Actas urologicas espanolas最新文献

{"title":"Association between perioperative blood transfusion and survival outcomes after radical cystectomy for bladder cancer","authors":"R. Monsonís Usó,&nbsp;P. Ponce Blasco,&nbsp;Á. Canos Nebot,&nbsp;L. Barrios Arnau,&nbsp;A. Sánchez Llopis,&nbsp;C. Garau Perelló,&nbsp;M. Bosquet Sanz,&nbsp;P. Juan Verdoy,&nbsp;M. Rodrigo Aliaga","doi":"10.1016/j.acuroe.2026.502001","DOIUrl":"10.1016/j.acuroe.2026.502001","url":null,"abstract":"<div><h3>Introduction</h3><div>Perioperative blood transfusion (BT) has been suggested as a potential prognostic factor in patients undergoing radical cystectomy (RC) for bladder cancer, although its impact remains controversial. We aimed to evaluate the association between perioperative BT and short- and long-term outcomes in a contemporary single-center RC series.</div></div><div><h3>Materials and methods</h3><div>We retrospectively analyzed consecutive patients who underwent RC for bladder cancer at our institution between 2017 and 2024. Demographic, perioperative, and pathological variables were collected. Outcomes included 30-day mortality, overall survival (OS), and cancer-specific survival (CSS). Survival analyses were performed using Kaplan–Meier estimates and compared with the log-rank test. Multivariable Cox and logistic regression models were constructed to adjust for potential confounders.</div></div><div><h3>Results</h3><div>A total of 200 patients were included (median age 69 years [31–88]), of whom 105 (52.5%) received perioperative blood transfusion (BT). Median estimated blood loss was 700 mL (100–3500). Thirty-day mortality was 6% (12 patients). Overall survival (OS) was 63.5% (127 patients), and cancer-specific survival (CSS) was 72.5% (145 patients) at the end of follow-up. Perioperative BT was significantly associated with worse overall survival (HR 3.28, 95% CI 1.88–5.72, <em>p</em> &lt; 0.001), cancer-specific survival (HR 5.33, 95% CI 2.55–11.13, <em>p</em> &lt; 0.001), and increased 30-day postoperative mortality (OR 10.88, 95% CI 1.38–85.6, <em>p</em> = 0.024). In multivariable analyses, perioperative BT remained independently associated with worse OS and CSS, together with advanced pathological T stage, positive nodal status, and higher ASA score, but was not independently associated with 30-day mortality.</div></div><div><h3>Conclusions</h3><div>Perioperative blood transfusion was associated with worse overall and cancer-specific survival after radical cystectomy, but not with early postoperative mortality after adjustment. These findings should be interpreted as an association rather than a causal relationship, as residual confounding cannot be excluded. Strategies aimed at optimizing preoperative anaemia and reducing transfusion requirements may contribute to improving perioperative management in patients undergoing radical cystectomy.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 8","pages":"Article 502001"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Consensus on Improving the Care Pathway for Overactive Bladder from an Adherence Perspective: The claVHes Consensus","authors":"A. Casteig Blanco,&nbsp;M. Merino,&nbsp;A. Cornet Cortada,&nbsp;claVHes Group","doi":"10.1016/j.acuroe.2026.502008","DOIUrl":"10.1016/j.acuroe.2026.502008","url":null,"abstract":"<div><div>Overactive bladder management within the Spanish healthcare system faces significant challenges, including suboptimal therapeutic adherence. This consensus proposes recommendations to improve the care process (both clinical and organizational) from an adherence perspective. A Multidisciplinary Working Group of 14 members critically reviewed and discussed the literature (individually and in joint sessions) and formulated recommendations around five pillars: (1) strategic planning, with a realistic medium-term horizon and progress toward common protocols; (2) technological innovation and digitalization, enabling bidirectional communication among professionals, follow-up, clinical decision-making, and interoperability; (3) coordination and collaboration, across levels of care, healthcare professionals, and patients; (4) a focus on health outcomes and quality of life, with personalized treatments and continuous monitoring; and (5) social awareness and patient empowerment, increasing disease visibility, raising awareness among the public and patients, and fostering active patient participation.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 8","pages":"Article 502008"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trifecta and Pentafecta in HoLEP: predictors of functional success in a prospective multicentre cohort study.","authors":"J Fernández Siles, L E Ortega Polledo, J M Martí Flores, A Romero Crespo, D Carrasco Gómez, J M Losa Calero, A R Arroyo Ruíz, M M Martínez Morales, J A Rivero Esteban, S Alonso Y Gregorio, J Moreno Sierra, E García Galisteo, R España Navarro","doi":"10.1016/j.acuroe.2026.502061","DOIUrl":"10.1016/j.acuroe.2026.502061","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the achievement of the Trifecta and Pentafecta excellence criteria in patients undergoing HoLEP and to determine the preoperative predictive factors for their attainment.</p><p><strong>Material and methods: </strong>A multicentre prospective observational study was conducted. Trifecta criteria were defined as Qmax ≥ 15 mL/s, complete continence, and Clavien-Dindo score <2 at 3 months. Pentafecta was defined as Trifecta plus a significant response in IPSS and ICIQ-SF. Descriptive and comparative analyses were performed, along with multivariate logistic regression models to identify predictors of success.</p><p><strong>Results: </strong>A total of 376 patients were included for the Trifecta analysis, with a success rate of 53.2%. Preoperatively, there were no significant differences in the univariate analysis between the Trifecta and non-successful groups in Qmax (8.0 [6.2-10.4] vs. 8.15 [6.0-10.0] mL/s; p = 0.812), total IPSS (23.0 [17.3-28.0] vs. 23.0 [18.0-27.3]; p = 0.547), or ICIQ-SF (2.0 [0.0-9.5] vs. 4.0 [0.8-10.0]; p = 0.118). Postoperatively, the Trifecta group achieved significantly better results in Qmax (27.0 [21.0-34.8] vs. 14.0 [9.9-23.1] mL/s), IPSS (4.0 [2.0-7.0] vs. 8.0 [3.8-14.0]), and ICIQ-SF (1.0 [0.0-5.0] vs. 5.0 [1.0-10.5]), all with p < 0.001. In the multivariate analysis, the absence of previous treatment for storage symptoms (OR: 2.49; 95% CI: 1.18-5.23; p = 0.017) was independent predictors of Trifecta achievement. For Pentafecta (n = 245), the success rate was 44.5%, highlighting a lower baseline ICIQ-SF score in the success group (p < 0.001) CONCLUSION: The absence of previous treatment for storage symptoms was identified as the main independent determinant of surgical excellence in HoLEP.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"502061"},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the Quadruple-D score versus other nephrolithometric tools in obese patients undergoing percutaneous nephrolithotomy.","authors":"A Halis, U Caglar, R Yusuf, U C Aksu, O Sarilar, F Ozgor","doi":"10.1016/j.acuroe.2026.502062","DOIUrl":"10.1016/j.acuroe.2026.502062","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether the CT-based Quadruple-D score predicts stone-free status after percutaneous nephrolithotomy (PCNL) in obese patients and to compare it with established nephrolithometric scores, including SCR, CROES, Guy's Stone Score, and S.T.O.N.E.</p><p><strong>Methods: </strong>We retrospectively analyzed obese adults (BMI > 30 kg/m²) who underwent PCNL at a tertiary center between January 2013 and June 2025 and had preoperative non-contrast CT and 1-month postoperative imaging. The Quadruple-D score (0-4) assigned one point each for stone volume <500 mm³, attenuation <1000 HU, skin-to-stone distance <100 mm, and non-lower calyceal single-site distribution. Stone-free status was defined as no residual fragment >4 mm. Comparative statistical and ROC analyses were performed.</p><p><strong>Results: </strong>Among 104 patients, 56 were stone-free and 48 were not. Age, sex, BMI, ASA class, laterality, and hydronephrosis were similar between groups (all p > 0.05). Stone-free patients had smaller stones (20.0 vs 29.5 mm, p = 0.001) and lower stone burden (293.0 vs 587.0 mm², p = 0.001). SCR (98.8 ± 4.9 vs 74.9 ± 12.3, p = 0.001) and CROES (212.7 ± 41.1 vs 146.0 ± 55.8, p = 0.001) were significantly higher in the stone-free group. Guy's Stone Score was also associated with stone-free status (p = 0.001), whereas S.T.O.N.E. showed weaker significance (p = 0.028). Quadruple-D did not differ between groups (p = 0.581) and showed poor ROC performance.</p><p><strong>Conclusion: </strong>In obese patients undergoing PCNL, SCR, CROES, and Guy's Stone Score were useful predictors of stone-free outcomes, whereas the Quadruple-D score had limited predictive value.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"502062"},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Main pharmacological differences between mirabegron and vibegron for the treatment of overactive bladder","authors":"A. Alcántara Montero","doi":"10.1016/j.acuroe.2025.501868","DOIUrl":"10.1016/j.acuroe.2025.501868","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501868"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When evidence is not interchangeable: The limits of therapeutic equivalence in high-risk biochemical recurrence of prostate cancer","authors":"D. Pérez Fentes,&nbsp;A. Gómez Iturriaga,&nbsp;M. Ramírez Backhaus,&nbsp;J. Gómez Rivas,&nbsp;F. López Campos","doi":"10.1016/j.acuroe.2026.501989","DOIUrl":"10.1016/j.acuroe.2026.501989","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501989"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors and oncological outcomes after trimodality bladder-preserving therapy for muscle-invasive bladder cancer: A multicenter real-world study","authors":"N. Feltes Benítez,&nbsp;F. Couñago,&nbsp;S. Paredes-Rubio,&nbsp;P. Peleteiro Higuero,&nbsp;J.G. Molina Osorio,&nbsp;A. Folgar Torres,&nbsp;A. Aissati,&nbsp;A. Mera,&nbsp;J.R. Pastor Peidró,&nbsp;M.I. Garrido Botella,&nbsp;M. González de Dueñas,&nbsp;V. Duque-Santana,&nbsp;J. Torices Caballero,&nbsp;A. Pons Sánchez,&nbsp;J. Andreescu Yagüe,&nbsp;A. Rodríguez Pérez,&nbsp;S. Guardado González,&nbsp;S. Fernández Alonso,&nbsp;A. Lazo-Prados,&nbsp;M. Gaztañaga Boronat,&nbsp;E. González del Portillo","doi":"10.1016/j.acuroe.2026.501967","DOIUrl":"10.1016/j.acuroe.2026.501967","url":null,"abstract":"<div><h3>Introduction</h3><div>Trimodality therapy (TMT), consisting of maximal transurethral resection of the bladder tumor followed by concurrent chemoradiotherapy, is an established bladder-preserving option for selected patients with muscle-invasive bladder cancer (MIBC). However, contemporary multicenter real-world data are needed to better define oncological outcomes and prognostic factors in routine clinical practice.</div></div><div><h3>Methods</h3><div>We conducted a retrospective multicenter cohort study including 369 patients with cT2–T4aN0M0 MIBC treated with definitive TMT between 2010 and 2022. Time-to-event outcomes were measured from radiotherapy completion and estimated using the Kaplan–Meier method. Endpoints included overall survival (OS), cancer-specific survival (CSS), metastasis-free survival (MFS), and progression-free survival (PFS). Bladder-preservation outcomes included complete local response (CLR) at first assessment and salvage cystectomy. Prognostic factors were evaluated using multivariable Cox proportional hazards regression.</div></div><div><h3>Results</h3><div>Median age was 76 years (IQR 66.5–81.0), and 85.1% of patients were male. After a median follow-up of 27.4 months, OS at 1, 2, and 3 years was 85.8%, 75.7%, and 65.7%, respectively, while CSS was 90.5%, 84.7%, and 79.9%. MFS rates at 1, 2, and 3 years were 85.8%, 83.1%, and 80.6%, and corresponding PFS rates were 82.9%, 75.4%, and 71.6%. A complete local response was achieved in 63.7% of patients, and salvage cystectomy was required in 9.7%. On multivariable analysis, increasing age, poorer ECOG performance status, and lymphovascular invasion were independently associated with worse outcomes, whereas the use of modern radiotherapy techniques (IMRT/VMAT) was associated with improved survival compared with three-dimensional conformal radiotherapy.</div></div><div><h3>Conclusions</h3><div>In this large contemporary real-world cohort, trimodality therapy achieved effective cancer control with durable bladder preservation and a low salvage cystectomy rate. While overall survival was influenced by baseline patient fitness, cancer-specific and metastasis-free outcomes remained favourable. These findings support TMT as a robust bladder-preserving strategy in routine clinical practice, provided that appropriate patient selection and high-quality radiotherapy delivery are ensured.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501967"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early- and late-onset male genital organ cancer mortality trends in Spain, 1999–2023","authors":"L. Cayuela,&nbsp;R. Roldán-Testillano,&nbsp;A. Rodríguez-Serrano,&nbsp;L. Rodríguez-Sánchez,&nbsp;A. Cayuela","doi":"10.1016/j.acuroe.2026.501966","DOIUrl":"10.1016/j.acuroe.2026.501966","url":null,"abstract":"<div><h3>Objective</h3><div>To assess long-term mortality trends for male genital organ (MGO) cancers in Spain from 1999 to 2023, stratified by age group and tumour type.</div></div><div><h3>Methods</h3><div>A retrospective, population-based ecological study was conducted using mortality records from the Spanish National Institute of Statistics. Deaths were classified by ICD-10 codes: penile (C60), prostate (C61), testicular (C62), and other/unspecified (C63). Age-standardised mortality rates (ASMRs) were calculated using the 2013 European Standard Population. Temporal trends were evaluated with Joinpoint regression to estimate annual percentage change (APC) and average annual percentage change (AAPC). Analyses were stratified by early-onset (&lt;50 years) and late-onset (≥50 years) disease.</div></div><div><h3>Results</h3><div>From 1999 to 2023, 147,917 MGO-related deaths were recorded; prostate cancer comprised approximately 97%, predominantly in men aged ≥50 years. Crude mortality increased slightly over time due to population ageing, whereas prostate cancer ASMR decreased from 49.61 to 27.26 per 100,000 (AAPC −2.5%; 95% CI −2.7 to −2.3). A joinpoint in 2016 indicated a slowing decline thereafter (APC −1.3%). Testicular cancer mortality remained low and stable (AAPC −0.4%), with a minor reduction in older men but stable or slightly increasing patterns among younger men. Penile cancer mortality showed persistently low and unchanged rates (AAPC −0.8%). Early-onset prostate and penile cancer mortality was rare and exhibited stable trends.</div></div><div><h3>Conclusions</h3><div>MGO cancer mortality in Spain is overwhelmingly driven by prostate cancer, which has declinedC markedly over 25 years but has plateaued since 2016. Mortality from testicular and penile cancers remains low with limited age-specific variability.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501966"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective randomized evaluation of patient- and physician-reported pain concordance in flexible cystoscopy: impact of experience and anxiety","authors":"G. Ozgur,&nbsp;C. Ozdemiroglu,&nbsp;M. Kars,&nbsp;Y. Senoglu,&nbsp;H.K. Cam","doi":"10.1016/j.acuroe.2026.501982","DOIUrl":"10.1016/j.acuroe.2026.501982","url":null,"abstract":"<div><h3>Introduction</h3><div>Flexible cystoscopy is commonly performed under local anesthesia. This study explores the effects of pre-procedural anxiety, depression, and physician experience on both patient pain and the physician's perception of it.</div></div><div><h3>Methods</h3><div>This prospective, randomized study included 120 male patients (≥18 years), scheduled for flexible cystoscopy under intraurethral 2% lidocaine. Patients were randomly assigned to four groups based on the experience level of the physician. Pain perception was assessed using the Visual Analog Scale (VAS), while pre-procedural anxiety and depression were measured with the Hospital Anxiety and Depression (HAD) scale.</div></div><div><h3>Results</h3><div>Postoperative VAS-pain scores were slightly higher than preoperative values (2 vs. 1.5; p &lt; 0.001), but this difference was considered clinically negligible due to the overall low pain levels observed. Although doctors tended to underestimate patients' pain, a correlation was observed between patient- and physician-reported postoperative VAS-pain (r = 0.487, p &lt; 0.01). Physician experience did not significantly affect pain perception (p = 0.585). Interestingly, although the differences in VAS-scores are not clinically important, the correlation analysis revealed that less experienced physicians -residents- demonstrated a stronger concordance between their perception of patient pain and the patients’ self-reported pain (r = 0.798 and r = 0.633). HADS-anxiety scores correlated positively with both preoperative and postoperative pain and anxiety levels (r = 0.194–0.404, p &lt; 0.05), while HADS-depression showed no association.</div></div><div><h3>Conclusion</h3><div>Flexible cystoscopy performed under local anesthesia is a well-tolerated procedure, irrespective of the physician’s level of experience. The correlation between patient and physician pain scores suggests that physicians can reliably assess patient discomfort. Managing preoperative anxiety is essential to enhance patient comfort during the procedure.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501982"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic prophylaxis in urodynamics: A systematic review of secondary studies","authors":"L. Castillo Carvajal,&nbsp;C.A. Zapata,&nbsp;E. Corrales Acosta,&nbsp;C. Errando Smet,&nbsp;M. Przydacz,&nbsp;S. De Cillis,&nbsp;C.G. Tantay,&nbsp;P. Geretto,&nbsp;A.L. Caceres","doi":"10.1016/j.acuroe.2026.501984","DOIUrl":"10.1016/j.acuroe.2026.501984","url":null,"abstract":"<div><div>Urodynamics is the functional study of the urinary tract and an invasive diagnostic test that involves inserting a catheter into the bladder to assess bladder-related symptoms. One major risk is the development of urinary tract infections (UTI) following the procedure. Currently, there is no global consensus on the use of antibiotic prophylaxis. This study aims to identify key recommendations regarding prophylactic antibiotic therapy associated with urodynamic procedures. A systematic review of clinical practice guidelines (CPG), systematic reviews, and meta-analyses was conducted with subsequent quality evaluation. Out of 320 references, four clinical practice guidelines, one meta-analysis, and one systematic review were selected. Three clinical practice guidelines had acceptable global quality, and one was a “Best Practice Statement”.</div><div>All guidelines agree that antibiotic prophylaxis is not recommended for low-risk patients but should be used in those at high risk of postoperative infection. The meta-analysis concluded that prophylactic antibiotics could reduce the risk of asymptomatic bacteriuria and symptomatic UTI post-urodynamics without increasing the incidence of adverse events. For high-risk patients, the recommended antimicrobials include trimethoprim-sulfamethoxazole or fluoroquinolones, considering the institution’s resistance profile. These recommendations are based on expert panel opinions following a systematic literature review. Current evidence indicates that routine antibiotic prophylaxis prior to urodynamic studies is not warranted, as its primary benefit lies in reducing asymptomatic bacteriuria without significantly decreasing the incidence of symptomatic urinary tract infections. Prophylactic antibiotics should be reserved for patients at high risk of infection, with antimicrobial selection guided by local resistance patterns and an individualized assessment of risk and benefit.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501984"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}