Purpose: Urinary incontinence (UI) is a common complication after radical prostatectomy (RP), adversely affecting patients’ quality of life. This study aimed to evaluate the efficacy and safety of high-intensity focused electromagnetic (HIFEM) therapy as a non-invasive treatment for post-prostatectomy UI. Patients and Methods: Twenty-seven men (mean age ± SD: 67.9 ± 3.4 years) with persistent UI after RP underwent six HIFEM sessions (28 min, twice weekly) using the BTL EMSELLA^® chair. Outcomes were assessed after the sixth session and at one-month follow-up. Primary endpoints were changes in International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF) scores and daily pad use. Results: Baseline mean ICIQ-SF score was 10.58 ± 4.15. This decreased to 5.43 ± 3.85 after treatment and to 4.16 ± 3.97 at one month, representing improvements of 53.1% and 60.6%, respectively (both p < 0.005). Daily pad use declined from baseline to 1.45 ± 1.54 after treatment and 1.13 ± 1.81 at follow-up (both p < 0.001). No adverse events were reported. Conclusion: HIFEM therapy significantly improved UI severity and reduced pad dependence in men with post-prostatectomy incontinence, with effects sustained for at least one month and no observed side effects. These findings support HIFEM as a safe, non-invasive treatment option warranting further study in larger, long-term trials.

Introduction: This study aimed to evaluate the relationship between postoperative systemic inflammatory response syndrome (SIRS) and a broad set of 30 commonly used clinical parameters, along with novel acute inflammation predictive indices such as the systemic immune-inflammation index (SII), the aggregate index of systemic inflammation (AISI), and the systemic inflammation response index (SIRI), in patients undergoing percutaneous nephrolithotomy (PCNL). Methods: A total of 233 patients aged 18– 75 years who underwent PCNL were prospectively included. All clinical variables and serum-based inflammatory indices, including SII, SIRI, and AISI, were prospectively pre-defined in the study protocol prior to patient enrollment. All patients had sterile preoperative urine cultures and no known disease that could cause fever. Clinical characteristics, operative findings, laboratory parameters, and serum-based inflammatory indices (SII, SIRI, AISI) were recorded. The median preoperative stone size was 270.0 mm² (IQR: 180.0– 447.0). Stone-free rates and postoperative SIRS development were assessed. Multivariate logistic regression analysis was used to determine independent predictors of SIRS. ROC analyses were conducted to evaluate the predictive performance of inflammatory indices. Results: The clinically significant stone-free rate was 89.3% (208/233), while the complete stone-free rate was 79.1% (182/233). Postoperative SIRS occurred in 75 patients (32.1%). According to multivariate logistic regression analysis, operation position, residual stone, white blood cell count (10³/μL), serum hemoglobin drop (g/dl), amount of physiological serum used (L), and positive renal pelvis urine culture were independently associated with SIRS. Inflammatory indices calculated from serum values, including SII, SIRI, and AISI, were directly associated with SIRS. ROC analysis demonstrated a moderate correlation between these indices and SIRS. Discussion: The findings of this prospective study indicate that postoperative SIRS risk can be predicted preoperatively and intraoperatively using a combination of commonly utilized clinical parameters and serum-based inflammatory indices. Higher values of SII, SIRI, and AISI were moderately predictive of SIRS development. Identifying high-risk patients prior to or during PCNL may help clinicians implement early preventive strategies and optimize postoperative management.

It has been more than a decade since fusion prostate biopsy (FPB) has been used in the diagnosis of prostate cancer (PCa). Therefore, patients with a previous history of negative FPB and ongoing suspicion of PCa are beginning to emerge. This study investigated whether the first biopsy type (standard or fusion) should be effective in deciding on a second biopsy. Male patients aged 40–75, with a serum prostate-specific antigen (PSA) value of less than 10 ng/mL and a negative biopsy history within the last 24 months, who underwent FPB in our clinic due to persistent PSA elevation and/or suspicious multiparametric prostate magnetic resonance imaging (MpMRI) findings were included to the study. Patients were divided into groups according to the type of first biopsy (Group 1; those whose first biopsy was FPB, Group 2; those whose first biopsy was standard prostate biopsy). Some demographic and clinical data of the groups, as well as PCa detection rates, were compared. A p value of less than 0.05 was considered statistically significant. A total of 275 patients (Group 1: 84, Group 2: 191) were included in this study. The groups were similar in terms of age, PSA values before the first biopsy, PSA values before the second biopsy, family history of PCa, and prostate volume. PCa was detected at a higher rate in Group 2 than Group 1 (23% vs 15.5%, p = 0.044). The data obtained from this study indicate that the type of initial biopsy should be taken into account when deciding on FPB in secondary patients with a previous negative biopsy history.