High-power holmium laser versus thulium fiber laser for endoscopic enucleation of the prostate in patients with glands larger than 80 ml: Results from the Prostate Endoscopic EnucLeation study group.

Background: Endoscopic enucleation of the prostate (EEP) has gained acceptance as an equitable alternative to transurethral resection of the prostate for benign prostate hyperplasia (BPH). Our primary aim is to compare peri-operative outcomes of EEP using thulium fiber laser (TFL) against high-power holmium laser (HPHL) in hands of experienced surgeons for large prostates (≥80 ml in volume). Secondary outcomes were assess complications within 1 year of follow up.

Incidence of complications and urinary incontinence following endoscopic enucleation of the prostate in men with a prostate volume of 80 ml and above: results from a multicenter, real-world experience of 2512 patients.

Purpose: To evaluate complications and urinary incontinence (UI) after endoscopic enucleation of the prostate (EEP) stratified by prostate volume (PV).

Methods: We retrospectively reviewed patients with benign prostatic hyperplasia who underwent EEP with different energy sources in 14 centers (January 2019-January 2023).

Inclusion Criteria: prostate volume ≥ 80 ml.

Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non- en-bloc techniques: a multicenter, real-world experience of 5068 patients.

We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate (EEP) comparing en-bloc (Group 1) versus 2-lobe/3-lobe techniques (Group 2). We performed a retrospective review of patients undergoing EEP for benign prostatic enlargement in 12 centers between January 2020 and January 2022. Data were presented as median and interquartile range (IQR).

Results from a global multicenter registry of 6193 patients to refine endoscopic anatomical enucleation of the prostate (REAP) by evaluating trends and outcomes and nuances of prostate enucleation in a real-world setting.

Purpose: To collect a multicentric, global database to assess current preferences and outcomes for endoscopic enucleation of the prostate (EEP).

Methods: Endourologists experienced in EEP from across the globe were invited to participate in the creation of this retrospective registry. Surgical procedures were performed between January 2020 and August 2022.

Holmium laser with MOSES technology (MoLEP) vs Thulium fiber laser enucleation of the prostate (ThuFLEP) in a real-world setting. Mid-term outcomes from a multicenter propensity score analysis.

Purpose: To compare Holmium laser with MOSES technology (MoLEP) and Thulium fiber laser enucleation of the prostate (ThuFLEP) in terms of surgical and functional outcomes.

Methods: We performed a retrospective analysis of all patients who underwent either procedure in five centers (January 2020-January 2022).

Exclusion Criteria: previous urethral/prostatic surgery, radiotherapy, concomitant surgery.

Which men with non-malignant pathology at magnetic resonance imaging-targeted prostate biopsy and persistent PI-RADS 3-5 lesions should repeat biopsy?

Purpose: To assess predictors of clinically significant (cs) prostate cancer (PCa) in men who had a non-malignant Multiparametric magnetic resonance imaging (mpMRI)-targeted biopsy and persistent Prostate Imaging-Reporting Data System (PI-RADS) 3 to 5 lesions in subsequent mpMRI.

Materials And Methods: We retrospectively analyzed MRI-targeted biopsy database in three centers.

Inclusion Criteria: persistence of at least one PI-RADS ≥3 lesion found negative for cancer in a previous MRI-targeted plus systemic biopsy (baseline biopsy).

Urethral and bladder neck stenosis after thulium laser enucleation of the prostate: Analysis of risk factors in a series of 1003 patients.

We assessed the incidence and risks factors of bladder neck and urethral stenosis after Thulium laser enucleation of the prostate. Patients who underwent surgery at two centres were retrospectively reviewed (December 2014-June 2020). Exclusion criteria: previous urethral/prostatic surgery, pelvic irradiation, prostate cancer, neurogenic bladder, history of bladder neck and urethral stenosis, concomitant transurethral surgery, active urinary tract infection.

Change in Postoperative Storage Symptoms and Urge Incontinence After Thulium:YAG Laser Enucleation of the Prostate: Results from a Prospective Multicenter Study.

To assess the change of storage symptoms (SS) and their impact on quality of life in men undergoing thulium:YAG laser enucleation of the prostate (ThuLEP) for benign prostatic hyperplasia (BPH). BPH patients requiring surgery were prospectively evaluated (April 2019-October 2020). Inclusion criteria: International Prostate Symptom Score (IPSS) ≥8, maximum urinary flow rate ≤15 mL/s, and urinary retention.

A Preliminary Validation of a New Surgical Procedure for the Treatment of Primary Bladder Neck Obstruction Using a Computational Modeling Approach.

A new surgical procedure for the treatment of primary bladder neck obstruction with maintenance of anterograde ejaculation is proposed. In place of monolateral or bilateral bladder neck incision, associated with a loss of ejaculation rate of up to 30%, the new surgical procedure consists of laser drilling the bladder neck with a number of holes and without muscle fiber disruption. The effect of this novel procedure has been studied numerically, with a simplified two-dimensional numerical model of the internal urethral sphincter, varying the position and the number of holes in the fibrotic region of the urethral tissue.

An Italian multicenter analysis of emergency admissions and treatment of upper tract urolithiasis during the lockdown and reopening phases of the COVID-19 pandemic: Are we ready for a second wave of the outbreak?

Objectives: To assess if the lockdown period (March-April 2020) during the coronavirus disease-19 outbreak in Italy influenced the number, presentation, and treatment of urgent admissions to the emergency department for ureteral lithiasis, and to evaluate the same variables during the reopening phase (May-June 2020).

Methods: We performed a retrospective analysis of patients admitted to the emergency department of three different hospitals (two coronavirus disease-19 hubs). Demographics and data on acute pyelonephritis, acute kidney injury, urinoma, hematuria, inpatient admission/discharge home, and type of treatment were gathered and compared with the same periods in 2019.

Oncological and functional outcome after partial prostate HIFU ablation with Focal-One: a prospective single-center study.

Background: We aimed to evaluate oncological and functional outcomes of index lesion HIFU ablation with Focal-One.

Materials And Methods: We prospectively assessed treatment-naïve men with localized prostate cancer between 2017 and 2019. Inclusion criteria were stage cT ≤ 2, ≥5 years of life expectancy, grade group ≤3.

Comparison between thulium laser vapoenucleation and plasmakinetic resection of the prostate in men aged 75 years and older in a real-life setting: a propensity score analysis.

Background: Urologists may hesitate to offer transurethral resection of the prostate (TURP) because of increased morbidity in elderly patients.

Aims: We aimed to compare data on postoperative outcomes of elderly men undergoing bipolar transurethral resection of the prostate (B-TURP) as compared to thulium laser vapoenucleation of the prostate (ThuVEP).

Methods: We retrospectively reviewed data of all patients aged ≥ 75 years who underwent benign prostatic hyperplasia surgery.

Fluid overload syndrome: A potentially life-threatening complication of Thulium Laser Enucleation of the Prostate.

Systemic fluid absorption frequently occurs during endoscopic surgery. When large volumes are absorbed, fluid overload is the result. The introduction of lasers allowed the use of normal saline (0.

Thulium Laser Vapoenucleation of the Prostate (ThuVEP) in Men at High Cardiovascular Risk and on Antithrombotic Therapy: A Single-Center Experience.

Bleeding is the most common complication of transurethral resection of the prostate and simple open prostatectomy, especially in men on antiplatelet/anticoagulant therapy. The present study aimed to evaluate the safety and effectiveness of thulium laser vapoenucleation of the prostate (ThuVEP) for benign prostatic hyperplasia in patients on chronic antithrombotic medications. Between January 2015 and December 2019, 88 men underwent the procedure under antithrombotic agents in our center.

What urologists need to know about ketamine-induced uropathy: A systematic review.

Aims: Ketamine is a general anesthetic. Dissociative effects and low cost led ketamine becoming an illegal recreational drug in young adults. Ketamine-induced uropathy (KIU) is one of the complications observed in abusers.

Combination of Multiparametric Magnetic Resonance Imaging With Elastic-fusion Biopsy Has a High Sensitivity in Detecting Clinically Significant Prostate Cancer in Daily Practice.

Background: The index lesion (IL) is the largest cancer focus, usually harbors the highest grade, and might drive the history of prostate cancer (PCA). Multiparametric magnetic resonance imaging (mp-MRI) has a high negative predictive value in ruling out clinically significant (cs)PCA. We aimed evaluating the efficiency of mp-MRI and targeted biopsy in detecting csPCA and the concordance between the MRI index lesion (MRI-IL) and the presence of csPCA inside it.

A Bladder Stone 28 Years After Burch Colposuspension.

An 86-year-old lady was referred for a 3-cm bladder stone 28 years after Burch colposuspension. Cystoscopy showed a stone over a nonabsorbable suture, eroding from the right anterolateral bladder wall. The patient underwent a transurethral holmium laser lithotripsy and thulium laser removal of the eroded bladder wall.

State of the Art of Thulium Laser Enucleation and Vapoenucleation of the Prostate: A Systematic Review.

Tm:YAG laser operates at a wavelength of 1940-2013 nm in a continuous wave mode, which enables smooth incision and rapid vaporization of prostatic tissue, with a shallow penetration of only 0.2 mm. These characteristics make Tm:YAG a versatile laser, allowing the surgeon to perform resection, vaporization, and vapoenucleation.

Thoracic continuous spinal anesthesia for high-risk comorbid older patients undergoing major abdominal surgery: one-year experience of an Italian geriatric hospital.

Background: General anesthesia is associated with high morbidity/mortality in comorbid older adults. Thoracic continuous spinal anesthesia/analgesia (TCSA) may be an alternative for major abdominal surgery. We report a one-year experience of the use of TCSA in an Italian geriatric center.

Multicenter Analysis of Postoperative Complications in Octogenarians After Radical Cystectomy and Ureterocutaneostomy: The Role of the Frailty Index.

Background: The purpose of this study was to assess patient frailty as a risk factor for radical cystectomy (RC) complications.

Materials And Methods: We performed an analysis of prospectively collected data of consecutive patients 80 years of age or older who underwent RC and ureterocutaneostomy in 6 primary care European urology centers. Frailty was measured using a simplified frailty index (sFI) with a 5-item score including: (1) diabetes mellitus; (2) functional status; (3) chronic obstructive pulmonary disease; (4) congestive cardiac failure; and (5) hypertension, with a maximum 5-item score meaning high level of frailty.

A structured framework for optimizing high-intensity focused ultrasound ablative treatment in localized prostate cancer.

High-intensity focused ultrasound (HIFU) treatment has recently been pursued to reduce radical treatment-related morbidity in low-to-intermediate-risk localized prostate cancer (PCa), especially in older men. The aim of this study was to develop a dedicated framework for HIFU therapy. All clinical data, such as risk categories, magnetic resonance with functional parametric imaging, and histopathology, are essential for driving proper HIFU treatment.

Medical management of urolithiasis in the Middle Ages: of Pope John XXI.

Background/objective: This paper will present a brief description of medicine in the Middle Ages, and more comprehensive analysis of the medical management of urolithiasis in , the main text of Pedro Hispano.

Method: An in-depth reading of the Italian translation of , and a review of the literature of the life of Pedro Rebuli Guiliani, known as Pedro Hispano, was performed.

Result: Pedro Hispano was born in Portugal around 1205.

Are Outcomes of Thulium Laser Enucleation of the Prostate Different in Men Aged 75 and Over? A Propensity Score Analysis.

Objective: To evaluate the outcomes of thulium laser enucleation of the prostate (ThuLEP) in men aged ≥75 years compared to youngers. Traditional surgery has increased and significant morbidity in older men. Lasers have been introduced as an alternative approach to overcome the morbidity of traditional surgery.