Actas urologicas espanolas最新文献

{"title":"Effect of mirabegron, tamsulosin, and tadalafil on quality of life in patients with indwelling ureteral (double-J) stents","authors":"A. Mahmoud Mohammed,&nbsp;E. Abdellah Ali Mostafa,&nbsp;A.M. Reyad,&nbsp;H. Ali Abdelhaleem,&nbsp;T. Ahmed Mahmoud","doi":"10.1016/j.acuroe.2026.501980","DOIUrl":"10.1016/j.acuroe.2026.501980","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate and compare the efficacy of mirabegron, tamsulosin, and tadalafil in improving stent-related symptoms and overall quality of life in urological patients following JJ stent insertion.</div></div><div><h3>Methods</h3><div>During the period from January 2022 to December 2022, 131 patients with ureteral double-J stents were randomly assigned two days post-insertion to receive either mirabegron (50 mg daily), tamsulosin (0.4 mg daily), or tadalafil (5 mg daily) for two weeks. Stent-related symptoms and health-related quality of life were assessed at baseline and at two weeks using the validated Ureteral Stent Symptom Questionnaire (USSQ). All groups completed follow-up.</div></div><div><h3>Results</h3><div>The tamsulosin group showed the greatest improvement in total USSQ score (<em>P</em> ≤ .001), with significantly lower urinary symptoms, general health, and sexual function scores than the mirabegron and tadalafil groups. Specifically, sexual matter scores [median (IQR)] were lowest in the tamsulosin group [5 (1)] versus tadalafil [7 (3.2)] and mirabegron [16.5 (11)] (<em>P</em> ≤ .001). Differences in work performance and additional problem domains were not significant. Adverse effects were mild: dizziness/hypotension (∼6% tamsulosin), palpitations/headache (∼4% mirabegron), and flushing/dyspepsia/back pain (∼10% tadalafil). No serious events occurred, and no patient discontinued therapy.</div></div><div><h3>Conclusion</h3><div>In conclusion, tamsulosin produced the most comprehensive symptom relief supporting its use as first-line therapy for patients with indwelling JJ stents. Mirabegron demonstrated good safety and modest benefits in pain and storage symptoms, suggesting its use as a viable alternative for patients intolerant to standard treatments. Larger placebo-controlled trials are needed to validate these findings.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501980"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617327","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":"Endpoints and evidence in prostate cancer screening","authors":"T. Takahashi","doi":"10.1016/j.acuroe.2026.501968","DOIUrl":"10.1016/j.acuroe.2026.501968","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501968"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482964","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: Predictive factors for urethral stricture development in patients with bladder tumor: The role of intravesical BCG therapy","authors":"Berk Yasin Ekenci","doi":"10.1016/j.acuroe.2026.501932","DOIUrl":"10.1016/j.acuroe.2026.501932","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 6","pages":"Article 501932"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313917","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":"Past and present of prostate cancer screening in the European Union","authors":"J. Gómez Rivas ,&nbsp;P. Gómez Dávila ,&nbsp;A.M. Tarrazo Antelo ,&nbsp;M. Corujo Quinteiro ,&nbsp;Á. Gómez Amorín ,&nbsp;A. Rodríguez Alonso ,&nbsp;J.M. Vilaseca ,&nbsp;H. López ,&nbsp;J.P. Salazar ,&nbsp;Á. Borque-Fernando ,&nbsp;J. Moreno-Sierra ,&nbsp;S. Collen ,&nbsp;K. Beyer ,&nbsp;J. Helleman ,&nbsp;M.J. Roobol ,&nbsp;H. van Poppel ,&nbsp;en representación de PRAISE-U Consortium","doi":"10.1016/j.acuroe.2026.501897","DOIUrl":"10.1016/j.acuroe.2026.501897","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer (PCa) screening based on prostate-specific antigen (PSA) testing has represented a major milestone in early detection; however, it has also prompted considerable debate due to the risks of overdiagnosis and overtreatment. This review examines the evolution of PCa screening, highlighting its main challenges and emerging approaches aimed at achieving more accurate and individualized detection.</div></div><div><h3>Methods</h3><div>A narrative review of the literature was conducted using databases such as PubMed and Google Scholar, applying MeSH terms related to screening, overdiagnosis, and prostate cancer. Clinical studies, systematic reviews, and recent guidelines pertinent to the topic were included.</div></div><div><h3>Results</h3><div>The PLCO, ERSPC, and Göteborg trials provide complementary insights into the impact of PSA-based screening, with outcomes ranging from limited benefit to significant reductions in PCa-specific mortality. Based on these this findings, a paradigm shift toward risk-stratified screening strategies has been advocated. The incorporation of new tools such as magnetic resonance imaging, blood and urine biomarkers, risk calculators, and artificial intelligence-based algorithms has improved diagnostic accuracy. These strategies reduce unnecessary biopsies and focus on the detection of clinically significant disease. Current guidelines recommend individualized assessment based on factors such as age, baseline PSA levels, family history, and comorbidities.</div></div><div><h3>Conclusion</h3><div>The future of PCa screening resides in personalized medicine, in which the integration of clinical, imaging, and molecular parameters will enable a more efficient approach, minimizing unnecessary interventions and improving overall patient outcomes.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 5","pages":"Article 501897"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919569","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":"Whole body bone mineral content and density associated with kidney stones in US adults: A national cross-sectional study","authors":"Li Chen ,&nbsp;Long Lv ,&nbsp;Zufa Zhang ,&nbsp;Sixiong Jiang","doi":"10.1016/j.acuroe.2026.501901","DOIUrl":"10.1016/j.acuroe.2026.501901","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Whole-body bone mineral content (BMC) and bone mineral density (BMD) can provide comprehensive information about the health of the whole body. This study aimed to assess whether BMC and BMD are potentially associated with self-reported kidney stones.</div></div><div><h3>Materials and methods</h3><div>Multiple logistic regression analysis was used to investigate the potential association between BMC/BMD and kidney stones. Subgroup analysis and interaction tests were used to examine the stability of the relationship. Restricted cubic spline plots were used to examine the dose-response relationship. Saturation effect and threshold effect analyses were used to assess inflection points in the dose-response relationship.</div></div><div><h3>Results</h3><div>The study population consisted of 8030 adults. Compared with those with low BMD levels, the prevalence of kidney stones was lower in those with high BMD levels (6.55% vs. 10.87%, <em>P</em> = 0.0001). After adjusting for all covariates, there was a negative association between whole-body BMC and kidney stones (OR = 0.06, 95% CI = 0.02−0.25; <em>P</em> &lt; 0.0001), and between whole-body BMD and kidney stones (OR = 0.19, 95% CI = 0.08−0.45; <em>P</em> = 0.0002). Subgroup analyses and interaction tests identified diabetes and smoking as significant influences. In the non-smoking population, a non-linear relationship was shown between BMD and kidney stones (non-linear P value = 0.039).</div></div><div><h3>Conclusions</h3><div>BMC and BMD were inversely associated with the prevalence of kidney stones in U.S. adults. Although causality cannot be established, these findings suggest that bone health assessment may help identify individuals at higher risk of kidney stones, especially among smokers and patients with diabetes.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 5","pages":"Article 501901"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919563","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":"Surgery or radiotherapy: Determining factors in therapeutic decision-making for localized prostate cancer in Spain","authors":"J. Perez-Ardavin ,&nbsp;C.D. Vera-Donoso ,&nbsp;J.M. Alapont ,&nbsp;M. Martinez-Sarmiento ,&nbsp;J.J. Monserrat ,&nbsp;J.L. Ruíz Cerdá ,&nbsp;A.J. Conde ,&nbsp;A. Budía Alba","doi":"10.1016/j.acuroe.2026.501929","DOIUrl":"10.1016/j.acuroe.2026.501929","url":null,"abstract":"<div><h3>Introduction</h3><div>The choice between radical prostatectomy (RP) and radiotherapy (RT) for localized prostate cancer depends on multiple factors. The aim of this study was to describe how urologists and radiation oncologists weigh these variables when recommending primary treatment, and to develop clinical decision support algorithms.</div></div><div><h3>Methods</h3><div>An online cross-sectional survey was designed for specialists in Urology and Radiation Oncology in Spain. The questionnaire was developed ad hoc and reviewed by an expert panel. Demographic data and treatment preferences were collected using a Likert scale (1–2 RP; 3 neutral; 4–5 RT) across hypothetical clinical scenarios. Clinical consensus was defined as agreement ≥75%.</div></div><div><h3>Results</h3><div>The mean age of respondents was 41.3 years (SD 10.3), with 68.5% urologists and 31.5% radiation oncologists. Overall, in young patients (&lt;50 years) with high IPSS (≥20), intravesical prostatic protrusion, Qmax &lt; 10 mL/sec, and elevated post-void residual (PVR), the preference for surgery was high (&gt;75%) (<em>p</em> &lt; 0.001). In contrast, in patients older than 70 years with multiple comorbidities and body mass index (BMI) &gt;35, a preference for radiotherapy (4–5) was observed in more than 75% of cases (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Treatment preferences for localized PCa depend primarily on age, comorbidity, and urinary symptoms, with consistent differences between specialties. These findings reinforce the need to integrate shared decision-making tools and to develop clinical decision support algorithms.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 5","pages":"Article 501929"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198322","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 use of presurgical urine cytology improves patient selection for a single instillation of MMC","authors":"C. Gómez del Cañizo ,&nbsp;N. Fernández Sánchez ,&nbsp;I. González Ginel ,&nbsp;M. Hernández Arroyo ,&nbsp;C. Martín-Arriscado Arroba ,&nbsp;A. de la Calle Moreno ,&nbsp;A. Rodríguez Antolín ,&nbsp;F. Guerrero Ramos","doi":"10.1016/j.acuroe.2026.501904","DOIUrl":"10.1016/j.acuroe.2026.501904","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess whether adding voided urine cytology to the European Organisation for Research and Treatment of Cancer (EORTC) score improves the indication for a single instillation of mitomycin C following transurethral resection of the bladder and whether this approach improves mitomycin C instillation rate.</div></div><div><h3>Materials and methods</h3><div>A retrospective observational study was conducted on 272 bladder cancer patients treated at a tertiary center from March 2020 to March 2022. After applying the exclusion criteria, 123 patients were included in the analysis. Voided urine cytology results and EORTC scores, with and without pathological data, were compared to the full EORTC 2006 score (gold standard) to evaluate the need for mitomycin C. Statistical analyses included sensitivity, specificity, receiver operating characteristic curves, and the Kappa index to measure test concordance. The method’s application in our center was also compared with existing literature.</div></div><div><h3>Results</h3><div>Combining urine cytology with the EORTC score without pathological data improved the accuracy of mitomycin C indications, increasing the area under the curve from 0.62 to 0.79. This approach reduced unnecessary mitomycin C administration in 53 patients, with only 6 patients missing beneficial treatment, none of whom were low-risk. Only 6 cases lacked documented reasons for not receiving the instillation, a better rate than reported in the literature.</div></div><div><h3>Conclusions</h3><div>Adding urine cytology to the EORTC score enhances the accuracy of mitomycin C indications, reducing unnecessary treatments while ensuring appropriate therapy for low-risk patients. Further studies are needed to validate these findings across different populations.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 5","pages":"Article 501904"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919560","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 ,&nbsp;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":"50 5","pages":"Article 501811"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","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":"50 5","pages":"Article 501813"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","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}

{"title":"Comment on “Profile of patients with clean intermittent catheterization and associated resource consumption. Multicenter study in Spain”","authors":"R. Mehta ,&nbsp;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":"50 5","pages":"Article 501795"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","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}