Actas urologicas espanolas最新文献

{"title":"Retrosigmoid ileal conduit versus traditional techniques after radical cystectomy: Impact on the incidence of ureteroileal anastomotic stricture","authors":"C. Casanova-Martín ,&nbsp;M. Álvarez-Maestro ,&nbsp;A. Rodríguez-Serrano ,&nbsp;A. Gómez-Villanueva ,&nbsp;A. Aguilera-Bazán ,&nbsp;M. Serrano-Liesa ,&nbsp;J.M. Alonso-Dorrego ,&nbsp;M.Á. Ortega-Núñez ,&nbsp;E. Ríos-González ,&nbsp;L. Martínez-Piñeiro Lorenzo","doi":"10.1016/j.acuroe.2026.501934","DOIUrl":"10.1016/j.acuroe.2026.501934","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Ureteroileal anastomotic stricture (UAS) is a relevant complication after radical cystectomy (RC). The retrosigmoid ileal conduit (RIC) may reduce its incidence by avoiding left ureteral transposition.</div></div><div><h3>Objective</h3><div>To compare the incidence of UAS, perioperative outcomes, and length of stay between RIC and conventional urinary diversions (Bricker/Wallace).</div></div><div><h3>Material and methods</h3><div>Retrospective, single-center observational study. All patients undergoing RC with bilateral urinary diversion were included: RIC between 01/2021–12/2024 and conventional techniques between 01/2018–12/2020. <em>Primary variable</em>: Multivariable logistic regression was performed using: age, body mass index (BMI), prior urinary tract dilation, Charlson Comorbidity Index (CCI), Eastern Cooperative Oncology Group (ECOG) score, and surgical technique. <em>Secondary variables</em>: operative time, 30-day postoperative complications (grouped as minor complications [Clavien 1-2] and major complications [Clavien ≥3]), time to stricture, length of hospital stay, and follow-up time after surgery.</div></div><div><h3>Results</h3><div>Seventy-one patients were analyzed: 36 RIC and 35 controls, with comparable baseline characteristics. UAS presented an incidence of 2.8% in RIC group and 22.9% in controls; the RIC technique was associated with a lower adjusted risk (OR: 0.05; 95% CI: 0.002-0.35; <em>P</em> = .011). Operative time was shorter with RIC (median: 292 [IQR: 274–315] vs. 330 [308–360] min; <em>p</em> = 0.00025). There were no differences in major complications (11.1 vs. 17.1%; <em>P</em> = .51) or minor complications (33.3 vs. 42.9%; <em>P</em> = .41), nor in hospital stay (11.5 vs. 9 days; <em>P</em> = .23). The median follow-up was 18 months (RIC) and 39 months (control).</div></div><div><h3>Conclusions</h3><div>In our series, RIC significantly reduced UAS without increasing morbidity and was associated with a shorter operative time compared with traditional techniques. The results support the anatomical consistency and reproducibility of the technique.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501934"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313902","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":"Impact of surgical waiting list on oncological outcomes of radical prostatectomy in patients with intermediate- and high-risk prostate cancer","authors":"P. de Pablos-Rodríguez ,&nbsp;P. Guedes Oliva ,&nbsp;Á. Gómez Ferrer ,&nbsp;M. Beamud Cortés ,&nbsp;A. Wong Gutiérrez ,&nbsp;C. Gutiérrez Castañé ,&nbsp;A. Calatrava Fons ,&nbsp;J. Aliaga Patiño ,&nbsp;Á. García Cortés ,&nbsp;J. Agustín López ,&nbsp;A. Collado Serra ,&nbsp;V. Rodríguez Part ,&nbsp;J.L. Casanova Ramón Borja","doi":"10.1016/j.acuroe.2026.501910","DOIUrl":"10.1016/j.acuroe.2026.501910","url":null,"abstract":"<div><h3>Introduction</h3><div>The prognosis of localized prostate cancer (PCa) following radical treatment is generally favorable, although up to 46% of patients may still experience adverse outcomes. The impact of delayed surgery in intermediate-risk (IR) or high-risk (HR) patients remains under discussion. This study evaluates its association with oncological outcomes.</div></div><div><h3>Materials and methods</h3><div>Retrospective study of 2296 patients with IR and HR PCa who underwent radical prostatectomy (RP) between 1986 and 2025. Upgrading, upstaging, positive margins, PSA persistence, and lymph node involvement were analyzed. Waiting time was grouped into &lt;3, 3–6, and &gt;6 months.</div></div><div><h3>Results</h3><div>The median waiting time was 3.5 months. Eighty-five percent of patients were operated on within 6 months. At 5 years, no difference was detected between waiting time and time to biochemical recurrence (BCR) when comparing the &lt;3-month group with the 3–6-month group (HR 0.93; 95% CI 0.76–1.13) and the &gt;6 months group (HR 0.74; 95% CI 0.53–1.04) among IR patients. In HR patients, no differences were observed either: 3–6 months (HR 0.85; 95% CI 0.71–1.01) and &gt;6 months (HR 0.79; 95% CI 0.61–1.03). No increased risk of adverse pathological outcomes was found with longer delays.</div></div><div><h3>Conclusions</h3><div>A waiting time of ≤6 months was not associated with worse oncological prognosis, supporting its safety in IR or HR PCa.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501910"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907354","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":"Predictive factors for urethral stricture development in patients with bladder tumor: The role of intravesical BCG therapy","authors":"İsmail Emre Ergin ,&nbsp;Adem Sanci ,&nbsp;Emre Hepşen ,&nbsp;Kubilay Sarıkaya ,&nbsp;Metin Yığman ,&nbsp;Azmi Levent Sağnak ,&nbsp;Ahmet Nihat Karakoyunlu","doi":"10.1016/j.acuroe.2026.501908","DOIUrl":"10.1016/j.acuroe.2026.501908","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the predictive role of intravesical Bacillus Calmette-Guérin (BCG) therapy on urethral stricture development in male patients undergoing bladder tumor surveillance, while also assessing the impact of repeated urethral instrumentation on stricture risk.</div></div><div><h3>Methods</h3><div>This retrospective study included male patients aged 18–90 with non-muscle invasive bladder tumors followed between 2018 and 2024. Demographics, cystoscopy and TUR procedures, intravesical treatments (BCG and chemotherapy), and urethral stricture diagnosis were recorded. Urethral stricture was confirmed by uroflowmetry, cystoscopy, and urethrography. Patients with prior urethral stricture or incomplete records were excluded. Statistical analyses included logistic regression to identify predictors of stricture development, adjusting for age and comorbidities. Sample size was calculated to ensure adequate power to detect a 15% difference in stricture incidence related to BCG therapy.</div></div><div><h3>Results</h3><div>A total of 187 male patients were analyzed, with a 12.3% urethral stricture incidence. BCG therapy was administered to 32.6% of patients and significantly increased stricture risk (OR: 4.11, <em>P</em> = .015). Each additional dose was associated with an increased risk (OR: 2.11, <em>P</em> = .001). TURP (OR: 2.95, <em>P</em> = .045) and the number of cystoscopies (OR: 1.42 per procedure, <em>P</em> = .040) were also significant predictors. Tumor size ≥3 cm was associated with higher risk (OR: 1.88, <em>P</em> = .037). Spearman analysis showed positive correlations between stricture severity and both BCG doses and cystoscopy number.</div></div><div><h3>Conclusion</h3><div>Intravesical BCG therapy, repeated cystoscopies, and TURP increase urethral stricture risk in bladder tumor patients. Preventive measures and careful monitoring are essential to reduce urethral complications.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501908"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919547","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 retroperitoneal access feasible using the single-port robotic platform for native nephrectomy after kidney transplantation?","authors":"H.B. Haberal ,&nbsp;F.M. Valenzi ,&nbsp;V. Santarelli ,&nbsp;S. Crivellaro","doi":"10.1016/j.acuroe.2025.501797","DOIUrl":"10.1016/j.acuroe.2025.501797","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501797"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295595","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":"Comparison of ultrasound-guided and fluoroscopy-guided supine mini percutaneous nephrolithotomy: a single-center retrospective evaluation based on clinical experience and current literature","authors":"E. Ördek ,&nbsp;S. Toksöz ,&nbsp;K. Gümüş ,&nbsp;İ. Özdoğan","doi":"10.1016/j.acuroe.2026.501930","DOIUrl":"10.1016/j.acuroe.2026.501930","url":null,"abstract":"<div><h3>Introduction</h3><div>The utilisation of fluoroscopy in percutaneous nephrolithotomy gives rise to concerns regarding radiation exposure, thus necessitating the exploration of alternative methodologies. This study sets out to compare the efficacy and safety of ultrasound-guided supine mini PCNL and fluoroscopy-guided supine mini PCNL for renal stone management.</div></div><div><h3>Methods</h3><div>Adult patients with renal stones ≥15 mm who underwent supine mini-PCNL were retrospectively reviewed. Patients were categorized into ultrasound-guided (US-PCNL, n = 64) and fluoroscopy-guided (FL-PCNL, n = 84) groups. Clinical variables, including operative time, number of puncture attempts, fluoroscopy duration, perioperative hemoglobin change, transfusion requirement, stone-free rate, complication rate, and length of hospital stay, were analysed. Surgical outcomes between the groups were compared using independent t-test or Mann–Whitney U test as appropriate. Wilcoxon test was used for dependent variables, and Chi-square test for categorical data.</div></div><div><h3>Results</h3><div>The US-PCNL group had a significantly shorter operative time and puncture time compared to the FL-PCNL group (p &lt; 0.05). No significant differences were found between the groups in terms of puncture attempts, tract formation rates, or stone-free rates (p &gt; 0.05). Postoperative complications, such as fever and the need for additional interventions, were similar between groups (p &gt; 0.05). Notably, the FL-PCNL group had a mean fluoroscopy duration of 6.3 min, while the US-PCNL group had none.</div></div><div><h3>Conclusions</h3><div>Ultrasound-guided supine mini-PCNL offers a promising, radiation-free alternative to fluoroscopy in renal stone management. This study shows comparable outcomes between the two techniques, emphasizing the potential of ultrasound to improve patient safety in endourology.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 4","pages":"Article 501930"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198354","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":"Comment on “Oncological outcomes of patients with node positive disease following neoadjuvant chemotherapy and radical cystectomy for muscle-invasive bladder cancer: A multicenter observational study of the EAU Young Academic Urologists (YAU) urothelial carcinoma working group”","authors":"V.D. Kumar Veldi ,&nbsp;R. Sah","doi":"10.1016/j.acuroe.2025.501792","DOIUrl":"10.1016/j.acuroe.2025.501792","url":null,"abstract":"","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501792"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295592","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":"Radical prostatectomy without prior biopsy in patients with positive PSMA PET and/or mpMRI: A practiced but poorly documented approach. Retrospective multicenter cohort study","authors":"D.R. Magdaleno Rodríguez ,&nbsp;L. Almazán Treviño ,&nbsp;L. Lamm Wiechers ,&nbsp;R. González Cosió ,&nbsp;L.F. Galicia Belauzaran ,&nbsp;J.A. Herrera Muñoz ,&nbsp;M. Cantellano Orozco ,&nbsp;C. Martínez Arroyo ,&nbsp;G. Fernandez Noyola ,&nbsp;M.E. Ortega González ,&nbsp;I. Navarro Ruesga ,&nbsp;M.A. Ascencio Martínez ,&nbsp;C.A. Silva Mendoza ,&nbsp;H.A. Miranda Blasnich ,&nbsp;R.E. Domínguez Castillo ,&nbsp;A. Haddad Servín ,&nbsp;J.G. Morales Montor","doi":"10.1016/j.acuroe.2026.501921","DOIUrl":"10.1016/j.acuroe.2026.501921","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer (PCa) is the most common malignancy among men and currently ranks as the second leading cancer worldwide in terms of incidence. In 2021, a total of 35,764 new cases were diagnosed. The development of new imaging tools such as multiparametric magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography (PET-PSMA) has enabled the exploration of less invasive diagnostic strategies in clinically significant prostate cancer. However, performing radical prostatectomy without a prior biopsy remains an exceptional practice, scarcely documented and highly controversial.</div></div><div><h3>Objective</h3><div>To report a series of Mexican cases undergoing radical prostatectomy without prior biopsy, using PET-PSMA and mpMRI as the main diagnostic tools, and to propose a preliminary risk stratification model based on SUVmax values: the “M&amp;M’s PSMA SCORE SUVmax”.</div></div><div><h3>Materials and Methods</h3><div>Retrospective, observational, multicenter study of 18 patients treated between 2021 and 2024. Clinical variables, imaging findings, and histopathological results were analyzed. Sensitivity, positive predictive value (PPV), and correlation between SUVmax and ISUP grade were calculated.</div></div><div><h3>Results</h3><div>All cases confirmed clinically significant adenocarcinoma. PET-PSMA showed 100% sensitivity and PPV; mpMRI showed 93.3% sensitivity and 100% PPV. A positive correlation was found between SUVmax and ISUP grade (r = 0.84; <em>P</em> = .038). A preliminary classification based on SUVmax cut-off points was proposed.</div></div><div><h3>Conclusions</h3><div>This series suggests that, in selected contexts, PET-PSMA and mpMRI could support surgical decision-making even without prior biopsy. However, prospective studies are needed to validate both this strategy and the proposed stratification system.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501921"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044470","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":"HoLEP in patients with and without catheter-dependent acute urinary retention: Surgical and functional outcomes","authors":"G. Ozgur ,&nbsp;M. Cetin ,&nbsp;T. Altuntas ,&nbsp;E. Gokmen ,&nbsp;H.K. Cam ,&nbsp;T. Tarcan ,&nbsp;T.E. Sener","doi":"10.1016/j.acuroe.2026.501906","DOIUrl":"10.1016/j.acuroe.2026.501906","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Holmium Laser Enucleation of the Prostate (HoLEP) is an effective treatment for benign prostatic obstruction; however, data on its outcomes in patients with acute urinary retention (AUR), particularly those who remained catheter-dependent until surgery, remain limited. This study compared HoLEP outcomes in patients with and without AUR.</div></div><div><h3>Methods</h3><div>Data from 140 male patients aged 50–80 who underwent HoLEP were retrospectively and exploratorily analyzed. Patients were grouped as catheter-dependent AUR (Group-1) and non-AUR (Group-2). The primary comparison was Qmax at 6 months, while secondary comparisons included functional outcomes and perioperative/postoperative complications.</div></div><div><h3>Results</h3><div>Thirty-four patients (24.3%) had catheter-dependent AUR. They were older (68.9 ± 6.9 vs. 66.2 ± 6.5 years) and had worse baseline IPSS (25[22−29] vs. 22[17−25]), quality of life (QoL; 5 [4–6] vs. 4 [3–5]), Qmax (0 vs. 8[5.6−10] mL/s), and PVR (400[197−560] vs. 100[60−150] mL) (<em>p</em> &lt; 0.05). Perioperative parameters and complication rates were not significantly different between the groups. Following HoLEP, AUR patients showed greater improvements in Qmax (Δ16[14−20.3] vs. 10 [7–15] mL/s), IPSS (Δ16.5[10.8−22.3] vs. 11.5[6−17.3]), QoL (Δ4 [3–5] vs. 3[1−3.3]), and PVR (Δ326[128−502] vs. 62.5[26−120] mL) (<em>p</em> &lt; 0.05). Although patients with catheter-dependent AUR demonstrated more pronounced improvements in functional outcomes, this was largely attributable to worse baseline parameters. No statistically significant differences were observed in postoperative outcomes between the groups. Notably, subjective measures (IPSS and QoL) improved more markedly in Group-1.</div></div><div><h3>Conclusions</h3><div>HoLEP is an effective treatment option for catheter-dependent AUR patients, providing significant functional improvement. Preoperative catheterization until surgery does not negatively affect surgical efficacy or postoperative outcomes.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501906"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919537","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":"The role of systemic inflammatory and prognostic índices in diabetic patients with non-muscle invasive bladder cancer receiving BCG therapy","authors":"A. Tunçekin ,&nbsp;Y. Aktaş","doi":"10.1016/j.acuroe.2026.501925","DOIUrl":"10.1016/j.acuroe.2026.501925","url":null,"abstract":"<div><h3>Introduction</h3><div>Systemic inflammatory and prognostic indices are emerging biomarkers in bladder cancer. Diabetes mellitus (DM), a chronic inflammatory disease, and Bacillus Calmette–Guérin (BCG) therapy may influence these indices in non-muscle invasive bladder cancer (NMIBC).</div></div><div><h3>Objective</h3><div>To evaluate the impact of DM and BCG therapy on inflammatory and prognostic indices in patients with NMIBC.</div></div><div><h3>Material and method</h3><div>A retrospective study of 156 NMIBC patients was conducted. Patients were stratified by DM and BCG status (DM+/DM−; BCG+/BCG−), and into four subgroups (DM−/BCG−, DM+/BCG+, DM−/BCG+, DM+/BCG−). Laboratory and clinical parameters were compared using standard statistical tests (<em>t</em>-test, Chi-square, ANOVA). A <em>P</em>-value &lt;.05 was considered significant.</div></div><div><h3>Results</h3><div>DM+ patients had significantly higher glucose (<em>P</em> = .001), HbA1c (<em>P</em> = .017), GKR (<em>P</em> = .014), and lower PNI (<em>P</em> = .014). Tumor recurrence was more common in DM+ (<em>P</em> = .021). In the BCG comparison, albumin (<em>P</em> = .002) and PNI (<em>P</em> = .009) differed. Four-group analysis showed significant differences in tumor grade, tumor recurrence, HbA1c, albumin, PNI, and MPR (all <em>P</em> &lt; .05), especially between DM+/BCG+ and DM−/BCG+.</div></div><div><h3>Conclusion</h3><div>DM and BCG therapy are associated with systemic inflammatory and prognostic indices in NMIBC. GKR and PNI may serve as practical, cost-effective markers for recurrence risk stratification.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501925"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198386","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":"Prospective analysis of urinary continence and urethral stricture after Holmium laser enucleation of the prostate (HoLEP): A consecutive 254-case series","authors":"L.E. Ortega Polledo ,&nbsp;A. Sánchez Pellejero ,&nbsp;G.F.J. Bianchini Hernández ,&nbsp;E. García Rico ,&nbsp;E. Redondo González ,&nbsp;J.D. Subiela Henríquez ,&nbsp;P. Mata Deniz ,&nbsp;M.J. Marugán Álvarez ,&nbsp;J. Gómez Rivas ,&nbsp;I. Galante Romo ,&nbsp;J. Moreno Sierra ,&nbsp;S. Ahyai ,&nbsp;B. Miñana ,&nbsp;S. Alonso y Gregorio","doi":"10.1016/j.acuroe.2026.501912","DOIUrl":"10.1016/j.acuroe.2026.501912","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the rate of stress urinary incontinence, time to continence recovery, and incidence of urethral stricture in a series of patients who underwent holmium laser enucleation of the prostate (HoLEP) from the beginning of the learning curve of a single surgeon.</div></div><div><h3>Materials and methods</h3><div>Prospective study of 254 patients consecutively operated on by one surgeon between December 2022 and December 2024. Continence was defined as the use of 0 pads. Survival analysis (Kaplan-Meier) was performed to estimate time to continence recovery. Results were stratified according to surgical technique (2- or 3-lobe vs. en bloc), prostate volume, and BMI. Overall and de novo urethral stricture rates were analyzed according to operative time, ultrasound volume, and enucleated weight.</div></div><div><h3>Results</h3><div>The median time to continence was 20 days. The continence rates at 1 month, 2 months, and 4 months were 80.7%, 91.2%, and 98.5%, respectively. Although incontinence decreased progressively, urgency was more frequent in persistent cases. No significant differences were observed in the time to continence according to surgical technique, prostate volume, or BMI. The overall rate of urethral stricture was 3.9%, with 3.65% de novo cases. No associated risk factors were identified.</div></div><div><h3>Conclusions</h3><div>HoLEP showed a low rate of transient incontinence and urethral stricture, and no correlation with surgical technique or patient clinical characteristics.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"50 3","pages":"Article 501912"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919609","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}