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Publisher: Elsevier   (Total: 3163 journals)

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Showing 1 - 200 of 3163 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 9)
AASRI Procedia     Open Access   (Followers: 14)
Academic Pediatrics     Hybrid Journal   (Followers: 30, SJR: 1.655, CiteScore: 2)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.015, CiteScore: 2)
Accident Analysis & Prevention     Partially Free   (Followers: 88, SJR: 1.462, CiteScore: 3)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.932, CiteScore: 2)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 35, SJR: 1.771, CiteScore: 3)
Achievements in the Life Sciences     Open Access   (Followers: 5)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 7)
Acta Astronautica     Hybrid Journal   (Followers: 395, SJR: 0.758, CiteScore: 2)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 27, SJR: 1.967, CiteScore: 7)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 2)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.18, CiteScore: 1)
Acta Haematologica Polonica     Free   (Followers: 1, SJR: 0.128, CiteScore: 0)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.661, CiteScore: 2)
Acta Materialia     Hybrid Journal   (Followers: 243, SJR: 3.263, CiteScore: 6)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.504, CiteScore: 1)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.542, CiteScore: 1)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.834, CiteScore: 2)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 2, SJR: 0.307, CiteScore: 0)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1, SJR: 1.793, CiteScore: 6)
Acta Poética     Open Access   (Followers: 4, SJR: 0.101, CiteScore: 0)
Acta Psychologica     Hybrid Journal   (Followers: 27, SJR: 1.331, CiteScore: 2)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.052, CiteScore: 2)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3, SJR: 0.374, CiteScore: 1)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.344, CiteScore: 1)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 6, SJR: 0.19, CiteScore: 0)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 15, SJR: 2.671, CiteScore: 5)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.53, CiteScore: 4)
Addictive Behaviors     Hybrid Journal   (Followers: 16, SJR: 1.29, CiteScore: 3)
Addictive Behaviors Reports     Open Access   (Followers: 8, SJR: 0.755, CiteScore: 2)
Additive Manufacturing     Hybrid Journal   (Followers: 9, SJR: 2.611, CiteScore: 8)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Cement Based Materials     Full-text available via subscription   (Followers: 3, SJR: 0.732, CiteScore: 3)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 137, SJR: 4.09, CiteScore: 13)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.167, CiteScore: 4)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.694, CiteScore: 3)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.277, CiteScore: 1)
Advances in Agronomy     Full-text available via subscription   (Followers: 12, SJR: 2.384, CiteScore: 5)
Advances in Anesthesia     Full-text available via subscription   (Followers: 28, SJR: 0.126, CiteScore: 0)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 10, SJR: 0.992, CiteScore: 1)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 1.551, CiteScore: 4)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 2.089, CiteScore: 5)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 14, SJR: 0.572, CiteScore: 2)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.61, CiteScore: 7)
Advances in Botanical Research     Full-text available via subscription   (Followers: 2, SJR: 0.686, CiteScore: 2)
Advances in Cancer Research     Full-text available via subscription   (Followers: 29, SJR: 3.043, CiteScore: 6)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 7, SJR: 1.453, CiteScore: 2)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 1.992, CiteScore: 5)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 3)
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: 27, SJR: 0.156, CiteScore: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.713, CiteScore: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.316, CiteScore: 2)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 1.562, CiteScore: 3)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 19, SJR: 1.977, CiteScore: 8)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.205, CiteScore: 1)
Advances in Dermatology     Full-text available via subscription   (Followers: 15)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 8)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 23)
Advances in Ecological Research     Full-text available via subscription   (Followers: 42, SJR: 2.524, CiteScore: 4)
Advances in Engineering Software     Hybrid Journal   (Followers: 27, SJR: 1.159, CiteScore: 4)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 43, SJR: 5.39, CiteScore: 8)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 1)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 9)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 53, SJR: 0.591, CiteScore: 2)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 17)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 1.354, CiteScore: 4)
Advances in Genome Biology     Full-text available via subscription   (Followers: 8, SJR: 12.74, CiteScore: 13)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 1.193, CiteScore: 3)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 21, SJR: 0.368, CiteScore: 1)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 11, SJR: 0.749, CiteScore: 3)
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: 0.193, CiteScore: 0)
Advances in Immunology     Full-text available via subscription   (Followers: 37, SJR: 4.433, CiteScore: 6)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 1.163, CiteScore: 2)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.938, CiteScore: 3)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6, SJR: 0.176, CiteScore: 0)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.682, CiteScore: 2)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 14, SJR: 0.88, CiteScore: 2)
Advances in Mathematics     Full-text available via subscription   (Followers: 11, SJR: 3.027, CiteScore: 2)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.694, CiteScore: 2)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.158, CiteScore: 3)
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: 8)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.182, CiteScore: 0)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 1)
Advances in Organ Biology     Full-text available via subscription   (Followers: 1)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 16, SJR: 1.875, CiteScore: 4)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 6, SJR: 0.174, CiteScore: 0)
Advances in Parasitology     Full-text available via subscription   (Followers: 5, SJR: 1.579, CiteScore: 4)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.461, CiteScore: 1)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 10)
Advances in Pharmacology     Full-text available via subscription   (Followers: 16, SJR: 1.536, CiteScore: 3)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.574, CiteScore: 1)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.109, CiteScore: 1)
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: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 19, SJR: 0.791, CiteScore: 2)
Advances in Psychology     Full-text available via subscription   (Followers: 59)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.371, CiteScore: 1)
Advances in Radiation Oncology     Open Access   (SJR: 0.263, CiteScore: 1)
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.101, CiteScore: 0)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 385, SJR: 0.569, CiteScore: 2)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Surgery     Full-text available via subscription   (Followers: 10, SJR: 0.555, CiteScore: 2)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, SJR: 2.208, CiteScore: 4)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 17)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 2.262, CiteScore: 5)
Advances in Water Resources     Hybrid Journal   (Followers: 46, SJR: 1.551, CiteScore: 3)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 1.117, CiteScore: 3)
Aerospace Science and Technology     Hybrid Journal   (Followers: 338, SJR: 0.796, CiteScore: 3)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.42, CiteScore: 2)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.296, CiteScore: 0)
Ageing Research Reviews     Hybrid Journal   (Followers: 10, SJR: 3.671, CiteScore: 9)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 437, SJR: 1.238, CiteScore: 3)
Agri Gene     Hybrid Journal   (SJR: 0.13, CiteScore: 0)
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 1.818, CiteScore: 5)
Agricultural Systems     Hybrid Journal   (Followers: 31, SJR: 1.156, CiteScore: 4)
Agricultural Water Management     Hybrid Journal   (Followers: 43, SJR: 1.272, CiteScore: 3)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 1)
Agriculture and Natural Resources     Open Access   (Followers: 2)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 56, SJR: 1.747, CiteScore: 4)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.589, CiteScore: 3)
Air Medical J.     Hybrid Journal   (Followers: 6, SJR: 0.26, CiteScore: 0)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.19, CiteScore: 0)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 1.153, CiteScore: 3)
Alcoholism and Drug Addiction     Open Access   (Followers: 9)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.604, CiteScore: 3)
Alexandria J. of Medicine     Open Access   (Followers: 1, SJR: 0.191, CiteScore: 1)
Algal Research     Partially Free   (Followers: 10, SJR: 1.142, CiteScore: 4)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.504, CiteScore: 1)
Allergology Intl.     Open Access   (Followers: 5, SJR: 1.148, CiteScore: 2)
Alpha Omegan     Full-text available via subscription   (SJR: 3.521, CiteScore: 6)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.201, CiteScore: 1)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 50, SJR: 4.66, CiteScore: 10)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4, SJR: 1.796, CiteScore: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4, SJR: 1.108, CiteScore: 3)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 6)
American Heart J.     Hybrid Journal   (Followers: 50, SJR: 3.267, CiteScore: 4)
American J. of Cardiology     Hybrid Journal   (Followers: 51, SJR: 1.93, CiteScore: 3)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 44, SJR: 0.604, CiteScore: 1)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 10)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.524, CiteScore: 3)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 7.45, CiteScore: 8)
American J. of Infection Control     Hybrid Journal   (Followers: 26, SJR: 1.062, CiteScore: 2)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 34, SJR: 2.973, CiteScore: 4)
American J. of Medicine     Hybrid Journal   (Followers: 43)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3, SJR: 1.967, CiteScore: 2)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 201, SJR: 2.7, CiteScore: 4)
American J. of Ophthalmology     Hybrid Journal   (Followers: 61, SJR: 3.184, CiteScore: 4)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5, SJR: 0.265, CiteScore: 0)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.289, CiteScore: 1)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, CiteScore: 1)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.139, CiteScore: 4)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 27, SJR: 2.164, CiteScore: 4)
American J. of Surgery     Hybrid Journal   (Followers: 37, SJR: 1.141, CiteScore: 2)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.767, CiteScore: 1)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.144, CiteScore: 3)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 63, SJR: 0.138, CiteScore: 0)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 15, SJR: 0.411, CiteScore: 1)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 3, SJR: 0.277, CiteScore: 0)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription  
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 5, SJR: 4.849, CiteScore: 10)
Analytica Chimica Acta     Hybrid Journal   (Followers: 39, SJR: 1.512, CiteScore: 5)
Analytical Biochemistry     Hybrid Journal   (Followers: 175, SJR: 0.633, CiteScore: 2)
Analytical Chemistry Research     Open Access   (Followers: 10, SJR: 0.411, CiteScore: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 23, SJR: 0.683, CiteScore: 2)
Angiología     Full-text available via subscription   (SJR: 0.121, CiteScore: 0)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1, SJR: 0.111, CiteScore: 0)

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Journal Cover
Actas Urológicas Españolas (English Edition)
Number of Followers: 1  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 2173-5786
Published by Elsevier Homepage  [3163 journals]
  • Clinical usefulness of random biopsies in diagnosis and treatment of
           non-muscle invasive bladder cancer: Systematic review and meta-analysis
    • Abstract: Publication date: June 2018
      Source:Actas Urológicas Españolas (English Edition), Volume 42, Issue 5
      Author(s): J.D. Subiela, J. Palou, C. Esquinas, J.M. Fernández Gómez, O. Rodríguez Faba
      Introduction and objective This systematic review of the literature has been focused on determining the clinical usefulness of random bladder biopsies (RB) in the diagnosis of carcinoma in situ. A meta-analysis was performed to establish the clinic and pathological factors associated to positive biopsies. Evidence acquisition A systematic review was performed using Pubmed/Medline database according to the PRISMA guidelines. Thirty-seven articles were included, recruiting a total of 12,657 patients, 10,975 were submitted to RB. Evidence synthesis The overall incidence of positive RB was 21.91%. Significant differences were found in the incidence of positive RB when patients were stratified according to urine cytology result, tumor multiplicity, tumor appearance, stage and grade. The results of the meta-analysis revealed that the presence of positive cytology, tumor multiplicity, non-papillary appearance tumors, stage T1 and histological grades G2 and G3 represent the risk factors to predict abnormalities in RB. Conclusions The incidence of positive RB in patients with non-muscle invasive bladder cancer was 21.91%. The maximum usefulness of RB was observed when these are performed in a standardized way. The results of the meta-analysis showed that besides positive cytology and non-papillary appearance tumors, tumor multiplicity and histological grades G2 and G3 represent risk factors associated to positive RB, suggesting that the use of RB might be extensive to the intermediate risk group of the European Organization for Research and Treatment of Cancer (EORTC).

      PubDate: 2018-05-31T16:30:38Z
       
  • Diagnosis and treatment of male patients with lower urinary tract symptoms
           in Spain – The MERCURY Study. Do urologists follow the recommendations
           of the European guidelines'
    • Abstract: Publication date: June 2018
      Source:Actas Urológicas Españolas (English Edition), Volume 42, Issue 5
      Author(s): C. Errando-Smet, C. Müller-Arteaga, M. Hernández, M. Roset
      Objectives To explore the management of lower urinary tract symptoms (LUTS) in men in Spain and assess the compliance with recommendations established in the European Association of Urology (EAU) guidelines. Material and methods MERCURY was an epidemiological and cross-sectional study which involved 227 Urology Units across Spain assessing adult male patients with mixed LUTS and persisting storage symptoms. Sociodemographic, clinical and resource use data for the 6 months prior to study inclusion were collected. Additionally, through a theoretical clinical case, clinicians described their attitude toward the diagnostic and therapeutic management of males with mixed LUTS and persisting storage symptoms during the first and second visits. Answer options given to clinicians about LUTS management were aligned with those recommended by EAU guidelines. Result 610 patients included in the study were evaluated. 87.7% of them consumed some health resource mainly due to: urologist visits (79.7%), PSA determination (76.6%) and treatment with alpha-blockers (37.5%) and alpha-blockers plus antimuscarinics (37.2%). According to the theoretical clinical case, urologists preference toward diagnostic tools and pharmacological treatment in first visit were mainly PSA determination (97.7%), digital rectal examination (91.4%) and treatment with alphablockers as monotherapy (56.6%), whereas in the second visit uroflowmetry (48.9%), voiding diary (40.3%) and treatment with alpha-blockers plus antimuscarinics (70.6%) were mainly preferred. Conclusions Urologists attitude toward management of male patients with mixed LUTS and persisting storage symptoms is aligned with that recommended in the EAU guidelines.

      PubDate: 2018-05-31T16:30:38Z
       
  • Factors involved in the late failure of endoscopic vesicoureteral reflux
           treatment
    • Abstract: Publication date: June 2018
      Source:Actas Urológicas Españolas (English Edition), Volume 42, Issue 5
      Author(s): S. Fuentes, A. Gómez-Fraile, I. Carrillo-Arroyo, C. Tordable-Ojeda, D. Cabezalí-Barbancho, F. López, A. Aransay Bramtot
      Introduction The short-term results of endoscopic treatment of vesicoureteral reflux (VUR) are excellent. Over time, however, a number of patients have been identified for whom VUR reappeared after being resolved with this technique. The aim of this study was to analyze the factors related to this event. Material and methods A retrospective, analytical, case–control study included 395 ureteral units with primary VUR treated successfully at our center, with a minimum follow-up of 3 years. We identified cases in which VUR reappeared and analyzed the demographic variables, those related to VUR (grade, laterality, initial study) and those related to the operation (materials used). Results We identified 77 ureteral units with recurrence in the 395 included units (19.5%). The recurrence rate was 29.7% for the patients treated with dextranomer/hyaluronic acid (Dx/HA), 20.2% for those treated with polydimethylsiloxane (MP) and 12.2% for polytetrafluoroethylene (PTFE). The onset of recurrence rose to 35% for patients treated before 1 year of age and those with grade V VUR. Urinary dysfunction symptoms also increased the recurrence rate to 34.9%. Conclusion The use of resorbable dextranomer/hyaluronic acid material was related to recurrence in the endoscopic treatment of VUR. The high-grade reflux and treatment at an early age, as well as the presence of urinary dysfunction, are also factors associated with recurrence.

      PubDate: 2018-05-31T16:30:38Z
       
  • Robot-assisted pudendal neurolysis in the treatment of pudendal nerve
           entrapment syndrome
    • Abstract: Publication date: June 2018
      Source:Actas Urológicas Españolas (English Edition), Volume 42, Issue 5
      Author(s): P. Moscatiello, D. Carracedo-Calvo, L. Yupanqui-Guerra, M.E. Rivera-Martínez, A. Mendiola de la Hoza, M. Sánchez-Encinas
      Introduction Pudendal nerve entrapment syndrome (PNE) is characterized by the presence of neuropathic pain in the pudendal nerve (PN) territory, associated or not with urinary, defecatory and sexual disorders. Surgical PN decompression is an effective and safe alternative for cases when conservative treatment fails. The aim of this study is to describe the first robot-assisted pudendal neurolysis procedure performed in our country. Material and methods We describe step by step the technique of robot-assisted laparoscopic neurolysis of the left PN performed with intraoperative neurophysiological monitoring on a 60-year-old patient diagnosed with left PNE. Results The procedure was performed satisfactorily without complications. After 24h, the patient was discharged from the hospital. We observed a 50% reduction in pain measured using the visual analog scale 2 weeks after the procedure, which remained after 10 weeks of the neurolysis. Conclusions Robot-assisted neurolysis of the PN constitutes a feasible and safe approach, enabling better visualization and accuracy in the dissection of the PN. Intraoperative neurophysiological monitoring is useful for locating the PN and for detecting intraoperative changes after the release of the nerve.

      PubDate: 2018-05-31T16:30:38Z
       
  • Intraprostatic injections for male lower urinary tract symptoms: Reality
           or fiction'
    • Abstract: Publication date: June 2018
      Source:Actas Urológicas Españolas (English Edition), Volume 42, Issue 5
      Author(s): A. Alcántara Montero, N. Pascual Regueiro


      PubDate: 2018-05-31T16:30:38Z
       
  • Imperforate syringocele of the Cowper's gland. Diagnosis by
           urethrosonography
    • Abstract: Publication date: June 2018
      Source:Actas Urológicas Españolas (English Edition), Volume 42, Issue 5
      Author(s): D. Martínez-García, V.J. Bañón-Pérez


      PubDate: 2018-05-31T16:30:38Z
       
  • Cumulative incidence and predictive factors of radiation cystitis in
           patients with localized prostate cancer
    • Abstract: Publication date: May 2018
      Source:Actas Urológicas Españolas (English Edition), Volume 42, Issue 4
      Author(s): D. Afonso-João, L. Pacheco-Figueiredo, T. Antunes-Lopes, L.A. Morgado, V. Azevedo, L. Vendeira, J. Silva, C. Martins-Silva
      Purpose To determine the cumulative incidence of overall and severe radiation cystitis in a high volume cohort of patients and to investigate its potential predictive factors. Methods We have performed a retrospective analysis of clinical data from patients diagnosed with localized prostate cancer and treated with radiotherapy at our institution (June 2005–January 2013), and quantified the cumulative incidence of radiation cystitis. Cox regression analysis and Kaplan–Meier curves were computed to evaluate the determinants of radiation cystitis. Results Data from 783 patients was retrieved (557 treated with primary radiotherapy, 188 with adjuvant and 38 with salvage). Median follow-up time was 49 months (P25–P75: 31.8–69.3). At 5 years of follow-up, cumulative incidence of overall and severe radiation cystitis was 9.1 and 1.6%, respectively. No association was found between the incidence of radiation cystitis and age, tumor T stage, baseline PSA level, Gleason score, D’Amico risk classification, radiotherapy setting (primary versus adjuvant versus salvage) or radiation dose applied. Conclusions Within our cohort, radiation cystitis is an uncommon complication of prostatic radiotherapy treatment, and severe cases requiring hospitalization are even more infrequent. We found no association between tumor characteristics, radiotherapy setting or radiation dose and the cumulative incidence of radiation cystitis.

      PubDate: 2018-05-31T16:30:38Z
       
  • Endoscopic treatment of urethrodeferential reflux in children
    • Abstract: Publication date: March 2018
      Source:Actas Urológicas Españolas (English Edition), Volume 42, Issue 2
      Author(s): B. Fernández Bautista, A. Parente Hernández, R. Ortiz Rodríguez, L. Burgos Lucena, J.M. Angulo Madero
      Introduction Urethrodeferential reflux is an underdiagnosed condition, and there is no consensus on its treatment. Our objective is to show our experience in the minimally invasive treatment of this disease using endoscopy. Material and methods We present 8 patients with recurrent suppurative orchitis due to urethrodeferential reflux treated endoscopically during the period 2008–2013. All patients presented unilateral orchitis. The minimum number of episodes of orchitis per patient prior to the operation was 3. The endoscopic treatment consists of ureteroscopy, locating the ejaculatory orifices and conducting an intraoperative contrast study to demonstrate the urethrodeferential reflux. Subejaculatory dextranomer/hyaluronic acid was subsequently injected in all the cases. Results The mean surgical time was 15min, and the procedure was outpatient for all patients. There were no postoperative complications, and the patients had good clinical progression. Only one case required a second injection of dextranomer/hyaluronic acid. The follow-up of these patients showed a complete resolution of the epididymitis and good testicular development, with a follow-up longer than 4 years in all cases. Conclusion We propose this form of treatment as a minimally invasive, easily reproducible alternative that shows good long-term results in our small series of patients.

      PubDate: 2018-05-31T16:30:38Z
       
  • Safety and efficacy of various strains of bacille Calmette–Guérin in
           the treatment of bladder tumors in standard clinical practice
    • Authors: M. Unda-Urzaiz; J.M. Cozar-Olmos; B. Miñana-Lopez; J. Camarero-Jimenez; X. Brugarolas-Rossello; C. Zubiaur-Libano; M.J. Ribal-Caparros; A.J. Suarez-Charneco; V. Rodriguez-Tesedo; V. Chantada-Abal; C. Gonzalez-Ruiz-de-Leon; C. Carrillo-George; J. Carballido-Rodriguez; F. Villacampa-Auba
      Abstract: Publication date: Available online 9 April 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): M. Unda-Urzaiz, J.M. Cozar-Olmos, B. Miñana-Lopez, J. Camarero-Jimenez, X. Brugarolas-Rossello, C. Zubiaur-Libano, M.J. Ribal-Caparros, A.J. Suarez-Charneco, V. Rodriguez-Tesedo, V. Chantada-Abal, C. Gonzalez-Ruiz-de-Leon, C. Carrillo-George, J. Carballido-Rodriguez, F. Villacampa-Auba
      Background The natural progression of bladder tumors (nonmuscle-invasive bladder cancer [NMIBC]) is recurrence with a high rate of progression. Bacille Calmette–Guérin (BCG) has been shown effective in reducing these rates, but there are few comparative studies between strains. Material and methods An observational, prospective and multicentre registry studied 433 patients with a 12-month follow-up visit from 961 registered patients, assessing disease-free survival (DFS), progression-free survival (PFS) cancer-specific survival (CSS) and adverse effects. We studied the Tice, Russian, Tokyo, Connaught and RIVM strains. Results The sociodemographic data, NMIBC history, comorbidities, size, number, stage, grade, associated carcinoma in situ and transurethral resection were well balanced. DFS There were 85 relapses (19.6%). The median DFS time was 20months. When comparing the various strains, we detected no statistically significant differences (log-rank test; p =0.93). LPS: There were 33 cases of progression (7.62%). When comparing the various strains, we detected no statistically significant differences (log-rank test; p =0.69). CSS: Seven patients died (1.68%). When comparing the various strains, we detected no statistically significant differences (log-rank test; p =0.93). In terms of safety, 33.3% of the patients presented some type of adverse effect, mostly lower urinary symptoms (no urinary tract infections) <48h, >48h and haematuria. According to the Common Toxicity Criteria of the European Organisation for Research and Treatment of Cancer, 92.7% of the patients were grade 1. There were no statistically significant differences between the strains. Conclusions In this intermediate analysis, the risk of recurrence, progression, specific death and safety were independent of the BCG strain employed.

      PubDate: 2018-04-15T12:04:46Z
      DOI: 10.1016/j.acuroe.2018.03.004
       
  • Clinical guidelines for male lower urinary tract symptoms and benign
           prostatic hyperplasia: Importance of periodic updates based on available
           evidence
    • Authors: Montero
      Abstract: Publication date: Available online 6 April 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Alcántara Montero, L. Fernández Fernández


      PubDate: 2018-04-15T12:04:46Z
       
  • Systematic review of kidney transplantation functional predictors
    • Authors: E. Miret-Alomar; E. Trilla-Herrera; D. Lorente-Garcia; L. Regis-Placido; R. López del Campo; M. Cuadras-Solé; T. Pont-Castellana; F. Moreso-Mateos; D. Serón-Micas; J. Morote-Robles
      Abstract: Publication date: Available online 5 April 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): E. Miret-Alomar, E. Trilla-Herrera, D. Lorente-Garcia, L. Regis-Placido, R. López del Campo, M. Cuadras-Solé, T. Pont-Castellana, F. Moreso-Mateos, D. Serón-Micas, J. Morote-Robles
      Context Kidney transplantation from donors with expanded criteria has increased the pool of kidneys at the cost of a higher risk of short and long-term graft dysfunction. The main issue lies in determining which kidneys will offer acceptable function and survival compared with the risk represented by surgery and subsequent immunosuppression. Objective The objective of our article is to review the current evidence on the tools for predicting the functionality of kidney transplantation from cadaveric donors with expanded criteria and determining the validity for their use in standard practice. Acquisition of evidence We conducted a systematic literature review according to the PRISMA criteria, through Medline (http://www.ncbi.nlm.nih.gov) and using the keywords (in isolation or in conjunction) “cadaveric renal transplantation; kidney graft function appraisal, graft function predictors”. We selected prospective and retrospective series and review articles. A total of 375 articles were analyzed, 39 of which were ultimately selected for review. Summary of the evidence The predictors of functionality include the following: The donor risk indices; the calculation of the renal functional weight or the assessment of the nephronic mass; the measurement of vascular resistances during perfusion in hypothermia; the measurement of the donor's biomarkers in urine and in the perfusion liquid; the measurement of functional and reperfusion parameters in normothermia; and the measurement of morphological parameters (microscopic and macroscopic) of the target organ. In this article, we present an explanatory summary of each of these parameters, as well as their most recent evidence on this issue. Discussion None of the reviewed parameters in isolation could reliably predict renal function and graft survival. There is a significant void in terms of the macroscopic assessment of kidney transplantation. Conclusions We need to continue developing predictors of renal functionality to accurately define the distribution of each currently available donor kidney.

      PubDate: 2018-04-15T12:04:46Z
      DOI: 10.1016/j.acuroe.2018.03.002
       
  • Quantification of prostate-specific antigen determination in usual
           clinical practice
    • Authors: Ibarrola
      Abstract: Publication date: Available online 5 April 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): N. Martínez-Velilla, C. Ibarrola Guillén


      PubDate: 2018-04-15T12:04:46Z
       
  • Radium-223 in the therapeutic sequence of metastatic castration-resistant
           prostate cancer
    • Authors: M. Unda-Urzaiz; R. Sousa-Campo; A. Rodríguez-Antolín; C. Silva-Marins; A. Juárez-Soto; B. Miñana-López; A. Figueiredo-de Castro; J.M. Cozar-Olmos
      Abstract: Publication date: Available online 31 March 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): M. Unda-Urzaiz, R. Sousa-Campo, A. Rodríguez-Antolín, C. Silva-Marins, A. Juárez-Soto, B. Miñana-López, A. Figueiredo-de Castro, J.M. Cozar-Olmos
      Context Radium-223 is an α-particle transmitter with specific action on bone metastases. The Alpharadin in Symptomatic Prostate Cancer Patients (ALSYMPCA) study showed that radium-223 extended overall survival and delayed the onset of bone events in patients with symptomatic castration-resistant prostate cancer with bone metastases (mCRPC) and without visceral metastases, with a good safety profile. Objective To review the new scientific evidence on radium-223 based on prespecified and post hoc analyses of the ALSYMPCA study and on early-access programs after the publication of the ALSYMPCA study, thereby providing new data on the management of patients with mCRPC. Acquisition of evidence We searched for evidence on PubMed and in the abstracts of international urology and oncology congresses, as well as ongoing clinical trials (ClinicalTrials.gov). Synthesis of the evidence The results of the reviewed studies offer promising results that will broaden the therapeutic benefits of radium-223 to patients with mild symptoms and those with no symptoms. The results also provide preliminary evidence on the benefit of radium-223 treatment after the failure of docetaxel, enzalutamide or abiraterone or the combination of radium-223 with these agents or other therapeutic agents such as bone-targeted agents and immunotherapy. Conclusion Radium-223 can be a treatment option for patients with mild symptoms and can provide a therapeutic benefit after failure of currently available treatments or in combination with these treatments. This evidence should be corroborated in clinical trials before being added to clinical practice.

      PubDate: 2018-04-15T12:04:46Z
      DOI: 10.1016/j.acuroe.2018.03.003
       
  • Is Spanish urology in 2018 mature enough to perform population screening
           for prostate cancer'
    • Authors: A. Sousa Escandón; J. León Mata
      Abstract: Publication date: Available online 31 March 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Sousa Escandón, J. León Mata


      PubDate: 2018-04-15T12:04:46Z
      DOI: 10.1016/j.acuroe.2018.03.001
       
  • Postoperative management of radical cystectomy. Review of the evidence on
           the prevention and treatment of urological complications
    • Authors: O. Rodríguez Faba; R. Parada Moreno; L. Malca; A. Palomino Martínez; N. Nervo; A. Breda; C. Esquinas; J. Palou
      Abstract: Publication date: Available online 10 March 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): O. Rodríguez Faba, R. Parada Moreno, L. Malca, A. Palomino Martínez, N. Nervo, A. Breda, C. Esquinas, J. Palou
      Introduction and objectives This review article focuses on the prevention and management of the most common postoperative urological complications of radical cystectomy. We reviewed the current literature and conducted an analysis of frequency, prevention and treatment of complications. Acquisition of evidence We conducted a search on Medline to identify original articles, literature reviews and editorials focusing on the urological complications of radical cystectomy during the first 90 days after surgery. We identified those series that included more than 100 patients. Synthesis of the evidence The literature regarding the prevention and treatment of complications after cystectomy is in general retrospective and nonstandardised. The level of evidence is generally low, and it is difficult to make evidence-based recommendations. Conclusions Progress has been made in recent years in reducing mortality and preventing the complications of cystectomy. The most common complications are gastrointestinal, for which significant efforts have been made to implement ERAS and Fast Track protocols. The complications that can most significantly change patients’ quality of life are urinary stoma.

      PubDate: 2018-03-18T11:03:22Z
      DOI: 10.1016/j.acuroe.2018.02.002
       
  • Impact of overactive bladder symptoms on work activity: The ACTIVHA study
    • Authors: M. Rapariz; A.M. Mora; M. Roset
      Abstract: Publication date: Available online 24 February 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): M. Rapariz, A.M. Mora, M. Roset
      Objectives To analyze the impact of overactive bladder (OAB) symptoms on the work activity of patients in Spain. Method An observational, multicentre cross-sectional study was conducted with 149 urologists and 131 gynecologists of Spain and included patients diagnosed with OAB, according to clinical judgment, who were of working age (18–65 years). We collected sociodemographic, clinical and work activity data. The patients filled out the Bladder Control Self-Assessment Questionnaire (B-SAQ) and the Work Productivity and Activity Impairment Questionnaire-General Health (WPAI-GH). The effect of each symptom on the daily and occupational activity was assessed. The results were stratified according to sex and the presence of emergency and urinary incontinence (UI) according to the B-SAQ. Results We assessed 768 patients (89% women), with a mean (SD) age of 52.5 (9.3) years and 2.6 (2.6) years of OAB progression. The most common symptoms according to the patients were urgent urination (89.8%), nocturia (75.7%), urge incontinence (68.5%) and frequent urination (68.2%). Ninety-six percent of the patients adopted adaptive measures for their OAB. According to the B-SAQ, 543 patients (71%) presented urgent urination; of these, 294 (54%) showed UI. The symptom that most affected work activity was frequent urination (59.8%). According to the WPAI-GH, the patients reported an impact of 32% during the workday (41% in patients with urgent urination and UI) and a loss of work time of 6.5% (9.9% in patients with urgent urination and UI). Conclusions The symptoms of OAB negatively affect work activity, especially in patients who have urgent urination and UI.

      PubDate: 2018-02-26T07:23:43Z
      DOI: 10.1016/j.acuroe.2018.02.009
       
  • Management of iatrogenic cystoscopic urethral lesion associated with
           sequela of cuff erosion in a patient after previous AMS 800 implantation.
           One-step technique with revision, without cuff explantation
    • Authors: P. Weibl; M. Rutkowski; W. Huebner
      Abstract: Publication date: Available online 23 February 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): P. Weibl, M. Rutkowski, W. Huebner
      Introduction Iatrogenic urethral lesion with subsequent cuff erosion during cystoscopy is a rare complication. The alternative surgical strategy with in situ urethroplasty while maintaining the open cuff left in situ will be presented. Materials and methods The authors report 3 cases of iatrogenic urethral lesion with cuff erosion during cystoscopic evaluation to exclude stricture or cuff erosion due to new onset of obstructive lower urinary tract symptoms. All patients had a history of a AMS 800 implantation due to postprostatectomy incontinence. Rigid cystoscopy was performed, which revealed no pathologies; however, iatrogenic small urethral lesion was identified during the removal of the cystoscope at the projection of the cuff. Results In situ urethroplasty was performed, and the cuff was left open in situ. Additionally a protection fat flap was placed around the urethra from the dorsolateral aspect, separating the cuff and urethra from the direct contact with each other. After 6 weeks the urethral defect was completely healed and via a primary perineal incision the cuff was readapted and closed. The device was fully functioning without any additional adjustments. Conclusion Our modification should be considered in select cases with absence of infection as part of management strategy for cases of iatrogenic urethral lesions with subsequent cuff erosion. Thereby the original cuff can be spared and the possibly difficult preparation of the urethra during reoperation can be avoided. However, additional more cases should be presented in the worldwide literature, to confirm the utility of this surgical principle.

      PubDate: 2018-02-26T07:23:43Z
      DOI: 10.1016/j.acuroe.2018.02.005
       
  • The personal and professional face of the Basque urologist José Julián
           Guimón Rezola (1898–1980)
    • Authors: J.C. Angulo
      Abstract: Publication date: Available online 22 February 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.C. Angulo
      Objective To understand certain outstanding aspects of the life of the Basque surgeon and urologist Julián Guimón Rezola. His personal and bibliographic documentary legacy helps reconstruct his works and personal character. Material and methods We analysed the written works of Julián Guimón Rezola and a collection of documents, letters, photographs, illustrations and objects from his personal and professional life, accessed through his family. We analysed the content of the author's main publications and related the documents to historic facts. Results Julián Guimón Rezola was an upstanding individual, a father, a family man and a nationalist before the struggle, who was dedicated to his work and particularly to teaching and health management. He started his urological career under the direction of Francisco Pérez Andrés in the Santo Civil Hospital of Bilbao. He endured unjust repression for participating in the creation of the Basque University in 1936. Sentenced to life imprisonment, he stated a new life as a reclusive surgeon in the prison of Puerto de Santa María. He was pardoned three years later but was deprived of all his offices and disqualified from civil service. He founded his clinic and maintained his training in the United States. He presided over the Medical-Surgical Insurance Group of Bilbao (Igualatorio Médico-Quirúrgico) and, on 2 occasions, the Bilbao Academy of Medical Sciences. He was considerably active professionally and focused on social medicine and modern urology. He wrote 104 scientific articles, a number of which were of considerable quality and impact. We observed an evolution in the subject matter of these articles, all with exquisite professionalism and humanity. He corresponded with renowned practitioners and was admitted to the Spanish Royal National Academy of Medicine in 1970. He ended his career with an appointment as honorary professor at the University of the Basque Country 2 years before his death. Conclusions Surgeon urologist Julián Guimón Rezola was a fundamental figure in Basque and Spanish medicine in the 20th century. He was the victim of a severe reprisal, not so much for political issues but rather for his institutional loyalty. However, he regained his professional and academic prestige. His written works reveal modern medicine with a considerable social foundation and the mind of a brilliant health manager.

      PubDate: 2018-02-26T07:23:43Z
      DOI: 10.1016/j.acuroe.2018.02.003
       
  • The role of cognitive training in endourology: A randomized controlled
           trial
    • Authors: M. Shah; A. Aydin; A. Moran; M.S. Khan; P. Dasgupta; K. Ahmed
      Abstract: Publication date: Available online 21 February 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): M. Shah, A. Aydin, A. Moran, M.S. Khan, P. Dasgupta, K. Ahmed
      Introduction Cognitive training is an important training modality which allows the user to rehearse a procedure without physically carrying it out. This has led to recent interests to incorporate cognitive training within surgical education but research is currently limited. The use of cognitive training in surgery is not clear-cut and so this study aimed to determine whether, relative to a control condition, the use of cognitive training improves technical surgical skills on a ureteroscopy simulator, and if so whether one cognitive training method is superior. Methods This prospective, comparative study recruited 59 medical students and randomized them to one of three groups: control- simulation training only (n =20), flashcards cognitive training group (n =20) or mental imagery cognitive training group (n =19). All participants completed three tasks at baseline on the URO Mentor simulator followed by the cognitive intervention if randomized to receive it. Participants then returned to perform an assessment task on the simulator. Outcome measures from the URO Mentor performance report was used for analysis and a quantitative survey was given to all participants to assess usefulness of training received. Results This study showed cognitive training to have minimal effects on technical skills of participants. The mental imagery group had fewer laser misfires in the assessment task when compared to both control and flashcards group (p =0.017, p =0.036, respectively). The flashcards group rated their preparation to be most useful when compared to control (p =0.0125). Other parameters analyzed between the groups did not reach statistical significance. Cognitive training was found to be feasible and cost effective when carried out in addition to simulation training. Conclusion This study has shown that the role of cognitive training within acquisition of surgical skills is minimal and that no form of cognitive training was superior to another. Further research needs to be done to evaluate other ways of performing cognitive training.

      PubDate: 2018-02-26T07:23:43Z
      DOI: 10.1016/j.acuroe.2018.02.011
       
  • Management of male hypogonadism and testosterone therapy: European
           Association of Urology position statement on the role of the urologist
    • Authors: Montero
      Abstract: Publication date: Available online 21 February 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Alcántara Montero


      PubDate: 2018-02-26T07:23:43Z
       
  • 3+4=6' Implications of the stratification of localized Gleason 7
           prostate cancer by number and percentage of positive biopsy cores in
           selecting patients for active surveillance
    • Authors: J.L. Ruiz-Cerdá; L. Lorenzo Soriano; D. Ramos-Soler; L. Marzullo-Zucchet; A. Loras Monfort; F. Boronat Tormo
      Abstract: Publication date: Available online 7 February 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.L. Ruiz-Cerdá, L. Lorenzo Soriano, D. Ramos-Soler, L. Marzullo-Zucchet, A. Loras Monfort, F. Boronat Tormo
      Objective To determine whether the number and percentage of positive biopsy cores identify a Gleason 3+4 prostate cancer (PC) subgroup of similar biologic behavior to Gleason 3+3. Material and method An observational post-radical prostatectomy study was conducted of a cohort of 799 patients with localized low-risk (n =582, Gleason 6, PSA<10ng/ml and cT1c-2a) and favorable intermediate PC (n =217, Gleason 3+4, PSA≤10ng/ml and pT2abc). The Gleason 3+4 tumors were stratified by number (≤3 vs. >3) and by percentage of positive cores (≤33% vs. >33%). We analyzed the tumors’ association with the biochemical recurrence risk (BRR) and cancer-specific mortality (CSM). We conducted various predictive models using Cox regression and estimated (C-index) and compared their predictive capacity. Results With a median follow-up of 71 months, the BRR and CSM of the patient group with Gleason 3+4 tumors and a low number (≤3) and percentage (≤33%) of positive cores were not significantly different from those of the patients with Gleason 6 tumors. At 5 and 10 years, there were no significant differences in the number of biochemical recurrences, the probability of remaining free of biochemical recurrences, the number of deaths by PC or the probability of death by PC between the 2 groups. In contrast, the patients with Gleason 3+4 tumors and more than 33% of positive cores presented more deaths by PC than the patients with Gleason 6 tumors. At 10 years, the probability of CSM was significantly greater. This subgroup of tumors showed a significantly greater BRR (RR, 1.6; p =0.02) and CSM (RR, 5.8, p ≤0.01) compared with the Gleason 6 tumors. The model with Gleason 3+4 stratified by the percentage of positive cores significantly improved the predictive capacity of BRR and CSM. Conclusions Fewer than 3 cores and a percentage <33% of positive cores identifies a subgroup of Gleason 3+4 tumors with biological behavior similar to Gleason 6 tumors. At 10 years, there were no differences in BRR and CSM between the 2 groups. These results provide evidence supporting active surveillance as an alternative for Gleason 3+4 tumors and low tumor extension in biopsy.

      PubDate: 2018-02-14T20:32:41Z
      DOI: 10.1016/j.acuroe.2017.12.005
       
  • Cognitive function in patients on androgen suppression: A prospective,
           multicentric study
    • Authors: J. Morote; Á.J. Tabernero; J.L. Álvarez-Ossorio; J.P. Ciria; J.L. Domínguez-Escrig; F. Vázquez; J. Angulo; F.J. López; R. de La Iglesia; J. Romero
      Abstract: Publication date: Available online 17 January 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J. Morote, Á.J. Tabernero, J.L. Álvarez-Ossorio, J.P. Ciria, J.L. Domínguez-Escrig, F. Vázquez, J. Angulo, F.J. López, R. de La Iglesia, J. Romero
      Objective To assess the effect of androgen deprivation therapy (ADT) on cognitive performance (CP) in patients with prostate cancer (PCa) after 6 months of treatment with luteinizing hormone-releasing hormone (LHRH) analogs. Material and methods Prospective, observational, multicentre, open-label study of patients diagnosed with nonmetastatic or asymptomatic metastatic PCa scheduled to receive LHRH analogs for ≥6 months. We assessed four CP domains at baseline and after 6 months of ADT: (1) Working memory: Wechsler Adult Intelligence Scale III (WAIS III) Digit Span Subtest (WAIS III-Digit); (2) Visual memory: ad hoc visual memory test; (3) Visuospatial ability: Judgment of Line Orientation (JLO) and Mental Rotation of Three-Dimensional Objects (3D-Rotation); and (4) Nonverbal analytical reasoning: WAIS III Matrix Reasoning Test (WAIS III-MRT). Changes outside the baseline 95% confidence intervals were considered significant. Results A total of 308 patients completed the study. Of these, 245 (79.6%) experienced no statistically significant changes on any test and 63 patients (20.4%) experienced significant changes in ≥1 test. Of these, most presented a change in only one test, distributed evenly between improvements (58 patients; 18.8%) and worsening (56 patients; 18.2%). For individual tests, most patients (87.8–91.8%) had no change from baseline; however, the significant changes (improvement vs. deterioration, respectively) were as follows: WAIS III-Digit (6.3% vs. 5.9%); visual memory (5.3% vs. 5.7%); JLO (5.3% vs. 4.5%); 3D-Rotation (4.1% vs. 4.1%); and WAIS III-MRT (4.8% vs. 5.8%). Conclusions CP in patients with PCa does not appear to be adversely affected by 6 months of LHRH analog administration.

      PubDate: 2018-01-25T19:06:32Z
      DOI: 10.1016/j.acuroe.2017.12.006
       
  • A systematic review of methods for quantifying serum testosterone in
           patients with prostate cancer who underwent castration
    • Authors: I. Comas; R. Ferrer; J. Planas; A. Celma; L. Regis; J. Morote
      Abstract: Publication date: Available online 17 January 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): I. Comas, R. Ferrer, J. Planas, A. Celma, L. Regis, J. Morote
      Background The clinical practice guidelines recommend measuring serum testosterone in patients with prostate cancer (PC) who undergo castration. The serum testosterone concentration should be <50ng/dL, a level established by using a radioimmunoassay method. The use of chemiluminescent immunoassays (IA) has become widespread, although their metrological characteristics do not seem appropriate for quantifying low testosterone concentrations. The objective of this review is to analyze the methods for quantifying testosterone and to establish whether there is scientific evidence that justifies measuring it in patients with PC who undergo castration, through liquid chromatography attached to a mass spectrometry in tandem (LC–MSMS). Material and methods We performed a search in PubMed with the following MeSH terms: measurement, testosterone, androgen suppression and prostate cancer. We selected 12 studies that compared the metrological characteristics of various methods for quantifying serum testosterone compared with MS detection methods. Results IAs are standard tools for measuring testosterone levels; however, there is evidence that IAs lack accuracy and precision for quantifying low concentrations. Most chemiluminescent IAs overestimate their concentration, especially below 100ng/dL. The procedures that use LC–MSMS have an adequate lower quantification limit and proper accuracy and precision. We found no specific evidence in patients with PC who underwent castration. Conclusions LC–MSMS is the appropriate method for quantifying low serum testosterone concentrations. We need to define the level of castration with this method and the optimal level related to better progression of the disease.

      PubDate: 2018-01-25T19:06:32Z
      DOI: 10.1016/j.acuroe.2017.12.003
       
  • Reliability and ordinal alpha
    • Authors: S. Dominguez-Lara
      Abstract: Publication date: Available online 17 January 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): S. Dominguez-Lara


      PubDate: 2018-01-25T19:06:32Z
      DOI: 10.1016/j.acuroe.2017.12.013
       
  • Where do we come from and where are we going in the treatment of premature
           ejaculation'
    • Authors: Montero
      Abstract: Publication date: Available online 17 January 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Alcántara Montero


      PubDate: 2018-01-25T19:06:32Z
       
  • Update on the role of endovesical chemotherapy in nonmuscle-invasive
           bladder cancer
    • Authors: M. Unda-Urzaiz; J.M. Fernandez-Gomez; J.M. Cozar-Olmos; A. Juárez; J. Palou; L. Martínez-Piñeiro
      Abstract: Publication date: Available online 11 January 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): M. Unda-Urzaiz, J.M. Fernandez-Gomez, J.M. Cozar-Olmos, A. Juárez, J. Palou, L. Martínez-Piñeiro


      PubDate: 2018-01-25T19:06:32Z
      DOI: 10.1016/j.acuroe.2017.12.001
       
  • Visceral and gastrointestinal complications in robotic urologic surgery
    • Authors: G. Velilla; C. Redondo; R. Sánchez-Salas; F. Rozet; X. Cathelineau
      Abstract: Publication date: Available online 10 January 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): G. Velilla, C. Redondo, R. Sánchez-Salas, F. Rozet, X. Cathelineau
      Introduction With the widespread use of minimally invasive techniques, robot-assisted urologic surgery has become widely adopted. Despite their infrequency, visceral and gastrointestinal complications could be life-threatening. Objectives To identify the main gastrointestinal injuries that occur in a robot-assisted urologic surgery. To know the overall incidence and how is their management. Acquisition of the evidence Search in PubMed of articles related to visceral and gastrointestinal complications in robot-assisted urology surgery, written in English or Spanish. Relevant publications as well literature reviews and chapters from books were reviewed. Synthesis of the evidence Along with vascular injuries, visceral and gastrointestinal lesions are among most dangerous complications. A complete preoperative study to individualize each patient characteristics and the correct use of imaging could help us to avoid complications in the first place. To know all the risky steps in the different robotic urologic procedures will let us anticipate the damage. Knowledge of main and most dangerous injuries in the different abdominal and pelvic organs is fully recommended. Early diagnosis and evaluation of lesions will let us an acute management during surgery. Recognition delay could change a repairable injury into a life-threatening situation. Conclusions Despite the undeniable benefits of robotic approach, there are minor and major gastrointestinal injuries that all urologic surgeons must know. Those related with trocar placement are especially important. Immediate diagnosis and management is mandatory.

      PubDate: 2018-01-25T19:06:32Z
      DOI: 10.1016/j.acuroe.2017.12.002
       
  • Prospective study comparing laparoscopic and open radical cystectomy:
           Surgical and oncological results
    • Authors: C. Esquinas; J.M. Alonso; E. Mateo; A. Dotor; A.M. Martín; J.F. Dorado; I. Arance; J.C. Angulo
      Abstract: Publication date: Available online 10 January 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): C. Esquinas, J.M. Alonso, E. Mateo, A. Dotor, A.M. Martín, J.F. Dorado, I. Arance, J.C. Angulo
      Introduction Laparoscopic radical cystectomy with lymphadenectomy and urinary diversion is an increasingly widespread operation. Studies are needed to support the oncological effectiveness and safety of this minimally invasive approach. Patients and methods A non-randomized, comparative prospective study between open radical cystectomy (ORC) and laparoscopic radical cystectomy (LRC) was conducted in a university hospital. The main objective was to compare cancer-specific survival. The secondary objective was to compare the surgical results and complications according to the Clavien–Dindo scale. Results We treated 156 patients with high-grade invasive bladder cancer with either ORC (n =70) or LRC (n =86). The mean follow-up was 33.5±23.8 (range 12–96) months. The mean age was 66.9+9.4 years, and the male to female ratio was 19:1. Both groups were equivalent in age, stage, positive lymph nodes, in situ carcinoma, preoperative obstructive uropathy, adjuvant chemotherapy and type of urinary diversion. There were no differences between the groups in terms of cancer-specific survival (log-rank; p =0.71). The histopathology stage was the only independent variable that predicted the prognosis. The hospital stay (p =0.01) and operative transfusion rates (p =0.002) were less for LRC. The duration of the surgery was greater for LRC (p <0.001). There were no differences in the total complications rate (p =0.62) or major complications (p =0.69). The risk of evisceration (p =0.02), surgical wound infection (p =0.005) and pneumonia (p =0.017) was greater for ORC. The risk of rectal lesion (p =0.017) and urethrorectal fistulae (p =0.065) was greater for LRC. Conclusion LRC is an equivalent treatment to ORC in terms of oncological efficacy and is advantageous in terms of transfusion rates and hospital stays but not in terms of operating room time and overall safety. Studies are needed to better define the specific safety profile for each approach.

      PubDate: 2018-01-25T19:06:32Z
      DOI: 10.1016/j.acuroe.2017.12.004
       
  • Controversy in the use of prostate cancer antigen 3 in Latin America and
           the Caribbean
    • Authors: J. Saldaña-Gallo; J.A. Grandez-Urbina
      Abstract: Publication date: Available online 10 January 2018
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J. Saldaña-Gallo, J.A. Grandez-Urbina


      PubDate: 2018-01-25T19:06:32Z
      DOI: 10.1016/j.acuroe.2017.12.012
       
  • Trends in the management of urolithiasis in Latin America, Spain and
           Portugal: Results of a survey in the Confederación Americana de Urología
           (CAU)
    • Authors: J.C. Angulo; N. Bernardo; H. Zampolli; M.A. Rivero; H. Dávila; J. Gutiérrez
      Abstract: Publication date: Available online 11 December 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.C. Angulo, N. Bernardo, H. Zampolli, M.A. Rivero, H. Dávila, J. Gutiérrez
      Objective To describe the trends in the current management of urolithiasis in the Confederación Americana de Urología (CAU) setting to recognize patterns of clinical practice and identify educational needs. Material and method An online survey was created with 31 multiple-choice questions (Spanish and Portuguese) through www.caunet.org, which revealed demographic data, patterns of clinical practice and approaches for specific clinical conditions. Results A total of 463 practitioners from Brazil, Mexico, Argentina, Spain, Colombia, Chile and other countries (3.96% of the members of CAU) completed the survey. All participants performed some type of urolithiasis treatment: 98.5% performed semirigid ureteroscopy (URS), 83.8% performed percutaneous nephrolithotomy (PCNL), 78.2% performed flexible URS, and 67.2% performed extracorporeal lithotripsy. The youngest physicians tended to perform PCNL (p <0.001), and the proportion of users of flexible URS was greater in the Portuguese countries (p =0.037). The main energy source was laser (60.7%). Small-caliber PCNL was performed by 15.3% of the respondents, more often in university hospitals (p <0.01) and by older practitioners (p <0.01). Only 3.2% of the respondents used percutaneous access to the kidney guided exclusively by ultrasound, especially the older practitioners (p <0.001). The supine position was used by 40.4% of the respondents, more often in Spain (p <0.001) and in the university setting (p =0.017). PCNL without nephrostomy was practiced by 3.9% of the respondents. For flexible URS, 19.2% of the respondents did not use ureteral access sheaths, and the older practitioners preferred thinner caliber sheaths (p <0.001). Conclusions The management of lithiasis in the CAU setting follows a profile similar to that recognized in the European and American clinical guidelines, although there are interesting variations based on the practitioner's age and preferences. We identified potential areas for improvement in small-caliber PCNL and ultrasound-guided puncture.

      PubDate: 2017-12-18T19:24:19Z
      DOI: 10.1016/j.acuroe.2017.11.007
       
  • Application of Lean Healthcare methodology in a urology department of a
           tertiary hospital as a tool for improving efficiency
    • Authors: F. Boronat; A. Budia; E. Broseta; J.L. Ruiz-Cerdá; D. Vivas-Consuelo
      Abstract: Publication date: Available online 6 December 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): F. Boronat, A. Budia, E. Broseta, J.L. Ruiz-Cerdá, D. Vivas-Consuelo
      Objective To describe the application of the Lean methodology as a method for continuously improving the efficiency of a urology department in a tertiary hospital. Material and methods The implementation of the Lean Healthcare methodology in a urology department was conducted in 3 phases: (1) team training and improvement of feedback among the practitioners, (2) management by process and superspecialization and (3) improvement of indicators (continuous improvement). The indicators were obtained from the Hospital's information systems. The main source of information was the Balanced Scorecard for health systems management (CUIDISS). The comparison with other autonomous and national urology departments was performed through the same platform with the help of the Hospital's records department (IASIST). A baseline was established with the indicators obtained in 2011 for the comparative analysis of the results after implementing the Lean Healthcare methodology. Results The implementation of this methodology translated into high practitioner satisfaction, improved quality indicators reaching a risk-adjusted complication index (RACI) of 0.59 and a risk-adjusted mortality rate (RAMR) of 0.24 in 4 years. A value of 0.61 was reached with the efficiency indicator (risk-adjusted length of stay [RALOS] index), with a savings of 2869 stays compared with national Benchmarking (IASIST). The risk-adjusted readmissions index (RARI) was the only indicator above the standard, with a value of 1.36 but with progressive annual improvement of the same. Conclusions The Lean methodology can be effectively applied to a urology department of a tertiary hospital to improve efficiency, obtaining significant and continuous improvements in all its indicators, as well as practitioner satisfaction. Team training, management by process, continuous improvement and delegation of responsibilities has been shown to be the fundamental pillars of this methodology.

      PubDate: 2017-12-08T06:42:44Z
      DOI: 10.1016/j.acuroe.2017.11.008
       
  • Validation of the prostate health index in a predictive model of prostate
           cancer
    • Authors: A. Sanchís-Bonet; M. Barrionuevo-González; A.M. Bajo-Chueca; L. Pulido-Fonseca; L.E. Ortega-Polledo; J.C. Tamayo-Ruiz; M. Sánchez-Chapado
      Abstract: Publication date: Available online 6 December 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Sanchís-Bonet, M. Barrionuevo-González, A.M. Bajo-Chueca, L. Pulido-Fonseca, L.E. Ortega-Polledo, J.C. Tamayo-Ruiz, M. Sánchez-Chapado
      Objectives To validate and analyze the clinical usefulness of a predictive model of prostate cancer that incorporates the biomarker “[-2] pro prostate-specific antigen” using the prostate health index (PHI) in decision making for performing prostate biopsies. Material and methods We isolated serum from 197 men with an indication for prostate biopsy to determine the total prostate-specific antigen (tPSA), the free PSA fraction (fPSA) and the [-2] proPSA (p2PSA). The PHI was calculated as p2PSA/fPSA×√tPSA. We created 2 predictive models that incorporated clinical variables along with tPSA or PHI. The performance of PHI was assessed with a discriminant analysis using receiver operating characteristic curves, internal calibration and decision curves. Results The areas under the curve for the tPSA and PHI models were 0.71 and 0.85, respectively. The PHI model showed a better ability to discriminate and better calibration for predicting prostate cancer but not for predicting a Gleason score in the biopsy ≥7. The decision curves showed a greater net benefit with the PHI model for diagnosing prostate cancer when the probability threshold was 15–35% and greater savings (20%) in the number of biopsies. Conclusions The incorporation of p2PSA through PHI in predictive models of prostate cancer improves the accuracy of the risk stratification and helps in the decision-making process for performing prostate biopsies.

      PubDate: 2017-12-08T06:42:44Z
      DOI: 10.1016/j.acuroe.2017.11.006
       
  • A systematic review of the diagnosis and treatment of patients with
           neurogenic hyperactivity of the detrusor muscle
    • Authors: A. Borau; J.M. Adot; M. Allué; S. Arlandis; D. Castro; M. Esteban; J. Salinas
      Abstract: Publication date: Available online 6 December 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Borau, J.M. Adot, M. Allué, S. Arlandis, D. Castro, M. Esteban, J. Salinas
      Background Neurogenic detrusor hyperactivity (NDH) is a urodynamic observation characterized by involuntary detrusor contractions during the filling phase that are caused by an underlying neurological disease. The common and severe complications that can result from NDH warrant the preparation of healthcare protocols for the proper management of patients with NDH. Objective The aim of this study is to standardize the criteria for the decision-making process in the management of patients with diagnosed or suspected NDH, providing personalized medical care. Acquisition of evidence We performed a systematic noncomprehensive literature review on the aspects of the diagnosis and treatment of NDH. Based on the review, recommendations were issued by nominal consensus of a group of urology specialists. Synthesis of the evidence In general, the diagnosis of NDH is arrived at by a proper review of the medical history, physical examination and voiding diary before performing any diagnostic study. The main treatment objectives are to protect the upper urinary tract, restore function of the lower tract and improve these patients’ continence and quality of life. The treatment consists of several steps aimed at obtaining proper bladder storage that allows for sufficiently spaced voidings. The follow-up should be personalized based on each patient's needs. Conclusions The identification and management of NDH is important for positively redirecting the function of the lower urinary tract, in terms of filling and voiding, thereby improving the patients’ quality of life.

      PubDate: 2017-12-08T06:42:44Z
      DOI: 10.1016/j.acuroe.2017.11.004
       
  • Indication for early cystectomy in nonmuscle-invasive bladder cancer.
           Literature review
    • Authors: L. Cogorno Wasylkowski; E. Ríos-González; E. Linares Espinós; A. Leibar Tamayo; L. Martínez-Piñeiro Lorenzo
      Abstract: Publication date: Available online 6 December 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): L. Cogorno Wasylkowski, E. Ríos-González, E. Linares Espinós, A. Leibar Tamayo, L. Martínez-Piñeiro Lorenzo
      Context High-risk nonmuscle-invasive bladder cancer is a disease that includes a heterogeneous group of patients, for whom close follow-up is recommended due to the risk of progression to a muscle-invasive tumor. The treatment of choice for these tumors is transurethral resection of the bladder tumor followed by a program of bacillus Calmette-Guerin instillations. There is a subgroup of patients who have a greater risk of progression and who benefit from early radical treatment. Objective To identify which patient group with nonmuscle-invasive bladder cancer will benefit from early radical treatment. Searching the evidence We performed a literature review to identify the risk factors for progression for these patients and thereby recommend a treatment that improves their survival rate. Synthesis of the evidence We identified the various prognostic factors associated with tumor progression: the persistence of T1 tumor in re-resection of the bladder tumor, the presence of carcinoma in situ, patients refractory to bacillus Calmette-Guerin treatment, patients older than 70 years, tumors larger than 3cm, the substaging of T1 tumors, the presence of lymphovascular invasion and the presence of a tumor in the prostatic urethra. Similarly, we comment on the advantages of radical versus conservative treatment, considering that the performance of an early cystectomy due to a high-risk noninvasive vesical tumor has a better cancer prognosis than those in which the operation is deferred until the progression. Conclusions In this disease, it is important to individualize the patients to provide them personalized treatment. For patients with the previously mentioned characteristics, it is recommended that early cystectomy not be delayed.

      PubDate: 2017-12-08T06:42:44Z
      DOI: 10.1016/j.acuroe.2017.11.005
       
  • Approach of the patient with renal cancer: Is there a collaboration
           between urology and oncology'
    • Authors: F. Sabell Pérez-Salgado; S. Vázquez-Estévez; U. Anido-Herranz; M. Blanco-Parra; F.J. Casas-Nebra; O. Fernández-Calvo; M. Lázaro-Quintela; S. López-García
      Abstract: Publication date: Available online 6 December 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): F. Sabell Pérez-Salgado, S. Vázquez-Estévez, U. Anido-Herranz, M. Blanco-Parra, F.J. Casas-Nebra, O. Fernández-Calvo, M. Lázaro-Quintela, S. López-García


      PubDate: 2017-12-08T06:42:44Z
      DOI: 10.1016/j.acuroe.2017.11.003
       
 
 
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