Purpose: Residual fragments not removed with urinary stone surgery may become symptomatic. In this context, this study was carried out to investigate the effect of performing retrograde intrarenal surgery, which is conventionally performed in the lithotomy position, in the modified lithotomy position (Trend-side) on stone-free rates following the surgery. Methods: This prospective study consisted of 100 patients with a single kidney stone smaller than 2 cm between 2021 and 2023. These patients were randomized into two groups of 50 patients each to be operated on in the conventional lithotomy and Trend-side positions. Variables were compared using independent t test for continuous variables and chi-square test for categorical variables. Results: There was no significant difference between the lithotomy and Trend-side position groups in terms of preoperative size, density, location of the stone, and hydronephrosis degree. Stone-free rate was 72% (n = 36) in the lithotomy group and 92% (n = 46) in the Trend-side group. Hence, there was a significant difference between the groups in the stone-free rate in favor of the Trend-side group (p = 0.009). Fragmentation time was statistically significantly shorter in the Trend-side group than in the lithotomy group (34 ± 17 min vs. 43 ± 14 min; p = 0.006). There was no significant difference between the groups in postoperative complication rates. Conclusion: Performing retrograde intrarenal surgery in the Trend-side position shortened the duration of fragmentation compared to the lithotomy position and was associated with higher stone-free rates. In conclusion, the Trend-side position can be safely preferred in patients undergoing retrograde intrarenal surgery due to kidney stones.

Purpose: Our aim was to assess the efficacy and safety of Rezum therapy in patients with symptomatic benign prostatic hyperplasia (BPH) in comparison to Holmium laser enucleation of the prostate (HoLEP). Methods: The retrospective study included 338 patients (204 HoLEP and 134 Rezum) operated on for BPH between January 2020 and November 2024. A 1:1 matching of treated patients (Rezum) to HoLEP patients based on the closest propensity score value was conducted for 131 successful matching pairs. The groups were compared regarding; Age, Prostate volume, PSA, Catheter-dependence, Qmax, PVR, IIEF, IPSS, PGI-I, operation time (OT) and hospital time (HS). Results: Concerning perioperative data, there was a statistically significant difference between the Rezum and HoLEP groups regarding OT (8.29 ± 1.21 vs. 68.01 ± 31.01 min; P < 0.001) and HS (1 vs. 2.61 ± 1.53 days; P < 0.001) with higher values for HoLEP. At the same time, the catheter duration was longer in the Rezum group (7.6 ± 2.19 vs. 3.49 ± 1.16 days; P < 0.001). In terms of clinical outcomes, there was a statistically significant improvement in Qmax, IPSS and a decrease in PVR at 12 months for the HoLEP group compared to the Rezum group (16.82 ± 2.27 ml/sn vs. 22.14 ± 7.17 ml/sn, P < 0.001; 12.1 ± 2.1 vs. 7.1 ± 1.9, P < 0.001; 43.05 ± 32.62 ml vs. 29.73 ± 43.73 ml, P = 0.006; respectively). PGI-I scores ( p = 0.620) and antegrade ejaculation ( p < 0.001) were in favour of Rezum therapy. Conclusion: The HoLEP technique demonstrates superior functional outcomes compared to Rezum, particularly in cases with larger prostates. However, Rezum is an ejaculation-sparing technique demonstrating high tolerability, and patient satisfaction even in larger prostates.

Key words: HER2-neu-derived peptide (654-662) [Supplementary Concept]; Serum; Urinary Bladder Neoplasms