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Objective: To identify risk factors for urethral stricture and/or bladder neck contracture after transurethral resection of benign prostatic hyperplasia. Materials and methods: We performed a retrospective analysis of 402 patients, which underwent a monopolar transurethral resection of the prostate in the urology clinic of Sechenov First Moscow State Medical University for prostatic hyperplasia during the period 2011-2014. Urethral stricture and (or) bladder neck contracture in the postoperative period were diagnosed in 61 (15.27%) patients; 34 patients (8.6%) had urethral stricture, 20 (4.97%) bladder neck contracture, and 7 (1.7%) had a combination of urethral stricture and bladder neck contracture. In 341 of cases (84.73%), no late postoperative complications were observed. A total of 106 of the 341 patients met the inclusion criteria, hence, containing all the information necessary for analysis such as the volume of the prostate, the duration of the surgery, the size of the endoscope, data on concomitant diseases, analysis prostatic secretion, and so on. Thus, two groups were formed. Group 1 (106 patients) is the control group in which urethral strictures and/or bladder neck contractures did not occur in the long-term postoperative period and group 2 (61 patients), in which was observed the formation of these complications. To calculate the statistical significance of the differences for categorical data, Fisher criterion was used. For quantitative variables, in the case of normal data distribution, an unpaired t-test or one-way analysis of variance was used; for data having a distribution different from normal, a Mann-Whitney rank test was used. Results: Regression analysis established the significance of the influence of four factors on the development of scarsclerotic changes of urethra and bladder neck: the tool diameter 27 Fr (p < 0.0001), presence of prostatitis in past medical history (p < 0.0001), prostate volume (p = 0.003), and redraining of the bladder (p = 0.0162). Conclusion: The relationship between the diameter of the instrument, presence of chronic prostatitis in anamnesis, increased volume of the prostate, and repeated drainage of the bladder using the urethral catheter with the risk of developing scar-sclerotic changes in the urethra and/or bladder neck are statistically reliable and confirmed as a result of regression analysis.

INTRODUCTION AND OBJECTIVES: The Moses Technology developed to enhance the High power Holmium lasers (HPH) lithotripsy is challenged by the novel Super-pulse Thulium fibre laser. The goal of our study was to evaluate in-vitro which laser has a better stone ablation effect.METHODS: An in-vitro observational study was performed using a Super-Pulse Thulium fiber (SPT) laser prototype with 200 µm fibre and a High-Power Holmium (HPH) laser Moses Technology (Lumenis Pulse 120H) with 230 µm fibre. A mechanical device for precisely holding the laser fibre was created (Fig. 1). Fine metal sheets calibrated at different widths were used to fix the laser fibre at the required distance from the tissue. The laser was activated for ten seconds using different laser settings and at different distances from the target (0 mm, 1 mm, 2 mm), in saline.Calcium oxalate monohydrate (COM) -like artificial stones were created in a standardised manner. The ablation volumes were precisely measured using a 3D high precision computer controlled optical microscanner. The obtained images were processed using two Autodesk softwares.RESULTS: On the stone phantoms, the laser ablation volume increased with the laser power and decreased with the distance to target.Moses technology in distance mode provided bigger ablation volumes than close mode, especially at 1 mm distance from the stone, at the same laser settings The difference was not statistically significant. SPT ablation volume was similar to HPH Moses distance mode when same power and energy were used. SPT ablation volume was similar to HPH Moses close mode when same power but very low energy and very high frequency were used.Ablation volume for each machine's best capabilities for dusting settings (HPH 0.2J/80Hz, SPT 0.05J/900 Hz) was almost three times better for SPT. (Table 1) CONCLUSIONS: At same power, HPH Moses and SPT have similar effect on stones.The big difference is when maximal dusting setting are used, SPT being more efficient than HPH Moses.