The treatment of recurrent lower urinary tract infections (RLUTIs) remains unresolved due to increasing antibiotic resistance and the ability of pathogens to form biofilms and parasitize intracellularly, creating microbial communities with biofilm-like properties. Therefore, great importance is placed on studying the effect of combination therapy on recurrent inflammation in the bladder mucosa using alternative enzymatic preparations, such as Wobenzym. This preparation exhibits anti-inflammatory, immunomodulatory, fibrinolytic, antiplatelet, and anti-edematous effects, as confirmed by several studies. Based on the above, we have planned and conducted a clinical trial in a group of patients with recurrent lower urinary tract infections. STUDY OBJECTIVE:To evaluate the efficacy and safety of Wobenzym compared to placebo as part of combination therapy in patients with exacerbation of chronic recurrent uncomplicated cystitis. MATERIALS AND METHODS:The clinical part of the study was conducted in compliance with all GCP requirements, in 20 research centers in the Russian Federation. The study included screening, therapy period and follow-up period - 8 planned visits and unplanned in case of disease relapse. 640 patients were included in the study, 638 patients took the study drug and were randomized into two groups: Wobenzym Group - 320 and Placebo Group - 318 women. As an antibacterial therapy, all patients were prescribed fosfomycin trometamol (Monural). Group I of patients additionally received Wobenzym, Group II - Placebo. Comparative analysis did not reveal statistically significant differences between the groups in somatic status and lifestyle, as well as its characteristics (p>0.05). In accordance with the primary endpoint, the incidence of recurrent exacerbation of chronic recurrent uncomplicated cystitis was assessed in the groups. Secondary efficacy criteria included a comparative assessment of the dynamics of changes in the main clinical symptoms; the proportion of patients who reported the absence of pain at the completion visit according to the pelvic pain, urgency, and frequency of urination symptom scale; the proportion of patients with symptoms of a current exacerbation of the disease after 14, 28, 56, and 84 days of therapy according to the patient diary; the dynamics of changes in objective laboratory parameters; the frequency of dysbiosis before and after therapy. The safety of Wobenzym was also assessed. RESULTS:In the Wobenzym group, recurrent exacerbation of chronic recurrent uncomplicated cystitis was observed in 12.62% of patients (95% CI: 8.94; 16.29), in the Placebo group - in 24.53% of patients (95% CI: 19.77; 29.28) (p<0.05). The main symptoms of cystitis resolved statistically faster in patients receiving Wobenzym (p<0.05). Laboratory safety parameters were comparable between groups. Wobenzym therapy was accompanied by lower concentrations of proinflammatory and regulatory cytokines, particularly IL-8 and IL-10, with a clear trend toward increased efficacy in the late stages of observation. In this study, 191 AEs were recorded (86 in the Wobenzym Group and 105 in the Placebo Group). DISCUSSION:Our results confirm previous studies and the stated pharmacological properties of Wobenzym. CONCLUSION:Wobenzym is a safe and effective combination therapy for lower urinary tract infections, exhibiting anti-inflammatory and immunomodulatory effects to significantly reduce the recurrence of bladder mucosal inflammation.

AIM:To evaluate the clinical efficiency and safety of a two-stage treatment regimen with Vitaprost (rectal suppositories followed by change to the tablet form) in patients with chronic prostatitis (CP) and lower urinary tract symptoms (LUTS) after failure of previous therapy in real-world clinical practice. MATERIALS AND METHODS:A prospective non-interventional study, LEVITATE (Long-term Evidence for VITAprost in Treatment of prostatE diseases), was carried out. The analysis included 30 men with CP and LUTS (mean age 36.1+/-4.6 years) after ineffective previous therapy. Patients received Vitaprost suppositories for 30 days followed by 30 days of tablet therapy. Patients were also followed for 90 days. Assessments were performed at four visits using the NIH-CPSI, IPSS, and SF-36 questionnaires, transrectal ultrasound, and uroflowmetry. Statistical analysis was performed using the Friedman test. RESULTS:The total NIH-CPSI score decreased from 12.8+/-1.3 to 8.6+/-0.9 (4.2; p<0.0001). Improvement in prostate structure on transrectal ultrasound was observed in most patients; the proportion of fibrotic changes decreased from 46.7% to 16.7%. Prostate size decreased from 26.1+/-8.4 to 24.1+/-6.8 mm (-2,0; p<0.0001). Improvement in voiding parameters and quality of life was also noted. No adverse events were recorded. CONCLUSION:Two-stage therapy with Vitaprost is effective in patients with CP and LUTS after failure of previous treatment, providing a significant reduction in symptoms, improvement in the morphological and functional state of the prostate and voiding parameters, with high adherence and a favorable safety profile.

Introduction. Partial nephrectomy is the gold‑standard treatment for localised renal cell carcinoma. Further gains in outcomes after nephron‑sparing surgery require a shift in treatment strategy, with management centred on optimising the technique of partial nephrectomy so as to preserve the greatest possible number of functioning nephrons.Objective. To develop an in-practice algorithm for robot‑assisted nephron‑sparing partial nephrectomy and to report early clinical outcomes following its implementation.Materials & methods. We outline the core principles underpinning nephron‑sparing surgery and provide a detailed, stepwise description of the operative workflow for partial nephrectomy. Technical considerations are discussed in relation to case complexity. We reviewed the first 100 nephron‑sparing procedures performed at the Botkin Moscow Multidisciplinary Clinical Research Centre between 2020 and 2021 (70 laparoscopic and 30 robot‑assisted partial nephrectomies) within a prospective cohort, with renal functional outcomes assessed at one year postoperatively.Results. Preoperatively, most patients had clinical stage cT1a disease (n=70), with cT1b (n=14) and cT2 (n=4) tumours comprising the remainder; cystic renal lesions were present in 12 patients. Warm ischaemia was applied in 14% of cases, with a mean duration of 9 minutes and a maximum duration of 25 minutes. The negative surgical margin rate was 97%. Trifecta outcomes were achieved in 89% of patients, while Pentafecta criteria were met in 55%.Conclusion. Adherence to nephron‑sparing surgical principles can enhance functional outcomes following organ‑preserving renal surgery. The detailed operative algorithm presented here may be particularly useful when establishing a minimally invasive partial nephrectomy programme.

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic inflammatory bladder disorder with a poorly understood etiology and limited therapeutic options. Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, has recently been implicated in bladder epithelial damage, suggesting a potential role in IC/BPS pathogenesis. To systematically review available preclinical studies examining the potential role of ferroptosis in experimental models relevant to interstitial cystitis, with a focus on molecular mechanisms and ferroptosis-related biomarkers. This systematic review was conducted in accordance with the PRISMA 2020 guidelines. A structured PICO framework was used to identify eligible preclinical studies that evaluated ferroptosis in animal models or ex vivo systems mimicking interstitial cystitis. Data were extracted regarding ferroptosis markers, signaling pathways, and therapeutic interventions. Four preclinical studies were included, involving rodent models of cyclophosphamide- and LPS-induced cystitis, cystitis glandularis, and one study incorporating human bladder biopsies. Across all studies, ferroptosis was consistently associated with bladder injury, characterized by decreased expression of GPX4 and SLC7A11, elevated malondialdehyde (MDA), and increased lipid ROS. Key regulatory pathways involved included Wnt/β-catenin, NF-κB, and Nrf2. Ferroptosis inhibitors such as dexrazoxane, hydrogen sulfide donors, dietary restriction, and pachymic acid attenuated bladder damage by restoring redox homeostasis. None of the studies evaluated pain-related outcomes or functional bladder parameters, which limits the translational interpretation of findings in the context of IC/BPS symptomatology. This systematic review highlights ferroptosis as a compelling mechanistic link between chronic inflammation and urothelial injury in interstitial cystitis/bladder pain syndrome. Targeting ferroptosis may offer a novel disease-modifying strategy in a condition where current treatments remain largely symptomatic. Future translation into clinical settings could involve biomarker-guided phenotyping and intravesical delivery of ferroptosis-modulating agents to achieve localized and pathogenesis-based therapy. However, given the limited number of studies and the lack of human validation, these findings should be considered preliminary and hypothesis-generating.

Background . Decision on using nerve-sparing technique during robot-assisted radical prostatectomy (RARP) involves a compromise between oncological safety and preservation of erectile function affecting patients' quality of life. One of the approaches to decreasing oncological risks of nerve-sparing technique is intraoperative histological examination of prostate regions adjacent to neurovascular bundle. Aim . To evaluate the efficacy of express intraoperative histological examination of prostate regions adjacent to neurovascular bundle (CELPM protocol) during nerve-sparing RARP. Materials and methods . Between March 2019 and October 2025 at the S.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center of the Moscow Healthcare Department, nerve-sparing RARP with express histological examination of the lateral prostate margin was performed in 58 patients. All surgical interventions were performed using Si and Xi da Vinci models through transperitoneal access by two surgeons. Express and final histological examinations of all samples were performed at the Division of Pathological Anatomy of the Center. Presence of tumor tissue in the stained resection margin was considered a positive result of the examination. Results . Mean time to CELPM was 35 min. Mean operative time was 190 min. Unilateral and bilateral preservation of the neurovascular bundle was performed in 22.4 and 77.6 % of cases, respectively. Risk of recurrence was intermediate in 17.2 % of cases and high in 72.4 %. of cases. Extraprostatic tumor extension per the final histological examination was observed in 22.4 % of patients. The CELPM protocol showed tumor tissue in the resection margin in 23 % of cases. Planned histological examination of secondarily resected neurovascular bundles confirmed tumor process in 10 of 11 cases (90.9 %). In 1 case, oncological process in secondarily resected tissue was not confirmed. Tumor tissue in the resection margin during planned histological examination of the gross specimen (prostate, seminal vesicles, parts of the distal urethra/bladder neck) was found in 9 (15.5 %) of 58 cases. It is important to note that in all cases it was found outside the scope of previous express histological examination. Conclusion . The use of express histological examination technique (CELPM protocol) during nerve-sparing RARP allows to intraoperatively evaluate the status of resection margin which allows to resect the neurovascular bundles with tumor tissue during a single surgery decreasing the risk of early biochemical recurrence. This technique might extend the indications for nerve-sparing RARP, especially in patients with intermediate and high risk.

Aim. To evaluate safety of robot-assisted access compared to laparoscopic, abdominal, and vaginal accesses during sacrocolpopexy for pelvic organ prolapse. Materials and methods. Randomized and non-randomized trials involving women suffering from pelvic organ prolapse were included in the analysis. A search for studies published prior to January of 2026 was performed in the PubMed, Medline and Cochrane Library databases. The following key words were used: robotic, sacrocolpopexy, and pelvic organ prolapse. Articles describing other types of interventions and articles without comparative analysis were not included in this review. Results. In total, 36 studies were selected for the systematic review. The rate of postoperative complications in robot-assisted sacrocolpopexy was comparable to the rates in surgeries without the use of robotic devices. The volume of intraoperative blood loss did not differ from the volume during standard intervention through laparoscopic or abdominal access, but in vaginal access blood loss volume was significantly higher. Additionally, conversion rate for robot-assisted access was lower than for laparoscopic access. However, laparoscopic and vaginal accesses were characterized by shorter operative time compared to robot-assisted sacrocolpopexy. In-hospital time was shorter for robot-assisted access but compared to vaginal surgeries, no significant differences were observed. Conclusion. Robot-assisted sacrocolpopexy might be associated with the following benefits: lower blood loss compared to vaginal access and shorter hospitalization time compared to laparoscopic sacrocolpopexy. However, more accurate and objective confirmation of safety of robot-assisted sacrocolpopexy requires further high-quality prospective randomized trials.

The aim of the study is to analyze current evidence on the use of fluorescence-guided navigation with indocyanine green (ICG) during robot-assisted radical prostatectomy (RARP) and to assess its impact on surgical accuracy and patient safety. Materials and methods . A literature review was conducted using the PubMed, Scopus, and Web of Science databases for the period 2010–2025. The search included the following key terms: indocyanine green, ICG, radical prostatectomy, robot-assisted prostatectomy, lymphadenectomy, fluorescence-guided surgery. Systematic reviews, prospective, and retrospective studies evaluating the application of ICG in RARP were analyzed. Results . The use of ICG during RARP improves intraoperative visualization of lymph nodes, neurovascular bundles, and the dorsal venous complex, thereby enhancing the accuracy of lymphadenectomy and reducing the risk of injury to critical anatomical structures. Most studies demonstrate that ICG application shortens operative time, decreases blood loss, and increases the rate of nerve-sparing procedures without raising the incidence of positive surgical margins. However, standardization of the ICG dosage and administration protocol remains lacking, and further large-scale randomized trials are required to confirm its efficacy and reproducibility. Conclusion . Fluorescence-guided surgery using indocyanine green represents a promising approach for intraoperative visualization during RARP, improving the precision and safety of surgical interventions. Further research is needed to optimize administration protocols and validate the method through multicenter clinical trials with high levels of evidence.

The practical use of terms presented in the Russian Society of Urology clinical guidelines "Male Infertility" is discussed in the article. Male infertility is caused by conditions that lead to impaired reproductive function and inability to conceive: sexual dysfunction and anatomical defects that prevent sperm delivery, azoospermia, cryptozoospermia, functional insufficiency of spermatozoa and of the genetic material they contain, such as 100%- astheno-, necro-, and globozoospermia, etc. Signs of insufficient reproductive function (reproductive dysfunction) in partners may include relative infertility in a couple, miscarriage in the spouse, and failure of treatment using assisted reproductive technologies. Male fertility can be negatively affected by risk factors including diseases, lifestyle factors, and environmental exposures; the probability of conception can be judged by continuously distributed values of reproductive function indicators characterizing sexual activity, ejaculate parameters, functional competence of spermatozoa, and the quality of the genetic material they contain. Unified views on terminology ensure standardization of diagnostic and treatment approaches and provide a basis for interdisciplinary interaction in couple infertility.

This review analyzes approaches used in different countries to preserve male fertility before the start of gonadotoxic treatment in cancer patients. A comparative analysis of legislation regulating the availability of fertility preservation services is conducted. Based on literature data, criteria for the most effective measures to improve the quality of medical care for patients in need of fertility preservation in the Russian Federation are determined.

The aim of this study was to compare postoperative outcomes of same-day catheter-free discharge (SDS) and overnight observation (OBS) following artificial urinary sphincter (AUS) implantation. A systematic literature search was performed in PubMed, Scopus, Cochrane Library, Google Scholar, and ClinicalTrials.gov up to April 2025. Studies comparing SDS and OBS in men undergoing AUS surgery were included. Main outcomes were postoperative urinary retention, emergency department (ED) visits within 90 days, and suprapubic catheter (SPC) placement. Risk ratios (RR) and 95

INTRODUCTION:Vaginal reconstructive surgery aims to correct pelvic dysfunctions, but some patients may experience new symptoms after the procedure. These patients may develop a negative attitude toward treatment. The available literature is ambiguous due to the use of different study samples, instruments, and insufficient follow-up periods for this patient group. OBJECTIVE:The aim of the prospective cohort study was to identify predictors of de novo pelvic dysfunction after vaginal reconstructive surgery while monitoring patients for 12 months. MATERIALS AND METHODS:A prospective cohort study included 159 patients admitted for surgery for pelvic dysfunction. Prior to surgery, patients completed validated questionnaires - PISQ-12, ICIQ-SF, PFIQ-7, PFDI-20. After the surgical treatment, patients were invited for follow-up visit after 3, 6, and 12 months, during which they were asked to complete questionnaires again and undergo a gynecological exam. RESULTS:The prevalence of de novo pelvic dysfunction in women after vaginal urogynecological surgery was 9,7%, according to our study. In three quoistionares (ICIQ-SF, PFDI-20, and PFIQ-7), a higher ICIQ-SF score significantly increases the risk of postoperative urinary incontinence. Higher BMI also increases of postoperative urinary incontinence. The PFDI-20 preoperative questionnaire scores predict a chance of pelvic organ prolapse. CONCLUSIONS:Modern research shows that despite the success of urogynecological operations, such as correction of pelvic prolapses and incontinence treatment, the risk of de novo pelvic dysfunction remains significant. Improving the treatment and monitoring of patients with pelvic dysfunctions creates favorable conditions for reducing the number of postoperative complications and de novo symptoms.

The aim of this study is to evaluate the safety of robot-assisted sacrocolpopexy (RSP) compared with other approaches of sacrocolpopexy and vaginal surgery in pelvic organ prolapse (POP). The search was performed on studies published prior to May 2024. The inclusion criteria were randomized and nonrandomized trials involving adult women with POP. Exclusion criteria comprised other forms of intervention treatments and articles lacking comparative analyses. This study adhered to the Population, Intervention, Comparison, and Outcome framework, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 checklist, and was registered in the Prospective Register of Systematic Reviews. The systematic review included 36 studies, whereas the meta-analysis included 30 studies. RSP demonstrated superior outcomes compared with laparoscopic (LSP), abdominal (ASP), and vaginal surgery (VS) approaches, with fewer perioperative complications (p < 0.00001 for RSP vs ASP; p = 0.01 for RSP vs VS), reduced blood loss (total p < 0.00001 for RSP vs LSP, ASP, and VS), and shorter hospital stays (p = 0.003 for RSP vs LSP; p = 0.27 for RSP vs VS). Additionally, RSP had fewer surgical conversions than LSP (p = 0.01). However, LSP and VS showed significantly shorter operation times than RSP (p < 0.00001). Robot-assisted sacrocolpopexy may offer advantages in reducing blood loss compared with VS and shortening hospital stays compared with LSP. Sensitivity analyses, however, revealed no significant differences in perioperative complications or blood loss compared with LSP and ASP. Further high-quality randomized studies are necessary to confirm the safety and efficacy of RSP.

Introduction. Urodynamic studies play an important role in urological and gynecological clinical practice. Specialized catheters used to measure pressures inside and outside the bladder play an important role in this process. International Continence Society (ICS) standards recommend the use of water-filled catheters with external transducers for complex urodynamic studies, which ensures standardization and comparability of results between different clinicsand patients. In recent years, interest in air-charged catheters has increased as a potential alternative to traditional water-perfusion catheters catheters, supposedly reducing artifacts and improving measurement accuracy. Purpose. To conduct a comparative analysis of the data obtained during urodynamic study with the simultaneous use of air-charged and water-filled catheters in women with stress urinary incontinence. Materials and methods. A prospective comparative study of catheters for urodynamics in 41 patients with stress urinary incontinence who underwent surgical treatment at the Botkin Hospital. Air-charged and water-filled catheters were used and installed according to ICS standards. The study was performed using two urodynamic units: Duet Clinic (Mediwatch UK Ltd., Great Britain) for air-charged catheters and Dynamic Proxima (Medetron s.r.o., Czech Republic) for water-filled catheters. When comparing quantitative characteristics of two independent groups with a non-normal distribution, the Mann-Whitney U test was used, with a normal distribution – the Student test. Results. Among the main findings, air-charged catheters showed significant differences in cough pressure and Valsalva test measurements compared with water-filled catheters (p<0.05). However, differences in intravesical and abdominal pressure measurements did not reach statistical significance. Conclusion. The results of our study show that the data obtained using two types of sensors when conducting a complex urodynamic study are not completely comparable. To accurately measure bladder pressure, the use of water perfusion sensors is recommended.

Introduction. In the era of digital progress and the development of artificial intelligence (AI) technologies, the potential application of chatbots in various fields, including medicine, has gained significant attention. With the global accessibility of the internet and the growing popularity of such services, there is an increasing need to evaluate the reliability and quality of the data generated, particularly concerning malignant neoplasms. The aim of this study was to analyze the quality of medical information related to prostate and bladder cancer using AI-based chatbots. Materials and methods. A study was conducted involving the examination and analysis of web traffic data from StatCounter. Based on the results of the web analysis to determine the leading search engine in overall web traffic in Russia, we used data from the Yandex Wordstat analytics service. We also conducted an assessment of responses from four AI-based chatbots to the most in-demand medical queries related to the two urological cancers with the highest incidence rates-prostate cancer and bladder cancer. We used publicly available versions of the four AI-based chatbots: ChatGPT, Perplexity, YaGPT, and GigaChat. To evaluate the quality of the medical information provided by the chatbots, we applied the validated DIS- CERN assessment tool. In addition, qualitative analysis and expert evaluation using DISCERN were carried out with the participation of 50 respondents-oncourologists with at least 10 years of professional experience in Russia. Results. We obtained and analyzed the evaluation results using the DISCERN scale. The highest overall score for medical information quality was achieved by the Perplexity chatbot, followed by ChatGPT in second place, and GigaChat in third. YaGPT ranked fourth and last. It is worth noting that all chatbots, to varying degrees, made errors and inaccuracies in generating medical information in response to the relevant queries. Conclusion. Today, AI-based chatbots represent a promising and in-demand direction. With the advancement of technology and the widespread adoption of software solutions, more people are turning to such services in search of authoritative medical information. However, at this stage, not all chatbots are capable of providing accurate medical content. Further development of AI architecture and internal algorithms is required, as well as the creation of standards and recommendations for integrating chatbots into medical information systems. This will help shape the direction of AI solutions for the coming decades and support both physicians and patients in diagnostics and decision-making.

AIM:To develop a new practical classification of urinary incontinence (UI) in men based on clinical features and disease severity. MATERIALS AND METHODS:The Botkin classification MI-CRONS is a system based on clinical features of patients and the degree of UI. Clinical assessment of the degree of UI is based on urination frequency, the ratio of spontaneous and involuntary urine output, the use of absorbent underwear, the level of physical efforts causing urine loss, and nocturia. The system uses five capital Russian or Latin letters: MI (Male Incontinentce) - C (cancer), R (radiation), O (obstruction), N (neurogenic and non-neurogenic bladder disorders), S (stricture). In an observational study, the medical records of 158 men with UI treated between March 2020 and April 2024 were analyzed. Twenty-one patients were prospectively enrolled in the study with a 24-hour pad test to assess the severity of UI. Patients were classified according to the new MI-CRONS classification of UI in men. A correlation analysis was performed between the MI-CRONS severity score and the pad test results. RESULTS:One patient could not be classified according to MI-CRONS due to a history of bladder exstrophy and sigmocystoplasty. The results of the 24-hour pad test in 21 patients showed a high correspondence between the subjective sensations and the objective severity of UI. According to the proposed classification, patients most commonly had UI types 2 and 3 after radical prostatectomy and urethral stricture or vesicourethral anastomosis. In the prospective part of the study (n=21), a significant positive correlation (r=0.97) was found between the volume of urine loss measured by the 24-hour pad test and the severity of UI according to the MI-CRONS classification. CONCLUSIONS:The new Botkin classification MI-CRONS demonstrated its convenient and quick-to-use potential for classifying male UI of any type. The classification is a simple tool for characterizing men with UI and promises to be useful in routine clinical practice. Further multicenter studies are needed to assess its prognostic value.

Introduction. Ureteroscopy is the primary treatment modality for patients with ureteral stones. Despite its high efficacy, this intervention can be associated with severe complications, among which ureteral avulsion is considered one of the most serious. An even rarer complication is mucosal avulsion, with only isolated cases reported in the literature. Clinacal case. We present the case of a patient with a stone in the upper third of the right ureter who underwent prestenting due to a narrowing of the distal ureter. Three weeks later, during the planning of lithotripsy, the ureteral stent was removed, along with a tubular tissue fragment prolapsing from the ureteral orifice, which clinically and macroscopically resembled a segment of the ureter. Intraoperative ureteroscopy revealed preservation of the ureteral wall integrity with a circumferential defect of the mucosa. A ureteral stent was placed. Histopathological examination of the excised fragment revealed mucosal tissue with marked eosinophilic infiltration. At four-week follow-up, a repeat endoscopic procedure demonstrated complete restoration of the mucosa. Subsequent imaging confirmed the absence of residual fragments and maintained ureteral patency. Conclusions. Ureteral mucosal avulsion is a rare complication of ureteroscopy. Conservative management with ureteral stenting and close follow-up is often sufficient, helping to avoid unnecessary surgical procedures. Further reporting of such cases will aid in developing evidence-based diagnostic and treatment algorithms.

Introduction and objective: Stress urinary incontinence (SUI) remains a significant challenge in male patients, particularly following prostate surgery. Despite advancements in surgical techniques and technologies, a standardized method for evaluating treatment success remains under discussion. This study aims to propose a conceptual and comprehensive model that incorporates three key outcomes: quality of life, urinary leakage control, and safety, to provide a structured approach to the assessment of surgical interventions for SUI. Evidence acquisition: A literature review was conducted, focusing on clinical guidelines and outcome measures used in studies of SUI treatment. Key parameters were selected based on their relevance to patient satisfaction, clinical practice, and international standards, including the International Continence Society (ICS) and patient-reported outcomes (PROs). Results: The proposed trifecta model includes three essential criteria: (1) Quality of life, assessed by the Visual Numeric Scale (VNS) with scores of 0–2 indicating significant improvement; (2) Urinary leakage control, defined as “social continence” (use of 0–1 pad per day), reflecting practical success; and (3) Safety, evaluated by the absence of complications within 90 days postoperatively, aligning with standard follow-up timelines. This model addresses both objective and subjective outcomes. While it does not encompass long-term results, the trifecta is adaptable for extended evaluations at 1, 5, and 10 years and serves as a conceptual framework requiring future clinical validation. Conclusion: The proposed trifecta model suggests a patient-centered framework to evaluate the outcomes of surgical interventions for SUI. By addressing critical domains, it offers a structured method for clinical and research assessment. However, its clinical applicability requires confirmation through prospective validation in diverse patient cohorts.