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Introduction: This study assessed the presence of osteoporosis/osteopenia in patients with severe lithogenic activity and compared their metabolisms with those in patients without lithiasis or with mild lithogenic activity. Methods: From a sample of 182 patients, those with osteopenia/osteoporosis at the hip and lumbar spine were studied separately in a two-pronged study. 66 patients with bone mineral densities (BMDs) < -1 standard deviation (SD) on a T-score scale at the hip were divided into three groups: group A1 without lithiasis (n = 15); group A2 with lithiasis and mild lithogenic activity (n = 22); and group A3 with lithiasis and severe lithogenic activity (n = 29). Similarly, 86 patients with BMDs < -1 SD on a T-score scale at the lumbar spine were divided into three groups: group B1 without lithiasis (n = 15); group B2 with lithiasis and mild lithogenic activity (n = 29); and group B3 with lithiasis and severe lithogenic activity (n = 42). Results: Patients from group A3 exhibited significantly higher levels of bone remodelling markers as compared to groups A1 and A2. Urinalysis also revealed higher excretion of calcium in 24-hour assessments in this group. Patients from group B3 differed from groups B1 and B2 mainly in bone remodelling markers and 24-hour urinary calcium excretion, which were significantly elevated in patients from group B3. Conclusion: Patients with calcium lithiasis and severe lithogenic activity in addition to osteopenia/osteoporosis present with higher levels of hypercalciuria and negative osseous balance, which possibly perpetuate and favour lithiasic activity. [ABSTRACT FROM AUTHOR]

Purpose: Our study aims to determine whether there are differences in the degree of detection of prostate cancer (PCa) and CsPCa between fusion prostate biopsy (FPB), cognitive biopsy (PCB), and randomized, systematic biopsy (SB)., Methods: A retrospective analysis was carried out of 195 patients with suspected PCa at the San Cecilio University Clinical Hospital in Granada who underwent a prostate biopsy between January and December 2021. Patients were divided into three groups: group 1, patients undergoing FPB transperineally with ultrasound BK 3000 (N = 87); group 2, PCB (N = 59) transperineally; and group 3, transrectal SB (N = 49), the latter two, with an ultrasound BK Specto., Results: We found differences in favor of image-directed biopsies (FPB and PCB) with a percentage of positive biopsies of 52.8% and 50%, respectively, compared to 41.4% with SB, but without these differences being significant. Given the controversy in performing prostate biopsies in PI-RADS 3 lesions reported in the literature, a subanalysis was performed excluding the FPB performed for PI-RADS 3 lesions (PI-RADS 4 and 5 are included), finding significant differences when comparing FPB with PCB and SB (group 1, 64% vs group 2, 45.8%; p = 0.05) (group 1, 64% vs group 3, 42.9%; p = 0.035)., Conclusion: With the results obtained in our series, we conclude that the finding of a PI-RADS 3 lesion in mpMRI should not be an absolute criterion to indicate prostate biopsy. On the other hand, for PI-RADS 4 and 5 lesions, FPB is recommended, which in this case turns out to be superior to PCB and SB., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: To determine whether androgen blockade produces metabolic changes in urine and increases the risk of calculi after 1 year of treatment., Materials and Methods: The study included 38 patients, from the period April 2015 to June 2016, diagnosed with locally advanced prostate cancer or lymph node metastasis, and with an indication of androgen blockade. Androgen blockade was started with luteinising hormone-releasing hormone (LHRH) analogues, and a blood specimen, a fasting urine and 24-h urine were collected at the time of inclusion, and then at 1 year of follow-up. A study was performed at baseline and at 1 year with imaging tests. An analysis of the variables was performed with a p ≤ 0.05 considered as statistically significant., Results: The mean age of the patients included in the study was 72.26 ± 6.75 years. As regards the biochemistry parameters, an increase in osteocalcin (from 16.28 ± 9.48 to 25.56 ± 12.09 ng/ml; p = 0.001) and an increase in β-crosslaps (from 0.419 ± 0.177 to 0.743 ± 0.268 ng/ml; p = 0.0001) were observed. In the urinary parameters, a significant increase was observed in the fasting calcium/creatinine ratio (from 0.08 ± 0.06 to 0.13 ± 0.06; p = 0.002) and in the 24-h calcium renal excretion (from 117.69 ± 66.92 to 169.42 ± 107.18 mg; p = 0.0001). Calculi formation was observed in 12 of the 38 patients included (31.6%), with a mean size of 3.33 ± 1.31 mm., Conclusion: Treatment with LHRH analogues, as well as increasing the appearance of metabolic syndrome and speeding up the loss bone mineral density, causes an increase in fasting urine calcium.

A 17-year-old adolescent boy was referred to the urology department of our institution for hematospermia after initiation of sexual relationship. A magnetic resonance imaging scan showed giant dilation of a multicystic left seminal vesicle with left renal agenesis. These findings are typical of the Zinner syndrome. In 70%-80% of the cases when renal agenesis is found, there is an ipsilateral cystic dilation of the seminal vesicle that in some cases may be associated with testicular ectopia or absence of the bladder trigone. The ejaculatory ducts, which are formed from the mesonephric system, are abnormally developed in these cases., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose: To compare the use of lubricant gel with lidocaine versus lubricant gel without anesthetic in flexible cystoscopy in terms of pain and tolerability., Materials and Methods: In this observational non-randomized study, 72 patients were divided into two groups. Group 1 included 38 patients in whom lidocaine gel 2% was used and group 2 included 34 patients in whom lubricant gel without anesthetic was administered. The main variables analyzed were score in visual analogue scale (VAS) and score in Spanish Pain Questionnaire (SPQ). Student's t-test and Chi-square test were used to compare differences between 2 groups. The P values < .05% were considered statistically significant., Results: Mean age of patients in group 1 was 64.50 ± 12.39 years and 67.79 ± 10.87 years in group 2 (P = .23). The distribution according to sex was 29 men and 9 women in group 1 and 25 men and 9 women in group 2 (P = .78). The total VAS score was 2.21 ± 2.05 in group 1 versus 1.59 ± 1.61 in group 2 (P = .16). In the SPQ, the current intensity value was 1.82 ± 0.86 in group 1 versus 1.53 ± 0.74 in group 2 (P = .14), and the total intensity value was 1.92 ± 1.86 in group 1 versus 1.03 ± 1.75 in group 2 (P = .04). The cost of gel with lidocaine is 1.25 euro and gel without anesthetic 0.22 euro., Conclusion: The use of lidocaine gel does not produce benefit in terms of pain relief in flexible cystoscopy and also is costly.

Metabolic evaluation is important in high-risk patients with a history of urinary calculi, in order to prevent recurrence. This study aimed to compare patients with calcium calculi and mild lithogenic activity with those with moderate to severe lithogenic activity. Patients with moderate to severe activity had higher levels of urinary calcium level (271.9 mg/24h versus 172.1 mg/24 h, P < .001), uric acid (612.3 mg/24 h versus 528.9 mg/24h, P = .008), and fasting calcium-creatinine ratio (0.16 versus 0.12, P = .001) compared to those with mild lithogenic activity. No association was observed between lithogenic factors in 24-hour urine and mild lithogenic activity in multivariable analysis. We initially thought that in patients who develop recurrent calculi after 5 years or who have mild lithogenic activity, complete metabolic evaluation would not be necessary. However, based on our study findings, it may be important to conduct further studies assessing the lithogenic activity.