Société Internationale d’Urologie Journal

Background/Objectives: Limited data exist on the outcomes of men with bladder stones undergoing cystolitholapaxy alone versus cystolitholapaxy with concurrent transurethral resection of the prostate (TURP). Additionally, factors associated with the need for subsequent TURP in these patients are not well defined. This study aimed to compare the clinical outcomes in men undergoing cystolitholapaxy alone with those undergoing concurrent cystolitholapaxy with TURP, and determine what factors were associated with the need for subsequent TURP. Methods: A retrospective review was conducted of men undergoing cystolitholapaxy at a single Australian hospital between 2014 and 2021. Patients were grouped into cystolitholapaxy alone (Group A) and cystolitholapaxy with concurrent TURP (Group B). Clinical outcomes compared included rates of acute urinary retention (AUR), urinary tract infection (UTI), and subsequent TURP. Prostate volume (PV), stone size, and the presence of intravesical prostatic protrusion (IPP) were evaluated as potential predictors of subsequent TURP in Group A. Results: Fifty men were included in the final analysis, with a median follow-up of 50 months (interquartile range [IQR] 24–81). Baseline characteristics did not differ significantly between groups. There was no statistically significant difference in the rates of AUR (11% vs. 13%) or UTI (22% vs. 30%) between Group A and Group B, respectively. However, 41% of Group A underwent subsequent TURP, compared to 9% in Group B (p = 0.0112). Within Group A, those requiring subsequent TURP had a significantly greater PV (65 vs. 34 cc, p = 0.0059), larger stone size (3.5 vs. 2.0 cm, p = 0.0175), and a higher prevalence of IPP (82% vs. 6%, p < 0.001). Conclusions: Cystolitholapaxy alone is a viable initial treatment for bladder stones, with comparable clinical outcomes to concurrent TURP. PV, stone size, and IPP may help identify patients likely to require future TURP, enabling more tailored treatment and potential reduction in TURP-related morbidity.

Background/Objectives: Reconstructive urology is critically underrepresented in global surgery initiatives, despite its essential role in managing congenital and acquired urogenital conditions. In response, a multinational Global Surgery Collaborative was launched in 2022 by a faculty from the University of Toronto, aiming to enhance reconstructive urology capacity in the Philippines, among other low- to low-middle-income countries through longitudinal mentorship and skills transfer. This report presents early experience from 2022 to 2024. Methods: This collaboration delivered annual in-person surgical missions from 2022 to 2024 at two major Philippine healthcare institutions. Training focused on pediatric and adult reconstructive urologic procedures. Local mentees participated in structured preoperative planning, intraoperative teaching, and postoperative debriefing. We conducted a prospective service evaluation comprising a prospective registry of consecutive cases and paired pre/post trainee surveys. Data were collected on patient demographics and surgical metrics. Primary clinical endpoints included operative time, length of stay, and complications (Clavien–Dindo), with standardized follow-up windows. Mentee educational outcomes were assessed through pre- and post-training trainee-reported (Likert) measures, evaluating comfort and technical understanding. Statistical analysis used the Wilcoxon signed-rank test to assess changes. Results: Over three years, 33 surgical cases were performed with 45 surgical resident mentees (Post-graduate year (PGY)4–PGY6) engaged. The median patient age was 23 (inter-quartile range [IQR] 12.5–41.5) years, with 33.3% pediatric and 84.8% of cases classified as major. The complication rate was 15.1%, with only one major event (3%). Across 45 mentees, comfort increased from a median 4.0 (IQR 2.5–5.0) to 7.0 (5.5–8.0) and technique understanding from 5.0 (4.0–6.5) to 9.0 (8.0–10.0), with large Wilcoxon effects (r = 0.877 and r = 0.875; both p < 0.001). Year-by-year analyses showed the same pattern with large effects. Conclusions: In this early three-year experience (33 cases, 84.8% major), this multi-institutional collaboration longitudinal mentorship model was feasible and safe, and was associated with significant trainee-reported improvements in comfort and technical understanding. This demonstrates a replicable model for global surgery in reconstructive urology, successfully enhancing surgical skills and fostering sustainable capacity in low- and middle-income countries (LMIC) settings.

I am grateful to the Société Internationale d’Urologie (SIU) Board of Directors for the opportunity to serve as the new Editor-in-Chief of the Société Internationale d’Urologie Journal (SIUJ), following a rigorous and competitive appointment process [...]