Actas urologicas espanolas最新文献

{"title":"Improving long-term monitoring in NMIBC: Digital Uromonitor® (dUM) as a complementary tool to cystoscopy for two-year recurrence risk stratification","authors":"J. Rubio-Briones,&nbsp;F. Guerrero Ramos,&nbsp;A. Mercadé Sánchez,&nbsp;I. Bezana Abadía,&nbsp;R. Martín Rodríguez,&nbsp;A. Alcaraz,&nbsp;M. Miqueleiz Legaz,&nbsp;F. Lozano,&nbsp;M. Arrabal Martín,&nbsp;A.L. Cardo,&nbsp;V. Gonzalo Rodríguez,&nbsp;J. Caño Velasco,&nbsp;M. Serrano Liesa,&nbsp;C. Ferreiro Pareja,&nbsp;R. Espílez Ortiz,&nbsp;I. González-Valcárcel de Torres,&nbsp;D. Sánchez Zalabardo,&nbsp;A. Guijarro,&nbsp;L. Mengual,&nbsp;A. Borque-Fernando,&nbsp;L. Martínez Piñeiro","doi":"10.1016/j.acuroe.2026.501994","DOIUrl":"10.1016/j.acuroe.2026.501994","url":null,"abstract":"<div><h3>Objective</h3><div>Non–muscle-invasive bladder cancer (NMIBC) has a high risk of recurrence and requires intensive long-term surveillance. Existing clinical risk models offer limited prognostic accuracy. Molecular urine-based assays may improve prognostic assessment accuracy of future recurrence. This study evaluated whether Digital Uromonitor® (dUM), detecting TERT and FGFR3 mutations via ddPCR, enhances prognostic assessment of two-year recurrence beyond cystoscopy and cytology in a prospective multicenter cohort.</div></div><div><h3>Methods</h3><div>This prospective, multicenter observational study (EVALUATION-CUETO; <span><span>NCT05864599</span><svg><path></path></svg></span>) enrolled consecutive NMIBC patients from 26 institutions. Eligible participants had an index tumor diagnosed 3 months–2 years before recruitment and completed two years of follow-up with sufficient DNA for dUM analysis. Clinical, pathological, and biomarker variables (cystoscopy, cytology, dUM) were collected. Recurrence rate was defined as events per year and classified as high (<em>R</em> &gt; 0.5) or low (<em>R</em> ≤ 0.5).</div></div><div><h3>Results</h3><div>Of 201 included patients, 75 (37%) were dUM-positive; TERT promoter mutations accounted for 88% of these cases. dUM showed prognostic value, correctly identifying 59% of recurrences over two years of standardized FU, outperforming cystoscopy alone (42%), with specificity of 74% and NPV of 78%. Combining dUM with cystoscopy increased sensitivity to 71%. Patients negative for both cystoscopy and TERT had the lowest recurrence risk (14%), whereas dual-positive patients exceeded 80%. High baseline recurrence rate consistently increased risk across all biomarker categories.</div></div><div><h3>Conclusions</h3><div>dUM provides robust, reproducible prognostic information and significantly improves molecular risk stratification in NMIBC. These findings support its potential integration into risk-adapted surveillance strategies, pending validation in larger populations.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501994"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038731","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":"Pelvic radiotherapy in high-risk prostate cancer: Beyond the irradiated volume","authors":"I. Henríquez,&nbsp;Ó. Abuchaibe","doi":"10.1016/j.acuroe.2026.501933","DOIUrl":"10.1016/j.acuroe.2026.501933","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501933"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313919","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":"Single-port robotic partial nephrectomy with the Da Vinci SP platform: Feasibility and early outcomes from the first Spanish series","authors":"V. Hevia-Palacios,&nbsp;R. Brime-Menéndez,&nbsp;C. Cámara-Martínez,&nbsp;R. Guevara,&nbsp;N. Paesano,&nbsp;E. García-Rojo,&nbsp;F. Barrientos,&nbsp;F. Lista-Mateos,&nbsp;J. Justo-Quintas,&nbsp;J. Romero-Otero","doi":"10.1016/j.acuroe.2026.501981","DOIUrl":"10.1016/j.acuroe.2026.501981","url":null,"abstract":"<div><h3>Introduction</h3><div>Single-port robot-assisted partial nephrectomy (SP-RAPN) is an emerging minimally invasive technique that integrates all instruments through a single multichannel port. Despite its increasing international use, European experience remains limited and no prior clinical series have been reported in Spain. This study aims to assess the feasibility, perioperative safety, and early outcomes of SP-RAPN in the first Spanish institutional experience.</div></div><div><h3>Materials and Methods</h3><div>Prospective observational study including the first eight consecutive patients undergoing SP-RAPN at a high-volume RAPN centre. Surgical approach was selected according to tumour location. Perioperative parameters, postoperative recovery, renal function at 3 months, and pathological outcomes were collected.</div></div><div><h3>Results</h3><div>All procedures were completed successfully without conversion. Mean tumour size was 33 mm and mean RENAL score 7. Access was transperitoneal in 50%, pure retroperitoneal in 25%, and SARA/LAA in 25% of cases. Mean warm ischemia time was 19 min and mean operative time 123 min. Estimated blood loss was low (125 mL), and no transfusions were required. Only one minor complication (Clavien I) occurred. Serum creatinine remained stable postoperatively and at 3 months. Final pathology confirmed renal cell carcinoma in 7 patients, with negative surgical margins in 87.5%. Early recurrence-free survival was 100%.</div></div><div><h3>Conclusions</h3><div>SP-RAPN is a feasible, reproducible, and safe procedure for localized T1 renal tumours. Perioperative, functional, and oncologic outcomes were favourable and within the ranges reported for RAPN in contemporary series. The versatility of transperitoneal, retroperitoneal, and SARA/LAA approaches may further expand its indications. Future multicentre studies with larger cohorts and long-term follow-up will be essential to confirm the durability and clinical benefits of this promising technique.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501981"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618916","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":"A new adjacent tool in the management of clinical T1a solid renal masses","authors":"T. Asi,&nbsp;M. Altan,&nbsp;E. Karabulut,&nbsp;M.S. Yazici,&nbsp;B. Akdogan,&nbsp;H. Ozen","doi":"10.1016/j.acuroe.2026.501927","DOIUrl":"10.1016/j.acuroe.2026.501927","url":null,"abstract":"<div><h3>Objectives</h3><div>To present a new nomogram that uses preoperative clinical features to predict benign pathology in clinical T1a solid renal masses.</div></div><div><h3>Materials and methods</h3><div>Demographic, clinical and pathologic data related to 579 patients diagnosed with clinical solid T1a renal mass were retrospectively collected. Univariate and multivariable logistic regression analyses were used to determine the variables related to benign pathology. Variables with statistical significance were used to develop a nomogram.</div></div><div><h3>Results</h3><div>The female-to-male ratio was 240/339, with a median age of 56 (47–64) years. 40% (232/579) of all patients had a diagnosis of hypertension or diabetes mellitus or both. All patients had solitary renal lesion with a median size of 3.0 (23–35) cm. Cystic component was noticed in 20.7% (119/579) of the lesions.</div><div>Benign pathology was detected in 19.9% (115/579) of cases. On univariate analysis, female gender, age less than 60 years, absence of hypertension or diabetes mellitus, symptomatic presentation, smaller tumor size and absence of cystic component were all related to benign pathology. Female gender, age less than 60 years, smaller tumor size and absence of cystic component kept their significance on multivariable analysis. A nomogram was built depending on these variables. The model was close to the ideal and had a c-index value of 0.79.</div></div><div><h3>Conclusion</h3><div>The nomogram in the present study has good predictive ability for benign pathology in T1a solid renal masses. This will help physicians and patients while making decisions related to the management paradigm.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501927"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198357","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":"Clinical and tumor-related determinants of early morbidity and prolonged hospital stay after TUR-BT","authors":"Y.M. Aydın,&nbsp;O. Ozdel,&nbsp;N.A. Mungan","doi":"10.1016/j.acuroe.2026.501987","DOIUrl":"10.1016/j.acuroe.2026.501987","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Transurethral resection of bladder tumor (TUR-BT) morbidity rates vary widely in the literature (4.3%–43.5%), and differences across studies reflect differences in patient populations and definitions of adverse events. We aimed to identify independent risk factors for postoperative complications and prolonged length of hospital stay (LOS) following TUR-BT.</div></div><div><h3>Materials and methods</h3><div>We analyzed data from 803 patients who underwent bipolar TUR-BT between 01/2012 and 10/2024. Demographic, clinical, and pathological variables were evaluated, including age, sex, ASA score, tumor size, number, morphology, grade, stage, resection status, intravesical treatment, history of prior TUR-BT, and reTUR-BT. Complications occurring within 30 days were classified according to the Clavien–Dindo system. A hospital stay exceeding the study’s median LOS (&gt;3 days) was defined as prolonged. Logistic regression models were used to identify independent predictors of complications and prolonged LOS.</div></div><div><h3>Results</h3><div>Postoperative complications occurred in 10.6% of cases, most of which were low-grade (Clavien–Dindo I–II, 82.3%). Hematuria and urinary tract infections were the most common events. Independent predictors of complications included higher ASA scores (3−4) (OR = 2.075, p = 0.016), tumor multiplicity (OR = 1.878, p = 0.021), incomplete resection (OR = 2.247, p = 0.018), pT2 stage (OR = 3.188, p = 0.002), and CIS (OR = 3.476, p = 0.017). Prolonged LOS was independently associated with larger tumor size (OR = 1.009, p = 0.005), non-papillary morphology (OR = 1.903, p = 0.001), incomplete resection (OR = 1.904, p = 0.035), reTUR-BT (OR = 1.926, p = 0.001), and the presence of complications (OR = 4.777, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>TUR-BT is generally safe; however, early morbidity and prolonged hospitalization are influenced by tumor characteristics, operative factors, and patient comorbidity, informing perioperative risk stratification.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501987"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793783","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":"Predictive factors for biochemical recurrence after radical prostatectomy in ISUP Grade Group 1 prostate cancer: a retrospective cohort with long-term follow-up","authors":"L. Diéguez-Álvarez,&nbsp;A.I. Hernández Álvarez,&nbsp;J. Panach-Navarrete,&nbsp;A. Castelló-Porcar,&nbsp;L. Esteban-Igual,&nbsp;J.M. Martínez-Jabaloyas","doi":"10.1016/j.acuroe.2026.501979","DOIUrl":"10.1016/j.acuroe.2026.501979","url":null,"abstract":"<div><h3>Introduction</h3><div>The clinical relevance of biochemical recurrence (BCR) after radical prostatectomy (RP) in ISUP Grade Group 1 prostate cancer is unclear. We evaluated the incidence of BCR, its pathological predictors, and long-term oncologic outcomes in this population.</div></div><div><h3>Materials and methods</h3><div>Retrospective observational study of consecutive patients who underwent RP between 1999 and 2012 with ISUP GG 1 adenocarcinoma in the specimen. BCR was defined as PSA ≥ 0.2 ng/mL in two consecutive measurements after postoperative nadir. BCR-free survival and overall survival were estimated using Kaplan–Meier analysis, and predictors of BCR were identified using Cox regression. Salvage treatments, events of radiologic progression, and mortality were described.</div></div><div><h3>Results</h3><div>A total of 208 patients were included. The median follow-up was 12.1 years. BCR was observed in 45 (21.6%), with a median time to BCR of 5.2 years (IQR 2.3–7.5). Five-year BCR-free survival was 92%, 81% at 10 years, and 78% at 15 years. Positive surgical margins were the only independent predictor of BCR (HR 3.27; 95% CI 1.64–6.53; p &lt; 0.001). Eleven patients with BCR (24.4%) received salvage radiotherapy. Only 3 patients developed radiologic progression (1.4%); 42 deaths (20.2%) were recorded; none of them were cancer-specific deaths.</div></div><div><h3>Conclusions</h3><div>In ISUP grade group 1 prostate cancer treated with RP, BCR is relatively common but rarely associated with radiologic progression; no cancer-specific deaths were observed during long-term follow-up. Positive margins were associated with a higher risk of BCR.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501979"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mini-percutaneous nephrolithotomy versus flexible ureteroscopic holmium laser lithotripsy using a negative-pressure ureteral access sheath: a minimally invasive approach for renal calculi","authors":"Q. Chen,&nbsp;P. Liu,&nbsp;F. Peng,&nbsp;Y. Zhang","doi":"10.1016/j.acuroe.2026.501978","DOIUrl":"10.1016/j.acuroe.2026.501978","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal calculi are a common urological condition, and minimally invasive surgical techniques have become the mainstay of treatment. We evaluated and compared the clinical effectiveness of mini-percutaneous nephrolithotomy (mini-PCNL) and flexible ureteroscopic holmium laser lithotripsy (FURL) assisted by a negative-pressure ureteral access sheath (NPUAS) in the management of renal calculi.</div></div><div><h3>Methods</h3><div>A total of 124 patients with renal calculi were assigned to mini-PCNL (n = 62) or NPUAS-FURL (n = 62) groups. Surgical parameters (operative time, blood loss), hospitalization, stone clearance, efficacy, complications, renal function (Scr, BUN, UA), inflammatory markers (IL-6, CRP, PCT), and postoperative pain (VAS at 4/12/24/48 h) were evaluated.</div></div><div><h3>Results</h3><div>Compared with mini-PCNL, the NPUAS-FURL group demonstrated shorter operative and hospitalization times and reduced intraoperative bleeding (<em>P</em> &lt; 0.05). Stone clearance and overall efficacy were higher in the NPUAS-FURL group (95.16% each) than in the mini-PCNL group (77.42% and 80.65%; <em>P</em> &lt; 0.05). The incidence of complications was similar between groups (14.52% vs. 22.58%, <em>P</em> &gt; 0.05). At 24 h postoperatively, Scr, BUN, UA, IL-6, CRP, and PCT increased in both groups but remained significantly lower in the NPUAS-FURL group (<em>P</em> &lt; 0.05). VAS scores progressively decreased over time, with consistently lower values observed in the NPUAS-FURL cohort (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>NPUAS-assisted FURL outperforms mini-PCNL in renal calculi treatment, offering higher stone clearance, reduced trauma, better renal function preservation, milder inflammation, and less pain, with comparable safety.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 7","pages":"Article 501978"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618888","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":"The role of stone composition in determining outcomes after percutaneous nephrolithotomy.","authors":"S Avci, O Ekici, E Buyukdemirci, U Akgun, I Yilmaz, E Onen, A Erdogan, V Caglayan, S Oner","doi":"10.1016/j.acuroe.2026.502050","DOIUrl":"10.1016/j.acuroe.2026.502050","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of stone composition on peroperative and postoperative outcomes in patients undergoing percutaneous nephrolithotomy (PCNL).</p><p><strong>Methods: </strong>We retrospectively analyzed data from 152 patients who underwent PCNL at our institution between January 2020 and August 2024. Patients were divided into subgroups based on stone composition: calcium oxalate, calcium phosphate, uric acid, cystine, and struvite. We compared peroperative and postoperative outcomes, including stone-free rates, complications, and the need for auxiliary procedures, between the groups.</p><p><strong>Results: </strong>The overall stone-free rate was 63.8%. When complications were grouped as minor and major according to Clavien, no statistically significant difference was found between the groups in terms of patient characteristics, stone characteristics and perioperative techniques. When patient characteristics, stone characteristics and perioperative data were compared between stone compositions, statistically significant differences were found between the groups in terms of age, gender, comorbidity, The American Society of Anesthesiologists (ASA) score, stone size and stone density. Stone-free rates varied significantly based on stone composition (p = 0.024). There was a statistically significant association between stone composition and postoperative sepsis (p < 0.001).</p><p><strong>Conclusion: </strong>Stone composition can significantly impact stone-free rates and postoperative complications in patients undergoing PCNL. These results underscore the importance of considering stone composition when planning PCNL and tailoring treatment strategies.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"502050"},"PeriodicalIF":0.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681877","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":"Effectiveness and safety of hormonal doublet therapy in metastatic hormone-sensitive prostate cancer: A multicenter real-world study.","authors":"P Guedes Oliva, D Pérez-Fentes, P De Pablos-Rodríguez, C Bardella-Altarriba, A Díaz-Pedrouzo, J Abuin-García, F J Vera-Ballesteros, A Abella-Serra, D Ribera-Díaz, M E Martínez-Corral, Á Gómez-Ferrer, N Picola-Brau, S Martínez-Breijo, M Costa-Planells, A López-Abad, M García-Puche, P Jiménez Marrero, R Martínez Corral","doi":"10.1016/j.acuroe.2026.502049","DOIUrl":"10.1016/j.acuroe.2026.502049","url":null,"abstract":"<p><strong>Introduction: </strong>Hormonal doublet therapy is currently a standard treatment strategy for metastatic hormone-sensitive prostate cancer (mHSPC). Evidence from clinical trials and real-world studies has consistently demonstrated survival benefits.</p><p><strong>Objectives: </strong>To describe the clinical characteristics, diagnostic and therapeutic approach, oncological outcomes, and treatment tolerability in a multicenter cohort of patients with mHSPC treated with hormonal doublet therapy.</p><p><strong>Materials and methods: </strong>This multicenter retrospective study included patients diagnosed with mHSPC who received hormonal doublet therapy between 2017 and 2025. A descriptive analysis of clinical variables and efficacy and safety outcomes was performed. Statistical analyses were conducted using SPSS version 25.</p><p><strong>Results: </strong>A total of 1062 patients were included, with a median age of 72 years (IQR, 66-77) and a median follow-up of 26 months (IQR, 15-39). At diagnosis, 56% of patients had metastatic disease, and 49% had high-volume disease. In 41% of patients, the diagnosis was made using next-generation imaging. PSA ≤ 0.02 ng/mL was observed in 38% of patients at 6 months, increasing to 58% during follow-up. Median progression-free survival and overall survival were reached only in patients with high-volume disease (54 and 62 months, respectively). Treatment dose adjustment or temporary interruption was required in 22% of patients.</p><p><strong>Conclusion: </strong>Hormonal doublet therapy demonstrated meaningful efficacy and an acceptable safety profile in patients with mHSPC, with results consistent with those reported in contemporary cohorts.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"502049"},"PeriodicalIF":0.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681810","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":"Predicting success after retrograde intrarenal surgery for 10-20 mm renal stones: A comparison of scoring systems.","authors":"S Ayvaz Selcuk, H B Haberal, F Celik, A S Kilicalp, F G Guvenir, M F Ozkaya, F E Sadioglu, C Senocak, O F Bozkurt","doi":"10.1016/j.acuroe.2026.502059","DOIUrl":"10.1016/j.acuroe.2026.502059","url":null,"abstract":"<p><strong>Objective: </strong>To determine the predictive performance of the SMASH score in patients undergoing retrograde intrarenal surgery (RIRS) for single renal stones measuring 10-20 mm and to compare its predictive performance with commonly used scoring systems.</p><p><strong>Methods: </strong>A total of 138 patients with a single renal stone measuring 10-20 mm who underwent RIRS were retrospectively analyzed. Residual stones smaller than 4 mm were considered clinically insignificant residual fragments (CIRFs). Patients who were stone-free or had CIRFs were considered to have achieved treatment success. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminative performance of the R.I.R.S., S.T.O.N.E., T.O.HO., and SMASH scoring systems. The relationships between scoring systems, stone-free rate (SFR), and treatment success were evaluated.</p><p><strong>Results: </strong>The SFR was 82.6%, increasing to 85.5% when CIRF cases were included. Median scores for the R.I.R.S., S.T.O.N.E. and T.O.HO. systems were 6, 10, and 6, respectively, whereas the mean SMASH score was 16.1. No significant differences were observed between stone-free and non-stone-free patients with respect to any of the evaluated scoring systems. ROC analysis demonstrated low discriminatory ability across all scoring systems for predicting stone-free status and treatment success.</p><p><strong>Conclusion: </strong>RIRS is an effective treatment option for patients with a single renal stone measuring 10-20 mm. In this patient population, none of the evaluated scoring systems, including the SMASH score, demonstrated adequate predictive performance for treatment success. Larger, multicenter, prospective studies are required to further clarify the role of the SMASH score in predicting RIRS outcomes.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"502059"},"PeriodicalIF":0.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687355","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}