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Aim: Rezūm is a novel treatment for patients with moderate to severe lower urinary tract symptoms as a result of benign prostatic hyperplasia (BPH). Recently, it has expanded to patients with urinary retention causing catheter dependence and the results are promising in Whites. However, it is unclear how effective Rezūm is in the Chinese population. Here, we report our experience in performing Rezūm on catheter‐dependent Chinese men with BPH and evaluate its safety and efficacy. Methods: A retrospective review of catheter‐dependent patients with BPH who underwent Rezūm from January to August 2022 was conducted. We evaluated the success rate of trial without catheter (TWOC) and compared pre‐ and post‐operative (at 6 months) uroflowmetry results, International Prostate Symptoms Score (IPSS), IPSS Quality of Life Score (IPSS QoL), and prostate volume. Results: Sixty‐three patients had Rezūm performed (44 and 19 patients had refractory urinary retention and obstructive uropathy, respectively) with a mean age of 74 years and a mean prostate size of 53.9 mL. The first attempt at TWOC was successful in 53 patients (85.5%; range 15–44 days post‐operation). By 98 days after the operation, all patients could void spontaneously. The 6‐month follow‐up showed that IPSS and IPSS QoL scores decreased by a mean of 9.0 and 1.8 points, respectively (both P <.01). The mean pre‐operative post‐voided residual urine was reduced by 559 mL (P <.01), with a mean prostate size reduction of 9.4 mL (P <.01). Seven patients had non‐serious complications (Grade 1–2 Clavien–Dindo classification) within 30 days of operation. Conclusion: Rezūm was shown to be effective and safe in catheter‐dependent Chinese men with BPH. [ABSTRACT FROM AUTHOR]

Objective: Proximal ureteric stricture is one of the many challenging problems urologists face. We aim to evaluate the results of buccal mucosal graft ureteroplasty at our institution. Methodology: All buccal mucosal graft ureteroplasties performed at the Princess Margaret Hospital, Hong Kong, between December 2020 and July 2022 were reviewed. This review included patients with ureteric strictures of different aetiologies and various stricture lengths. Collected data consisted of patients' demographics, previous interventions, surgical approach, early and intermediate outcomes. Results: Six patients (median age 59.5 years) were included in this case series. Four had previously failed ureteral interventions. Pre‐operatively four had ureteral stents and two were on nephrostomy tubes. Five had a robotic‐assisted laparoscopic repair while one had an open repair. Onlay graft was performed in five patients and augmented anastomotic repair in one patient. The median stricture length was 2 cm. Median operative time was 268 min, estimated blood loss was 200 mL, and length of stay was 7.5 days. Four patients with adequate follow‐up were considered successful at a median follow‐up of 13.7 months. There were no intra‐operative complications. Anastomotic leakage and donor site bleeding were observed in one patient (Clavien‐Dindo III). Conclusion: Buccal mucosal graft ureteroplasty is suitable in appropriately selected patients with proximal ureteral strictures. Robotic surgical approaches have made this technique promising. Long‐term outcomes are eagerly awaited. [ABSTRACT FROM AUTHOR]

We aim to evaluate prostate health index as an additional risk-stratification tool in patients with Prostate Imaging Reporting and Data System score 3 lesions on multiparametric magnetic resonance imaging. Men with biochemical or clinical suspicion of having prostate cancer who underwent multiparametric magnetic resonance imaging in two tertiary centers (Queen Mary Hospital and Princess Margaret Hospital, Hong Kong, China) between January 2017 and June 2022 were included. Ultrasound-magnetic resonance imaging fusion biopsies were performed after prostate health index testing. Those who only had Prostate Imaging Reporting and Data System score 3 lesions were further stratified into four prostate health index risk groups and the cancer detection rates were analyzed. Out of the 747 patients, 47.3% had Prostate Imaging Reporting and Data System score 3 lesions only. The detection rate of clinically significant prostate cancer in this group was 15.0%. The cancer detection rates of clinically significant prostate cancer had statistically significant differences 5.3% in prostate health index <25.0, 7.4% in prostate health index 25.0-34.9, 17.9% in prostate health index 35.0-54.9, and 52.6% in prostate health index ≥55.0 (P < 0.01). Among the patients, 26.9% could have avoided a biopsy with a prostate health index <25.0, at the expense of a 5.3% risk of missing clinically significant prostate cancer. Prostate health index could be used as an additional risk stratification tool for patients with Prostate Imaging Reporting and Data System score 3 lesions. Biopsies could be avoided in patients with low prostate health index, with a small risk of missing clinically significant prostate cancer., (Copyright © 2023 Copyright: © The Author(s)(2023).)