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Article: Four vertex technique for correcting urethral prolapse: technique description and cohort study.

Noya-Mourullo, Andrea / Herrero-Polo, Manuel / Heredero-Zorzo, Oscar / García-Gómez, Francisco / Urrea-Serna, Carmen / Marquez-Sanchez, Magaly-Teresa / Flores-Fraile, Javier / Padilla-Fernandez, Barbara-Yolanda / Lorenzo-Gómez, María-Fernanda

Frontiers in surgery

2023 Volume 10, Page(s) 1149729

Abstract: Introduction/objectives: This study aims to describe the procedure and effectiveness of the four-vertex technique for correcting urethral prolapse in women.: Methods and materials: includes a retrospective case series of 17 patients who underwent ... ...

Abstract	Introduction/objectives: This study aims to describe the procedure and effectiveness of the four-vertex technique for correcting urethral prolapse in women. Methods and materials: includes a retrospective case series of 17 patients who underwent surgery for urethral prolapse. Two study groups were distinguished based on the presence or absence of pelvic heaviness symptoms. The variables were analyzed, including age, BMI, concomitant diseases, obstetric and gynecological history, time from diagnosis to surgery, and outcomes of treatment. Results: All patients were postmenopausal, with a mean age at the time of the intervention of 70.41 years, with no differences between groups. Mean BMI was 23.67 kg/m2, higher in the group with a sensation of vaginal heaviness ( Conclusion: The four-vertex technique was effective in resolving symptoms in most patients. However, some patients experienced dysuria, urinary urgency, and pelvic organ prolapse after surgery. Urinary incontinence improved in most patients, but a few required additional treatments with suburethral tape. The study also identified associations between variables and the presence of cystocele, consultation for a bulging sensation, and bleeding from urethral prolapse. Overall, this study sheds light on the challenges and outcomes of surgical treatment for urethral prolapse and provides valuable insights for future research in this area.
Language	English
Publishing date	2023-06-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2023.1149729
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Article ; Online: Defective chaperone-mediated autophagy is a hallmark of joint disease in patients with knee osteoarthritis.

Lorenzo-Gómez, I / Nogueira-Recalde, U / García-Domínguez, C / Oreiro-Villar, N / Lotz, M / Pinto-Tasende, J A / Blanco, F J / Caramés, B

Osteoarthritis and cartilage

2023 Volume 31, Issue 7, Page(s) 919–933

Abstract: Objective: Defects in autophagy contribute to joint aging and Osteoarthritis (OA). Identifying specific autophagy types could be useful for developing novel treatments for OA.: Design: An autophagy-related gene array was performed in blood from non- ... ...

Abstract	Objective: Defects in autophagy contribute to joint aging and Osteoarthritis (OA). Identifying specific autophagy types could be useful for developing novel treatments for OA. Design: An autophagy-related gene array was performed in blood from non-OA and knee OA subjects from the Prospective Cohort of A Coruña (PROCOAC). The differential expression of candidate genes was confirmed in blood and knee cartilage and a regression analysis was performed adjusting for age and BMI. HSP90A, a chaperone mediated autophagy (CMA) marker was validated in human knee joint tissues, as well as, in mice with aging-related and surgically-induced OA. The consequences of HSP90AA1 deficiency were evaluated on OA pathogenesis. Finally, the contribution of CMA to homeostasis was studied by assessing the capacity to restore proteostasis upon ATG5-mediated macroautophagy deficiency and genetic HSP90AA1 overexpression. Results: 16 autophagy-related genes were significantly down-regulated in blood from knee OA subjects. Validation studies showed that HSP90AA1 was down-regulated in blood and human OA cartilage and correlated with risk incidence of OA. Moreover, HSP90A was reduced in human OA joints tissues and with aging and OA in mice. HSP90AA1 knockdown was linked to defective macroautophagy, inflammation, oxidative stress, senescence and apoptosis. However, macroautophagy deficiency increased CMA, highlighting the CMA-macroautophagy crosstalk. Remarkably, CMA activation was sufficient to protect chondrocytes from damage. Conclusions: We show that HSP90A is a key chaperone for chondrocyte homeostasis, while defective CMA contributes to joint damage. We propose that CMA deficiency is a relevant disease mechanism and could represent a therapeutic target for OA.
MeSH term(s)	Humans ; Mice ; Animals ; Osteoarthritis, Knee/pathology ; Chaperone-Mediated Autophagy ; Prospective Studies ; Cartilage, Articular/pathology ; Aging/genetics ; Knee Joint/pathology ; Autophagy/genetics ; Chondrocytes/metabolism
Language	English
Publishing date	2023-03-08
Publishing country	England
Document type	Journal Article
ZDB-ID	1167809-4
ISSN	1522-9653 ; 1063-4584
ISSN (online)	1522-9653
ISSN	1063-4584
DOI	10.1016/j.joca.2023.02.076
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Article ; Online: The impact of psychiatric pathology on the prognosis and survival of men with prostate cancer undergoing radical prostatectomy.

Cózar-Ortiz, J D / Cózar-Olmo, J M / Álvarez-Ossorio-Fernández, J L / Esteban-Fuertes, M / Chantada-Abal, V / Valverde-Martínez, L S / Márquez-Sánchez, M T / Padilla-Fernández, B Y / Lorenzo-Gómez, M F

Actas urologicas espanolas

2022 Volume 46, Issue 10, Page(s) 646–652

Abstract: Introduction and objective: Cancer-specific anxiety is the most frequently reported psychological response after radical prostatectomy (RP). We evaluated the prevalence of pretreatment psychiatric pathology in patients with prostate cancer undergoing RP ...

Abstract	Introduction and objective: Cancer-specific anxiety is the most frequently reported psychological response after radical prostatectomy (RP). We evaluated the prevalence of pretreatment psychiatric pathology in patients with prostate cancer undergoing RP and identified the effects of psychiatric diagnoses on their survival and prognosis. Material and methods: Retrospective multicenter observational study including 1078 men treated with RP for organ-confined prostate cancer. Groups: GP: patients with psychiatric pathology prior to RP; GNP: patients without psychiatric pathology prior to RP. Urological, oncological and psychiatric variables, descriptive statistics and multivariate analysis were included. Results: 37.94% of patients presented a psychiatric diagnosis. Adjuvant radiotherapy was required in 27.83% and hormone therapy in 23.38%; being more frequent in GP. Cancer-specific survival was higher in GNP. Anxiety, depression, insomnia, smoking, psychosis and alcoholism were the most frequent. Low TNM and low presence of LUTS and SUI increased the probability of absence of psychiatric pathology. Fatigue, erectile dysfunction and cognitive impairment after RP with RT and/or HT were higher in GP. Older age and higher PSA at diagnosis increased the relative risk of psychiatric pathology and worse outcome. The most frequently related factors were RP, PSA, age and survival time. Conclusions: Psychiatric pathology is present in patients undergoing radical prostatectomy for prostate cancer, with a high impact on survival and prognostic outcomes.
MeSH term(s)	Humans ; Male ; Prostatic Neoplasms/surgery
Language	Spanish
Publishing date	2022-10-20
Publishing country	Spain
Document type	Multicenter Study ; Observational Study ; Journal Article
ISSN	2173-5786
ISSN (online)	2173-5786
DOI	10.1016/j.acuroe.2022.10.003
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Article ; Online: The influence of smoking on bacterial resistance after vaccine or antibiotic prophylaxis against recurrent urinary tract infections.

Lorenzo-Gómez, M F / Santos-Antunes, M T / Nieto-Huertos, A / Lorenzo-Gómez, A / Marquez-Sanchez, M T / Flores-Fraile, M C / Valverde-Martinez, L S / González-Casado, I / García-Cenador, M B / Mirón-Canelo, J A / Padilla-Fernández, B

Actas urologicas espanolas

2020 Volume 44, Issue 7, Page(s) 497–504

Abstract: Introduction: The influence of tobacco on the microbiological spectrum, resistance-sensitivity pattern and evolution in patients with recurrent urinary tract infections (RUTI) is analyzed. Evaluation of the effect of polyvalent bacterial vaccine on the ... ...

Title translation	Influencia del tabaquismo en la resistencia bacteriana después de la profilaxis frente a infecciones urinarias recurrentes con antibiótico o con vacuna.
Abstract	Introduction: The influence of tobacco on the microbiological spectrum, resistance-sensitivity pattern and evolution in patients with recurrent urinary tract infections (RUTI) is analyzed. Evaluation of the effect of polyvalent bacterial vaccine on the prevention of RUTI and smoking status. Material and methods: Retrospective multicenter study of 855 women with RUTI receiving suppressive antibiotic treatment or bacterial vaccine between 2009 and 2013. Group A (GA): Antibiotic (n=495); Subgroups: GA1 non-smoker (n=417), GA2 smoker (n=78). Group B (GB): Vaccine (n=360); Subgroups: GB1 non-smoker (n=263), GB2 smoker (n=97). Variables: Age, pre-treatment UTI, disease-free time (DFT), microbial species, sensitivity and resistance. Follow-up at 3, 6 and 12 months with culture and SF-36 questionnaire. Results: Mean age 56.51 years (18-75), similar between groups (P=.2257). No difference in the number of pretreatment UTIs (P=.1329) or in the distribution of the bacterial spectrum (P=.7471). DFT was higher in subgroups B compared with A. Urine cultures in GA1: E. coli 62.71% with 8.10% resistance (33% quinolones; 33% cotrimoxazole; 33% quinolones + cotrimoxazole); in GA2 E. coli 61.53% with 75% resistance (16.66% quinolones; 33.33% quinolones + cotrimoxazole; 16.66% amoxicillin-clavulanate; 16.66% erythromycin + phosphomycin + clindamycin) (P=.0133). There were no differences between patients of GA treated with cotrimoxazole and nitrofurantoin (P=.8724). Urine cultures in GB1: E. coli 47.36% with 22.22% resistance (5.55% ciprofloxacin; 5.55% cotrimoxazole; 5.55% ciprofloxacin + cotrimoxazole; 5.55% amoxicillin/clavulanic acid). In GB2 E. coli 70.02% with 61.90% resistances (30.76% quinolones; 30.76% cotrimoxazole; 30.76% quinolones + cotrimoxazole; 17.69% amoxicillin-clavulanic acid) (P=.0144). Conclusions: The development of bacterial resistance is more frequent among women with smoking habits and recurrent urinary infections. This could influence a worse response to preventive treatments, either with antibiotics or vaccines.
MeSH term(s)	Adolescent ; Adult ; Aged ; Antibiotic Prophylaxis ; Bacterial Infections/drug therapy ; Bacterial Infections/prevention & control ; Bacterial Vaccines ; Drug Resistance, Bacterial ; Female ; Humans ; Middle Aged ; Recurrence ; Retrospective Studies ; Smoking/adverse effects ; Urinary Tract Infections/drug therapy ; Urinary Tract Infections/microbiology ; Young Adult
Chemical Substances	Bacterial Vaccines
Language	Spanish
Publishing date	2020-06-25
Publishing country	Spain
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ISSN	2173-5786
ISSN (online)	2173-5786
DOI	10.1016/j.acuro.2020.04.002
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Article ; Online: Validation of the Spanish Acute Cystitis Symptoms Score (ACSS) in native Spanish-speaking women of Europe and Latin America.

Medina-Polo, José / Arrébola-Pajares, Ana / Corrales-Riveros, Juan Guillermo / Alidjanov, Jakhongir F / Lorenzo-Gómez, María F / Tapia, Ana-María H / Martínez-Berganza, María Lourdes / Ospina-Galeano, Irma A / Padilla-Fernández, Bárbara / Pilatz, Adrian / Naber, Kurt G / Wagenlehner, Florian M

Neurourology and urodynamics

2022 Volume 42, Issue 1, Page(s) 263–281

Abstract: Introduction and objectives: The Acute Cystitis Symptom Score (ACSS) is a patient self-reporting questionnaire for clinical diagnostics and patient-reported outcome (PRO), which may assess the symptoms and the effect on the quality of life in women with ...

Abstract	Introduction and objectives: The Acute Cystitis Symptom Score (ACSS) is a patient self-reporting questionnaire for clinical diagnostics and patient-reported outcome (PRO), which may assess the symptoms and the effect on the quality of life in women with acute cystitis (AC). The current study aimed to create a validated Spanish version of the ACSS questionnaire. Material and methods: The process of linguistic validation of the Spanish version of the ACSS consisted of the independent forward and backward translations, revision and reconciliation, and cognitive assessment. Clinical evaluation of the study version of the ACSS was carried out in clinics in Spain and Latin America. Statistical tests included the calculation of Cronbach's α, split-half reliability, specificity, sensitivity, diagnostic odds ratio, positive and negative likelihood ratio, and area under the receiver-operating characteristic curve (AUC). Results: The study was performed on 132 patients [age (mean;SD) 45.0;17.8 years] with AC and 55 controls (44.5;12.2 years). Cronbach's α of the ACSS was 0.86, and the split-half reliability was 0.82. The summary scores of the ACSS domains were significantly higher in patients than in controls, 16.0 and 2.0 (p < 0.001), respectively. The predefined cut-off point of ≥6 for a summary score of the "Typical" domain resulted in a specificity of 83.6% and a sensitivity of 99.2% for the Spanish version of the ACSS. AUC was 0.91 [0.85; 0.97]. Conclusions: The validated Spanish ACSS questionnaire evaluates the symptoms and clinical outcomes of patients with AC. It can be used as a patient's self-diagnosis of AC, as a PRO measure tool, and help to rule out other pathologies in patients with voiding syndrome.
MeSH term(s)	Humans ; Female ; Adolescent ; Quality of Life ; Reproducibility of Results ; Latin America ; Cystitis/diagnosis ; Europe ; Surveys and Questionnaires ; Translations ; Acute Disease
Language	English
Publishing date	2022-11-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	604904-7
ISSN	1520-6777 ; 0733-2467
ISSN (online)	1520-6777
ISSN	0733-2467
DOI	10.1002/nau.25079
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Article ; Online: Sublingual MV140 for Prevention of Recurrent Urinary Tract Infections.

Lorenzo-Gómez, María-Fernanda / Foley, Stephen / Nickel, J Curtis / García-Cenador, María-Begoña / Padilla-Fernández, Barbara-Yolanda / González-Casado, Ignacio / Martínez-Huélamo, Misericordia / Yang, Bob / Blick, Christopher / Ferreira, Francini / Caballero, Raquel / Saz-Leal, Paula / Casanovas, Miguel

NEJM evidence

2022 Volume 1, Issue 4, Page(s) EVIDoa2100018

Abstract: Sublingual MV140 for Prevention of Recurrent UTIThis randomized placebo-controlled trial tested MV140, a sublingual preparation of whole-cell inactivated bacteria, in women with recurrent urinary tract infection (UTI). MV140 administered sublingually for ...

Abstract	Sublingual MV140 for Prevention of Recurrent UTIThis randomized placebo-controlled trial tested MV140, a sublingual preparation of whole-cell inactivated bacteria, in women with recurrent urinary tract infection (UTI). MV140 administered sublingually for either 3 or 6 months decreased UTI incidence and prevented recurrence for up to 1 year compared with placebo, without serious adverse events.
Language	English
Publishing date	2022-01-21
Publishing country	United States
Document type	Journal Article
ISSN	2766-5526
ISSN (online)	2766-5526
DOI	10.1056/EVIDoa2100018
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Article ; Online: Complications of transrectal prostate biopsy in our context. International multicenter study of 3350 patients.

Perán Teruel, M / Lorenzo-Gómez, M F / Veiga Canuto, N / Padilla-Fernández, B Y / Valverde-Martínez, L S / Migliorini, F / Jorge Pereira, B / Pires Coelho, H M / Osca García, J M

Actas urologicas espanolas

2020 Volume 44, Issue 3, Page(s) 196–204

Abstract: Introduction: Prostate cancer is the most common visceral neoplasm in men and the second one in the United States with the highest mortality behind lung cancer and ahead of colorectal cancer. While prostate cancer mortality rates have been reduced in ... ...

Title translation	Complicaciones de la biopsia transrectal de próstata en nuestro medio. Estudio multicéntrico internacional de 3.350 pacientes.
Abstract	Introduction: Prostate cancer is the most common visceral neoplasm in men and the second one in the United States with the highest mortality behind lung cancer and ahead of colorectal cancer. While prostate cancer mortality rates have been reduced in the United States, Austria, United Kingdom and France, 5-year survival rates have been incremented in Sweden, probably due to a higher diagnostic activity and non-lethal tumor detection. TRPB usually has low rates of serious complications, with a not negligible number of minor complications. Mortality directly associated with this procedure is low and usually related to septic shock. The main complications derived from prostate biopsy can be infectious (mild or severe) and non-infectious (hematuria consistent with hemorrhage, urethral bleeding, rectal bleeding or hemospermia, acute urinary retention, pain or vasovagal reactions). Material and method: The objective of the study is to compare three usual TRPB protocols and their relationship with the incidence of complications. Retrospective multicenter observational study conducted in three countries (Spain, Italy and Portugal). We have reviewed the medical records of 3350 men who underwent TRPB to evaluate the existence of prostate cancer, with a minimum evolutionary control of 6months. Results: The mean age was 65,50years, median 66, range 43-79. The subgroup analysis showed that younger patients had higher rates of acute urine retention (AUR) (P=.0000001). Likewise, our results revealed that younger patients presented more procedural pain (P=.0000001) than older patients. Regarding PSA, the mean value was 10.44, SD 7.73, median 8.15, range 0.98-68.09. A higher body mass index (BMI) was not associated with further infection (P=.000004). When performing the multivariate analysis, it was found that the significant variables in the general group were: age (P=.0013), PSA (P=.0402), local infiltration anesthesia (P=.0001) and prophylaxis with metronidazole +tobramycin +amoxicillin/clavulanic acid +gentamicin (P=.0001), presenting a normal distribution with high confidence interval (95%) and significant correlation. Prophylaxis is the most significant variable for no complications and pain (P=.0001), age (P=.0013) and prophylaxis (P=.0001) are for bleeding, age (P=.0013), prophylaxis and PSA (P=.0001) are for infection, and finally, age (P=.0013), anesthesia with local infiltration and prophylaxis (P=.0001) and PSA (P=.0402) are for AUR. Conclusions: Sedation has fewer side effects and complications related to the transrectal prostate biopsy procedure with respect to transrectal local anesthesia. The choice of the antibiotic prophylaxis scheme is decisive in the onset of complications arising from the performance of a transrectal prostate biopsy.
MeSH term(s)	Adult ; Aged ; Biopsy/adverse effects ; Biopsy/methods ; Clinical Protocols ; Humans ; Italy ; Male ; Middle Aged ; Portugal ; Postoperative Complications/etiology ; Prostate/pathology ; Prostatic Neoplasms/pathology ; Rectum ; Retrospective Studies ; Spain
Language	Spanish
Publishing date	2020-02-29
Publishing country	Spain
Document type	Comparative Study ; Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ISSN	2173-5786
ISSN (online)	2173-5786
DOI	10.1016/j.acuro.2019.11.004
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Article ; Online: Late diagnosis of ureteral injury from anterior lumbar spine interbody fusion surgery: Case report and literature review.

Migliorini, Filippo / de Maria, Nicola / Tafuri, Alessandro / Porcaro, Antonio Benito / Rubilotta, Emanuele / Balzarro, Matteo / Lorenzo-Gomez, Maria-Fernanda / Antonelli, Alessandro

Urologia

2021 Volume 90, Issue 3, Page(s) 579–583

Abstract: Background: Anterior Lumbosacral Interbody Fusion (ALIF) is a type of back surgery with the advantages of direct access to the spinal interbody space and the potential lessening morbidity related to posterior approaches.: Purpose: To describe a rare ... ...

Abstract	Background: Anterior Lumbosacral Interbody Fusion (ALIF) is a type of back surgery with the advantages of direct access to the spinal interbody space and the potential lessening morbidity related to posterior approaches. Purpose: To describe a rare case of left ureteral lesion from ALIF surgery diagnosed 4 months after the procedure. Case description: A 37-year-old Caucasian man with a long history of painful post-traumatic spondylolisthesis and degenerative L5-S1 disc disease underwent a retroperitoneal anterior L5-S1 discectomy, insertion of an interbody tantallium cage, and placement of a pyramid titanium plate fixed with screws. Four months later, due to recurrent left lumbar pain and mild renal failure, a CT scan was performed showing left hydronephrosis with a homolateral urinoma of 17 cm in diameter. A left nephrostomy was placed and the nephrostography detected a filiform leakage at L5-S1 level in communication with the urinoma. The patient underwent laparoscopic urinoma drainage, distal left ureterectomy, and Casati-Boari flap ureterocystoneostomy with ureteral double J stent placement. The stent was held for six weeks and, 1 month later, the control ultrasound scan was negative for hydronephrosis, the creatinine level had normalized and the patient was asymptomatic. Conclusion: Ureteral lesion from ALIF surgery is a very rare event. Spinal surgeons should be more awareness regarding the susceptibility of ureteral injuries along with the clinical presentation, diagnostic work-up, and management options for this kind of complication.
MeSH term(s)	Male ; Humans ; Adult ; Delayed Diagnosis ; Urinoma/diagnosis ; Urinoma/etiology ; Spinal Fusion/adverse effects ; Spinal Fusion/methods ; Lumbar Vertebrae/surgery ; Hydronephrosis/etiology ; Treatment Outcome
Language	English
Publishing date	2021-07-12
Publishing country	United States
Document type	Case Reports ; Review ; Journal Article
ZDB-ID	204043-8
ISSN	1724-6075 ; 0376-0057 ; 0391-5603
ISSN (online)	1724-6075
ISSN	0376-0057 ; 0391-5603
DOI	10.1177/03915603211030230
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Article ; Online: Spanish jurisprudence on complaints related to pelvic floor surgery.

Sánchez-Sánchez, F J / Pérez-Esteban, M B / Padilla-Fernández, B / Lorenzo-Gómez, M F

Actas urologicas espanolas

2015 Volume 39, Issue 8, Page(s) 463–464

MeSH term(s)	Humans ; Malpractice/legislation & jurisprudence ; Pelvic Floor Disorders/surgery ; Spain
Language	Spanish
Publishing date	2015-10
Publishing country	Spain
Document type	Editorial
ZDB-ID	604530-3
ISSN	1699-7980 ; 0210-4806
ISSN (online)	1699-7980
ISSN	0210-4806
DOI	10.1016/j.acuro.2015.02.007
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Article ; Online: Quality of information about urologic pathology in English and Spanish from ChatGPT, BARD, and Copilot.

Szczesniewski, J J / Ramos Alba, A / Rodríguez Castro, P M / Lorenzo Gómez, M F / Sainz González, J / Llanes González, L

Actas urologicas espanolas

2024

Abstract: Introduction and objective: Generative artificial intelligence makes it possible to ask about medical pathologies in dialog boxes. Our objective was to analyze the quality of information about the most common urological pathologies provided by ChatGPT ( ... ...

Abstract	Introduction and objective: Generative artificial intelligence makes it possible to ask about medical pathologies in dialog boxes. Our objective was to analyze the quality of information about the most common urological pathologies provided by ChatGPT (OpenIA), BARD (Google), and Copilot (Microsoft). Methods: We analyzed information on the following pathologies and their treatments as provided by AI: prostate cancer, kidney cancer, bladder cancer, urinary lithiasis, and benign prostatic hypertrophy (BPH). Questions in English and Spanish were posed in dialog boxes; the answers were collected and analyzed with DISCERN questionnaires and the overall appropriateness of the response. Surgical procedures were performed with an informed consent questionnaire. Results: The responses from the three chatbots explained the pathology, detailed risk factors, and described treatments. The difference is that BARD and Copilot provide external information citations, which ChatGPT does not. The highest DISCERN scores, in absolute numbers, were obtained in Copilot; however, on the appropriacy scale it was noted that their responses were not the most appropriate. The best surgical treatment scores were obtained by BARD, followed by ChatGPT, and finally Copilot. Conclusions: The answers obtained from generative AI on urological diseases depended on the formulation of the question. The information provided had significant biases, depending on pathology, language, and above all, the dialog box consulted.
Language	Spanish
Publishing date	2024-02-17
Publishing country	Spain
Document type	Journal Article
ISSN	2173-5786
ISSN (online)	2173-5786
DOI	10.1016/j.acuroe.2024.02.009
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