{"title":"Comment on \"Clinical profile and risk factors identified in patients with renal cancer in Mexican population\".","authors":"R Mehta, R Sah","doi":"10.1016/j.acuroe.2025.501833","DOIUrl":"10.1016/j.acuroe.2025.501833","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501833"},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777476","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":"Management of incontinence after classic bladder exstrophy closure.","authors":"K Godlewski, M Davis, D Weiss, A Shukla","doi":"10.1016/j.acuroe.2025.501818","DOIUrl":"10.1016/j.acuroe.2025.501818","url":null,"abstract":"<p><strong>Introduction: </strong>Classic bladder exstrophy presents a unique challenge for reconstructive surgeons given the significant alternations it has on normal pelvic anatomy. The ultimate goal of surgery, whether in one stage or more, is simple; close the bladder, reconstruct the bladder neck and urethra, and place the unit into a more orthotopic position deep in the pelvis, and establish normal genitalia. Despite significant improvements with the success of bladder exstrophy closure, a patient's ability to volitionally void and achieve urinary continence after initial closure remain an elusive «holy grail» for bladder exstrophy surgeons. After closure many patients will endure persistent urinary incontinence post exstrophy closure. In this review, we will discuss the conservative strategies and surgical options to facilitate continence in our bladder exstrophy patients. Regardless of surgical approach or initial outcome, all patients with bladder exstrophy require lifelong urologic follow-up.</p><p><strong>Methods: </strong>A comprehensive search of electronic databases (MEDLINE, PubMed, Embase, PsycINFO and CINAHL), and citation tracking platforms (Google Scholar and Web of Science) was performed. Keywords included Classic Bladder Exstrophy, Incontinence, behavioral therapy, urotherapy, biofeedback, bulking agents, artificial urinary sphincter, bladder neck reconstruction, bladder neck closure, urinary diversion.</p><p><strong>Results: </strong>Conservative measures such as behavioral therapy, physical therapy and uropsychological counseling should be first line for the treatment of urinary incontinence after exstrophy closure. These interventions along with maturation of the child and bladder growth can improve incontinence without surgery. Patients should be counseled on the limited success of bulking agents and significant risk of erosion with sphincters. Although success after bladder neck reconstruction or bladder neck closure with or without augmentation and catheterizable channel can be variable, these surgical options can be offered to patients that have exhausted conservative treatment strategies.</p><p><strong>Conclusions: </strong>A patient's ability to volitionally void and achieve urinary continence remain an elusive goal for bladder exstrophy surgeons with many experiencing persistent urinary incontinence following exstrophy closure. Behavioral therapy, physical therapy and pyschological support should be provided to all bladder exstrophy patients and families. Giving children time to grow and mature can potentially facilitate continence without surgical intervention. If surgical intervention is pursued lifelong follow-up and monitoring is critical.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501818"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651710","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}
K Weller, G M Eggenhuizen, K Zandbergen, L A 't Hoen, J Mulder, A T J I Go
{"title":"Prenatal ultrasonographic evaluation and management of renal and urogenital anomalies: A comprehensive review based on experience in a tertiary care center and literature analysis.","authors":"K Weller, G M Eggenhuizen, K Zandbergen, L A 't Hoen, J Mulder, A T J I Go","doi":"10.1016/j.acuroe.2025.501816","DOIUrl":"10.1016/j.acuroe.2025.501816","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital renal and urogenital anomalies represent a major part of all congenital anomalies. These range from mild, transient conditions to severe forms leading to irreversible organ damage or perinatal mortality. Timely prenatal identification is crucial for expecting parents and their healthcare providers to decide about the continuation of a pregnancy or for careful planning of perinatal and postnatal care.</p><p><strong>Objective: </strong>To describe the most common indications for referral of fetal renal and urogenital malformations, the process of narrowing the differential diagnosis based on prenatal ultrasonography and the coordination between prenatal and postnatal care in a tertiary care center in the Netherlands.</p><p><strong>Results: </strong>The most common indications for referral of fetal renal and urogenital malformations are (1) Abnormal Renal Parenchyma, (2) Urinary Tract Dilatation, (3) Abnormal Bladder Appearance, and (4) Atypical Genitalia. In the differential diagnosis, ultrasonographic evaluation is crucial to determine the specific region of the urogenital system affected, its onset during pregnancy, and its progression throughout gestation. Integrated prenatal and postnatal care for these types of malformations relies on a multidisciplinary approach to guide parental decision-making in continuation of the pregnancy and optimize outcomes. Some cases only require routine perinatal care in secondary care centers, while complex malformations benefit from specialized planning at tertiary centers to improve outcomes.</p><p><strong>Conclusion: </strong>Dedicated ultrasonographic evaluation of fetal renal and urogenital anomalies in a tertiary care center enables accurate diagnosis and individualized care planning, particularly in complex cases. This approach provides parents with timely information, supports decision-making, and guides individualized perinatal care.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501816"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602746","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 \"Analysis of device survival and predictive factors in a cohort of patients undergoing male artificial urinary sphincter implantation\".","authors":"R Sah, A Mathur","doi":"10.1016/j.acuroe.2025.501811","DOIUrl":"10.1016/j.acuroe.2025.501811","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501811"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602736","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":"Transference of video game skills to robotic and laparoscopic surgery: Feasibility in contemporary practice.","authors":"G Fernández-Conejo","doi":"10.1016/j.acuroe.2025.501813","DOIUrl":"10.1016/j.acuroe.2025.501813","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501813"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602747","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}
O. Mar-Herrera, J. Llaca-Díaz, A. Flores-Aréchiga, N. Casillas-Vega
{"title":"Molecular detection and clinical relevance of Haemophilus spp. in male urethritis: Prevalence and risk factors","authors":"O. Mar-Herrera, J. Llaca-Díaz, A. Flores-Aréchiga, N. Casillas-Vega","doi":"10.1016/j.acuroe.2025.501790","DOIUrl":"10.1016/j.acuroe.2025.501790","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Urethritis is the most common sexually transmitted infection in men. <em>Haemophilus influenzae</em> and <em>Haemophilus parainfluenzae</em>, commensal microorganisms of the respiratory and oral tract, have been proposed as potential etiological agents of non-gonococcal urethritis (NGU). This study aimed to determine the prevalence of these species in urine samples from men with urethritis and analyze their clinical correlation.</div></div><div><h3>Methods</h3><div>A total of 200 urinary DNA samples from patients diagnosed with urethritis were analyzed. Microorganisms were identified through multiplex PCR, amplifying the <em>P6</em> and <em>16S rRNA</em> genes. Associations between risk factors and infection were evaluated by calculating odds ratios (OR) and 95% confidence intervals (CI) using OpenEpi 3.03a.</div></div><div><h3>Results</h3><div>The mean age of the population was 55 years (range 20–95). Among the participants, 32.5% had received prior sexual education, and 75% reported not using contraceptive methods. <em>H. influenzae</em> was not detected in any sample, whereas <em>H. parainfluenzae</em> was present in 9.5% (n = 19) of cases. Significant associations were identified with the absence of formal education, a history of more than ten sexual partners, masturbation, and sexual intercourse under the influence of alcohol and/or drugs.</div></div><div><h3>Conclusions</h3><div>Although <em>H. influenzae</em> and <em>H. parainfluenzae</em> have been rarely identified in urethritis, their high transmissibility and clinical relevance suggest the need for their detection in high-risk populations. Their identification may contribute to improving diagnosis and the implementation of therapeutic strategies.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501790"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251707","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}
J. Iregui-Parra , V. Rojas Ossa , C.M. Arias Salazar , A.D. López Estupiñán , D. Díaz Varela , L.M. Sinisterra Parra , L. Diéguez , E. Emiliani
{"title":"Phyllanthus niruri in the management of nephrolithiasis: A systematic review of the literature","authors":"J. Iregui-Parra , V. Rojas Ossa , C.M. Arias Salazar , A.D. López Estupiñán , D. Díaz Varela , L.M. Sinisterra Parra , L. Diéguez , E. Emiliani","doi":"10.1016/j.acuroe.2025.501791","DOIUrl":"10.1016/j.acuroe.2025.501791","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Nephrolithiasis is one of the most prevalent urological pathologies worldwide, with an increasing incidence and multifactorial etiology, particularly influenced by diet. Surgical interventions or extracorporeal shock wave lithotripsy (ESWL) are the cornerstone treatments. However, as emphasized by the EAU and AUA guidelines, post-surgical medical management is recommended to reduce recurrence risk. <em>Phyllanthus niruri</em> (PN), widely used in traditional medicine, has been extensively researched, yielding mixed results and presenting an opportunity to explore its role further. This review aims to evaluate PN’s potential in enhancing treatment efficacy and reducing stone recurrence.</div></div><div><h3>Materials and methods</h3><div>A systematic literature review was conducted, encompassing articles published from January 1994 to September 2022 in English and Spanish. The review included studies on humans and rats accessible through the authors’ institutional affiliations. Titles and abstracts were screened, and relevant studies were selected for in-depth analysis.</div></div><div><h3>Results</h3><div>Out of the 16 selected studies, various mechanisms of action for PN were identified, such as promoting glycosaminoglycan (GAG) aggregation, inhibiting nucleation processes, and altering stone density to favor a stone-free state (SFR). Evidence consistently supports PN’s long-term safety, confirmed by serial measurements of serum electrolytes and liver function. Novel applications, such as PN as an adjuvant to ESWL, show benefits for lower renal pole stones.</div></div><div><h3>Conclusions</h3><div>Growing evidence suggests that PN, when used alongside traditional interventions, is safe, without significant adverse effects, and may improve SFR outcomes after ESWL.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501791"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251708","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}
R. Monsonís-Usó , P. Ponce-Blasco , B. Amaya-Barroso , P. Martínez-Meneu , A. Sánchez-Llopis , L. Barrios-Arnau , C. Garau-Perelló , P. Juan , M. Rodrigo-Aliaga
{"title":"Identification of risk factors for evisceration in open radical cystectomy","authors":"R. Monsonís-Usó , P. Ponce-Blasco , B. Amaya-Barroso , P. Martínez-Meneu , A. Sánchez-Llopis , L. Barrios-Arnau , C. Garau-Perelló , P. Juan , M. Rodrigo-Aliaga","doi":"10.1016/j.acuroe.2025.501759","DOIUrl":"10.1016/j.acuroe.2025.501759","url":null,"abstract":"<div><h3>Introduction</h3><div>Abdominal wall closure defects (AWCD) represent a cause of morbidity and mortality in patients undergoing laparotomy.</div></div><div><h3>Objective</h3><div>The aim of this study was to determine the risk factors contributing to the appearance of AWCD in open radical cystectomy.</div></div><div><h3>Methods</h3><div>A retrospective, analytical, observational, descriptive study and multivariate analysis was conducted including patients who underwent open radical cystectomy for bladder cancer at the General University Hospital of Castellón between January 2018 and December 2021.</div></div><div><h3>Results</h3><div>A total of 80 patients were included. The mean age was 70 years, with 86.3% being men. Sixteen presented with an evisceration (20%). Risk factors in the multivariate analysis were age, history of vascular or coronary disease, preoperative albumin, hemodynamic instability, and surgical time. Eight patients presented with an eventration (10%). A higher body mass index and a lower preoperative hemoglobin level were associated with eventration.</div></div><div><h3>Conclusion</h3><div>The risk factors associated with abdominal wall closure defects are identifiable and preventable.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501759"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049536","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}
U. Aydin , S. Cetin , M. Yavuz Koparal , C. Coskun , I. Isık Gonul , S. Yesil , T.S. Sozen
{"title":"Is the presence of lymphovascular invasion associated with recurrence and progression in bladder cancer patients that have received adequate BCG therapy?","authors":"U. Aydin , S. Cetin , M. Yavuz Koparal , C. Coskun , I. Isık Gonul , S. Yesil , T.S. Sozen","doi":"10.1016/j.acuroe.2025.501785","DOIUrl":"10.1016/j.acuroe.2025.501785","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To investigate whether lymphovascular invasion (LVI) could be a factor in predicting recurrence and progression in patients with high and very high-risk non-muscle-invasive bladder cancer (NMIBC) who received Bacillus Calmette-Guérin (BCG) treatment.</div></div><div><h3>Methods</h3><div>Ninety-three patients with high and very high-risk NMIBC, diagnosed initially in our clinic, were treated with at least 1 year of BCG therapy, and they were followed up to assess recurrence and progression, comparing those with and without lymphovascular invasion (LVI) at the time of diagnosis.</div></div><div><h3>Results</h3><div>In the entire cohort, LVI was present in 33 (35.5%) patients while absent in 60 (64.5%) patients. Among patients with LVI, 17 (51.5%) showed recurrence, and 11 (33.3%) showed progression. Statistically significant differences were observed in both recurrence and progression in patients with LVI compared to those without LVI (p < 0.001 and 0.04, respectively). Additionally, univariate and multivariate regression analysis revealed that the presence of LVI was an independent factor predicting recurrence (p = 0.001).</div></div><div><h3>Conclusion</h3><div>In our study, we demonstrated the importance of being cautious regarding recurrence and progression in patients with high and very high-risk NMIBC who also have LVI despite receiving standard treatment. We found that approximately one-third of these patients may experience recurrence within one year.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501785"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048938","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}