{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T07:40:19Z","timestamp":1792309219506,"version":"4.4.0"},"reference-count":19,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Urologia"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Achieving both relief of urinary obstruction and preservation of ejaculatory function is a key goal of modern surgical management for benign prostatic hyperplasia (BPH). However, standardized definitions of success that integrate multiple clinical domains remain limited. This study introduces a composite definition of clinical success and explores its predictors using a multicenter dataset of minimally invasive, ejaculation-preserving procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Multi-institutional data were combined, including patients who underwent urethral-sparing robot-assisted simple prostatectomy (usRASP;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200994), Aquablation (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200995), or Rezum (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009308). Complete clinical success (CSS) was defined as: (1) \u2a7e30% International Prostatic Symptoms Score (IPSS) reduction at 12-months; (2) preserved ejaculation, based on a positive response to the Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD Q3); and (3) absence of \u2a7eGrade III Clavien\u2013Dindo complications. Partial clinical success (PCS) was defined as the achievement of any two of the three criteria. A multivariable logistic regression analysis identified independent predictors of CCS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The final cohort included 497 patients. CCS rates were 66.0% (usRASP), 73.6% (Aquablation), and 68.8% (Rezum); PCS rates were 28.7%, 14.7%, and 20.1%, respectively. No significant differences were observed among groups for IPSS (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.455), ejaculation rates (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.07), or complication rates (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.445). On multivariable analysis, prostate volume\u2009&lt;\u2009110\u2009mL (OR 0.52;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.034), higher MSHQ-EjD Q3 (OR 1.07;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and shorter catheterization time (OR 0.91;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.02) independently predicted CCS at 1\u2009year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This composite endpoint offers a pragmatic and clinically relevant framework for evaluating success in minimally invasive BPH surgery. Its adoption may enhance cross-technique comparisons and inform individualized treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03915603261457524","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T06:57:02Z","timestamp":1781679422000},"page":"705-712","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Redefining clinical success in minimally invasive surgery for BPH: A composite endpoint integrating ejaculatory function, urinary improvement, and safety metrics"],"prefix":"10.1177","volume":"93","author":[{"given":"Umberto","family":"Anceschi","sequence":"first","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Amparore","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Candiolo Cancer Institute FPO-IRCCS, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Minore","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Campus Bio Medico Di Roma, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4223-2216","authenticated-orcid":false,"given":"Antonio","family":"Tufano","sequence":"additional","affiliation":[{"name":"Department of Urology, San Carlo Di Nancy Hospital GVM Care and Research, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Ferrando","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera Universitaria San Luigi Gonzaga, Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Ortenzi","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Candiolo Cancer Institute FPO-IRCCS, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Checcucci","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Candiolo Cancer Institute FPO-IRCCS, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giampaolo","family":"Siena","sequence":"additional","affiliation":[{"name":"AOU Careggi, Department of Urology and Andrology, University of Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Cocci","sequence":"additional","affiliation":[{"name":"AOU Careggi, Department of Urology and Andrology, University of Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco Simone","family":"Flammia","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3084-6210","authenticated-orcid":false,"given":"Francesco","family":"Prata","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Campus Bio Medico Di Roma, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Basile","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Campus Bio Medico Di Roma, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"De Cillis","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera Universitaria San Luigi Gonzaga, Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Mastroianni","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Brassetti","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Consiglia","family":"Ferriero","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo Maria","family":"Bove","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Tuderti","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Department of Urology, Hesperia Hospital and CURE Group, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Varvello","sequence":"additional","affiliation":[{"name":"Department of Urology, Michele e Pietro Ferrero Hospital, Alba-Bra, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Pansadoro","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Robotic Urology, Fondazione Vincenzo Pansadoro, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Minervini","sequence":"additional","affiliation":[{"name":"AOU Careggi, Department of Urology and Andrology, University of Florence, 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Predictors of mid-term functional outcomes for robot-assisted Madigan simple prostatectomy: results of a multicentric series according to the BPH-6 achievement. 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