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Publisher: Elsevier   (Total: 3048 journals)

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Showing 1 - 200 of 3048 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 7)
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 25, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 86, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 30, 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: 361, 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   (Followers: 1)
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: 226, 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: 10, 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: 1)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 24, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, 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: 4, 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)
Acute Pain     Full-text available via subscription   (Followers: 13)
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: 6)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 21)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 135, 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: 17, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, 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: 26, 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: 11, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, 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: 25, 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 Cell Aging and Gerontology     Full-text available via subscription   (Followers: 4)
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: 0.183, 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: 9, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, 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 Dermatology     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 6)
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: 44, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 26, 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: 42, 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: 50, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
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: 12)
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: 22, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 26)
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: 36, 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: 6)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
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: 6, 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: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 8, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
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: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, 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: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 62)
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: 2, SJR: 0.1, h-index: 2)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 361, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 7, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 16)
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: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 44, 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: 327, 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: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 413, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 16, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 40, 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: 55, 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: 5, 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: 11, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 8)
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   (Followers: 1)
Algal Research     Partially Free   (Followers: 8, 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: 4, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 46, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 48, 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: 40, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 9, 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: 26, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 46, 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: 200, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 59, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6)
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: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 26, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 24, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 35, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, 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: 58, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 12)
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: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 37, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 167, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 12)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 23, 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: 172, SJR: 1.907, h-index: 126)

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Journal Cover Actas Urológicas Españolas (English Edition)
  [2 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 2173-5786
   Published by Elsevier Homepage  [3048 journals]
  • Risk models for patients with localized renal cell carcinoma
    • Authors: J.M. Velis; F.J. Ancizu; M. Hevia; I. Merino; A. García; P. Doménech; R. Algarra; A. Tienza; J.I. Pascual; J.E. Robles
      Pages: 564 - 570
      Abstract: Publication date: Available online 12 October 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.M. Velis, F.J. Ancizu, M. Hevia, I. Merino, A. García, P. Doménech, R. Algarra, A. Tienza, J.I. Pascual, J.E. Robles
      Introduction We conducted a retrospective analysis of our series to assess the factors that influenced disease-free survival (DFS) and cancer-specific survival (CSS) for patients with localized renal cell carcinoma (RCC). We also created our own risk groups. Material and methods Between January 1990 and December 2012, 596 patients underwent surgery for localized RCC (clear cell, papillary or chromophobe). Using Cox regression models, we analyzed the clinical-pathological variables that influenced DFS and CSS and designed risk groups for DFS and CSS with the variables. Results The median follow-up for the series was 5.96 years. By the end of the study, 112 patients (18.8%) had a recurrence of the disease, with DFS rates of 82%, 77% and 72% at 5, 10 and 15 years, respectively. The independent factors that influenced DFS in the multivariate study were the following: A Furhman grade of 3–4, haematuria, lymphocytic or vascular invasion, the presence of tumor necrosis and a disease stage pT3-pT4. Furthermore, by the end of the study, 57 patients (9.6%) died due to renal cancer, with CSS rates of 92%, 86% and 83% at 5, 10 and 15 years, respectively. The independent factors that influenced CSS in the multivariate study were the following: A Furhman grade of 3–4, perinephric fat invasion and the presence of tumor necrosis. Conclusions Factors in addition to the disease stage pT3-pT4 in patients with localized RCC are important, such as the presence of haematuria and lymphocytic or vascular invasion for DFS. A Furhman grade of 3–4 and the presence of tumor necrosis are especially relevant for DFS and CSS.

      PubDate: 2017-10-18T08:20:17Z
      DOI: 10.1016/j.acuroe.2017.08.007
      Issue No: Vol. 41, No. 9 (2017)
       
  • 5α-reductase inhibitors and depression
    • Authors: Montero
      Abstract: Publication date: Available online 12 November 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Alcántara Montero


      PubDate: 2017-11-16T09:31:26Z
       
  • Predictors of urinary and rectal toxicity after external conformed
           radiation therapy in prostate cancer: Correlation between clinical, tumor
           
    • Authors: C.M. Martínez-Arribas; C. González-San Segundo; P. Cuesta-Álvaro; F.A. Calvo-Manuel
      Abstract: Publication date: Available online 12 November 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): C.M. Martínez-Arribas, C. González-San Segundo, P. Cuesta-Álvaro, F.A. Calvo-Manuel
      Objective To determine rectal and urinary toxicity after external beam radiation therapy (EBRT), assessing the results of patients who undergo radical or postoperative therapy for prostate cancer (pancreatic cancer) and their correlation with potential risk factors. Method A total of 333 patients were treated with EBRT. Of these, 285 underwent radical therapy and 48 underwent postoperative therapy (39 cases of rescue and 9 of adjuvant therapy). We collected clinical, tumor and dosimetric variable to correlate with toxicity parameters. We developed decision trees based on the degree of statistical significance. Results The rate of severe acute toxicity, both urinary and rectal, was 5.4% and 1.5%, respectively. The rate of chronic toxicity was 4.5% and 2.7%, respectively. Twenty-seven patients presented haematuria, and 9 presented hemorrhagic rectitis. Twenty-five patients (7.5%) presented permanent limiting sequela. The patients with lower urinary tract symptoms prior to the radiation therapy presented poorer tolerance, with greater acute bladder toxicity (p =0.041). In terms of acute rectal toxicity, 63% of the patients with mean rectal doses >45Gy and anticoagulant/antiplatelet therapy developed mild toxicity compared with 37% of the patients with mean rectal doses <45Gy and without anticoagulant therapy. We were unable to establish predictors of chronic toxicity in the multivariate analysis. The long-term sequelae were greater in the patients who underwent urological operations prior to the radiation therapy and who were undergoing anticoagulant therapy. Conclusions The tolerance to EBRT was good, and severe toxicity was uncommon. Baseline urinary symptoms constitute the predictor that most influenced the acute urinary toxicity. Rectal toxicity is related to the mean rectal dose and with anticoagulant/antiplatelet therapy. There were no significant differences in severe toxicity between radical versus postoperative radiation therapy.

      PubDate: 2017-11-16T09:31:26Z
      DOI: 10.1016/j.acuroe.2017.10.005
       
  • Prevalence of urinary incontinence and its relation with sedentarism in
           Spain
    • Authors: J.L.
      Abstract: Publication date: Available online 11 November 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): R. Leirós-Rodríguez, V. Romo-Pérez, J.L. García-Soidán
      Objectives To determine the prevalence of urinary incontinence in the elderly Spanish population of both sexes and identify a possible relationship between physical activity habits and the presence of urinary incontinence in the elderly. Material and methods We used data from 8146 individuals older than 60 years (age range, 60–94 years), from which data from a 15-year cohort were obtained. Of these, 4745 (58.2%) were women and 3401 (41.8%) were men. We analyzed the presence of urinary incontinence, physical activity habits and the influence of other variables such as sex, age, weight and body mass index. Results We detected a prevalence of urinary incontinence of 15% for the women and 11.6% for the men. Those with urinary incontinence had a greater average age, weight and body mass index than the healthy participants. At the same time, the patient group with incontinence showed more sedentary habits compared with the healthy participants. Conclusions A strong relationship was observed between the body mass index and prevalence of urinary incontinence. Urinary incontinence was also related to attitudinal aspects such as physical inactivity, a behavior that predisposes the elderly to developing incontinence. For the first time, we observed a reduction in the prevalence of incontinence compared with previous studies.

      PubDate: 2017-11-16T09:31:26Z
       
  • Comment to «Prospective study comparing laparoscopic and open
           adenomectomy: Surgical and functional»
    • Authors: Sancha
      Abstract: Publication date: Available online 11 November 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): F. Gómez Sancha


      PubDate: 2017-11-16T09:31:26Z
       
  • Treatment algorithm proposal for patients with drug resistant overactive
           bladder syndrome
    • Authors: Montero
      Abstract: Publication date: Available online 11 November 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Alcántara Montero


      PubDate: 2017-11-16T09:31:26Z
       
  • Appreciation to the reviewers of Actas Urológicas Españolas
    • Authors: J.M.
      Abstract: Publication date: Available online 11 November 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.M. Fernández Gómez


      PubDate: 2017-11-16T09:31:26Z
       
  • The management of the acute ischemic priapism: A state of the art review
    • Authors: M. Falcone; A. Gillo; M. Capece; A. Raheem; D. Ralph; G. Garaffa
      Abstract: Publication date: Available online 11 November 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): M. Falcone, A. Gillo, M. Capece, A. Raheem, D. Ralph, G. Garaffa
      Objective To review the current literature on early penile prosthesis implantation in patients with refractory ischemic priapism (IP). Acquisition of evidence A systematic search for the terms “penile prosthesis”, “priapism”, “impotence”, “fibrosis”, “downsized prosthesis cylinders”, and “patient satisfaction” has been carried out in PubMed, EMBASE, Cochrane, SCOPUS and Science Citation Index databases. Synthesis of evidence Cavernosal tissue damage in IP is time related. Conservative measures and aspiration with or without intracorporeal instillation of α-adrenergic agonists are usually successful in the early stages. Shunt surgery in patients remains debatable, as the lack of response to aspiration and instillation of α-adrenergic agonists indicates that irreversible changes in the cavernosal smooth muscle are likely to have already occurred. Immediate penile prosthesis implantation in patients with refractory IP settles the priapic episode, maintains the long term rigidity necessary to engage in penetrative sexual intercourse and prevents the otherwise inevitable penile shortening. Although complication rates after penile prosthesis implantation in acute priapism are higher than in virgin cases, they are still lower than after implantation in patients with severe corporal fibrosis due to chronic priapism. Regardless of the complication rates, penile prosthesis implantation in refractory IP should be preferred as it allows the preservation of penile length, which is one of the main factors influencing postoperative patient's satisfaction following surgery.

      PubDate: 2017-11-16T09:31:26Z
      DOI: 10.1016/j.acuroe.2017.10.003
       
  • Sodium glucose cotransporter 2 inhibitors and males lower urinary tract
           symptoms, an aspect to consider
    • Authors: Montero
      Abstract: Publication date: Available online 18 September 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Alcántara Montero


      PubDate: 2017-09-20T05:51:22Z
       
  • Is there room for luminal-basal urothelial cell population
           quantification'
    • Authors: G.R. Passos; J.A. Camargo; K.L. Ferrari; G.C. Franch; A.E. Nowill; L.O. Reis
      Abstract: Publication date: Available online 15 September 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): G.R. Passos, J.A. Camargo, K.L. Ferrari, G.C. Franch, A.E. Nowill, L.O. Reis
      Purpose Three cell layers compose the urothelium: basal, intermediate and luminal (“umbrella cells”) and different diseases might arise from different cell populations. The aim of this study is to analyze the quantification ability of such cell populations by using four different protocols. Methods Twenty male rats (Wistar) were randomized in four groups of five animals: scraping, enzymatic 30, 45 and 60min. The cells were isolated, analyzed by flow cytometer and data processed by BD FACSDIVA™ software. Results The urothelium was separated in two cell populations that are different in size and complexity. The group that showed more efficiency in cells dissociation and cells separation was enzymatic protocol 45min. Conclusions Enzymatic protocol 45min was able to isolate urothelial cell populations and might be explored as potential prognostic tool, patient selection and therapeutic target in urothelial diseases. Future studies should validate the potential clinical application to the proposed rational of luminal-basal paradigm in the urothelial cancer as hope for individualized approach.

      PubDate: 2017-09-20T05:51:22Z
      DOI: 10.1016/j.acuroe.2017.07.004
       
  • Comment to: “Management and follow-up of the male with lower urinary
           tract symptoms secondary to benign prostate hyperplasia”
    • Authors: Montero
      Abstract: Publication date: Available online 13 September 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Alcántara Montero


      PubDate: 2017-09-15T05:22:37Z
       
  • Adjuvant intravesical treatment for non-muscle invasive bladder cancer:
           The importance of the strain and maintenance
    • Authors: F. Guerrero-Ramos; A. Lara-Isla; J. Justo-Quintas; J.M. Duarte-Ojeda; F. de la Rosa-Kehrmann; F. Villacampa-Aubá
      Abstract: Publication date: Available online 12 September 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): F. Guerrero-Ramos, A. Lara-Isla, J. Justo-Quintas, J.M. Duarte-Ojeda, F. de la Rosa-Kehrmann, F. Villacampa-Aubá
      Background and objective Intravesical Bacillus Calmette-Guérin (BCG) is essential for preventing recurrence and progression of Non-muscle invasive bladder cancer (NMIBC). The aim of our study was to compare the efficacy and toxicity of the Connaught and Tice strains, as well as the importance of the maintenance schedule. Material and methods We retrospectively reviewed 110 patients with NMIBC who underwent adjuvant endovesical treatment. The patients were distributed into 3 groups, based on whether the treatment was with the Connaught strain, the Tice strain or both sequentially. We calculated the recurrence-free survival rate in each group and compared the patients who completed the maintenance treatments against those who did not. To identify the predictors of recurrence, we performed a multivariate analysis. We also assessed the toxicity by analyzing the onset of BCGitis, urinary urgency, fever, urinary tract infection and treatment withdrawal due to adverse effects. Results We found no differences in the efficacy parameters. The patients in the Connaught group completed the maintenance to a lesser extent (38.4 vs. 72% for the Tice group and 76.3% for both strains group; p =0.010). The patients who completed the maintenance had better recurrence-free survival at 60 months (88.5 vs. 74.2%; p =0.036), regardless of the strain used. The following risk factors of recurrence were identified by multivariate analysis: size larger than 3cm, more than 3 implants and not completing the manteinance. Patients under therapy with Connaught strain had a higher rate of BCGitis, with no differences in the other events studied. Conclusion Completing the maintenance phase is essential, regardless of the strain employed. The Connaught strain has a greater risk of BCGitis, and a sequential regimen could be useful in certain scenarios.

      PubDate: 2017-09-15T05:22:37Z
      DOI: 10.1016/j.acuroe.2017.08.008
       
  • Usefulness of GATA-3 as a marker of seminal epithelium in prostate
           biopsies
    • Authors: J.A. Ortiz-Rey; D. Chantada-de la Fuente; M.Á. Peteiro-Cancelo; C. Gómez-de María; M.P. San Miguel-Fraile
      Abstract: Publication date: Available online 6 September 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.A. Ortiz-Rey, D. Chantada-de la Fuente, M.Á. Peteiro-Cancelo, C. Gómez-de María, M.P. San Miguel-Fraile
      Objectives The incidental presence of seminal vesicle epithelium in prostate needle biopsies is generally recognizable through routine microscopy. However, it can sometimes be erroneously interpreted as malignant due to its architectural and cytological characteristics, and immunohistochemistry can be useful for correctly identifying the seminal epithelium. Our objective was to analyze the potential usefulness of GATA-3 as a marker of seminal epithelium. Material and methods Through immunohistochemistry with a monoclonal anti-GATA-3 antibody (clone L50-823), we studied seminal vesicle sections from 20 prostatectomy specimens, 12 prostate needle biopsies that contained seminal vesicle tissue and 68 prostate biopsies without seminal vesicle epithelium, 36 of which showed adenocarcinoma. Results Staining for GATA-3 was intense in the 20 seminal vesicles of the prostatectomy specimens and in the 12 prostate needle biopsies that contained seminal epithelium. In the 60 biopsies without a seminal vesicle, GATA-3 was positive in the prostate basal cells and even in the secretory cells (57 cases), although with less intensity in 55 of the cases. One of the 36 prostatic adenocarcinomas tested positive for GATA-3. Conclusions The intense immunohistochemical expression of GATA-3 in the seminal vesicle epithelium can help identify it in prostate biopsies. This marker is also positive in the basal cells of healthy prostates and, with less intensity, in the secretory cells. Positivity, weak or moderate, is observed on rare occasions in prostatic adenocarcinomas.

      PubDate: 2017-09-08T23:42:02Z
      DOI: 10.1016/j.acuroe.2017.08.009
       
  • Small-caliber percutaneous nephrolithotomy (SC-PCNL). Therapeutic decision
           algorithm
    • Authors: J.H. Amón Sesmero; M. Cepeda Delgado; B. de la Cruz Martín; J.A. Mainez Rodriguez; D. Alonso Fernández; V. Rodriguez Tesedo; D.A. Martín Way; J. Gutiérrez Aceves
      Abstract: Publication date: Available online 5 September 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.H. Amón Sesmero, M. Cepeda Delgado, B. de la Cruz Martín, J.A. Mainez Rodriguez, D. Alonso Fernández, V. Rodriguez Tesedo, D.A. Martín Way, J. Gutiérrez Aceves
      Introduction The progressive reduction in the caliber of the tract in percutaneous kidney surgery to the point of miniaturization has expanded its use to smaller stones that until now have been treated with extracorporeal shock wave lithotripsy (ESWL) and retrograde intrarenal surgery (RIRS). Objective To provide an update on the various techniques of small-caliber nephrolithotomy (SC-PCNL) analyze their efficacy, safety and indications and determine their degree of implantation at this time. Material and methods We performed a review in PubMed of Spanish and English medical literature on the various techniques of SC-PCNL. Results The use of SC-PCNL has reduced the morbidity associated with standard PCNL, particularly bleeding, and has enabled tubeless nephrolithotomy with greater safety. There are various techniques with blurred terminology (Miniperc, Microperc, Mini-microperc, Ultraminiperc), which differ in terms of gauge employed and in certain technical aspects that require their indications be specified. Currently, SC-PCNL competes with techniques that are less invasive than standard PCNL such as ESWL and the RIRS in treating small stones, but the role of SC-PCNL is still not sufficiently understood and continues to be the subject of debate. Conclusions The indications for PCNL are expanding to small stone sizes due to the miniaturization of the technique. PCNL competes in this field with ESWL and RIRS. Larder studies are needed to establish the specific indications for PCNL in treating nephrolithiasis.

      PubDate: 2017-09-08T23:42:02Z
      DOI: 10.1016/j.acuroe.2017.08.001
       
  • Primary signet ring cell carcinoma of the prostate with response to
           abiraterone
    • Authors: F. Sáez Barranquero; B. Herrera Imbroda
      Abstract: Publication date: Available online 5 September 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): F. Sáez Barranquero, B. Herrera Imbroda


      PubDate: 2017-09-08T23:42:02Z
      DOI: 10.1016/j.acuroe.2017.08.005
       
  • Prognostic factors for vesical relapse in patients with upper urothelium
           tumours treated with surgery
    • Authors: J. Aragón Chamizo; F. Herranz Amo; C. Hernández Fernández; C. González Enguita
      Abstract: Publication date: Available online 5 September 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J. Aragón Chamizo, F. Herranz Amo, C. Hernández Fernández, C. González Enguita
      Objective To identify the prognostic factors for vesical relapse in patients with tumours of the upper urothelium treated with surgery. Material and methods We conducted a retrospective analysis of patients with tumours of the upper urothelium who underwent surgery between 1999 and 2011 at our centre (139 patients). We collected demographic, clinical, diagnostic and pathological variables, as well as the treatment, complications and progression. A descriptive analysis was performed using the chi-squared test for categorical variables and the ANOVA test for continuous variables. We also performed a univariate and multivariate analysis using the Cox proportional hazards model. Statistical significance was considered when p <0.05. All calculations were performed with SPSS Statistics version 21. Results During the follow-up, 26.6% of the patients (37 cases) showed vesical relapse. Some 19.6% of the patients with no history of bladder tumours showed a bladder tumour relapse compared with 48.6% of the patients with a history of bladder tumours (p <0.001). In the multivariate analysis, only the presence of bladder tumours prior to or concomitant with the upper urinary tract tumour diagnosis was identified as an independent predictor of bladder tumour relapse (p =0.007). Conclusion In our series, only the presence of a prior or synchronous bladder tumour behaved as an independent predictor of bladder tumour relapse in patients with tumours of the upper urothelium treated with surgery.

      PubDate: 2017-09-08T23:42:02Z
      DOI: 10.1016/j.acuroe.2017.08.003
       
  • Reflections on lower urinary tract symptoms in older population: Proposal
           for a different classification
    • Authors: A. Alcántara Montero; F.J. Brenes Bermúdez
      Abstract: Publication date: Available online 12 August 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Alcántara Montero, F.J. Brenes Bermúdez


      PubDate: 2017-08-24T20:06:13Z
      DOI: 10.1016/j.acuroe.2017.07.009
       
  • Shock wave therapy for erectile dysfunction: The lack of evidence at the
           Latin America and Caribbean level
    • Authors: J. Saldaña-Gallo; J.S. Torres-Román; J.A. Grandez-Urbina
      Abstract: Publication date: Available online 10 August 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J. Saldaña-Gallo, J.S. Torres-Román, J.A. Grandez-Urbina


      PubDate: 2017-08-14T19:17:43Z
      DOI: 10.1016/j.acuroe.2016.10.001
       
  • New technique for nephron-sparing surgery in polar tumors. A modification
           of the Kim technique
    • Authors: C. Ameri; F.M. Lopez; G.J. Vitagliano; H. Rios Pita; J.M. Guglielmi; L. Blas
      Abstract: Publication date: Available online 10 August 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): C. Ameri, F.M. Lopez, G.J. Vitagliano, H. Rios Pita, J.M. Guglielmi, L. Blas
      Introduction and objectives Nephron-sparing surgery (NSS) is the indication, provided it is feasible and meets the international treatment guidelines. One of the objectives of performing NSS is to reduce the ischemia time as much as possible. We propose a surgical technique for treating polar renal tumors and those larger than 4cm based on the principle of the technique described by Kim in 1964. Method The technique performs a continuous circular suture on the base of the tumor, achieving compression of the renal pole without vascular clamping, facilitating haemostasis and avoiding the blind transfixion performed in Kim's original technique. We selected 28 patients for the implementation of the technique. Results The patients’ mean age was 56 years (30–69). The RENAL scores were as follows: 12 of low complexity, 12 of moderate complexity and 4 of high complexity. The mean surgical time was 109minutes (75–140), and the mean estimated blood loss was 120mL (50–300mL). No positive margins were identified, and no patients required blood transfusions. The mean stay was 3.7 days (2–6). There were no Clavien grade 2 or higher complications. There were 3 Clavien 1 complications (fever). The difference in glomerular filtration rate was –0.71mL/min/m2. The pathology was malignant in 26 cases, 19 of them clear-cell carcinomas. Two cases were reported as oncocytomas. Conclusion The proposed technique showed acceptable results, with a low rate of complications in the patient group.

      PubDate: 2017-08-14T19:17:43Z
      DOI: 10.1016/j.acuroe.2017.07.008
       
  • Immunohistochemical study of the neural development transcription factors
           (TTF1, ASCL1 and BRN2) in neuroendocrine prostate tumors
    • Authors: E. Rodríguez-Zarco; A. Vallejo-Benítez; S. Umbría-Jiménez; S. Pereira-Gallardo; S. Pabón-Carrasco; A. Azueta; R. González-Cámpora; P.S. Espinal; A. García-Escudero
      Abstract: Publication date: Available online 10 August 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): E. Rodríguez-Zarco, A. Vallejo-Benítez, S. Umbría-Jiménez, S. Pereira-Gallardo, S. Pabón-Carrasco, A. Azueta, R. González-Cámpora, P.S. Espinal, A. García-Escudero
      Objective Prostatic small-cell neuroendocrine carcinoma is an uncommon malignancy that constitutes 0.5–1% of all prostate malignancies. The median cancer-specific survival of patients with prostatic small-cell neuroendocrine carcinoma is 19 months, and 60.5% of the patients have metastatic disease. Neural development transcription factors are molecules involved in the organogenesis of the central nervous system and of neuroendocrine precursors of various tissues, including the suprarenal gland, thyroid glands, lungs and prostate. Material and methods We present 3 cases of this uncommon condition, applying the new World Health Organisation criteria. We conducted studies through hematoxylin and eosin staining and analysed the expression of the neural development transcription factors achaete-scute homolog like 1, thyroid transcription factor 1 and the class III/IV POU transcription factors, as a new research line in the carcinogenesis of prostatic neuroendocrine tumors. Results In case 1, there was no TTF1 immunoexpression. Cases 2 and 3 had positive immunostaining for ASCL1, and Case 1 had negative immunostaining. BRN2 immunostaining was negative in case 1 and positive in cases 2 and 3. Conclusion The World Health Organisation does not recognise any molecular or genetic marker with prognostic value. ASCL-1 is related to the NOTCH and WNT signaling pathways. ASCL-1, TTF1 and BRN2 could be used for early diagnosis and as prognostic factors and therapeutic targets.

      PubDate: 2017-08-14T19:17:43Z
      DOI: 10.1016/j.acuroe.2017.07.007
       
  • Efficacy of low-intensity shock wave therapy for erectile dysfunction: A
           systematic review and meta-analysis
    • Authors: J.C. Angulo; I. Arance; M.M. de las Heras; E. Meilán; C. Esquinas; E.M. Andrés
      Abstract: Publication date: Available online 10 August 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.C. Angulo, I. Arance, M.M. de las Heras, E. Meilán, C. Esquinas, E.M. Andrés
      Context The low-intensity shockwave (LISW) therapy is a recently developed modality for treating erectile dysfunction. Objective To assess the efficacy of LISW therapy for treating erectile dysfunction as described in the literature. Acquisition of evidence Two independent reviewers identified studies eligible for a systematic review and meta-analysis of various sources written in English and Spanish, using the databases of PubMed, EMBASE and Web of Science. We excluded studies on Peyronie's disease. We employed the DerSimonian-Laird method for defining heterogeneity, calculating the grouped standard deviation of the mean (SDM). The primary objective of this review is to assess efficacy based on the change in the International Index of Erectile Function (IIEF-EF) over baseline at 1 month from the start of treatment, both for the treatment arm and the placebo arm. The secondary objective is focused on analysing IIEF-EF at 3–6 months from the start of the therapy. Summary of the evidence The pooled data of 636 patients from 12 studies showed that treatment with LISW resulted in a significant increase in IIEF-EF at 1 month with respect to baseline (SDM, −2.92; p =0.000), to a greater degree than placebo (SDM, −0.99; p =0.000). The IIEF-EF at 3–6 months for the treated patients was significantly greater than baseline (SDM, −2.78; p =0.000). Only one study compared the efficacy of placebo at 3–6 months vs baseline (SDM, −9.14). The comparison between LISW and placebo favors active treatment (SDM, 2.53; p =0.000) at 1 month. There are insufficient data in the literature to assess the response over placebo at 3–6 months. Conclusions According to the literature, treatment with LISW for erectile dysfunction is effective, both in the short and medium term. LISW has been described as more effective than placebo in the short term. The long-term efficacy data are insufficient. More studies are needed to explain the role of this therapy according to specific causes of erectile dysfunction.

      PubDate: 2017-08-14T19:17:43Z
      DOI: 10.1016/j.acuroe.2017.07.001
       
  • Androgen deprivation in prostate cancer and the long-term risk of fracture
    • Authors: S. Ojeda; M. Lloret; A. Naranjo; F. Déniz; N. Chesa; C. Domínguez; P.C. Lara
      Abstract: Publication date: Available online 9 August 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): S. Ojeda, M. Lloret, A. Naranjo, F. Déniz, N. Chesa, C. Domínguez, P.C. Lara
      Objectives To determine the rate of bone mass loss and the risk of fracture induced by androgen deprivation therapy in patients with prostate cancer. Material and methods Prospective study in 2 phases. In the first phase, demographic variables, FRAX®, bone mineral density and clinical fractures were collected, before starting the therapy and up to 1 year after ending the therapy. In the second phase, we conducted a telephone interview a mean of 8.5 years after the start of the study to assess new fractures. Results We included 150 patients with a mean age of 67 years and a mean therapy duration of 24 months. Before starting the treatment, 62 patients (41%) showed osteoporosis or low bone mass in the densitometry. After the first year of treatment, the bone mineral density decreased a mean of 3.7% and 2.1% in the lumbar spine and femoral neck, respectively. At the end of the second and third year, the loss rate was lower. During the first phase of the study, 4 patients (2.7%) experienced a fracture. In the telephone interviews with 80 patients (53%), only 1 had experienced a fracture. Conclusions In the patients with prostate cancer and androgen deprivation therapy, greater bone loss occurred during the first year. When the treatment did not exceed 2 years, the absolute risk of fracture was low, and clinical fractures were uncommon in the short and long term.

      PubDate: 2017-08-14T19:17:43Z
      DOI: 10.1016/j.acuroe.2017.07.002
       
  • Prevalence of metabolic syndrome and its association with lower urinary
           tract symptoms and sexual function
    • Authors: M. Plata; J.I. Caicedo; C.G. Trujillo; Á.M. Mariño-Alvarez; N. Fernandez; A. Gutierrez; F. Godoy; M. Cabrera; J.G. Cataño-Cataño; D. Robledo
      Abstract: Publication date: Available online 9 August 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): M. Plata, J.I. Caicedo, C.G. Trujillo, Á.M. Mariño-Alvarez, N. Fernandez, A. Gutierrez, F. Godoy, M. Cabrera, J.G. Cataño-Cataño, D. Robledo
      Objectives To estimate the frequency of metabolic syndrome (MetS) in a daily urology practice and to determine its association with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). Material and methods A retrospective study was conducted. Data from all male patients aged ≥40 years who attended our outpatient urology clinic from 2010 to 2011 was collected. Prevalence of MetS was determined, and LUTS and ED were assessed. A logistic model was used to determine possible associations, controlling for confounders and interaction factors. Results A total of 616 patients were included. MetS was observed in 43.8% (95% CI 39.6–48.3). The bivariate model showed an association between MetS and LUTS (p <0.01), but not between MetS and ED. The logistic model showed an association between MetS and the International Prostate Symptom Score (IPSS), while controlling for other variables. Patients exhibiting moderate LUTS had a greater risk for MetS than patients with mild LUTS (OR 1.83, 95% CI 1.14–2.94). After analyzing for individual components of MetS, positive associations were found between diabetes and severe LUTS (OR 1.3, 95% CI 1.24–7.1), and between diabetes and ED (OR 2.57, 95% CI 1.12–5.8). Conclusion This study was able to confirm an association between MetS and LUTS, but not for ED. Specific components such as diabetes were associated to both. Geographical differences previously reported in the literature might account for these findings. Given that MetS is frequent among urological patients, it is advisable that urologists actively screen for it.

      PubDate: 2017-08-14T19:17:43Z
      DOI: 10.1016/j.acuroe.2017.07.006
       
  • The use of bovine serum albumin-glutaraldehyde tissue adhesive (BioGlue®)
           for tumor bed closure following open partial nephrectomy
    • Authors: Z. Bahouth; S. Halachmi; S. Shprits; Y. Burbara; O. Avitan; I. Masarwa; B. Moskovitz; O. Nativ
      Abstract: Publication date: Available online 9 August 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): Z. Bahouth, S. Halachmi, S. Shprits, Y. Burbara, O. Avitan, I. Masarwa, B. Moskovitz, O. Nativ
      Objectives To report the results of the use of Bovine Serum Albumin-Glutaraldehyde tissue adhesive (BioGlue®) for tumor bed closure in open nephron-sparing surgery (NSS). Materials and methods The cohort included 255 patients with enhancing renal mass who underwent open NSS. We used open flank approach, with in situ hypothermia and enucleation of the tumor. For tumor bed closure, we used the BioGlue® sealant for tumor bed filling, without suturing the edges. Results Mean patients’ age was 65.4 years. 5.1% of patients had pre-operative chronic renal failure. Mean renal mass diameter was 4.2±1.6cm and mean R.E.N.A.L nephrometry score was 8.0±1.6. Mean ischemia time was 21.8±7.6. Mean estimated blood loss was 42±82ml and only two patients required blood transfusion. Urine leak and pseudo-aneurysm were recorded in two and one patient, respectively. None of the operations were converted to radical nephrectomy. The average change between post-operative and pre-operative eGFR (Δ=−1.7ml/min) was insignificant in a mean follow-up of 30.1±29.6 months. The 10-year recurrence-free survival rate was 99% and the 10-year overall survival rate was 85%. Conclusions The use of BioGlue® alone for hemostasis after NSS is a feasible and safe alternative to classical suturing. Its use enables satisfactory functional outcome and could potentially reduce ischemia time.

      PubDate: 2017-08-14T19:17:43Z
      DOI: 10.1016/j.acuroe.2017.07.005
       
  • Is extracorporeal shock wave lithotripsy a current treatment for
           urolithiasis' A systematic review
    • Authors: P. Bahílo Mateu; A. Budía Alba; E. Liatsikos; M. Trassierra Villa; J.D. López-Acón; D. de Guzmán Ordaz; F. Boronat Tormo
      Abstract: Publication date: Available online 21 July 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): P. Bahílo Mateu, A. Budía Alba, E. Liatsikos, M. Trassierra Villa, J.D. López-Acón, D. de Guzmán Ordaz, F. Boronat Tormo
      Introduction Technological advances have prompted a change in the management of urolithiasis. Endourological techniques are gaining importance because they are highly effective treatments. The aim of this study was to answer the question of whether extracorporeal shock wave lithotripsy (ESWL) is still a competitive alternative compared with other therapeutic modalities. Acquisition of evidence We conducted a literature search of articles published in the past 5 years. We identified 12 randomized and comparative studies and assessed the methodology and results of the study variables. We performed a narrative synthesis of the included studies. To summarize the variables, we used the mean and standard deviation for continuous variables and absolute numbers and percentages for the qualitative variables. Analysis of the evidence Of the studies reviewed, 7 evaluated the various treatments for nephrolithiasis and 5 evaluated the treatments for ureteral lithiasis. At the renal level, a stone-free rate of 33.33–91.5% at 3 months was reached with ESWL, while a rate of 90.4–100% was achieved with the other endourological techniques, without finding statistically significant differences in the studies. At the ureteral level, a stone-free rate of 73.5–82.2% at 3 months was reached with ESWL, while a rate of 79–94.1% was achieved with the other endourological techniques, without finding statistically significant differences in the studies. Conclusion There is a lack of homogeneity among the published studies. ESWL is a minimally invasive treatment that with an appropriate technique and patient selection achieves high effectiveness, thus maintaining an important role at this time.

      PubDate: 2017-07-26T06:33:24Z
      DOI: 10.1016/j.acuroe.2017.01.001
       
  • Systematic review of perioperative outcomes and complications after open,
           laparoscopic and robot-assisted radical cystectomy
    • Authors: A. Palazzetti; R. Sanchez-Salas; P. Capogrosso; E. Barret; N. Cathala; A. Mombet; D. Prapotnich; M. Galiano; F. Rozet; X. Cathelineau
      Abstract: Publication date: Available online 8 July 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Palazzetti, R. Sanchez-Salas, P. Capogrosso, E. Barret, N. Cathala, A. Mombet, D. Prapotnich, M. Galiano, F. Rozet, X. Cathelineau
      Radical cystectomy and regional lymph node dissection is the standard treatment for localized muscle-invasive and for high-risk non-muscle-invasive bladder cancer, and represents one of the main surgical urologic procedures. The open surgical approach is still widely adopted, even if in the last two decades efforts have been made in order to evaluate if minimally invasive procedures, either laparoscopic or robot-assisted, might show a benefit compared to the standard technique. Open radical cystectomy is associated with a high complication rate, but data from the laparoscopic and robotic surgical series failed to demonstrate a clear reduction in post-operative complication rates compared to the open surgical series. Laparoscopic and robotic radical cystectomy show a reduction in blood loss, in-hospital stay and transfusion rates but a longer operative time, while open radical cystectomy is typically associated with a shorter operative time but with a longer in-hospital admission and possibly a higher rate of high grade complications.

      PubDate: 2017-07-09T21:50:38Z
      DOI: 10.1016/j.acuroe.2017.06.001
       
  • OnabotulinumtoxinA in urinary incontinence: Prospective study of a case
           series
    • Abstract: Publication date: Available online 8 July 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Martín-Martínez, A. Fernández-Mederos, J.Á. García-Hernández
      Objective To assess the safety and efficacy of a single intravesical injection of onabotulinumtoxinA (OnaBTA) for treating urge urinary incontinence (UUI) in women. Method We performed a prospective case-series study of consecutive patients with refractory UUI treated with an intravesical injection of OnaBTA. The patients were administered 100 units of OnaBTA injected into the bladder wall following 4 weeks of flushing with anticholinergic agents or beta-3 agonists. The urodynamic and clinical endpoints were evaluated before and 6 months after the injection of OnaBTA. The primary study endpoint was the number of episodes of urinary leakage. Results A total of 204 of the 210 selected patients conducted a valid visit 6 months after the therapeutic application. At 6 months of treatment with OnaBTA, 110 (53.9%) patients remained continent and were considered a success. However, 57 (27.9%) patients experienced one episode of urinary leakage per day, and 37 (18.2%) had 2 or more. In terms of the urodynamic parameters, we observed the following changes: increase in maximum bladder capacity (p <0.0001) and reduced maximum pressure of the detrusor (p <0.0001). In terms of the safety profile, 8 (3.9%) patients had self-limiting haematuria during the procedure, which resolved spontaneously, and 9 (4.4%) patients had acute urinary retention that required intermittent catheterisation. Conclusions This study supports the use of OnabotulinumtoxinA in patients with urge urinary incontinence that does not respond to medical treatment.

      PubDate: 2017-07-09T21:50:38Z
       
  • Role of PET-CT with 18F-fluorocholine in biochemical recurrence after
           treatment of prostate cancer with curative intent
    • Authors: I. Puche-Sanz; E. Triviño-Ibáñez; F. Vázquez-Alonso; J.M. Llamas-Elvira; J.M. Cózar-Olmo; A. Rodríguez-Fernández
      Abstract: Publication date: Available online 8 July 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): I. Puche-Sanz, E. Triviño-Ibáñez, F. Vázquez-Alonso, J.M. Llamas-Elvira, J.M. Cózar-Olmo, A. Rodríguez-Fernández
      Objectives To analyze the ability of the PET-CT with 18F-fluorocholine (18F-FCH) to detect disease on biochemical recurrence after treatment with curative intent. To determine the clinical variables that would be able to optimize the test's diagnostic yield. Material and methods A retrospective study of PET-CTs with 18F-fluorocholine performed on 61 patients with prostate cancer who had undergone treatment with curative intent and met the criteria for biochemical recurrence. The results of the PET-CT were categorized into positive or negative and were validated using pre-established criteria. The relationship between the result of the PET-CT and the initial PSA nadir, PSA trigger, rising PSA velocity (PSAva) and PSA doubling time (PSAdt). The relationship between the metastatic sites on the PET-CT and the remaining variables was analyzed. Results There was a 34.4% detection rate of the disease. The initial PSA, PSA nadir, PSA trigger and PSAva showed statistically significant differences according to the result of the PET-CT. The best discriminatory cut-off point between a positive or negative PET-CT for PSA trigger and PSAva was 3.5ng/ml and 0.25ng/ml/month respectively. The PSAdt was significantly lower in patients with remote disease compared to patients with localized disease (5.1 vs 16.8 months, p =0.01). The probability that the PET-CT would detect remote disease vs localized disease was 3.2 times higher if the PSAdt was under 6 months (80% vs 20%, OR: 3.2, p =0.02). In the multivariate analysis, only the initial PSA and not having undergone radical prostatectomy were demonstrated as independent predictive factors of a positive PET-CT result. Conclusions The PET-CT with 18F-FCH can detect disease in a high percentage of patients with biochemical recurrence and provides information on its anatomical location. PSA kinetics and the patient's previous treatment are key variables in increasing the test's diagnostic.

      PubDate: 2017-07-09T21:50:38Z
      DOI: 10.1016/j.acuroe.2017.06.002
       
  • Transcutaneous stimulation of the posterior tibial nerve for treating
           refractory urge incontinence of idiopathic and neurogenic origin
    • Authors: C. Valles-Antuña; M.L. Pérez-Haro; C. González-Ruiz de León; A. Quintás-Blanco; E.M. Tamargo-Diaz; J. García-Rodríguez; A. San Martín-Blanco; J.M. Fernandez-Gomez
      Abstract: Publication date: Available online 8 July 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): C. Valles-Antuña, M.L. Pérez-Haro, C. González-Ruiz de León, A. Quintás-Blanco, E.M. Tamargo-Diaz, J. García-Rodríguez, A. San Martín-Blanco, J.M. Fernandez-Gomez
      Objective To assess the efficacy of treatment with transcutaneous posterior tibial nerve stimulation (TPTNS) in patients with urge urinary incontinence, of neurogenic or nonneurogenic origin, refractory to first-line therapeutic options. Material and methods We included 65 patients with urge urinary incontinence refractory to medical treatment. A case history review, a urodynamic study and a somatosensory evoked potentials (SEP) study were conducted before the TPTNS, studying the functional urological condition by means of a voiding diary. The treatment consisted of 10 weekly sessions of TPTNS lasting 30min. Results Some 57.7% of the patients showed abnormal tibial SEPs, and 42% showed abnormal pudendal SEPs. A statistically significant symptomatic improvement was observed in all clinical parameters after treatment with TPTNS, and 66% of the patients showed an overall improvement, regardless of sex, the presence of underlying neurological disorders, detrusor hyperactivity in the urodynamic study or SEP disorders. There were no adverse effects during the treatment. Conclusions TPTNS is an effective and well tolerated treatment in patients with urge incontinence refractory to first-line therapies and should be offered early in the treatment strategy. New studies are needed to identify the optimal parameters of stimulation, the most effective treatment protocols and long-term efficacy, as well as its applicability to patients with a neurogenic substrate.

      PubDate: 2017-07-09T21:50:38Z
      DOI: 10.1016/j.acuroe.2017.01.003
       
  • Experimental murine model of renal cancer
    • Authors: B. Padilla-Fernández; M.B. García-Cenador; P. Rodríguez-Marcos; J.F. López-Marcos; P. Antúnez-Plaza; J.M. Silva-Abuín; D. López-Montañés; F.J. García-Criado; M.F. Lorenzo-Gómez
      Abstract: Publication date: Available online 8 July 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): B. Padilla-Fernández, M.B. García-Cenador, P. Rodríguez-Marcos, J.F. López-Marcos, P. Antúnez-Plaza, J.M. Silva-Abuín, D. López-Montañés, F.J. García-Criado, M.F. Lorenzo-Gómez
      Introduction The objective of this study was to determine the reproducibility in a murine model of renal tumors of various histological strains that could be useful for investigating the response to target drugs. Material and methods Development and analysis of the “in vivo” model: tumor xenograft of renal cell carcinomas with Balb/c nude athymic mice. Nontumourous human renal tissue was implanted in the interscapular region of 5 mice, chromophobe renal cell carcinoma was implanted in 5 mice (which, after checking its growth, was prepared for implantation in another 10 mice) and Fuhrman grade 2 clear cell renal cell carcinoma (CCRCC) was implanted in 5 mice (which was also subsequently implanted in 10 mice). We monitored the tumor size, onset of metastases and increase in size and number of tumors. When the size had reached a point greater than or equal to locally advanced or metastatic carcinoma, the animals were euthanised for a pathological and immunohistochemical study and a second phase of implantation. Results The subcutaneous xenograft of the healthy tissue did not grow. The animals were euthanised at 6 months and no renal tissue was found. The chromophobe renal cell carcinoma cells grew in the initial phase (100%); however, in the second phase, we observed a chronic lymphomonocyte inflammatory reaction and a foreign body reaction. The CCRCC grew at 5–8 months both in the first and second phase (100%), maintaining the tumor type and grade. Conclusions The model with athymic Balb/c nude mice is useful for reproducing CCRCC, with the same histological characteristics and aggressiveness as native human tumors, promoting the development of the second experimental phase.

      PubDate: 2017-07-09T21:50:38Z
      DOI: 10.1016/j.acuroe.2017.06.003
       
  • Comparing groups with an effect size and confidence intervals approach: A
           reminder
    • Authors: S.A. Dominguez-Lara
      Abstract: Publication date: Available online 5 July 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): S.A. Dominguez-Lara


      PubDate: 2017-07-09T21:50:38Z
      DOI: 10.1016/j.acuroe.2017.03.011
       
  • Total phallic reconstruction using radial forearm free flap after
           iatrogenic penile amputation
    • Authors: J.C. Angulo; I. Arance; C. Gómez-Llorens; C. Esquinas; C. Gómez-Martín; J.L. Fernández-Cañamaque
      Abstract: Publication date: Available online 5 July 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.C. Angulo, I. Arance, C. Gómez-Llorens, C. Esquinas, C. Gómez-Martín, J.L. Fernández-Cañamaque
      Introduction The iatrogenic loss of the penis is a rare situation. We present a challenging case of deferred total penile reconstruction in a genetic male. Material and methods A 57-year-old man with the loss of the penis due to a penile abscess and necrosis secondary to penile curvature surgery. The reconstruction was performed over several operations using a radial forearm free flap (RFFF) and placement of a customized inflatable prosthesis a year later. Results During the first operation, the penile abscess was drained, the necrotic residues were debrided and placement of hypogastric drainage. Seven weeks later, phalloplasty was performed with RFFF and a tube-in-tube neourethra was constructed. Multiple microsurgical anastomosis was performed, and the donor site was coated with a skin graft from the thigh of partial thickness. The surgery lasted 10h and had the complication of hair growth in the neourethra, which required mechanical endoscopic depilation on repeated occasions. The patient regained penile sensitivity. Eighteen months after the phalloplasty, a Zephyr single-body inflatable prosthesis (Geneva, Switzerland) was implanted, using the tunica albuginea of the proximal corpus cavernosum. The patient was satisfied with the esthetics and urinary and sensory function. Four months later, the patient is gaining confidence to consider penetration. Conclusions Despite the risk of postoperative complications and the need for multiple operations, phallic reconstruction with RFFF and the placement of a customized prosthetic implant can improve urinary and sexual function secondary to the loss of the penis.

      PubDate: 2017-07-09T21:50:38Z
      DOI: 10.1016/j.acuroe.2017.06.004
       
  • Comment to “Benign prostatic hyperplasia and lower urinary tract
           symptoms. A review of current evidence”
    • Authors: Montero
      Abstract: Publication date: Available online 4 July 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): A. Alcántara Montero


      PubDate: 2017-07-09T21:50:38Z
       
  • Chemotherapy should not yet be considered in patients with
           hormone-sensitive metastatic prostate cancer
    • Abstract: Publication date: Available online 31 May 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): B. Miñana López


      PubDate: 2017-06-01T23:35:04Z
       
  • Muscle invasive bladder cancer: Prognostic factors, follow-up and
           treatment of relapses
    • Authors: C. Hernández-Fernández; F. Herranz-Amo; M. Moralejo-Gárate; D. Subirá-Ríos; J. Caño-Velasco; G. Barbas-Bernardos
      Abstract: Publication date: Available online 31 May 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): C. Hernández-Fernández, F. Herranz-Amo, M. Moralejo-Gárate, D. Subirá-Ríos, J. Caño-Velasco, G. Barbas-Bernardos
      Context Bladder cancer is the cause of more than 150,000 deaths per year. The overall rate of survival is approximately 45%, with a 10-year recurrence-free rate of 50–59%, with no changes in the last decade. Objective Due to a lack of agreement on the follow-up of cystectomy or on a uniform treatment when faced with the various types of recurrence, we have analyzed the most recent literature in an attempt to unify the criteria for the diagnosis and treatment of bladder cancer. Acquisition of evidence Review of Spanish and English publications in the medical literature in the last 10 years, highlighting the most significant series in terms of the number of patients, follow-up time, as well as the existing meta-analyses. Synthesis of the evidence Recurrence after cystectomy can occur in the urinary apparatus (upper urinary tract or distal urethra) and local (cystectomy bed) and/or distant metastases. Despite strict control, more than 60% of the relapses are discovered based on symptoms and not by the routine follow-up test. Locoregional and distant relapses are more common the more advanced the stage at the time of cystectomy, going from 11–21% in pT2N0 to 52–72% when there is lymphocytic N+ involvement. Recurrence in the urethra and/or upper urinary track has other prognostic factors such as multiplicity, the presence of Cis and involvement of prostatic stroma. There are various treatments for tumor relapses. Increasingly, the patient's comorbidity is considered when deciding on the therapeutic strategy. Treatments are typically multimodal and include surgery, radiotherapy and chemotherapy. Conclusion The follow-up of patients who undergo cystectomy should be individualized, taking into account the prognostic factors of recurrence and the patient's comorbidity, assuming that in some cases, multimodal treatment is indicated.

      PubDate: 2017-06-01T23:35:04Z
      DOI: 10.1016/j.acuroe.2016.07.010
       
  • Impact of locally advanced or metastatic prostate cancer on the quality of
           life
    • Authors: I. López-Calderero; L. López-Fando; E. Ríos-González; P. Maisonobe; E. Hernández-Yuste; M. Sarmiento-Jordán
      Abstract: Publication date: Available online 31 May 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): I. López-Calderero, L. López-Fando, E. Ríos-González, P. Maisonobe, E. Hernández-Yuste, M. Sarmiento-Jordán
      Objective The aim of this study was to assess the health-related quality of life of patients with prostate cancer in advanced phases to obtain additional information on the patients’ health. The growing interest in understanding the patient's perspective and the scarcity of prospective studies of this population motivated this research study. Material and methods We present an observational study performed on 131 urology consultations, with a sample of 601 patients with locally advanced or metastatic prostate cancer, assessed during 2 visits: baseline and at 12 months. We collected demographic, clinical, quality-of-life (PROSQoLI and EuroQoL-5D-5L questionnaires) and anxiety/depression (HADS questionnaire) endpoints. Results The mean age (SD) was 73.8 (8.2) years, and 87.2% of the participants were retired or pensioners. Some 58.7% of the patients presented locally advanced prostate cancer. Urinary symptoms were the most common, decreasing significantly after 1 year (p <0.05). Urinary problems and fatigue were the most affected measures, and pain/discomfort was the dimension present in most patients (65.3%). According to the linear regression model, asthenia and pain were 2 of the factors most closely related to a poorer quality of life. The presence of anxiety/depression was low. Finally, the health condition as assessed by the clinician was more positive than when assessed by the patients. Conclusions This study broadens the scarce information on the quality of life of the population with advanced prostate cancer, information of use for the clinical management of these patients.

      PubDate: 2017-06-01T23:35:04Z
      DOI: 10.1016/j.acuroe.2017.05.005
       
  • Comparative study of the B-SAQ, OAB-V8 and OAB-V3 questionnaires as
           screening tools for overactive bladders in clinical practice
    • Authors: J.C. Angulo; M.P. Calderín; Y. Fernández; M. González; E. Gómez; M.B. Herreros; P. Peñasco; M. Zapatero; J.F. Dorado
      Abstract: Publication date: Available online 31 May 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.C. Angulo, M.P. Calderín, Y. Fernández, M. González, E. Gómez, M.B. Herreros, P. Peñasco, M. Zapatero, J.F. Dorado
      Objective To compare the capacity shown by 3 self-assessment questionnaires validated in Spanish (B-SAQ, OAB-V8 and OAB-V3) for the screening of patients with overactive bladder (OAB) in clinical practice. Material and method A noninterventional observational study was conducted of men and women older than 30 years evaluated in primary care consultations. The clinical diagnosis of OAB was conducted through a case history review, physical examination, urine analysis, ultrasonography and voiding diary. The presence of coping strategies and discomfort was investigated. The differential diagnosis was established in patients with symptoms not due to OAB. We assessed the correlation between the clinical tests and diagnosis (kappa<0.4 poor; 0.4–0.6 moderate; >0.6 good; >0.8 excellent) and ROC curves to define the capacity to screen the assessed questionnaires. Results A total of 411 patients were investigated. OAB was detected in 207 (50.4%) patients, other causes for the lower urinary tract symptoms were detected in 63 (15.3%), and 141 (34.3%) patients had no diagnosis. The voiding diary suggested OAB in 197 (47.9%) patients. The correlation between the clinical diagnosis and the diagnosis based on the voiding diary was 0.702. The correlation between the clinical diagnosis and B-SAQ, OAB-V8 and OAB-V3 was 0.59, 0.673 and 0.732, respectively. The area under the curve (AUC) was 0.799 for B-SAQ; 0.837 for OAB-V8 and 0.867 for OAB-V3 (OAB-V3 vs. OAB-V8, p =0.02; OAB-V3 vs. B-SAQ, p <0.0001). The AUC for the voiding diary was 0.852 (OAB-V3 vs. diary, p =0.47). Conclusions OAB-V3 is a simple questionnaire with excellent performance for screening OAB in a specific population and that is superior to the OAB-V8 and B-SAQ. The accuracy of the voiding diary for the same indication is equivalent to that of the OAB-V3 in our setting.

      PubDate: 2017-06-01T23:35:04Z
      DOI: 10.1016/j.acuroe.2017.05.003
       
  • Metalloproteinase 11, potential marker and molecular target in advanced
           and castration-resistant prostate cancer. Culture study of peritumoral
           fibroblasts
    • Authors: J.M. Fernandez-Gomez; N. Eiro; J.J. García-Rodríguez; A. Quintás-Blanco; C. Gonzalez-Ruiz de León; M.L. Perez de Haro; F. Vizoso-Piñero
      Abstract: Publication date: Available online 28 May 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): J.M. Fernandez-Gomez, N. Eiro, J.J. García-Rodríguez, A. Quintás-Blanco, C. Gonzalez-Ruiz de León, M.L. Perez de Haro, F. Vizoso-Piñero
      Objective To analyze the expression of metalloprotein 11 (MMP11) in cultured fibroblasts obtained from human prostate tumors with different clinical and pathological characteristics. Material and methods For this study we analyzed samples of transrectal prostate biopsies from tumors with different characteristics, treated with or without androgen deprivation (AD). After optimization of the culture method, fibroblasts were isolated and cultured to perform the study (PCR) of MMP11 mRNA. Results Finally, 37 cases were studied: 5 samples of benign prostatic hyperplasia, 14 cases with localized neoplasms (7 high-risk according to the D’Amico classification), 5 with metastasic tumors (bone metastases), and 13 treated with AD therapy, of which 6 fulfilled the requirements to be defined as resistant to castration. In tumors without AD therapy, MMP11 expression was significantly higher (p =0.001) in fibroblasts of higher grade tumors. A significant (p =0.001) correlation was found between PSA and expression of MMP11 in fibroblast s and a significant increase of MMP11 expression in metastatic tumors. In tumors with AD therapy, a significantly greater expression of MMP11 was observed in resistant to castration patients than in those sensitive to castration (p =0.003). Conclusion In advanced prostate tumors or in stages of increased tumor aggressiveness, the production of MMP11 by fibroblasts is significantly greater than in non-metastatic tumors or in AD sensitive tumors.

      PubDate: 2017-06-01T23:35:04Z
      DOI: 10.1016/j.acuroe.2017.05.004
       
  • Diagnosis and treatment for clinically localized prostate cancer.
           Adherence to the European Association of Urology clinical guidelines in a
           nationwide population-based study – GESCAP group
    • Authors: F. Gómez-Veiga; A. Rodríguez-Antolín; B. Miñana; C. Hernández; J.F. Suárez; J.M. Fernández-Gómez; M. Unda; J. Burgos; A. Alcaraz; P. Rodríguez; R. Medina; J. Castiñeiras; C. Moreno; E. Pedrosa; J.M. Cózar
      Abstract: Publication date: Available online 28 May 2017
      Source:Actas Urológicas Españolas (English Edition)
      Author(s): F. Gómez-Veiga, A. Rodríguez-Antolín, B. Miñana, C. Hernández, J.F. Suárez, J.M. Fernández-Gómez, M. Unda, J. Burgos, A. Alcaraz, P. Rodríguez, R. Medina, J. Castiñeiras, C. Moreno, E. Pedrosa, J.M. Cózar
      Objective To assess the adherence to European Association of Urology (EAU) guidelines in the management of prostate cancer (PCa) in Spain. Patients and methods Epidemiological, population-based, study including a national representative sample of 3918 incident patients with histopathological confirmation during 2010; 95% of the patient's sample was followed up for at least one year. Diagnosis along with treatment related variables (for localized PCa – low, intermediate, high and locally-advanced by D’Amico risk stratification) was recorded. Differences between groups were tested with Chi-squared and Kruskal–Wallis tests. Results Mean (SD) age of PCa patients was 68.48 (8.18). Regarding diagnostic by biopsy procedures, 64.56% of all patients had 8–12 cores in first biopsy and 46.5% of the patients over 75 years, with PSA<10ng/ml were biopsied. Staging by computer tomography (CT) or bone scan (BS) was used for determining tumor extension in 60.09% of high-risk cases and was applied differentially depending on patients’ age; 3293 (84.05%) patients received a treatment for localized PCa. Radical prostatectomy was done in 1277 patients and 206 out of these patients also had a lymphadenectomy, being 4.64% low-risk, 22.81% intermediate-risk and 36.00% high-risk patients; 86.08% of 1082 patients who had radiotherapy were treated with 3D or IMRT and 35.77% received a dose ≥75Gy; 419 patients were treated with brachytherapy (BT): 54.81% were low-risk patients, 22.84% intermediate-risk and 12.98% high-risk. Hormonotherapy (HT, n =521) was applied as single therapy in 9.46% of low-risk and 17.92% of intermediate-risk patients. Additionally, HT was combined with RT in 14.34% of lower-risk patients and 58.26% of high-risk patients, and 67.19% low-intermediate risk with RT and/or BT received neoadjuvant/concomitant/adjuvant HT. Finally, 83.75% of high-risk patients undergoing RT and/or BT also received HT. Conclusions Although EAU guidelines for PCa management are easily available in Europe, the adherence to their recommendations is low, finding the highest discrepancies in the need for a prostate biopsy and the diagnostic methods. Improve information and educational programs could allow a higher adherence to the guidelines and reduce the variability in daily practice (Controlled-trials.com: ISRCTN19893319).

      PubDate: 2017-06-01T23:35:04Z
      DOI: 10.1016/j.acuroe.2017.05.006
       
 
 
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