Background/Objectives: To assess the incidence and factors associated with urethral stricture following monopolar transurethral resection of the prostate (mTURP) and open simple prostatectomy (OSP) over a 21-year period. Methods: We conducted a retrospective cohort study of adult male patients insured by Clalit Health Services in Israel, who underwent either mTURP or OSP at multiple centers. Key baseline characteristics, including age, body mass index (BMI), socioeconomic status, Charlson comorbidity index score, and the incidence of urethral stricture, were collected. Postoperative urethral strictures were identified using the ICD-10 code N35.9 (urethral stricture, unspecified). Results: Between January 2000 and December 2021, 54,872 patients underwent simple prostatectomy across 29 hospitals, with 43,525 (79%) undergoing mTURP and 11,347 (21%) undergoing OSP. The median age of patients undergoing mTURP was 73.6 years, while those undergoing OSP had a median age of 72.1 years (p < 0.0001). The incidence of urethral strictures was 1.15% (500) following mTURP and 0.538% (61) following OSP, with an incidence rate ratio (IRR) of 2.139 (p < 0.0001). On multivariable analysis, factors associated with the development of urethral stricture included the type of procedure (HR = 2.349, 95% CI: 2.081–2.653, p < 0.0001), older age at surgery (HR = 1.012, 95% CI: 1.007–1.018, p < 0.0001), higher Charlson Index score (HR = 1.128, 95% CI: 1.109–1.148, p < 0.0001), and lower BMI (HR = 0.990, 95% CI: 0.982–0.999, p = 0.027). Conclusions: Our study highlights a higher incidence of urethral stricture following mTURP compared to OSP. Additionally, older age and a higher Charlson comorbidity index were associated with increased risk of stricture development postsurgery.

Introduction: This study directly compared the real-world effectiveness of bevacizumab, aflibercept 2 mg, and ranibizumab as first-line treatments for neovascular age-related macular degeneration (nvAMD). Methods: A multicenter retrospective cohort of treatment-naïve nvAMD eyes managed with a treat-and-extend regimen in Israel and Canada. Primary outcomes were changes in visual acuity (VA) and central retinal thickness (CRT). Secondary outcomes included treatment burden (total injections and final maintained interval), non-response (persistent/worsening exudation or functional decline despite adequate treatment), non-extension (final interval of 4 weeks), and absence of active exudation. Results: A total of 322 eyes received bevacizumab (n = 174), aflibercept (n = 110), or ranibizumab (n = 38) over a mean follow-up of 16.75 ± 12.66 months. Mean VA improved from 0.77 ± 0.47–0.60 ± 0.45 logarithm of the minimum angle of resolution following an average of 10.5 ± 6.3 injections. Aflibercept produced greater CRT reduction (−51.94 μm; p < 0.001), fewer injections (−2.35; p = 0.001), longer final intervals (+2.14 weeks; p < 0.001), and lower odds of non-response (adjusted odds ratio [aOR] 0.016; p < 0.001) and non-extension (aOR 0.128, p < 0.001) versus bevacizumab. It showed the largest mean VA gain, just short of significance on multivariable analysis (p = 0.059). Ranibizumab showed greater CRT reduction (−44.53 μm; p = 0.012) and lower non-extension odds (aOR 0.079; p = 0.001) than bevacizumab but did not significantly reduce treatment burden or improve VA. Conclusion: In this first real-world, head-to-head comparison, aflibercept and ranibizumab outperformed bevacizumab in key anatomic and treatment-efficiency outcomes, with aflibercept showing the most consistent advantages. These findings highlight clinically relevant differences among anti-vascular endothelial growth factor agents and underscore the importance of real-world data to guide nvAMD management.

Background/Objectives: We aimed to evaluate nonadherence to topical glaucoma therapy and identify risk factors for repeated prescription fulfillment failure in a large national population-based cohort. Methods: The electronic medical records from a large health maintenance organization were retrospectively reviewed for all patients aged 18 years or older with a diagnosis of glaucoma from 2000 to 2023. Data on patients who had purchased at least one anti-glaucoma medication were retrieved. Compliance was defined as prescription fulfillment within predefined expiration windows of 1, 2, and 3 months. Repeated nonadherence was defined as three unfulfilled prescriptions within a 3-month expiration window. Multivariable Cox proportional hazards models were used to identify risk factors for repeated failure. Results: Among 40,200 treated patients, ≥80% cumulative prescription fulfillment was achieved in 80.3% of the population under a 3-month expiration definition. Under a strict 1-month definition, the incidence rate of the third compliance failure was 335 per 1000 person-years. In multivariable Cox analysis, obesity (HR 1.37, 95% CI 1.29–1.45) and current smoking (HR 1.07, 95% CI 1.04–1.11) were independently associated with increased risk of repeated failure. Older age (≥70 years: HR 0.73, 95% CI 0.62–0.87) and higher baseline intraocular pressure (≥25 mmHg: HR 0.65, 95% CI 0.61–0.68) were associated with reduced risk. Initiation with prostaglandin analogs was associated with lower hazard compared with alpha-2 adrenergic agonists (HR 0.53, 95% CI 0.49–0.57), whereas treatment alterations (≥3 changes) were associated with increased hazard (HR 1.64, 95% CI 1.39–1.95). Conclusions: Repeated nonadherence to topical glaucoma therapy is common and is associated with identifiable behavioral and treatment-related factors. Recognition of patients at elevated risk may support targeted strategies to enhance long-term treatment stability.