Game CHANGER!!! Milep digital una nueva era en la enucleacion de próstata #prostata #laser #holep @fgomsan @scoffonecesare @dr_karian @YaroML

🚨 More expensive technology ≠ Better clinical outcomes.

HoLEP: Standard Holmium vs. MOSES 1.0 vs. MOSES 2.0.

Other premium laser platforms may also fail to demonstrate meaningful clinical superiority despite their higher costs.

New in @wjurol: thi scoping review in World Journal of Urology synthesizes 35 studies on intrarenal pressure during #PCNL. Irrigation, tract size and outflow matter; suction-assisted systems lower pressure without compromising stone clearance.

doi.org/10.1007/s00345…

Grateful to all coauthors for this first ever true prospective randomized controlled study on MiLEP vs HoLEP.

Why is HoLEP size-independent? Simple geometry.

From 30 to 500 cc we remove 48× more adenoma, but the enucleation plane grows only 13×. A median lobe adds only its base.

Interactive 3D model + free slides in 8 languages:
holep.icua.es/3d

#HoLEP #Urology
holep.icua.es/3d
#HoLEP #Urology

Prone vs Supine PCNL — think beyond “posterior calyx.”

In prone PCNL, access is predominantly through the posterior calyx, which usually lies closer to the horizontal access line.

In supine PCNL, we gain something valuable: flexibility to choose either an anterior or posterior al rotation and the shortest, straightest tract.

My practical decoding of renal anatomy:

In a Brödel-type kidney, the posterior calyces lie more horizontally and closer to the lateral convex border. They are therefore readily approachable within roughly ±15° of a straight horizontal tract.

In a Hodson-type kidney, the anterior calyces lie closer to this horizontal trajectory and may provide the more favorable access.

And an important geometric principle:
Enter through the more lateral calyx → easier alignment and navigation toward the medial calyces.

In supine PCNL, don’t choose anterior vs posterior by convention—choose the calyx that lies closest to your straight-line trajectory.

#SupinePCNL #PCNL #Endourology #Urolithiasis

20 years after TURP: a 90 cc prostate.

Secondary MiLEP with the new U-MAX UroLase laser system and pulse modulation: improved hemostasis, less carbonization, and faster enucleation.

What will we see 20 years after MiLEP? 🤔

#MiLEP #TFL #Thulium #EEP #PulseModulation #BPH

Is there an upper size limit for enucleation?
MiLEP with the new pulse-modulated U-MAX TFL and a 22 Fr high-flow sheath.
186 mL → 13 mL at 3 months.
Miniaturization without compromising enucleation efficiency.
#MiLEP #BPH #Enucleation #TFL

Does the HoLEP learning curve affect sexual outcomes?

Glad to share our recently published study in CEJU.

Erectile and ejaculatory outcomes after HoLEP: A longitudinal analysis during the learning curve ceju.online/journal/2026/E… - via @CEJUrol

Mini-HoLEP 💥
Side-by-side demonstration using the RZ 22F and Hawk 22F laser scopes, each with its dedicated morcelloscope.

#Urology #Endourology #HoLEP #MiLEP

[Yes, size does matter ]
Sheath size was independent factor for overall complications in multivariat analysis.
#MILEP
#BPH
@mohamed92902484
@hazemelmansy1
@uroprince
@Mohamedendourol
@trwherrmann
@FCAFigueiredo
@abdullalrefai
@oalhunaidi
@OTBuro
@drsalhelal
@elshal_ahmed

This month's HoLEP Academy course wrapped at Hill Clinic — visitors from Russia, Israel, Georgia, Ecuador, Mexico and Chile. Six countries, three continents.

One week — two innovations at our Institute.
Rezūm and MiLEP 18.5 Ch with a high-flow sheath.
Inspired by Prof. Figueiredo👋🏻🇧🇷
Advancing minimally invasive BPH treatment.
#MiLEP #Rezūm #TFL #BPH #highflowsheath

The 18th edition of our Cambridge HoLEP Course will be held on 13-14 July. This is a comprehensive course covering every aspect of HoLEP. Suitable for those contemplating the start of their HoLEP journey, through to experienced HoLEP surgeons
If you’d like to attend please DM me

Are we entering the era of real-time prostate biopsy interpretation? 👀

Same-day prostate cancer diagnosis may be closer than we think. Excited to share our recent work in @BJUIjournal. 🔬

@ZSchwen @drjkaouk @ricautor @JaneNguyen44 @CleClinicUro

bjui-journals.onlinelibrary.wiley.com/doi/10.1111/bj…

Intravesical Prostatic Protrusion (IPP) is measured on ultrasound (usually transabdominal) and reflects how much the prostate projects into the bladder lumen.

Grade 1: < 5 mm → Mild
Grade 2: 5–10 mm → Moderate
Grade 3: > 10 mm → Severe

El HoLEP es trabajo en equipo. Este vídeo muestra nuestro protocolo completo de enfermería para HoLEP en bloque — desde la colocación del paciente hasta la morcelación. Este video se presentó en el Congreso Europeo de Enfermería Urológica de 2026, celebrado en Londres, por el equipo de enfermería del ICUA.

Estandarizar el flujo del quirófano es clave para obtener resultados consistentes.

youtu.be/E5PpGexPzzQ

Obstructive azoospermia or recurrent seminal vesiculitis ✌️No worries any more 👍watch our semi-live session from the European Association of Urology Congress 2026. Although I couldn’t attend in person this year, I’m glad to share this work with you.

🧵 EAU26 | 5 cosas que me llevo de los abstracts sobre enucleación prostática (hilo):

1/5 Dos RCTs confirman que el resectoscopio 22F reduce la incontinencia precoz frente al 26F estándar (6.5% vs 29.5%). La miniaturización en enucleación ya tiene evidencia de nivel 1. #HoLEP #EAU26

2/5 HoLEP, ThuLEP, AEEP, Aquablation... los resultados a largo plazo convergen cuando la técnica es anatómica. "Enucleation is enucleation" no es un eslogan — es lo que dicen los datos. #BPH

3/5 Tranexámico intraoperatorio en pacientes anticoagulados: OR 0.17 para complicaciones hemorrágicas. 932 pacientes, 30 centros. Dato clínicamente muy aplicable. #Urología #EAU26

4/5 El 35,9 % de pacientes candidatos a enucleación prioriza la eyaculación entre sus 3 primeros outcomes. El 14,8 % de urólogos no lo mencionan en el consentimiento. Dato incómodo pero necesario.

5/5 LMU Munich documenta una década completa de transición de TURP a enucleación láser. En centros de alto volumen, el cambio ya ocurrió. La pregunta es cuándo llega al resto. 🔗 icua.es #HoLEP

@EduardoMazzucc1 sharing insight for ureteroscopy position: Gravity helps!

Using Trendelenburg positioning in ureteroscopic laser lithotripsy boosts stone-free rates to 92.1% vs 76.7% standard! OR 2.90 (95% CI 1.88-4.48)

#Urology #KidneyStones #MedEd
@urousp @so_uro ologia