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Panach-Navarrete J, Devís-Peiró A, Lloret-Durà MA, Sánchez-Gimeno S, Murcia-Díez E, Martínez-Jabaloyas JM. Quality of life in patients with non-muscle invasive bladder tumor undergoing adjuvant intravesical treatment. Actas Urol Esp 2023:S2173-5786(23)00012-4. [PMID: 36746347 DOI: 10.1016/j.acuroe.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/25/2022] [Accepted: 12/27/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The objective of the study was to establish a possible relationship between mitomycin-C (MMC) and bacillus Calmette-Guérin (BCG) treatments and quality of life impairment. MATERIAL AND METHODS Quasi-experimental, prospective, and longitudinal study including patients undergoing adjuvant treatment in NMIBC. The Short form-12 (SF-12) and Urogenital Distress Inventory-6 (UDI-6) questionnaires were used to measure quality of life. Questionnaire scores were compared between cases with MMC and BCG before induction (M1), at 4 weeks (M2) and at 2 months (M3). RESULTS Of the 90 patients enrolled, 54 were in the BCG group and 36 in the MMC group. It was found that BCG patients had worse perceived physical quality of life compared to MMC patients in M2 (OR:2.59, p=0.046). In addition, significant changes were found in the urinary quality of life of patients on MMC treatment between the different time points (UDI-6 score: 33.33 in M1, 27.78 in M2 and 16.67 in M3, p=0.001). CONCLUSIONS There are no differences in urinary quality of life between patients treated with MMC and BCG. Patients with MMC show a significant recovery of urinary quality of life from the completion of the induction course, which becomes even more significant after 2 months. In addition, BCG-treated patients have worse physical quality of life after 4 weeks of treatment than those treated with MMC.
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Affiliation(s)
- J Panach-Navarrete
- Department of Urology, University Clinic Hospital of Valencia, INCLIVA, Instituto de Investigación Sanitaria, Facultat de Medicina i Odontologia, Universitat de València, Valencia, Spain.
| | - A Devís-Peiró
- Department of Urology, University Clinic Hospital of Valencia, INCLIVA, Instituto de Investigación Sanitaria, Facultat de Medicina i Odontologia, Universitat de València, Valencia, Spain
| | - M A Lloret-Durà
- Department of Urology, University Clinic Hospital of Valencia, INCLIVA, Instituto de Investigación Sanitaria, Facultat de Medicina i Odontologia, Universitat de València, Valencia, Spain
| | - S Sánchez-Gimeno
- Department of Urology, University Clinic Hospital of Valencia, INCLIVA, Instituto de Investigación Sanitaria, Facultat de Medicina i Odontologia, Universitat de València, Valencia, Spain
| | - E Murcia-Díez
- Department of Urology, University Clinic Hospital of Valencia, INCLIVA, Instituto de Investigación Sanitaria, Facultat de Medicina i Odontologia, Universitat de València, Valencia, Spain
| | - J M Martínez-Jabaloyas
- Department of Urology, University Clinic Hospital of Valencia, INCLIVA, Instituto de Investigación Sanitaria, Facultat de Medicina i Odontologia, Universitat de València, Valencia, Spain
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Panach-Navarrete J, Devís-Peiró A, Lloret-Durà M, Sánchez-Gimeno S, Murcia-Díez E, Martínez Jabaloyas J. CALIDAD DE VIDA EN PACIENTES CON TUMOR VESICAL NO MÚSCULO-INVASIVO SOMETIDOS A TRATAMIENTO ADYUVANTE INTRAVESICAL. Actas Urol Esp 2023. [DOI: 10.1016/j.acuro.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Lloret-Durá MA, Panach-Navarrete J, Martínez-Jabaloyas JM, Valls-González L, Cózar-Olmo JM, Miñana-López B, Gómez-Veiga F, Rodríguez-Antolín A. Factors related to early castration resistance in metastatic prostate cancer. Results from the National Prostate Cancer Registry in Spain. Actas Urol Esp 2019; 43:562-567. [PMID: 31301868 DOI: 10.1016/j.acuro.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 04/13/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The objective of the study was to determine the factors independently related with the development of castration resistance (CR) in prostate cancer (PC) in the medium term. MATERIAL AND METHODS 155 patients diagnosed with metastatic PC with a follow-up of up to 39 months. Data taken from the National PC Registry. The evaluated variables were age, PSA, nadir PSA, Gleason, perineural invasion, TNM stages, and ADT type (intermittent/continuous). RESULTS Mean follow-up 26,2±13,4 months. 47.1% developed early CR, with mean time until onset of 12,2±8,7 months. Univariate analysis the mean PSA was correlated with CR (290±905,1 ng/mL in non CR, 519,1±1437,2 ng/mL in CR, P<.001), mean age (73,3±8,3 years in non CR, 69,1±9,3 in CR P=.01), mean PSA nadir (15,5±57,3ng/mL in non CR, 15,9±23,7 ng/mL in CR, p<0,001), Gleason (in ≥8, HR:2,11. 95% CI: 1.22-3.65, p=0.006), and T stage (in T3-T4, HR: 2.85. 95% CI: 1.57-5.19, P<.001). Multivariate analysis the independent variables associated to CR are age (HR: 0.96. 95% CI: 0.94-0.99, P=.01), PSA nadir (HR: 1.65. 95% CI: 1,43-1,91, P<.001), and T3-T4 stage (HR: 2.11. 95% CI: 1.10-4.04, P=.02). CONCLUSIONS PSA nadir and T3-T4 tumor stage at diagnosis are associated to an increased risk of developing CR. In addition, age at diagnosis is shown as a variable that decreases risk. Therefore, an older age would be associated with lower risk probability of CR in the medium term.
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Affiliation(s)
- M A Lloret-Durá
- Servicio de Urología, Hospital Clínico Universitario de Valencia, Facultat de Medicina i Odontologia, Universitat de València, Valencia, España.
| | - J Panach-Navarrete
- Servicio de Urología, Hospital Clínico Universitario de Valencia, Facultat de Medicina i Odontologia, Universitat de València, Valencia, España
| | - J M Martínez-Jabaloyas
- Servicio de Urología, Hospital Clínico Universitario de Valencia, Facultat de Medicina i Odontologia, Universitat de València, Valencia, España
| | - L Valls-González
- Servicio de Urología, Hospital Clínico Universitario de Valencia, Facultat de Medicina i Odontologia, Universitat de València, Valencia, España
| | - J M Cózar-Olmo
- Servicio de Urología, Hospital Virgen de las Nieves, Granada, España
| | - B Miñana-López
- Servicio de Urología, Clínica Universidad de Navarra, Pamplona, España
| | - F Gómez-Veiga
- Servicio de Urología, C.H.U.A.C., Hospital Universitario de Salamanca, Salamanca, España
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March-Villalba J, Panach-Navarrete J, Herrero-Cervera M, Aliño-Pellicer S, Martínez-Jabaloyas J. hTERT mRNA expression in urine as a useful diagnostic tool in bladder cancer. Comparison with cytology and NMP22 BladderCheck Test®. Actas Urol Esp 2018; 42:524-530. [PMID: 29631914 DOI: 10.1016/j.acuro.2018.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION To study the relationship between quantitative mRNA determination (hTERT) in patients with bladder tumor, history of bladder tumor, and in subjects without a history of this neoplasia. MATERIAL AND METHODS A prospective randomized controlled study with 91 subjects included. The value of mRNA-hTERTN was determined in 63 patients with a history or suspicion of bladder tumor and in 28 controls. Urine samples were sent for evaluation of the mRNA level (hTERT), the cytological study and the NMP22 result. RESULTS Differences were observed in mean hTERTN levels in each of the groups: tumor presence 21.33+/- 40.66, tumor history 2.16+/- 2.67, controls 0.9+/- 1, 75 (p<0.001). In patients with tumor, there was no difference in mean hTERTN levels between the different grades and stages, although there was a tendency: low grade tumor 9.04+/- 16.95, high grade 28.95+/- 48.36 (p=.069), stage Ta 10.33+/- 19.39, T1 17.88+/- 27.14, T2 54.8+/- 74.05 (p=.056). In addition, the sensitivity of hTERTN was superior to that of other test (76%), although specificity and positive and negative predictive values were better for cytology (94%, 88.4% and 72.3% respectively) and NMP22 (88%, 80.6% and 73.3% respectively). CONCLUSIONS hTERTN mRNA levels in urine were higher in patients with bladder tumors compared to patients with a history of bladder tumor and with negative cystoscopy, as well as in the control group. This determination showed a higher diagnostic yield compared with the detection of NMP22 and urinary cytology.
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Panach-Navarrete J, Morales-Giraldo A, Ferrandis-Cortés C, García-Morata F, Pastor-Lence J, Martínez-Jabaloyas J. Satisfaction and treatment adherence in erectile dysfunction in the medium and long term. Actas Urol Esp 2017; 41:258-266. [PMID: 27865471 DOI: 10.1016/j.acuro.2016.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 09/25/2016] [Accepted: 09/26/2016] [Indexed: 12/26/2022]
Abstract
INTRODUCTION The aim of this study was to show the satisfaction and treatment adherence in erectile dysfunction (ED) in the medium and long term. MATERIAL AND METHODS A descriptive, comparative study was conducted in 2 centres through telephone interviews with patients who came for an initial visit between 2012 and 2014 for ED. A complete case history review was conducted on the use of and withdrawal from treatment. For current use, the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and the Global Assessment Questionnaire (GAQ) were filled out; for past use, only the GAQ was filled out. For the statistical analysis, we employed Fisher's exact test for comparisons of percentages and the Kruskal-Wallis test to compare means. RESULTS The study included 250 patients; 20.8% were prescribed intraurethral alprostadil (ALP-IU), 17.2% were prescribed intracavernous alprostadil (ALP-IC), 92.8% were prescribed a first IPD5, and 24.8% were prescribed at least a second IPD5. The treatment withdrawal rate was 62.07% for the first IPD5, 41.94% for the last IPD5, 69.23% for the ALP-IU and 65.11% for the ALP-IC (P=.007). The main reason for withdrawal for the IPD5 was a lack of response (32.76% of those who took IPD5). In addition to withdrawal, there were adverse reactions for ALP-IU and ALP-IC (28.85% and 11.63%, respectively). The mean duration of use until withdrawal was 4.3 months for IPD5, 2.2 months for ALP-IU and 5.5 months for ALP-IC (P=.064). The most favourable GAQ and EDITS scores were observed for IPD5 (EDITS score of 74). Sildenafil and tadalafil had the longest usage times (mean >5 months). CONCLUSIONS The withdrawal rate for treating ED is high, with short usage times of a few months. A lack of response and adverse reactions were the main causes for withdrawal. The drugs that provide greater satisfaction are the IPD5, although there are no significant differences in the mean usage time between the different types and in aspects such as the mean usage time to withdrawal or the withdrawal rates.
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Palmero-Martí JL, Panach-Navarrete J, Valls-González L, Ganau-Ituren A, Miralles-Aguado J, Benedicto-Redón A. Comparative study between thulium laser (Tm: YAG) 150W and greenlight laser (LBO:ND-YAG) 120W for the treatment of benign prostatic hyperpplasia: Short-term efficacy and security. Actas Urol Esp 2017; 41:188-193. [PMID: 27894613 DOI: 10.1016/j.acuro.2016.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/14/2016] [Accepted: 09/15/2016] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To compare the results of efficacy and safety of Thulium laser 150W against Greenlight laser 120W in the treatment of short term benign prostatic hyperplasia (12 months after surgery). MATERIAL AND METHODS This is a retrospective observational study where men who underwent the surgical technique of prostate vaporization over a period of four years in our center are included. The homogeneity of the sample was checked, and postoperative complications (acute urinary retention, reentry, need for transfusion), failures per year of surgery (reoperation, peak flow <15ml/sec, no improvement in comparing the I-PSS), and decreased PSA were compared a year after surgery. A bivariate analysis using Chi-square and t-Student was carried out. RESULTS 116 patients were treated with thulium and 118 with green laser. The sample was homogeneous for preoperative variables (P>.05). No differences in complications were observed: in urine acute retention, 4.3% with thulium and 6.8% with green laser (P=.41); in readmissions, 2.6% with thulium and 1.7% with green laser (P=.68); in need for transfusion, 2.6% with thulium and 0% with green laser (P=.12). No differences were observed in the percentage of patients reoperation (1.7% in the group of thulium, 5.1% in the green laser, P=.28); or in individuals with Qmáx less than 15ml/sec (6.9% with thulium, 6.77% with green laser, P=.75), or in the absence of improvement in the IPSS (5, 2% with thulium, 3.4% with green laser, P=.65). There was also no difference in the levels of PSA in ng/mL a year after surgery: with thulium 2.78±2.09 and with green laser 1.83±1.48 (P=.75). CONCLUSIONS Prostate vaporization with thulium laser 150W is comparable to that made with green laser 120W for the treatment of lower urinary tract symptoms caused by BPH, being both effective and safe techniques to 12 months after surgery. Future prospective randomized studies are needed to confirm this conclusion on both techniques.
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Affiliation(s)
- J L Palmero-Martí
- Servicio de Urología, Hospital Universitario de La Ribera, Alzira, Valencia, España
| | - J Panach-Navarrete
- Servicio de Urología, Hospital Universitario de La Ribera, Alzira, Valencia, España.
| | - L Valls-González
- Servicio de Urología, Hospital Universitario de La Ribera, Alzira, Valencia, España
| | - A Ganau-Ituren
- Servicio de Urología, Hospital Universitario de La Ribera, Alzira, Valencia, España
| | - J Miralles-Aguado
- Servicio de Urología, Hospital Universitario de La Ribera, Alzira, Valencia, España
| | - A Benedicto-Redón
- Servicio de Urología, Hospital Universitario de La Ribera, Alzira, Valencia, España
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Panach-Navarrete J, Gironés-Montagud A, Sánchez-Cano E, Doménech-Pérez C, Martínez-Jabaloyas JM. [Use of prostatic specific antigen in primary care (PSA)]. Semergen 2016; 43:189-195. [PMID: 27344583 DOI: 10.1016/j.semerg.2016.04.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 03/06/2016] [Accepted: 04/20/2016] [Indexed: 12/30/2022]
Abstract
INTRODUCTION In the literature it is shown that the use of PSA is occasionally wrong, by requesting this marker in very young or very old men, and repeated measurements in short periods of time. The main objective of this study was to describe the use of PSA in daily practice by primary care physicians in our area, dealing with aspects such as the importance of patient age, the value in the screening for prostate cancer, or the subjective beliefs about its usefulness. A secondary objective was the comparison of use, and beliefs among doctors who claim to know PSA well, and those who do not. PATIENTS AND METHODS A descriptive and comparative study was conducted using questionnaires that were handed to primary care doctors in all health centres in our area. A descriptive analysis was performed and response rates among doctors who thought they had enough information about PSA, and those who did not, were compared using the Chi-squared test. RESULTS A total of 103 questionnaires were received from the physicians, with 83.5% claiming to have sufficient knowledge about the PSA. The professionals in this latter group request PSA at an earlier age (P=.029), with a higher frequency (P=.011) and have more doubts about its usefulness (P=.009) than those with less knowledge. Almost half (49.5%) said they request less than 50 determinations per year, and 33% between 50 and 100. More than half (53.4%) of doctors would not request the first PSA on a patient until their 50s, and up to 49% request it up to 80 years. The true value of PSA has been established many times by 64.1% of requesters, and 29.1% believe it is unhelpful in the diagnosis of cancer. CONCLUSIONS In our study, 64% of primary care physicians have considered the true value of the PSA several times, and 29% believe it to be of little use in the diagnosis of prostate cancer. In addition, some data suggest it has limited use due to the fact that 50% made less than 50 PSA requests per years, and 28% of the professionals would never request it on a male without urinary symptoms. In this study, it has been observed that those professionals who claim not to have enough information about the PSA make more requests in patients of an older age, and consider that it is of limited use as a marker.
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Affiliation(s)
- J Panach-Navarrete
- Servicio de Urología, Hospital Clínico Universitario de Valencia, Valencia, España.
| | - A Gironés-Montagud
- Servicio de Urología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - E Sánchez-Cano
- Servicio de Urología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - C Doménech-Pérez
- Servicio de Urología, Hospital Clínico Universitario de Valencia, Valencia, España
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