zaher bahouth | Hadassah-Hebrew University Medical Center (original) (raw)
Papers by zaher bahouth
Journal of Molecular and Clinical Medicine, 2020
Background: Prostate cancer is one of the most common cancers affecting men worldwide with an inc... more Background: Prostate cancer is one of the most common cancers affecting men worldwide with an increasing incidence in most countries. The gold standard for diagnosis is Transrectal Ultrasonography-guided prostate biopsy. The quality of the biopsy is determined by parameters like the length of the biopsy core and the degree of fragmentation, affecting detection rate. SmartBx™ is a tool designed for the handling of prostate biopsy specimens and is intended for maximal tissue preservation. The aim of the current study was to evaluate the detection rate of prostate cancer using the new SmartBx™ tool. Patients and Methods: The study group had a biopsy using the SmartBx™ system and each biopsy core was applied into a cassette, which included two cores of biopsies which were then downloaded into a formalin-filled container. The control group included patients who underwent a Transrectal Ultrasonography-guided biopsy using the "standard" technique of biopsy collection. Data were collected prospectively in the study group, and retrospectively in the control group. Overall detection rate, and detection rate per core, were calculated and compared between the two groups. Results: The study included 600 patients, 300 in each group. There were no statistically significant differences between the groups regarding baseline characteristics. The average core numbers obtained per patient were 13.0 ± 2.7 and 14.1 ± 4.4 (P = 0.001) in the SmartBx™ and control groups, respectively. The use of the SmartBx™ system resulted in 21.2% better tissue preservation than in the control group. The overall detection rate as well as the detection rate per core were higher in the study group. More Gleason score 4 + 3 (Grade Group III) were detected in the study group (44.1% vs. 12.5%, P = 0.01). Conclusions: The use of the SmartBx™ system yielded more biopsy tissue for diagnosis. It increased the detection rate per core and the detection of Gleason score 4 + 3 (Grade Group III) prostate cancer.
PubMed, 2016
Introduction: The increase in the use of imaging studies led to an increase in the diagnosis of s... more Introduction: The increase in the use of imaging studies led to an increase in the diagnosis of small renal masses. However, most of the small renal masses are asymptomatic, grow slowly, and will not metastasize due to their relative benign biology. We still cannot differentiate malignant from benign masses using imaging studies, hence there is a dilemma between excision and follow-up. Objective: To report our intermediate-term results of active surveillance in patients with small renal masses in our urology department at the Bnai-Zion Medical Center. Patients and methods: Retrospective analysis of 70 patients diagnosed at our department with renal mass < 4cm in its maximal diameter between 2003 and 2012. The maximal diameter of the masses at diagnosis was measured using computed tomography and diameter was recorded during follow-up. Results: Seventy patients with 78 small renal masses met the inclusion criteria. Mean age at diagnosis was 68 years. The mean folow-up period was 34 months; 54 of 78 masses grew in size, of them 8 were excised. All patients who had surgery had a nephron-sparing procedure. The growth rate and the size at diagnosis were both higher in the group of patients who underwent surgery. Conclusion: Most of the small renal masses can be managed safely by active surveillance. Discussion: Only 4% of the masses were upstaged, and none to stage > 2. None of the patients developed metastasis or died from renal cancer during the follow-up period. Summary: Active surveillance is a safe and reliable option for some patients with small renal mass.
PubMed, Nov 1, 2015
Background: Erectile dysfunction (ED), a common problem in males of all ages, can be of organic, ... more Background: Erectile dysfunction (ED), a common problem in males of all ages, can be of organic, psychogenic or combined etiology. Organic ED is mainly caused by vascular and neurological disorders. One of the available tests for differentiating organic from inorganic ED is measuring penile tumescence and rigidity during the REM phase of sleep. However, this test lacks the ability to differentiate between a vascular and non-vascular cause of organic ED. Objectives: To compare the results of the EndoPAT test and the nocturnal penile tumescence (NPT) test in patients with erectile dysfunction. Methods: Twenty patients with ED were recruited for the study. Each participant was evaluated by the SHIM score, RigiScan during polysomnography, and two EndoPAT tests (at the beginning and end of the study). Results: Seventeen patients had a SHIM score 21; 4 of them had organic ED with a mean EndoPAT score of 1.49, significantly lower than the 1.93 mean EndoPAT score of the 11 patients in the psychogenic ED group (P = 0.047). Two participants had a neurological impairment (spinal trauma and herniated disk). The average SHIM score in the vascular organic group was 6.25 points as compared to 11.69 for the psychogenic group (P = 0.027). The positive predictive value was 43% and the negative predictive value 90%. Conclusions: EndoPAT could be helpful in excluding organic ED.
BMC Urology, Oct 22, 2018
Background: This study aims to prospectively evaluate the ability of Neutrophil-to-Lymphocyte rat... more Background: This study aims to prospectively evaluate the ability of Neutrophil-to-Lymphocyte ratio (NLR) to forecast recurrence in patients with non-muscle invasive bladder cancer (NMIBC). This is a continuation of our two previous retrospective studies that indicated the NLR > 2.5 criterion as a predictor of recurrence in patients with NMIBC. Methods: Since December 2013, all patients admitted to our department for TUR-BT and agreed to participate, had a blood drawn for cell count and differential 24 h prior to surgery. Patients with pathological NMIBC were followed prospectively for disease recurrence. The end-point of the follow up was either a cancer recurrence or the termination of the study. Univariate and multivariate Cox regressions were performed to assess the NLR > 2.5 predictive capability for recurrence, versus and in conjunction to the pathologically based EORTC score, among additional statistical analyses. Results: The study cohort included 96 men and 17 women with a median age of 72 years. Sixty-four patients (56.6%) have had a recurrence during the study occurring at the median time of 9 months (IQR 6, 13), while the median follow-up time for patients without recurrence was 18 months (IQR 10, 29). Univariate Cox regressions for recurrence demonstrated significance for NLR > 2.5 for the whole cohort (p = 0.011, HR 2.015, CI 1.175-3.454) and for the BCG subgroup (p = 0.023, HR 3.7, CI 1.2-11.9), while the EORTC score demonstrated significance for the 'No Treatment' subgroup (p = 0.024, HR 1.278, CI 1.03-1.58). When analyzed together as a multivariate Cox model, the NLR > 2.5 and EORTC score retained their significance for the aforementioned groups, while also improving the EORTC score significance for the whole cohort. Conclusion: NLR > 2.5 was found to be a significant predictor of disease recurrence and demonstrated high hazard ratio and worse recurrence-free survival in patients with NMIBC, especially in those treated with BCG. Additionally, our data demonstrated statistical evidence that NLR > 2.5 might have an improving effect on the EORTC score's prediction when analyzed together.
PubMed, Dec 1, 2015
Introduction: Chronic ureteral stricture and ureteral fistula are treated with urinary diversion ... more Introduction: Chronic ureteral stricture and ureteral fistula are treated with urinary diversion using percutaneous nephrostomy or double pigtail stent. Both of these techniques require replacement of the tube every few months in order to prevent encrustations and obstruction. Objectives: To report the long-term efficacy of the new Allium Ureteral Stent (URS) in the treatment of ureteral stricture and fistula. Methods: The Allium URS is a newly-developed ureteral stent made of nickel-titanium (Nitinol), which is inserted in a small diameter and spontaneously expands into and preserves a large-caliber. The stent is coated with a biochemical co-polymer which prevents tissue ingrowth and incrustations. The stent is inserted antegradely or retrogradely with intraoperative x-ray guidance after dilation of the stricture. The Allium URS stent was inserted into 107 ureters of 92 patients in 5 different centers worldwide; 69 patients carried a percutaneous nephrostomy before the procedure and 38 patients had a ureteral stent. The etiologies underlying the strictures were: gynecological cancer (with or without irradiation), bladder cancer, iatrogenic stricture, ureteroileal stenosis, stricture following uretero-pelvic junction obstruction repair and iatrogenic ureteral fistula. Results: During a mean follow-up of 27 months, only one stent was obstructed after eleven-indwelling months; 21 patients died of their primary disease carrying the stent. Stent migration was seen in 11 patients within 8 months after its insertion, and these stents were removed. In 4 patients with early stent migration, the stents were replaced. In 18 patients the stents were removed as planned after one year of indwelling time, and these patients were asymptomatic in a follow-up period of up to 59 months. Conclusion: The results of our study show that the use of Allium URS for the treatment of ureteral strictures is feasible, safe and effective. The relative ease of its insertion could encourage its use in a wide range of other indications. Discussion: Due to its unique structure, the Allium URS is superior to the regular pigtail stents in the treatment of ureteral strictures. Stent migration was seen in only 10.7% of the patients, mainly in patients with stricture of the mid-ureter. Summary: The use of the Allium URS stent in the treatment of proximal and distaL ureteral strictures is safe and effective.
Rambam Maimonides Medical Journal, Oct 16, 2017
Stents are widely use in endoscopic urological procedures. One of the most important indications ... more Stents are widely use in endoscopic urological procedures. One of the most important indications is the treatment of urinary tract strictures. Allium™ Medical has introduced several types of stents for the treatment of different types of urinary tract strictures, based on anatomic location. All the stents are made of nitinol and coated with a co-polymer that reduces encrustations. These stents are self-expandable and have a large caliber and a high radial force. They have different shapes, designed especially for the treatment of each type of stricture. One of the most important features of Allium-manufactured stents is the ease of removal, due to their special unraveling feature. The company has introduced the Bulbar Urethral Stent (BUS) for treatment of bulbar urethral strictures; a rounded stent available in different lengths. Initial data on 64 patients with bulbar urethral stricture treated with the BUS showed a significant improvement in symptoms, with minimal complications and few adverse events. For treatment of prostate obstruction in patients unfit for surgery or unwilling to undergo a classical prostatic surgery, the Triangular Prostatic Stent (TPS) was introduced, which has a triangular shape that fits in the prostatic urethra. Its body has a high radial force attached to an anchor (which prevents migration) through a trans-sphincteric wire (which Allium Stents in Urology Rambam Maimonides Medical Journal 2 October 2017 Volume 8 Issue 4 e0043 reduces incontinence rate). Initial data on 51 patients showed significant improvement in symptoms and in urinary peak flow rate, with a relatively small number of complications. The Round Posterior Stent (RPS) was designed for treatment of post radical prostatectomy bladder neck contracture. This short, round stent has an anchor, which is placed in the bladder neck. This stent being relatively new, the clinical data are still limited. Ureteral strictures can be treated with the Ureteral Stent (URS), which is round-shaped, available in different lengths, and has an anchor option (for very distal or very proximal strictures). We have previously published data on 107 URSs inserted in patients with ureteral stricture due to several etiologies, including patients who failed previous treatment. All patients were asymptomatic for a long period of follow-up after stent removal, with only one case of re-stenosis. In this paper, we review the urological "covered" stents produced by Allium Medical with the relevant clinical data available at the present time.
PubMed, Oct 1, 2016
Urethral stents were first introduced in 1988, and since then, they have undergone significant im... more Urethral stents were first introduced in 1988, and since then, they have undergone significant improvements. However, they did not gain a wide popularity and their use is limited to a small number of centers around the world. Urethral stents can be used in the entire urethra and for various and diverse indications. In the anterior urethra, it can be used to treat urethral strictures. In the prostatic urethra, they can be used for the treatment of prostatic obstruction, including benign, malignant and iatrogenic prostatic obstruction. Moreover, although not widely used, it can be also applied for the treatment of posterior urethral stricture and bladder neck contracture, usually resulting in urinary incontinence and the need for subsequent procedures. Our main experience are with Allium urethral stents, and as such, we provide the latest updates in urethral stents with special emphasis on the various types of Allium urethral stents: bulbar, prostatic and bladder neck stents.
Advances in Urology, 2015
Aim. To describe the natural history of small renal mass on active surveillance and identify para... more Aim. To describe the natural history of small renal mass on active surveillance and identify parameters that could help in predicting the need for intervention in patients with small renal masses undergoing active surveillance. We also discuss the need for renal biopsy in the management of these patients. Methods. A retrospective analysis of 78 renal masses ≤4 cm diagnosed at our Urology Department at Bnai Zion Medical Center between September 2003 and March 2012. Results. Seventy patients with 78 small renal masses were analyzed. The mean age at diagnosis was 68 years (47-89). The mean follow-up period was 34 months (12-112). In 54 of 78 masses there was a growth of at least 2 mm between imaging on last available follow-up and diagnosis. Eight of the 54 (15%) masses which grew in size underwent a nephron-sparing surgery, of which two were oncocytomas and six were renal cell carcinoma. Growth rate and mass diameter on diagnosis were significantly greater in the group of patients who underwent a surgery. Conclusions. Small renal masses might eventually be managed by active surveillance without compromising survival or surgical approach. All masses that were eventually excised underwent a nephron-sparing surgery. None of the patients developed metastases.
Journal of Endourology, Mar 1, 2016
Introduction: Several prostatic stents were developed in the last three decades, none of which we... more Introduction: Several prostatic stents were developed in the last three decades, none of which were able to provide a real alternative in patients unfit or unwilling to undergo classical prostatic surgeries. In this study, we report the results of the use of a newly developed prostatic stent-the AlliumÔ Triangular Prostatic Stent (TPS). Patients and Methods: The Allium TPS is a highly flexible, nitinol-built polymer-covered stent, which prevents tissue ingrowth and reduces encrustations. Between 2008 and 2014, at two centers (Israel and Turkey), the stent was inserted under local or regional anesthesia in 51 patients with benign prostatic obstruction (BPO) who are unwilling or unfit for surgery. Patients were followed for 12 months from surgery. The primary outcome was symptom improvement as measured by the international prostate symptom score (IPSS) and improvement in peak urinary flow. Results: Stent insertion was successful in all patients. The mean IPSS decreased from 26.4 to 7.7 on the last follow-up. The mean peak flow increased from 5.5 mL/second before stent insertion to 16.0 mL/second 1 year thereafter. The main adverse effect was transient pain in nine patients. No stent migration or obstruction was seen. Patients reported satisfaction and improvement in quality of life. Conclusion: Our short-term results show that Allium TPS is safe and effective for the treatment of patients with BPO.
The Journal of Urology, Apr 1, 2017
CONCLUSIONS: Cabazitaxel, gemcitabine and cisplatin appears to be a well-tolerated intravesical s... more CONCLUSIONS: Cabazitaxel, gemcitabine and cisplatin appears to be a well-tolerated intravesical salvage chemotherapy regimen for the treatment of BCG-refractory non-muscle invasive bladder cancer.
Journal of genital system & disorders, 2017
Penile size is a major concern among men all over world. Men throughout history and still today, ... more Penile size is a major concern among men all over world. Men throughout history and still today, feel the need to enlarge their penis in order to improve their self-esteem and sexual performance. There are a variety of social, cultural, and psychological aspects regarding the size of men genitals, resulting such that, men often feel the need to enlarge their penis. “Bigger is better” is still a relevant belief in our days and based on the “phallic identity” – the tendency of males to seek their personality in their penis. This trend is supported by the numerous and still increasing number of penile enlargement procedures performed in the past years and today, generally in men with normal size penises. This condition is called “the locker room syndrome” – men concerned about their flaccid penile size even though in most cases their penile length and girth are normal. however, the surgical procedures available for changing penile appearance remains highly controversial mainly due to high complication rates and low satisfactory surgical outcomes.
Open Journal of Urology, 2016
Objectives: To report the 2-years follow-up of patients with bulbar urethral strictures treated w... more Objectives: To report the 2-years follow-up of patients with bulbar urethral strictures treated with the new Allium TM Bulbar Urethral Stent (Allium BUS). Methods: The stent is a fully covered, selfexpendable, large caliber metal stent specially designed for the treatment of bulbar urethral strictures. The stent is comprised of a coiled super-elastic structure covered by a polymeric coating designed to prevent mucosal hyperplasia. The indwelling time is 12 months, after which the stent should have been removed. Sixty-four patients with recurrent bulbar stricture were treated with Allium BUS in 3 worldwide centers. Results: All stents were successfully inserted with no peri-operative complications. In a median follow-up of 25.5 months, the mean maximal flow rate following stent insertion was significantly higher compared to the pre-surgical flow rate (14 ml/sec vs 6.6 ml/sec, p < 0.0001). Longer indwelling time and shorter stricture length were significantly related to success rate. The main complications were stent migration, stent re-stenosis and urinary tract infections. Conclusions: The temporary placement of the Allium TM BUS showed encouraging results with long-term failure rate of only 25%.
Urology, Mar 1, 2017
OBJECTIVE To characterize patients who develop late obstruction after subureteral injection of bu... more OBJECTIVE To characterize patients who develop late obstruction after subureteral injection of bulking agent for the treatment of pediatric vesicoureteral reflux (VUR). METHODS We retrospectively evaluated the medical records of all patients who underwent endoscopic injection for the correction of VUR during 2008-2015 in 2 centers in Israel: Bnai-Zion Medical Center, Haifa, and Schneider Children's Medical Center, Petah Tikva. Nine patients who developed late-onset obstruction were included in the study, and their data were reviewed and analyzed. RESULTS Three boys and 6 girls with mean age of 3 years were included in the study. All patients had moderateto-high grade VUR. Following injection, all children had a radiographic evidence showing resolution of the reflux. During follow-up, patients were diagnosed with late obstruction in a mean time of 13.4 months. All patients underwent open re-implantation. CONCLUSION Late-onset obstruction may develop in patients treated with subureteral injection for VUR. Patients with high grade reflux and dilated ureters are at risk of late obstruction. Long-term follow-up with ultrasound is mandatory following endoscopic treatment of VUR. UROLOGY ■■: ■■-■■, 2016.
BioMed Research International, 2017
Background. Pathology of urothelial carcinoma may vary in different populations at diagnosis. Our... more Background. Pathology of urothelial carcinoma may vary in different populations at diagnosis. Our aim was to evaluate the histopathologic differences between Jewish and Arab patients in Israel at first diagnosis of urothelial cancer. Patients and Methods. We retrospectively collected data of all patients with confirmed urothelial cancer, treated at our department between January 2010 and January 2015. We examined the distribution of the histopathologic data among the studied populations. To compare the categorical variables we used the Chi-Square Pearson test. Comparison of independent variables was made by Student'stest. value below 0.05 was considered significant. Results. The study group included 413 patients, 345 Jews and 68 Arabs. The major differences were that Arab patients were younger (62.61 versus 68.55 years, = 0.001), had more aggressive tumors that were detected at a more advanced stage, and had also a higher rate of metastatic disease (7.4% versus 3.2%, = 0.05). Nonurothelial cell tumors were 2.3 times more prevalent in Arab population. Unlike Jewish population, Arab women had higher rate of invasive/metastatic disease compared with Arab men (40% versus 22.4%). Conclusion. At time of diagnosis the tumors were more aggressive in Arab patients, especially in Arab women. The reasons for those differences constitute a target for a separate research. These results should have an impact on prevention medicine and education of physicians treating mixed populations.
Actas urológicas españolas, Oct 1, 2017
Objectives: To report the results of the use of Bovine Serum Albumin-Glutaraldehyde tissue adhesi... more Objectives: To report the results of the use of Bovine Serum Albumin-Glutaraldehyde tissue adhesive (BioGlue ®) for tumor bed closure in open nephron-sparing surgery (NSS). Materials and methods: The cohort included 255 patients with enhancing renal mass who underwent open NSS. We used open flank approach, with in situ hypothermia and enucleation of the tumor. For tumor bed closure, we used the BioGlue ® sealant for tumor bed filling, without suturing the edges. Results: Mean patients' age was 65.4 years. 5.1% of patients had pre-operative chronic renal failure. Mean renal mass diameter was 4.2 ± 1.6 cm and mean R.E.N.A.L nephrometry score was 8.0 ± 1.6. Mean ischemia time was 21.8 ± 7.6. Mean estimated blood loss was 42 ± 82 ml and only two patients required blood transfusion. Urine leak and pseudo-aneurysm were recorded in two and one patient, respectively. None of the operations were converted to radical nephrectomy. The average change between post-operative and pre-operative eGFR (= −1.7 ml/min) was insignificant in a mean follow-up of 30.1 ± 29.6 months. The 10-year recurrence-free survival rate was 99% and the 10-year overall survival rate was 85%. Conclusions: The use of BioGlue ® alone for hemostasis after NSS is a feasible and safe alternative to classical suturing. Its use enables satisfactory functional outcome and could potentially reduce ischemia time.
Actas Urologicas Espanolas, Oct 1, 2017
Cómo citar este artículo: Bahouth Z, et al. El uso de adhesivo tisular de albúmina-glutaraldehído... more Cómo citar este artículo: Bahouth Z, et al. El uso de adhesivo tisular de albúmina-glutaraldehído sérico bovino (BioGlue ®) para el cierre del lecho tumoral después de una nefrectomía parcial abierta. Actas Urol Esp. 2017.
Urologia Internationalis, Feb 19, 2016
Introduction: A relatively high proportion of patients who undergo partial or radical nephrectomy... more Introduction: A relatively high proportion of patients who undergo partial or radical nephrectomy for enhancing renal mass actually have oncocytoma, a benign renal tumor. Several parameters have been shown to be typical for oncocytoma, but only a small number of patients present with these parameters. The aim of our study was to report the clinical, operative and postoperative characteristics of patients who underwent nephron-sparing surgery in our center with a histopathological diagnosis of oncocytoma compared to patients with malignant renal tumor. Patients and Methods: Sixty-three out of 530 patients who underwent nephron-sparing surgery for enhancing renal mass were diagnosed with oncocytoma. Clinical and radiological features and operational data of these patients were compared with patients who had malignant renal tumors. Results: Mean age of patients with histologically proven non-malignant oncocytoma was significantly higher than that in patients with malignant renal cell carcinoma (66.7 vs. 61.4 years). All other analyzed variables showed no significant difference between the 2 groups. Conclusions: No reliable clinical, operative or radiological parameters can differentiate preoperatively between oncocytoma and malignant renal neoplasms.
Current Urology, Oct 1, 2019
Usage and distribution for commercial purposes as well as any distribution of modified material r... more Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. Nephron sparing surgery • Sutures • Sealant • Volume loss • Partial nephrectomy Objectives: To quantitatively compare the functional renal volume loss, following nephron sparing surgery (NSS) between patients in whom tumor bed closure was done by biological tissue adhesive and those who were managed by standard suture technique. Methods: From our institutional NSS database we retrospectively collected patients who had two sequential quantitative single-photon emission computed tomography of 99m Tc-dimercaptosuccinic acid uptake studies, the first study immediately before surgery and the second one 3-6 months following surgery. The study group included 69 patients: 26 (37.7%) patients in the sealant group (BioGlue®) and 43 (62.3%) patients in the standard suture group. Results: No statistically significant differences were noted in the baseline clinical and pathological characteristics of the studied groups. However, there were several statistically significant differences in operative variables: patients in the suture group had larger amount of blood loss (3-fold), longer ischemia time (26.6 vs. 21 minutes,) and slightly longer operation time. Patients in whom tumor bed was closed by sutures had nearly 3-fold higher parenchymal loss compared to patients managed by sealant (26.28 vs. 8.92 ml, p = 0.048). Conclusions: The use of tissue sealant
Case reports in oncological medicine, 2015
Angiosarcoma of the urinary bladder is an extremely rare and poorly characterized tumor. We are p... more Angiosarcoma of the urinary bladder is an extremely rare and poorly characterized tumor. We are presenting the 13th reported patient who was an 89-year-old man initially presented with massive hematuria. His past medical history included externalbeam radiation for prostate cancer 12 years ago. His PSA was 0.26 ng/dL. His CT-Urography demonstrated a highly vascular mass originating from the bladder base. The mass was partially resected, transurethrally. The pathology was consistent with primary angiosarcoma of the urinary bladder. Bone scan and CT-U showed metastasis to spine. The patient was treated with palliative radiotherapy for back pain due to metastasis, and he refused chemotherapy. The patient died 3 months after his initial diagnosis.
Urologia Internationalis, 2022
Introduction: Ureteral strictures could be a chronic illness that leads to severe side effects an... more Introduction: Ureteral strictures could be a chronic illness that leads to severe side effects and poor quality of life. A treatment with an Allium ureteral stent (URS), a self-expanding, large-caliber URS, was implemented in our department for ureteral stricture. Our study aim was to report the longterm results, including success rate, complications, and adverse effects. Methods: We retrospectively collected data on all patients who were treated with an Allium URS in our department between January 2017 and January 2021. Demographic, clinical, radiological, and perioperative parameters were retrieved and analyzed. The primary outcome was stricture resolution rates following stent removal. Results: Our cohort included 17 patients, 9 men and 8 women. The etiology of ureteral strictures was urolithiasis in 76.5% and pelvic procedure injury in 17.6%. The overall success rate was 35.29% in an average follow-up of 10.42 ± 2.39 months after stent removal. A higher failure rate was observed in the urolithiasis etiology group (90% vs. 66.7%, p = 0.38). The mean indwelling time of the Allium stent was 14.29 ± 1.29 months. Conclusions: Although an Allium URS could be considered as a feasible and attractive treatment of ureteral strictures, due to its minimal invasiveness, the success rate of this treatment is relatively low. Therefore, this option should be carefully considered and should be discouraged in young and fit patients and reserved for older unfit patients who are unwilling to undergo surgical repair of ureteral strictures.
Journal of Molecular and Clinical Medicine, 2020
Background: Prostate cancer is one of the most common cancers affecting men worldwide with an inc... more Background: Prostate cancer is one of the most common cancers affecting men worldwide with an increasing incidence in most countries. The gold standard for diagnosis is Transrectal Ultrasonography-guided prostate biopsy. The quality of the biopsy is determined by parameters like the length of the biopsy core and the degree of fragmentation, affecting detection rate. SmartBx™ is a tool designed for the handling of prostate biopsy specimens and is intended for maximal tissue preservation. The aim of the current study was to evaluate the detection rate of prostate cancer using the new SmartBx™ tool. Patients and Methods: The study group had a biopsy using the SmartBx™ system and each biopsy core was applied into a cassette, which included two cores of biopsies which were then downloaded into a formalin-filled container. The control group included patients who underwent a Transrectal Ultrasonography-guided biopsy using the "standard" technique of biopsy collection. Data were collected prospectively in the study group, and retrospectively in the control group. Overall detection rate, and detection rate per core, were calculated and compared between the two groups. Results: The study included 600 patients, 300 in each group. There were no statistically significant differences between the groups regarding baseline characteristics. The average core numbers obtained per patient were 13.0 ± 2.7 and 14.1 ± 4.4 (P = 0.001) in the SmartBx™ and control groups, respectively. The use of the SmartBx™ system resulted in 21.2% better tissue preservation than in the control group. The overall detection rate as well as the detection rate per core were higher in the study group. More Gleason score 4 + 3 (Grade Group III) were detected in the study group (44.1% vs. 12.5%, P = 0.01). Conclusions: The use of the SmartBx™ system yielded more biopsy tissue for diagnosis. It increased the detection rate per core and the detection of Gleason score 4 + 3 (Grade Group III) prostate cancer.
PubMed, 2016
Introduction: The increase in the use of imaging studies led to an increase in the diagnosis of s... more Introduction: The increase in the use of imaging studies led to an increase in the diagnosis of small renal masses. However, most of the small renal masses are asymptomatic, grow slowly, and will not metastasize due to their relative benign biology. We still cannot differentiate malignant from benign masses using imaging studies, hence there is a dilemma between excision and follow-up. Objective: To report our intermediate-term results of active surveillance in patients with small renal masses in our urology department at the Bnai-Zion Medical Center. Patients and methods: Retrospective analysis of 70 patients diagnosed at our department with renal mass < 4cm in its maximal diameter between 2003 and 2012. The maximal diameter of the masses at diagnosis was measured using computed tomography and diameter was recorded during follow-up. Results: Seventy patients with 78 small renal masses met the inclusion criteria. Mean age at diagnosis was 68 years. The mean folow-up period was 34 months; 54 of 78 masses grew in size, of them 8 were excised. All patients who had surgery had a nephron-sparing procedure. The growth rate and the size at diagnosis were both higher in the group of patients who underwent surgery. Conclusion: Most of the small renal masses can be managed safely by active surveillance. Discussion: Only 4% of the masses were upstaged, and none to stage > 2. None of the patients developed metastasis or died from renal cancer during the follow-up period. Summary: Active surveillance is a safe and reliable option for some patients with small renal mass.
PubMed, Nov 1, 2015
Background: Erectile dysfunction (ED), a common problem in males of all ages, can be of organic, ... more Background: Erectile dysfunction (ED), a common problem in males of all ages, can be of organic, psychogenic or combined etiology. Organic ED is mainly caused by vascular and neurological disorders. One of the available tests for differentiating organic from inorganic ED is measuring penile tumescence and rigidity during the REM phase of sleep. However, this test lacks the ability to differentiate between a vascular and non-vascular cause of organic ED. Objectives: To compare the results of the EndoPAT test and the nocturnal penile tumescence (NPT) test in patients with erectile dysfunction. Methods: Twenty patients with ED were recruited for the study. Each participant was evaluated by the SHIM score, RigiScan during polysomnography, and two EndoPAT tests (at the beginning and end of the study). Results: Seventeen patients had a SHIM score 21; 4 of them had organic ED with a mean EndoPAT score of 1.49, significantly lower than the 1.93 mean EndoPAT score of the 11 patients in the psychogenic ED group (P = 0.047). Two participants had a neurological impairment (spinal trauma and herniated disk). The average SHIM score in the vascular organic group was 6.25 points as compared to 11.69 for the psychogenic group (P = 0.027). The positive predictive value was 43% and the negative predictive value 90%. Conclusions: EndoPAT could be helpful in excluding organic ED.
BMC Urology, Oct 22, 2018
Background: This study aims to prospectively evaluate the ability of Neutrophil-to-Lymphocyte rat... more Background: This study aims to prospectively evaluate the ability of Neutrophil-to-Lymphocyte ratio (NLR) to forecast recurrence in patients with non-muscle invasive bladder cancer (NMIBC). This is a continuation of our two previous retrospective studies that indicated the NLR > 2.5 criterion as a predictor of recurrence in patients with NMIBC. Methods: Since December 2013, all patients admitted to our department for TUR-BT and agreed to participate, had a blood drawn for cell count and differential 24 h prior to surgery. Patients with pathological NMIBC were followed prospectively for disease recurrence. The end-point of the follow up was either a cancer recurrence or the termination of the study. Univariate and multivariate Cox regressions were performed to assess the NLR > 2.5 predictive capability for recurrence, versus and in conjunction to the pathologically based EORTC score, among additional statistical analyses. Results: The study cohort included 96 men and 17 women with a median age of 72 years. Sixty-four patients (56.6%) have had a recurrence during the study occurring at the median time of 9 months (IQR 6, 13), while the median follow-up time for patients without recurrence was 18 months (IQR 10, 29). Univariate Cox regressions for recurrence demonstrated significance for NLR > 2.5 for the whole cohort (p = 0.011, HR 2.015, CI 1.175-3.454) and for the BCG subgroup (p = 0.023, HR 3.7, CI 1.2-11.9), while the EORTC score demonstrated significance for the 'No Treatment' subgroup (p = 0.024, HR 1.278, CI 1.03-1.58). When analyzed together as a multivariate Cox model, the NLR > 2.5 and EORTC score retained their significance for the aforementioned groups, while also improving the EORTC score significance for the whole cohort. Conclusion: NLR > 2.5 was found to be a significant predictor of disease recurrence and demonstrated high hazard ratio and worse recurrence-free survival in patients with NMIBC, especially in those treated with BCG. Additionally, our data demonstrated statistical evidence that NLR > 2.5 might have an improving effect on the EORTC score's prediction when analyzed together.
PubMed, Dec 1, 2015
Introduction: Chronic ureteral stricture and ureteral fistula are treated with urinary diversion ... more Introduction: Chronic ureteral stricture and ureteral fistula are treated with urinary diversion using percutaneous nephrostomy or double pigtail stent. Both of these techniques require replacement of the tube every few months in order to prevent encrustations and obstruction. Objectives: To report the long-term efficacy of the new Allium Ureteral Stent (URS) in the treatment of ureteral stricture and fistula. Methods: The Allium URS is a newly-developed ureteral stent made of nickel-titanium (Nitinol), which is inserted in a small diameter and spontaneously expands into and preserves a large-caliber. The stent is coated with a biochemical co-polymer which prevents tissue ingrowth and incrustations. The stent is inserted antegradely or retrogradely with intraoperative x-ray guidance after dilation of the stricture. The Allium URS stent was inserted into 107 ureters of 92 patients in 5 different centers worldwide; 69 patients carried a percutaneous nephrostomy before the procedure and 38 patients had a ureteral stent. The etiologies underlying the strictures were: gynecological cancer (with or without irradiation), bladder cancer, iatrogenic stricture, ureteroileal stenosis, stricture following uretero-pelvic junction obstruction repair and iatrogenic ureteral fistula. Results: During a mean follow-up of 27 months, only one stent was obstructed after eleven-indwelling months; 21 patients died of their primary disease carrying the stent. Stent migration was seen in 11 patients within 8 months after its insertion, and these stents were removed. In 4 patients with early stent migration, the stents were replaced. In 18 patients the stents were removed as planned after one year of indwelling time, and these patients were asymptomatic in a follow-up period of up to 59 months. Conclusion: The results of our study show that the use of Allium URS for the treatment of ureteral strictures is feasible, safe and effective. The relative ease of its insertion could encourage its use in a wide range of other indications. Discussion: Due to its unique structure, the Allium URS is superior to the regular pigtail stents in the treatment of ureteral strictures. Stent migration was seen in only 10.7% of the patients, mainly in patients with stricture of the mid-ureter. Summary: The use of the Allium URS stent in the treatment of proximal and distaL ureteral strictures is safe and effective.
Rambam Maimonides Medical Journal, Oct 16, 2017
Stents are widely use in endoscopic urological procedures. One of the most important indications ... more Stents are widely use in endoscopic urological procedures. One of the most important indications is the treatment of urinary tract strictures. Allium™ Medical has introduced several types of stents for the treatment of different types of urinary tract strictures, based on anatomic location. All the stents are made of nitinol and coated with a co-polymer that reduces encrustations. These stents are self-expandable and have a large caliber and a high radial force. They have different shapes, designed especially for the treatment of each type of stricture. One of the most important features of Allium-manufactured stents is the ease of removal, due to their special unraveling feature. The company has introduced the Bulbar Urethral Stent (BUS) for treatment of bulbar urethral strictures; a rounded stent available in different lengths. Initial data on 64 patients with bulbar urethral stricture treated with the BUS showed a significant improvement in symptoms, with minimal complications and few adverse events. For treatment of prostate obstruction in patients unfit for surgery or unwilling to undergo a classical prostatic surgery, the Triangular Prostatic Stent (TPS) was introduced, which has a triangular shape that fits in the prostatic urethra. Its body has a high radial force attached to an anchor (which prevents migration) through a trans-sphincteric wire (which Allium Stents in Urology Rambam Maimonides Medical Journal 2 October 2017 Volume 8 Issue 4 e0043 reduces incontinence rate). Initial data on 51 patients showed significant improvement in symptoms and in urinary peak flow rate, with a relatively small number of complications. The Round Posterior Stent (RPS) was designed for treatment of post radical prostatectomy bladder neck contracture. This short, round stent has an anchor, which is placed in the bladder neck. This stent being relatively new, the clinical data are still limited. Ureteral strictures can be treated with the Ureteral Stent (URS), which is round-shaped, available in different lengths, and has an anchor option (for very distal or very proximal strictures). We have previously published data on 107 URSs inserted in patients with ureteral stricture due to several etiologies, including patients who failed previous treatment. All patients were asymptomatic for a long period of follow-up after stent removal, with only one case of re-stenosis. In this paper, we review the urological "covered" stents produced by Allium Medical with the relevant clinical data available at the present time.
PubMed, Oct 1, 2016
Urethral stents were first introduced in 1988, and since then, they have undergone significant im... more Urethral stents were first introduced in 1988, and since then, they have undergone significant improvements. However, they did not gain a wide popularity and their use is limited to a small number of centers around the world. Urethral stents can be used in the entire urethra and for various and diverse indications. In the anterior urethra, it can be used to treat urethral strictures. In the prostatic urethra, they can be used for the treatment of prostatic obstruction, including benign, malignant and iatrogenic prostatic obstruction. Moreover, although not widely used, it can be also applied for the treatment of posterior urethral stricture and bladder neck contracture, usually resulting in urinary incontinence and the need for subsequent procedures. Our main experience are with Allium urethral stents, and as such, we provide the latest updates in urethral stents with special emphasis on the various types of Allium urethral stents: bulbar, prostatic and bladder neck stents.
Advances in Urology, 2015
Aim. To describe the natural history of small renal mass on active surveillance and identify para... more Aim. To describe the natural history of small renal mass on active surveillance and identify parameters that could help in predicting the need for intervention in patients with small renal masses undergoing active surveillance. We also discuss the need for renal biopsy in the management of these patients. Methods. A retrospective analysis of 78 renal masses ≤4 cm diagnosed at our Urology Department at Bnai Zion Medical Center between September 2003 and March 2012. Results. Seventy patients with 78 small renal masses were analyzed. The mean age at diagnosis was 68 years (47-89). The mean follow-up period was 34 months (12-112). In 54 of 78 masses there was a growth of at least 2 mm between imaging on last available follow-up and diagnosis. Eight of the 54 (15%) masses which grew in size underwent a nephron-sparing surgery, of which two were oncocytomas and six were renal cell carcinoma. Growth rate and mass diameter on diagnosis were significantly greater in the group of patients who underwent a surgery. Conclusions. Small renal masses might eventually be managed by active surveillance without compromising survival or surgical approach. All masses that were eventually excised underwent a nephron-sparing surgery. None of the patients developed metastases.
Journal of Endourology, Mar 1, 2016
Introduction: Several prostatic stents were developed in the last three decades, none of which we... more Introduction: Several prostatic stents were developed in the last three decades, none of which were able to provide a real alternative in patients unfit or unwilling to undergo classical prostatic surgeries. In this study, we report the results of the use of a newly developed prostatic stent-the AlliumÔ Triangular Prostatic Stent (TPS). Patients and Methods: The Allium TPS is a highly flexible, nitinol-built polymer-covered stent, which prevents tissue ingrowth and reduces encrustations. Between 2008 and 2014, at two centers (Israel and Turkey), the stent was inserted under local or regional anesthesia in 51 patients with benign prostatic obstruction (BPO) who are unwilling or unfit for surgery. Patients were followed for 12 months from surgery. The primary outcome was symptom improvement as measured by the international prostate symptom score (IPSS) and improvement in peak urinary flow. Results: Stent insertion was successful in all patients. The mean IPSS decreased from 26.4 to 7.7 on the last follow-up. The mean peak flow increased from 5.5 mL/second before stent insertion to 16.0 mL/second 1 year thereafter. The main adverse effect was transient pain in nine patients. No stent migration or obstruction was seen. Patients reported satisfaction and improvement in quality of life. Conclusion: Our short-term results show that Allium TPS is safe and effective for the treatment of patients with BPO.
The Journal of Urology, Apr 1, 2017
CONCLUSIONS: Cabazitaxel, gemcitabine and cisplatin appears to be a well-tolerated intravesical s... more CONCLUSIONS: Cabazitaxel, gemcitabine and cisplatin appears to be a well-tolerated intravesical salvage chemotherapy regimen for the treatment of BCG-refractory non-muscle invasive bladder cancer.
Journal of genital system & disorders, 2017
Penile size is a major concern among men all over world. Men throughout history and still today, ... more Penile size is a major concern among men all over world. Men throughout history and still today, feel the need to enlarge their penis in order to improve their self-esteem and sexual performance. There are a variety of social, cultural, and psychological aspects regarding the size of men genitals, resulting such that, men often feel the need to enlarge their penis. “Bigger is better” is still a relevant belief in our days and based on the “phallic identity” – the tendency of males to seek their personality in their penis. This trend is supported by the numerous and still increasing number of penile enlargement procedures performed in the past years and today, generally in men with normal size penises. This condition is called “the locker room syndrome” – men concerned about their flaccid penile size even though in most cases their penile length and girth are normal. however, the surgical procedures available for changing penile appearance remains highly controversial mainly due to high complication rates and low satisfactory surgical outcomes.
Open Journal of Urology, 2016
Objectives: To report the 2-years follow-up of patients with bulbar urethral strictures treated w... more Objectives: To report the 2-years follow-up of patients with bulbar urethral strictures treated with the new Allium TM Bulbar Urethral Stent (Allium BUS). Methods: The stent is a fully covered, selfexpendable, large caliber metal stent specially designed for the treatment of bulbar urethral strictures. The stent is comprised of a coiled super-elastic structure covered by a polymeric coating designed to prevent mucosal hyperplasia. The indwelling time is 12 months, after which the stent should have been removed. Sixty-four patients with recurrent bulbar stricture were treated with Allium BUS in 3 worldwide centers. Results: All stents were successfully inserted with no peri-operative complications. In a median follow-up of 25.5 months, the mean maximal flow rate following stent insertion was significantly higher compared to the pre-surgical flow rate (14 ml/sec vs 6.6 ml/sec, p < 0.0001). Longer indwelling time and shorter stricture length were significantly related to success rate. The main complications were stent migration, stent re-stenosis and urinary tract infections. Conclusions: The temporary placement of the Allium TM BUS showed encouraging results with long-term failure rate of only 25%.
Urology, Mar 1, 2017
OBJECTIVE To characterize patients who develop late obstruction after subureteral injection of bu... more OBJECTIVE To characterize patients who develop late obstruction after subureteral injection of bulking agent for the treatment of pediatric vesicoureteral reflux (VUR). METHODS We retrospectively evaluated the medical records of all patients who underwent endoscopic injection for the correction of VUR during 2008-2015 in 2 centers in Israel: Bnai-Zion Medical Center, Haifa, and Schneider Children's Medical Center, Petah Tikva. Nine patients who developed late-onset obstruction were included in the study, and their data were reviewed and analyzed. RESULTS Three boys and 6 girls with mean age of 3 years were included in the study. All patients had moderateto-high grade VUR. Following injection, all children had a radiographic evidence showing resolution of the reflux. During follow-up, patients were diagnosed with late obstruction in a mean time of 13.4 months. All patients underwent open re-implantation. CONCLUSION Late-onset obstruction may develop in patients treated with subureteral injection for VUR. Patients with high grade reflux and dilated ureters are at risk of late obstruction. Long-term follow-up with ultrasound is mandatory following endoscopic treatment of VUR. UROLOGY ■■: ■■-■■, 2016.
BioMed Research International, 2017
Background. Pathology of urothelial carcinoma may vary in different populations at diagnosis. Our... more Background. Pathology of urothelial carcinoma may vary in different populations at diagnosis. Our aim was to evaluate the histopathologic differences between Jewish and Arab patients in Israel at first diagnosis of urothelial cancer. Patients and Methods. We retrospectively collected data of all patients with confirmed urothelial cancer, treated at our department between January 2010 and January 2015. We examined the distribution of the histopathologic data among the studied populations. To compare the categorical variables we used the Chi-Square Pearson test. Comparison of independent variables was made by Student'stest. value below 0.05 was considered significant. Results. The study group included 413 patients, 345 Jews and 68 Arabs. The major differences were that Arab patients were younger (62.61 versus 68.55 years, = 0.001), had more aggressive tumors that were detected at a more advanced stage, and had also a higher rate of metastatic disease (7.4% versus 3.2%, = 0.05). Nonurothelial cell tumors were 2.3 times more prevalent in Arab population. Unlike Jewish population, Arab women had higher rate of invasive/metastatic disease compared with Arab men (40% versus 22.4%). Conclusion. At time of diagnosis the tumors were more aggressive in Arab patients, especially in Arab women. The reasons for those differences constitute a target for a separate research. These results should have an impact on prevention medicine and education of physicians treating mixed populations.
Actas urológicas españolas, Oct 1, 2017
Objectives: To report the results of the use of Bovine Serum Albumin-Glutaraldehyde tissue adhesi... more Objectives: To report the results of the use of Bovine Serum Albumin-Glutaraldehyde tissue adhesive (BioGlue ®) for tumor bed closure in open nephron-sparing surgery (NSS). Materials and methods: The cohort included 255 patients with enhancing renal mass who underwent open NSS. We used open flank approach, with in situ hypothermia and enucleation of the tumor. For tumor bed closure, we used the BioGlue ® sealant for tumor bed filling, without suturing the edges. Results: Mean patients' age was 65.4 years. 5.1% of patients had pre-operative chronic renal failure. Mean renal mass diameter was 4.2 ± 1.6 cm and mean R.E.N.A.L nephrometry score was 8.0 ± 1.6. Mean ischemia time was 21.8 ± 7.6. Mean estimated blood loss was 42 ± 82 ml and only two patients required blood transfusion. Urine leak and pseudo-aneurysm were recorded in two and one patient, respectively. None of the operations were converted to radical nephrectomy. The average change between post-operative and pre-operative eGFR (= −1.7 ml/min) was insignificant in a mean follow-up of 30.1 ± 29.6 months. The 10-year recurrence-free survival rate was 99% and the 10-year overall survival rate was 85%. Conclusions: The use of BioGlue ® alone for hemostasis after NSS is a feasible and safe alternative to classical suturing. Its use enables satisfactory functional outcome and could potentially reduce ischemia time.
Actas Urologicas Espanolas, Oct 1, 2017
Cómo citar este artículo: Bahouth Z, et al. El uso de adhesivo tisular de albúmina-glutaraldehído... more Cómo citar este artículo: Bahouth Z, et al. El uso de adhesivo tisular de albúmina-glutaraldehído sérico bovino (BioGlue ®) para el cierre del lecho tumoral después de una nefrectomía parcial abierta. Actas Urol Esp. 2017.
Urologia Internationalis, Feb 19, 2016
Introduction: A relatively high proportion of patients who undergo partial or radical nephrectomy... more Introduction: A relatively high proportion of patients who undergo partial or radical nephrectomy for enhancing renal mass actually have oncocytoma, a benign renal tumor. Several parameters have been shown to be typical for oncocytoma, but only a small number of patients present with these parameters. The aim of our study was to report the clinical, operative and postoperative characteristics of patients who underwent nephron-sparing surgery in our center with a histopathological diagnosis of oncocytoma compared to patients with malignant renal tumor. Patients and Methods: Sixty-three out of 530 patients who underwent nephron-sparing surgery for enhancing renal mass were diagnosed with oncocytoma. Clinical and radiological features and operational data of these patients were compared with patients who had malignant renal tumors. Results: Mean age of patients with histologically proven non-malignant oncocytoma was significantly higher than that in patients with malignant renal cell carcinoma (66.7 vs. 61.4 years). All other analyzed variables showed no significant difference between the 2 groups. Conclusions: No reliable clinical, operative or radiological parameters can differentiate preoperatively between oncocytoma and malignant renal neoplasms.
Current Urology, Oct 1, 2019
Usage and distribution for commercial purposes as well as any distribution of modified material r... more Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. Nephron sparing surgery • Sutures • Sealant • Volume loss • Partial nephrectomy Objectives: To quantitatively compare the functional renal volume loss, following nephron sparing surgery (NSS) between patients in whom tumor bed closure was done by biological tissue adhesive and those who were managed by standard suture technique. Methods: From our institutional NSS database we retrospectively collected patients who had two sequential quantitative single-photon emission computed tomography of 99m Tc-dimercaptosuccinic acid uptake studies, the first study immediately before surgery and the second one 3-6 months following surgery. The study group included 69 patients: 26 (37.7%) patients in the sealant group (BioGlue®) and 43 (62.3%) patients in the standard suture group. Results: No statistically significant differences were noted in the baseline clinical and pathological characteristics of the studied groups. However, there were several statistically significant differences in operative variables: patients in the suture group had larger amount of blood loss (3-fold), longer ischemia time (26.6 vs. 21 minutes,) and slightly longer operation time. Patients in whom tumor bed was closed by sutures had nearly 3-fold higher parenchymal loss compared to patients managed by sealant (26.28 vs. 8.92 ml, p = 0.048). Conclusions: The use of tissue sealant
Case reports in oncological medicine, 2015
Angiosarcoma of the urinary bladder is an extremely rare and poorly characterized tumor. We are p... more Angiosarcoma of the urinary bladder is an extremely rare and poorly characterized tumor. We are presenting the 13th reported patient who was an 89-year-old man initially presented with massive hematuria. His past medical history included externalbeam radiation for prostate cancer 12 years ago. His PSA was 0.26 ng/dL. His CT-Urography demonstrated a highly vascular mass originating from the bladder base. The mass was partially resected, transurethrally. The pathology was consistent with primary angiosarcoma of the urinary bladder. Bone scan and CT-U showed metastasis to spine. The patient was treated with palliative radiotherapy for back pain due to metastasis, and he refused chemotherapy. The patient died 3 months after his initial diagnosis.
Urologia Internationalis, 2022
Introduction: Ureteral strictures could be a chronic illness that leads to severe side effects an... more Introduction: Ureteral strictures could be a chronic illness that leads to severe side effects and poor quality of life. A treatment with an Allium ureteral stent (URS), a self-expanding, large-caliber URS, was implemented in our department for ureteral stricture. Our study aim was to report the longterm results, including success rate, complications, and adverse effects. Methods: We retrospectively collected data on all patients who were treated with an Allium URS in our department between January 2017 and January 2021. Demographic, clinical, radiological, and perioperative parameters were retrieved and analyzed. The primary outcome was stricture resolution rates following stent removal. Results: Our cohort included 17 patients, 9 men and 8 women. The etiology of ureteral strictures was urolithiasis in 76.5% and pelvic procedure injury in 17.6%. The overall success rate was 35.29% in an average follow-up of 10.42 ± 2.39 months after stent removal. A higher failure rate was observed in the urolithiasis etiology group (90% vs. 66.7%, p = 0.38). The mean indwelling time of the Allium stent was 14.29 ± 1.29 months. Conclusions: Although an Allium URS could be considered as a feasible and attractive treatment of ureteral strictures, due to its minimal invasiveness, the success rate of this treatment is relatively low. Therefore, this option should be carefully considered and should be discouraged in young and fit patients and reserved for older unfit patients who are unwilling to undergo surgical repair of ureteral strictures.