for Journals by Title or ISSN
for Articles by Keywords
help

Publisher: Elsevier   (Total: 3031 journals)

 A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  

        1 2 3 4 5 6 7 8 | Last   [Sort by number of followers]   [Restore default list]

Showing 1 - 200 of 3031 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 20, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 79, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 22, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 302, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 195, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 21, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 119, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 24, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 21, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 26, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 8, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 39, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 38, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 41, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 18, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 22)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 33, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 7, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 8)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 5, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 6, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 20, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 14)
Advances in Pharmacology     Full-text available via subscription   (Followers: 13, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 17, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 56)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 1, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 332, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 7)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 28, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 14)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 12)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 42, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 303, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 4, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 389, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 29, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 36, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 48, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 3, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 9, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 5)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 7, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 45, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 45, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 31, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 48, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 173, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 51, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 22, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 32, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 13, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 52, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 3)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 152, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 7, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 141, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

        1 2 3 4 5 6 7 8 | Last   [Sort by number of followers]   [Restore default list]

Journal Cover Actas Urológicas Españolas (English Edition)
  [2 followers]  Follow
    
   Full-text available via subscription Subscription journal  (Not entitled to full-text)
   ISSN (Print) 2173-5786
   Published by Elsevier Homepage  [3031 journals]
  • Systematic review of renal carcinoma prognostic factors
    • Authors: D. Lorente; E. Trilla; A. Meseguer; J. Planas; J. Placer; A. Celma; C. Salvador; L. Regis; J. Morote
      Abstract: Publication date: Available online 5 April 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): D. Lorente, E. Trilla, A. Meseguer, J. Planas, J. Placer, A. Celma, C. Salvador, L. Regis, J. Morote
      Context and objectives The natural history of renal cell carcinoma is heterogeneous. Some scenarios can be found in terms of clinical presentation, clinical evolution or type of recurrence (local/metastatic). The aim of this publication is to analyze the most important prognostic factors published in the literature. Evidence acquisition A literature review ob published papers was performed using the Pubmed, from first Motzer's classification published in 1999–2015, according to PRISMA declaration. Search was done using the following keywords: kidney neoplasm, kidney cancer, renal cell carcinoma, prognostic factors, mortality, survival and disease progression. Papers were classified according to level of evidence, the number of patients included and the type of study performed. Evidence synthesis The evolution in the knowledge of molecular pathways related to renal oncogenesis and the new targeted therapies has left to remain obsolete the old prognostic models. It is necessary to perform a continuous review to actualize nomograms and to adapt them to the new scenarios. Conclusions Is necessary to perform a proper external validation of existing prognostic factors using prospective and multicentric studies to add them into the daily urologist clinical practice.

      PubDate: 2017-04-11T07:36:48Z
      DOI: 10.1016/j.acuroe.2017.03.010
       
  • Influence of the location and number of metastases in the survival of
           metastatic prostatic cancer patients
    • Authors: A. Guijarro; V. Hernández; J.M. de la Morena; I. Jiménez-Valladolid; E. Pérez-Fernández; E. de la Peña; C. Llorente
      Abstract: Publication date: Available online 1 April 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Guijarro, V. Hernández, J.M. de la Morena, I. Jiménez-Valladolid, E. Pérez-Fernández, E. de la Peña, C. Llorente
      Introduction The prognosis of patients diagnosed with metastatic prostate cancer seems to be modulated by factors such as the number and site of metastases. Our objective is to evaluate survival outcomes according to the number and site of metastases in our series of metastatic patients over the last 15 years. Materials and methods A retrospective analysis was performed on patients diagnosed between 1998 and 2014. We analyzed overall survival and progression-free survival, depending on the number and location of metastases on patients with newly diagnosed metastatic prostate cancer. Other potential prognostic factors were also evaluated: age, clinical stage, PSA at diagnosis, Gleason, PSA nadir, time till PSA nadir and first-line or second-line treatment after progression. Results We analyzed a series of 162 patients. The mean age was 72.7yr (SD: 8.5). The estimated median overall survival was 3.9yr (95% CI 2.6–5.2). The overall survival in patients with only lymph node metastases was 7yr (95% CI 4.1–9.7), 3.9 (95% CI 2.3–5.5) in patients with only bone metastases, 2.5yr (95% CI 2–2.3) in lymph nodes and bone metastases, and 2.2yr (95% CI 1.4–3) in patients with visceral metastases (p <0.001). In multivariate analysis, the location of metastasesis significantly associated with overall survival and progression-free survival. The number of metastases showed no association with survival. Conclusions The site of metastases has a clear impact on both overall survival and progression-free survival. Patients with only lymph node involvement had a better prognosis. The number of metastases showed no significant impact on survival in our series.

      PubDate: 2017-04-04T06:17:52Z
      DOI: 10.1016/j.acuroe.2017.03.001
       
  • Effect of 5α-reductase inhibitors on sexual function: New
           contributions
    • Authors: Montero
      Abstract: Publication date: Available online 1 April 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Alcántara Montero


      PubDate: 2017-04-04T06:17:52Z
       
  • Renal cell carcinoma in Latin America: Do we know the relationship between
           demographic changes and the impact on our population?
    • Authors: J.A. Grandez-Urbina; R. Arias-Nolazco
      Abstract: Publication date: Available online 31 March 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.A. Grandez-Urbina, R. Arias-Nolazco


      PubDate: 2017-04-04T06:17:52Z
      DOI: 10.1016/j.acuroe.2017.03.009
       
  • Global vision system in laparoscopy
    • Authors: I. Rivas-Blanco; E. Sánchez-de-Badajoz; I. García-Morales; J.M. Lage-Sánchez; P. Sánchez-Gallegos; C.J. Pérez-del-Pulgar; V.F. Muñoz
      Abstract: Publication date: Available online 31 March 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): I. Rivas-Blanco, E. Sánchez-de-Badajoz, I. García-Morales, J.M. Lage-Sánchez, P. Sánchez-Gallegos, C.J. Pérez-del-Pulgar, V.F. Muñoz
      Objective The main difficulty in laparoscopic or robot-assisted surgery is the narrow visual field, restricted by the endoscope's access port. This restriction is coupled with the difficulty of handling the instruments, which is due not only to the access port but also to the loss of depth of field and perspective due to the lack of natural lighting. In this article, we describe a global vision system and report on our initial experience in a porcine model. Material and methods The global vision system consists of a series of intraabdominal devices, which increase the visual field and help recover perspective through the simulation of natural shadows. These devices are a series of high-definition cameras and LED lights, which are inserted and fixed to the wall using magnets. The system's efficacy was assessed in a varicocelectomy and nephrectomy. Results The various intraabdominal cameras offer a greater number of intuitive points of view of the surgical field compared with the conventional telescope and appear to provide a similar view as that in open surgery. Areas previously inaccessible to the standard telescope can now be reached. The additional light sources create shadows that increase the perspective of the surgical field. Conclusion This system appears to increase the possibilities for laparoscopic or robot-assisted surgery because it offers an instant view of almost the entire abdomen, enabling more complex procedures, which currently require an open pathway.

      PubDate: 2017-04-04T06:17:52Z
      DOI: 10.1016/j.acuroe.2017.03.007
       
  • Comparative study of hybrid laparoendoscopic single-site (LESS) partial
           nephrectomy and conventional multiport laparoscopy
    • Authors: C. Redondo; C. Esquinas; E. Meilán; A. García-Tello; I. Arance; J.C. Angulo
      Abstract: Publication date: Available online 31 March 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): C. Redondo, C. Esquinas, E. Meilán, A. García-Tello, I. Arance, J.C. Angulo
      Objective To investigate the surgical and oncological outcomes of hybrid laparoendoscopic single-site (LESS) in partial nephrectomy with reusable components compared with multiport laparoscopy. Material and method Hybrid LESS technique with auxiliary 3.5mm trocar (n =20) was compared with conventional multiport laparoscopy (n =26) by a prospective, paired, nonrandomized, and comparative study in partially nephrectomized patients. Results Follow-up average was 31±18.6 months. In one case, LESS was converted to laparoscopy. No differences were found regarding age, sex, body mass index, laterality, localization, tumor size or use of double J stent. Dominance of Loop-I (P =0.09) and benign histology (P =0.05) were observed in the LESS group. Neither there were differences regarding operating time, ischemia time, use of hemostatic materials, estimated blood loss, postoperative hemoglobin levels, transfusion or other complications. In any case, to extend the skin incision for specimen extraction was not necessary. Drainage time (P =0.006) and hospital stay (P =0.003) were better in LESS patients. Concerning complications, no significant differences were observed according Clavien-Dindo scale. In laparoscopic group one patient died of pulmonary embolism after hospital discharge. No positive margins were observed in any case. During follow-up neither tumor recurrence nor disease progression were observed. Conclusions Regarding surgical outcomes, partial nephrectomy by LESS technique does not imply improvements, excepting shorter hospital stay, probably due to accurate surgical hemostasis and/or selection of cases. No surgical and oncological risks are involved, as well as no improvement in ischemia time, blood loss or transfusion rate. We find no significant difference in cosmetic outcomes.

      PubDate: 2017-04-04T06:17:52Z
      DOI: 10.1016/j.acuroe.2017.03.003
       
  • Muscle function of the pelvic floor in healthy and puerperal women and
           with pelvic floor dysfunction
    • Authors: M.A. Castro-Pardiñas; M. Torres-Lacomba; B. Navarro-Brazález
      Abstract: Publication date: Available online 31 March 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): M.A. Castro-Pardiñas, M. Torres-Lacomba, B. Navarro-Brazález
      Objectives To understand the function of the pelvic floor muscles (PFM) at different ages in healthy women and in puerperal women with pelvic floor dysfunctions (PFD) and to ascertain whether there are differences among them. Material and methods A descriptive cross-sectional study was conducted between June 2014 and September 2016 and included 177 women, 70 of whom had no symptoms of PFD, 53 primiparous mothers in late postpartum and 54 with PFD. The function of the PFM was measured through vaginal palpation (quality of the contraction); manometry (force); dynamometer (tone, strength, and response to stretching), and surface electromyography (neuromuscular activity and resistance). Results The healthy women showed superior values for PFM tone, maximum strength, neuromuscular activity and resistance than the puerperal mothers and the women with PFD (p <0.01). The puerperal women and those with PFD showed similar functional PFM values (p >0.05). The muscle function of the healthy women did not vary significantly with age, except in the case of tone, which was lower in the women older than 46 years (p =0.004). Conclusions Age and births decrease the baseline tone of the PFM in healthy women. Therefore, lower strength, resistance and neuromuscular activity appear to be the main difference between the PFM of women with PFD and the PFM of healthy women.

      PubDate: 2017-04-04T06:17:52Z
      DOI: 10.1016/j.acuroe.2017.03.004
       
  • A comparison of 3 on-line nomograms with the detection of primary
           circulating prostate cells to predict prostate cancer at initial biopsy
    • Authors: N.P. Murray; C. Fuentealba; E. Reyes; O. Jacob
      Abstract: Publication date: Available online 31 March 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): N.P. Murray, C. Fuentealba, E. Reyes, O. Jacob
      Introduction The use of nomograms which include the PSA may improve the predictive power of obtaining a prostate biopsy (PB) positive for cancer. We compare the use of three on-line nomagrams with the detection of primary malignant circulating prostate cells (CPCs) to predict the results of an initial PB in men with suspicion of prostate cancer. Methods and patients Consecutive men with suspicion of prostate cancer underwent a 12 core TRUS prostate biopsy; age, total serum PSA, percent free PSA, family history, ethnic origin and prostate ultrasound results were used for risk assessment using the online nomograms. Mononuclear cells were obtained by differential gel centrifugation from 8ml of blood and CPCs were identified using double immunomarcation with anti-PSA and anti-P504S. A CPC was defined as a cell expressing PSA and P504S and defined as negative/positive. Biopsies were classified as cancer/no-cancer. Areas under the curve (AUC) for each parameter were calculated and compared and diagnostic yields were calculated. Results 1223 men aged >55 years participated, 467 (38.2%) had a biopsy positive for cancer of whom 114/467 (24.4%) complied with the criteria for active observation. Area under the curve analysis showed CPC detection to be superior (p <0.001), avoiding 57% of potential biopsies while missing 4% of clinically significant prostate cancers. Conclusions The CPC detection was superior to the nomograms in predicting the presence of prostate cancer at initial biopsy; its high negative predictive value potentially reduces the number of biopsies while missing few significant cancers, being superior to the nomograms in this aspect. Being a positive/negative test the detection of CPCs avoids defining a cutoff value which may differ between populations.

      PubDate: 2017-04-04T06:17:52Z
      DOI: 10.1016/j.acuroe.2017.03.002
       
  • Satisfaction and treatment adherence in erectile dysfunction in the medium
           and long term
    • Authors: J. Panach-Navarrete; A. Morales-Giraldo; C. Ferrandis-Cortés; F. García-Morata; J.C. Pastor-Lence; J.M. Martínez-Jabaloyas
      Abstract: Publication date: Available online 30 March 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J. Panach-Navarrete, A. Morales-Giraldo, C. Ferrandis-Cortés, F. García-Morata, J.C. Pastor-Lence, J.M. Martínez-Jabaloyas
      Introduction The aim of this study was to show the satisfaction and treatment adherence in erectile dysfunction (ED) in the medium and long term. Material and methods A descriptive, comparative study was conducted in 2 centres through telephone interviews with patients who came for an initial visit between 2012 and 2014 for ED. A complete case history review was conducted on the use of and withdrawal from treatment. For current use, the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and the Global Assessment Questionnaire (GAQ) were filled out; for past use, only the GAQ was filled out. For the statistical analysis, we employed Fisher's exact test for comparisons of percentages and the Kruskal–Wallis test to compare means. Results The study included 250 patients; 20.8% were prescribed intraurethral alprostadil (ALP-IU), 17.2% were prescribed intracavernous alprostadil (ALP-IC), 92.8% were prescribed a first IPD5, and 24.8% were prescribed at least a second IPD5. The treatment withdrawal rate was 62.07% for the first IPD5, 41.94% for the last IPD5, 69.23% for the ALP-IU and 65.11% for the ALP-IC (p =0.007). The main reason for withdrawal for the IPD5 was a lack of response (32.76% of those who took IPD5). In addition to withdrawal, there were adverse reactions for ALP-IU and ALP-IC (28.85% and 11.63%, respectively). The mean duration of use until withdrawal was 4.3 months for IPD5, 2.2 months for ALP-IU and 5.5 months for ALP-IC (p =0.064). The most favourable GAQ and EDITS scores were observed for IPD5 (EDITS score of 74). Sildenafil and tadalafil had the longest usage times (mean >5 months). Conclusions The withdrawal rate for treating ED is high, with short usage times of a few months. A lack of response and adverse reactions were the main causes for withdrawal. The drugs that provide greater satisfaction are the IPD5, although there are no significant differences in the mean usage time between the different types and in aspects such as the mean usage time to withdrawal or the withdrawal rates.

      PubDate: 2017-04-04T06:17:52Z
      DOI: 10.1016/j.acuroe.2017.03.005
       
  • Robot-assisted radical cystoprostatectomy: Analysis of the complications
           and oncological and functional aspects
    • Authors: A. Kanashiro; J.M. Gaya; J. Palou; L. Gausa; H. Villavicencio
      Abstract: Publication date: Available online 29 March 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Kanashiro, J.M. Gaya, J. Palou, L. Gausa, H. Villavicencio
      Objectives To review our experience in robot-assisted radical cystectomy, assessing the complications and oncological and functional results. Materials and methods From 2007 to 2014, we performed 67 robot-assisted radical cystectomies combined with lymphadenectomy in 61 cases. The operations were performed on 37 patients due to muscle-invasive tumors and on 30 due to high-risk nonmuscle-invasive tumors. Urinary diversion was conducted extracorporeally, using a Studer neobladder in 47 cases. Results The mean blood loss was 300mL. No case required conversion to open surgery. The median number of lymph nodes extracted was 16 (range 3–33). Pathology revealed 16 pT0, 15 pTis, -pT1-pTa and 44 muscle-invasive tumors, 8 pN+ and 1 with positive margins. The mean hospital stay was 9 days. With a median follow-up of 16 months, 9 (13%) patients were readmitted after the discharge, most for infections associated with the vesical catheter and other catheters. Forty patients (59.7%) presented complications (most were Clavien grade 1–2). There was recurrence during the follow-up in 4 cases (6%), and 4 (5.9%) patients died from cancer. Nineteen (28.3%) patients had complications after 30 days, most of which were urinary tract infections. Of the 47 patients with a neobladder, 45 (96%) had proper daytime continence and 42 (89%) had proper nighttime continence. Ninety percent and 64% of the patients with previously normal sexual function and reduced sexual function, respectively, were able to preserve sexual function with or without drug treatment. Conclusions Robot-assisted radical cystectomy plus lymphadenectomy, with extracorporeal reconstruction of the urinary diversion, offers good oncological and functional results without increasing the number of complications.

      PubDate: 2017-04-04T06:17:52Z
      DOI: 10.1016/j.acuroe.2017.03.006
       
  • Comparative study between thulium laser (Tm: YAG) 150W and Greenlight
           laser (LBO: ND-YAG) 120W for the treatment of benign prostatic
           hyperpplasia: Short-term efficacy and security
    • Authors: J.L. Palmero-Martí; J. Panach-Navarrete; L. Valls-González; A. Ganau-Ituren; J. Miralles-Aguado; A. Benedicto-Redón
      Abstract: Publication date: Available online 1 March 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.L. Palmero-Martí, J. Panach-Navarrete, L. Valls-González, A. Ganau-Ituren, J. Miralles-Aguado, A. Benedicto-Redón
      Objective To compare the results of efficacy and safety of thulium laser 150W against Greenlight laser 120W in the treatment of short term benign prostatic hyperplasia (12 months after surgery). Material and methods This is a retrospective observational study where men who underwent the surgical technique of prostate vaporization over a period of four years in our center are included. The homogeneity of the sample was checked, and postoperative complications (acute urinary retention, reentry, need for transfusion), failures per year of surgery (reoperation, peak flow <15ml/s, no improvement in comparing the I-PSS), and decreased PSA were compared a year after surgery. A bivariate analysis using Chi-square and t-Student was carried out. Results 116 patients were treated with thulium and 118 with green laser. The sample was homogeneous for preoperative variables (p >0.05). No differences in complications were observed: in urine acute retention, 4.3% with thulium and 6.8% with green laser (p =0.41); in readmissions, 2.6% with thulium and 1.7% with green laser (p =0.68); in need for transfusion, 2.6% with thulium and 0% with green laser (p =0.12). No differences were observed in the percentage of patients reoperation (1.7% in the group of thulium, 5.1% in the green laser, p =0.28); or in individuals with Qmáx less than 15ml/sec (6.9% with thulium, 6.77% with green laser, p =0.75), or in the absence of improvement in the IPSS (5, 2% with thulium, 3.4% with green laser, p =0.65). There was also no difference in the levels of PSA in ng/mL a year after surgery: with thulium 2.78±2.09 and with green laser 1.83±1.48 (p =0.75). Conclusions Prostate vaporization with thulium laser 150W is comparable to that made with green laser 120W for the treatment of lower urinary tract symptoms caused by BPH, being both effective and safe techniques to 12 months after surgery. Future prospective randomized studies are needed to confirm this conclusion on both techniques.

      PubDate: 2017-03-02T14:41:58Z
      DOI: 10.1016/j.acuroe.2017.02.007
       
  • Gleason sum upgrading between biopsy and radical prostatectomy in Chinese
           population: Updated nomograms
    • Authors: H. Xu; P.D. Bai; M.B. Hu; S.H. Mao; W.H. Zhu; J.M. Hu; S.H. Liu; T. Yang; J.Y. Hou; Y. Hu; Q. Ding; H.W. Jiang
      Abstract: Publication date: Available online 28 February 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): H. Xu, P.D. Bai, M.B. Hu, S.H. Mao, W.H. Zhu, J.M. Hu, S.H. Liu, T. Yang, J.Y. Hou, Y. Hu, Q. Ding, H.W. Jiang
      Introduction To assess the risk factors of Gleason sum upgrading between biopsy and radical prostatectomy (RP) and update the nomogram for the prediction of Gleason sum upgrading. Methods The study cohort consisted of 237 Chinese prostate adenocarcinoma patients who underwent 10-core prostate biopsy and subsequently received RP in Huashan Hospital from February 2011 to May 2015. The main outcome of our study was Gleason sum upgrading between biopsy and RP pathology. Univariate and multivariate logistic regression models were conducted to explore the potential predictors, and ultimately to build the nomograms. The prediction model was further evaluated for its ability to predict significant upgrading in patients with biopsy Gleason sum<8. Results In the main cohort of all the patients, Gleason sum upgrading was observed in 62 (26.16%) patients. The pre-operative prostate-specific antigen (PSA) level, biopsy Gleason sum, and digital rectal examination were used in building the nomogram, which was validated internally with a bootstrap-corrected concordance index of 0.787. In the sub-cohort of 115 patients with standardized biopsy details, Gleason sum upgrading was observed in 31 (26.96%) patients. The pre-operative PSA level, biopsy Gleason sum, and number of positive cores were used in the nomogram, which was also validated internally with a bootstrap-corrected concordance index of 0.833. These two nomograms both demonstrated satisfactory statistical performance for predicting significant upgrading. Conclusions Updated nomograms to predict Gleason sum upgrading in Chinese population between biopsy and RP were developed, demonstrating good statistical performance upon internal validation.

      PubDate: 2017-03-02T14:41:58Z
      DOI: 10.1016/j.acuroe.2017.02.004
       
  • Influence of social networks on congresses of urological societies and
           associations: Results of the 81st National Congress of the Spanish
           Urological Association
    • Authors: J. Gómez-Rivas; M.E. Rodríguez-Socarrás; L. Tortolero-Blanco; M. Garcia-Sanz; M. Alvarez-Maestro; M.J. Ribal; M. Cózar-Olmo
      Abstract: Publication date: Available online 28 February 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J. Gómez-Rivas, M.E. Rodríguez-Socarrás, L. Tortolero-Blanco, M. Garcia-Sanz, M. Alvarez-Maestro, M.J. Ribal, M. Cózar-Olmo
      Objective To measure social network activity during the 81st National Congress of the Spanish Urological Association (AEU) and to compare it with the activity during other congresses of national and international urological associations. Material and methods We designed and registered the official hashtag #AEU16 for the 81st National Congress of the AEU on the Symplur website. The following measurements were recorded: number of participants, number of tweets, tweets by participant, tweets per hour and views. Results The number of participants in the social network activity during the congress was 207. The measurements of activity in Twitter consisted of a total of 1866 tweets, a mean rate of 16 tweets/h, 9 tweets per participant and 1,511,142 views. The activity during the international congresses is as follows: 2016 American Urological Association annual congress (views: 28,052,558), 2016 European Association of Urology annual congress (views: 13,915,994), 2016 Urological Society of Australia and New Zealand (views: 4,757,453), 2015 Société Internationale d’Urologie annual congress (views: 1,023,038). The activity during the national congresses was recorded as follows: 2016 Annual Conference of The British Association of Urological Surgeons (views: 2,518,880), 81st National Congress of the AEU (views: 1,511,142), 109th Congress of l’Association Française d’Urologie (views: 662,828), 67th German Congress of Urology (views: 167,347). We found 10 posts in Facebook and 2 communications via Periscope TV related to #AEU16. Conclusions The social network activity during the 81st National Congress of the AEU was notable given the results of this study. The use of social networks has expanded among urological associations, congresses and meetings, giving them a global character.

      PubDate: 2017-03-02T14:41:58Z
      DOI: 10.1016/j.acuroe.2017.02.006
       
  • Expression of proteins FGFR3, PI3K, AKT, p21Waf1/Cip1 and cyclins D1 and
           D3 in patients with T1 bladder tumors: Clinical implications and
           prognostic significance
    • Authors: A.M. Blanca Pedregosa; Á. Sánchez-González; J. Carrasco Valiente; J.M. Ruiz García; E. Gómez Gómez; A. López Beltrán; M.J. Requena Tapia
      Abstract: Publication date: Available online 28 February 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A.M. Blanca Pedregosa, Á. Sánchez-González, J. Carrasco Valiente, J.M. Ruiz García, E. Gómez Gómez, A. López Beltrán, M.J. Requena Tapia
      Objective To determine the differential protein expression of biomarkers FGFR3, PI3K (subunits PI3Kp110α, PI3KClassIII, PI3Kp85), AKT, p21Waf1/Cip1 and cyclins D1 and D3 in T1 bladder cancer versus healthy tissue and to study their potential role as early recurrence markers. Material and method This is a prospective study that employed a total of 67 tissue samples (55 cases of T1 bladder tumors that underwent transurethral resection and 12 cases of adjacent healthy mucosa). The protein expression levels were assessed using Western blot, and the means and percentages were compared using Student's t-test and the chi-squared test. The survival analysis was conducted using the Kaplan–Meier method and the log-rank test. Results Greater protein expression was detected for FGFR3, PI3Kp110α, PI3KClassIII, cyclins D1 and D3 and p21Waf1/Cip1 in the tumor tissue than in the healthy mucosa. However, these differences were not significant for PI3Kp85 and AKT. We observed statistically significant correlations between early recurrence and PI3Kp110α, PI3KClassIII, PI3Kp85 and AKT (P =.003, P =.045, P =.050 and P =.028, respectively), between the tumor type (primary vs. recurrence) and cyclin D3 (p =0.001), between the tumor size and FGFR3 (p =0.035) and between multifocality and cyclin D1 (p =0.039). The survival analysis selected FGFR3 (p =0.024), PI3Kp110α (p =0.014), PI3KClassIII (p =0.042) and AKT (p =0.008) as markers of early-recurrence-free survival. Conclusions There is an increase in protein expression levels in bladder tumor tissue. The overexpression of FGFR3, PI3Kp110α, PI3KClassIII and AKT is associated with increased early-recurrence-free survival for patients with T1 bladder tumors.

      PubDate: 2017-03-02T14:41:58Z
      DOI: 10.1016/j.acuroe.2017.02.014
       
  • Castrate resistant prostate cancer. Consensus recommendations of the
           Spanish Association of Urology
    • Authors: A. Loizaga-Iriarte; I. Lacasa-Viscasillas; N. Senarriaga-Ruiz de la Illa; M. Unda-Urzaiz; A. Rodriguez-Antolin; B. Miñana-Lopez; J.M. Cozar-Olmo
      Abstract: Publication date: Available online 24 February 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Loizaga-Iriarte, I. Lacasa-Viscasillas, N. Senarriaga-Ruiz de la Illa, M. Unda-Urzaiz, A. Rodriguez-Antolin, B. Miñana-Lopez, J.M. Cozar-Olmo


      PubDate: 2017-03-02T14:41:58Z
      DOI: 10.1016/j.acuroe.2017.02.001
       
  • Median raphe cysts in men. Presentation of our experience and literature
           review
    • Authors: V. Navalón-Monllor; M.V. Ordoño-Saiz; F. Ordoño-Domínguez; V. Sabater-Marco; Y. Pallás-Costa; P. Navalón-Verdejo
      Abstract: Publication date: Available online 24 February 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): V. Navalón-Monllor, M.V. Ordoño-Saiz, F. Ordoño-Domínguez, V. Sabater-Marco, Y. Pallás-Costa, P. Navalón-Verdejo
      Objectives To present our experience with the diagnosis and treatment of median raphe cysts treated in our department in the last 25 years. Material and method We conducted a retrospective study of 28 men with median raphe cysts who underwent surgery in our department from June 1990 to March 2015. We analyzed the age of presentation, reason for consultation, clinical manifestations, histological findings, treatment and outcome after exeresis. Results The majority of the patients (22; 79%) were asymptomatic and consulted for the esthetic defect. Four cases (14%) presented urinary abnormalities, and 2 cases (7%) reported discomfort during sexual intercourse. In all cases, the treatment consisted of surgical extirpation of the cysts, with excellent esthetic and functional results and no lesion recurrence in any of the patients during a mean follow-up of more than 10 years. The most common histological type was the transitional cell type in 15 cases (54%), followed by the mixed type (transitional and squamous) in 11 cases (39%). One case (6%) was pure squamous type, and in another case (6%) the epithelium was glandular. Conclusions Median raphe cysts are an uncommon type of disembryoplasia that can occur in any location of the median raphe, from the balanic meatus to the edges of the anus. These cysts are generally asymptomatic and their treatment of choice is surgical extirpation.

      PubDate: 2017-03-02T14:41:58Z
      DOI: 10.1016/j.acuroe.2017.02.010
       
  • Alphablockers and 5 α-reductase inhibitors, before or after meals? Do
           they interact with alcohol?
    • Authors: Montero
      Abstract: Publication date: Available online 24 February 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Alcántara Montero


      PubDate: 2017-03-02T14:41:58Z
       
  • Combination of extracorporeal lithotripsy and flexible ureterorenoscopy
           optimize renal lithiasis therapy
    • Authors: A. Pérez-Lanzac; P. Parra-Serván; C. León-Delgado; Z. Okhunov; A. Lusch; J.L. Álvarez-Ossorio
      Abstract: Publication date: Available online 24 February 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Pérez-Lanzac, P. Parra-Serván, C. León-Delgado, Z. Okhunov, A. Lusch, J.L. Álvarez-Ossorio
      Objective Describe our initial experience in the treatment of renal lithiasis with extracorporeal lithotripsy controlled by simultaneous flexible ureterorenoscopy and combined with holmium laser lithotripsy. Material and methods We performed this novel technique in a previously selected patient with left renal lithiasis, two in the superior calix, two in the medium calix and two in the inferior calix, the biggest of which was placed in medium calix and was 6mm long. We proceeded to an extracorporeal shock wave lithotripsy and a simultaneous flexible ureterorenoscopy for better controlling the fragmentation of the lithiasis with the use of a holmium laser. In the immediate post-operative, an ultrasound was performed and, one month later, a computerized tomography (CT) was done. Results The complete fragmentation of all the lithiasis was obtained and a double-J catheter was placed. After the assessment of the absence of stone fragments by CT the catheter was removed. No intra-operative or post-operative complications were described. Conclusions The technique described is novel, safe and reproducible. The good result obtained through this combined technique increases our interest in continuing with its application and consider it as an option for the treatment of renal lithiasis in our patients.

      PubDate: 2017-03-02T14:41:58Z
      DOI: 10.1016/j.acuroe.2017.02.009
       
  • Treatment of Leydig cell tumors of the testis: Can testis-sparing surgery
           replace radical orchidectomy? Results of a systematic review
    • Authors: G. Bozzini; D. Ratti; L. Carmignani
      Abstract: Publication date: Available online 24 February 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): G. Bozzini, D. Ratti, L. Carmignani
      Introduction The gold standard for Leydig cell tumors (LCTs) is still considered radical orchidectomy, but testis sparing surgery (TSS) in conjunction with intraoperative frozen section (FSE) has been recently attempted with promising results. Acquisition of evidence Studies were identified by searching electronic databases. A bibliographic search covering the period from January 1980 to December 2012 was conducted using PubMed/MEDLINE and EMBASE database. Studies were excluded if they were single case reports, meeting abstracts and conference proceedings. Synthesis of evidence The present analysis is based on a total of 13 studies that fulfilled the predefined inclusion criteria. A total of 247 participants were included in the 13 studies examined in this systematic review. 145 were treated with radical orchiectomy and 102 with TSS. In the radical surgery group, the follow-up varied from 6 to 249 months. In the TSS group, the follow-up varied from 6 to 192 months. Frozen section was performed in a total of 96 patients. Sensitivity was 87.5%. None of the patients treated with TSS presented a metastatic recurrence, while in patients treated with radical orchiectomy three patients presented with metastatic recurrence. In selected cases radical surgery appears excessive and the potential for a shift to TSS as the standard management is gathering momentum. Conclusions The results confirm the favorable course of LCT treated with TSS. The results obtained are encouraging and the concept is attractive to become the standard therapy in all patients and not only in people affected by (sub)fertility or with solitary testis.

      PubDate: 2017-03-02T14:41:58Z
      DOI: 10.1016/j.acuroe.2017.02.002
       
  • Higher number of transrectal ultrasound guided prostate biopsy cores is
           associated with higher blood loss and perioperative complications in robot
           assisted radical prostatectomy
    • Authors: A. Carneiro; A. Sivaraman; R. Sanchez-Salas; I. Nunes-Silva; M. Baghdadi; V. Srougi; E. di Trapani; F. Uriburu Pizzaro; S. Doizi; E. Barret; F. Rozet; M. Galiano; X. Cathelineau
      Abstract: Publication date: Available online 24 February 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Carneiro, A. Sivaraman, R. Sanchez-Salas, I. Nunes-Silva, M. Baghdadi, V. Srougi, E. di Trapani, F. Uriburu Pizzaro, S. Doizi, E. Barret, F. Rozet, M. Galiano, X. Cathelineau
      Introduction The local inflammatory process after prostate biopsies can have a negative impact on functional outcomes of radical prostatectomy. There is no evidence in literature demonstrating its impact on radical prostatectomy. Objectives To evaluate the impact of the number of TRUS core biopsies in the surgical morbidity and rate of positive margin on robot assisted radical prostatectomy (RARP). Material and methods A prospectively maintained database of 2054 RARPs in a single institution. Patients were further grouped into 2 groups based on the number of TRUS biopsy cores (G1≤12 cores; G2>12 cores). Multivariable logistic regression model was applied to analyze the impact of number of cores on complications. Results A total number of 1042 patients in the group 1 (≤12 cores) and 1012 patients in the group 2 (>12 cores) were included. The rate of perioperative complications increased with higher number of biopsies (G1 6.4 vs. G2 8.5%; p =0.03), but high grade complication (Clavien 3–4) were similar (G1 1.4 vs. G2 2.2%; p =0.16). Positive surgical margin rates were similar in both groups (G1 11.8 vs. 9.98%; p =0.2). At the multivariable logistic regression analysis shown that G2 had a 39% (OR 0.645) higher rate to experience perioperative complications during RARP. Conclusion Higher number of TRUS biopsy cores (>12) is associated to higher blood loss and perioperative complications during RARP. Careful preoperative evaluation for those patients underwent multiple biopsies or saturation protocols is mandatory. Application of longer intervals (>6 weeks) between biopsy and surgery may be advisable to minimize potential risks of surgical complications in patients may benefit from RARP. Further studies are still necessary to confirm these results.

      PubDate: 2017-03-02T14:41:58Z
      DOI: 10.1016/j.acuroe.2017.02.003
       
  • Internal consistency reliability of single-item measures
    • Authors: S.A. Dominguez-Lara; C. Merino-Soto
      Abstract: Publication date: Available online 24 February 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): S.A. Dominguez-Lara, C. Merino-Soto


      PubDate: 2017-03-02T14:41:58Z
      DOI: 10.1016/j.acuroe.2017.02.013
       
  • Abiraterone acetate suppression syndrome
    • Authors: A. Husillos-Alonso; E. Bolufer-Moragues; C. González-Enguita
      Abstract: Publication date: Available online 24 February 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Husillos-Alonso, E. Bolufer-Moragues, C. González-Enguita


      PubDate: 2017-03-02T14:41:58Z
      DOI: 10.1016/j.acuroe.2017.02.011
       
  • Comparative analysis between percutaneous nephrolithotomy and flexible
           ureteroscopy in kidney stones of 2–3cm
    • Authors: E. Pieras; V. Tubau; X. Brugarolas; J. Ferrutxe; P. Pizá
      Abstract: Publication date: Available online 24 February 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): E. Pieras, V. Tubau, X. Brugarolas, J. Ferrutxe, P. Pizá
      Introduction To compare percutaneous nephrolithotomy and flexible ureterorenoscopy for treating kidney stones between 2 and 3cm. Material and methods A prospective, comparative, nonrandomised study was conducted with 108 patients with kidney stones between 2 and 3cm. Fifty-four patients underwent percutaneous nephrolithotomy and 54 underwent flexible ureteroscopy. We compared the following variables: lithiasis-free rate (%), surgical time, the need for an auxiliary process, postoperative complications, hospital stay, readmission rates and recovery time. Results There were no differences in the lithiasis-free rate between the 2 surgical techniques (76% for ureteroscopy vs. 87% for nephrolithotomy; p =0.1) or in the complications (29% for nephrolithotomy vs. 27% for ureteroscopy; p =0.4). A larger number of auxiliary process were needed for the ureteroscopy group (20%) than for the nephrolithotomy group (7%) (p =0.04). The surgical time was longer for the nephrolithotomy group (121±52min) than for the ureteroscopy group (93±42min) (p =0.004). The ureteroscopy group had shorter hospital stays (2.1±1.6 vs. 3.9±1.9 days; p =0.002), shorter convalescence (8.1±4.9 vs. 13.3±4.2 days; p =0.005) and higher readmission rates (7.4% vs. 0%, p =0.05) than the nephrolithotomy group. Conclusions Nephrolithotomy and ureteroscopy have similar efficacy for treating kidney stones measuring 2–3cm, with no differences in complications. Ureteroscopy results in shorter hospital stays, quicker recoveries but more readmissions and a greater need for auxiliary procedures.

      PubDate: 2017-03-02T14:41:58Z
      DOI: 10.1016/j.acuroe.2017.02.008
       
  • High-dose rate brachytherapy as monotherapy in prostate cancer: A
           systematic review of its safety and efficacy
    • Authors: L.M. Sánchez-Gómez; M. Polo-deSantos; J.I. Rodríguez-Melcón; J.C. Angulo; S. Luengo-Matos
      Abstract: Publication date: Available online 18 January 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): L.M. Sánchez-Gómez, M. Polo-deSantos, J.I. Rodríguez-Melcón, J.C. Angulo, S. Luengo-Matos
      Context High-dose rate brachytherapy (HDR-BT) is an increasingly popular treatment for patients with localized prostate cancer (PC). Objective To assess the safety and efficacy of HDR-BT as monotherapy in PC. Acquisition of evidence A systematic literature review was conducted through searches on MEDLINE (PubMed), Cochrane Library, CDR, ClinicalTrials and EuroScan. We assessed safety and efficacy indicators. Summary of the evidence We selected 2 reviews and 12 uncontrolled studies, included in these 2 reviews. In terms of efficacy, local control in 6 studies was 97–100%. The biochemical progression-free survival varied as follows: 85–100% for low risk and 79–92% for high risk. Survival free of metastases was >95% at 8 years, except in one study where the survival rate was 87% at 5 years. The overall survival was ≥95% in 8 studies. In terms of safety, most of the studies recorded acute and long-term genitourinary and gastrointestinal complications, especially grade ≥2. Only 3 studies found grade 4 complications. All studies, except for one without complications, observed genitourinary complications that were more frequent and severe than the gastrointestinal complications. Two studies assessed the quality of life and showed an initial reduction in various domains and subsequent partial or total recovery, except in the sexual domain. Conclusions HDR-BT is effective as monotherapy, especially in cases of low to intermediate risk. There is insufficient information on high-risk patients. The short to medium-term toxicity was acceptable. Further research needs to be funded to provide more information on the long-term safety and efficacy of this treatment.

      PubDate: 2017-01-21T21:55:48Z
      DOI: 10.1016/j.acuroe.2016.12.001
       
  • Cost analysis of surgical treatment for pelvic organ prolapse by
           laparoscopic sacrocolpopexy or transvaginal mesh
    • Authors: D. Carracedo; L. López-Fando; M.D. Sánchez; M.Á. Jiménez; J.M. Gómez; I. Laso; M.Á. Rodríguez; F.J. Burgos
      Abstract: Publication date: Available online 18 January 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): D. Carracedo, L. López-Fando, M.D. Sánchez, M.Á. Jiménez, J.M. Gómez, I. Laso, M.Á. Rodríguez, F.J. Burgos
      Objectives The objective of this study is to compare direct costs of repairing pelvic organ prolapse by laparoscopic sacrocolpopexy (LS) against vaginal mesh (VM). Our hypothesis is the correction of pelvic organ prolapse by LS has a similar cost per procedure compared to VM. Material and methods We made a retrospective comparative analysis of medium cost per procedure of first 69 consecutive LS versus first 69 consecutive VM surgeries. We calculate direct cost for each procedure: structural outlays, personal, operating room occupation, hospital stay, perishable or inventory material and prosthetic material. Medium cost per procedure were calculated for each group, with a 95% confidence interval. Results LS group has a higher cost related to a longer length of surgery, higher operating room occupation and anesthesia; VM group has a higher cost due to longer hospital stay and more expensive prosthetic material. Globally, LS has a lower medium cost per procedure in comparison to VM (5985.7€±1550.8€ vs. 6534.3€±1015.5€), although it did not achieve statistical signification. Conclusions In our midst, pelvic organ prolapse surgical correction by LS has at least similar cost per procedure compared to VM.

      PubDate: 2017-01-21T21:55:48Z
      DOI: 10.1016/j.acuroe.2016.12.006
       
  • Impact of neoadjuvant chemotherapy on complications of minimally invasive
           radical cystectomy
    • Authors: D. Lizée; R.S. Salas; E. Barret; M. Galiano; E. Di Trapani; F. Montorsi; X. Cathelineau
      Abstract: Publication date: Available online 12 January 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): D. Lizée, R.S. Salas, E. Barret, M. Galiano, E. Di Trapani, F. Montorsi, X. Cathelineau
      Background Neoadjuvant chemotherapy (NC) before minimally invasive radical cystectomy (MIRC) is considered a standard of care in muscle-invasive bladder cancer or recurrent high-risk non–muscle-invasive bladder cancer. Objective To evaluate the impact of NC on morbidity and mortality after MIRC. Design, setting, and participants We prospectively evaluated 135 patients who underwent MIRC (laparoscopic: n =100; robotic: n =35) between 2007 and 2013 with ≥90 days of follow-up (median age: 66 years). Complications were analyzed and graded according to the Clavien–Dindo classification system. Outcome measurements and statistical analysis Logistic regression models were used to evaluate the impact of NC on postoperative complications. Kaplan–Meier methods with the log-rank test were used for cancer-specific survival probabilities and differences between the two groups (MIRC with and without NC). Results and limitations Sixty-two of 135 patients received NC. A total of 118 patients (87.4%) developed 179 complications, chiefly infectious (48.0%) or gastrointestinal (21.2%), ≤90 days after surgery; 3 patients died <90 days after cystectomy (none had NC). NC had no impact on the incidence of postoperative complications but was associated with fewer positive nodes (p =0.004) compared with patients without NC. The median duration of follow-up was 17.2 months. Overall survival rates were 83% and 79% at 2 years in patients with NC and without NC, respectively. Conclusions NC does not affect postoperative morbidity or postoperative mortality. Longer follow-up is needed to evaluate the impact of NC on oncologic outcomes. Patient summary Perioperative complications of radical cystectomy were compared for patients with bladder cancer who had NC vs no NC. We did not find any significant differences in terms of early or late complications, length of stay, or reintervention. The oncologic outcomes regarding NC were encouraging.

      PubDate: 2017-01-14T21:23:30Z
      DOI: 10.1016/j.acuroe.2016.12.003
       
  • Adipocyte accumulation in corpus cavernosum: First clinical evidence and
           pathophysiological implications in erectile dysfunction
    • Authors: J. Vinay; J. Sarquella; J. Sanchez; F. Algaba; I. Gallegos; E. Ruiz-Castañe; C. Palma
      Abstract: Publication date: Available online 12 January 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J. Vinay, J. Sarquella, J. Sanchez, F. Algaba, I. Gallegos, E. Ruiz-Castañe, C. Palma
      Objectives Animal models have shown that erectile dysfunction is associated with adipocyte accumulation under tunica albugínea, which could be involved in venous leakage and loss of penile rigidity. In the current study, we compared the histology of the penile sub-albuginean region of drug-refractory erectile dysfunction patients undergoing penile prosthesis implantation with potent patients with Peyronie's disease undergoing curvature correction procedures. Materials and methods Seventeen refractory erectile dysfunction patients and fourteen potent patients with Peyronie's disease were recruited. Sub-albuginean tissue samples were taken in each surgery. An expert uropathologist analyzed each section. A bivariate analysis was performed. Multivariate logistic regression was used to calculate adjusted odds ratios; p value <0.05 was considered significant. Results Eleven patients (11/17) in the case group presented cavernous fat cell accumulation, while only one patient (1/14) in the control group presented this finding (p <0.05). Adjusted odds ratio for erectile dysfunction was 40.72; 95% CI 2.28–727.29 (p =0.012). Conclusions Different studies have shown that androgen disruption could be involved in penile structural changes, leading to trabecular smooth muscle apoptosis and trans or de-differentiation into adipocytes. This is the first prospective study in humans to report an association between erectile dysfunction and sub-albuginean adipocyte accumulation. Venous leakage secondary to this phenomenon could be a factor in the pathophysiology of erectile dysfunction, especially in patients that do not respond to medical therapy.

      PubDate: 2017-01-14T21:23:30Z
      DOI: 10.1016/j.acuroe.2016.12.011
       
  • Corynebacterium urealyticum: The historical importance of its discovery
    • Authors: C. González-Enguita; R. Vela-Navarrete
      Abstract: Publication date: Available online 12 January 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): C. González-Enguita, R. Vela-Navarrete


      PubDate: 2017-01-14T21:23:30Z
      DOI: 10.1016/j.acuroe.2016.12.010
       
  • Treatment of long anterior urethral stricture associated to lichen
           sclerosus
    • Authors: J.C. Angulo; I. Arance; C. Esquinas; D. Nikolavsky; N. Martins; F. Martins
      Abstract: Publication date: Available online 12 January 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.C. Angulo, I. Arance, C. Esquinas, D. Nikolavsky, N. Martins, F. Martins
      Introduction Panurethral stricture associated with lichen sclerosus is a therapeutic challenge. We present the analysis of our results using two urethroplasty techniques based on oral mucosa graft. Material and method Retrospective study in patients with long anterior urethral stricture (>8cm) associated with lichen sclerosus. Patients received urethroplasty with oral mucosa graft technique according Kulkarni (n =25) or two-step Johanson–Bracka urethroplasty (n =15). Demographics, operative time, complications (Clavien–Dindo), hospital stay, days with catheter, EAV postoperative pain, failure rate, need for retreatment and functional data including IPSS, QoL, Qmax, post void residual (PVR) are evaluated. Results In all cases there was involvement of glandular and penile urethra, and in 75% of bulbar urethra. A single graft was used in 22.5%, two in 72.5% and three in 5%. Patients treated at a single step were younger (p =0.007). Although the length of the stenosis was equivalent in both techniques (p =0.96), relapse and complication rates were higher in two-step surgery (p =0.05 and p =0.03; respectively) and so was operative time (p <0.0001) and overall stay (p =0.0002). There were no differences in preoperative IPSS, QoL, Qmax or PVR, neither in postoperative values of IPSS or Qmax; but there was a difference in QoL (p =0.006) and PVR (p =0.03) favoring single-step urethroplasty. VAS pain on postoperative day 1 was also lower in Kulkarni urethroplasty than in the first step of Johanson–Bracka technique (p <0.0001). Conclusions In patients with lichen sclerosus and long anterior urethral stricture Kulkarni urethroplasty provides more efficient and better patient reported outcomes than Johanson–Bracka urethroplasty. It also prevents cosmetic, sexual and voiding temporary deterioration inherent to 2-step surgery.

      PubDate: 2017-01-14T21:23:30Z
      DOI: 10.1016/j.acuroe.2016.12.007
       
  • Satisfaction of patients with Peyronie's disease after plaque surgery and
           bovine pericardium graft
    • Authors: A. Silva Garretón; D. Santillán; D. Chávez; A. Gioielli; G. Rey-Valzacchi; O. Layus; G. Gueglio
      Abstract: Publication date: Available online 11 January 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Silva Garretón, D. Santillán, D. Chávez, A. Gioielli, G. Rey-Valzacchi, O. Layus, G. Gueglio
      Introduction Plaque and bovine pericardium graft surgery is a useful tool for treating Peyronie's disease. Objective To determine patient satisfaction following this operation. Materials and methods This was a retrospective, observational and descriptive study. We collected data from the medical records of patients who underwent surgery between 2004 and 2015 and were evaluated through a postoperative satisfaction questionnaire. Results Twenty-eight operations were performed. Curve correction was achieved in 26 patients (95.3%). One patient (3.57%) required residual curve correction using Yachia's technique, and 1 patient (3.57%) had a severe complication consisting of prosthetic infection and urethrocutaneous fistulae. Twenty-one patients (75%) expressed satisfaction with the surgery. Conclusions Our results show an acceptable level of satisfaction among our patients, with a low number of complications. However, further prospective, controlled and randomized studies are needed.

      PubDate: 2017-01-14T21:23:30Z
      DOI: 10.1016/j.acuroe.2016.12.004
       
  • Surgical wound infection in urology. Analysis of risk factors and
           associated microorganisms
    • Authors: M. Alonso-Isa; J. Medina-Polo; A. Lara-Isla; S. Pérez-Cadavid; A. Arrébola-Pajares; R. Sopeña-Sutil; R. Benítez-Sala; J. Justo-Quintas; J. Gil-Moradillo; J.B. Passas-Martínez; A. Tejido-Sánchez
      Abstract: Publication date: Available online 9 January 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): M. Alonso-Isa, J. Medina-Polo, A. Lara-Isla, S. Pérez-Cadavid, A. Arrébola-Pajares, R. Sopeña-Sutil, R. Benítez-Sala, J. Justo-Quintas, J. Gil-Moradillo, J.B. Passas-Martínez, A. Tejido-Sánchez
      Objectives Open surgery continues to have a fundamental role in urology, and one of its main complications is surgical wound infection. Our objective was to analyze surgical wound infection in patients who underwent surgery in our Department of Urology and to assess the risk factors, microorganisms and resistances by type of surgery. Material and methods This was a prospective observational study that included 940 patients: 370 abdominal/open lumbar surgeries and 570 genitoperineal surgeries. We analyzed age, sex, comorbidities, stay and type of surgery, as well as the causal microorganisms and antibiotic resistances. Results For genitoperineal surgery, we found 15 cases (2.6%) of surgical wound infection associated with previous urinary catheterisation. Most of the isolated microorganisms corresponded to enterobacteriaceae, highlighting the resistance to beta-lactam. In abdominal/lumbar surgery, we found 41 cases (11.1%) of surgical wound infection. The incidence rate was 3.3% in prostate surgery; 9.8% in renal surgery; and 45.0% in cystectomy. Heart disease was associated with a higher incidence rate of surgical wound infection. The most common microorganisms were Enterococcus spp. (27.1%), E. coli (22.9%) and Staphylococcus aureus (14.6%). Enterococcus was resistant to ampicillin in 37.5%, and Extended-Spectrum Betalactamase-producing E. coli were isolated in 41.7%. Conclusions We found a low incidence rate of surgical wound infection in genitoperineal surgery, compared with renal surgery and cystectomy. The presence of heart disease and carrying a previous urinary catheter are factors associated with surgical wound infection. Enterococcus and E. coli are the most common pathogens, with high rates of resistance.

      PubDate: 2017-01-14T21:23:30Z
      DOI: 10.1016/j.acuroe.2016.12.005
       
  • Renal cell carcinoma with vascular invasion: Mortality and prognostic
           factors
    • Authors: M.A. Rodríguez-Cabello; I. Laso-García; F. Donis-Canet; V. Gómez-Dos-Santos; C. Varona-Crespo; F.J. Burgos-Revilla
      Abstract: Publication date: Available online 6 January 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): M.A. Rodríguez-Cabello, I. Laso-García, F. Donis-Canet, V. Gómez-Dos-Santos, C. Varona-Crespo, F.J. Burgos-Revilla
      Objective Analysis of the results of patients who had been operated of renal cell carcinoma with vascular invasion in our institution, evaluation of prognostic factors and complications. Methods Retrospective observational study of 37 patients diagnosed of renal cell carcinoma with vascular invasion operated between May 1999 and July 2013. We used the method of Kaplan–Meier survival analysis and the Mantel–Haenszel's test (log rank) and the Cox's proportional hazards analysis test to analyse the risk factors of mortality. Results The median age was 60 years. Mean follow-up period was 42.1 months. The median overall survival and disease-free survival were 53.8 and 36.3 months, respectively. There was statistical association between overall survival and American Society of Anesthesiologists Classification score (p =0.047), tumor stage (p =0.003), lymph node involvement (p =0.024), presence of metastases (p =0.013), level of tumor thrombus (p =0.05) and histological type (p =0.001). 14 patients had grade IIIb complications or higher according to the Clavien Dindo classification, the most frequent was bleeding. Conclusions Renal cell carcinoma with vascular invasion is a disease with high rate of mortality. Surgery is a therapeutic option that can be curative. The number of complications is important. Survival is conditioned by the American Society of Anesthesiologists Classification score, tumor stage, the level of tumor thrombus, lymph node involvement, metastasis and histological type.

      PubDate: 2017-01-14T21:23:30Z
      DOI: 10.1016/j.acuroe.2016.12.008
       
  • The role of IGF-1 and the distribution of body fat in decreasing the
           number of prostate rebiopsies
    • Authors: E. Morán; M. Martínez; A. Budía; E. Broseta; R. Cámara; F. Boronat
      Abstract: Publication date: Available online 6 January 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): E. Morán, M. Martínez, A. Budía, E. Broseta, R. Cámara, F. Boronat
      Objective To assess the usefulness of IGF-1 and internal organ fat measured by bioelectrical impedance audiometry to avoid rebiopsies in patients with persistently high prostate-specific antigen (PSA) levels. Material and method A prospective study was conducted with 92 patients who underwent prostate rebiopsy due to high PSA levels with negative results in the rectal examination and a lack of preneoplastic lesions. The patients previously had their IGF-1 levels measured and had undergone an impedance audiometry test using the abdominal Fat Analyzer AB-140 TANITA system. We calculated the receiver operating characteristic (ROC) curves for the PSA levels, %PSA, internal organ fat and IGF-1 and PSA density. Results Twenty-five patients were diagnosed with prostate cancer. These patients had significantly higher PSA, PSAd and IGF-1 values and a tendency toward higher internal organ fat levels and lower %PSA readings (p =.001, p =0.003, p =0.001, p =0.24 and p =0.28, respectively). The ROC curve showed an area under the curve for IGF-1 and PSA of 0.82 and 0.81, respectively. Using the cutoff points for 95% sensitivity and using the 3 criteria as an indication of rebiopsy, 74% of the biopsies would have been spared, leaving undiagnosed only 1 patient with clinically significant cancer—Gleason score>7 (4+3). The positive and negative predictive values for the set of variables were higher than for each one separately (PPV: 66/NPV: 63). The cost of both determinations was 82 euros. Conclusions Our results suggest that measuring IGF-1 could significantly decrease the number of unnecessary rebiopsies in an inexpensive and safe manner.

      PubDate: 2017-01-14T21:23:30Z
      DOI: 10.1016/j.acuroe.2016.12.002
       
  • Diagnostic tests in urology: Is the diagnostic gain sufficient to assess
           extended lymphadenectomy in prostate cancer'
    • Authors: H.A. García-Perdomo; R. Manzano
      Abstract: Publication date: Available online 6 January 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): H.A. García-Perdomo, R. Manzano


      PubDate: 2017-01-06T20:45:33Z
      DOI: 10.1016/j.acuroe.2016.12.009
       
  • Nontraumatic posterior urethral stenosis
    • Authors: F. Campos-Juanatey; J.A. Portillo Martín; R. Gómez Illanes; L. Velarde Ramos
      Abstract: Publication date: Available online 18 December 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): F. Campos-Juanatey, J.A. Portillo Martín, R. Gómez Illanes, L. Velarde Ramos
      Introduction Posterior urethral stenoses and contractures are complications after treatment of benign prostatic hyperplasia (BPH), localized prostate cancer (PCa), and orthotopic neobladder formation, compromising prognosis and functional outcomes. Objectives To identify factors related to etiology, prevention and treatment of non-traumatic posterior urethral stenosis and contractures. Acquisition of evidence Review of the published evidence related to posterior urethral stenosis and contractures after PCa treatment, BPH therapies and orthotopic neobladder formation. PubMed database search with English and Spanish papers considered. Cohort studies, case series, prospective and retrospective studies and review papers were included. Synthesis of evidence Posterior urethral stenoses and contractures are common, leading to significant morbidity. A worsening on voiding quality should rise some concerns. Careful surgical and/or radiotherapic techniques prevent their development. Endoscopic therapies are the initial approach, with complex urethroplasties often required. Subsequent urinary incontinence, the most important sequelae, may need artificial sphincters. Conclusions Non-traumatic posterior urethral stenoses could be important complications, potentially compromising the outcomes of initial therapy. They could require complex surgeries leading to urinary incontinence.

      PubDate: 2016-12-20T16:18:46Z
      DOI: 10.1016/j.acuroe.2016.11.001
       
  • HoLEP turns 20. Not yet?
    • Authors: O. Buisan-Rueda
      Abstract: Publication date: Available online 10 December 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): O. Buisan-Rueda


      PubDate: 2016-12-13T12:50:37Z
      DOI: 10.1016/j.acuroe.2016.11.003
       
  • Comment to: “Oral vaccine (OM-89) in the recurrent urinary tract
           infection prophylaxis: A realistic systematic review with meta-analysis”
           
    • Abstract: Publication date: Available online 9 December 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Jiménez-Pacheco


      PubDate: 2016-12-13T12:50:37Z
       
  • Is the adjustable TVA mesh effective for the long-term treatment of female
           stress incontinence?
    • Authors: J. Romero-Maroto; H. Pérez-Seoane; L. Gómez-Perez; C. Pérez-Tomás; J.J. Pacheco-Bru; A. López-López
      Abstract: Publication date: Available online 8 December 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J. Romero-Maroto, H. Pérez-Seoane, L. Gómez-Perez, C. Pérez-Tomás, J.J. Pacheco-Bru, A. López-López
      Objectives To assess the long-term safety and efficacy of the adjustable TVA mesh in treating stress urinary incontinence. Material and methods Pseudoexperimental study, before and after, conducted in a university urology department. Eighty-two patients were invited to participate from January 2002 to March 2005. Thirty-two patients agreed to participate and were implanted an adjustable TVA mesh. The preoperative study included a medical history review, physical examination with full bladder, flowmetry, residue study, complete urodynamic study and the self-administered questionnaires I-QoL and ICIQ-SF. In the postoperative assessment, the PGI-I questionnaire was added, but a complete urodynamic study was not performed. Results Twenty-nine (90.6%) and 28 (87.5%) patients were continent in the stress test at 1 and 10 years, respectively. Twenty (62.5%) and 16 (50%) patients had no urine escape at 1 and 10 years, respectively. Twenty-eight (87.5%) and 25 (78%) patients were satisfied 1 and 10 years after the surgery, respectively. Twenty-eight (87.5%) and 21 (62.5%) patients had a good quality of life at 1 year and at 10 years, respectively. There were no significant complications at the end of the study period. Conclusions Treatment of stress urinary incontinence with the TVA mesh presented a high degree of objective healing and satisfaction at 10 years, with no severe adverse effects. The study showed that satisfaction does not always mean total continence but rather it reflects the improvement of symptoms and consequent quality of life.

      PubDate: 2016-12-13T12:50:37Z
      DOI: 10.1016/j.acuroe.2016.11.009
       
  • Multicystic dysplastic kidney: Assessment of the need for renal
           scintigraphy and the safety of conservative treatment
    • Authors: M.E. Carazo-Palacios; M. Couselo-Jerez; A. Serrano-Durbá; B. Pemartín-Comella; C. Sangüesa-Nebot; F. Estornell-Moragues; C. Domínguez-Hinarejos
      Abstract: Publication date: Available online 8 December 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): M.E. Carazo-Palacios, M. Couselo-Jerez, A. Serrano-Durbá, B. Pemartín-Comella, C. Sangüesa-Nebot, F. Estornell-Moragues, C. Domínguez-Hinarejos
      Objectives To assess the need for implementing renal scintigraphy in the diagnosis of the multicystic dysplastic kidney (MCDK) and the safety of its conservative treatment. Material and methods A retrospective study of patients with unilateral MCDK was conducted at our center from January 2005 to August 2015. We calculated the positive predictive value (PPV) of ultrasonography, taking renal scintigraphy and pathology as the gold standard. We calculated a survival curve according to the Kaplan–Meier method to assess the annual probability of spontaneous resolution of the multicystic kidney. Results Fifty-six patients were identified, 48 (85.7%) of whom had a prenatal diagnosis. Thirty eight (67.9%) of the patients were males, and the left side was affected in 33 (58.9%) of the patients. We observed associated urological abnormalities in 22 (39.29%) patients, with vesicoureteral reflux the most common (8, 14.29%). Seven patients (12.5%) developed renal failure. Forty-nine (87.5%) patients developed compensatory contralateral renal hypertrophy. Of the 33 patients who underwent surgery, the pathology results confirmed the MCDK diagnosis in 32. Compared with scintigraphy and pathology, the PPV of ultrasonography was 100% and 97%, respectively. The rate of spontaneous involution was 5.4% at 3 months of life, 11.3% at 2 years and 38.4% at 5 years. Conclusions In our experience, the conservative treatment of MCDK, until at least 5 years of age, is safe. Our data suggest that performing scintigraphy is not required for these patients, which means lower radiation exposure, as well as financial savings.

      PubDate: 2016-12-13T12:50:37Z
      DOI: 10.1016/j.acuroe.2016.11.004
       
  • Variability in complications and operative mortality after radical
           cystectomy in Spain
    • Authors: C. Llorente; B. López; V. Hernández; A. Guijarro; E. Pérez-Fernández
      Abstract: Publication date: Available online 8 December 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): C. Llorente, B. López, V. Hernández, A. Guijarro, E. Pérez-Fernández
      Background In the literature, mortality for radical cystectomy (RC) varies between 2.3% and 7.5%. In Spain, there are no published general data on morbidity and mortality. Objective To identify the complications and mortality of RC in Spain through an analysis of all procedures performed over a 3-year period and to study the geographic variability of these results. Material and methods We identified patients who underwent RC in the Spanish National Health System between 2011 and 2013 based on the minimum basic data set. We analyzed the complications and mortality during hospitalization and at 30, 60 and 90 days. We compared these results in the various autonomous communities, adjusted them by age, Charlson score and sex and subsequently added the hospital size. Results We studied 7999 patients who underwent RC in 197 hospitals of the Spanish National Health System. The mean age of the series was 67.2±9.8 years. The median stay was 15 days (IQR, 11–24). Some 47.2% of the patients had complications. The mean mortality in-hospital and at 30, 60 and 90 days was 4.7, 2.9, 5 and 6.2%, respectively. There was considerable variability in the mortality at 90 days among the communities (3.8–9.1%). When adjusting by the patient and hospital characteristics, there were still significant geographic variations (3.8–11.5%). Conclusions RC mortality in Spain at 90 days is similar to the rate in the literature. There are significant geographic variations unexplained by the characteristics of the patients or by those of the hospitals in which these operations were performed.

      PubDate: 2016-12-13T12:50:37Z
      DOI: 10.1016/j.acuroe.2016.11.007
       
  • Comparative study of multiport laparoscopy and umbilical laparoendoscopic
           single-site surgery with reusable platform for treating renal masses
    • Authors: C. Chantada; A. García-Tello; C. Esquinas; A. Moraga; C. Redondo; J.C. Angulo
      Abstract: Publication date: Available online 8 December 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): C. Chantada, A. García-Tello, C. Esquinas, A. Moraga, C. Redondo, J.C. Angulo
      Introduction Umbilical laparoendoscopic single-site (LESS) surgery is an increasingly used modality for treating renal masses. We present a prospective comparison between LESS renal surgery and conventional laparoscopy. Material and method A comparative paired study was conducted that evaluated the surgical results and complications of patients with renal neoplasia treated with LESS surgery (n =49) or multiport laparoscopy (n =53). The LESS approach was performed with reusable material placed in the navel and double-rotation curved instruments. An additional 3.5-mm port was employed in 69.4% of the cases. We assessed demographic data, the type of technique (nephrectomy, partial nephrectomy and nephroureterectomy), surgical time, blood loss, hemoglobin, need for transfusion, number and severity of complications (Clavien-Dindo), hospital stay, histological data and prognosis. Results There were no differences in follow-up, age, sex, body mass index, preoperative hemoglobin levels or type of surgery. Conversion occurred in 2 cases (1 in each group). The surgical time was equivalent (p =0.6). Intraoperative transfusion (p =0.03) and blood loss (p <0.0001) was lower with LESS, postoperative hemoglobin levels were higher (p <0.0001) and haemostatic agents were used more frequently (p <0.0001). There were no differences in the number (p =0.6) or severity (p =0.47) of complications. The length of stay (p <0.0001), the proportion of patients with drainage (p =0.04) and the number of days with drainage (p =0.0004) were lower in LESS. Twenty-five percent of the lesions operated on with LESS were benign, but the mean size was similar in the 2 groups (p =0.5). Tumor recurrence and/or progression were more frequent in multiport laparoscopy (p =0.0013). Conclusions Umbilical LESS surgery with reusable platform enables various surgical techniques to be performed when treating renal masses, with time consumption and safety comparable to conventional laparoscopy. The LESS approach is advantageous in terms of blood loss and hospital stay.

      PubDate: 2016-12-13T12:50:37Z
      DOI: 10.1016/j.acuroe.2016.11.005
       
  • Prospective study comparing laparoscopic and open adenomectomy: Surgical
           and functional results
    • Authors: A. Garcia-Segui; J.C. Angulo
      Abstract: Publication date: Available online 7 December 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Garcia-Segui, J.C. Angulo
      Introduction Open adenomectomy (OA) is the surgery of choice for large volume benign prostatic hyperplasia, and laparoscopic adenomectomy (LA) represents a minimally invasive alternative. We present a long-term, prospective study comparing both techniques. Patients and methods The study consecutively included 199 patients with benign prostatic hyperplasia and prostate volumes >80g who were followed for more than 12 months. The patients underwent OA (n =97) or LA (n =102). We recorded and compared demographic and perioperative data, functional results and complications using a descriptive statistical analysis. Results The mean age was 69.2±7.7 years (range 42–87), and the mean prostate volume (measured by TRUS) was 112.1±32.7mL (range 78–260). There were no baseline differences among the groups in terms of age, ASA scale, prostate volume, PSA levels, Qmax, IPSS, QoL or treatments prior to the surgery. The surgical time (p <.0001) and catheter time (p <0.0002) were longer in the LA group. Operative bleeding (p <0.0001), transfusion rate (p =0.0015) and mean stay (p <0.0001) were significantly lower in the LA group. The LA group had a lower rate of complications (p =0.04), but there were no significant differences between the groups in terms of major complications (Clavien score≥3) (p =0.13) or in the rate of late complications (at one year) (p =0.66). There were also no differences between the groups in the functional postoperative results: IPSS (p =0.17), QoL (p =0.3) and Qmax (p =0.17). Conclusions LA is a reasonable, safe and effective alternative that results in less bleeding, fewer transfusions, shorter hospital stays and lower morbidity than OA. LA has similar functional results to OA, at the expense of longer surgical times and longer catheter times.

      PubDate: 2016-12-13T12:50:37Z
      DOI: 10.1016/j.acuroe.2016.11.002
       
  • Competing risk analysis of mortality in prostate cancer treated with
           radical prostatectomy
    • Authors: J.L. Ruiz-Cerdá; A. Soto-Poveda; S. Luján-Marco; A. Loras-Monfort; M. Trassierra-Villa; R. Rogel-Bertó; F. Boronat-Tormo
      Abstract: Publication date: Available online 7 December 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.L. Ruiz-Cerdá, A. Soto-Poveda, S. Luján-Marco, A. Loras-Monfort, M. Trassierra-Villa, R. Rogel-Bertó, F. Boronat-Tormo
      Objective To determine the risk of cancer-specific mortality (CSM) versus the competing risk of mortality by other causes (MOC) in patients with localized prostate cancer (LPC) treated with radical prostatectomy (RP). Material and method An observational cohort study of 982 patients with LPC treated with RP selected from our department's PC registry database. A competing risk analysis was performed, calculating the probability of CSM in the presence of the competing risk of MOC. Cumulative incidence curves were constructed, and point estimates were performed at 5, 10 and 15 years. The analysis was stratified by age (≤65 vs. >65 years) and risk group: low (Gleason score ≤6 and pT2abc); intermediate (Gleason score of 7 and pT2abc) and high (Gleason score of 8–10 or pT3ab). Results With a median follow-up of 60 months, the overall probability of dying from PC was 3.5%, and the probability of dying from other causes was 9%. A competing effect for MOC was observed. The risk of MOC was almost 3 times greater than that of CSM. This effect remained for all risk groups, although its magnitude decreased progressively according to the risk group level. At 10 years, CSM was only 0%, 1% and 2% for the low, intermediate and high-risk groups, respectively, while the likelihood of MOC was 4%, 4% and 10%, respectively. The mortality risk was shown after 10 years of follow-up and was higher for other causes not attributable to PC and for patients older than 65 years. Conclusions The benefit of RP might be overestimated, given that the risk of MOC is greater than that of CSM, regardless of the age group and risk group, especially after 10 years of follow-up. The only parameter that varied was the magnitude of the CSM/MOC ratio. This information could help in choosing the active treatment for patients with LPC and short life expectancies.

      PubDate: 2016-12-13T12:50:37Z
      DOI: 10.1016/j.acuroe.2016.11.010
       
  • Beyond the Briganti nomogram: Individualisation of lymphadenectomy using
           selective sentinel node biopsy during radical prostatectomy for prostate
           cancer
    • Authors: J.J. Monserrat-Monfort; M. Martinez-Sarmiento; C.D. Vera-Donoso; V. Vera-Pinto; P. Sopena-Novales; P. Bello-Arqués; F. Boronat-Tormo
      Abstract: Publication date: Available online 7 December 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.J. Monserrat-Monfort, M. Martinez-Sarmiento, C.D. Vera-Donoso, V. Vera-Pinto, P. Sopena-Novales, P. Bello-Arqués, F. Boronat-Tormo
      Objective To validate the technique of selective sentinel node biopsy for diagnosing and staging intermediate to high-risk prostate cancer by comparing the technique with conventional extended lymphadenectomy (eLFD) in a prospective, longitudinal comparative study. Methods We applied the technique to 45 patients. After an intraprostatic injection of 99mTc-nanocolloid and preoperative single-photon emission computed tomography (SPECT/CT), we extracted the sentinel lymph nodes, guided by a portable Sentinella® gamma camera and a laparoscopic gamma-ray detection probe. The eLFD was completed to establish the negative predictive value of the technique. Results SPECT/CT showed radiotracer deposits outside the eLFD territory in 73% of the patients and the laparoscopic gamma probe in 60%. The mean number of active foci per patient was 4.3 in the SPECT/CT and 3.2 in the laparoscopic gamma probe. The mean number of extracted sentinel lymph nodes was 4.3 (0–14), with 26% outside the eLFD territory. The lymph nodes were metastatic in 10 patients (22%), 6/40 (15%) when the prostatectomy was the primary treatment. In all cases with metastatic lymph nodes, there was at least one positive sentinel node. Metastatic sentinel lymph nodes were found outside the eLFD territory in 3/10 patients (30%). The sensitivity was 100%, the specificity was 94.73%, the positive predictive value was 81.81%, and the negative predictive value was 100%. Conclusion Selective sentinel node biopsy is superior to eLFD for diagnosing lymph node involvement and can avoid eLFD when metastatic sentinel lymph nodes are not found (85%), with the consequent functional advantages.

      PubDate: 2016-12-13T12:50:37Z
      DOI: 10.1016/j.acuroe.2016.11.006
       
  • Prevalence of storage lower urinary tract symptoms in male patients
           attending Spanish urology office. Urinary urgency as predictor of quality
           of life
    • Authors: J. Cambronero Santos; C. Errando Smet
      Abstract: Publication date: Available online 27 October 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J. Cambronero Santos, C. Errando Smet
      Introduction The study sought to determine the symptomatic profile of men with lower urinary tract symptoms (LUTS) who visited a urology clinic in Spain and its impact on their health-related quality of life (HRQL). Materials and methods A national, epidemiological cross-sectional study was conducted and included 291 urology clinics. The prevalence of storage LUTS was investigated in 25,482 men. The study collected sociodemographic and clinical data from a subgroup of 1015 patients with storage LUTS who filled out the International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire Short Form (OABq-SF) and Patient Perception of Bladder Condition (PPBC) questionnaires. The impact of urinary urgency on HRQL was analyzed. Results The prevalence of storage LUTS was 41%, increasing with age: 14.1%, 41.5% and 60.8% for patients aged 18–49, 50–64 and ≥65 years, respectively. Of the 1015 selected patients, only 2.6% had storage symptoms exclusively. Symptom severity (IPSS) increased with age. Nocturia, frequency and urgency were the most common symptoms and had the most impact on HRQL (IPSS and OABq-SF). The number of urgency episodes was inversely correlated with the HRQL (r =−0.773; p <0.0001). In the multivariate analysis, only the IPSS and OABq-SF bother scores were significant predictors of HRQL (p <0.001). Conclusion Storage LUTS are highly prevalent among patients attending urology clinics in Spain. The severity of the urgency (number of urgency episodes) predicted a poorer quality of life for the patient.

      PubDate: 2016-11-01T11:14:40Z
      DOI: 10.1016/j.acuroe.2016.04.002
       
  • Clinical performance of transperineal template guided mapping biopsy for
           therapeutic decision making in low risk prostate cancer
    • Authors: Y. Ahallal; R. Sanchez-Salas; A. Sivaraman; E. Barret; F.P. Secin; P. Validire; F. Rozet; M. Galiano; X. Cathelineau
      Abstract: Publication date: Available online 27 October 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): Y. Ahallal, R. Sanchez-Salas, A. Sivaraman, E. Barret, F.P. Secin, P. Validire, F. Rozet, M. Galiano, X. Cathelineau
      Objectives To evaluate the role of transperineal template guided mapping biopsy (TTMB) in determining the management strategy in patients with low risk prostate cancer (PCa). Methods We retrospectively evaluated 169 patients who underwent TTMB at our institution from February 2008 to June 2011. Ninety eight of them harbored indolent PCa defined as: Prostate Specific Antigen<10ng/ml, Gleason score 6 or less, clinical stage T2a or less, unilateral disease and a maximum of one-third positive cores at first biopsy and <50% of the core involved. TTMB results were analyzed for Gleason score upgrading and upstaging as compared to initial transrectal ultrasound (TRUS) biopsies and its influence on the change in the treatment decisions. Results TTMB detected cancer in 64 (65%) patients. The upgrade, upstage and both were noted in 33% (n =21), 12% (n =8) and 7% (n =5) respectively of the detected cancers. The disease characteristics were similar to initial TRUS in 30 (48%) patients and TTMB was negative in 34 (35%) patients. Prostate volume was significantly smaller in patients with upgrade and/or upstage noted at TTMB (45.4 vs 37.9; p = 0.03). TTMB results influenced 73.5% of upgraded and/or upstaged patients to receive radical treatment while 81% of the patients with unmodified stage and/or grade continued active surveillance or focal therapy. Conclusions In patients with low risk PCa diagnosed by TRUS, subsequent TTMB demonstrated cancer upgrade and/or upstage in about one-third of the patients and resulted in eventual change in treatment decision.

      PubDate: 2016-11-01T11:14:40Z
      DOI: 10.1016/j.acuroe.2016.05.012
       
  • The quality of Actas Urológicas Españolas and its editors
    • Authors: J.M.
      Abstract: Publication date: Available online 22 October 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.M. Fernández Gómez


      PubDate: 2016-10-24T19:25:34Z
       
  • Vascular accident code: A security system in massive bleeding in
           laparoscopic urologic surgery
    • Authors: Á. Juárez-Soto; M. Pérez-García; M. Fuentes-Curtido; C. Guisado-Martin; M. Hernández-Garrido; M.A. Arrabal-Polo; M. de Paz-Suárez
      Abstract: Publication date: Available online 22 October 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): Á. Juárez-Soto, M. Pérez-García, M. Fuentes-Curtido, C. Guisado-Martin, M. Hernández-Garrido, M.A. Arrabal-Polo, M. de Paz-Suárez


      PubDate: 2016-10-24T19:25:34Z
      DOI: 10.1016/j.acuroe.2016.09.004
       
  • Utility of the RENAL index – Radius; Exophytic/endophytic; Nearness to
           sinus; Anterior/posterior; Location relative to polar lines – in the
           management of renal masses
    • Authors: C. Konstantinidis; E. Trilla; D. Lorente; J. Morote
      Abstract: Publication date: Available online 22 October 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): C. Konstantinidis, E. Trilla, D. Lorente, J. Morote
      Context The growing incidence of renal masses and the wide range of available treatments require predictive tools that support the decision making process. The RENAL index – Radius; Exophytic/endophytic; Nearness to sinus; Anterior/posterior; Location relative to polar lines – helps standardize the anatomy of a renal mass by differentiating three groups of complexity. Since the introduction of the index, there have been a growing number of studies, some of which have been conflicting, that have evaluated the clinical utility of its implementation. Objective To analyze the scientific evidence on the relationship between the RENAL index and the main strategies for managing renal masses. Acquisition of the evidence A search was conducted in the Medline database, which found 576 references on the RENAL index. In keeping with the PRISM Declaration, we selected 100 abstracts and ultimately reviewed 96 articles. Synthesis of the evidence The RENAL index has a high degree of interobserver correlation and has been validated as a predictive nomogram of histological results. In active surveillance, the index has been related to the tumor growth rate and probability of nephrectomy. In ablative therapy, the index has been associated with therapeutic efficacy, complications and tumor recurrence. In partial nephrectomy, the index has been related to the rate of complications, conversion to radical surgery, ischemia time, function preservation and tumor recurrence, a finding also observed in radical nephrectomy. Conclusions The RENAL index is an objective, reproducible and useful system as a predictive tool of highly relevant clinical parameters such as the rate of complications, ischemia time, renal function and oncological results in the various currently accepted treatments for the management of renal masses.

      PubDate: 2016-10-24T19:25:34Z
      DOI: 10.1016/j.acuroe.2016.09.005
       
  • High intensity focused ultrasound with Focal-One® device:
           Prostate-specific antigen impact and morbidity evaluation during the
           initial experience
    • Authors: J.I. Perez-Reggeti; R. Sanchez-Salas; A. Sivaraman; E. Linares Espinos; A.E. de Gracia-Nieto; E. Barret; M. Galiano; F. Rozet; A. Fregeville; R. Renard-Penna; N. Cathala; A. Mombet; D. Prapotnich; X. Cathelineau
      Abstract: Publication date: Available online 17 September 2016
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.I. Perez-Reggeti, R. Sanchez-Salas, A. Sivaraman, E. Linares Espinos, A.E. de Gracia-Nieto, E. Barret, M. Galiano, F. Rozet, A. Fregeville, R. Renard-Penna, N. Cathala, A. Mombet, D. Prapotnich, X. Cathelineau
      Objective We report our initial experience in the treatment of prostate cancer (PCa) with high-intensity focused ultrasound (HIFU) using the Focal-One® device. Material and methods Retrospective review of the prospectively populated database. Between June 2014 and October 2015, 85 patients underwent HIFU (focal/whole-gland) treatment for localized PCa. Preoperative cancer localization was done with multiparametric magnetic resonance imaging (mpMRI) and transperineal mapping biopsies. Treatment was carried out using the Focal-One® device under general anesthesia. Oncological follow-up: PSA measurement and control biopsy with mpMRI according to protocol. Questionnaire-based functional outcome assessment was done. Complications were reported using Clavien classification. Results The median PSA was 7.79ng/ml (IQR: 6.32–9.16), with a median prostate volume of 38cc (IQR: 33–49.75). Focal and whole-gland therapy was performed in 64 and 21 patients respectively. Ten patients received salvage HIFU. Complications were encountered in 15% of cases, all Clavien 2 graded. Mean hospital stay was 1.8 days (0–7) and bladder catheter was removed on day 2 (1–6). Mean percentage reduction of PSA was 54%. Median follow-up was 3 months (IQR: 2–8). Functional outcomes: All patients were continents at 3 months and potency was maintained in 83% of the preoperatively potent. Conclusions Focal-One® HIFU treatment appears to be a safe procedure with few complications. Functional outcomes proved no urinary incontinence and sexual function were maintained in 83%.

      PubDate: 2016-09-22T15:24:09Z
      DOI: 10.1016/j.acuroe.2016.04.001
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
Home (Search)
Subjects A-Z
Publishers A-Z
Customise
APIs
Your IP address: 54.166.186.79
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-2016