Actas urologicas espanolas最新文献

{"title":"Risk factors for obturator nerve reflex during bipolar transurethral resection of lateral bladder wall tumors.","authors":"G Ozgur, Y E Genc, C Ozdemiroglu, B M Bektaş, Y Senoglu, M Kars, H K Cam, T E Sener","doi":"10.1016/j.acuroe.2026.502007","DOIUrl":"10.1016/j.acuroe.2026.502007","url":null,"abstract":"<p><strong>Introduction: </strong>Obturator nerve reflex (ONR) remains a relevant intraoperative challenge during transurethral resection (TUR) of lateral wall bladder tumors (LWBT), even with bipolar technology. Identifying patients at increased risk may improve surgical safety and decision-making.</p><p><strong>Material and methods: </strong>We retrospectively analyzed 737 patients who underwent bipolar TUR between July 2019 and October 2025. Patients with LWBT were grouped according to the intraoperative occurrence of ONR. Demographic, tumor-related, and perioperative variables were compared. ROC analyses and multivariable logistic regression analysis were performed.</p><p><strong>Results: </strong>Three hundred and four patients with LWBT were included, and ONR occurred in 36 cases (11.8%). Patients with ONR had significantly larger tumor size (50 vs. 25 mm, P = .006). In multivariable analysis, increasing LWBT size (OR:1.02, P = .041) and older age (OR:1.04, P = .048) were independently associated with ONR. ROC analysis demonstrated a modest predictive ability for tumor size (AUC = 0.643) and age (AUC = 0.614). A tumor size of approximately 30 mm and age ≥65 years provided clinically relevant thresholds for ONR risk. Overall complication rates, bleeding-related outcomes, and bladder perforation rates were similar between groups, although catheterization duration was longer in patients with ONR.</p><p><strong>Conclusion: </strong>Despite bipolar technology, ONR occurs in a meaningful proportion of patients undergoing LWBT resection. Larger tumor size and advanced age were independently associated with ONR risk, although their discriminatory ability was modest. These parameters may provide supportive information for preoperative risk assessment and help guide individualized consideration of preventive strategies.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"502007"},"PeriodicalIF":0.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407585","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":"Position paper of the Spanish Society of Radiotherapeutic Oncology (SEOR) and its genitourinary tumors group (URONCOR) on the prescription of parp inhibitors in advanced prostate cancer","authors":"P. Diezhandino,&nbsp;F. Couñago,&nbsp;A. Ocanto,&nbsp;A. Gómez de Iturriaga,&nbsp;A. Conde,&nbsp;X. Maldonado,&nbsp;J. Serrano,&nbsp;F. López-Campos","doi":"10.1016/j.acuroe.2026.501991","DOIUrl":"10.1016/j.acuroe.2026.501991","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501991"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019810","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":"i-PCNL: a novel ureteral-catheter application for continuous unidirectional high-flow irrigation during Percutaneous Nephrolithotomy. Technique description and preliminary outcomes","authors":"A. Servera Ruiz de Velasco,&nbsp;B. Ballesta Martínez,&nbsp;C. Barrera Rodríguez,&nbsp;J. Benejam Gual","doi":"10.1016/j.acuroe.2026.501988","DOIUrl":"10.1016/j.acuroe.2026.501988","url":null,"abstract":"<div><h3>Introduction</h3><div>Percutaneous nephrolithotomy (PCNL) remains the technique of choice for the treatment of complex renal stones. Despite technical advances, limitations remain in terms of visibility, fragment migration, and effective evacuation of the material. Optimizing irrigation is the key to improve the efficiency and safety of the procedure.</div></div><div><h3>Materials and methods</h3><div>A prospective observational study was done at one referral center, including 14 patients undergoing supine PCNL. A continuous retrograde irrigation technique directed at the upper renal pole was evaluated by adapting commercially available ureteral devices of a specific caliber. Irrigation was performed using a passive system based on hydrostatic pressure dependent on the height of the irrigation bags. Demographic variables, stone characteristics, operative and postoperative parameters, complications, stone-free rate (SFR), and a subjective evaluation of the system using a Likert scale were analyzed.</div></div><div><h3>Results</h3><div>The technique was performed in all cases without incident. No migration of fragments to the upper pole was observed. The mean effective lithotripsy time was 10.07 min. No relevant complications were recorded, except for one case of postoperative anemia. The SFR was 100% in the tomographic control at 4 weeks. The subjective assessment showed high scores for irrigation efficacy, vision quality, and fragment evacuation.</div></div><div><h3>Conclusions</h3><div>Continuous retrograde irrigation during PCNL is a simple and reproducible technique that, in this preliminary series, showed favorable results, making it a promising option.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501988"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038774","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":"Urinary pH and oncologic outcomes after bacillus calmette–guérin in non-muscle invasive bladder cancer: a retrospective cohort study","authors":"K. Kayar,&nbsp;R. Kayar,&nbsp;B.B. Ozdemir,&nbsp;E. Karabay,&nbsp;C. Tosun,&nbsp;M.I. Ozturk,&nbsp;O.E. Yucebas","doi":"10.1016/j.acuroe.2026.501995","DOIUrl":"10.1016/j.acuroe.2026.501995","url":null,"abstract":"<div><h3>Introduction</h3><div>Urinary pH may influence intravesical Bacillus Calmette–Guérin (BCG) efficacy by modulating the local immune microenvironment. We evaluated baseline urinary pH as a continuous variable and its association with oncologic outcomes in BCG-treated non-muscle invasive bladder cancer (NMIBC).</div></div><div><h3>Methods</h3><div>In this retrospective cohort, 248 NMIBC patients receiving adequate BCG therapy were analyzed. Recurrence-free survival (RFS) and progression-free survival (PFS) were assessed using Cox proportional hazards models. Given limited progression events, ridge (L2-penalized) multivariable regression was applied. Urinary pH was modeled per 1-unit increase and age per 10-year increment. Model discrimination was evaluated using Harrell’s concordance index.</div></div><div><h3>Results</h3><div>During follow-up, 43 patients (17.3%) developed recurrence and 28 (11.3%) experienced progression. In multivariable analysis, urinary pH was independently associated with improved RFS (HR 0.53, 95% CI 0.29–0.96, p = 0.035). For PFS, urinary pH showed a similar inverse direction but borderline significance after ridge adjustment (HR 0.69, 95% CI 0.48–1.00, p = 0.052). Concomitant carcinoma in situ and tumor stage remained independent predictors of progression. Model discrimination was good for RFS (C-index 0.713) and strong for PFS (C-index 0.841).</div></div><div><h3>Conclusions</h3><div>Baseline urinary pH demonstrated an independent association with recurrence and a consistent directional association with progression in BCG-treated NMIBC. While dominant pathological features primarily determine progression risk, urinary pH may represent an accessible microenvironmental modifier of BCG responsiveness. Prospective validation is warranted.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501995"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038785","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":"Computed tomography–based prediction of ureteroscopic failure in impacted ureteral stones: A focus on stone volume and ureteral anatomy","authors":"M. Dinckal,&nbsp;K.E. Ergun,&nbsp;A. Akyol,&nbsp;M.S. Kalemci,&nbsp;A. Simsir,&nbsp;A.B. Altay,&nbsp;F. Kizilay","doi":"10.1016/j.acuroe.2026.501992","DOIUrl":"10.1016/j.acuroe.2026.501992","url":null,"abstract":"<div><h3>Introduction</h3><div>Impacted ureteral stones are associated with lower ureteroscopic success and increased procedural complexity. Although ureteroscopy is the standard treatment, reliable preoperative predictors of failure are limited, and decision-making often depends on intraoperative findings. This study evaluated the association between preoperative CT-based stone and ureteral anatomical parameters and ureteroscopic failure among patients with endoscopically confirmed impacted ureteral calculi.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 123 patients with impacted ureteral calculi who underwent URS. Preoperative non-contrast computed tomography images were evaluated for stone characteristics, ureteral wall thickness (UWT), and ureteral anatomical features, including kinking. URS success was defined as stone-free status after the initial procedure, and the predictive value of CT parameters was assessed using receiver operating characteristic analysis and univariate and multivariate logistic regression models.</div></div><div><h3>Results</h3><div>The overall URS success rate was 68.3%. In univariate analysis, stone volume, proximal kink width, and proximal kink length were significantly larger in the failed group. Multivariate logistic regression analysis identified stone volume as the sole independent predictor of URS failure (OR: 3.05; 95% CI: 1.06–8.78; <em>P</em> = .039). A stone volume ≥ 451.28 mm³ demonstrated modest predictive power (AUC = 0.615). Although proximal kink parameters showed promising results in univariate analysis and ROC curves, these associations were not independent of other factors. UWT showed no significant differences between the groups.</div></div><div><h3>Conclusions</h3><div>Stone volume is the only independent predictor of ureteroscopic failure in impacted ureteral stones, while ureteral anatomy may provide complementary information regarding procedural complexity.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501992"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007777","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":"Factors associated with urinary incontinence after endoscopic prostate enucleation: A scoping review","authors":"N. Rodríguez Caicedo,&nbsp;H.E. López Ramos,&nbsp;J.M. Huertas,&nbsp;N. Vivas Ramírez,&nbsp;J. González-Nieto","doi":"10.1016/j.acuroe.2026.501985","DOIUrl":"10.1016/j.acuroe.2026.501985","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Endoscopic enucleation of the prostate is an established treatment for benign prostatic obstruction, providing substantial improvement in lower urinary tract symptoms and urinary flow. However, postoperative urinary incontinence (UI), typically transient, remains a relevant concern. Evidence regarding factors associated with postoperative UI remains heterogeneous. This scoping review aimed to synthesize available literature describing variables associated with urinary incontinence following endoscopic prostate enucleation.</div></div><div><h3>Materials and methods</h3><div>A scoping review was conducted using PubMed and Embase. The search identified 490 records; after duplicate removal and screening by three independent reviewers, 52 studies were included. Most were retrospective cohort studies with heterogeneous designs, follow-up intervals, and definitions of UI. Data analyzed descriptively in accordance with PRISMA-ScR guidelines.</div></div><div><h3>Results</h3><div>Reporting of postoperative UI varied across studies, including differences in subtype classification and outcome measurement methods. Early postoperative UI was commonly reported (15–35%), with most cases resolving within 6 months and persistent incontinence generally below 3% at one year. Advanced age, diabetes mellitus, obesity, larger prostate volume, greater resected tissue weight, and elevated preoperative post-void residual were described as associated with early UI. However, variability in outcome definitions and inconsistent multivariable adjustment limited identification of definitive independent predictors.</div></div><div><h3>Conclusions</h3><div>Postoperative urinary incontinence after endoscopic prostate enucleation is transient and resolves over time. Although several patient and surgical factors are repeatedly linked to early UI, heterogeneity of existing evidence precludes firm conclusions regarding independent predictors. Standardized outcome definitions and prospective studies are needed to improve risk stratification and guide perioperative counseling.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501985"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793825","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":"Cognitive and fusion MRI-Targeted prostate biopsies: A multicenter comparative analysis in 485 patients","authors":"Emre Hepşen,&nbsp;Furkan Çapar,&nbsp;İsmail Emre Ergin,&nbsp;Ahmet Emin Doğan,&nbsp;Ahmet Nihat Karakoyunlu,&nbsp;Uğur Kesimal","doi":"10.1016/j.acuroe.2026.501983","DOIUrl":"10.1016/j.acuroe.2026.501983","url":null,"abstract":"<div><h3>Objectives</h3><div>This multicenter study aimed to compare the diagnostic performance of cognitive registration targeted biopsy (Cog-Tb) and MRI–transrectal ultrasound fusion targeted biopsy (Fus-Tb) in men with Prostate Imaging Reporting and Data System (PI-RADS) ≥3 lesions.</div></div><div><h3>Materials and methods</h3><div>Men with PSA ≥ 3 ng/mL and/or abnormal digital rectal examination findings who had mpMRI lesions scored as PI-RADS ≥3 were included. This was a retrospective multicenter study, and the Cog-Tb and Fus-Tb groups were obtained from non-contemporary time periods and from different operators (Cog-Tb performed by urologists, Fus-Tb by a dedicated interventional radiologist). Atotal of 267 patients who underwent Cog-Tb and 218 who underwent Fus-Tb were retrospectively analyzed. At least two targeted cores were obtained from each mpMRI-defined lesion, in addition to 10–12 systematic cores. csPCa was defined as International Society of Urological Pathology (ISUP) Grade Group ≥2. Patients were stratified using a PSAd cutoff value of 0.15. In addition, a predefined stratified analysis by PI-RADS category (3 vs. 4–5) was performed, and odds ratios with 95% confidence intervals were calculated to assess independent predictors of csPCa.</div></div><div><h3>Results</h3><div>There was no significant difference between Cog-Tb and Fus-Tb in the detection of ISUP ≥ 2 prostate cancer (p = 0.91). In the PI-RADS 3 subgroup, PSAd values were significantly higher in patients with ISUP ≥ 2 compared with those with benign or ISUP 1 pathology for both Cog-Tb (p = 0.02) and Fus-Tb (p = 0.04). Similarly, in the PI-RADS 4–5 subgroup, PSAd levels were significantly higher in patients with ISUP ≥ 2 disease for both biopsy techniques (p = 0.01). Multivariate logistic regression showed that biopsy modality was not an independent predictor of csPCa (OR 1.4, 95% CI 0.8–2.5). In contrast, both PSAd (OR 5.9, 95% CI 2.6–13.1) and PI-RADS category (OR 6.8, 95% CI 3.4–13.4) were strong independent predictors of csPCa.</div></div><div><h3>Conclusion</h3><div>Cog-Tb and Fus-Tb demonstrated comparable effectiveness in detecting csPCa in patients with PI-RADS ≥3 lesions, particularly when PSAd ≥0.15. In settings lacking fusion technology, Cog-Tb performed by experienced clinicians remains a reliable and cost-effective alternative.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501983"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625235","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 of email reminders to reduce outpatient non-attendance: A quasi-experimental study in a urology department","authors":"D. Santillan,&nbsp;D.H. Giunta","doi":"10.1016/j.acuroe.2026.501986","DOIUrl":"10.1016/j.acuroe.2026.501986","url":null,"abstract":"<div><h3>Introduction</h3><div>Non-attendance at scheduled medical appointments implies negative consequences for both healthcare systems and individual patient health. An email reminder system that includes a link to easily cancel appointments was implemented. The objective of this study is to evaluate the effectiveness of this tool to reduce non-attendance.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, quasi-experimental before-and-after study using two complementary analytical approaches: an individual-level analysis of scheduled appointments and an aggregated interrupted time series (ITS) analysis by epidemiological weeks. All consecutive adult urology appointments from twelve months before the implementation (July 2021) to twelve months after (March 2024) were included. Appointments scheduled before the intervention were considered unexposed, while those scheduled afterward were considered exposed. We used logistic regression for individual-level and segmented Poisson regression for aggregated ITS analysis.</div></div><div><h3>Results</h3><div>A total of 272,331 appointments corresponding to 73,387 individuals were analyzed over 144 epidemiological weeks. In the main individual-level analysis, the non-attendance percentage was nearly 3% lower in the exposed group. The adjusted odds ratio for the effect of the reminder on non-attendance was 0.76 (95% CI 0.73−0.81). In the ITS analysis, segmented regression confirmed an immediate 13% drop at intervention (Relative Risk 0.868, RR), and a post-intervention decline of 0.4% per week (RR 0.996). Sensitivity and subgroup analyses yielded similar results.</div></div><div><h3>Conclusions</h3><div>We observed a consistent association between the reminders and the reduction in non-attendance percentages for urology appointments, both in the individual-level and aggregated analyses.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501986"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793759","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":"Functional outcomes of pyeloplasty in children with reduced preoperative renal function: A multicenter study","authors":"S. Tobía González,&nbsp;A. Bujons-Tur,&nbsp;J.P. Corbetta,&nbsp;J.L. Fadil-Iturralde,&nbsp;L.I. Smith-Harrison,&nbsp;I. Tobía-González,&nbsp;J. Ruiz,&nbsp;Y. Quiroz,&nbsp;A. Maiolo,&nbsp;J.C. Contardi,&nbsp;S. Weller,&nbsp;T. Rosito","doi":"10.1016/j.acuroe.2026.501990","DOIUrl":"10.1016/j.acuroe.2026.501990","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate functional outcomes after dismembered pyeloplasty in children with unilateral ureteropelvic junction obstruction (UPJO) and preoperative differential renal function (DRF) ≤40%.</div></div><div><h3>Materials and methods</h3><div>Retrospective multicenter review (2003–2022) including 74 children with primary unilateral UPJO and DRF ≤ 40%. Exclusions: bilateral UPJO, solitary kidney, secondary causes, prior surgery, and &lt;1-year follow-up. Group 1: DRF &lt; 20%; Group 2: 20–40%.</div></div><div><h3>Results</h3><div>Median age 9 years; 50% right-sided obstruction; 20.3% prenatal hydronephrosis. DRF improved from median 26% preoperatively to 36.9% postoperatively (<em>p</em> &lt; 0.001). Functional improvement &gt;5% occurred in 58.1% overall (73.9% G1 vs. 51.0% G2, <em>p</em> = 0.06). DRF was stable or improved in 93.2%. Prenatal hydronephrosis predicted postoperative deterioration (OR 7.12, 95% CI 1.7–47.3). The median follow-up duration was 48 months (IQR 13–64).</div></div><div><h3>Conclusions</h3><div>Pyeloplasty was associated with stabilization or improvement of renal function in children with UPJO and reduced preoperative DRF, including those with DRF &lt; 20%. Prenatal hydronephrosis identifies a subgroup at higher risk of postoperative decline.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501990"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038693","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":"Long-term endocrine sequelae in testicular cancer: clinical manifestations, mechanisms, and follow-up considerations","authors":"C.S. González Beltrán,&nbsp;H.A. García-Perdomo,&nbsp;A.F. García Ramos","doi":"10.1016/j.acuroe.2026.501935","DOIUrl":"10.1016/j.acuroe.2026.501935","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the main long-term endocrine sequelae in testicular cancer survivors and their clinical relevance.</div></div><div><h3>Material and methods</h3><div>A narrative review of the clinical literature on the endocrine consequences of curative therapies for TC (orchiectomy, platinum-based chemotherapy, and radiotherapy) was conducted. The impact of these interventions on the hypothalamic-pituitary-gonadal (HPG) axis and other relevant endocrine systems was examined.</div></div><div><h3>Results</h3><div>The most prevalent endocrine finding was hypergonadotropic hypogonadism (primary testicular dysfunction), characterized by elevated FSH and altered testosterone levels. The etiology is multifactorial, involving the direct deficiency following orchiectomy and the toxicity of chemotherapy/radiotherapy on Leydig cells. Hypogonadism is correlated with adverse effects on quality of life, fertility, bone metabolism, and body composition.</div><div>Additionally, an increased risk of osteopenia/osteoporosis and thyroid dysfunction was documented, the latter associated explicitly with mediastinal or cervical irradiation.</div></div><div><h3>Conclusions</h3><div>CT survivors present a significant and persistent risk of chronic endocrine dysfunction. It is imperative to establish systematic endocrine surveillance, especially for symptomatic patients or those with borderline hormonal parameters, to facilitate early identification and initiate interventions such as hormone replacement therapy. This strategy is crucial for preserving functional health and quality of life in this young population.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501935"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313924","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}