access to a robotic system, 25% and 23% reported having access to theoretical and practical training, respectively. The existence of a formal training program was low (13%) and 85% of the respondents considered robotic surgery training in Spain to be deficient.</p></div><div><h3>Conclusions</h3><p>Training for Spanish residents in robotic urological surgery is perceived as inadequate, emphasizing the crucial need for improvement in training programs in this field.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 7","pages":"Pages 545-551"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142117600","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}

引用次数: 0

¿Por qué es necesario tener una cepa de BCG fabricada en España? 为什么必须在西班牙生产 bcg 菌株？

IF 1.2 4区医学

Actas urologicas espanolas Pub Date : 2024-09-01 DOI: 10.1016/j.acuro.2024.01.006

引用次数: 0

Prevalencia y manejo de la incontinencia urinaria asociada a cirugía de prolapso órgano pélvico (colposacropexia). Revisión de la literatura 与盆腔器官脱垂手术（COLPOSACROPEXY）相关的尿失禁的发生率和处理。文献综述

IF 1.2 4区医学

Actas urologicas espanolas Pub Date : 2024-09-01 DOI: 10.1016/j.acuro.2023.11.005

{"title":"Prevalencia y manejo de la incontinencia urinaria asociada a cirugía de prolapso órgano pélvico (colposacropexia). Revisión de la literatura","authors":"","doi":"10.1016/j.acuro.2023.11.005","DOIUrl":"10.1016/j.acuro.2023.11.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Stress urinary incontinence (SUI) is frequently associated with pelvic organ prolapse (POP) and may occur after its surgical treatment.</p></div><div><h3>Aim</h3><p>To determine the incidence, risk factors and management of SUI during and after POP surgery through a review of the available literature.</p></div><div><h3>Materials and method</h3><p>Narrative literature review on the incidence and management of SUI after POP surgery after search of relevant manuscripts indexed in PubMed, EMBASE and Scielo published in Spanish or English between 2013-2023.</p></div><div><h3>Results</h3><p>Occult SUI is defined as visible urine leakage when prolapse is reduced in patients without SUI symptoms. De novo SUI develops after prolapse surgery without having previously existed. In continent patients, the number needed to treat (NNT) to prevent one case of de novo SUI is estimated to be 9 patients and about 17 to avoid repeat incontinence surgery. In patients with occult UI, the NNT to avoid repeat incontinence surgery is around 7. Patients with POP and concomitant SUI are the group most likely to benefit from combined surgery with a more favorable NNT (NNT2).</p></div><div><h3>Conclusion</h3><p>Quality studies on combined surgery for treatment SUI and POP repair are lacking. Continent patients with prolapse should be warned of the risk of de novo SUI, although concomitant incontinence treatment is not currently recommended. Incontinence surgery should be considered on an individual basis in patients with prolapse and SUI.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 7","pages":"Pages 490-496"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139193931","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}

引用次数: 0

Manejo conservador del traumatismo renal de alto grado 高位肾创伤的保守治疗

IF 1.2 4区医学

Actas urologicas espanolas Pub Date : 2024-09-01 DOI: 10.1016/j.acuro.2024.01.001

{"title":"Manejo conservador del traumatismo renal de alto grado","authors":"","doi":"10.1016/j.acuro.2024.01.001","DOIUrl":"10.1016/j.acuro.2024.01.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Renal trauma is the most common of urological trauma and accounts for up to 5% of all. The AAST scale is the most widely used to assess renal trauma. This study focuses on high-grade trauma, whose treatment has evolved towards a conservative approach, with techniques such as angioembolization. The aim is to describe the evolution in the management of high-grade renal trauma in all patients treated at La Paz University Hospital from 2001 to 2022.</p></div><div><h3>Material and methods</h3><p>A descriptive retrospective study was conducted on patients treated at the hospital. The study was divided into two periods (2001-2010 and 2011-2022). A total of 285 patients with renal trauma were collected, of which 54 were high grade. The main variable is the type of management, conservative (embolization) or interventional through nephrectomy.</p></div><div><h3>Results</h3><p>In the completed series, there was a decrease in radical nephrectomy in high-grade renal trauma from 50% to 13.8% over time, with an increase in embolization from 23.1% to 44.8%. In patients with isolated renal trauma, those treated with embolization increased from 28.6% to 69.2%, while those undergoing radical/partial nephrectomy decreased from 42.8% to 7.69%.</p></div><div><h3>Conclusion</h3><p>The management of renal trauma has evolved over the years in our center. The number of patients treated by embolization has increased, while the number of complications and nephrectomies has decreased.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 7","pages":"Pages 521-525"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139539123","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}

引用次数: 0

Resultados quirúrgicos en mujeres diagnosticadas de endometriosis profunda con afectación urológica 被诊断为泌尿系统受累的深部子宫内膜异位症妇女的手术治疗效果

IF 1.2 4区医学

Actas urologicas espanolas Pub Date : 2024-09-01 DOI: 10.1016/j.acuro.2024.02.002

{"title":"Resultados quirúrgicos en mujeres diagnosticadas de endometriosis profunda con afectación urológica","authors":"","doi":"10.1016/j.acuro.2024.02.002","DOIUrl":"10.1016/j.acuro.2024.02.002","url":null,"abstract":"<div><h3>Introduction</h3><p>The prevalence of endometriosis is estimated to be about 10% among women of reproductive age. In about 5-10% of these patients, involvement of urological structures will be developed due to deep endometriosis. Urologists should be familiar with the management of these patients, who will require multidisciplinary care with medical and surgical treatment.</p></div><div><h3>Material and methods</h3><p>Retrospective study of patients diagnosed with deep endometriosis involving urological structures who underwent surgery performed jointly with gynecology and colorectal surgery departments from June 2012 until June 2021 (60 cases). Urologic symptoms were grouped into 3 groupers for subsequent analysis (storage symptoms, voiding symptoms, and low back pain).</p></div><div><h3>Results</h3><p>Storage symptoms (frequency and urgency) are the most frequent urologic symptoms. Patients with storage symptoms and low back pain showed improvement after surgery. In contrast, patients with voiding symptoms did not improve with surgical treatment.</p></div><div><h3>Conclusions</h3><p>The prevalence of endometriosis and the likelihood of involving urologic structures require the urologic community to be aware of the pathology.</p><p>Patients with storage symptoms will improve following excision of the endometriotic nodules. The need for Partial cystectomies with ureteral reimplantation can be safely performed by laparoscopic or robotic approach, even in previously operated patients, without compromising long-term function.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 7","pages":"Pages 532-537"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140273983","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}

引用次数: 0

¿Por qué los pacientes con derivaciones urinarias tienen un mayor riesgo de fractura ósea? Revisión sistemática sobre los factores de riesgo de osteoporosis y pérdida de densidad mineral ósea en este grupo de pacientes 为什么尿路改道患者的骨折风险会增加？关于该类患者骨质疏松症和骨矿物质密度下降风险因素的系统回顾。

IF 1.2 4区医学

Actas urologicas espanolas Pub Date : 2024-09-01 DOI: 10.1016/j.acuro.2023.11.007

{"title":"¿Por qué los pacientes con derivaciones urinarias tienen un mayor riesgo de fractura ósea? Revisión sistemática sobre los factores de riesgo de osteoporosis y pérdida de densidad mineral ósea en este grupo de pacientes","authors":"","doi":"10.1016/j.acuro.2023.11.007","DOIUrl":"10.1016/j.acuro.2023.11.007","url":null,"abstract":"<div><h3>Introduction</h3><p>Patients undergoing radical cystectomy with urinary diversions (UDs) are at increased risk of bone fractures compared to the general population. Although a loss of bone mineral density (BMD) has been described in patients with UDs, we still do not know with certainty why these patients follow this tendency.</p></div><div><h3>Objective</h3><p>We performed a systematic review of the available literature to analyze the prevalence of osteoporosis and bone alterations in patients with ileal UD and the possible associated risk factors.</p></div><div><h3>Evidence acquisition</h3><p>We systematically searched PubMed® and Cochrane Library for original articles published before December 2022 according to PRISMA guidelines.</p></div><div><h3>Evidence synthesis</h3><p>A total of 394 publications were identified. We selected 12 studies that met the inclusion criteria with 496 patients included. Six of the twelve studies showed decreased BMD values. Prevalence of osteoporosis was specified in three articles, with values ranging from 0% to 36%. Risk factors such as age, sex, body mass index, metabolic acidosis and renal function appear to have an impact on bone tissue reduction, while type of UD, follow-up, 25-hydroxyvitaminD and parathormone had less evidence or contradictory data. The heterogeneity of the studies analyzed could led to interpretation bias.</p></div><div><h3>Conclusions</h3><p>UDs are associated with multiple risk factors for osteoporosis and bone fractures. Identifying patients at highest risk and establishing diagnostic protocols in routine clinical practice are essential to reduce the risk of fractures and the resulting complications.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 7","pages":"Pages 497-511"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139191686","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}

引用次数: 0

Tasa de fluctuación del PSA: un indicador prometedor para el cribado del cáncer de próstata PSA 波动率：前列腺癌筛查的一个有前途的指标

IF 1.2 4区医学

Actas urologicas espanolas Pub Date : 2024-07-01 DOI: 10.1016/j.acuro.2023.11.008

U. Can , A. Coskun , C. Canakci , B. Simsek , Y. Karaca , K. Sabuncu , O. Akca

{"title":"Tasa de fluctuación del PSA: un indicador prometedor para el cribado del cáncer de próstata","authors":"U. Can , A. Coskun , C. Canakci , B. Simsek , Y. Karaca , K. Sabuncu , O. Akca","doi":"10.1016/j.acuro.2023.11.008","DOIUrl":"10.1016/j.acuro.2023.11.008","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate whether PSA fluctuation can be used to predict the risk of prostate cancer.</p></div><div><h3>Materials and methods</h3><p>The study included 1244 patients who underwent prostate biopsy at Kartal Dr. Lutfi Kirdar City Hospital between 2013 and 2021 (848 in non-cancer; 396 in cancer). The patient's age, last two PSA values (PSA<sub>1</sub> and PSA<sub>2</sub>) within three months before the biopsy, the duration between two PSAs (days), prostate size (g) and PSA density (PSAD) were all recorded. PSA fluctuation rate (PSAfr) was defined as the change rate between two PSA values.</p></div><div><h3>Results</h3><p>PSAfr was significantly higher in the non-cancer group than in the prostate cancer group (15.2% [20.5] and 9.6% [14.4], <em>P</em>  =.019). The odds ratio, adjusted for age, PSAD, and PSA2, was calculated as 0.545 (0.33-0.89) using logistic regression analysis to show the relationship between prostate cancer and PSAfr. As a result, those with high PSAfr were found to be 1.83 times less likely to be diagnosed with prostate cancer than those with low fluctuations.</p></div><div><h3>Conclusion</h3><p>PSAfr could be used in nomograms to predict prostate cancer risk and reduce the number of unnecessary biopsies.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 6","pages":"Pages 470-475"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139187826","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}

引用次数: 0

La experiencia del cirujano en la re-resección transuretral (RE-RTU) del cáncer de vejiga: un estudio prospectivo 外科医生经尿道膀胱癌切除术（TUR-RTU）的经验：一项前瞻性研究

IF 1.2 4区医学

Actas urologicas espanolas Pub Date : 2024-07-01 DOI: 10.1016/j.acuro.2023.10.007

C.N. Fernandes , L. Vale , J.V. Sousa , T.A. Lopes , C.M. Silva , J. Silva

{"title":"La experiencia del cirujano en la re-resección transuretral (RE-RTU) del cáncer de vejiga: un estudio prospectivo","authors":"C.N. Fernandes , L. Vale , J.V. Sousa , T.A. Lopes , C.M. Silva , J. Silva","doi":"10.1016/j.acuro.2023.10.007","DOIUrl":"10.1016/j.acuro.2023.10.007","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Transurethral resection of bladder tumor (TURBT) is crucial in the treatment of bladder tumors and when incorrectly performed can cause staging mistakes. To avoid these errors, a second resection is recommended in selected cases. The aim of this study is to evaluate the surgeon's ability to predict histologically complete primary resection of newly diagnosed bladder tumors avoiding the need for a second TURBT.</p></div><div><h3>Methods</h3><p>This is a prospective, observational study involving 47 consecutive patients with newly diagnosed bladder tumors who had previously undergone primary TURBT, and met EAU criteria for second-look TURBT. Second-look TURBT specimens were analyzed for routine histological assessment and compared with the surgeon's impression of the tumor at initial resection.</p></div><div><h3>Results</h3><p>Of 91 patients submitted to primary TURBT, 47 met the criteria for second-look TURBT. Second-look specimens revealed residual disease in 20.9% of patients and 3 (6.4%) of patients showed upstaging disease. The sensitivity of a senior to detect disease on second-look TURBT in relation to muscle invasion was 75%, and the specificity was 85%.</p></div><div><h3>Conclusions</h3><p>Second-look TURBT is crucial in the treatment of bladder cancer and cannot be replaced by a surgeon's opinion, so international recommendations should be followed. Supervision of less experienced surgeons is a cornerstone.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 6","pages":"Pages 448-453"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135515731","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}

引用次数: 0

La relación entre el virus del papiloma humano (VPH) y el diagnóstico de cáncer de vejiga: revisión sistemática y metaanálisis 人类乳头瘤病毒（HPV）与膀胱癌诊断之间的关系：系统回顾与荟萃分析

IF 1.2 4区医学

Actas urologicas espanolas Pub Date : 2024-07-01 DOI: 10.1016/j.acuro.2024.01.013

I.J. Otero-Muriel , S. Jiménez Giraldo , H.A. García-Perdomo

{"title":"La relación entre el virus del papiloma humano (VPH) y el diagnóstico de cáncer de vejiga: revisión sistemática y metaanálisis","authors":"I.J. Otero-Muriel , S. Jiménez Giraldo , H.A. García-Perdomo","doi":"10.1016/j.acuro.2024.01.013","DOIUrl":"10.1016/j.acuro.2024.01.013","url":null,"abstract":"<div><h3>Background</h3><p>Bladder cancer (BC) is the seventh most common cancer worldwide. Not every infection ends as cancer, although the HPV-induced carcinogenesis is a complex process consequence of inflammation. To determine the association between human papillomavirus (HPV) and the diagnosis of bladder cancer.</p></div><div><h3><em>Methods</em></h3><p>We carried out a systematic review according to Cochrane and PRISMA recommendations. We searched in EMBASE, Medline (Ovid), and The Cochrane Central Register of Controlled Trials (CENTRAL), from inception to nowadays. We included case-control studies. The risk of bias assessment was performed based on QUADAS2. We performed a random effect Meta-analysis.</p></div><div><h3>Results</h3><p>We included 14 studies in qualitative and quantitative analysis. There was mainly a low risk of bias. We finally found a strong association between the presence of HPV and bladder cancer diagnosis (OR 4.18 95%CI 2.63 to 6.66; I2=40%).</p></div><div><h3>Conclusions</h3><p>HPV is currently associated with the diagnosis of bladder cancer.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 6","pages":"Pages 427-436"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140467543","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}

引用次数: 0

Abordaje laparoscópico en pacientes con pielonefritis xantogranulomatosa y pionefrosis 黄疽性肾盂肾炎和肾盂积水患者的腹腔镜治疗方法

IF 1.2 4区医学

Actas urologicas espanolas Pub Date : 2024-07-01 DOI: 10.1016/j.acuro.2024.01.010

T. Telecan , I. Andras , N. Crousen , E.D. Cata , P. Medan , D.V. Stanca , A. Territo , I. Coman , N. Crisan

{"title":"Abordaje laparoscópico en pacientes con pielonefritis xantogranulomatosa y pionefrosis","authors":"T. Telecan , I. Andras , N. Crousen , E.D. Cata , P. Medan , D.V. Stanca , A. Territo , I. Coman , N. Crisan","doi":"10.1016/j.acuro.2024.01.010","DOIUrl":"10.1016/j.acuro.2024.01.010","url":null,"abstract":"<div><h3>Introduction</h3><p>Xanthogranulomatous pyelonephritis (XGPN) is a rare form of chronic renal inflammation, caused by long-term obstruction of the urinary tract. Pyonephrosis is a severe suppurative complication of acute obstructive pyelonephritis. Although minimally invasive approaches have many advantages, the safe dissection of the kidney may not be always achievable.</p></div><div><h3>Materials and methods</h3><p>We reviewed 27 cases diagnosed with either XGPN or pyonephrosis, who underwent laparoscopic total nephrectomy between October 2016 and March 2022 in our department. All interventions were performed using the Karl Storz 3D laparoscopic system. The surgical approach was standard transperitoneal nephrectomy for the majority of XGPN, while pyonephrosis cases were carried out in a retroperitoneally. All procedures were performed or supervised by the same surgeon.</p></div><div><h3>Results</h3><p>The mean operative time was 269.85minutes (range 145–360). The mean hemoglobin drop after surgery was 1.41g/dl (range 0.3–2.3g/dl). Difficult dissection was encountered in 13 cases (48.14%). Nine out of 13 interventions were carried out in a complete intracorporeal fashion, while conversion to open surgery was needed in 4 cases. Vascular complications involving the major blood vessels comprised of one case of inferior vena cava (IVC) tear. Digestive tract-related complications comprised two fistulas of the descending colon and one peritoneal breach. Multiorgan resection was performed in 6 cases.</p></div><div><h3>Conclusion</h3><p>Total nephrectomy in cases of XGPN and pyonephrosis is a challenging procedure. The laparoscopic approach is feasible, as most complications are resolved intracorporeally. However, it may remain reserved for large-volume centers with experienced surgeons.</p></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 6","pages":"Pages 476-483"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139830192","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}

引用次数: 0