1
|
García Cortés Á, Colombás Vives J, Gutiérrez Castañé C, Chiva San Román S, Doménech López P, Ancizu Marckert FJ, Hevia Suárez M, Merino Narro I, Velis Campillo JM, Guillén Grima F, Torres Roca M, Diez-Caballero Y Alonso F, Rosell Costa D, Villacampa Aubá F, Ramón de Fata Chillón F, Andrés Boville G, Barbas Bernardos G, Miñana López B, Robles García JE, Pascual Piédrola JI. What is the impact of post-radical prostatectomy urinary incontinence on everyday quality of life? Linking Pad usage and International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) for a COMBined definition (PICOMB definition). Neurourol Urodyn 2021. [PMID: 33604977 DOI: 10.1002/nau.24631)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
AIMS To identify the definition for urinary continence (UC) after radical prostatectomy (RP) which reflects best patients' perception of quality of life (QoL). METHODS Continence was prospectively assessed in 634 patients, 12 months after RP using the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) and the number of pads employed in a 24-hour period (pad usage). We used the one-way ANOVA technique with posthoc pairwise comparisons according to Scheffé's method (homogeneous subsets) for assessing the degree of QoL deficit related to urinary incontinence (UI). RESULTS The continence prevalence is 64.4%, 74.1%, 88.3%, and 35.8% using "0 pads," "1 safety pad," "1 pad," and "ICIQ score 0" definitions, respectively. Pad usage is moderately strongly associated with ICIQ 1, 2, and 3 (ρ = 0.744, 0.677, and 0.711, respectively; p < 0.001). Concordance between classical UC definitions is acceptable between "0 pads-ICIQ score 0" (K = 0.466), but poor for "1 safety pad" and "1 pad" (K = 0.326 and 0.137, respectively). Patients with "0 pad usage" have better QoL related to urine leakage than patients with "1 safety pad" or "1 pad" (1.41 vs. 2.44 and 3.11, respectively; p < 0.05). There were no significant differences found regarding QoL between patients with ICIQ score 0 and ICIQ score 2 (1.01 vs. 1.63; p = 0.63). CONCLUSIONS Pad usage and the ICIQ-SF's answers provide useful information. We propose a combined definition (0 pads and ICIQ score ≤2) as it is the definition with the least impact on daily QoL.
Collapse
Affiliation(s)
- Ángel García Cortés
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Juan Colombás Vives
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | | | | | - Pablo Doménech López
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | | | - Mateo Hevia Suárez
- Department of Urology, Complejo Asistencial Universitario de León, León, Spain
| | - Imanol Merino Narro
- Department of Urology, Hospital Universitario de Araba, Vitoria-Gasteiz, Spain
| | | | - Francisco Guillén Grima
- Department of Preventive Medicine and Public Health, Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Marcos Torres Roca
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | | | - David Rosell Costa
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Felipe Villacampa Aubá
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | | | | | | | - Bernardino Miñana López
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - José E Robles García
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Juan I Pascual Piédrola
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| |
Collapse
|
2
|
García Cortés Á, Colombás Vives J, Gutiérrez Castañé C, Chiva San Román S, Doménech López P, Ancizu Marckert FJ, Hevia Suárez M, Merino Narro I, Velis Campillo JM, Guillén Grima F, Torres Roca M, Diez-Caballero Y Alonso F, Rosell Costa D, Villacampa Aubá F, Ramón de Fata Chillón F, Andrés Boville G, Barbas Bernardos G, Miñana López B, Robles García JE, Pascual Piédrola JI. What is the impact of post-radical prostatectomy urinary incontinence on everyday quality of life? Linking Pad usage and International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) for a COMBined definition (PICOMB definition). Neurourol Urodyn 2021; 40:840-847. [PMID: 33604977 DOI: 10.1002/nau.24631] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/30/2021] [Accepted: 01/31/2021] [Indexed: 12/13/2022]
Abstract
AIMS To identify the definition for urinary continence (UC) after radical prostatectomy (RP) which reflects best patients' perception of quality of life (QoL). METHODS Continence was prospectively assessed in 634 patients, 12 months after RP using the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) and the number of pads employed in a 24-hour period (pad usage). We used the one-way ANOVA technique with posthoc pairwise comparisons according to Scheffé's method (homogeneous subsets) for assessing the degree of QoL deficit related to urinary incontinence (UI). RESULTS The continence prevalence is 64.4%, 74.1%, 88.3%, and 35.8% using "0 pads," "1 safety pad," "1 pad," and "ICIQ score 0" definitions, respectively. Pad usage is moderately strongly associated with ICIQ 1, 2, and 3 (ρ = 0.744, 0.677, and 0.711, respectively; p < 0.001). Concordance between classical UC definitions is acceptable between "0 pads-ICIQ score 0" (K = 0.466), but poor for "1 safety pad" and "1 pad" (K = 0.326 and 0.137, respectively). Patients with "0 pad usage" have better QoL related to urine leakage than patients with "1 safety pad" or "1 pad" (1.41 vs. 2.44 and 3.11, respectively; p < 0.05). There were no significant differences found regarding QoL between patients with ICIQ score 0 and ICIQ score 2 (1.01 vs. 1.63; p = 0.63). CONCLUSIONS Pad usage and the ICIQ-SF's answers provide useful information. We propose a combined definition (0 pads and ICIQ score ≤2) as it is the definition with the least impact on daily QoL.
Collapse
Affiliation(s)
- Ángel García Cortés
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Juan Colombás Vives
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | | | | | - Pablo Doménech López
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | | | - Mateo Hevia Suárez
- Department of Urology, Complejo Asistencial Universitario de León, León, Spain
| | - Imanol Merino Narro
- Department of Urology, Hospital Universitario de Araba, Vitoria-Gasteiz, Spain
| | | | - Francisco Guillén Grima
- Department of Preventive Medicine and Public Health, Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Marcos Torres Roca
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | | | - David Rosell Costa
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Felipe Villacampa Aubá
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | | | | | | | - Bernardino Miñana López
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - José E Robles García
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Juan I Pascual Piédrola
- Department of Urology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| |
Collapse
|
3
|
Pascual Piédrola JI, Hevia Suárez M, Ancizu Markert FJ, García Cortés A, Doménech López P, Chiva San Román S, Velis Campillo JM, Díez-Caballero Alonso F, Robles García JE, Rosell Costa D, Villacampa Aubá F, de Fata Chillón FR, Miñana López B. [Prognostic factors and response predictors in castration resistant prostate cancer.]. ARCH ESP UROL 2018; 71:704-710. [PMID: 30319130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Prostate cancer is a health problem in many Countries worldwide. Understanding the essential function of androgens in the prostate physiology led to the development of hormonal blockade as a therapeutic option in advanced disease, with limited response with time and development of resistance. In this stage, where castration resistant prostate cancer (CRPC) is defined, it is associated with poor prognosis because survival varies between 18 and 24 months. Even with castration levels, tumors are dependent on the functional androgen receptor (AR). In this paper, we analyze pretreatment clinical parameters such as prognostic or progression-predictive biomarkers, castration resistance mechanisms, the development of new technologies for the use of the so called liquid biopsies from biological ayufluids and the identification of circulating tumor cells as CRPC response and progression biomarkers. Currently ongoing clinical trials are partially oriented to the search of new prognostic and predictive biomarkers, that will enable to open up precision medicine and so to improve oncological patient's quality of life with it.
Collapse
Affiliation(s)
| | - Mateo Hevia Suárez
- Departamento de Urología. Clínica Universidad de Navarra. Pamplona. España
| | | | | | | | | | | | | | | | - David Rosell Costa
- Departamento de Urología. Clínica Universidad de Navarra. Pamplona. España
| | | | | | | |
Collapse
|
4
|
Miñana López B, Villacampa Aubá F, de Fata Chillón FR, Ancizu Markert FJ, García Cortés A, Doménech López P, Chiva San Román S, Velis Campillo JM, Díez-Caballero Alonso F, Robles García JE, Rosell Costa D, Pascual Piédrola JI. [Immunotherapy in castration resistant prostate cancer.]. ARCH ESP UROL 2018; 71:685-695. [PMID: 30319128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We review the role of immunotherapy in castration resistant prostate cancer. Two immunotherapeutic strategies have been applied, isolated or in combination, either with each other or with other agents with demonstrated efficacy in this scenario that would play a role as immunomodulators: vaccines or monoclonal antibodies aimed to block immune response checkpoint inhibitors. Although CRPC presents, a priori, characteristics suggesting that immunotherapy may play a relevant role as a therapeutic strategy, its clinical application has demonstrated a limited and heterogeneous activity, in terms of proportion of responders and response intensity. Generally, the objective response rate is very low, although, in patients who have response it is possible to detect a clear, long-lasting benefit. Only the autologous vaccine Sipuleucel T has demonstrated an overall survival increase in patients with good prognosis criteria. In these treatments, it is characteristic that no progression free survival increase is visible due to its action mechanism. PSA evolution may not be considered a surrogate variable of radiological response or clinical benefit in this environment either. It is necessary to identify what patient's or tumor's characteristics are able to maximize the response. An important limitation is the absence of response predictive biomarkers that serve for patient preselection. As a general rule, the best responses with isolated immunotherapeutic treatments have been observed in patients with low tumor load, which may suggest that their optimal application could be in earlier phases of the disease (high risk localized, biochemical failure, etc) Combination strategy, without doubt the one with best future, is based on additional treatments increasing cell lysis with the subsequent antigen exposure and/ or producing an immunomodulatory effect that can surmount tumor induced immunologic tolerance. The results obtained suggest that immunotherapy may be more effective in combined therapy with other active therapies (abiraterone, enzalutamide, Radium 223, docetaxel) in a fight to achieve disease chronification.
Collapse
Affiliation(s)
| | | | | | | | - Angel García Cortés
- Departamento de Urología. Clínica Universidad de Navarra. Madrid/Pamplona. España
| | - Pablo Doménech López
- Departamento de Urología. Clínica Universidad de Navarra. Madrid/Pamplona. España
| | | | | | | | | | - David Rosell Costa
- Departamento de Urología. Clínica Universidad de Navarra. Madrid/Pamplona. España
| | | |
Collapse
|
5
|
Buj Pradilla MJ, Martí Ballesté T, Torra R, Villacampa Aubá F. Recommendations for imaging-based diagnosis and management of renal angiomyolipoma associated with tuberous sclerosis complex. Clin Kidney J 2017; 10:728-737. [PMID: 29225800 PMCID: PMC5716090 DOI: 10.1093/ckj/sfx094] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/16/2017] [Indexed: 01/12/2023] Open
Abstract
Renal angiomyolipomas are found in up to 80% of tuberous sclerosis complex (TSC) patients. Although these tumours are usually asymptomatic, lesions >3 cm in diameter are prone to bleeding and up to 10% of TSC patients may experience a massive and potentially fatal retroperitoneal haemorrhage. Diagnosis can be complicated because of the initial lack of symptoms and the fat-poor content of atypical renal angiomyolipomas. After diagnosis, tumour growth and the emergence of new tumours must be monitored. Treatment with mammalian target of rapamycin (mTOR) inhibitors can reduce tumour size and is indicated in patients with TSC-associated renal angiomyolipomas >3 cm in diameter. Imaging-based assessment of kidney disease is essential to the diagnosis and management of patients with TSC. The aims of imaging studies in this context are to detect and characterize tumours, assess and detect the risk of complications and evaluate the response to treatment, especially in patients treated with mTOR inhibitors. A multidisciplinary expert panel developed a series of recommendations based on current evidence and professional experience for imaging studies in adults and children with TSC-associated renal angiomyolipoma. The recommendations cover radiological diagnosis and follow-up of the classic and atypical or fat-poor TSC-associated renal angiomyolipomas, biopsy indications, minimal requirements for radiological requests and reports and recommended technical features and protocols for computed tomography and magnetic resonance imaging.
Collapse
Affiliation(s)
| | | | - Roser Torra
- Inherited Renal Diseases, Department of Nephrology, Fundació Puigvert, REDINREN, IIB Sant Pau, Universitat Autónoma de Barcelona, Spain
| | - Felipe Villacampa Aubá
- Department of Urology, University Hospital 12 de Octubre, Madrid, Spain.,Centro de investigación Biomédica en Red de Cáncer CIBERONC
| |
Collapse
|
6
|
Guerrero Ramos F, Cavero Escribano T, Tejido Sánchez A, Rodríguez Antolín A, Pamplona Casamayor M, Medina Polo J, de la Rosa Kehrmann F, Duarte Ojeda JM, Villacampa Aubá F, Andrés Belmonte A, Passas Martínez J. MP30-02 SURVIVAL OF KIDNEY TRANSPLANTS FROM UNCONTROLLED DCD DONORS UNDER NORMOTHERMIC PRESERVATION: ARE THEY AS GOOD AS DBD KIDNEYS? J Urol 2017. [DOI: 10.1016/j.juro.2017.02.935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
7
|
Villacampa Aubá F, Guerrero Ramos F, Díez Sicilia L, García Gómez B, Sepúlveda Sánchez JM, Ospina Galeano IA, Garc ía González LÍ, Jiménez Alcaide E, Duarte Ojeda JM, de la Rosa Kehrman F, Castellano Gauna D, Díaz González R. 468 HOW DO GENETIC POLYMORPHISMS INFLUENCE IN SUNITINIB TREATED METASTATIC RENAL CARCINOMA?: A PROSPECTIVE OBSERVATIONAL STUDY AND VALIDATION. J Urol 2013. [DOI: 10.1016/j.juro.2013.02.1859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
8
|
Feltes Ochoa JA, Blanco Carballo O, Sánchez Angel T, Villacampa Aubá F, Conde Gallego E. [Adenocarcinoma of the female urethra: report of two cases and bibliography review]. ARCH ESP UROL 2005; 58:677-82. [PMID: 16294793 DOI: 10.4321/s0004-06142005000700015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Primary adenocarcinoma of the female urethra is a rare malignancy. We report two cases and a review of the latest articles focused on classification and treatment of this kind of neoplasm. METHODS We present two females diagnosed of urethral adenocarcinoma, describing clinic and pathological features, diagnosis and treatment. CONCLUSIONS Female urethral adenocarcinoma is an uncommon neoplasm with a heterogeneous histogenesis. The distal urethral carcinoma is more amenable to treatment, and the prognosis is better than that of proximal or entire urethral carcinoma, which is often associated with extensive local invasion and metastasis.
Collapse
|
9
|
Villacampa Aubá F, Martín Muñoz M, Tejido Sánchez A, de la Morena Gallego JM, Suárez Charneco A, Rosíno Sánchez A, Capitán Manjón C, Díaz González R, Leiva Galvis O. [Soft lithiasis ("mous")]. ARCH ESP UROL 2003; 56:1161-3. [PMID: 14763426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
OBJECTIVES To describe the most relevant features of matrix lithiasis, an infrequent type of lithiasis seldom reported since the generalization of extracorporeal shock wave lithotripsy. METHODS We report a clinical case and analyze the most important bibliography found by MEDLINE search (1950-1999). We will focus on the physiopathology and etiology of these stones to understand its development and the clinical presentation showed by these patients. RESULTS Matrix lithiasis is a very rare entity, described almost one century ago. It is mainly composed of lithiasis matrix, and the percentage of mineral content is really low in comparison with usual stones. Persistent urinary tract infection is another constant in these patients, which to some extent conditions the modification of the usual urinary components, creating a series of the disturbances within the urinary tract that favour the aggregation of the components of the lithiasis matrix up to the formation of a stone, without need of aggregation of mineralized crystals. CONCLUSIONS A high degree of suspicion is necessary for the diagnosis of matrix lithiasis, because it does not show the usual clinical picture of a renal stone. Exhaustive lavage of caliceal cavities and elimination of bacteriuria are essential elements for treatment, in order to avoid recurrence of the disease.
Collapse
|
10
|
Martínez Silva VM, Villacampa Aubá F, Tejido Sánchez A, Martín Muñoz MP, Cruceyra Betriú G, Rosino Sánchez A, Leiva Galvis O. [Encrusted pyelitis in patients with urinary diversion]. ARCH ESP UROL 2003; 56:76-81. [PMID: 12701486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVE This is a case of Encrusted Pyelitis (EP) caused by Corynebacterium urealyticum (CU) in a patient who had undergone a cystectomy and Bricker type urinary diversion 28 months beforehand. METHODS/RESULTS After the immediate post-operative period no urinary catheterisation or any other urological procedure was performed on the patient. Before surgery, the patient presented non functional of the right kidney, secondary to a lithiasic obstructive uropathy. Clinical symptoms were deteriorated renal function, anuria, haematuria, pyrexia and left lumbar pain. It was suspected that the patient had this pathology and this was fundamental in diagnosis. Helicoid CT was the principal method used to show calcification plaques on the wall of the left renal pelvis, and selective culture of CU confirmed the diagnosis. Early commencement of treatment with vancomycin at an initial dosage of 500 mg/12 hours, and subsequent adjustment of dosage according to blood drug levels, achieved negative urine culture within a fortnight. Oral acidification was effected using acetohidroxamic acid 125 mg/12 hours, and it was continued until CT confirmed the disappearance or considerable reduction of the pyelic calcification plaques. CONCLUSION The presence of EP in patients with urinary diversion is a matter worthy of consideration, even in patients who have not undergone recent urological procedures. Awareness of risk factors and early commencement of effective treatment may improve the prognosis of these patients.
Collapse
|
11
|
Capitán Manjón C, Tejido Sánchez A, Rosino Sánchez A, Cruceyra Betriu G, Piedra Lara JD, Villacampa Aubá F, Leiva Galvis O. [[Primary psoas abscess. Presentation of 3 cases]. ARCH ESP UROL 2002; 55:552-5. [PMID: 12174424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
OBJECTIVE To present 3 cases of primary abscess of the psoas muscle. The clinical features, diagnostic tests, treatment and outcome are discussed. METHODS/RESULTS Three patients that presented with fever and pain referred to the renal and/or iliac fossa are described. Physical examination showed psoas involvement in only one patient. Among the complementary tests performed, ultrasound demonstrated the abscess in one of the cases; the definitive diagnosis was made by contrast-enhanced CT. One of the cases was treated only with antibiotics while the other two cases were treated with CT-guided percutaneous drainage and appropriate antibiotic therapy. CONCLUSIONS Psoas abscess is an uncommon pathology whose presenting features are usually unspecific. CT with contrast enhancement is considered to be the technique of choice for the diagnosis and to corroborate the resolution of the condition. Recently, the use of CT or US-guided percutaneous drainage has replaced surgery as the initial therapeutic approach for this condition.
Collapse
|