Urologiia最新文献

{"title":"[Pathomorphological changes in ejaculate revealed by electron transmission microscopy in patients who have had COVID-19].","authors":"S Ibishev Kh, O Prokop Ya, V Sizyakin D, I Kogan M","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Disturbances due to the novel coronavirus infection (COVID-19) caused economic, physical and psychological damage to the population of the whole world. The number of people who have suffered SOVID-19 is growing, and there is a number of negative consequences are documented for many organs and systems of the body, including reproductive.</p><p><strong>Aim: </strong>To study the pathomorphological changes in ejaculate revealed by transmission electron microscopy in patients who have had COVID-19.</p><p><strong>Materials and methods: </strong>The results of the electronic transmission microscopy of ejaculate 157 men were analyzed. They were divided into four groups. In group 1, there were 49 patients with idiopathic infertility who suffered COVID-19, group II included 42 patients with idiopathic infertility without prior of history of COVID-19, group III consisted of 39 fertile men who have had COVID-19, while in group IV there were 27 fertile men without prior of history of COVID -19.</p><p><strong>Results: </strong>In most cases, pathological changes detected during morphological examination of patients before and after inclusion in the study were detected in the head of the sperm, which were resulted in a small specific gravity, but 12 months after infection with SARS-CoV-2, the percentage of acrosome changes increased in groups I and III. Moreover, combined pathological changes in the acrosome were recorded.</p><p><strong>Conclusions: </strong>Thus, transmission electron microscopy revealed morphometric sperm disorders that were associated with energy processes in the cell, which naturally should be taken into account when rehabilitation of reproductive men who have had SARS-COV-2. In addition, in patients of SARS-COV-2, a severe cell pathology was noted, due to the residualization of the cytoplasm and the pathology of mitochondria.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 2","pages":"50-55"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recurrent balanoposthitis, dermatoses and oncological diseases of the anogenital zone].","authors":"I Chernova N, G Markosyan T, S Zadorozhnaya I","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Oncological diseases of the anogenital zone in men have become increasingly relevant in recent years. It is associated with the increasing incidence, subtle clinical manifestations, and difficulties in establishing a diagnosis, requiring, in most cases, histological examination, since the diagnostic capabilities of non-invasive methods, unfortunately, are limited. Precancerous conditions, both associated with the human papillomavirus (HPV) and HPV-negative, occupy a special place among penile oncological disorders, timely diagnosis of which is extremely important.</p><p><strong>Aim: </strong>To determine the frequency of precancerous and malignant diseases of the penis in the general structure of anogenital dermatoses in men, as well as to describe their main clinical features.</p><p><strong>Materials and methods: </strong>The results of a survey of 160 men aged 18 to 86 years with various dermatoses of the anogenital zone who seek medical help in dermatological or urological departments are presented in the article.</p><p><strong>Results: </strong>Various forms of penile squamous cell carcinoma were detected in 17 (10.6%), and precancerous conditions were detected in 21 (13.1%) cases. Among the latter, HPV-associated subtype of penile intraepithelial neoplasia (bowenoid papulosis, Bowen's disease, erythroplasia of Queyrat) was diagnosed in 19 (11.8%) patients. Objective symptoms were characterized by a variety of morphological and clinical manifestations. The list of incorrect clinical diagnoses which patients are followed with included banal balanoposthitis, lichen sclerosis, psoriasis, lichen planus, leukoplakia, and papillomatous nevus, which are characterized by a recurrent course and low efficiency of therapy. Histological examination was required to confirm the diagnosis of squamous cell carcinoma and precancerous diseases.</p><p><strong>Conclusions: </strong>The oncological alertness of urologists and dermatologists in patients with chronic recurrent processes of the external genitalia is justified. If there is any doubt, tissue biopsy for morphological diagnostics should be done.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 2","pages":"44-49"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Use of a combined form of prostate extract and alpha-adrenoblocker in patients after transurethral resection of the prostate].","authors":"N Pavlov V, A Kazikhinurov A, Sh Sabirzyanov S, A Kazikhinurov R, A Karaguzin R","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Prostate extract has pronounced anti-inflammatory and anti-androgenic properties, which contribute to a reduction in the volume of the prostate and an improvement in urination. Alpha-adrenoblockers, in turn, exert a relaxing effect on the smooth muscles of the bladder and prostate, thereby facilitating the urination. The combined use of these two drugs may provide a synergistic effect, leading to a pronounced improvement in quality of urination and accelerates recovery in patients after transurethral resection of the prostate. This approach may be more effective than using only one of these drugs.</p><p><strong>Aim: </strong>To investigate the efficiency and safety profile of the prostate extract in combination with tamsulosin in patients after transurethral bipolar resection of the prostate.</p><p><strong>Materials and methods: </strong>A total of 147 patients with benign prostatic hyperplasia (BPH) of stage II without severe concomitant diseases were included in the clinical study. The age of the men ranged from 48 to 81 years (61.7+/-1.4). All patients underwent transurethral bipolar resection of the prostate. Patients were randomized into two groups. In the main group, men received from the first postoperative day a combination of prostate extract with an alpha-adrenoblocker (prostate extract in powder 50 mg in terms of water-soluble peptides 10 mg and tamsulosin hydrochloride 0.4 mg) in the form of suppository after spontaneous bowel evacuation or enema daily for 30 days (n=70). In the control group, only alpha-adrenoblocker (tamsulosin 0.4 mg once a day for 30 days) in the postoperative period was given (n=77).</p><p><strong>Results: </strong>In the main group, there was a reduction in the mean total IPSS score by 34.5% (p <0.05), and improvement in quality of life by 52% (p <0.05). The maximum urine flow rate increased by 69% (p <0.05), and the average urine flow rate increased by 94.6% (p<0.05). The positive effect on erectile function was 17.8% (p <0.05).</p><p><strong>Conclusions: </strong>Our data allow to recommend this drug in the combined treatment of patients with benign prostatic hyperplasia (BPH) after transurethral resection of the prostate to restore urination function and improve quality of life.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 2","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Is the rate of complications in simultaneous inguinal hernia repair and extraperitoneal simple prostatectomy using laparoscopic approach increased compared to simple prostatectomy alone?]","authors":"G Biktimirov R, G Martov A, R Biktimirov T, A Kaputovsky A","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The correlation between inguinal hernia and benign prostatic hyperplasia (BPH) is well known. Minimal invasive simple prostatectomy (MISP) may be method of choice for surgical treatment of BPH with volume more than 80 cc. Literature review has revealed retrospective studies of laparoscopic or robot-assisted radical prostatectomy with simultaneous inguinal hernia repair and acceptable complication rate. Open simple and radical prostatectomy provide the same results. Similar studies for MISP have not been found.</p><p><strong>Aim: </strong>To evaluate the rate of complications of simultaneous laparoscopic hernioplasty of inguinal hernia and MISP compared to MISP alone.</p><p><strong>Materials and methods: </strong>The data of 79 patients, who underwent MISP, were analyzed retrospectively. The two groups were formed. In the group I, only MISP (n=34) was performed. In the group II, MISP and simultaneous inguinal hernia repair (n=17) were done, including three bilateral and other unilateral procedure. Three patients in group II additionally underwent simultaneous cystolithotomy. The same surgical approach was used for both groups. The Fishers exact test was used for statistical analysis.</p><p><strong>Results: </strong>There were no significant differences (p>0.005) in mean age of patients (68 vs. 71 years), volume of blood loss (416 vs. 238 ml), duration of procedure (190 vs. 221 min) and complications rates (11.7% vs. 5.8%) between two groups. The mean prostate volume was 128 cc in both groups.</p><p><strong>Conclusions: </strong>Simultaneous MISP and laparoscopic inguinal hernioplasty in patients with BPH does not result in higher complication rate compared to MISP.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 2","pages":"25-28"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prediction of erectile dysfunction in patients with localized prostate cancer undergoing radical prosta- tectomy].","authors":"V Pomeshkin E, V Shamin M, I Bragin-Maltsev A, S Kagan E","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Penile rehabilitation strategies have been developed to accelerate and improve the recovery of erectile function after radical prostatectomy. However, the differential efficacy and the best penile rehabilitation strategy are still unclear. Therefore, the search for factors influencing the prognosis of erectile dysfunction (ED) one year after radical prostatectomy and the formulation of algorithms for patient management is highly relevant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To analyze pre- and postoperative factors that affect erectile function after radical prostatectomy with the development of an algorithm for calculating the risk of developing ED.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A total of 104 patients with localized prostate cancer who underwent nerve-sparing prostatectomy were retrospectively examined. A year after surgery, regardless of whether medicinal penile rehabilitation was used or not, patients were divided into two groups depending on the possibility of having sexual intercourse.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The following indicators were identified as predictors of an unfavorable prognosis using multiple regression analysis with a stepwise inclusion method: age, erectile function assessed using the International Index of Erectile Dysfunction-5 (IIEF-5) before surgery, the presence of type 2 diabetes mellitus, use of phosphodiesterase type 5 (PDE-5) inhibitors in the postoperative period, type of radical prostatectomy (unilateral or bilateral nerve sparing). It was found that the presence of factors such as the older age, type 2 diabetes mellitus and a lower preoperative IIEF-5 score were associated with lower IIEF-5 score after a year. Taking PDE-5 inhibitors for a year and bilateral nerve-sparing RP increased IIEF-5 score. Of the five factors presented in the model, four (patients age, presence/absence of diabetes mellitus, IIEF-5 level before surgery) were not controlling factors, since they could not influence the choice of rehabilitation method. The indicator reflecting the fact of taking PDE-5 inhibitors during the year was a controlling factor, since its inclusion in the model allowed to choose the appropriate method of rehabilitation for the patient. The multiple correlation coefficient is 0.898, which characterizes the high predictive level of this model. The data obtained were converted into an algorithm that allowed to calculate the risk of developing ED, taking into account modern methods of treatment and rehabilitation, and make the right decision in choosing the optimal strategy for further rehabilitation interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;From the presented data we can conclude that the prognosis for the development of ED after radical prostatectomy can be determined with high reliability based on the following risk factors: the type of surgical treatment, namely bilateral nerve sparing, affects the preservation of innervation, which affects the postoperative r","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 2","pages":"56-62"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Usage of artificial intelligence in the clinical practice of urologists in observations with renal parenchymal neoplasms].","authors":"A Izmailova A, V Glybochko P, G Alayev Y, V Butnaru D, V Shpot E, M Chernenkyi M, M Chernenkyi I, N Fiev D, V Proskura A, V Lobanov M, V Konychev A, S Sirota E, M Ismailov K, K Shurygina R, A Zholdubaev A, P Sarkisyan I","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>to assess the needs and attitudes of urologists regarding the use of technologies related to artificial intelligence, particularly the web platform \"Sechenov.AI_nephro\", in the surgical treatment of patients with renal parenchymal neoplasms.</p><p><strong>Materials and methods: </strong>a qualitative study was conducted through in-depth interviews. A questionnaire was developed for the interviews, including 14 categories of questions covering various aspects of the use of artificial intelligence (AI) aimed at optimizing preoperative planning for patients with renal parenchymal neoplasms. The study involved 8 urologists with extensive experience in the surgical treatment of patients with renal parenchymal neoplasms.</p><p><strong>Results: </strong>the survey results highlight the growing interest in the implementation of AI technologies in medical practice.</p><p><strong>Conclusion: </strong>in-depth interviews among urologists in Russia showed that there is a high interest in AI developments in urological practice. At the same time, successful integration of technologies requires overcoming several obstacles, including training specialists and ensuring data security. The \"Sechenov.AI_nephro\" platform has the potential to become an important tool in optimizing preoperative planning, but its success will depend on the readiness of physicians for new technologies and support from the medical community.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 2","pages":"121-127"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Bladder hernias in childhood].","authors":"E Soloviev A","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To study the features of the clinical manifestations, diagnosis and treatment of children with bladder hernias.</p><p><strong>Materials and methods: </strong>A total of 8 children with bladder hernias were observed, including five patients with inguinal hernias of the bladder and two with femoral hernias. One girl had a perineal bladder hernia. To verify the diagnosis, clinical and laboratory examinations, ultrasound and Doppler examination of the scrotum, bladder catheterization, cystoscopy and cystography, intravenous urography, CT, and morphological studies of the surgical specimen were used. In this article, we presented four clinical cases.</p><p><strong>Results: </strong>Difficulties in diagnosing bladder hernias in children, especially when they are incarcerated, are associated with atypical clinical manifestations, which mimic an incarcerated inguinal hernia. In 5 children with inguinal and two children with femoral hernia of the bladder, the diagnosis was not correctly made before the surgical procedure. In two cases, there was bladder damage during intervention. Combined surgical procedure with abdominal and herniotomy approaches allowed to perform radical procedures for both inguinal and femoral hernias of the bladder. A girl with a perineal hernia of the bladder complicated by urolithiasis was undergone to anterior colporrhaphy and posterior colpoperineorraphy with a removal of bladder stones.</p><p><strong>Conclusions: </strong>Bladder hernias in children are always sliding and are rare. Clinically, bladder hernias in children mimic an incarcerated inguinal hernia. Correct diagnosis of bladder hernias is difficult. No child with inguinal and femoral bladder hernias was correctly diagnosed before surgical intervention. Abdominal and herniotomy approaches can be the method of choice for femoral hernias of the bladder. With perineal hernia of the bladder, anterior colporrhaphy and posterior colpoperineorraphy are indicated.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 2","pages":"63-66"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Multiple schwannoma of the scrotum: a clinical case].","authors":"S Boshchenko V, M Mikhailovskiy D, V Krakhmal N, V Vtorushin S","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Schwannoma is a benign tumor arising from the peripheral nerve sheaths and consisting of highly differentiated Schwann cells, which under physiological conditions produce the essential component of nerve fibers myelin. Frequent localization of neoplasms are areas with developed and abundant nerve supply - the head, neck, limbs, less often its occur in the chest, mediastinum, retroperitoneum, adrenal glands, organs of the gastrointestinal tract, cases of schwannoma of the penis and vulva are also described. In clinical practice, extratesticular schwannoma of the scrotum is extremely rare, when analyzing literary sources, descriptions of only isolated observations were found. Scrotal schwannoma is often associated with systemic pathology - neurofibromatosis type 2 or schwannomatosis, isolated development of the tumor is rather considered an exceptional event. In this article, we present a description of a clinical case of multiple large scrotal schwannoma in a 45-year-old man who underwent surgical treatment with excision of the tumor in 2011. During the period 2011-2024, the patient had no relapse of the disease, the quality of life was high and the prognosis was favorable.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 2","pages":"67-72"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Evaluation of the possibility of using neural networks for automatic diagnostics of obstructive urination].","authors":"S Panferov A, K Gadzhiev N, S Yastrebov V, A Filist S, I Puchenkov K","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive type of urination requires accurate and timely diagnosis to prevent complications and improve the quality of life of patients. Traditional diagnostic methods such as uroflowmetry, although they remain the standard, have their limitations. In this context, videography of urine stream followed by image analysis is a more cost-effective and promising approach that allows for a more detailed picture of urination, accessible not only to urologists, but also to patients.</p><p><strong>Aim: </strong>To establish the possibility of recognizing and classifying graphs of the urination using neural network and machine learning technologies.</p><p><strong>Materials and methods: </strong>This retrospective study involved 152 male patients aged 19 to 87 years who underwent examination and treatment at the MC Medassist clinic from June 2024 to January 2025. There were 43 patients (28%) with obstructive type of urination, 39 patients with benign prostatic hyperplasia, 4 patients with urethral stricture, and 109 patients (72%) with normal urination. The diagnostics algorithm included a general urinalysis, kidney and bladder ultrasound and/or MRI of the prostate, as well as uroflowmetry. The neural network architecture was designed based on the Keras framework of the Python programming language.</p><p><strong>Results: </strong>Three studies with obtained data were carried out, which differed in the architecture of the neural network and the methods of preparing the initial data. The average area under the ROC curve for a network with random image feed averaged 0.5 for both the training and test samples. For a network with linear feed of the entire data set, it was 1 for the training and test samples. A neural network with three inputs differing in two-threshold binarization ranges showed a result of 0.9 for the training and 0.7 for the test sample.</p><p><strong>Discussion: </strong>An important aspect of this study is the possibility of using neural networks to process large amounts of video data. Automating the analysis of images of urine stream allows not only to reduce the time required for diagnosis, but also to identify hidden patterns that may be overlooked during visual assessment by a specialist. The study of methods for analyzing video recordings of urination based on artificial neural network technologies and machine learning algorithms can become the basis for creating new diagnostic tools that will increase the speed of diagnosis, accelerate drug research, and monitor patients with chronic diseases.</p><p><strong>Conclusion: </strong>Despite the current limitations, this study confirms that the use of neural networks and machine learning in urology has significant potential and can become the basis for the development of new diagnostic tools that can improve the efficiency of medical care, and thereby improve the quality of life of patients.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 2","pages":"128-134"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Postoperative stress urinary incontinence in patients after various techniques of laser enucleation for benign prostatic hyperplasia].","authors":"D Dibiraliev C, T Markosyan G, V Olefir Yu, M Dymov A, B Sukhanov R, A Bezrukov E, A Gazimiev M","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To compare the incidence of postoperative stress urinary incontinence (SUI) in patients with benign prostatic hyperplasia after three different techniques of thulium fiber laser prostate enucleation (ThuFLEP): two-lobe, enucleation of all lobes in a single block (en-bloc) and enucleation of all lobes in a single block without additional longitudinal incisions (total en-bloc).</p><p><strong>Materials and methods: </strong>A retrospective and prospective comparative analysis included 472 patients, who were undergone to three different techniques of ThuFLEP. The surgical interventions were performed by three experienced surgeons from January 2015 to May 2023. The incidence of postoperative stress urinary incontinence (SUI), risk factors for SUI, and the rate of improvement in patients with SUI were evaluated. The patients were examined pre- and postoperatively.</p><p><strong>Results: </strong>Logistic regression analysis was used to assess the effect of two main predictors, surgical technique and prostate volume, on the SUI after the surgical procedure. The postoperative SUI developed in 49 (10.4%) patients. After 6 months, SUI persisted in only 6 (1,3%) cases. Uni- and multivariate analysis of these predictors was performed. Depending on the technique of laser enucleation, the incidence of SUI reached 13.9% after the two-lobe technique, 12.4% after the en-bloc technique, and 5.4% after the total en-bloc technique. In addition, the total en-bloc technique proved an earlier restoration of urinary continence after laser enucleation. Uni- and multivariate analysis showed the significant influence of the surgical technique on the SUI (p=0.013 for the univariate analysis, p=0.046 for the multivariate analysis).</p><p><strong>Conclusions: </strong>We confirmed the significant reduction of the postoperative SUI in the first six months when used the total en-bloc technique with additional beneficial effect on early recovery of urinary continence.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 2","pages":"141-146"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}