Actas urologicas espanolas最新文献

{"title":"Comparing Prostatype P-score and traditional risk models for predicting prostate cancer outcomes in Spain","authors":"P. González-Peramato ,&nbsp;M. Álvarez-Maestro ,&nbsp;V. Heredia-Soto ,&nbsp;M. Mendiola Sabio ,&nbsp;E. Linares ,&nbsp;Á. Serrano ,&nbsp;J.L. Álvarez-Ossorio ,&nbsp;E. López Alcina ,&nbsp;L. Prieto ,&nbsp;F. Vázquez Alonso ,&nbsp;M. Aller Rodríguez ,&nbsp;E. Berglund","doi":"10.1016/j.acuroe.2025.501788","DOIUrl":"10.1016/j.acuroe.2025.501788","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer (PCa) shows varied aggressiveness, complicating personalised treatment decisions. Traditional risk stratification systems rely on clinical parameters but may miss crucial genetic insights. The Prostatype® score (P-score) integrates gene expression with clinical data to improve PCa risk assessment precision.</div></div><div><h3>Objectives</h3><div>To validate the P-score’s predictive performance for prostate cancer-specific mortality (PCSM) and metastasis in a Spanish cohort, comparing it with NCCN, D’Amico, and EAU systems.</div></div><div><h3>Materials and methods</h3><div>This study was multicentre, retrospective and included seven Spanish hospitals. Of 154 core needle biopsies, 93 met RNA criteria, and for those, P-score was calculated based on IGFBP3, VGLL3, and F3 genes expression and clinical data.</div><div>The primary endpoint was PCa-specific mortality (PCSM), with secondary endpoints being development of metastasis, adverse pathology (AP), and International Society of Urological Pathology (ISUP) grading.</div></div><div><h3>Results</h3><div>The P-score demonstrated superior accuracy in predicting 10-year PCSM, with an AUC of 0.81 and a C-index of 0.75, outperforming NCCN (AUC 0.77, C-index 0.69) and D’Amico/EAU (AUC 0.70, C-index 0.62). For metastasis prediction, the P-score achieved a C-index of 0.77, significantly higher than NCCN, D’Amico, and EAU (0.58). Kaplan–Meier analysis underscored the P-score’s ability to better stratify patients by risk, especially high-risk groups. Additionally, the P-score correlated with tumour burden, showing significant associations with positive biopsy cores (p = 0.017) and ISUP grade at radical prostatectomy (p = 0.0028).</div></div><div><h3>Conclusions</h3><div>In this Spanish cohort, the P-score outperformed traditional clinicopathological systems in predicting PCSM, development of metastasis, and pathological markers, supporting its clinical utility for more personalised PCa management.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501788"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152535","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":"Bladder cancer risk in aluminum production workers: A systematic review","authors":"E. Kasperczyk ,&nbsp;M. Lesicka ,&nbsp;E. Reszka","doi":"10.1016/j.acuroe.2025.501789","DOIUrl":"10.1016/j.acuroe.2025.501789","url":null,"abstract":"<div><h3>Objective</h3><div>To summarize the key findings of occupational exposures during aluminum production in cohort studies on bladder cancer published between 1979 and 2023.</div></div><div><h3>Materials and methods</h3><div>This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO. Study quality was evaluated using the Newcastle–Ottawa scale.</div></div><div><h3>Results</h3><div>The literature search identified 24 cohort studies examining the standardized incidence (SIR) and mortality ratios (SMR) of bladder cancer among aluminum production workers. Five of the 13 studies examined SIR (95% CI) and three of the 16 studies that examined SMR (95% CI) reported a statistically significant increased risk of bladder cancer among aluminum production workers. The highest SIR was recorded in the secondary aluminum smelter (2.85; 95% CI: 1.23–5.62), suggesting a significantly elevated risk. In aluminum reduction plants, the SIR was 1.82 (95% CI: 1.59–2.07), while in Söderberg plants, it was 1.69 (95% CI: 1.06–2.57) and 1.4 (95% CI: 1.0–1.9), respectively. For aluminum plants overall, the SIR was 1.30 (95% CI: 1.10–1.50). The results indicate an increased risk, with the highest SMR of 5.90 (95% CI: 1.58–15.1), suggesting a significantly elevated hazard in the secondary aluminum smelter. The other values—3.47 (95% CI: 1.25–9.62) for the aluminum smelter and 2.24 (95% CI: 1.77–2.79) for the aluminum reduction plant—also indicate an increased risk, albeit with varying degrees of statistical certainty.</div></div><div><h3>Conclusion</h3><div>The International Agency for Research on Cancer has classified aluminum production as a Group 1 carcinogenic activity, providing strong evidence of its association with bladder cancer. The studies primarily included workers from Prebake, Söderberg, and aluminum reduction plants. Some findings indicate a significant yet variable risk across different segments of aluminum production. However, the review did not clearly confirm an increased risk of bladder cancer in specific aluminum-related occupations. Aluminum exposure may influence the lifetime risk of bladder cancer among these workers.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501789"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251705","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":"Analysis of device survival and predictive factors of failure in a cohort of patients with male artificial urinary sphincter","authors":"C. Mínguez Ojeda,&nbsp;A. Artiles Medina,&nbsp;A. Fraile Poblador,&nbsp;Á. Sánchez González,&nbsp;J.D. Subiela Henríquez,&nbsp;J. Brasero Burgos,&nbsp;I. de la Parra Sánchez,&nbsp;D. López Curtis,&nbsp;P. del Olmo Durán,&nbsp;A. Fernández-Mardomingo Díaz,&nbsp;M.A. Jiménez Cidre,&nbsp;V. Gómez Dos Santos,&nbsp;F.J. Burgos Revilla","doi":"10.1016/j.acuroe.2025.501786","DOIUrl":"10.1016/j.acuroe.2025.501786","url":null,"abstract":"<div><h3>Introduction</h3><div>Stress urinary incontinence (SUI) affects between 2.5% and 40% of patients after radical prostatectomy. Although the implantation of an artificial urinary sphincter (AUS) offers continence rates of 70%–80%, its failure rate reaches 25% in some series. This single-center retrospective study analyzed the survival of AUS and the factors associated with its failure.</div></div><div><h3>Materials and methods</h3><div>A total of 145 patients treated with the AMS 800 device (Boston Scientific®) between 2010 and 2023 were included. Kaplan-Meier analysis and the Cox proportional hazards model were used to evaluate device survival and identify predictive factors for failure.</div></div><div><h3>Results</h3><div>The mean age was 68.6 years; 28% of patients were smokers, 43.7% had diabetes, and 26.2% had undergone prior radiation therapy. Radical prostatectomy was the main cause of SUI (86.9%). In the majority of cases (91.5%), the artificial urinary sphincter was implanted around the bulbar urethra. During follow-up, 25.5% of patients required revision surgery. The probability of functional sphincter survival was 89% at 1 year, 78% at 2 years, 64% at 5 years, and 51% at 10 years. On multivariate analysis, prior radiation therapy [HR 2.06; <em>P</em> = .029] and diabetes [HR 2.24; <em>P</em> = .04] were associated with poorer device survival.</div></div><div><h3>Conclusions</h3><div>The AUS is an effective and safe treatment for severe SUI, although radiotherapy and diabetes may adversely affect its durability.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501786"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145367","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":"Burnout syndrome among urologists in Spain: Prevalence, risk factors, and implications for mental health","authors":"B. Nakdali Kassab ,&nbsp;J.V. Segura Heras ,&nbsp;M. Gómez Garberí ,&nbsp;J.J. Pacheco Bru ,&nbsp;M.A. Ortiz Gorraiz ,&nbsp;J.J. Mira Solves","doi":"10.1016/j.acuroe.2025.501793","DOIUrl":"10.1016/j.acuroe.2025.501793","url":null,"abstract":"<div><h3>Introduction</h3><div>Burnout syndrome is a significant occupational phenomenon among healthcare professionals, characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. Urologists, due to the demands of their specialty, are particularly vulnerable. This study aims to assess the prevalence and risk factors for burnout syndrome among urologists in Spain.</div></div><div><h3>Method</h3><div>A cross-sectional survey was conducted among 257 practicing urologists in Spain. Data were collected using the Maslach Burnout Inventory and additional demographic and occupational questions. Burnout was defined based on high emotional exhaustion combined with either high depersonalization or low personal accomplishment. Statistical analyses included univariate and multivariate logistic regression to identify significant predictors.</div></div><div><h3>Results</h3><div>In the study, the prevalence of burnout among Spanish urologists was 54.9%. Fewer years of experience and female gender were associated with higher burnout rates. Significant stressors included workload and work schedule. Despite the high prevalence, only one third of affected professionals sought psychological support.</div></div><div><h3>Conclusions</h3><div>Burnout is highly prevalent among Spanish urologists and poses serious risks to both healthcare professionals and patients. Its impact on patient care includes increased likelihood of medical errors, reduced quality of care and patient satisfaction. Targeted interventions and psychological support are urgently needed to address this issue.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501793"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251706","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":"Profile of patients practicing clean intermittent catheterization and associated resource consumption. Multicenter study in Spain","authors":"C. Muller-Arteaga ,&nbsp;L. Resel Folkersma ,&nbsp;J. Medina-Polo ,&nbsp;A.M. López García-Moreno ,&nbsp;R. González López ,&nbsp;C. García Sánchez ,&nbsp;B. Madurga Patuel ,&nbsp;C. Zubiaur Libano ,&nbsp;P. Blasco Hernández","doi":"10.1016/j.acuroe.2025.501756","DOIUrl":"10.1016/j.acuroe.2025.501756","url":null,"abstract":"<div><h3>Introduction</h3><div>Clean intermittent catheterization (CIC) is a technique used for bladder emptying in patients with neurogenic or non-neurogenic lower urinary tract dysfunction. CIC is considered the best option for most patients with dysfunctional voiding, as it improves their quality of life with a low complication rate. However, there is considerable variability in the management of CIC across regions and countries, as well as a lack of standardized guidelines. This study aims to determine the patient profile, associated complications and resource utilization related to the procedure.</div></div><div><h3>Methods</h3><div>This descriptive, multicenter, cross-sectional study was conducted in the functional urology and urodynamics units of 23 hospitals across Spain between April 2019 and April 2021. Patient characteristics were collected and stored in the Multicenter Studies Research Platform of the Spanish Urology Association.</div></div><div><h3>Results</h3><div>This study included 573 CIC users, with a mean age of 54.1 years (SD: 19.1). Of the participants, 78.6% lived in urban areas, and 53.9% had additional comorbidities. The primary indication for CIC was spinal cord injury (29.5%), followed by hypocontractile neurogenic bladder (20.8%). Most patients performed one clean intermittent catheterization per day (87.3%), with a median of three. The most common complication observed was urinary tract infection (51.8%). Additionally, 95.3% of patients attended at least one urology consultation in the past year.</div></div><div><h3>Conclusions</h3><div>CIC is mostly indicated for neurological pathologies, and urinary tract infection is the most common associated complication. CIC is a fundamental procedure in functional urology units and is linked to significant healthcare resource consumption. Knowledge on the patient profile and the characteristics associated with CIC is crucial for comprehensive patient management, as it helps reduce and prevent potential complications while also informing healthcare strategies for more efficient resource management.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501756"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996408","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 \"Oncological outcomes of patients with node positive disease following neoadjuvant chemotherapy and radical cystectomy for muscle-invasive bladder cancer: A multicenter observational study of the EAU Young Academic Urologists (YAU) urothelial carcinoma working group\".","authors":"V D Kumar Veldi, R Sah","doi":"10.1016/j.acuroe.2025.501792","DOIUrl":"10.1016/j.acuroe.2025.501792","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501792"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295592","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 \"Profile of patients with clean intermittent catheterization and associated resource consumption. Multicenter study in Spain\".","authors":"R Mehta, R Sah","doi":"10.1016/j.acuroe.2025.501795","DOIUrl":"10.1016/j.acuroe.2025.501795","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501795"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295593","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":"Is retroperitoneal access feasible using the single-port robotic platform for native nephrectomy after kidney transplantation?","authors":"H B Haberal, F M Valenzi, V Santarelli, S Crivellaro","doi":"10.1016/j.acuroe.2025.501797","DOIUrl":"10.1016/j.acuroe.2025.501797","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501797"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295595","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":"Pure embryonal carcinoma of the testis: A new case report and review of the literature","authors":"C. Ramírez Sevilla ,&nbsp;M. Puyol Pallàs ,&nbsp;D.H. Llanos Manzano ,&nbsp;Y. Zboromirskyy Pronuk","doi":"10.1016/j.acuroe.2025.501693","DOIUrl":"10.1016/j.acuroe.2025.501693","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 5","pages":"Article 501693"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416400","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":"Biological and therapeutic implications of FGFR alterations in urothelial cancer: A systematic review from non-muscle-invasive to metastatic disease","authors":"R. Pichler ,&nbsp;N.C.H. van Creij ,&nbsp;J.D. Subiela ,&nbsp;A. Cimadamore ,&nbsp;J. Caño-Velasco ,&nbsp;K.H. Tully ,&nbsp;K. Mori ,&nbsp;R. Contieri ,&nbsp;L. Afferi ,&nbsp;A. Mari ,&nbsp;F. Soria ,&nbsp;F. Del Giudice ,&nbsp;C. D’Elia ,&nbsp;R. Mayr ,&nbsp;L.S. Mertens ,&nbsp;N. Pyrgidis ,&nbsp;M. Moschini ,&nbsp;A. Gallioli ,&nbsp;Asociación Europea de Urología-Jóvenes Urólogos Académicos (EAU-YAU): Grupo de Trabajo de Carcinoma Urotelial","doi":"10.1016/j.acuroe.2025.501719","DOIUrl":"10.1016/j.acuroe.2025.501719","url":null,"abstract":"<div><div>FGFR3 mutations are among the most frequent genomic alterations in urothelial cancer (UC) being mainly associated with the luminal papillary (LumP) subtype. With the establishment of fibroblast growth factor receptor (FGFR) inhibitors, the treatment of UC is now shifting more and more towards personalized medicine. A systematic review using Medline and scientific meeting records was carried out according to the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines to assess the potential role of FGFR inhibitors in combination with additional therapies for the management of UC. Ongoing trials were identified via a systematic search on ClinicalTrials.gov. A total of eleven full-text papers, ten congress abstracts, and 5 trials on ClinicalTrials.gov were identified. Following the BLC2001 and THOR study, erdafitinib is the only approved FGFR1-4 inhibitor for metastatic UC with susceptible FGFR2/3 alterations following platinum-based chemotherapy. According to the THOR data of cohort 2, erdafitinib should not be recommended in patients who are eligible for and have not received prior immune checkpoint inhibitors (ICIs). One phase 3 trial is currently evaluating the intravesical device system (TAR210) in FGFR-altered intermediate non-muscle invasive bladder cancer (MoonRISe-1). Preclinical evidence suggests that combination-based approaches could be considered to improve the efficacy of FGFR inhibitors in patients with UC. Nine phase 1b/2 trials are focusing on the combination of FGFR inhibitors with ICIs, chemotherapy, or enfortumab vedotin. In metastatic disease, some preliminary analyses have reported promising results from these combinations (e.g. NORSE and FORT-2 trial). However, no phase 3 trial is terminated, so there is currently no level 1 evidence with long-term outcomes to support the combination of FGFR inhibitors with ICIs, chemotherapy, or targeted therapies. A better understanding of the different mechanisms of action to inhibit FGFR signaling pathways, optimal patient selection and treatment approaches is still needed.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 5","pages":"Article 501719"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426830","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}