Querying the capability of the post-HoLEP endoscopic aspect of the membranous urethral mucosa in predicting urinary incontinence: a prospective AI-based analysis.

Introduction: Transient stress urinary incontinence (SUI) after holmium laser enucleation of prostate (HoLEP) is commonly linked to intraoperative injury of the external urethral sphincter (EUS). We assessed the reliability of the post-HoLEP endoscopic appearance of the membranous urethra mucosa (MUM) in predicting post-HoLEP continence.

Methods: Forty HoLEPs were prospectively recorded by an artificial intelligence video platform capable of segmenting clips by surgical steps.

A novel tool to predict lymph node metastasis in patients with prostate cancer based on clinical and Ga-PSMA PET/CT parameters.

Introduction: We sought to develop a model that predicts lymph node invasion (LNI) in patients with intermediate- and high-risk prostate cancer incorporating preoperative clinical and Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) parameters.

Methods: A cohort of 413 consecutive patients diagnosed with prostate cancer who underwent Ga- PSMA PET/CT prior to radical prostatectomy from 2015-2020 was used to develop and validate the model. The cohort was split into a learning (70%) and a validation group (30%).

Do 5-Alpha Reductase Inhibitors Influence the Features of Suspicious Lesions on Magnetic Resonance Imaging and Targeted Biopsy Results for Prostate Cancer Diagnosis?

Background: 5-alpha reductase inhibitors (5-ARIs) change hormonal pathways and reduce prostate size. We evaluated the effects of 5-ARIs on prostatic multiparametric magnetic resonance imaging (mpMRI) suspicious findings and in the identification of prostate cancer using targeted biopsies.

Methods: We conducted a retrospective study including 600 consecutive patients who, between 2017 and 2021, underwent combined transperineal fusion biopsies.

Parental regret following decision for sons to undergo elective post-neonatal circumcision.

Introduction: The reasons for performing a circumcision among males after the neonatal period are usually cultural or medical. We aimed to evaluate parental regret for providing consent and to identify factors associated with such regret.

Methods: Included were the parents of males aged 6 months to 18 years who underwent circumcision under general anesthesia at a single center between 2/2017 and 01/2023.

Comparative Analysis of Safety and Efficacy Between Anterior and Posterior Calyceal Entry in Supine Percutaneous Nephrolithotomy.

One advantage of supine percutaneous nephrolithotomy (sPCNL) is the ability to access anterior as well as posterior calyces, but the safety and efficacy of anterior calyceal entry has never been investigated to our knowledge. We prospectively evaluated patients scheduled for sPCNL comparing anterior and posterior calyceal access. After Institutional Review Board approval, we prospectively enrolled 100 consecutive patients undergoing sPCNL from February to September 2023.

Transformations in Benign Prostatic Hyperplasia Surgical Practices: A Longitudinal Study of Trends and Predictions.

Introduction: The workload for benign prostatic hyperplasia (BPH) surgery is expected to rise with an increase in life expectancy and a growing population. Surgical modalities for BPH have evolved, shifting toward minimally invasive transurethral procedures. This study aimed to investigate the trends in BPH surgical procedures across medical centers in Israel.

Evaluating the Survival Benefits of Perioperative Chemotherapy in Frail and Morbid Muscle-Invasive Bladder Cancer Patients.

Introduction: Current guidelines endorse the use of perioperative chemotherapy (POC) in muscle-invasive bladder cancer (MIBC) to enhance the long-term overall survival (OS) compared to radical cystectomy (RC) alone. This study aims to assess the impact of POC on the OS in frail and morbid (F-M) patients undergoing RC.

Methods: A retrospective multicenter study of 291 patients who underwent RC between 2015 and 2019 was performed.

Identifying patients at risk for depression after radical cystectomy.

Introduction: We aimed to assess rates of depression in patients with bladder cancer undergoing radical cystectomy and identify its predictors.

Methods: Depressive symptoms in 42 consecutive patients were evaluated using the Beck's Depression Inventory (BDI) on the day prior to surgery, postoperative day (POD) 6, six weeks after surgery, and 12-18 months postoperatively.

Results: Fifteen patients (36%) presented with BDI scores ≥10 before the operation; this rate increased to 64% on POD 6 and 69% at six weeks post-surgery.

Bowel Perforation During Percutaneous Nephrolithotomy: Diagnosis, Management, and Follow-up.

Unlabelled: Percutaneous nephrolithotomy (PCNL) is the procedure of choice for large kidney stones, but serious complications such as bowel perforation may occur. We discuss the diagnosis and management of colonic and small-bowel perforations due to PCNL and suggest principles for care and prevention. We emphasize the significance of imaging tools to direct percutaneous access, the importance of early diagnosis, and the relatively high success rate for conservative management.

Optimizing Colon Identification by Window Setting Modulation on Noncontrast Computed Tomography Prior to Percutaneous Nephrolithotomy.

Preoperative identification of the bowel on imaging is essential in planning renal access during percutaneous nephrolithotomy (PCNL) and avoiding colonic injury. We aimed this study to assess which noncontrast computed tomography (NCCT) window setting provides the optimal colonic identification for PCNL preoperative planning. Ten urologic surgeons (four seniors, six residents) reviewed 22 images of NCCT scans in both abdomen and lung window settings in a randomized blinded order.

Natural history and health care burden of non-curative treatment for muscle-invasive bladder cancer.

Objective: Muscle-invasive bladder cancer is an aggressive disease. Yet, many patients, especially those with advanced age and multiple comorbidities, do not receive treatment with curative intent. We evaluated the disease course and health care burden of these patients.

Identifying patients at risk for depression after radical cystectomy.

Introduction: We aimed to assess rates of depression in patients with bladder cancer undergoing radical cystectomy and identify its predictors.

Methods: Depressive symptoms in 42 consecutive patients were evaluated using the Beck's Depression Inventory (BDI) on the day prior to surgery, postoperative day (POD) 6, six weeks after surgery, and 12-18 months postoperatively.

Results: Fifteen patients (36%) presented with BDI scores ≥10 before the operation; this rate increased to 64% on POD 6 and 69% at six weeks post-surgery.

A combined MRI-PSAD risk stratification system for prioritizing prostate biopsies.

Introduction:   Prostate cancer screening with PSA is associated with low specificity; furthermore, little is known about the optimal timing of biopsy.  We aimed to evaluate whether a risk classification system combining PSA density (PSAD) and mpMRI can predict clinically significant cancer and determine biopsy timing.

Materials And Methods:  We reviewed the medical records of 256 men with a PI-RADS ≥ 3 lesion on mpMRI who underwent transperineal targeted and systematic biopsies of the prostate between 2017-2019.

Assessing the Impact of Percutaneous Nephrostomy Presence on Neoadjuvant Treatment Quality in Patients With Muscle Invasive Bladder Cancer.

Introduction: Symptomatic hydronephrosis associated with muscle invasive bladder cancer (MIBC) necessitates percutaneous nephrostomy (PCN) insertion before neoadjuvant chemotherapy (NAC). This study assesses the impact of PCN presence on standard intended NAC quality, its related complications and outcome after radical cystectomy (RC).

Materials And Methods: The study comprises a retrospective, multicenter cohort of 193 consecutive RCs performed between 2016 and 2019.

Megameatus intact prepuce variant reconstruction: Long-term outcomes and comparison to post-circumcision hypospadias repair.

Background: Megameatus intact prepuce (MIP) variant is considered a surgical challenge with associated high complication rates. It is usually diagnosed and corrected only after neonatal circumcision, which is discouraged in non-MIP hypospadias.

Objective: In order to determine whether the features of the MIP variant or the performance of a secondary reconstruction following circumcision comprise the cause of higher complication rates, we now compared the results of post-circumcision MIP hypospadias repair to the results of children who underwent repair of non-MIP hypospadias following neonatal circumcision.

11-item modified frailty index and outcomes after radical cystectomy.

Introduction: To investigate the association between modified frailty index (mFI) scores and radical cystectomy outcomes.

Materials And Methods: We conducted a multicenter retrospective analysis of 292 patients who underwent radical cystectomy between 2015 and 2019. The patients were stratified according to mFI scores (mFI 0-1 vs.

En bloc holmium laser enucleation of prostate in octogenarians and nonagenarians: clinical characteristics and outcome.

Extended longevity leads to greater numbers of elderly patients with benign prostatic hyperplasia (BPH) who seek surgical solutions. We assessed the clinical characteristics and outcomes of octogenarians and nonagenarians with BPH who underwent en bloc holmium laser enucleation of prostate (HoLEP). Retrospective cohort of all consecutive HoLEP patients treated in our medical center between January 2020 and January 2023.

Mini-HoLEP (MILEP) vs HoLEP: a propensity score-matched analysis.

Background And Purpose: Minimal invasiveness improves outcome in many surgical fields including urology. We aimed to assess intraoperative performance and clinical outcome of miniaturized holmium laser enucleation of prostate (MiLEP) (22FR).

Methods: We ran a propensity score-matched analysis among all consecutive laser enucleations of prostate performed between 9/2022 and 2/2023.

The role of malnutrition universal screening tool in predicting outcomes after radical cystectomy.

Purpose: The Malnutrition Universal Screening Tool integrates body mass index, unintentional weight loss and present illness to assess risk for malnutrition. The predictive role of 'MUST' among patients undergoing radical cystectomy is unknown. We investigated the role of 'MUST' in predicting postoperative outcomes and prognosis among patients after RC.

The role of tumor density in predicting significant cancer on targeted biopsy of the prostate.

Objective: Multiparametric magnetic resonance imaging (mpMRI) is central to diagnosing prostate cancer; however, not all imaged lesions represent clinically significant tumors. We aimed to evaluate the association between the relative tumor volume on mpMRI and clinically significant prostate cancer on biopsy.

Materials And Methods: We retrospectively reviewed the medical records of 340 patients who underwent combined transperineal targeted and systematic prostate biopsies between 2017 and 2021.

Long-Term Indwelling Tandem Polymeric Ureteral Stents for Benign Ureteral Obstruction.

To assess the outcome of tandem polymeric internal stents (TIS) for benign ureteral obstruction (BUO). We conducted a retrospective study that included all consecutive patients treated for BUO by means of TIS in a single tertiary center. Stents were replaced routinely every 12 months or earlier, when indicated.