ABSTRACT Introduction: The superiority of the functional results of robot-assisted radical prostatectomyis still controversial. Despite this, it is known that minimally invasive surgery obtains better results when analyzing blood loss, blood transfusion and length of stay, for example. Several studies have analyzed the impact of the resident physician's involvement on the results of urological surgeries. The simple learning curve for robot-assisted radical prostate surgery is estimated to be around 10 to 12 cases. Learning curve data for robotic surgeons is heterogeneous, making it difficult to analyze. Rare studies compare the results of a radical prostatectomy of an inexperienced surgeon starting his training in open surgery, with the results of the same surgeon, a few years later, starting training in robotic surgery. Objective: to analyze the results of open radical prostatectomy surgeries (ORP) performed by urology residents, comparing them to the results of robot-assisted radical prostatectomy (RARP), performed by these same surgeons, after completing their training in urology. Materials and methods: a retrospective analysis of the cases of only 3 surgeons was performed. 50 patients underwent ORP (group A). The surgeons who operated on the ORP patients were in the 3rd and final year of the urology residency program and beginners in ORP surgery, but with at least 4 years of experience in open surgery. The same surgeons, already trained urologists, began their training in robotic surgery and performed 56 RARP surgeries (group B). For the comparative analysis, data were collected on age, number of lymph nodes removed, surgery time, hospitalization time, drain volume, drain permanence time, indwelling bladdercateter (IBC) permanence time, positive surgical margin, biochemical recurrence, risk classification (ISUP), intra and postoperative complications, urinary incontinence (UI) and erectile dysfunction (ED). The console used was the Da Vinci Si, from Intuitive®. For statistical analysis, the Shapiro-Wilk test verified that the data did not follow normality, the Levene test guaranteed homogeneity, and the Mann-Whitney test performed the comparative analysis of the quantitative data. For the analysis of qualitative data, the Chi-square test was used for nominal variables and the Mann-Whitney U test for ordinal variables. Additionally, the Friedman test analyzed whether there was an improvement in the perception of UI or ED over the months, for each group individually (without comparing them), and the post-hoc Durbin-Conover test, for the results with statistically significant difference. We used a p-value < 0.05, and the Jamovi® program (Version 2.0). Results: there was no statistically significant difference between the groups for age, number of lymph nodes removed, positive surgical margin, biochemical recurrence, risk classification and urinary incontinence. Additionally, we observed that the surgical time was longer in group B. On the other hand, the length of stay, drain volume, drain time, IBC time, complication rate and levels of erectile dysfunction in the third and sixth months were higher in group A, when compared to group B. We also observed that there was no evolutionary improvement in ED over the months in both groups, and that there was a perception of improvement in UI from the 1st to the 3rd month in group A, and from the 1st to the 6th month, and from the 3rd to the 12th month, in group B. Conclusion: the learning curve of RARP is equivalent to the curve of ORP. In general, the results for the robotic group were better, however, the functional results were similar between the groups, with a slight tendency of advantage for the robotic arm. Introduction robotassisted robot assisted controversial this loss stay example physicians physician s 1 heterogeneous later Objective (ORP residents RARP, , (RARP) methods 5 A. A . A) rd urologists B B) age removed volume (IBC margin recurrence ISUP, ISUP (ISUP) complications (UI ED. (ED) Si Intuitive Intuitive® ShapiroWilk Shapiro Wilk normality homogeneity MannWhitney Mann Whitney Chisquare Chi square Additionally without them, them) posthoc post hoc DurbinConover Durbin Conover pvalue p value 005 0 05 0.05 Jamovi Version 2.0. 20 2.0 2 2.0) Results hand st th Conclusion general however arm (RARP (ISUP (ED 00 0.0 2. 0.

ABSTRACT Purpose: To evaluate the effectiveness of mapping-targeted biopsies (MTB) on the index lesion for the detection of clinically significant prostate cancer (csPCa) in transperineal fusion-image prostate biopsies. Materials and Methods: A retrospective analysis was conducted on 309 men with suspected PCa who underwent prostate biopsies at the Creu Blanca reference center in Barcelona, Spain. The Prostate Imaging-Reporting and Data System (PI-RADS v.2.1) of the magnetic resonance images (MRI) were reclassified by an expert radiologist reading of pre-biopsy biparametric MRI used for segmentation of suspected lesions. Transperineal MTB of suspicious lesions and 12-core systematic biopsies were performed using the Artemis™ platform. CsPCa was defined as International Society of Urological Pathology grade group ≥ 2. Results: CsPCa was detected in 192 men (62.1%), with detection rates of 6.3% for PI-RADS 2, 26.8% for PI-RADS 3, 87.3% for PI-RADS 4, and 93.1% for PI-RADS 5. MTB of the index lesion identified 185 csPCa (96.3%). CsPCa was detected solely in systematic biopsies in three cases (1.6%), while an additional four cases (2.1%) were identified only in the second suspected lesion. A predictive model for csPCa detection in MTB of the index lesion was developed, with an AUC of 0.918 (95% CI 0.887-0.950). Conclusions: This model had the potential to avoid 23.3% of prostate biopsies without missing additional csPCa cases. MTB of the index lesion was highly effective for identifying csPCa in fusion transperineal prostate biopsies. A developed predictive model successfully reduced the need for almost one quarter of biopsies without missing csPCa cases. Purpose mappingtargeted mapping targeted (MTB (csPCa fusionimage image Methods 30 Barcelona Spain ImagingReporting Imaging Reporting PIRADS PI RADS v.2.1 v21 v 2 1 (MRI prebiopsy pre biopsy 12core core 12 Artemis platform Results 19 62.1%, 621 62.1% , 62 (62.1%) 63 6 3 6.3 268 26 8 26.8 873 87 87.3 4 931 93 93.1 5 18 96.3%. 963 96.3% . 96 (96.3%) 1.6%, 16 1.6% (1.6%) 2.1% 21 (2.1% 0918 0 918 0.91 95% 95 (95 0.8870.950. 08870950 0.887 0.950 887 950 0.887-0.950) Conclusions 233 23 23.3 v.2. v2 62.1 (62.1% 6. 26. 87. 9 93. 96.3 (96.3% 1.6 (1.6% 2.1 (2.1 091 91 0.9 (9 8870 0.8870.950 0887095 0887 0.88 0950 0.95 88 0.887-0.950 23. v.2 62. (62.1 96. (96.3 1. (1.6 (2. 09 0. ( 0.8870.95 088709 088 0.8 095 0.887-0.95 v. (62. (96. (1. (2 0.8870.9 08870 08 0.887-0.9 (62 (96 (1 0.8870. 0.887-0. (6 0.8870 0.887-0 0.887-

ABSTRACT Introduction: Urethral stricture is a common, albeit complex, condition that predominantly affects men. The aim of this study was to translate, culturally adapt, and validate the Patient-Reported Outcome Measure questionnaire for patients undergoing urethroplasty (USS-PROM) into Brazilian Portuguese using validated psychometric criteria. Materials and Methods: The process involved translating and culturally adapting the original USS-PROM into Brazilian Portuguese (USS-PROMbr), synthesizing, back-translating, cross-culturally adapting, and analyzing the pre-final version with experts from our committee. This pre-version was administered to 10 patients who had undergone urethroplasty by the Reconstructive Urology team at the Hospital de Clínicas de Porto Alegre for face validation, linguistic, and semantic adjustments, resulting in the final USS-PROMbr version. Subsequently, well-established psychometric criteria, including content validity, internal consistency, and test-retest reproducibility, were assessed after administering the questionnaire to a total of 56 patients, with 50 of them responding to the test and retest. Results: Evaluation of the pre-final version identified 15 questions as clear, and only one question was considered somewhat unclear necessitating modifications based on patient suggestions and subsequent reassessment by the research team. Psychometric criteria demonstrated good content validity, with a content validity index exceeding 0.80 for all questions; good internal consistency, Cronbach's alpha of 0.77, ranging from 0.70 to 0.78 with the exclusion of any item, and item-total correlations ranging from 0.33 to 0.67. The test-retest intraclass correlation coefficient was 0.74 for the lower urinary tract symptoms construct (Q1-Q6). Conclusion: The USS-PROMbr demonstrated acceptable cross-cultural adaptation and psychometric properties, making it a valid and useful tool for evaluating patients undergoing urethroplasty. Introduction common complex men translate adapt PatientReported Patient Reported USSPROM USS PROM (USS-PROM Methods USSPROMbr, USSPROMbr PROMbr , (USS-PROMbr) synthesizing backtranslating, backtranslating back translating, back-translating crossculturally cross prefinal pre committee preversion 1 validation linguistic adjustments Subsequently wellestablished well established consistency testretest retest reproducibility 5 Results clear 080 0 80 0.8 Cronbachs Cronbach s 077 77 0.77 070 70 0.7 078 78 item itemtotal 033 33 0.3 067 67 0.67 074 74 Q1Q6. Q1Q6 QQ Q1 Q6 . Q (Q1-Q6) Conclusion crosscultural cultural properties (USS-PROMbr 08 8 0. 07 7 03 3 06 6 0.6 Q1Q (Q1-Q6 (Q1-Q

ABSTRACT Background: Success rates in endourological procedures, notably percutaneous nephrolithotomy (PCNL) and ureteroscopy (URS), have demonstrated suboptimal outcomes, leading to more reinterventions and radiation exposure. Recently, the use of intraoperative computed tomography (ICT) scans has been hypothesized as a promising solution for improving outcomes in endourology procedures. With this considered, we conducted a comprehensive systematic review and meta-analysis encompassing all available studies that evaluate the impact of the use of intraoperative CT scans on surgical outcomes compared to conventional fluoroscopic-guided procedures. Methods: This systematic review was conducted in accordance with PRISMA guidelines. Multiple databases were systematically searched up to December of 2023. This study aimed to directly compare the use of an ICT scan with the standard non-ICT-guided procedure. The primary endpoint of interest was success rate, and the secondary endpoints were complications and reintervention rates, while radiation exposure was also evaluated. Data extraction and quality assessment were performed following Cochrane recommendations. Data was presented as an Odds ratio with 95%CI across trials and a random-effects model was selected for pooling of data. Results: A comprehensive search yielded 533 studies, resulting in the selection of 3 cohorts including 327 patients (103 ICT vs 224 in non-ICT). Primary outcome was significantly higher in the experimental group versus the control group (84.5% vs 41.4% respectively, 307 patients; 95% CI [3.61, 12.72]; p<0.00001; I2=0). Reintervention rates also decreased from 32.6% in the control to 12.6% in the ICT group (OR 0.34; 95%CI [0.12,0.94]; p =0.04; I2= 48%), whereas complication rates did not exhibit significant differences. Radiation exposure was also significantly reduced in two of the included studies. Conclusion: This meta-analysis highlights a favorable outcome with intraoperative CT scan use in PCNL procedures, showing a considerable increase in SFR when compared to standard fluoroscopy and nephroscopy. Despite limited studies, our synthesis underscores the potential of ICT scans to significantly reduce residual stones and their consequences for endourology patients, as reinterventions and follow-up ionizing radiation studies. Background procedures (PCNL URS, URS , (URS) Recently (ICT considered metaanalysis meta analysis fluoroscopicguided fluoroscopic guided Methods guidelines 2023 nonICTguided non procedure rate evaluated recommendations 95CI 95 randomeffects random effects data Results 53 32 103 (10 22 nonICT. nonICT . non-ICT) 84.5% 845 84 5 (84.5 414 41 4 41.4 respectively 30 3.61, 361 61 [3.61 12.72 1272 12 72 12.72] p<0.00001 p000001 0 00001 I2=0. I20 I I2=0 I2 I2=0) 326 6 32.6 126 12.6 OR 0.34 034 34 0.12,0.94 012094 94 [0.12,0.94] =0.04 004 04 48%, 48 48% 48%) differences Conclusion nephroscopy followup follow (URS 202 9 10 (1 2 non-ICT 84.5 8 (84. 41. 3.61 36 [3.6 12.7 127 1 7 p<0.0000 p00000 0000 32. 12. 0.3 03 0.12,0.9 01209 [0.12,0.94 =0.0 00 20 ( 84. (84 3.6 [3. p<0.000 p0000 000 0. 0.12,0. 0120 [0.12,0.9 =0. (8 3. [3 p<0.00 p000 0.12,0 012 [0.12,0. =0 [ p<0.0 p00 0.12, 01 [0.12,0 = p<0. p0 0.12 [0.12, p<0 0.1 [0.12 p< [0.1 [0. [0

ABSTRACT Purpose: To analyze the prevalence of lower urinary tract symptoms (LUTS) in patients who survived moderate and severe forms of COVID-19 and the risk factors for LUTS six months after hospitalization. Materials and Methods: In this prospective cohort study, patients were evaluated six months after hospitalization due to COVID-19. LUTS were assessed using the International Prostate Symptom Score. General health was assessed through the Hospital Anxiety and Depression Scale and the EQ5D-L5 scale, which evaluates mobility, ability to perform daily activities, pain and discomfort and completed a self-perception health evaluation. Results: Of 255 participants, 54.1% were men and the median age was 57.3 [44.3 – 66.6] years. Pre-existing comorbidities included diabetes (35.7%), hypertension (54.5%), obesity (30.2%) and physical inactivity (65.5%). One hundred and twenty-four patients (48.6%) had a hospital stay >15 days, 181 (71.0%) were admitted to an ICU and 124 (48.6%) needed mechanical ventilation. Median IPSS was 6 [3-11] and did not differ between genders. Moderate to severe LUTS affected 108 (42.4%) patients (40.6% men and 44.4% women; p=0.610). Nocturia (58.4%) and frequency (45.9%) were the most prevalent symptoms and urgency was the only symptom that affected men (29.0%) and women (44.4%) differently (p=0.013). LUTS impacted the quality of life of 60 (23.5%) patients with women more severely affected (p=0.004). Diabetes, hypertension, and self-perception of worse general health were associated with LUTS. Conclusions: LUTS are highly prevalent and bothersome six months after hospitalization due to COVID-19. Assessment of LUTS may help ensure appropriate diagnosis and treatment in these patients. Purpose (LUTS COVID19 COVID 19 COVID-1 Methods study COVID19. 19. Score EQ5DL5 EQDL EQ5D L5 EQ D L EQ5D-L scale mobility activities selfperception self perception evaluation Results 25 participants 541 54 1 54.1 573 57 3 57. 44.3 443 44 [44. 66.6 666 66 years Preexisting Pre existing 35.7%, 357 35.7% , 35 7 (35.7%) 54.5%, 545 54.5% 5 (54.5%) 30.2% 302 30 2 (30.2% 65.5%. 655 65.5% . 65 (65.5%) twentyfour twenty four 48.6% 486 48 (48.6% 15 >1 days 18 71.0% 710 71 0 (71.0% 12 ventilation 311 11 [3-11 genders 10 42.4% 424 42 4 (42.4% 40.6% 406 40 (40.6 444 44.4 p=0.610. p0610 p p=0.610 610 p=0.610) 58.4% 584 58 (58.4% 45.9% 459 45 9 (45.9% 29.0% 290 29 (29.0% (44.4% p=0.013. p0013 p=0.013 013 (p=0.013) 23.5% 235 23 (23.5% p=0.004. p0004 p=0.004 004 (p=0.004) Diabetes Conclusions COVID1 COVID- DL EQ5DL EQD 54. 44. [44 66. 35.7 (35.7% 54.5 (54.5% 30.2 (30.2 65.5 (65.5% 48.6 (48.6 > 71.0 (71.0 31 [3-1 42.4 (42.4 40.6 (40. p061 p=0.61 61 58.4 (58.4 45.9 (45.9 29.0 (29.0 (44.4 p001 p=0.01 01 (p=0.013 23.5 (23.5 p000 p=0.00 00 (p=0.004 [4 35. (35.7 (54.5 30. (30. 65. (65.5 48. (48. 71. (71. [3- 42. (42. 40. (40 p06 p=0.6 58. (58. 45. (45. 29. (29. (44. p00 p=0.0 (p=0.01 23. (23. (p=0.00 [ (35. (54. (30 (65. (48 (71 [3 (42 (4 p0 p=0. (58 (45 (29 (44 (p=0.0 (23 (35 (54 (3 (65 (7 ( p=0 (5 (2 (p=0. (6 p= (p=0 (p= (p

ABSTRACT Background: To evaluate the 10-year functional outcomes (primary) and frequency and predictors of BPH surgical retreatment (secondary) after ThuLEP. Materials and Methods: A single-center retrospective analysis of consecutive patients undergoing ThuLEP between 2010 and 2013 was performed. Inclusion criteria were: age ≥ 40 years, prostate volume (PV) ≥ 80 mL, International Prostate Symptom Score (IPSS)-Total score ≥ 8 points. IPSS-Total score was the primary outcome, and BPH surgical retreatment rate was the secondary outcome. Paired t-test, McNemar test, and Wilcoxon signed-rank test were used to compare variables. Logistic regression analysis was performed to evaluate predictors of surgical retreatment. Results: A total of 410 patients with a mean ±SD age of 63.9 ± 9.7 years and a PV of 115.6 ± 28.6 mL were included. Mean ±SD follow-up was 108.2 ± 29.6 months. IPSS-Total score was significantly improved at 1 year compared to baseline (23.3 ± 4.7 vs. 10.3 ± 3.8; p<0.001). It was similar after 5 years (10.5 ± 3.6 vs. 10.7 ± 5.0; p=0.161), with a significant worsening at 10 years (10.3 ±4.8 vs. 13.8 ±4.5; p=0.042) but remaining statistically and clinically better than baseline (13.8 ±4.5 vs. 22.1 ±4.3; p<0.001). After 10 years, 21 (5.9%) patients had undergone BPH reoperation. Baseline PV (adjusted OR 1.27, 95% CI 1.09-1.41; p<0.001) and time from BPH surgery (adjusted OR 1.32, 95% CI 1.15-1.43; p<0.001) were predictors of BPH surgical retreatment. Conclusions: ThuLEP is associated with optimal functional outcomes and a low frequency of BPH surgical retreatment in the long-term. Baseline PV and time from surgery were predictors of BPH reoperation. Background 10year (primary (secondary Methods singlecenter single center 201 4 (PV IPSSTotal IPSS Total points outcome ttest, ttest t t-test signedrank signed rank variables Results 41 SD 639 63 9 63. 97 7 9. 1156 115 6 115. 286 28 28. included followup follow up 1082 108 2 108. 296 29 29. months 23.3 233 23 3 (23. 47 4. vs 103 10. 3.8 38 p<0.001. p0001 p p<0.001 . 0 001 10.5 105 (10. 36 3. 107 5.0 50 p=0.161, p0161 p=0.161 , 161 p=0.161) 48 ±4. 138 13 13. 45 p=0.042 p0042 042 (13. 221 22 22. ±4.3 43 5.9% 59 (5.9% reoperation adjusted 127 27 1.27 95 1.091.41 109141 1.09 1.41 09 1.09-1.41 132 32 1.32 1.151.43 115143 1.15 1.43 15 1.15-1.43 Conclusions longterm. longterm long term. term long-term 20 11 23. (23 p000 p<0.00 00 (10 5. p016 p=0.16 16 ±4 p=0.04 p004 04 (13 5.9 (5.9 12 1.2 091 1.091.4 10914 109 1.0 141 1.4 1.09-1.4 1.3 151 1.151.4 11514 1.1 143 1.15-1.4 (2 p00 p<0.0 (1 p01 p=0.1 p=0.0 (5. 1. 1.091. 1091 14 1.09-1. 1.151. 1151 1.15-1. ( p0 p<0. p=0. (5 1.091 1.09-1 1.151 1.15-1 p<0 p=0 1.09- 1.15- p< p=

ABSTRACT Purpose: This video aims to present an in-depth, step-by-step tutorial on microsurgical reconstruction for obstructive azoospermia, featuring a distinctive case involving anastomosis from vas deferens to rete testis. The primary aim of this endeavor is to offer thorough and practical insights for healthcare professionals and researchers within the realm of reproductive medicine. The video endeavors to disseminate expertise, methodologies, and perspectives that can be advantageous to individuals grappling with obstructive azoospermia, providing a significant contribution to the progress of reproductive medicine and the augmentation of existing treatment alternatives. Materials and Methods: Surgical footage was recorded using the ORBEYE 4K 3D Orbital Camera System by Olympus America, with patient consent acquired for research purposes. Additionally, a retrospective examination of patient records was undertaken to compile relevant medical histories. Results: This video furnishes an exhaustive guide to microsurgical reconstruction for obstructive azoospermia, encompassing a distinctive instance of anastomosis from vas deferens to rete testis. State-of-the-art technology, such as the ORBEYE 4K 3D Orbital Camera, heightens procedural transparency, accentuating the significance of advanced instrumentation. The ethical underpinning is emphasized by obtaining patient consent for footage utilization, and a retrospective chart review augments the repository of valuable patient data. This comprehensive approach serves as an invaluable reservoir of knowledge for medical professionals and underscores excellence in clinical and ethical healthcare research. Conclusions: Anastomosis from vas deferens to rete testis emerges as a viable surgical reconstruction alternative for obstructive azoospermia, particularly when confronted with non-dilated tubules within the epididymis. Purpose indepth, indepth depth, depth in-depth stepbystep step azoospermia expertise methodologies alternatives Methods K D America purposes Additionally histories Results Stateoftheart State art technology transparency instrumentation utilization data Conclusions nondilated non dilated epididymis

ABSTRACT Purpose: To create a nomogram to predict the absence of clinically significant prostate cancer (CSPCa) in males with non-suspicion multiparametric magnetic resonance imaging (mpMRI) undergoing prostate biopsy (PBx). Materials and Methods: We identified consecutive patients who underwent 3T mpMRI followed by PBx for suspicion of PCa or surveillance follow-up. All patients had Prostate Imaging Reporting and Data System score 1-2 (negative mpMRI). CSPCa was defined as Grade Group ≥2. Multivariate logistic regression analysis was performed via backward elimination. Discrimination was evaluated with area under the receiver operating characteristic (AUROC). Internal validation with 1,000x bootstrapping for estimating the optimism corrected AUROC. Results: Total 327 patients met inclusion criteria. The median (IQR) age and PSA density (PSAD) were 64 years (58-70) and 0.10 ng/mL2 (0.07-0.15), respectively. Biopsy history was as follows: 117 (36%) males were PBx-naive, 130 (40%) had previous negative PBx and 80 (24%) had previous positive PBx. The majority were White (65%); 6% of males self-reported Black. Overall, 44 (13%) patients were diagnosed with CSPCa on PBx. Black race, history of previous negative PBx and PSAD ≥0.15ng/mL2 were independent predictors for CSPCa on PBx and were included in the nomogram. The AUROC of the nomogram was 0.78 and the optimism corrected AUROC was 0.75. Conclusions: Our nomogram facilitates evaluating individual probability of CSPCa on PBx in males with PIRADS 1-2 mpMRI and may be used to identify those in whom PBx may be safely avoided. Black males have increased risk of CSPCa on PBx, even in the setting of PIRADS 1-2 mpMRI Purpose (CSPCa nonsuspicion non (mpMRI . (PBx) Methods T followup. followup follow up. up follow-up 12 1 2 1- mpMRI. mpMRI) ≥2 elimination (AUROC) 1000x x 000x Results 32 criteria IQR (IQR (PSAD 6 5870 58 70 (58-70 010 0 10 0.1 ngmL2 ngmL ng mL2 mL ng/mL 0.070.15, 007015 0.07 0.15 , 07 15 (0.07-0.15) respectively follows 11 36% 36 (36% PBxnaive, PBxnaive naive, naive PBx-naive 13 40% 40 (40% 8 24% 24 (24% 65% 65 (65%) selfreported self reported Overall 4 13% (13% race 015ngmL2 15ng ≥0.15ng/mL 078 78 0.7 075 75 0.75 Conclusions avoided (PBx ≥ (AUROC 3 587 5 7 (58-7 01 0. 070 0.070.15 00701 007 0.0 015 (0.07-0.15 (36 (40 (24 (65% (13 015ngmL (58- 0.070.1 0070 00 (0.07-0.1 (3 (4 (2 (65 (1 (58 0.070. (0.07-0. ( (6 (5 0.070 (0.07-0 (0.07- (0.07 (0.0 (0. (0

ABSTRACT Purpose: Partial nephrectomies in the salvage setting after ablative or surgical therapy remain challenging cases that are underreported in the literature (1-5). The aim of this video is to demonstrate techniques for robotic salvage partial nephrectomy to manage recurrent renal cell carcinoma (RCC) after failed prior partial nephrectomy and primary cryotherapy. Materials and methods: A 55-year-old man after previous robotic-assisted right partial nephrectomy presented with a 2.5 cm locally recurrent renal mass abutting the collecting system. A 59-year-old man with right renal cell carcinoma initially treated with cryoablation presented local recurrence. CT imaging demonstrated 2.6 cm right renal mass consistent with tumor recurrence at previous treatment site. Results: Both procedures were completed in under 180 minutes. Clamp time was 22 minutes after the previous partial nephrectomy and 25 minutes after previous cryotherapy. There were no perioperative complications. Pathology in both cases demonstrated pT1a clear cell RCC with negative margins. Both patients have since no evidence of recurrent disease on follow-up imaging at 1 and 2 years, respectively. Conclusions: Salvage robotic partial nephrectomy should be considered as a feasible treatment option after failure of initial therapy—surgical or ablative. A salvage procedure is often more challenging than its standard therapy-naïve counterpart due to development of dense inflammation after previous interventions. Despite this, robotic partial nephrectomies in the salvage setting can be safely carried out with good surgical outcomes, particularly when utilizing intraoperative ultrasound to identify tumor margins and key anatomy. Purpose 15. 15 5 . (1-5) (RCC cryotherapy methods 55yearold yearold 55 year old roboticassisted assisted 2. system 59yearold 59 26 6 site Results 18 complications pTa pT followup follow up years respectively Conclusions therapysurgical therapynaïve naïve interventions outcomes anatomy (1-5 (1- (1 (

ABSTRACT Purpose: To compare biochemical recurrence, sexual potency and urinary continence outcomes of ablative therapy and radical treatment (radical prostatectomy or radiotherapy with androgen deprivation therapy). Material and methods: A systematic review and meta-analysis followed the PRISMA guidelines were performed. We searched MEDLINE/PubMed. Biochemical recurrence at three and five years; incontinence rate (patients who used one pad or more) and erectile dysfunction rate at 12 and 36 months (patients who did not have sufficient erection to achieve sexual intercourse) were evaluated. The Mantel-Haenszel method was applied to estimate the pooled risk difference (RD) in the individual studies for categorical variables. All results were presented as 95% confidence intervals (95%CI). Random effects models were used regardless of the level of heterogeneity (I²). (PROSPERO CRD42022296998). Results: Eight studies comprising 2,677 men with prostate cancer were included. There was no difference in biochemical recurrence between ablative and radical treatments. We observed the same biochemical recurrence between ablative therapy and radical treatment within five years (19.3% vs. 16.8%, respectively; RD 0.07; 95%CI=-0.05, 0.19; I2=68.2%; P=0.08) and continence rate at 12 months (9.2% vs. 31.8%, respectively; RD −0.13; 95%CI, −0.27, 0.01; I2=89%; P=0.32). When focal treatment was analyzed alone, two studies with 582 patients found higher erectile function at 12 months in the ablative therapy group than in the radical treatment (88.9% vs. 30.8%, respectively; RD −0.45; 95%CI −0.84, −0.05; I2=93%; P=0.03). Conclusion: Biochemical recurrence and urinary continence outcomes of ablative therapy and radical treatment were similar. Ablative therapy appears to have a high rate of sexual potency. Purpose therapy. . therapy) methods metaanalysis meta analysis performed MEDLINEPubMed MEDLINE PubMed MEDLINE/PubMed more 1 3 intercourse evaluated MantelHaenszel Mantel Haenszel (RD variables 95 95%CI. 95CI CI (95%CI) I². I² I (I²) PROSPERO CRD42022296998. CRD42022296998 CRD CRD42022296998) Results 2677 2 677 2,67 included treatments 19.3% 193 19 (19.3 vs 168 16 8 16.8% respectively 0.07 007 0 07 95%CI=0.05, 95CI005 95%CI= 0.05, 05 95%CI=-0.05 0.19 019 I2=68.2% I2682 I2 68 P=0.08 P008 P 08 9.2% 92 9 (9.2 318 31 31.8% −0.13 013 13 027 27 −0.27 0.01 001 01 I2=89% I289 89 P=0.32. P032 P=0.32 32 P=0.32) alone 58 88.9% 889 88 (88.9 308 30 30.8% −0.45 045 45 084 84 −0.84 −0.05 005 I2=93% I293 93 P=0.03. P003 P=0.03 03 P=0.03) Conclusion similar (95%CI (I² CRD4202229699 267 67 2,6 19.3 (19. 16.8 0.0 00 95%CI=0.05 95CI00 0.05 95%CI=-0.0 0.1 I2=68.2 I268 6 P=0.0 P00 9.2 (9. 31.8 −0.1 02 −0.2 I2=89 I28 P03 P=0.3 5 88.9 (88. 30.8 −0.4 04 4 −0.8 −0.0 I2=93 I29 (I CRD420222969 26 2, 19. (19 16. 0. 95%CI=0.0 95CI0 95%CI=-0. I2=68. I26 P=0. P0 9. (9 31. −0. I2=8 88. (88 30. I2=9 CRD42022296 (1 95%CI=0. 95%CI=-0 I2=68 P=0 ( −0 I2= (8 CRD4202229 95%CI=0 95%CI=- I2=6 P= − CRD420222 CRD42022 CRD4202 CRD420 CRD42 CRD4