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Objective: To perform a systematic review to assess the incidence of transient (<6 months) and persistent (>6 months) stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence (MUI) after transurethral surgeries for benign prostatic hyperplasia. Materials and Methods: A systematic literature search was performed using Embase, PubMed, and Web of Science. We included studies comparing monopolar (M)/bipolar (B) transurethral resection of the prostate (TURP) vs ablation vs enucleation procedures. Incidence of incontinence was assessed using Cochran-Mantel-Haenszel Method and reported as odds ratio (OR), 95% confidence interval (CI), and p-values. Statistical significance was set at p < 0.05 Evidence Synthesis: Twenty-eight studies were included. Incidence of transient SUI was 4.6%, 6.0%, 3.0%, and 2.4% after ablation, enucleation, M-TURP, and B-TURP, respectively. Incidence of persistent SUI was 1.1% after ablation, 1.7% after enucleation and M-TURP, and 1.0% after B-TURP. Incidence of transient UUI was 2.0%, 7.3%, 4.4%, and 2.8% after ablation, enucleation, M-TURP, and B-TURP, respectively. Incidence of persistent UUI was 2.2% after M-TURP. The incidence of transient MUI was 5.1%, 0.8%, 5.4%, and 0.9% after ablation, enucleation, M-TURP, and B-TURP, respectively. Incidence of persistent MUI was 3.1% after ablation and 4.8% after M-TURP. Incidence of transient and persistent SUI and UUI did not differ after TURP vs enucleation. Incidence of transient (OR 3.32, 95% CI 0.41–26.65, p = 0.26) and persistent SUI (OR 4.79, 95% CI 0.52–43.89, p = 0.17) was not significantly higher after ablation. Incidence of transient UUI was not significantly higher after ablation (OR 2.62, 95% CI 0.04–166.01, p = 0.65), whereas persistent UUI did not differ. Incidence of transient MUI was significantly higher after enucleation (OR 3.26, 95% CI 1.51–7.05, p = 0.003). Incidence of transient and persistent MUI did not differ after TURP vs ablation. Conclusions: Ablation, enucleation, and TURP have an impact on all forms of incontinence, but this is transient in most cases with no difference between the groups, except for MUI, which was higher after enucleation vs M-TURP. [ABSTRACT FROM AUTHOR]

Introduction: To date, some data available in literature on simultaneous bilateral endoscopic surgery (SBES) have shown good outcomes in terms of both effectiveness and safety. The aim of this study was to report the outcomes pertaining to the effectiveness and safety of SBES performed in our series of patients with bilateral renal stones. Materials and Methods: A prospective analysis of consecutive patients who underwent SBES for bilateral renal stones at our institution between June 2017 and September 2021 was performed. Routine preoperative and 1-month postoperative work-up included history, physical examination, urinalysis, urine culture, and blood tests, including the evaluation of estimated glomerular filtration rate using the Cockcroft-Gault equation. An abdominal noncontrast CT scan was performed in all cases preoperatively and 1 month postoperatively. Peri-/postoperative complications were reported according to the Clavien-Dindo classification system. The primary endpoint of the study was stone-free rate (SFR), and the secondary endpoints were Clavien-Dindo complications grade 1 or higher. Results: Altogether, 101 patients met the inclusion criteria and were enrolled in the study. SFR for all renal units was achieved in 82 patients (81.1%) at the 1-month follow-up. Twelve patients underwent additional flexible ureteroscopy for residual fragments, and 7 asymptomatic patients with single small residual fragment were observed. Eighteen patients (17.8%) experienced Clavien-Dindo Grade I–II complications, whereas one patient (1%) experienced Clavien-Dindo Grade IIIa complication (renal arteriovenous fistula embolization under local anesthesia). Conclusions: SBES is a safe and effective procedure for the treatment of bilateral renal stones. Further randomized studies with larger populations are needed to confirm these favorable outcomes of SBES to establish it as an alternative to staged surgeries in patients with bilateral renal stones. Appropriate patient selection is of paramount importance for achieving good outcomes without experiencing severe complications. [ABSTRACT FROM AUTHOR]

Background: Systemic inflammatory response syndrome (SIRS) is a dangerous complication after percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). We aimed to review the diagnostic accuracy of midstream urine culture (MSUC), pelvic urine culture (PUC), and stone culture (SC) derived from the same cases to predict SIRS after PCNL and/or RIRS. Materials and Methods: A comprehensive literature search was performed, using MEDLINE, EMBASE, and Cochrane Central Controlled Register of Trials. Sensitivity and specificity were calculated for MSUC, PUC, and SC. The diagnostic odds ratio (DOR) was estimated for each study with a random effect and hierarchical summary receiver operating characteristic (HSROC) model leading to a corresponding 95% confidence interval (CI). Overall test accuracy was measured by finding the area under the curve (AUC). An AUC value >0.70 stands for adequate overall accuracy. Results: The search retrieved 537 articles. After screening, 21 studies involving 5238 patients were included for the meta-analysis. The pooled sensitivity for MSUC was 0.322 (95% CI 0.2228–0.432), and pooled specificity 0.854 (95% CI 0.810–0.889). The DOR was low at 2.780 (95% CI 1.769–4.368), showing poor overall diagnostic accuracy. The pooled sensitivity for PUC was 0.323 (95% CI 0.224–0.440) and specificity 0.931 (95% CI 0.896–0.954). The DOR was 6.377 (95% CI 4.065–10.004), showing a mild overall diagnostic accuracy. The pooled sensitivity for SC was 0.552 (95% CI 0.441–0.658) and specificity 0.847 (95% CI 0.798–0.886). The DOR was 6.820 (95% CI 4.435–10.488), showing mild overall diagnostic accuracy. The AUC for HSROC for MSUC was 0.65, 0.73, and 0.75 for PUC and SC, respectively. Conclusion: MSUC is a poor predictor for postoperative SIRS. PUC or SC should be collected during lithotripsy to better predict the possibility of developing postoperative SIRS after PCNL and RIRS. [ABSTRACT FROM AUTHOR]