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Introduction: This study aimed to evaluate the safety and efficacy of HoLEP in patients aged > 85 years with indwelling catheter (IDC). Methods: We retrospectively analyzed our bicentric HoLEP database to identify consecutive patients with IDC and trial without catheter (TWOC) failure who underwent surgery between June 2012 and April 2020. Our primary focus was on the population over 85 years of age; Patients under 70 years of age were used as controls. We evaluated the rate of postoperative spontaneous micturition, adverse events and mortality, as well as catheterization duration, hospital stay, and rate of urinary incontinence. Results: In total, 144 patients were included, with 71 (49.3%) and 73 (50.8%) in the ≥ 85 and control group, respectively. The median [IQR] prostatic volume and Charlson score was 90 [70–130] vs. 90 [65–120] mL and 6 [5–7] vs. 3 [2–4] in the ≥ 85 and control groups, respectively. Postoperatively, the rates of major complications (2% vs. 3%) and transfusion (11% vs. 9%) were not significantly different. The median length of stay (2 [1–3] vs. 1 [1–2]; p = 0.03) and rate of TWOC failure during hospitalization (24% vs. 5%, p < 0.001) were significantly higher in the ≥ 85 group. At 3 months and one year follow-up visits, 0 and 10 patients (14.1%) in the ≥ 85 group and 0 and 2 patients (3%) in the control group died, respectively. One year after surgery, 69 (97%) and 73 (100%) (p = 0.2) patients in the ≥ 85 and control groups, respectively, could void spontaneously. Conclusion: HoLEP is a safe and effective procedure for elderly patients with indwelling catheters. At one year, 97% of patients achieved spontaneous voiding, while the urinary incontinence rate was 11%. The 1-year mortality rate was 14%, comparable to that of the general male population of the same age. [ABSTRACT FROM AUTHOR]

Background/Objectives: This multicentric study aimed to evaluate the efficacy and safety of prostatic artery embolization (PAE) to remove indwelling urinary catheter (IUC) in patients with symptomatic benign prostatic hyperplasia (BPH). Secondary objectives were to identify features associated with post-PAE catheter-free survival (PCFS). Methods: All consecutive patients who underwent PAE for IUC related to BPH with a follow-up of at least 2 years (except for early death) in 6 French University Hospitals were retrospectively included. Clinical efficacy was defined as the removal of the IUC after PAE (through a trial without catheter [TWOC]) and evaluated at regular intervals. Chi-square tests, Wilcoxon tests and multivariable binary logistic regressions were utilized to investigate predictors of TWOC success. Univariable and multivariable Cox regressions were utilized to investigate predictors of PCFS in patients with TWOC success. Results: 140 men with IUC (median age: 82.5 years, interquartile range [IQR] = 73–88.2 years, range: 46–100) who underwent PAE between January 2017 and March 2021 were included. Initial successful catheter removal (TWOC success) following PAE occurred in 113/140 (80.7%) patients, and 3/140 (2.1%) patients encountered major complications. In patients with TWOC success, PCFS at 6 months, 1 year and 2 years were 87.5% (95%CI: 81.4–94.1), 84.4% (95%CI: 77.7–91.7) and 79% (71.3–87.4), respectively. No independent predictive factors for TWOC success and PCFS were identified. Conclusions: PAE should be considered as a safe option with good clinical efficacy in the short and long term for elderly and inoperable patients with IUC due to symptomatic BPH. [ABSTRACT FROM AUTHOR]

Background/Objectives: MRI-guided focal laser ablation (MRI-FLA) is an emerging minimally invasive technique for treating localized prostate tumors, aiming to provide effective cancer control while minimizing side effects. This meta-analysis systematically evaluates the clinical outcomes, technical efficacy, and complication rates associated with MRI-FLA to better understand its therapeutic potential and safety profile in prostate cancer management. Methods: In July 2024, PubMed (MEDLINE) was searched for eligible trials using the PRISMA guidelines. The primary outcome was residual disease (RD). The secondary outcomes were technical efficacy, progression to metastatic disease, cancer-specific mortality, complications, and decreases in the prostate-specific antigen (PSA) level. Results: Nine clinical trials involving 296 patients with prostate tumors treated via MRI-FLA were analyzed. A random effects model showed that the overall RD prevalence after ablation was 20.37% (12.56–29.28%; p = 0.03) and the cancer-free survival rate was 75.62% (64.88–85.10%). The rate of major and minor adverse effects was 14.26% (0.61–37.3%, p < 0.01). Conclusions: MRI-FLA is safe, feasible, and effective, although further trials are required. [ABSTRACT FROM AUTHOR]

Bladder cancer remains a prevalent and challenging malignancy. Myeloid-derived suppressor cells (MDSCs) have emerged as key contributors to the immunosuppressive tumor microenvironment, facilitating tumor progression, immune evasion, and resistance to therapies. This review explores the role of MDSC in bladder cancer, highlighting their involvement in immune regulation; tumor progression; and resistance to therapies such as bacillus Calmette–Guérin (BCG) therapy, chemotherapy, and immune checkpoint inhibitors (ICIs). We also discuss their potential as biomarkers and therapeutic targets, with current evidence suggesting that targeting MDSCs, either alone or in combination with existing treatments such as BCG and ICIs, may enhance anti-tumor immunity and improve clinical outcomes. However,, challenges remain, particularly regarding the identification and therapeutic modulation of MDSC subpopulations. Further research is warranted to fully elucidate their role in bladder cancer and to optimize MDSC-targeted therapies. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer is an example of the undervaluation of clinical examinations in care of patients. After external radiotherapy, cancer recurrence is primarily determined biologically by measuring prostate-specific antigen concentration. Consequently, there is no systematic requirement for the digital rectal examination (DRE). Nevertheless, research has shown that patients attach both practical and symbolic significance to being examined by their physicians. This study aimed to assess how patients perceive DRE omission after prostate cancer radiation therapy., Materials and Methods: We conducted a survey of 107 men in remission after radiotherapy for prostate cancer in the Radiotherapy Oncology Department of Bordeaux University Hospital, France. The aim of the survey was to assess the significance that patients place on undergoing a DRE as part of their follow-up care, both from a practical perspective (medical relevance) and a symbolic perspective (influence on the perception of the treating radiation oncologist)., Results: Despite receiving information on the lack of relevance of DRE during follow-up, 40 of the 100 respondents still perceived a practical benefit of undergoing DRE (pragmatic dimension). On a symbolic level, many patients associated the performance of DRE by their radiotherapy oncologist with impressions of competence, concern for their health and concern for them personally (61%, 63% and 64%, respectively). Although the correlations between the pragmatic and symbolic dimensions were significant, more than one-third of patients who understood the lack of clinical relevance of DRE still attributed symbolic value to it., Conclusions: A positive perception of DRE persists among patients, mainly at the symbolic level, including a proportion of patients who understand the low clinical utility of DRE. Importantly, the persistence of these perceptions regarding DRE should not be misconstrued as justification for performing pelvic examinations without clear clinical reasons., (© 2025 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

Background: Complete responses to immunotherapy in metastatic kidney cancer have led to a renewed interest in primary-site surgery. The prolonged survival of these patients has prompted consideration for nephron-sparing surgery when technically feasible. Given the surgical difficulties reported in the literature, it is essential to assess the feasibility as well as functional and oncological results of partial nephrectomy (PN) after immunotherapy., Methods: Multicentric retrospective study based on UroCCR database, including all metastatic patients who underwent PN after a complete response to immunotherapy at metastatic sites. Morbidity, renal function, positive margin rate, and oncological outcomes were assessed., Results: Thirteen patients underwent PN after immune checkpoint inhibitor (ICI), between January 2019 and September 2023. Median age at surgery was 64 [50-68]; 84.6% received ICI as first-line treatment with a median duration of 11.7 [7.7-14.9] months. None of the patients had positive surgical margins, five patients (38.5%) were ypT0. Two patients (15.4%) presented intraoperative complications and 1 a severe postoperative complication. Median GFR at 3 months was 84.7 [66.6-95.2] mL/min/1.73 m2 with no significant difference from preoperative GFR. After surgery, immunotherapy was not reintroduced in ten patients (77%). Median follow- up was 25.6 [19.6-30.2] months, median treatment-free survival was 22.4 [15.8-34.7] months. RFS at 12 months and at last follow-up were 84.6% and 53.8%. OS rate at last follow-up was 92.3%., Conclusion: This series demonstrates the feasibility of partial nephrectomy following immune checkpoint inhibitor treatment, with acceptable morbidity rates and no major difficulties specifically attributable to the prior treatment. While the data suggest promising functional and oncological outcomes, further investigation is needed. The study underscores the importance of early re-evaluation of metastatic cases in multidisciplinary tumor boards., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)