Société Internationale d’Urologie Journal

As is the case for all medical journals, we have at times struggled to secure timely peer review of submitted manuscripts [...]

Background/Objectives: Benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) affects up to 60% of men by age 90. With Singapore’s aging population, minimally invasive surgical therapies (MIST) have emerged as effective alternatives for patients unsuitable for traditional surgery. We sought to evaluate real-world outcomes of MIST procedures: Water Vapor Thermal Therapy (WVTT) and Prostatic Urethral Lift (PUL) in treating BPH-related LUTS. Methods: This is a retrospective analysis of 62 MIST patients treated at a tertiary hospital in Singapore between August 2021 and February 2025, with a minimum of three-month follow-up. Primary outcomes included improvements in maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and Quality of Life (QoL) scores. Secondary outcomes included complications, re-treatment rates, and healthcare utilization metrics. Results: Thirty-six patients underwent WVTT, and 26 underwent PUL. Median age was 67 years, with a mean prostate volume of 61 cm³. At three months, both procedures showed improvements: Qmax increased by 4.28 mL/s (WVTT, p < 0.001) and 3.46 mL/s (PUL, p = 0.06); IPSS decreased by 12.8 (WVTT, p < 0.001) and 12.5 (PUL, p < 0.001); QoL scores improved by 2.53 (WVTT, p < 0.001) and 3.31 (PUL, p < 0.001). The complication rate was 32.3%, with complications being predominantly Clavien–Dindo grades 1–2. Day surgery was achieved in 83.9% of cases, with only 4.8% requiring readmission within 30 days. At three months, 98.4% were catheter-free, and excluding prior catheter-dependent patients, 82.4% were medication-free. At a median follow-up of 5.9 months, the re-treatment rate was 3.2%. Conclusions: MIST procedures are safe and effective for BPH-LUTS, showing comparable outcomes between WVTT and PUL while optimizing healthcare resource utilization.

Background/Objectives: Third-generation cephalosporins are used to treat many infections, including urinary tract infections. Despite the risk of inducing resistance in SPICE-HaM microorganisms (Serratia, Providencia, indole-positive Proteus, Citrobacter freundii complex, Enterobacter cloacae complex, Klebsiella aerogenes, Hafnia alvei and Morganella morganii), a group of microorganisms with inducible beta-lactamase potentials, guidelines still recommend treating uncomplicated cystitis with third-generation cephalosporins. To improve outpatient pediatric antimicrobial practice, this study aimed to develop a five-year pediatric cumulative antimicrobial susceptibility testing report for SPICE-HaM microorganisms in urine and compare the in vitro sensitivity of cefixime/ceftriaxone with sulfamethoxazole/trimethoprim. Methods: Over 300 pediatric SPICE-HaM urine isolates, processed at regional microbiology laboratories of LifeLabs British Columbia between 2020 and 2024, were analyzed. Results: Compared to cefixime, sulfamethoxazole/trimethoprim demonstrated higher sensitivity against Citrobacter freundii complex (65% versus 95%, p < 0.05, n = 57), Enterobacter cloacae complex (49% versus 92%, p < 0.05, n = 89), and Morganella morganii (68% versus 92%, p < 0.05, n = 76). Compared to ceftriaxone, sulfamethoxazole/trimethoprim failed to show significantly different sensitivities for the SPICE-HaM microorganisms. Conclusions: Sulfamethoxazole/trimethoprim is possibly a more favourable oral agent for SPICE-HaM-associated urinary tract infections in the local pediatric community population compared to cefixime, a third-generation cephalosporin. However, compared to ceftriaxone, sulfamethoxazole/trimethoprim appears to have similar efficacy for SPICE-HaM-associated urinary tract infections.