Actas urologicas espanolas最新文献

{"title":"New insights and emerging approaches in bladder-sparing treatment for muscle-invasive bladder cancer","authors":"J.D. Subiela ,&nbsp;F. Guerrero-Ramos ,&nbsp;Ó. Rodríguez-Faba ,&nbsp;J. Aumatell ,&nbsp;P. Gajate ,&nbsp;F. López-Campos ,&nbsp;E. Sevillano ,&nbsp;M. Hernández-Arroyo ,&nbsp;E. García-Rojo ,&nbsp;A. Artiles Medina ,&nbsp;D. Sáenz-Calzada ,&nbsp;C. Gómez-Cañizo ,&nbsp;J. Romero-Otero ,&nbsp;Felipe Couñago","doi":"10.1016/j.acuroe.2025.501758","DOIUrl":"10.1016/j.acuroe.2025.501758","url":null,"abstract":"<div><h3>Introducction and objective</h3><div>Muscle-invasive bladder cancer (MIBC) poses significant challenges, traditionally treated with radical cystectomy, a procedure with considerable morbidity and impact on quality of life. Bladder-sparing approaches aim to preserve the bladder while maintaining oncological efficacy. This review explores emerging perspectives in bladder-sparing strategies for MIBC, focusing on patient selection criteria, molecular characterization, non-invasive treatment response assessment, systemic therapies, radiation techniques, and the role of intravesical devices.</div></div><div><h3>Methods</h3><div>A comprehensive narrative review provides insights into novel perspectives in bladder-sparing strategies for treating MIBC.</div></div><div><h3>Results</h3><div>Patient selection criteria for bladder preservation remain challenging. While the traditional approach focuses on selecting candidates with MIBC with fewer clinicopathological risk characteristics, some studies suggest that histological variants and the presence of hydronephrosis may not be absolute exclusion criteria. Molecular classification data shows promise but lacks sufficient evidence, while immune cell infiltration may provide insights into potential treatment response. MRI and radiomics offer the potential for non-invasive treatment response assessment. Ongoing trials investigate new systemic therapies, radiation therapy approaches, and the role of intravesical devices in bladder preservation, with some preliminary data appearing promising.</div></div><div><h3>Conclusion</h3><div>Bladder-sparing strategies for MIBC are currently experiencing substantial evolution. Achieving optimal patient selection may entail the integration of clinical, radiological, histopathological, and molecular data. It is likely that shortly, multimodal approaches incorporating neoadjuvant systemic therapy, radiotherapy, intravesical devices, and possibly maintenance or adjuvant regimens guided by biomarker-driven strategies will become standard practice.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501758"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057181","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":"Managing hypospadias failure: A comprehensive review of strategies and outcomes","authors":"L.E. Jesus ,&nbsp;J.L. Pippi-Salle","doi":"10.1016/j.acuroe.2025.501809","DOIUrl":"10.1016/j.acuroe.2025.501809","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypospadias surgery has a failure rate ranging from 10% for distal cases to over 30% for proximal cases. However, real-world outcomes may be worse, as some complications emerge late in puberty or are underreported. The expectations for surgical success have evolved, shifting from basic urinary and sexual functionality to achieving a normal penile appearance. Bias in research favors retrospective studies with short follow-ups, and qualitative research remains scarce. This review describes complications following hypospadias surgery, their management, and prognosis.</div></div><div><h3>Methodology</h3><div>A non-systematic critical review of existing literature on hypospadias complications and surgical management was conducted.</div></div><div><h3>Results</h3><div>Common complications include urethrocutaneous fistulae (UCF), glans dehiscence (GD), urethral stenosis (US), urethral diverticulae (UD), urine spraying, and recurrent curvature (RC). UCF is the most frequently reported complication, treated through multilayer closure with vascularized flap coverage. GD occurs more frequently in proximal hypospadias, requiring glans reformatting and tissue augmentation. US often manifests as meatal stenosis or neourethral strictures, requiring meatoplasty or staged urethroplasty. UD arises from loose urethral segments subjected to high urinary flow resistance and is managed via excision or remodeling. Urine spraying is linked to insufficient glans fusion or meatal irregularities, sometimes requiring surgical correction. RC is a significant complication impacting sexual function, requiring individualized correction through dorsal plication or ventral lengthening.</div></div><div><h3>Conclusion</h3><div>Hypospadias complications require individualized assessment and surgical planning. Late complications, often underrecognized, should be considered in long-term follow-up. Proper surgical technique selection and postoperative evaluation help mitigate recurrence and improve patient outcomes.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501809"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602745","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":"Duration of androgen deprivation therapy with salvage radiotherapy in patients with prostate cancer and biochemical recurrence after surgery: Initial recruitment data in the phase III URONCOR 06-24 trial","authors":"C. González San Segundo ,&nbsp;F. López-Campos ,&nbsp;A. Gómez Iturriaga ,&nbsp;M. Santos ,&nbsp;A. Ocanto ,&nbsp;L. Montezuma ,&nbsp;A.M. Boladeras-Inglada ,&nbsp;L. Glaria ,&nbsp;S. Guardado ,&nbsp;A. Rodríguez ,&nbsp;I. Henríquez ,&nbsp;J. Olivera ,&nbsp;V. Duque-Santana ,&nbsp;J. Garre ,&nbsp;S. Moreno ,&nbsp;J. Valero ,&nbsp;A.J. Conde ,&nbsp;A. Doval ,&nbsp;G. Sancho ,&nbsp;P. Martin Nieto ,&nbsp;F. Couñago","doi":"10.1016/j.acuroe.2025.501823","DOIUrl":"10.1016/j.acuroe.2025.501823","url":null,"abstract":"<div><h3>Introduction</h3><div>URONCOR 06-24 (NCT05781217) is a prospective, multicenter, randomized, open-label, phase III trial evaluating the impact on distant metastasis-free survival (MFS) of short-term (6 months) versus long-term (24 months) androgen deprivation therapy (ADT) in combination with salvage radiotherapy in high- and intermediate-risk patients after biochemical recurrence (BCR).</div></div><div><h3>Material and method</h3><div>A total of 534 men will be randomized to receive either 6 or 24 months of ADT. Stratification is based on risk group (intermediate vs high) and nodal status (pN0 vs pNx).</div></div><div><h3>Results</h3><div>From March 2023 to November 2024, 122 patients have been enrolled: 34 (28%) with intermediate risk and 88 (72%) with high risk. Fifty-five patients (45%) are pNx. The mean time from surgery to BCR is 25.4 months, and the PSA at inclusion was 0.55 ng/ml. Restaging was performed in 89 patients, 75 of whom underwent PET/CT (97%, PSMA PET/CT). Hypofractionation was used in 68% of cases, and elective pelvic irradiation in 33%. At the time of analysis, all patients had PSA normalization. No severe ADT-related toxicity has been reported.</div></div><div><h3>Conclusion</h3><div>URONCOR 06-24 is the first clinical trial comparing long- versus short-term ADT in the setting of BCR after prostatectomy, with stratification by risk group. Initial recruitment data show a balanced distribution of prognostic factors between both arms and no serious adverse events related to ADT.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501823"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769517","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":"Can we use intense intravesical neoadjuvant chemotherapy to treat recurrent LG-IR NMIBC and avoid TURBT?","authors":"G Villoldo, A Kamat, G Fernández Candia","doi":"10.1016/j.acuroe.2025.501829","DOIUrl":"10.1016/j.acuroe.2025.501829","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501829"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777475","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":"Use of hormonal therapy for undescended testis? Results of a worldwide questionnaire.","authors":"R J M Lammers, L A 't Hoen, F O'Kelly, I Selvi, Y Quiroz Madarriaga, N Baydilli, B Bañuelos Marco, M I Dönmez, S Sforza, E Bindi, B Haid","doi":"10.1016/j.acuroe.2025.501820","DOIUrl":"10.1016/j.acuroe.2025.501820","url":null,"abstract":"<p><p>The objective of this study was provide an overview of current practices on hormonal therapy (HT) in children with undescended testes (UDT). An online questionnaire about HT, referral patterns, and orchidopexy was spread via several (social media) networks involved in pediatric urology. A total of 283 individuals responded, with 54 countries sampled. The majority (84%) did not prescribe HT for UDT, predominantly due to a paucity of scientific evidence (76%). Among those who use HT, main reason was bilateral UDT (62%). There was no clear preference in administration type (50% intramuscular injection, 50% nasal spray). GnRH was slightly more favoured over HCG (50% vs. 32%). No standardized schedule was used. Most respondents (67%) felt all forms of UDT should be treated by either a pediatric urologist or -surgeon. Eighty-seven percent follow the current guidelines and perform orchidopexy between 6-18 months of age.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501820"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777480","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":"International Overview on Diagnosis and Treatment of Nocturnal Enuresis: A Survey Study by EAU YAU Paediatric Urology Working Group.","authors":"N Baydilli, M I Dönmez, Y Quiroz Madarriaga, B Banuelos Marco, I Selvi, E Bindi, R Lammers, S Sforza, L A 't Hoen","doi":"10.1016/j.acuroe.2025.501822","DOIUrl":"10.1016/j.acuroe.2025.501822","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed global diagnostic and therapeutic approaches to nocturnal enuresis (NE), highlighting current practices and variations.</p><p><strong>Materials and methods: </strong>An 18-question survey by the European Association of Urology (EAU) Young Academic Urologist (YAU) Paediatric Urology Working Group targeted clinicians managing NE. Distributed online, it reached Urologists, Pediatric Urologists, Pediatricians, Nephrologists, and Urotherapists. The survey collected demographic data and details on diagnostic and treatment practices. Responses were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Most respondents worked in university or government hospitals, with pediatric urologists forming the largest group (43.6%). A significant portion had 11-20 years of NE management experience. Initial treatment favored behavioral strategies and urotherapy (84.5%), with desmopressin as a common first-line medication (23.8%). Most clinicians initiated treatment at ages 5-6. Bladder diaries were widely used (82.0%), while airway assessments were inconsistent (52.1%). Diagnostic test usage varied, with urinary tract ultrasonography (53.65%) and urinalysis (51.5%) employed to identify underlying abnormalities. Psychological referrals were common for secondary enuresis (58.9%).</p><p><strong>Conclusion: </strong>NE management varies globally due to regional practices, clinician experience, and specialty focus. The findings emphasize the need for standardized guidelines and education on comprehensive assessments, including sleep-related factors. International collaboration and guideline development could enhance consistency and improve patient outcomes.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501822"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777478","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":"Comment on «Comparing Prostatype® P-score and traditional risk models for predicting prostate cancer outcomes in Spain».","authors":"S Kumar, R Sah","doi":"10.1016/j.acuroe.2025.501827","DOIUrl":"10.1016/j.acuroe.2025.501827","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501827"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786335","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":"Metabolic evaluation in paediatric urolithiasis: Is a key component being overlooked? An international survey by the YAU-PU Working Group.","authors":"Y Quiroz Madarriaga, M I Dönmez, R J M Lammers, B Bañuelos Marco, N Baydilli, E Bindi, S Sforza, I Selvi, L A Hoen","doi":"10.1016/j.acuroe.2025.501832","DOIUrl":"10.1016/j.acuroe.2025.501832","url":null,"abstract":"<p><p>Paediatric urolithiasis is increasing globally, with metabolic abnormalities as a key contributing factor. However, standardized protocols for metabolic evaluation in children are lacking. This study assessed current practices and knowledge among paediatric urologists worldwide. An international survey was distributed in Spanish and English, gathering data on clinician demographics and metabolic evaluation strategies. A total of 194 clinicians from 49 countries responded. Only 11% routinely performed metabolic evaluations, and while 78% requested stone analysis, just 46% ordered 24-h urine studies. In 84% of cases, paediatric nephrologists were responsible for evaluations, with urologists involved in fewer than 25%. Knowledge of spot urine indices varied, and only 55% recognized crystalluria as a lithogenic risk factor. Fewer than one-third felt confident interpreting metabolic results or initiating treatment. These findings highlight inconsistent practices and limited involvement of paediatric urologists, underscoring the need for clearer guidelines and targeted education to enhance metabolic assessment in stone disease.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501832"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777479","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":"Comparing «Prostatype® P-score and traditional risk models for predicting prostate cancer outcomes in Spain». Author reply.","authors":"P González-Peramato, E Berglund","doi":"10.1016/j.acuroe.2025.501828","DOIUrl":"10.1016/j.acuroe.2025.501828","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501828"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786336","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":"Attendings versus supervised residents: Educational results and future perspective in transurethral resection of bladder tumors.","authors":"P Diana, A Gallioli, A Uleri, L Mas, R Pujol, A Territo, O Rodriguez-Faba, J M Gaya, F Sanguedolce, J Huguet, R Parada, F Algaba, J Palou, A Breda","doi":"10.1016/j.acuroe.2025.501830","DOIUrl":"10.1016/j.acuroe.2025.501830","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Urology residents training programs across Europe are uneven and often unsatisfactory. The significance of resident mentoring should not be overstated and trainees should be mentored by training-trained attending urologist even in case of common procedures such transurethral resection of bladder tumor (TURBT). The goal of this study is to demonstrate the comparability in TURBT performance between supervised urology residents and attendings.</p><p><strong>Materials and methods: </strong>This study is a subanalysis of a prospective, randomized trial enrolling patients diagnosed with BC and undergoing endoscopic intervention. The trial (NCT04712201) was approved by the Institutional Review Board (2017/09c). Surgeons were either urology attendings or supervised residents of the 3rd-5th year. Primary outcome was to compare surgical and post-operative outcomes in both groups.</p><p><strong>Results: </strong>From 04/2018 to 06/2021, 300 patients met inclusion criteria and 248 (83%) of these underwent the assigned intervention. 200 (80.6%) patients were males and median (SD) age was 72.2 (11.2). No statistical differences were found in terms of intra and post-operative outcomes (all P > .05). Linear and logistic regression analysis resulted comparable for all variables (all P > .05).</p><p><strong>Conclusion: </strong>Supervised urology residents do not put the patient at an increased risk of complications neither perform a suboptimal procedure. Resident mentoring is fundamental in order to reach comparable results in surgical outcomes and pathological diagnosis. A structured standardized program with trained trainers and proficiency evaluations are warranted to gain and maintain these outcomes across Europe.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501830"},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777474","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}