Central European Journal of Urology最新文献

{"title":"Single-J versus double-J stents after ureterorenoscopy for renal stones: A randomized comparison of safety and tolerability.","authors":"Catarina Laranjo Tinoco, Luis Martins, Francisca Costa, Andreia Cardoso, Ana Sofia Araújo, Mariana Capinha, Luis Pinto, Aparício Coutinho, Carlos Oliveira, Vera Marques, Joao Pimentel Torres, Paulo Mota","doi":"10.5173/ceju.2024.0212","DOIUrl":"10.5173/ceju.2024.0212","url":null,"abstract":"<p><strong>Introduction: </strong>Ureteral stents are generally used after ureterorenoscopy (URS) procedures, even in uncomplicated ones. We aimed to compare the safety and tolerability of single-J (SJ) stents and double-J (DJ) stents in patients submitted to flexible URS for renal stones.</p><p><strong>Material and methods: </strong>This prospective, randomized, unblinded, single-center study was conducted between July 2022 and May 2024, involving patients undergoing flexible URS with holmium laser lithotripsy for renal stones. Patients were randomized to either SJ stents (removed within 24 hours) or DJ stents (removed 2-4 weeks post-surgery). Primary endpoints included emergency department admissions, postoperative complications, and reintervention rates. Secondary endpoints included stent tolerability and surgery efficacy. A symptom questionnaire was applied at postoperative weeks 1 (W1) and 4 (W4).</p><p><strong>Results: </strong>We included 125 patients (60 in group SJ and 65 in group DJ), with comparable baseline characteristics. Emergency department admissions were similar (18.3% vs 16.9%, p = 0.84), as were complications (18.3% vs 21.5%, p = 0.65) and reintervention rates (1.7% vs 3.1%, p = 1.0). SJ stents showed better tolerability, with lower scores for lower urinary tract symptoms (LUTS) and pain at both time points.</p><p><strong>Conclusions: </strong>SJ stents placed for less than 24 hours after complete flexible URS are comparable to DJ stents regarding safety and are better tolerated, particularly 4 weeks after the surgery. SJ stents should be prioritized, reducing costs and hospital visits for stent removal.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 2","pages":"192-198"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary incontinence as the first clinical symptom of urinary bladder leiomyosarcoma.","authors":"Łukasz Mazurczyk, Michał Czarnogórski, Aleksandra Czernicka, Paweł Lipowski, Adam Ostrowski, Kajetan Juszczak, Jan Adamowicz, Tomasz Drewa","doi":"10.5173/ceju.2024.0280","DOIUrl":"10.5173/ceju.2024.0280","url":null,"abstract":"<p><p>Urinary bladder leiomyosarcoma is an extremely rare malignancy of the urogenital system. We present the case of a 59-year-old Caucasian male with a gigantic bladder leiomyosarcoma. The patient was subdued to the surgical excision of the urinary bladder - laparoscopic radical cystectomy with extended pelvic lymphadenectomy, with urinary diversion by bilateral ureterocutaneostomy. The excision was complete both macroscopically and microscopically. No additional adjuvant therapy was administered. In the 6-month follow-up, the patient remained in radiological remission. Surgical excision with extended pelvic lymphadenectomy seems to be sufficient in the treatment of urinary bladder leiomyosarcoma.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 2","pages":"103-108"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting extracorporeal shock wave lithotripsy success with a machine learning nomogram: A pilot study.","authors":"Jan Svihra, Peter Svihra, Igor Sopilko","doi":"10.5173/ceju.2025.0104","DOIUrl":"https://doi.org/10.5173/ceju.2025.0104","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this pilot study was to develop and validate a machine learning (ML)-based clinical nomogram to predict the success rate of extracorporeal shock wave lithotripsy (ESWL) for kidney stones, optimizing patient selection and treatment outcomes.</p><p><strong>Material and methods: </strong>A retrospective analysis of ESWL data in all nephrolithiasis patients was performed from January 2018 to September 2022. Age, gender, stone size, stone area, stone location inside the kidney, stone density, skin-to-stone distance (SSD), stent presence, hydronephrosis presence, complications, and number of ESWL procedures were analysed. Inclusion criteria were a single kidney stone, stone size 5 mm to 20 mm, stone density less than average 1000 HU according to a native CT scan, and an adult patient. Statistical analysis was performed using the T test, mean, and standard deviation, and the calculations were processed using IBM SPSS Statistics for Macintosh, Version 25.0 with statistically significant values indicated by p <0.05. Python programming language was used to test machine learning models based on the previous study data. The scikit-learn library was used as a source of different ML models.</p><p><strong>Results: </strong>102 patients fulfilled inclusion and exclusion criteria. There were 70 male and 32 female patients. The mean age was 54.1 ±13.2 years, mean stone size 9.1 ±3.1 mm, stone area 47.3 ±30.8 mm² and SSD 8.4 ±1.8 cm. Patients were divided into two groups. The first group consisted of patients who achieved an SFR ≤3 mm after single ESWL procedure (group ESWL 1^st, n = 42), the second group were patients who needed more than one ESWL procedure to achieve the SFR (group ESWL n^th, n = 60). Statistically significant predictors of single-treatment success were stone size (7.9 ±2.2 mm vs 10.0 ±3.4 mm, p <0.001), stone area (34.1 ±19.4 mm² vs 56.6 ±33.9 mm², p <0.001), and SSD (7.2 ±1.3 cm vs 9.3 ±1.7 cm, p <0.001). The Linear Discriminant Analysis model (LDA) achieved a mean predictive accuracy of ~70%. The final nomogram identified the highest probability of single-treatment ESWL success for SSD ≤8 cm and stone area ≤60 mm², in all locations except for stones in the lower kidney pole.</p><p><strong>Conclusions: </strong>Using machine learning we have introduced the nomogram predicting single treatment success rate of an ESWL procedure. The application of this ML-nomogram in clinical practice enables the nomogram to continuously improve and refine its outputs as new data become available.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 4","pages":"540-545"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulatory T cells in non-muscle invasive bladder cancer: Immune modulators, prognostic markers, and therapeutic targets.","authors":"Dimitrios Diamantidis, Georgios Tsakaldimis, Stilianos Giannakopoulos, Alexandra Giatromanolaki, Evangelia Deligeorgiou, Stavros Lailisidis, Christos Kalaitzis","doi":"10.5173/ceju.2025.0036","DOIUrl":"https://doi.org/10.5173/ceju.2025.0036","url":null,"abstract":"<p><strong>Introduction: </strong>Non-muscle invasive bladder cancer (NMIBC) is characterized by a high recurrence rate and variable response to intravesical Bacillus Calmette-Guérin (BCG) therapy. Regulatory T cells (Tregs), a specialized subset of CD4+ T lymphocytes expressing FOXP3, play a crucial role in shaping the tumor immune microenvironment by suppressing anti-tumor immune responses. Their presence in NMIBC has been associated with both immune evasion and, paradoxically, potential protective effects under specific conditions.This review examines the role of Tregs in NMIBC, focusing on their impact on the tumor microenvironment, prognosis, and therapeutic potential.</p><p><strong>Material and methods: </strong>A literature review was conducted using PubMed to analyze studies on Tregs in NMIBC, including their immunosuppressive mechanisms and therapeutic targeting strategies.</p><p><strong>Results: </strong>Tregs suppress anti-tumor immunity through cytokine secretion (interleukin-10, tumor growth factor β), metabolic adaptations, and inhibition of CD8+ T cells. High FOXP3+ Treg levels are associated with increased recurrence and progression, particularly post-BCG. PD-L1+ Tregs contribute to BCG resistance, making them a potential target for immune checkpoint inhibitors and combination therapies.</p><p><strong>Conclusions: </strong>Tregs are key modulators of NMIBC progression and treatment response. Targeting their suppressive functions may enhance immunotherapy outcomes and improve patient prognosis.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 4","pages":"462-469"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential of gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography as a main diagnostic tool in prostate cancer staging.","authors":"Oleksii Pisotskyi, Piotr Petrasz, Piotr Zorga, Marcin Gałęski, Paweł Szponar, Krzysztof Koper, Katarzyna Brzeźniakiewicz-Janus, Tomasz Drewa, Krzysztof Kaczmarek, Michał Cezary Czarnogórski, Jan Adamowicz","doi":"10.5173/ceju.2025.0014","DOIUrl":"https://doi.org/10.5173/ceju.2025.0014","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate cancer (PC) remains a significant global health burden, necessitating accurate staging for optimal treatment planning. Conventional imaging methods, including multiparametric magnetic resonance imaging (mpMRI), computed tomography (CT), and bone scintigraphy (BS), exhibit limitations in sensitivity and specificity. Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography (⁶⁸Ga PSMA-PET/CT) has emerged as a promising alternative, with potential advantages in staging accuracy.</p><p><strong>Material and methods: </strong>A comprehensive review of current literature was conducted to assess the role of ⁶⁸Ga PSMA-PET/CT in primary PC staging. The diagnostic performance of PSMA-PET/CT was compared with conventional imaging techniques in detecting locoregional and distant metastases. Studies evaluating sensitivity, specificity, and clinical utility in treatment decision-making were analyzed.</p><p><strong>Results: </strong>⁶⁸Ga PSMA-PET/CT demonstrated superior sensitivity and specificity in detecting lymph node and distant metastases compared to conventional imaging. It enables earlier and more precise disease staging, potentially reducing the need for multiple imaging modalities. Emerging evidence suggests its role in guiding therapeutic strategies, particularly in high-risk and recurrent PC cases. Despite its advantages, limitations such as accessibility, cost, and occasional false-negative findings must be considered.</p><p><strong>Conclusions: </strong>⁶⁸Ga PSMA-PET/CT represents a transformative diagnostic tool for PC staging, offering enhanced accuracy compared to traditional imaging. Its integration into clinical practice could streamline diagnostic pathways, improve treatment selection, and potentially optimize patient outcomes. Further research and cost-effectiveness analyses are needed to establish its widespread implementation.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"52-60"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of gabapentin in the management of neurogenic overactive bladders: A systematic review.","authors":"Roshan Chanchlani, Ketan Mehra, Pramod K Sharma, Sudarsan Agarwal, Amit Gupta, Reyaz Ahmad, Rakesh Mishra, Amit Agarwal, Suresh Kumar Thanneeru","doi":"10.5173/ceju.2024.0125","DOIUrl":"https://doi.org/10.5173/ceju.2024.0125","url":null,"abstract":"<p><strong>Introduction: </strong>Neurogenic lower urinary tract dysfunction is typically managed through a step-up approach, beginning with anticholinergic medications, progressing to Botulinum toxin injections, and surgical interventions. Gabapentin offers a less invasive option, either as an adjunct to anticholinergics or as a standalone therapy. This systematic review examines gabapentin's efficacy and safety in treating neurogenic overactive bladders (NOAB) in both paediatric and adult populations.To determine gabapentin's effect on reducing bladder pressure, increasing bladder capacity, and alleviating incontinence symptoms in NOAB patients.</p><p><strong>Material and methods: </strong>A systematic search was conducted on PubMed, Scopus, ScienceDirect, and Cochrane to identify studies on gabapentin for NOAB. Articles were sorted according to PRISMA guidelines, and the risk of bias was assessed using the JBI clinical appraisal tool. Data from the selected articles were synthesized qualitatively.</p><p><strong>Results: </strong>Of the 116 identified articles, 6 were selected. Two focused on paediatric patients with neural tube defects, while four studies involved adults with conditions like spinal trauma, Parkinson's disease, and multiple sclerosis. Urodynamic parameters improved in four studies, whether gabapentin was used alone or as an adjunct. All 6 studies reported significant improvements and minimal side effects.</p><p><strong>Conclusions: </strong>While limitations in dosages and study durations hinder a definitive endorsement of gabapentin, the overall positive response across studies suggests its potential efficacy in managing NOAB. Further high-quality randomized controlled trials comparing gabapentin with other treatments and exploring factors related to non-responsiveness are warranted for conclusive insights.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"61-69"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Kaczmarek K, Jankowska M, Kalembkiewicz J, et al. Assessment of the incidence and risk factors of postoperative urosepsis in patients undergoing ureteroscopic lithotripsy. Cent European J Urol. 2024; 77: 122-128.","authors":"Akif Erbin, Bilal Kaya, Halil Lutfi Canat","doi":"10.5173/ceju.2024.0257","DOIUrl":"https://doi.org/10.5173/ceju.2024.0257","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"100-101"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal and ureteral temperatures changes during ureteroscopic pulsed thulium: YAG laser lithotripsy: an <i>in vitro</i> analysis.","authors":"Felipe Urrea, José M Villena, Matias Larrañaga, José Antonio Salvadó","doi":"10.5173/ceju.2024.0177","DOIUrl":"https://doi.org/10.5173/ceju.2024.0177","url":null,"abstract":"<p><strong>Introduction: </strong>Promising studies have shown a high stone-free rate achieved with the pulsed solid-state thulium YAG laser. However, studies on its safety concerning temperature effects during activation remain limited. The aim of this study was to characterize temperature variations during laser activation.</p><p><strong>Material and methods: </strong>This <i>in vitro</i> experimental study utilized a high-fidelity uretero-renal simulation model to assess temperature changes during intracorporeal laser lithotripsy. Temperatures reached after laser activation at 15, 20, and 30 seconds were recorded. The flow rates used were 10 ml/min and 20 ml/min. The maximum allowed temperature was set at 43°C, given its association with thermal tissue damage. A linear logistic regression model was used to analyze variations and project temperature behavior over time.</p><p><strong>Results: </strong>In the renal model, temperature increases were correlated with the applied energy. With a 10 ml/min flow rate, no laser configuration exceeded 43°C at 15 seconds; at 20 seconds, only the 30 W (2.5 J/20 Hz) configuration exceeded this temperature. By 30 seconds, all 30 W configurations exceeded 43°C, except for 0.4 J/75 Hz. With a 20 ml/min flow rate, no laser configuration exceeded 43°C. The 20 ml/min flow rate decreased renal temperature by 1.96°C (p = 0.01). In the ureteral model, the temperature increase was not proportional to the applied energy, but in no scenario the temperatures reach the 43°C.</p><p><strong>Conclusions: </strong>The temperature variations observed in this study with the use of the pulsed solid-state thulium YAG laser should be considered to avoid potential renal and ureteral thermal damage.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"70-76"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Rezum water vapor therapy for benign prostate obstruction with 1-year follow-up: Largest real-world data from Turkey.","authors":"Basri Cakiroglu, İsmail Cenk Acar, Bekir Sami Uyanık","doi":"10.5173/ceju.2024.0224","DOIUrl":"10.5173/ceju.2024.0224","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to retrospectively assess the safety and efficacy of Rezum, a promising minimally invasive treatment method for BPH, in patients treated at our clinic.</p><p><strong>Material and methods: </strong>From January 1, 2022, to December 31, 2022, a cohort of 71 patients presenting with moderate to severe lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) were enrolled in the study. These individuals opted for Rezum therapy as their treatment approach. Primary outcome measures included the International Prostate Symptom Score (IPSS), maximum flow rate (Q_max), post-void residual volume (PVR), Quality of Life (QoL), prostate volume (PV), prostate-specific antigen (PSA), and the International Index of Erectile Function (IIEF) questionnaire.</p><p><strong>Results: </strong>The median age of the 71 patients was 62.1 ±9.3 years, with a median PV of 60.4 ±16.6 ml. Preoperatively, IPSS was 21.9 ±5.2, Q_max was 9.67 ±3.2, QoL was 3.35 ±0.61, IIEF-5 was 23.9 ±5.4, total PSA was 2.43 ±1.27 ng/ml, and PVR was 177.4 ±216.5 ml. At the 3-month follow-up, IPSS improved to 10.1 ±5.6, Q_max to 24.5 ±3.7, QoL to 1.2±0.51, IIEF-5 to 24.5 ±5.4, total PSA to 1.8 ±0.9 ng/ml, and PVR remained at 177.4 ±216.5 ml. At the 12-month follow-up, IPSS was 6.0 ±3.1, Q_max was 18.12 ±3.7, QoL was 1.2 ±0.51, IIEF-5 was 24.5 ±5.4, total PSA was 1.8 ±0.9 ng/ml, and PVR was 24.9 ±25.2 ml.</p><p><strong>Conclusions: </strong>Rezum therapy is a safe, effective, and minimally invasive option for the treatment of men with moderate to severe lower urinary tract symptoms (LUTS).</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 2","pages":"144-150"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Holmium laser enucleation of the prostate: Learning curve analysis and comparison with TURP.","authors":"Tarik Emre Sener, Turker Altuntas, Yasir Sahak, Kader Ada Dogan, Omer Faruk Asker, Yusuf Senoglu, Haydar Kamil Cam","doi":"10.5173/ceju.2025.0071","DOIUrl":"https://doi.org/10.5173/ceju.2025.0071","url":null,"abstract":"<p><strong>Introduction: </strong>Benign prostatic obstruction (BPO) is a prevalent cause of lower urinary tract symptoms (LUTS), traditionally managed with transurethral resection of the prostate (TURP). However, advances in technology, particularly holmium laser enucleation of the prostate (HoLEP), offer an alternative approach. Our aim was to compare the outcomes of HoLEP, during both the surgeon's learning and expert phases, to TURP, assessing perioperative safety, efficacy, and functional recovery.</p><p><strong>Material and methods: </strong>This prospective study included 200 men with BPO-related LUTS, divided into three groups: group 1: TURP (n = 100), group 2: HoLEP during the learning curve (n = 50), and group 3: post-learning curve (n = 50). Outcomes analyzed included learning curve analysis, IPSS, QoL, Q_max, PVR, surgical efficiency, and complication rates. Postoperative outcomes were assessed at 1 and 6 months.</p><p><strong>Results: </strong>The HoLEP learning curve reached a plateau around case 30, and improved after case 50. Group 3 demonstrated significantly better outcomes in surgical efficiency and functional recovery compared to groups 1 and 2. Enucleation efficiency in group 3 was higher, and the operative time was shorter. Postoperatively, the Q_max, IPSS and PVR improved significantly across all groups but were highest in group 3, followed by group 2 and group 1. Regarding safety, group 3 had the lowest complication rates, with significantly less frequent postoperative bleeding. Catheter removal time was slightly shorter in group 2 compared to both groups 1 and 3.</p><p><strong>Conclusions: </strong>HoLEP, especially after overcoming the learning curve, provides better perioperative safety, greater efficiency, and improved functional outcomes compared to TURP, making it a highly effective treatment.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 4","pages":"511-521"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}