Search Results (725)

Background/Objectives: Spinal cord stimulation (SCS) is an established therapy for chronic refractory pain, but its clinical value depends on whether benefit persists beyond the early post-implant period. Although short-term SCS studies are abundant, reports with follow-up of 24 months or longer are dispersed, methodologically heterogeneous, and difficult to interpret across indications and stimulation platforms. This scoping review aimed to map the clinical literature reporting SCS outcomes at ≥24 months, characterize the represented populations and modalities, summarize the long-term outcome domains assessed, and identify major methodological and clinical gaps in the evidence base. Methods: This PRISMA-ScR-informed scoping review applied a Population–Concept–Context framework. PubMed/MEDLINE and Scopus were searched through April 2026, yielding 6866 records before deduplication. Following staged title/abstract screening, iterative full-text retrieval, and the reconciliation of overlapping publications, 292 unique full-text reports were assessed for eligibility. Studies reporting original clinical SCS data with extractable outcomes at ≥24 months were included. No meta-analysis or formal GRADE assessment was undertaken, as the objective was evidence mapping rather than pooled effect estimation. Results: The final evidence map comprised 65 unique reports representing a cumulative report-level population of 11,518 participants across non-overlapping cohorts. The literature was dominated by non-randomized evidence (55 observational reports; 10 randomized or randomized-derived). The most frequent indication was mixed chronic pain (30/65; 46.2%), followed by failed back surgery syndrome/persistent spinal pain syndrome (FBSS/PSPS; 16/65; 24.6%), chronic back and/or leg pain (6/65; 9.2%), complex regional pain syndrome (CRPS; 5/65; 7.7%), and painful diabetic neuropathy (PDN; 4/65; 6.2%). Most reports involved conventional or unspecified SCS (47/65; 72.3%), with smaller contemporary clusters for 10 kHz high-frequency SCS and ECAP-controlled closed-loop SCS. The most frequently reported outcome domains were pain durability, function and quality of life, device-related outcomes, and opioid use. At a descriptive level, the literature more often supported persistence of benefit than complete erosion of effect, particularly in spinal pain populations and in contemporary PDN and closed-loop SCS cohorts. Interpretation was constrained by outcome heterogeneity, cohort overlap, mixed indication categories, and inconsistent opioid and device-maintenance reporting. Conclusions: The long-term SCS literature supports the view that durable benefit is achievable in a substantial patient subset, particularly in FBSS/PSPS populations, and in more recent evidence, in PDN, nonsurgical refractory back pain, and closed-loop SCS cohorts. The evidence base remains heterogeneous and does not support a uniform certainty-ranked estimate across indications and technologies. Future studies should prioritize indication-specific cohorts, standardized multidomain outcome reporting, and transparent separation of unique cohorts from secondary analyses of the same clinical populations. Full article

Background/Objectives: Advanced renal cell carcinoma (aRCC) remains incurable, with no established optimal sequence of targeted therapies due to interpatient heterogeneity and acquired resistance. We developed a luciferase-enabled patient-derived orthotopic xenograft (PDOX) avatar platform to evaluate sequential targeted therapies in individualized aRCC models that recapitulate tumor architecture, proliferation, angiogenesis, metastasis, and PD-L1 expression. Methods: Tumor specimens from two renal cell carcinoma (RCC) patients were expanded subcutaneously in NOD/SCID mice, transduced with luciferase/red fluorescent protein (Luc/RFP), and orthotopically implanted into mouse kidneys (KiCa-Pt58: sarcomatoid RCC, pT3aN1M1, Fuhrman grade 4; KiCa-Pt118: clear cell RCC with sarcomatoid component, pT3aNxM0, Fuhrman grade 4, respectively). Tumor growth and metastasis were monitored weekly by bioluminescence imaging (BLI). Mice were randomized into vehicle control or four sequential treatment groups (Everolimus→Sunitinib [E→S], Sunitinib→Everolimus [S→E], Pazopanib→Sunitinib [P→S], Pazopanib→Everolimus [P→E]). Drugs were administered orally three times weekly until resistance (>200% BLI increase), with one switch. At necropsy, tumor burden, ex vivo BLI metastasis, weights, H&E histology, and immunohistochemistry (Ki67, CD44, CD31, PD-L1) were assessed. Results: Two independent experiments were performed. In dosing optimization, PDOX tumors recapitulated parental histology and proliferative indices, mirroring patient trajectories. KiCa-Pt58 (metastatic sarcomatoid RCC; deceased 1-month post-nephrectomy) showed aggressive features: rapid engraftment at low doses, early growth (week 2), and lung metastases in 78% of mice (sacrifice day 34), reflecting a fulminant course. KiCa-Pt118 (non-metastatic; patient recurrence-free >8 years post nephrectomy) exhibited indolent behavior: delayed engraftment requiring higher doses plus lymph node stromal (HK) support, slower growth (week 4), no metastases, and later sacrifice (day 78), consistent with remission. In sequential therapy evaluation, for KiCa-Pt58, P→E yielded greatest reductions in tumor weight (p < 0.01), lung metastases (p < 0.01), Ki67+ proliferation, CD31+ angiogenesis, and PD-L1 expression versus control; E→S and S→E were also effective. For KiCa-Pt118, S→E and P→E reduced tumor burden (p < 0.01) and Ki67⁺ proliferation; S→E lowered CD31 and PD-L1. Conclusions: This RCC PDOX platform faithfully preserves patient-specific biology—including metastatic propensity, engraftment efficiency, growth kinetics, and stromal dependency—while enabling real-time evaluation of sequential targeted therapies. Given the limited number of models tested, these findings provide proof-of-concept for individualized treatment exploration in advanced RCC and support future investigation of rational combinations with immune checkpoint blockade in humanized or immunocompetent systems. Full article

Alveolar ridge preservation (ARP) aims to reduce post-extraction bone resorption and facilitate implant placement. Among alloplastic grafts, β-tricalcium phosphate (β-TCP) is widely used due to its osteoconductive properties and complete resorbability. This systematic review evaluated the clinical effectiveness of β-TCP for ARP, focusing on ridge dimensional changes assessed by cone–beam computed tomography (CBCT). Electronic searches were performed in major scientific databases up to April 2026. Randomized controlled trials (RCTs) reporting CBCT-based dimensional outcomes after at least 4 months were included. Five RCTs met the inclusion criteria. Considerable heterogeneity was observed in biomaterial formulations, socket management, and outcome assessment. When used alone, β-TCP showed variable results, ranging from greater ridge resorption compared with xenograft to outcomes comparable with those of freeze-dried bone allograft. More consistent findings were reported when β-TCP was used in combination with other biomaterials, with outcomes generally comparable to those of deproteinized bovine bone mineral (DBBM). Overall, β-TCP may have a potential role in alveolar ridge preservation; however, evidence remains limited and heterogeneous. Differences between β-TCP alone and composite formulations should be carefully considered, and no definitive conclusions can be drawn regarding its comparative predictability versus xenografts. Further RCTs are needed to clarify its clinical effectiveness and identify optimal applications. Full article

Objective: Atherosclerotic renal artery stenosis (ARAS) is increasingly prevalent among aging populations and in patients with diabetes, hyperlipidemia, aortoiliac obstructive disease, coronary artery disease, and/or hypertension. Patients with severe ARAS are at a substantially elevated risk of cardiovascular disease, recurrent congestive heart failure, stroke, ischemic nephropathy, and chronic kidney disease. Therefore, the ARAS-TR study aims to evaluate the effect of renal artery stenting on the clinical outcomes in patients with severe ARAS and renovascular hypertension. Materials: This study was conducted as a multicenter, prospective study between July 2024 and September 2025. It encompassed 278 patients with angiographically confirmed severe ARAS who underwent renal artery stent implantation. Patients were subsequently monitored for 6 months. A paired-samples t-test was used to compare continuous variables pre- and post-intervention, while categorical variables were analyzed using the Pearson chi-square test and Fisher’s exact test. Results: The mean age of the patients was 63.6 [±13.4] years, and the male gender ratio was 52.5%. After renal artery stenting, systolic and diastolic blood pressures decreased significantly at the 6-month follow-up compared with the pre-procedure levels (SBP 166.99 [21.24] vs. 135.40 [15.69], p < 0.001; DBP 96.28 [13.03] vs. 80.39 [11.03], p < 0.001, respectively). GFR (61.23 [28.33] vs. 63.35 [26.36], p = 0.029) and creatinine (1.40 [0.93] vs. 1.29 [0.66], p = 0.004) levels improved compared to baseline. The mean number of antihypertensive drugs required for patients to remain normotensive decreased significantly (3.19 [1.04] vs. 2.48 [1.13], p < 0.001) during the follow-up period. Conclusions: Percutaneous renal artery intervention appears to be a promising and safe strategy for carefully selected high-risk patients presenting with severe ARAS, renovascular hypertension, and non-atrophic kidneys. In this specific clinical context, restoring renal artery patency through percutaneous stenting was associated with improved renal function and observed reduction in the burden of antihypertensive drugs required to sustain normotension. Full article

Background/Objectives: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition characterized by pelvic pain, urinary symptoms, and reduced quality of life, with limited effective treatment options. Regenerative approaches using adipose-derived mesenchymal stromal cells (MSCs) have shown promising preclinical results. This study aimed to evaluate the feasibility, safety, and preliminary efficacy of transurethral implantation of autologous micronized adipose tissue (MAT) in patients with refractory IC/BPS. Methods: We conducted a single-center retrospective observational pilot study including 20 patients with refractory IC/BPS treated between April and October 2024. Adipose tissue was harvested via liposuction and mechanically processed using a closed system (Matrigen device) to obtain minimally manipulated micronized adipose tissue. The product was injected transurethrally into the bladder submucosa. Patients were evaluated at baseline and at 1, 3, and 6 months using validated questionnaires (ICSI/ICPI, SF-36, MOS Sexual Function), verbal rating scale (VRS) for pain and urgency, urodynamic parameters, and cystoscopic findings. Changes over time were assessed using paired non-parametric tests. Results: At 6 months, 65% of patients met responder criteria, defined as ≥50% improvement in pain and/or urgency or a positive global response. Significant improvements were observed in IC Problem Index, SF-36, MOS scores, and VRS urgency, while VRS pain improved significantly at 6 months. Urodynamic parameters showed increased bladder capacity (median 275 to 325 mL, p < 0.001) and reduced post-void residual volume (80 to 40 mL, p < 0.001). Cystoscopic findings demonstrated improvement in bladder mucosal appearance. The procedure was well tolerated, with no serious adverse events or immunological complications observed. Conclusions: In this exploratory pilot study, transurethral implantation of autologous micronized adipose tissue was associated with improvements in symptoms, bladder function, and cystoscopic findings in patients with refractory IC/BPS. These results support the feasibility and potential role of minimally manipulated adipose-derived therapies in this setting. Given the small sample size and absence of a control group, findings should be considered exploratory. Larger controlled studies are warranted to confirm efficacy and evaluate long-term outcomes. Full article

To address issues such as thermal stress concentration in metal bone implants produced via high-energy beam direct additive manufacturing, a method was proposed to fabricate porous titanium scaffolds. This approach combined Fused Deposition Modeling (FDM) with a debinding–sintering process. Ti/ABS composite filaments with titanium volume fractions of 35%, 40%, and 45% were successfully developed via a single-screw extrusion process. Their feasibility in the FDM process was subsequently verified. The effects of different processing parameters on the forming quality and dimensional accuracy of the green bodies were investigated. After debinding and sintering the composite scaffolds prepared with optimized parameters, structurally intact porous titanium scaffolds were obtained. Microscopic characterization shows that the scaffold surface consists primarily of titanium, and the pore structure remains intact. Furthermore, compression tests were performed on three types of porous titanium scaffolds with different porosities. The results indicate that the combination of ABS/titanium alloy composite filaments, FDM technology, and debinding–sintering post-processing enables the high-quality and efficient production of porous titanium scaffolds. The elastic modulus of the resulting scaffolds ranges from 1.2 to 1.6 GPa, and the compressive strength is between 25.7 and 68.3 MPa. The elastic modulus matches that of human cancellous bone. Meanwhile, the compressive strength is significantly higher than that of cancellous bone and falls between the values for cancellous and cortical bone. These mechanical properties meet the requirements for human bone, providing a new approach for the manufacture of orthopedic implants. Full article

Background/Objectives: Nowadays, transcatheter aortic valve implantation (TAVI) is widespread in patients with severe aortic valve stenosis. New prosthesis designs are becoming available to address the shortcomings of their predecessors and improve clinical outcomes. Methods: Electronic databases were screened for studies comparing outcomes of TAVI with Portico and SAPIEN 3. In a random-effects meta-analysis the pooled incidence rates of procedural, clinical and functional outcomes, according to VARC-2 definitions, were assessed. Results: Thirteen observational studies and one multi-center randomized clinical trial enrolling 20,522 patients (Portico N = 3001 and SAPIEN 3 N = 17,521) were included in the analysis. The need for more than one prosthesis during initial implantation was significantly higher among Portico recipients compared to SAPIEN 3 recipients: (RR 2.72 [1.36, 5.45] p = 0.005). Pre- and post-dilatation were performed more frequently in the Portico group (RR 1.53 [1.12, 2.09], p = 0.008 and RR 4.21 [2.83, 6.26], p < 0.00001, respectively). Moderate-to-severe paravalvular leak (PVL) was significantly more common in the Portico arm (RR 3.27 [1.80, 5.91] p < 0.0001). In contrast, the mean gradient and rate of prosthesis–patient mismatch (PPM) was significantly lower in the Portico group (MD −31.58 [−37.02; −26.14] mmHg and RR 0.42 [0.32, 0.55], p < 0.00001). Recipients of Portico demonstrated over 60% higher risk of permanent pacemaker implantation (PPI) compared to SAPIEN 3 (RR 1.62 [1.25, 2.10], p = 0.0002). Other procedural and short-term clinical outcomes, including neurologic events, major vascular complications, life threatening or major bleeding, acute kidney injury, myocardial infarction and mortality did not differ between the devices. A difference in mortality was observed at the 1-year follow-up (RR 1.26 [1.06, 1.51], p = 0.01; I² = 5%). Conclusions: The evidence shows good short-term outcomes for both valves. Compared to SAPIEN 3, Portico was associated with a significantly higher rate of moderate-to-severe PVL and PPI, but a lower mean gradient and incidence of PPM. A significantly higher 1-year mortality was observed in the Portico group. Full article

Dental implants are widely used to replace missing teeth, but peri-implantitis remains a major biological complication associated with bacterial biofilm formation on implant surfaces. The increasing incidence of peri-implant infections underscores the need for alternative antimicrobial strategies that effectively decontaminate complex titanium implant surfaces. This study evaluated the inhibitory effect of low-temperature microwave argon plasma on bacteria in an experimental model simulating peri-implant conditions and compared the responses of microorganisms with different biological characteristics. A 3D-printed mandibular bone segment model with an inserted Straumann BLX Roxolid^® dental implant was used to reproduce the peri-implant environment. Bacterial suspensions of Streptococcus mutans NBIMCC 1786 and the extremophilic bacterium Chromohalobacter canadensis NBIMCC 9077 have been exposed to a microwave non-equilibrium argon plasma jet (2.45 GHz, atmospheric pressure) for 1–7 min. Optical density measurements and colony growth analysis were used to assess antimicrobial effects. Plasma treatment induced a pronounced reduction in bacterial growth during the early post-treatment period. In C. canadensis, growth inhibition reached a plateau (~47–55% at 24 h) regardless of exposure time. In contrast, S. mutans showed a nonlinear response, with stable inhibition after short exposures (1–3 min) and partial recovery after longer treatments (5–7 min). These findings indicate that microwave argon plasma exhibits significant antimicrobial activity under controlled in vitro conditions, although its effectiveness depends on microorganism-specific biological characteristics. Because the present model was based on simplified single-species systems, direct clinical extrapolation remains limited and should be addressed in future studies using polymicrobial peri-implant biofilm models. Full article

Background: Emerging evidence highlights the importance of the MIF–sCD74 axis in health and disease, including its role in regulating cell death. While studies in routine cardiac surgery suggest perioperative relevance, its role in end-stage heart failure (ESFH) patients undergoing left ventricular assist device (LVAD) implantation remains unexplored. Moreover, although MIF and sCD74 induce necroptosis in neonatal cardiac myofibroblasts, the effects of MIF, its paralog D-DT, and sCD74 on adult cardiac myofibroblasts (CMFs) are unknown. Methods: Plasma concentrations of sCD74, MIF and D-DT were measured perioperatively in a small cohort of patients with ESHF undergoing LVAD implantation (n = 20). As a preclinical model of ESHF, primary adult CMFs were treated with recombinant MIF, D-DT and sCD74 to evaluate their effects on cellular viability and health. Results: In LVAD patients, sCD74 and D-DT levels were significantly increased 24 h postoperatively, whereas MIF levels were reduced compared to baseline. ROC curve analysis demonstrated a good discriminatory power of 24 h post-OP sCD74 (AUC = 0.83), sCD74/MIF ratio (AUC = 0.82), and D-DT levels (AUC = 0.88) for acute kidney injury, composite outcome, and right heart failure (RHF), respectively. In adult CMFs, MIF and sCD74 synergistically reduced viable cell counts (p = 0.0083), whereas D-DT reduced cell counts in an sCD74-independent manner (p = 0.0004). Yet, measures of metabolism, proliferation, apoptosis and necrosis along with inflammatory gene expression remained unchanged. Conclusions: Our findings indicate that the balance of MIF, D-DT, and sCD74 during LVAD implantation may be clinically relevant. In particular, an imbalance characterized by elevated sCD74 or D-DT and reduced MIF levels 24 h post-surgery was associated with unfavorable clinical outcomes. Yet, the current findings are exploratory and hypothesis-generating because of a small sample size. Thus, the prognostic value of plasma levels for postoperative complications after LVAD implantation, and the effects of MIF/D-DT/sCD74 imbalance on cardiac myofibroblasts, need to be validated in larger cohorts and in advanced human experimental models. Full article

Background and objectives: Valve-in-valve transcatheter aortic valve replacement (ViV TAVR) has become an established treatment for failed surgical bioprostheses in patients at high surgical risk. However, procedures performed in degenerated stentless aortic valves remain particularly challenging because of the absence of a radiopaque frame, variable surgical implantation techniques, and a potentially increased risk of coronary obstruction. Evidence in this specific setting is limited. We conducted a systematic review of the literature to identify studies reporting ViV TAVI in degenerated stentless surgical bioprostheses. Materials and methods: Case reports and case series were included when patient-level or clearly identifiable data were available. Baseline characteristics, anatomical features, procedural strategies, and clinical outcomes were extracted and analyzed using a descriptive approach. A total of 54 studies were included, encompassing 294 ViV TAVI procedures performed in failed stentless aortic valves. Results: The mean patient age was 73.9 years, and the average STS-PROM score was 13.45%, reflecting a high-risk population. The most frequently treated prosthesis was the Medtronic Freestyle valve, and the predominant mechanism of failure was regurgitation. Transfemoral access represented the most common approach, while balloon-expandable and self-expanding transcatheter valves were used with similar frequency. Coronary protection strategies were adopted in a minority of procedures, whereas adjunctive procedural techniques such as pre- or post-dilation were relatively common. Device-related complications were mainly driven by coronary obstruction, while cardiac complications included myocardial infarction and unplanned coronary intervention. Overall, VARC-3 device success was achieved in the majority of procedures, with acceptable short-term mortality despite the complexity of the treated population. Conclusions: ViV TAVR in degenerated stentless bioprostheses appears feasible and generally effective but remains associated with specific procedural challenges, particularly related to coronary obstruction risk. Careful anatomical assessment and tailored procedural planning are essential, and larger contemporary studies are needed to better define optimal management strategies in this complex setting. Full article

Treatment of cats with pharmacological reproductive control is becoming increasingly common, with deslorelin implants as the primary non-surgical method. However, few studies have systematically documented behavioral changes after implantation. This study evaluated 28 behaviors, grouped into eight categories, in 82 cats at one and three months post-deslorelin implantation. At the group level, behavioral changes over time showed a consistent pattern, with decreases in reproductive behaviors, inappropriate elimination, and activity and increases in positive social behaviors and feeding and drinking from one to three months post-implantation. Given the large number of statistical comparisons performed, these findings should be interpreted with caution in the context of multiple testing. Sex-related differences were limited, with females showing a greater increase in feeding and drinking than males at one month. Age-related effects were also observed, with cats younger than one year being more active than those older than three years at one month. Coat type was associated with behavioral variation at three months, with shorthaired cats showing higher levels of reproductive behavior and inappropriate elimination compared with longhaired cats; however, these effects should be interpreted cautiously given multiple testing considerations. Full article

Zirconia is known as a strong and bioinert load-bearing material for dental implants. It typically exhibits no antibacterial activity. Inflammation is a crucial problem for dental implant surgery: about 3–5% of all dental implants experience inflammation. This study demonstrates that either fullerene C₆₀ films or a tribomechanical loading of zirconia without the fullerene C₆₀ coating can cause an improvement in antibacterial activity against Gram-positive Staphylococcus aureus. This moderate antibacterial activity is especially important, because a strong antibacterial effect could disturb the sensitive and beneficial oral bacterial biota. In the present study, different fullerene C₆₀ films were examined. In addition to fullerene C₆₀ film in an “as deposited” condition, treatment with nitrogen plasma as well as tribomechanical produced surface patterns with and without plasma post-treatment were tested. An 85.8% (log reduction 0.85) reduction in Gram-positive Staphylococcus aureus bacterial formation was observed on the zirconia with fullerene C₆₀ film. Plasma treatment of the C₆₀ film increases the antibacterial impact to 72.2% (log reduction 0.56) in comparison to zirconia without fullerene C₆₀ film. Also, tribomechanical loaded fullerene C₆₀ films suppress the growth of Gram-positive Staphylococcus aureus. The tribomechanical loading seems to compensate for the effect of the plasma treatment. ZrO₂ samples with fullerene C₆₀ film and tribomechanical loading achieve an increase in antibacterial impact of 83.36% (log reduction 0.78). Furthermore, surprisingly yttria-stabilized zirconia bioceramic without fullerene C₆₀ film also shows an improved antibacterial efficacy after a tribomechanical patterning procedure. The addition of surface patterning on the ZrO₂ by scratching microgroove arrangements with a diamond tip, increased the antibacterial effect against Gram-positive Staphylococcus aureus by 70.46% (log reduction 0.53). Full article

Background: Screw loosening remains a common mechanical complication in implant-supported restorations; however, the combined effect of sealing and superstructure materials on abutment screw stability warrants further investigation. Methods: This study evaluated the influence of access channel sealing material and superstructure material on abutment–implant screw stability after thermomechanical cyclic loading. Forty-eight Straumann analog–abutment assemblies restored with monolithic zirconia or resin nano-ceramic (Cerasmart) crowns were assigned to two sealing protocols: Polytetrafluoroethylene (PTFE) + composite or polyvinyl siloxane (PVS) putty (n = 12). After 750,000 off-axis cycles, reverse torque values (RTV) were analyzed using two-way analysis of variance (ANOVA) and Tukey’s HSD, with effect sizes calculated (α = 0.05). Results: A significant interaction between restorative material and sealing protocol was observed (p = 0.0170; η² = 0.116). Superstructure material showed no significant influence on RTV (p = 0.8368), whereas sealing protocol had a significant main effect (p = 0.0499). RTVs were highest for zirconia + PVS putty (36.33 ± 4.53 Ncm) and lowest for zirconia + PTFE (29.32 ± 6.30 Ncm), while the Cerasmart groups showed intermediate values. Post hoc analysis confirmed higher RTV for zirconia + PVS compared with zirconia + PTFE (p = 0.0138). Conclusions: Access channel sealing materials showed a material-dependent influence on abutment screw stability. Silicone-based sealing improved torque maintenance in zirconia, indicating that rigid restorative materials may be more sensitive to sealing material selection. In contrast, Cerasmart showed comparable RTV regardless of sealing protocol, suggesting that resilient restorative materials may reduce the influence of sealing on preload maintenance. Full article

Background: To explore the correlation between spatial dose distribution and post-implant urinary toxicity, aiming to assist decision making in low-dose-rate (LDR) treatment planning, thereby improving patient outcomes. Methods: Eighty-five prostate LDR patients with >12-month follow-up were included. Patient-reported urinary toxicity was collected prospectively using the International Prostate Symptom Score (IPSS) questionnaire, from before implant (baseline) to post-implant follow-up. Patients were then grouped into those whose symptom scores returned to ≤2 points above baseline by 12 months (no long-term toxicity) vs. those who did not (long-term toxicity). A total of 106 features were extracted for each patient, including principal components of dose-volume histograms (DVHs) from multiple prostate subzones, the whole prostate and urethra, along with baseline IPSS, implantation characteristics, and additional DVH indicators for the prostate and the urethra. A machine learning (ML) model incorporating backward feature selection algorithm was developed to predict long-term toxicity status, using a shuffle-and-split validation strategy for model evaluation during feature selection. A univariate statistical analysis was conducted on the model’s selected features. Results: Out of 85 patients, 41 (48%) had long-term urinary toxicity. Seven features were selected during model training, including baseline IPSS and six dosimetric features from several prostate subzones primarily located in the posterior prostate. The model achieved a high mean area under the receiver operating characteristic curve (AUC) of 0.81, with a balanced sensitivity and specificity of 0.78 by adjusting the probability threshold. In univariate analysis, only baseline IPSS and one selected dose feature were significantly correlated with long-term toxicity with AUC < 0.71. Conclusions: The proposed ML model, integrating baseline IPSS and spatial dosimetric features, effectively predicts long-term urinary toxicity after prostate LDR. This approach offers a practical method for risk stratification, allowing clinicians to identify patients at elevated risk and prioritize them for targeted preventative measures and closer follow-up. Full article

Background/Objectives: For men with bothersome lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) requiring surgical intervention, UroLift has been shown to be an effective and durable, minimally invasive method. Methods: A retrospective review was conducted for 72 patients who underwent UroLift at a single hospital in Australia between 2018 and 2025. Data regarding baseline demographics, the pre- and post-operative International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), the post-void residual (PVR), and complications were collected prospectively. Inclusion criteria for patients selected for UroLift were males over 50 years with a prostate volume between 20 and 70 mL, pre-operative PVR of <350 mL and Qmax and IPSSs of <15 mL/s and >12 respectively. The purpose of this study is to assess the clinical outcomes of patients treated with UroLift at our institution and compare these findings to the existing literature. Results: Complete data was available for 34 patients. Our cohort had a median age of 63.0 years (interquartile range [IQR] 58.0–69.0) and UroLift was performed using a median number of 4.05 implants per patient. Median prostate volume (mL) was 43.0 (IQR 38.0–59.0). Post-operatively, the median percentage changes in the IPSS, Qmax (mL/s) and PVR (mL) were −30.9% (IQR 5.8–−71.1, p = 0.0048), 40.1% (IQR −6.6–165.1, p = 0.0159) and −36.4% (IQR −84.6–29.8, p = 0.0232), respectively. Most patients (n = 24, 73.5%) were discharged on the same day of the UroLift procedure with the remainder (n = 9, 26.5%) being discharged on day 1 post-operatively. The median time (months) for post-operative review was 2 (IQR 0.9–3.3). Conclusions: UroLift is safe, effective, and a minimally invasive treatment option in suitable patients with bothersome LUTS requiring surgical intervention. Full article