We aimed to review the current evidence on surgical and functional outcomes of Transperineal Laser Ablation for LUTS due to BPH. A comprehensive review of the English-language literature was performed using the MEDLINE and Web of Science databases until 1 August 2022, aiming to select studies evaluating TPLA for the treatment of LUTS due to BPH. Additional records were found from Google Scholar. Data were extracted and summarized in Tables. An appropriate form was used for qualitative data synthesis. Seven studies were included in the review, with all being single arm, non-comparative studies. In all studies, functional outcomes were evaluated with uroflowmetry parameters and validated questionnaires, showing a promising effectiveness at short- and mid-term follow-up. There is a lack of standardized pathways for preoperative assessment of patients suitable for TPLA, and even the technique itself has been reported with a few nuances. A good safety profile has been reported by all the authors. Although promising results have been reported by different groups, selection criteria for TPLA and few technical nuances regarding the procedure were found to be heterogeneous across the published series that should be standardized in the future. Further research is needed to confirm these findings.

Purpose: Transperineal laser ablation (TPLA) is a new minimally-invasive surgical treatment for patients with benign prostatic obstruction (BPO). We report the perioperative and mid-term functional results of the first 100 consecutively patients undergoing TPLA at our institution. Methods: Clinical data from consecutive patients undergoing TPLA at our institution from April 2021 to July 2023 were prospectively collected. Primary endpoints were the postoperative changes in IPSS, QoL and MSHQ 3-item questionnaires and in Qmax and post-void residual volume (PVR). Results: Overall, 100 consecutive patients underwent the procedure. Median age and prostate volume were 66 (IQR 60–75) years and 50 (IQR 40–70) ml, respectively. In the cohort, 14 (14%) patients had an indwelling catheter and 81 (81%) were under oral BPO therapy at the time of TPLA. Baseline median Qmax (ml/s) and PVR (ml) were 9.1 (IQR 6.9–12) and 90 (IQR 50–150), respectively, while median IPSS and QoL were 18 (IQR 15–23) and 4 (IQR 3–4). At all the follow-up timepoints, the evaluated outcomes on both symptoms and functional parameters showed a statistically significant improvement (p < 0.001). Antegrade ejaculation was preserved in all sexually active patients. No postoperative Clavien-Dindo > 2 complications were recorded. Conclusions: TPLA represents a safe option for selected well-informed patients swith LUTS due to BPO. Our prospective study confirms the feasibility and favorable perioperative and functional outcomes in a real-world cohort with heterogenous prostate volumes and patient characteristics.

Background: The aim of our study is to evaluate the prevalence and predictive factors of short- (30 d) and mid-term continence in a contemporary cohort of patients treated with robotic-assisted laparoscopic prostatectomy (RALP) without any posterior or anterior reconstruction at our referral academic center. Methods: Data from patients undergoing RALP between January 2017 and March 2021 were prospectively collected. RALP was performed by three highly experienced surgeons following the principles of the Montsouris technique, with a bladder-neck-sparing intent and maximal preservation of the membranous urethra (if oncologically safe) without any anterior/posterior reconstruction. (Self-assessed urinary incontinence (UI) was defined as the need of one or more pads per die (excluding the need for a safety pad/die. Univariable and multivariable logistic regression analysis was used to assess the independent predictors of early incontinence among routinely collected patient- and tumor-related variables). Results: A total of 925 patients were included; of these, 353 underwent RALP (38.2%) without nerve-sparing intent. The median patient age and BMI were 68 years (IQR 63–72) and 26 (IQR 24.0–28.0), respectively. Overall, 159 patients (17.2%) reported early (30 d) incontinence. In multivariable analysis adjusting for patient- and tumor-related features, a non-nerve-sparing procedure (OR: 1.57 [95% CI: 1.03–2.59], p = 0.035) was independently associated with the risk of urinary incontinence in the short-term period, while the absence of cardiovascular diseases before surgery (OR: 0.46 [95% CI: 0.320.67], p ≤ 0.01) was a protective factor for this outcome. At a median follow-up of 17 months (IQR 10–24), 94.5% of patients reported to be continent. Conclusions: In experienced hands, most patients fully recover urinary continence after RALP at mid-term follow-up. On the contrary, the proportion of patients who reported early incontinence in our series was modest but not negligible. The implementation of surgical techniques advocating anterior and/or posterior fascial reconstruction might improve the early continence rate in candidates for RALP.

Despite transrectal prostate biopsy (TRPB) being still widespread globally, the EAU Guidelines strongly recommend the transperineal approach, due to the reported lower infectious risk. Our study aims to evaluate the impact of a standardized clinical pathway for TRPB on post-operative complications. We prospectively collected data from all patients undergoing mpMRI-targeted TRPB at our Academic Centre from January 2020 to December 2022. All patients followed a standardized, structured multistep pathway. Post-procedural complications were collected and classified according to the Clavien–Dindo (CD) Classification. Among 458 patients, post-procedural adverse events were reported by 203 (44.3%), of which 161 (35.2%) experienced CD grade 1 complications (hematuria [124, 27.1%], hematochezia [22, 4.8%], hematospermia [14, 3.1%], or a combination [20, 4.4%]), and 45 (9.0%) reported CD grade 2 complications (acute urinary retention or hematuria needing catheterization, as well as urinary tract infections, of which 2 cases required hospitalization). No major complications, including sepsis, were observed. At uni- and multivariable analysis, age > 70 years and BMI > 25 kg/ m² for patients were identified as predictors of post-operative complications. The results of our study confirm that TRPB is a safe and cost-effective procedure with a low risk of severe adverse events in experienced hands and following a standardized pathway.

Background: Benign prostatic hyperplasia (BPH) is a common condition in men over 50, leading to lower urinary tract symptoms (LUTS). A nutraceutical containing pollen extract (Graminex® G96®) and teupolioside has shown potential in alleviating LUTS by targeting inflammation and dihydrotestosterone production. This prospective, monocentric study enrolled 60 patients with mild to moderate LUTS due to BPH.Methods: Participants received one tablet daily for three months. Assessments included the international prostate symptom score (IPSS), quality of life (QoL), uroflowmetry, postvoid residual (PVR), and sexual function (IIEF-5, MSHQ EjD).Results: Fifty-three patients completed the follow-up. Significant improvements were observed in IPSS and QoL (p0.05). Sexual function and PSA levels remained stable, with no significant adverse effects reported.Conclusions: The combination of pollen extract and teupolioside effectively alleviates LUTS in BPH patients with a favorable safety profile, particularly in avoiding sexual dysfunction.

Background: Peyronie’s disease (PD) is a condition with significant physical, sexual, and psychological impact that is not fully captured by existing Patient-Reported Outcome (PRO) instruments. Aim: To develop and preliminarily validate the PEYROnie’s disease Questionnaire (PEYRO-Q), a novel multidimensional PRO questionnaire designed to provide a comprehensive and inclusive assessment of PD. Methods: A prospective multicenter study was conducted between April and July 2025, enrolling 206 adult patients with PD. The PEYRO-Q, developed in accordance with COSMIN guidelines, includes 10 domains and 12 items assessing deformity severity and stability, pain, penile shortening, sexual function, erectile function, psychological distress, and sexual avoidance. Content validity was established through expert panel review. Internal consistency was evaluated using Cronbach’s alpha, while test–retest reliability was assessed over a 2-week interval. Exploratory Factor Analysis (EFA) with promax rotation was performed to investigate the underlying structure. Outcomes: Primary outcomes were internal consistency, test–retest reliability, and factor structure of the PEYRO-Q. Results: The study population had a median age of 62 years, with most patients reporting moderate penile curvature and long-standing disease stability. The PEYRO-Q demonstrated excellent internal consistency (Cronbach’s α = 0.90) and test–retest reliability (α = 0.89–1.00; Intraclass Correlation Coefficient, ICC up to 0.99). EFA supported a three-factor structure explaining 62.2% of total variance, corresponding to clinical/functional burden, disease perception and evolution, and psychological/behavioral impact. Moderate correlations between domains (eg, erectile aid use and psychological distress, r = 0.41) confirmed related but distinct constructs. The questionnaire allowed detailed and inclusive profiling of sexual function and psychological burden. Clinical Implications: The PEYRO-Q offers a practical, inclusive, and comprehensive tool for assessing PD burden in both clinical practice and research settings. Strengths & Limitations: Strengths include the multidimensional and inclusive design, strong psychometric performance, and multicenter prospective validation. Limitations include the predominantly Italian cohort, lack of longitudinal responsiveness data, absence of direct comparison with existing instruments, and limited clinical characterization such as plaque localization. Conclusion: The PEYRO-Q is a reliable and clinically relevant PRO instrument for PD, warranting further validation to confirm responsiveness and cross-cultural applicability.