Actas urologicas espanolas最新文献

{"title":"A new machine learning model to predict novel trifecta achievement and validation of its prognostic significance in a large single centre series of minimally invasive partial nephrectomy","authors":"A. Farré ,&nbsp;A. Uleri ,&nbsp;A. Gallioli ,&nbsp;M. Baboudjian ,&nbsp;I. Sanz ,&nbsp;M. Casadevall ,&nbsp;P. Hernández ,&nbsp;A. Territo ,&nbsp;P. Gavrilov ,&nbsp;O. Rodríguez Faba ,&nbsp;J. Huguet ,&nbsp;J.M. Gaya ,&nbsp;J. Palou ,&nbsp;A. Breda","doi":"10.1016/j.acuroe.2026.501900","DOIUrl":"10.1016/j.acuroe.2026.501900","url":null,"abstract":"<div><h3>Introduction</h3><div>Novel trifecta has been proposed to define surgical success in patients undergoing partial nephrectomy (PN). This study aimed to evaluate its role in predicting survival outcomes and to identify the predictors of trifecta achievement via a machine-learning based model.</div></div><div><h3>Methods</h3><div>Data from consecutive patients who underwent minimally invasive PN between 2003 and 2022 were retrospectively analysed. Surgical success was defined through the achievement of novel trifecta (No Clavien-Dindo ≥ 3 postoperative complications, negative surgical margins and &lt;30% reduction in postoperative eGFR). Kaplan-Meier curves were used to assess the impact of trifecta achievement on survival. Automated chi-squared interaction detection (CHAID), a recursive machine-learning algorithm, was applied to predict trifecta achievement.</div></div><div><h3>Results</h3><div>A total of 465 patients were included, with a median follow-up of 72 (IQR 38–108) months. The trifecta was achieved in 73% of cases and was associated with significantly improved overall survival (85% vs. 69.8%; <em>P</em> = .04). Solitary kidney status, patient age, and surgical experience were the most relevant predictors, allowing classification into three clusters. Trifecta rates were 43.6% in cluster #1 (solitary kidney), 71.2% in cluster #2 (non-solitary kidney with surgical experience ≤ 80 cases or &gt;80 cases and patients-age ≥ 65), and 88.5% in cluster #3 (non-solitary kidney, patients-age &lt; 65, surgical experience &gt; 80 cases).</div></div><div><h3>Conclusions</h3><div>Novel trifecta achievement after PN correlates with overall survival but not with other oncological outcomes. A predictive model was developed, highlighting surgical experience as the only modifiable factor. Tailored perioperative strategies and advanced surgical training may improve trifecta achievement.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 5","pages":"Article 501900"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907309","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 the Modified Frailty Index-5 a reliable predictor of postoperative morbidity in elderly radical cystectomy patients? A comparative study with CCI and G8","authors":"A. Ayten,&nbsp;H. Ceylan,&nbsp;A.H. Kınık,&nbsp;M. Gelmis,&nbsp;S. Kardas","doi":"10.1016/j.acuroe.2026.501902","DOIUrl":"10.1016/j.acuroe.2026.501902","url":null,"abstract":"<div><h3>Objective</h3><div>In this study, the success of the Modified Frailty Index-5 (mFI-5) score in predicting postoperative morbidity in elderly patients who underwent radical cystectomy (RC) for bladder cancer was evaluated, and this score was compared with the widely used Charlson Comorbidity Index (CCI) and Geriatric 8 (G8) screening tools.</div></div><div><h3>Methods</h3><div>Between January 2017 and April 2025, 102 patients aged ≥65 years who underwent open RS for T2–T4a N0M0 bladder cancer were retrospectively reviewed. mFI-5, CCI, and G8 scores were calculated from preoperative data. Patients were divided into two groups based on mFI-5 scores: &lt;2 (Group 1, non-frail) and ≥2 (Group 2, frail). Major complications were defined as Clavien–Dindo (CD) ≥3. Clinical data, complication rates, hospital stay duration, and readmission rates after discharge were compared.</div></div><div><h3>Results</h3><div>Of the patients, 40 (39.2%) were in Group 1 and 62 (60.8%) were in Group 2. The rates of any complications and CD ≥ 3 complications were higher in Group 2 (<em>p</em> = 0.006 and <em>p</em> = 0.018, respectively). In multivariate analysis, mFI-5 ≥ 2 approximately tripled the risk of CD ≥ 3 complications (OR = 3.036; 95% CI 0.966–9.546; <em>p</em> = 0.043). In ROC analysis, the AUC value of mFI-5 for CD ≥ 3 complications was 0.718 (95% CI: 0.613–0.822), which was higher than that of CCI and G8. The AUC value of mFI-5 for predicting readmission was 0.704 (95% CI: 0.599–0.810).</div></div><div><h3>Conclusion</h3><div>mFI-5 is a practical frailty assessment tool that predicts postoperative morbidity in elderly RS patients with higher accuracy than CCI and G8.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 5","pages":"Article 501902"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907372","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 and rectal cancer development in prostate cancer patients treated with surgery or radiotherapy: A population-based study","authors":"P. Martínez Rodríguez,&nbsp;A. Poza Fernandez,&nbsp;G. García Fadrique,&nbsp;J. Acedo González,&nbsp;O. Montero Adriá,&nbsp;N. Mateo Cárcel,&nbsp;L. Marzullo Zucchet,&nbsp;F. Gómez Palomo,&nbsp;C. Reig Ruiz","doi":"10.1016/j.acuroe.2026.501928","DOIUrl":"10.1016/j.acuroe.2026.501928","url":null,"abstract":"<div><h3>Introduction</h3><div>Radical prostatectomy (RP) and radiotherapy (RT) are the main treatment options for localized and locally advanced (LA) prostate cancer (PCa). While erectile dysfunction and urinary incontinence have been widely studied, there is limited evidence regarding pelvic malignancies and radiation-induced rectal or urinary toxicity.</div></div><div><h3>Materials and methods</h3><div>This retrospective study involved patients with localized and LA PCa treated exclusively with RP or RT between 2010 and 2019 in our Health Department. A total of 356 patients were included: 138 treated with RP and 218 with RT. Rectal and bladder tumors, as well as urinary and gastrointestinal toxicity variables, were compared using the chi-square test (Fisher’s exact test when expected frequencies were &lt;5). Multivariate analysis was performed using logistic regression adjusted for clinical variables. Statistical significance was set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>Both groups were homogeneous in terms of tumor stage and smoking status. Statistically significant differences were observed between groups in the incidence of pelvic tumors [<em>P</em> = .032], bladder tumors [<em>P</em> = .033], and urinary and gastrointestinal toxicity [<em>P</em> &lt; .001]. Patients treated with radiotherapy had an almost 11-fold increased risk of bladder tumors (OR: 10.61; CI: 1.42–224.98).</div></div><div><h3>Conclusions</h3><div>In our series, patients with localized and LA PCa treated with RT presented a higher incidence of pelvic tumors and urinary/rectal toxicity compared with those treated with RP.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 5","pages":"Article 501928"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198384","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":"Incidence, risk factors and prognostic impact of pyelonephritis in cancer patients with percutaneous nephrostomy for malignant ureteral obstruction.","authors":"M Selman Mert, O Murat Ipek","doi":"10.1016/j.acuroe.2026.501993","DOIUrl":"10.1016/j.acuroe.2026.501993","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Percutaneous nephrostomy (PCN) is commonly used for malignant ureteral obstruction but carries significant infection risk in immunocompromised cancer patients. Data on pyelonephritis incidence, risk factors, and prognostic impact in this population remain limited. This study aimed to determine the incidence, risk factors, and prognostic impact of nephrostomy-related pyelonephritis and identify modifiable targets for infection prevention.</p><p><strong>Materials and methods: </strong>In this prospective observational study, 115 adult patients with malignancy-associated grade ≥2 hydronephrosis who underwent primary PCN were followed for two years. Demographic, oncological and procedural data, handwashing education status and laboratory parameters were recorded. Serial urine, renal pelvis, skin and catheter tip cultures were obtained. Pyelonephritis was defined by fever, flank pain and inflammatory markers with a positive urine culture. Pyelonephritis-free survival and overall survival were analyzed using Kaplan-Meier and Cox regression models.</p><p><strong>Results: </strong>During follow-up, pyelonephritis occurred in 65 patients (56.5%), with a mean pyelonephritis-free survival of 82.7 days. Female sex, prior colectomy, catheter dislocation, higher baseline WBC and higher C-reactive protein levels were independently associated with pyelonephritis. Two-year overall survival was 66.1% and baseline levels of albumin (low), WBC (high) and pyelonephritis presence independently predicted mortality. Handwashing education was strongly associated with a lower incidence of pyelonephritis and shorter hospital stay.</p><p><strong>Conclusions: </strong>In patients with malignant ureteral obstruction requiring PCN, pyelonephritis is a common complication with prognostic implications. Hand hygiene education, better catheter care, early detection/treatment, and follow-up of routine laboratory markers may reduce infection burden and improve survival in this highly vulnerable population.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501993"},"PeriodicalIF":0.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007761","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 ,&nbsp;A. Kamat ,&nbsp;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":"50 4","pages":"Article 501829"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","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":"Comment on “Analysis of device survival and predictive factors in a cohort of patients undergoing male artificial urinary sphincter implantation”. Authors’ reply","authors":"C. Minguez Ojeda,&nbsp;A. Artiles Medina","doi":"10.1016/j.acuroe.2025.501840","DOIUrl":"10.1016/j.acuroe.2025.501840","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501840"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058867","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 impact of multidisciplinary team meetings on the management of metastatic prostate cancer in a reference center","authors":"L.A. Pereira do Nascimento ,&nbsp;R.M. Mariano da Costa Junior ,&nbsp;V. Ramos Machado ,&nbsp;J.J. Saab Filho ,&nbsp;M.H. Bueno Bavaresco ,&nbsp;R. Panhoca ,&nbsp;W. Aparecido França ,&nbsp;L.A. Seabra Rios ,&nbsp;G. Pinheiro Soares","doi":"10.1016/j.acuroe.2026.501905","DOIUrl":"10.1016/j.acuroe.2026.501905","url":null,"abstract":"<div><h3>Introduction</h3><div>The management of metastatic prostate cancer (MPC) is complex and requires timely, coordinated decision-making across multiple specialties. Multidisciplinary team meetings (MDMs) have been increasingly adopted to optimize treatment planning, yet evidence regarding their impact on objective clinical outcomes in genitourinary cancers remains limited.</div></div><div><h3>Methods</h3><div>This retrospective, single-center cohort study compared two periods of MPC care: before MDM implementation (2018–2019) and after implementation (2021–2022). Patients were identified through institutional records. Demographic data, treatment timelines, therapeutic choices, and follow-up patterns were collected. Primary outcomes included time to clinical oncology consultation, time to treatment initiation, systemic therapy use, and follow-up adherence.</div></div><div><h3>Results</h3><div>One hundred thirty-nine patients were included, 72 in the 2018–2019 period and 67 in the 2021–2022 period. There was a significant reduction in the time taken to consult clinical oncology (<em>P</em> &lt; .05) and to start treatment (<em>P</em> &lt; .05). Systemic therapy started predominantly in the castration-sensitive setting (70.2% vs 14.3%; <em>P</em> &lt; .001). The MDM promoted a higher quality of treatment, with a greater prescription of docetaxel and novel antiandrogens (95.7% vs 64.3%; <em>P</em> = .001) and zoledronic acid in the castration-resistant phase (92.5% vs 79.2%; <em>P</em> = .047). The MDM discussion optimized follow-up, with loss to follow-up observed in only 7.5% of cases (<em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The implementation of multidisciplinary team meetings significantly improved the timeliness, quality, and adherence to oncological care for patients with metastatic prostate cancer. MDMs should be incorporated as a standard component of care in institutions managing this population.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501905"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919614","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":"Confirmatory MRI and re-biopsy findings during active surveillance in patients with grade group 2 prostate cancer","authors":"F. Sanguedolce ,&nbsp;M. Baboudjian ,&nbsp;A. Redondo Ríos ,&nbsp;R. Leni ,&nbsp;M. Oderda ,&nbsp;A. Peyrottes ,&nbsp;C. Kesch ,&nbsp;M. Al-Nader ,&nbsp;A. Uleri ,&nbsp;T. Long-Depaquit ,&nbsp;C. Dariane ,&nbsp;H. Baud ,&nbsp;J. Olivier ,&nbsp;V. Benard ,&nbsp;O. Windisch ,&nbsp;M. Valerio ,&nbsp;G. Gandaglia ,&nbsp;G. Ploussard","doi":"10.1016/j.acuroe.2026.501924","DOIUrl":"10.1016/j.acuroe.2026.501924","url":null,"abstract":"<div><h3>Introduction</h3><div>To report the results of confirmatory MRI/biopsy in a European cohort of MRI-selected patients with Gleason Grade Group (GG) 2 prostate cancer (PCa) in active surveillance (AS).</div></div><div><h3>Methods</h3><div>Multicenter study enrolled patients with GG2 PCa managed by AS between 2016−2024. Serial MRI scans were interpreted according to PRECISE recommendations. Diagnostic accuracy of PRECISE score to predict upgrading on confirmatory biopsy was assessed by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with 95% Confident Intervals (CIs).</div></div><div><h3>Results</h3><div>A total of 77 patients with GG2 PCa was included, with a PI-RADS 4−5 in 48 patients (63%). On confirmatory MRI, 32 cases were classified as PRECISE 4−5 (42%). On confirmatory biopsy, 39 patients (51%) were downgraded to GG0-1, 27 patients (35%) were GG 2 and upgrading occurred in 11 cases (14%). Sensitivity, specificity, NPV and PPV of the PRECISE score 4−5 to detect upgrading was 63.6% (95%CI 31–89), 62.1% (95%CI, 49–74), 91.1% (95%CI, 82–96) and 21.8% (95%CI, 14–32), respectively. In multivariable Cox hazards regression analysis, downgrading at confirmatory biopsy was significantly associated with a reduced risk of subsequent GG3 reclassification (HR 0.125, 95%CI, 0.277−0.560, <em>p</em> = 0.002) and definitive treatment (HR 0.409, 95%CI, 0.199−0.839, <em>p</em> = 0.015).</div></div><div><h3>Conclusion</h3><div>MRI selection of patients with GG2 PCa in AS allows better initial characterization of the disease. The absence of progression on MRI indicates a very low risk of grade reclassification, but signs of imaging progression are not always predictive of progression and should not be considered alone for prompting active treatment.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501924"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055876","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":"Active surveillance as the treatment of choice for low-risk prostate cancer: Reliability of results obtained through clinical language processing systems and big data","authors":"C. García-Fuentes ,&nbsp;V. Hernández ,&nbsp;J. Arias ,&nbsp;M. López ,&nbsp;E. de la Peña ,&nbsp;A. Guijarro ,&nbsp;E. Pérez-Fernández ,&nbsp;C. Llorente","doi":"10.1016/j.acuroe.2026.501907","DOIUrl":"10.1016/j.acuroe.2026.501907","url":null,"abstract":"<div><h3>Introduction</h3><div>Advances in natural language processing (NLP) technologies have gained prominence for extracting relevant clinical information. Savana is a platform capable of analyzing free-text data and interpreting the content of electronic health records (EHRs).</div></div><div><h3>Objective</h3><div>To validate the results obtained through NLP by Savana from data of patients with prostate cancer (PC) included in active surveillance (AS), compare them with our database, and assess their reliability.</div></div><div><h3>Methods</h3><div>Observational and retrospective study of patients with PC in AS between 2014 and 2022. The results from our database were blinded to Savana. Information from the EHRs was transformed by Savana into analysis-ready data. After an initial evaluation, it was necessary to refine the preliminary results and readjust the variables and terminology to eliminate discrepancies.</div></div><div><h3>Results</h3><div>Of the 2865 patients included in our database, 306 met the selection criteria. Savana detected 366 patients with the terms \"PC,\" \"Gleason,\" and \"AS.\" The results were similar regarding Gleason score at diagnosis: 93.4% Gleason 6 in our series vs. 92% in Savana. Likewise, the proportion of patients who received treatment with curative intent, and the type of treatment were comparable: 33.3% in our series (RP: 56.9%; RT: 42.1%) vs. 32.5% in Savana (RP: 59.7%; RT: 40.3%). However, only 24.8% showed Gleason progression in our series vs. 31% in Savana. The mortality rate was 3.2% in our series vs. 7.4% in Savana.</div></div><div><h3>Conclusions</h3><div>NLP represents a promising tool in clinical research, but its implementation should be approached with caution.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501907"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919271","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":"Erectile dysfunction and related variables due to anabolic steroid use. A review of reviews","authors":"M. García Vidal,&nbsp;A. Vázquez Méndez,&nbsp;I. Mollinedo Cardalda,&nbsp;I. De Oliveira","doi":"10.1016/j.acuroe.2026.501926","DOIUrl":"10.1016/j.acuroe.2026.501926","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Anabolic androgenic steroids are synthetic substances that mimic testosterone, promoting increased strength and muscle mass. Although they were initially used to achieve an increase in sports performance, nowadays most users are not professional athletes. Their use can cause various adverse effects, but despite these, they continue to be used to improve aesthetic and performance aspects. The purpose of this review of reviews was to examine the effects of anabolic androgenic steroids on male erectile function and related variables.</div></div><div><h3>Materials and methods</h3><div>A systematised literature review was carried out in Medline, Scopus, Pubmed, Cinahl, ScienceDirect, SPORTDiscus databases in July 2025. The search terms were ‘Anabolic Androgenic Steroids’, ‘Erectile Dysfunction’ and ‘Adverse effect’. The A Measurement Tool to Assess Systematic Review (AMSTAR-2) was used to assess the methodological quality of the selected reviews.</div></div><div><h3>Results</h3><div>Six systematic reviews were valid. Assessment of methodological quality using the AMSTAR-2 scale revealed that four reviews had critically low confidence, one review had low confidence, and one review had medium confidence. Despite methodological limitations, the reviews showed common findings associating prolonged use of anabolic androgenic steroids with the reduction in hormone levels, testosterone levels and reproductive function, leading to erectile dysfunction, in young adults (28–33 years) involved in weightlifting, powerlifting or bodybuilding.</div></div><div><h3>Conclusions</h3><div>The use of anabolic androgenic steroids appears to have a negative impact on erectile function and male reproductive health, with evidence of hypogonadism and hormonal alterations.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501926"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198376","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}