Benign prostatic hyperplasia (BPH) is one of the most common diseases of the genitourinary system. The prevalence of BPH increases in men with advancing age. While transurethral resection of the prostate gland entails complications such as retrograde ejaculation, urinary incontinence, hematuria, urethral strictures, bladder neck sclerosis, and other adverse events, it is necessary to apply minimally invasive surgical methods such as superselective embolization of the prostatic arteries (PAE), particularly Proximal Embolization First Then Distal Embolization (PErFecTED). The data from 1,015 BPH patients who underwent endovascular surgery demonstrate the benefits of PErFecTED treatment during 24 months after surgery. Both Quality of Life score and International Prostate Symptom Score were around three times better in the PErFecTED group and remained stable during the entire observation period. However, the technique needs to be improved due to the high risk of postembolization syndrome.

Aim. To evaluate the efficacy and safety of implantation of a free synthetic loop (Tension-free Vaginal Tape - TVT) in the treatment of stress urinary incontinence in women. Methods. Examined and operated were 80 patients suffering from stress urinary incontinence. Suburethral implantation of a free loop (sling) in 3 patients was performed using standard TVT kit, while in 77 - using the IVS kit (Intravagynal Sling), which has some design differences from the TVT kit. Results. The observation period ranged from 3 months to 5 years. According to a questionnaire survey designed by the authors, which includes 21 questions, the following results were obtained: good - in 72 (90%) patients, satisfactory - in 6 (7.5%), unsatisfactory - in 2 (2.5%) patients. According to uroflowmetry, after the conducted treatment the duration and volume of urination increased, the maximal urine flow rate decreased to the normal values. Conclusion. The operation of implantation of a free synthetic loop serves as a rational and effective treatment method for the correction of stress urinary incontinence in women without prolapse of the vaginal walls; the success of intervention largely depends on the proper selection of patients and on the surgical technique.

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Purpose: To evaluate the use of prostatic artery embolization (PAE) as a treatment option for patients with symptomatic benign prostatic hyperplasia (BPH) with prostate volumes of 80 cc and more. Materials and Methods: The study included 75 patients with high anesthesia-related risks for conventional surgery (TURP). All patients were surveyed for symptom burden, using IPSS and quality of life score. The prostate volume was determined by transrectal ultrasonography (TRUS). At baseline, prostate-specific antigen (PSA) level was obtained in all patients. Urodynamics was evaluated using uroflowmetry. Clinical outcomes were assessed at follow-up 1, 3, 6, 12, and 24 months after PAE. Results: The prostate volume decreased significantly at months 1 and 3 post-treatment; the prostate continued shrinking until month 12, and the size was then stabilized. At month 24, prostate volume decreased by 40.82%, from 134.0 ± 8.3 mL at baseline to 79.3 ± 6.6 mL. Postvoid residual (PVR) urine volume was significantly decreased from 55.9 ± 5.3 mL to 22.0 ± 1.8 mL 1 month after PAE ( p < 0.001). Qmax increased from 9.2 ± 0.3 mL/s to 15.7 ± 0.4 mL/s. IPSS score following PAE decreased from 28.2 ± 0.7 to 9.7 ± 0.8 ( p < 0.001). QoL improvement was observed from 4.8 ± 0.2 at baseline to 1.8 ± 0.2 at month 24 ( p < 0.001). Decreased activity and density of adenomatous tissue resulted in decreased total PSA levels: from 5.9 ± 1.1 ng/mL to 2.6 ± 0.2 ng/mL ( p < 0.001). TURP became feasible in 35 patients due to reduction of prostate volumes below 80 mL after PAE. Conclusions: PAE was effective in relieving LUTS and reducing prostate size, and may be considered as a preoperative approach for patients with large prostate.