Pirfenidone (PFD), a broad-spectrum anti-fibrotic agent, shows therapeutic potential in various fibrotic diseases. However, its effect on neurogenic bladder fibrosis following spinal cord injury (SCI) and its association with ferroptosis remain unclear. This study aimed to investigate the therapeutic efficacy of PFD against bladder fibrosis after SCI and to preliminarily analyze its potential link with ferroptosis using a rat SCI model and a Transforming Growth Factor-β1 (TGF-β1)-induced fibrotic model in Simian Virus 40-Transformed Human Urothelial Cells (SV-HUC-1). In SCI rats, PFD treatment significantly improved urodynamic parameters, while markedly reducing collagen deposition, inflammatory infiltration, and the progression of epithelial-mesenchymal transition (EMT) in bladder tissue. In the cellular model, PFD effectively attenuated TGF-β1-induced fibrotic responses. Mechanistically, network pharmacology analysis predicted that PFD could modulate the TGF-β1 signaling and lipid peroxidation pathways. In vivo experiments confirmed that PFD reversed the dysregulation of key ferroptosis-related molecules, and in vitro studies demonstrated that PFD antagonized Erastin-induced ferroptosis, an effect comparable to the ferroptosis inhibitor Ferrostatin-1 (Fer-1). However, in the TGF-β1-induced fibrotic model, inhibition of ferroptosis alone only partially ameliorated the fibrotic phenotype, and its effect was weaker than that of PFD. This study demonstrates that PFD can effectively alleviate bladder fibrosis after SCI, and its therapeutic effect may be associated with the ferroptosis pathway. These findings suggest that PFD likely exerts its anti-fibrotic action through multi-pathway synergy, with ferroptosis inhibition representing an important contributing pathway supported by the current data, providing a new theoretical basis for treating neurogenic bladder fibrosis.

Neurogenic bladder (NB) is a devastating complication following sacral spinal cord injury (SSCI), often leading to urinary incontinence, recurrent infections, and progressive renal dysfunction, which severely impair patients' quality of life and survival. Current therapeutic options remain largely palliative and fail to reverse the underlying neurogenic pathology. This study employed mild photothermal therapy (MPTT) to treat SSCI-induced NB in rats and systematically investigated its efficacy and mechanisms. Results showed that MPTT effectively improved bladder morphology and urodynamic parameters, with more significant effects observed in early intervention. Mechanistically, MPTT inhibited bladder fibrosis, alleviated chronic inflammation, restored the balance between cell proliferation and apoptosis, promoted functional angiogenesis, and repaired structural damage and function of bladder nerve fibers. MPTT ameliorates SSCI-NB function through multi-target effects, and its time-dependent therapeutic efficacy suggests the necessity of early and repeated interventions, providing experimental and theoretical evidence for new NB treatment strategies.

This article presents the clinical experience of our center with the SHURUI Single-Port Serpentine-Arm Robotic System for pyeloplasty in infants with ureteropelvic junction obstruction.

BackgroundComplicated urinary tract infections (cUTIs) represent a critical subset of pediatric UTIs, characterized by diverse complex factors stemming from the patient, disease status, and pathogen-related attributes. Without timely and precise management, cUTIs may progress to invasive renal parenchymal infection (IRPI), posing long−term health risks. A central challenge in cUTI management lies in the limitations of urine culture, including prolonged turnaround time and suboptimal sensitivity, particularly post-antibiotic exposure. Hybrid Capture-Based targeted next-generation sequencing (hc-tNGS), a culture-independent emerging etiological assay, provides a potential solution to optimize clinical care. However, evidence regarding its utility in pediatric cUTI cohorts remains limited.MethodsThis single−center, retrospective study enrolled 88 pediatric cUTI patients. All participants underwent sequential urine culture followed by hc−tNGS. The performance of the two methods in terms of pathogen spectrum, detection rate, and potential implications for antibiotic therapy optimization were compared.ResultsHc−tNGS demonstrated significantly higher pathogen detection sensitivity compared to conventional urine culture (92.5% vs. 33.0%, p < 0.001). Meanwhile, hc−tNGS uniquely identified polymicrobial bacterium-bacterium or bacterial-fungal infections in 58% cases, a profile missed by culture. Furthermore, Klebsiella species infection was identified as an independent risk factor for IRPI. Pathogen genetic profiling revealed that virulence and resistance genes were primarily clustered within E. coli-associated monomicrobial or polymicrobial pathogens, mainly including adhesion−related ompA, siderophore genes (iucA/B/C), and CTX−M resistance genotypes, respectively. In the vesicoureteral reflux (VUR) subgroup, this comprehensive profiling was associated with antibiotic adjustments in 71% cases.ConclusionSequential hc−tNGS provides a clinical diagnostic approach for cUTI as a complement to urine culture, especially after prior antibiotic use or suspected renal involvement. It enables accurate detection of polymicrobial and difficult−to−culture pathogens. These findings suggest that hc−tNGS may be integrated into routine diagnostic workflows to help guide targeted therapy and improve patient management in complex UTI settings.

Background:Circumcision is a common pediatric urological procedure for phimosis, balanitis, or cultural/religious reasons, but postoperative pain, edema, delayed healing, and infection remain key concerns. This study aimed to evaluate the safety and efficacy of Compound Chamomile-Lidocaine Gel for postoperative wound healing in children undergoing classical circumcision. Methods:A multicenter, randomized, controlled trial was conducted in 186 boys aged 8-17 years. Participants were randomly assigned to receive postoperative wound treatment with either saline alone (control group) or saline combined with Compound Chamomile-Lidocaine Gel (intervention group). The primary outcome was the degree of local edema 1 week after surgery, assessed by blinded evaluators. Secondary outcomes included maximum pain score (Visual Analogue Scale, VAS) within 2 days postoperatively, wound healing scores (days 3, 7, 14), total wound healing time, cosmetic scores at 4 weeks, patient satisfaction, and infection rates (days 7, 14). Results:In the per-protocol set (PPS), the incidence of moderate-to-severe edema was significantly lower in the intervention group than in the control group (10.59% vs. 24.10%, P=0.04). The intervention group also demonstrated a lower maximum VAS pain score (3.12±1.28 vs. 5.29±1.17, P<0.001) and a shorter mean wound healing time (11.13±4.04 vs. 12.53±2.59 days, P<0.001). However, no significant differences were observed in wound healing scores, cosmetic scores, patient satisfaction, or infection rates. Three adverse events occurred in the control group: wound bleeding on day 3, unexplained fever at 4 weeks, and purulent wound discharge on day 5, all of which resolved with outpatient treatment; no adverse events were reported in the intervention group. Conclusions:Compound Chamomile-Lidocaine Gel combined with saline significantly reduces edema, alleviates pain, and shortens healing time after pediatric circumcision. These findings suggest its potential value in clinical applications. Trial Registration:Chinese Clinical Trial Registry (Registration No. ChiCTR2400084075); Date of Registration: 10/05/2024.

Extracellular vesicles (EVs) are not only involved in cell-to-cell communications but have other functions as “garbage bags”, as bringing nutrients to cells, and as inducing mineral during bone formation and ectopic calcification. These minuscule entities significantly contribute to the regulation of bodily functions. However, the clinical application of EVs faces challenges due to limited production yield and targeting efficiency. In our study, we propose a method for efficiently harvesting EVs utilizing simian virus 40 large T antigen (SV40LT) immortalized human placental chorionic mesenchymal stromal cells (CMSCs). We investigated immortalized placental chorionic mesenchymal stromal cells (imCMSCs), a stromal cell line that surpasses the growth limitations of primary passage cells while retaining phenotypic characteristics and differentiation potential. This development offers the prospect of a consistent, uniform source of EVs, which is essential for regenerative medicine. Our findings indicate that the immortalization process preserves the particle size, quantity and surface marker profiles of EVs, providing a possible approach to produce high-yield EVs suitable for disease diagnosis and treatment.

Hedyotis diffusa Willd. (HDW), a traditional Chinese medicinal plant, exhibits a variety of pharmacological effects and has anticancer potential for a wide range of cancer types; Ferroptosis is a non-apoptosis-regulated cell death induced by iron accumulation and subsequent lipid peroxidation; and there is currently an increasing interest in the therapeutic role of ferroptosis in cancer. However, the effects of HDW on bladder cancer and its underlying molecular mechanisms remain largely unknown. In this study, a combination of in vivo and in vitro experiments, network pharmacology and data mining methods were used to investigate the effects of HDW on BLCA. The results showed that HDW exerted its anticancer activity by inducing ferroptosis in bladder cancer cells. Subsequently, we demonstrated for the first time that HDW induced ferroptosis in vitro and in vivo. To further explore the possible targets of HDW-induced ferroptosis in bladder cancer, we performed network pharmacological analyses, transcriptomic analyses, and single-cell analyses; through integrative analyses, we identified three key pivotal genes associated with iron death, CAV1, VEGFA, and JUN.Mechanistically, we showed that CAV1, VEGFA and JUN are key determinants of HDW-induced ferroptosis in BLCA. Knockdown of target genes altered the anticancer effects of HDW in 5637 and T24 cells. In conclusion, our data show for the first time that HDW exerts its anticancer effects on BLCA through CAV1, VEGFA and JUN gene-induced ferroptosis. This is expected to provide a promising compound for bladder cancer therapy.

PURPOSE:The study aimed to explore the relationship between different types of meat intake and the risk of nephrolithiasis using NHANES data and Mendelian randomization (MR) techniques. MATERIALS AND METHODS:This study was a cross-sectional study supplemented by a two-sample MR approach. Weighted multivariable-adjusted logistic regression analysis was conducted on the gathered data to assess the link between meat consumption and the risk of developing kidney stones. Subsequently, a two-sample MR study was conducted utilizing genome-wide association study (GWAS) summary statistics to explore the causal link between meat intake and nephrolithiasis. The main inverse variance weighted (IVW) method along with supplementary MR techniques were applied to validate the causal relationship. RESULTS:Prospective study analysis demonstrated a negative relationship between nephrolithiasis risk and salmon intake (OR = 0.861, 95% CI: 0.745 - 0.996) and a positive relationship with cod intake (OR = 1.288, 95% CI: 1.040 - 1.596). Mendelian randomization results showed that oily fish intake was negatively associated with nephrolithiasis (OR = 0.67, 95% CI: 0.51 - 0.89), while non-oily fish (OR = 1.55, 95% CI: 1.05 - 2.28) and pork (OR = 1.54, 95% CI: 1.04 - 2.28) intake were associated with an increased risk. CONCLUSION:Findings indicate that oily fish intake may lower the risk of kidney stone and highlight the significance of specific dietary modifications for preventing and controlling nephrolithiasis.

Background:Cardiac arrest (CA) is a critical condition that would cause high mortality. Fibrinogen, as a macromolecular protein involved in both inflammatory response and coagulation regulation, was reported to be associated with a series of life-threatening conditions. The aim of this study is to investigate the association between fibrinogen level and prognosis of patients after cardiac arrest. Methods:This study is a retrospective study utilizing the database MIMIC-IV version 1.0. Logistic regression and Cox proportional hazards regression were applied to explore the relationship between fibrinogen and in-hospital, 30-day, 90-day mortality of patients after cardiac arrest. Kaplan-Meier survival curve was also drawn. Subgroup analysis was conducted to explore whether the association remains in various subgroups. In addition, propensity score matching (PSM) was used to adjust confounding factor. Results:525 eligible patients were enrolled in total. Among them, 238 patients survived and 287 died during ICU hospitalization. Kaplan-Meier curve showed significant difference in survival probability (p < 0.01). For in-hospital mortality, reduced fibrinogen level was considered as a risk factor regardless of univariate regression (OR = 1.67, 95 % CI [1.08, 2.58], p = 0.022) or multivariate regression (OR = 1.26, 95 % CI [1.09, 1.43], p = 0.031). For 30-day mortality and 90-day mortality, reduced fibrinogen level was still a significant risk factor. Furthermore, such an association was demonstrated by subgroup analysis and propensity score matching. Conclusion:The presence of reduced fibrinogen level indicates a heightened risk of mortality in patients after cardiac arrest, whereas elevated fibrinogen level may be not associated with mortality.

Extracellular vesicles (EVs) secreted by mesenchymal stromal cells (MSCs) have been shown to provide significant protection against renal ischemia–reperfusion injury (IRI). Hypoxia has emerged as a promising strategy to enhance the tissue repair capabilities of MSCs. However, the specific effects of hypoxia on MSCs and MSC-EVs, as well as their therapeutic potential in renal IRI, remain unclear. In this study, we investigated the alterations occurring in MSCs and the production of MSC-EVs following hypoxia pre-treatment, and further explored the key intrinsic mechanisms underlying the therapeutic effects of hypoxic MSC-EVs in the treatment of renal IRI. Human umbilical cord MSCs were cultured under normoxic and hypoxic conditions. Proliferation and related pathways were measured, and RNA sequencing was used to detect changes in the transcriptional profile. MSC-EVs from both normoxic and hypoxic conditions were isolated and characterized. In vivo, the localization and therapeutic effects of MSC-EVs were assessed in a rat renal IRI model. Histological examinations were conducted to evaluate the structure, proliferation, and apoptosis of IRI kidney tissue respectively. Renal function was assessed by measuring serum creatinine and blood urea nitrogen levels. In vitro, the therapeutic potential of MSC-EVs were measured in renal tubular epithelial cells injured by antimycin A. Protein sequencing analysis of hypoxic MSC-EVs was performed, and the depletion of Glutathione S-Transferase Omega 1 (GSTO1) in hypoxic MSC-EVs was carried out to verify its key role in alleviating renal injury. Hypoxia alters MSCs transcriptional profile, promotes their proliferation, and increases the production of EVs. Hypoxia-pretreated MSC-EVs demonstrated a superior ability to mitigate renal IRI, enhancing proliferation and reducing apoptosis of renal tubular epithelial cells both in vivo and in vitro. Protein profiling of the EVs revealed an accumulation of numerous anti-oxidative stress proteins, with GSTO1 being particularly prominent. Knockdown of GSTO1 significantly reduced the antioxidant and therapeutic effects on renal IRI of hypoxic MSC-EVs. Hypoxia significantly promotes the generation of MSC-EVs and enhances their therapeutic effects on renal IRI. The antioxidant stress effect induced by GSTO1 is identified as one of the most critical underlying mechanisms. Our findings highlight that hypoxia-pretreated MSC-EVs represent a novel and promising therapeutic strategy for renal IRI.

Introduction To analyze the characteristics of early clinical symptoms of hemorrhagic cystitis (HC) after hematopoietic stem cell transplantation (HSCT) and the risk factors of severe HC. Methods We retrospectively analyzed 77 children with post‐HSCT HC treated at our hospital between June 2013 and June 2021. Clinical characteristics were collected and catalogued. Results Among the children with urinary tract irritation symptoms (UTIS) as the first symptom, symptoms appeared earlier than hematuria symptoms (28 day vs. 31 day, p = 0.027), and the time progressing to severe HC was significantly longer in these children (12 day vs. 7 day, p = 0.038), but there was no significant difference in the number of participants (57.8% vs. 59.4%, p = 0.889). BK polyomavirus (BKV) infection was an independent risk factor (hazard ratio [HR] = 2.782, p = 0.035) for severe HC, which was also positively associated with multi‐viral infection (HR = 2.215, p = 0.020). Conclusions In HC children, when the first urinary tract symptom was UTIS, it appeared earlier than hematuria, and the time of progression to severe HC was significantly longer, suggesting that we still need more aggressive treatment for these children to prevent the worsening of symptoms. The severity of HC was positively correlated with BKV infection and multiple infections.

ObjectivesBenign prostatic hyperplasia (BPH) management has evolved from transurethral resection of the prostate (TURP) to holmium laser enucleation of the prostate (HoLEP). Recent innovation introduces MosesTM technology in holmium lasers, with the Lumenis PulseTM system.MethodsTo compare Moses-augmented HoLEP (MoLEP) to non-Moses HoLEP in terms of enucleation efficiency, hemostasis, and applicability in day surgery settings. A single-blind, prospective, parallel randomized controlled trial was conducted in Shanghai, China, from March to December 2022. Ethical approval (SK2020-038) was obtained, and 100 consenting men over 50 with BPH indications were randomized (1:1) into MoLEP and HoLEP groups. Surgical procedures were standardized, and outcomes were assessed by blinded analysts.ResultsData from 80 participants (38 MoLEP, 42 HoLEP) were analyzed. Baseline characteristics were comparable. MoLEP demonstrated superior enucleation efficiency (3.5±0.8 g/min) and shorter enucleation time (22.5±7.6 minutes) compared to HoLEP, although not statistically significant. MoLEP achieved hemostasis in less time (6.6±4.2 minutes) than HoLEP (11.2±5.1 minutes). Postoperative care demands varied, with MoLEP requiring less bladder irrigation. MoLEP exhibited a shorter average catheterization time (1.3±0.1 days) and reduced hospitalization compared to HoLEP. Both groups showed significant postoperative improvements in functional outcomes.ConclusionWhile statistical significance was not achieved in certain outcome measures, MoLEP exhibited potential advantages in postoperative care demands, shorter catheterization time, and reduced hospitalization, suggesting its feasibility and safety in day surgery settings. Postoperative functional outcomes improved significantly in both groups.

The treatment of severe acute pancreatitis (SAP), with high mortality rates, poses a significant clinical challenge. Investigating the pathological changes associated with SAP using animal models can aid in identifying potential therapeutic targets and exploring novel treatment approaches. Previous studies primarily induced pancreatic injury through retrograde bile duct injection of sodium taviaurocholate, but the impact of surgical damage on the quality of the animal model remains unclear. In this study, we employed various frequencies of intraperitoneal Caerulein injections combined with different doses of LPS to induce pancreatic injury in C57BL/6J mice and compared the extent of injury across five intraperitoneal injection protocols. Regarding inducing acute pancreatitis in mice, an intraperitoneal injection protocol is proposed that results in a mortality rate as high as 80% within 5 days. Specifically, mice received ten daily intraperitoneal injections of Caerulein (50 µg/kg), followed by an injection of LPS (15 mg/kg) one hour after the last Caerulein administration. By adjusting the frequency and dosage of injected medications, one can manipulate the severity of pancreatic injury effectively. This model exhibits strong controllability and has a short replication cycle, making it feasible for completion by a single researcher without requiring expensive equipment. It conveniently and accurately simulates key disease characteristics observed in human SAP while demonstrating a high degree of reproducibility.

Sacral spinal cord injury (SSCI) can disrupt bladder neuromodulation and impair detrusor function. Current studies provide limited information on the histologic and genetic changes associated with SSCI-related neurogenic lower urinary tract dysfunction (NLUTD), resulting in few treatment options. This study aimed to establish a simple animal model of SSCI to better understand the disease progression. Ninety 8-week-old Sprague-Dawley (SD) rats were randomly separated into sham operation and SSCI groups. The SSCI group underwent sacral spinal cord injury, while the sham group did not. Urodynamic and histological assessments were conducted at various intervals (1, 2, 3, 4, and 6 weeks) post-injury to elucidate the disease process. Urodynamic examinations revealed significant bladder dysfunction in the SSCI group compared to the sham group, stabilizing around 3–4 weeks post-injury. Histological examination, including hematoxylin–eosin and Masson’s trichrome staining, correlated these functional changes with bladder microstructural alterations. RNA-seq was performed on bladder tissues from the sham group and SSCI group at 6 weeks to identify differentially expressed genes and pathways. Selected genes were further analyzed using polymerase chain reaction (PCR). The findings indicated a pronounced inflammatory response in the first 2 weeks post-SSCI, progressing to bladder fibrosis at 3–4 weeks. In conclusion, this study presents a reliable, reproducible, and straightforward SSCI model, providing insights into bladder functional and morphological alterations post-SSCI and laying the groundwork for future therapeutic research.

The evolution of laser medical devices for benign prostatic hyperplasia (BPH) treatment aims to enhance vaporization, coagulation, or tissue removal. In this study, we aim to evaluate the effectiveness and safety of the innovative application of insulated-gate bipolar transistor (IGBT) xenon lamp-pulsed drive technology holmium laser in endoscopic prostate enucleation operations using canine models. Six canines were used as an experimental unit, the breed of the canine unit used was beagle. Each canine served as its own control to minimize the number of experimental units. Endoscopic enucleation, performed by a single surgeon, involved enucleating the left hemi-prostate, leaving the right hem-prostate untouched to serve as the control. Throughout the study period, all canines maintained good health. No adverse events were observed in all six canines. Postoperatively, there were no indications of redness, swelling, or other adverse effects at the surgical sites. No abnormalities were observed in the appearance and morphology of major organs. The prostate and bladder, removed for further pathological evaluation, exhibited no abnormalities in size, color, or texture. No abnormalities or inflammation were observed, and the tissues were free of adhesions, indicating successful healing. In conclusion, our comparison of preoperative and postoperative parameters in canines suggests that the IGBT pulsed laser, at a power setting of 100 W, demonstrates characteristics of safety, efficacy, minimal tissue damage, and no major postoperative complications. This study establishes a theoretical foundation for future applications in human settings, encouraging further exploration of the IGBT holmium laser’s potential in clinical practice.

There is little known about the contribution of exosomal microRNAs (exomiRs) in the children's cardiac surgery-associated acute kidney injury (CSA-AKI). This study aimed to find diagnostic biomarkers for predicting CSA-AKI in children. A prospective observational study was conducted from April 2020 to March 2021.According to the changes of serum creatinine (SCr) value and urine volume within 48 h, the children were divided into acute kidney injury (AKI) group and non-AKI group. Serum samples were collected 4 h after cardiac surgery. Isolation of extracellular vesicles (EVs) and extraction of exomiRs from serum samples. Illumina high-throughput sequencing was used to quantify exomiRs and screen candidate microRNAs (miRNAs). Expression levels of candidate miRNAs were validated using droplet digital polymerase chain reaction (ddPCR). Normal and injuried rats' kidney tissue were collected for tissue validation. In the pre-experimental stage (4 AKI vs. 4 non-AKI), hsa-miR-184, hsa-miR-4800-3p, hsa-miR-203a-3p and hsa-miR-6766-3p were selected as candidate genes. In the verification stage (8 AKI vs. 12 non-AKI), the expression of hsa-miR-184 in AKI group was significantly lower than that in non-AKI group (P = 0.031), and the expression of hsa-miR-4800-3p and hsa-miR-6766-3p in AKI group was significantly higher than that in non-AKI group (P = 0.01 and P = 0.047). There was no significant difference in the expression of hsa-miR-203a-3p between the two groups (P > 0.05). The expression of rats' kidney tissue rno-miR-184 in AKI group was significantly lower than that in the normal group (P = 0.044). The area under the curve (AUC) of AKI predicted by hsa-miR-184 is 0.7865 and the AUC of hsa-miR-6766-3p is 0.7708. Combined with two kinds of miRNAs, the area under the curve of AKI is predicted to be 0.8646. The change of exomiRs level in circulatory system occurred in the early stage after cardiac operation, and the changes of hsa-miR-184 and hsa-miR-6766-3p content in circulatory system could predict CSA-AKI well.

Background: Senile osteoporosis (SOP) is an age-related metabolic bone disease that currently lacks specific therapeutic interventions. Thus, this study aimed to investigate the effect of Astragaloside IV (AS -IV) on macrophage senescence, bone marrow mesenchymal stem cell (BMSC) osteogenesis, and SOP progression. Methods: A senescent macrophage model was established and treated with varying concentrations of AS -IV. Cell activity was measured using the CCK8 assay. The senescence levels of macrophages were evaluated through beta-galactosidase staining, PCR, and immunofluorescence. Macrophage mitochondrial function was assessed using ROS and JC-1 staining. Macrophage polarization was evaluated through PCR, Western blot, and immunofluorescence. The inhibitory effects of AS -IV on macrophage senescence were investigated using Western blot analysis. Furthermore, the effects of macrophage conditioned medium (CM) on BMSCs osteogenic were detected using ALP, alizarin red, and PCR. Results: AS -IV inhibited macrophage senescence and M1 polarization, alleviated mitochondrial dysfunction, and promoted M2 polarization. Mechanistically, it suppressed the STING/NF-kappa B pathway in H2O2-activated macrophages. Conversely, the STING agonist c-di-GMP reversed the effects of AS -IV on macrophage senescence. Additionally, AS-IV-induced macrophage CM promoted BMSC osteogenic differentiation. In vivo, AS -IV treatment ameliorated aberrant bone microstructure and bone mass loss in the SOP mouse model, inhibited macrophage senescence, and promoted M2 polarization. Conclusions: By modulating the STING/NF-kappa B signaling pathway, AS -IV potentially inhibited macrophage senescence and stimulated osteogenic differentiation of BMSCs, thus exerting an anti-osteoporotic effect. Consequently, AS -IV may serve as an effective therapeutic candidate for the treatment of osteoporosis.

Our study aimed to describe the outcomes of transurethral enucleation of the prostate (HoLEP) for large-sized benign prostatic hyperplasia over 150 mL (bBPH). We conducted a retrospective, descriptive, and analytical study of patients undergoing HoLEP for bBPH. The primary endpoint was the success of the procedure, defined by a mixed criteria: complete endoscopic enucleation of the prostate, absence of blood transfusion or reoperation for bleeding, post-operative improvement of quality of life (assessed by a ≥ 2 points increase at in the 8th question of the IPSS test) and post-operative continence (no pads use) at 3 months. Eighty-one patients were included with a mean age of 73.9 ± 7.3 and a mean measured prostate volume of 183.3 ± 34.5 cc. The mean operative time was 57.5 ± 29.7 min and the average wet weight of resected tissue removed was 151.8 ± 44.7 g. Mean hospitalization stay was 1.3 ± 0.7 days with a mean post-operative catheterization period of 1.9 ± 0.9 days. The success of the surgery was achieved in 77 patients (95