Background: Artificial intelligence (AI) and big data are transforming urological oncology by enhancing diagnostic precision, prognostic assessment and treatment personalisation for prostate, bladder and kidney cancer.

Methods: We searched PubMed and MEDLINE up to September 2025 for English-language, peer-reviewed human studies using terms including “artificial intelligence”, “deep learning”, “radiomics”, “real-world evidence” and “urological oncology”.

Results: AI-driven radiomics and deep learning models have demonstrated high accuracy in detecting and characterising urological malignancies by using magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET) and histopathology. In prostate, bladder and kidney cancers, AI-driven radiomics and deep learning models have demonstrated high diagnostic performance, with reported area under the curves (AUCs) typically ranging from 0.80 to 0.95 for lesion detection, staging and risk stratification. Sensitivities and specificities in cystoscopic image analysis often exceed 90%, but radiogenomic models for renal cancer achieve mutation prediction accuracies of 85%–95%.

Conclusions: AI and big data are reshaping urological oncology by integrating diagnostic imaging, pathology and real-world practice. Their continued integration promises a precise, equitable and adaptive model of cancer care. Despite these robust results, most studies rely on retrospective or single-centre datasets with limited external validation, raising concerns about generalisability. Future progress will depend on multicentre standardisation, federated learning frameworks and incorporation of multimodal real-world data to facilitate clinically robust and implementable AI systems.

Background: This study aimed to compare the outcomes of open partial nephrectomy (OPN) and robot-assisted partial nephrectomy (RAPN) based on preoperative risk assessment using Martini’s nomogram and postoperative trifecta and pentafecta criteria.

Methods: We retrospectively reviewed patients who underwent OPN or RAPN between 2017 and 2021. Renal function was assessed pre- and postoperatively using estimated glomerular filtration rate (eGFR) calculated by the Cockcroft–Gault formula. Baseline renal function was defined in accordance with the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The Martini’s nomogram was used preoperatively to estimate the risk of >25% postoperative eGFR decline; Surgical outcomes were evaluated in accordance with trifecta and pentafecta criteria.

Results: A total of 103 patients were included (OPN: 63; RAPN: 40). The median follow-up was 77 (65–87) months. Median warm ischemia time was significantly lower in the OPN group (20 vs. 27.5 min, p < 0.001). Trifecta and pentafecta achievement rates were higher in the OPN group (65% vs. 25%, p < 0.001; 30.1% vs. 10%, p < 0.05, respectively). Martini’s nomogram showed good discrimination in OPN (area under the curve (AUC) = 0.87) and RAPN (AUC = 0.80). Calibration analyses indicated overestimation in the OPN high-risk stratum, whereas the RAPN high/very-high strata were consistent with predictions.

Conclusions: In this retrospective cohort, OPN was associated with higher trifecta and pentafecta achievement than RAPN. The Martini’s nomogram showed good discrimination but procedure-dependent calibration: Strata-level predictions aligned in RAPN, whereas risk was overestimated in the OPN high-risk stratum. These findings support cautious use for risk ranking and underscore the need for procedure-specific recalibration and further external validation, particularly for OPN.

Background: The use of anticoagulant (AC) and antiaggregant (AG) medications is increasingly common in elderly patients undergoing urologic surgeries. This prospective observational study aimed to evaluate the influence of AC/AG therapy on bleeding-related complications following transurethral resection of the prostate (TURP), transurethral resection of bladder tumour (TURBT) and open prostatectomy (OP).

Methods: Patients who underwent TURP, TURBT or OP between March 2022 and January 2023 were included in this study. Patients were stratified according to AC/AG usage. Perioperative management details, including low-molecular-weight heparin (LMWH) bridging, were recorded. We evaluated parameters including duration of irrigation, length of stay, episodes of clot retention, transfusion rate and re-admission rate due to haematuria.

Results: Among TURP patients, those using AC/AG therapy had significantly higher rates of transfusion (2.27% vs 0%, p = 0.038), postoperative clot retention (7.57% vs 0.53%, p = 0.008), re-catheterisation (9.09% vs 3.72%, p = 0.046) and re-admission due to haematuria (11.36% vs 3.72%, p = 0.008) compared with those not receiving AC/AG therapy. In the TURBT group, AC/AG use was associated with an elevated rate of rehospitalisation (p = 0.026). OP patients on AC/AG therapy experienced increased transfusion rates (p = 0.030), early postoperative clot retention (p = 0.034) and re-operations (p = 0.016). LMWH bridging was associated with further increases in irrigation volume, early clot retention and rehospitalisation, particularly in TURBT and OP patients.

Conclusions: AC/AG therapy significantly influences bleeding outcomes after TURP, TURBT and OP. LMWH bridging may further exacerbate these risks. This study emphasises the need for caution regarding bleeding-related complications in patients receiving AC/AG therapy.

Background: Renal cell carcinoma (RCC) is a radiation-resistant tumor. Eg5, a spindle motor protein, plays a crucial role in centrosome separation and bipolar spindle formation during mitosis. We explored whether Eg5 is an important therapeutic target for treating RCC.

Methods: We selected radiation-resistant 786-O renal carcinoma cells and divided them into four groups: Control, 10 Gy irradiation, Eg5 inhibitor, and 10 Gy + Eg5 inhibitor. The proliferative ability of the tumor cells was assessed using the cell counting kit-8 assay; A transwell assay was employed to evaluate their invasive capacity. A clonogenic assay was performed to assess clonogenic survival. We divided the 786-O renal carcinoma cells into 10 Gy irradiation and 10 Gy + Eg5 inhibitor groups. Flow cytometry, cell cycle analysis, polymerase chain reaction (PCR), and western blotting were conducted to compare radiosensitivity between the two groups and to investigate potential underlying mechanisms.

Results: The levels of cell proliferation, clonogenic survival, and migration in the 10 Gy + Eg5 inhibitor group (0.395 ± 0.007, 119.3 ± 7.513, 24.33 ± 2.333, respectively) were significantly lower than those in the control (0.772 ± 0.005, 294.3 ± 10.710, 83.00 ± 3.786, respectively) and 10 Gy groups (0.667 ± 0.006, 211.7 ± 9.528, 54.33 ± 2.728, respectively) (p < 0.05). Flow cytometry showed that the level of apoptosis in the 10 Gy + Eg5 inhibitor group (16.87 ± 2.476, 17.0%) was significantly higher than in the 10 Gy group (6.319 ± 0.380, 6.0%) (p < 0.05). Flow cytometry analysis further revealed that the proportion of cells in the G1 phase in the 10 Gy + Eg5 inhibitor group (10.037 ± 1.434) was lower than in the 10 Gy group (24.327 ± 2.252) (p < 0.05). PCR results showed that the messenger ribonucleic acid (mRNA) levels of H2AX, TP53BP1, XRCC1, and CDKN1A in the 10 Gy + Eg5 inhibitor group were significantly higher than those in the 10 Gy group (p < 0.05).

Conclusions: Eg5 inhibitors specifically bind to the Eg5 protein and disrupt mitosis, thereby improving the radiosensitivity of RCC by regulating the cell cycle. An Eg5 inhibitor combined with radiotherapy may represent an effective adjuvant therapy for RCC.

Objective: This study aims to evaluate the diagnostic effectiveness of prostate biopsies using transperineal colour ultrasound with magnetic resonance imaging (MRI) against transrectal colour ultrasound with MRI in treating prostate cancer (PCa) and oxidative stress injuries in patients.

Methods: We conducted a backward-looking study on the medical records of 65 individuals suspected of having PCa who underwent prostate biopsies at our hospital from March 2022 to March 2024. In the transrectal prostate biopsy (TRPB) group, 32 patients underwent TRPB, whereas the transperineal prostate biopsy (TPPB) group utilised TPPB for 33 patients. Every patient received an MRI scan to verify the location of the puncture prior to it. The length of the puncture, the amount of biopsy cores collected and confirmed as positive and any negative responses postprocedure were thoroughly documented. The indices of oxidative stress injuries in both groups were assessed postpuncture, and the effectiveness levels of TPPB and TRPB in diagnosing PCa were compared.

Results: No significant statistical variance existed between the two groups in the count of biopsy and positive biopsy cores (p > 0.05). However, compared with the duration of puncture in the TRPB group, that in the TPPB group was extended (p < 0.05). No significant variance in oxidative stress damage postpuncture existed amongst the groups (p > 0.05), and the TPPB group experienced fewer negative reactions than the TRPB group (p < 0.05). In terms of diagnostic effectiveness, TPPB’s sensitivity, specificity and accuracy in detecting PCa stood at 84.62%, 85.00% and 84.85%, respectively, surpassing those of TRPB in Kappa value. Additionally, the overall prostate-specific antigen levels in the TPPB group’s genuinely positive patients were notably less than those in the TRPB group (p < 0.05).

Conclusions: The combination of transperineal colour ultrasound and MRI is highly efficient in PCa diagnosis and is advised as the primary option in clinical settings.

Erectile dysfunction (ED) is a common sexual dysfunction in men that can occur with the onset of sexual activity or even earlier, and the development of ED involves a variety of pathophysiologic mechanisms. Organic erectile dysfunction refers to a type of erectile dysfunction that is primarily caused by physical or organic factors rather than psychological or emotional factors. Worldwide, the incidence and prevalence of ED are high. Currently, the mainstay of ED treatment is the use of medications such as phosphodiesterase type 5 inhibitors (PDE5Is). However, these medications cause adverse effects such as flushing, indigestion and headaches and are not effective for some ED patients. Therefore, there is an urgent need to explore new targets of action for the treatment of ED. Ferroptosis is a type of iron-dependent regulated cell death initiated by lipid peroxidation and is a novel form of programmed cell death associated with the pathogenesis of various diseases. Prior research has provided evidence that the ferroptosis pathway plays a pivotal role in the modulation of ED, establishing this pathway as a significant foundation for the development of potential therapeutic interventions for ED. Experiments have shown that the inhibition of ferroptosis can improve ED. This article systematically introduces the role and influence of ferroptosis in various types of organic erectile dysfunction and describes the molecular mechanism, related pathways, and potential targets, providing a theoretical basis for the clinical diagnosis and treatment of ED.

Prostate cancer remains a significant global health challenge. Traditionally anchored by the Gleason score/Grade Group (GS/GG), the landscape of prostate cancer diagnosis is undergoing transformative steps, particularly in the domain of biopsy procedures. GS/GG continues to be pivotal in malignancy grading, but recent technological strides have augmented the diagnostic relevance of biopsies. Integral to this progression is the adoption of advanced imaging techniques, especially magnetic resonance imaging, which has refined biopsy accuracy and efficiency. A deep understanding of prostate cancer pathology reveals a cribriform pattern and intraductal carcinoma of the prostate as independent forms of malignancy, suggesting a potentially aggressive disease course. Furthermore, the distinct behaviour of ductal adenocarcinoma and small cell carcinoma of the prostate, compared with acinar adenocarcinoma, necessitates their accurate differentiation during biopsy. The genomic era ushers in a renewed emphasis on tissue samples obtained from prostate biopsies, especially as mutations in genes, such as BRCA1/2, and paves the way for precision medicine. This review encapsulates the evolving dynamics of prostate biopsy, from technological advancements to the profound implications on prostate cancer management and therapy.

Objective: Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epitomizes the best preventative SARS-CoV-2 infection strategy to counteract the severe consequences of infection. However, concerns have been raised that the vaccines could have an adverse effect on sperm function and overall reproductive health. This combined systematic review and meta-analysis aimed to investigate the effects of different available SARS-CoV-2 vaccines on semen parameters.

Methods: A systematic PubMed, Scopus, Google Scholar, ScienceDirect, LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud), and Scilit database literature search until mid-June 2022 was conducted. Prospective and retrospective studies were eligible. No limitation was placed on language. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were thereafter obtained.

Results: Upon search completion, 122 studies were identified and retrieved and 110 were excluded, while the remaining 12 independent studies evaluating the effects of coronavirus disease 2019 (COVID-19) vaccines on semen parameters were included in this review. The total number of men included was 1551, aged 22.4–48 years. Following meta-analysis, the SMD summary measure with 95% CI for each semen parameter included a concentration of 0.22 (0–0.22); Total sperm count of 0.11 (0.18–0.24); Total motility of 0.02 (0.05–0.09); Volume of 0.02 (–0.1–0.14); Vitality of 0.55 (–0.19–0.29), progressive motility of –0.43 (–0.54 to –0.32); Total motile sperm count of –0.38 (–0.44 to –0.31); And normal morphology of 0.42 (–0.54 to –0.3). In brief, the total sperm count was slightly increased post-vaccination, while progressive motility, total motile sperm count, and normal morphology were marginally reduced post-vaccination, according to the meta-analysis.

Conclusions: No effects were observed regarding sperm viability and semen volume since the results of all the studies crossed the line of no effect. All seminal parameters analyzed showed a negligible or small change in relation to the vaccination effect. Furthermore, the parameters remained within the normal World Health Organization reference ranges, making the clinical significance unclear. Therefore, based on these results, it appears that vaccination does not have negative effects on semen quality. The individual study findings suggested that COVID-19 vaccines are not associated with decreased semen parameters.

Introduction: To evlauate role of peritoneal re-approximation methods in the prevention of symphtomatic lymphocele formation in patients underwent transperitoneal robot-assisted laparoscopic prostatectomy (tRALP) and extendeded pelvic lympadenoctomy (ePLND).

Materials and Methods: Between January 2016 and April 2020, 120 consecutive patients who were administered anterior t-RALP and ePLND were analyzed retrospectively. In group 1 (n = 40), peritoneal approximation was not performed after t-RALP and ePLND application, peritoneal half re-approximation was performed in group 2 (n=40), and peritoneal full re-approximation was performed in group 3 (n=40). Operative parameters and symptomatic lymphocele rates were compared between the groups.

Results: There was no statistically significant difference between the groups in terms of mean age, body mass index and prostatespecific antigen levels, Gleason score on biopsy, D'amico risk groups, the mean number of lymph nodes removed, Clavien-Dindo complication grade and mean duration of the surgery. Patients with symptomatic lymphocele in Group 1, Group 2, and Group 3 were found to be 2 (5%), 3 (7.5%) and 5 (12.5%), respectively. There was no statistically significant difference between the groups in terms of symptomatic lymphocele formation.

Conclusion: Half or full closure of the peritoneum does not affect the symptomatic lymphocele formation in patients who underwent tRALP and ePLND.

Background: The clinicopathological and prognostic relevance of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) in non-muscular invasive bladder cancer (NMIBC) was investigated.

Methods: All patients who underwent transurethral resection of bladder tumor (TURBT) and postoperative intravesical chemotherapy had their peripheral blood levels of NLR, PLR, and MLR quantified. The preoperative peripheral blood levels of NLR, PLR, and MLR were analyzed in patients with G1, G2, and G3 NMIBC. A total of 208 patients was divided into poor prognosis (PP, with recurrence, n=51) and good prognosis (GP, no recurrence, n=157) groups, according to whether the recurrence of NMIBC was observed at 1-year follow-up after treatment. Univariate and multivariate logistic regression analyses were performed to evaluate the prognostic factors in NMIBC. In addition, receiver operating characteristic (ROC) curves were used to analyze the prognostic performance of NLR, PLR, and MLR in NMIBC.

Results: The preoperative peripheral blood level of PLR was significantly increased in patients with G3 NMIBC compared with that in patients with G1 (p < 0.05) and G2 NMIBC (p < 0.05). The results of univariate and multivariate logistic regression analyses showed that the tumor diameter, differentiation grade, and preoperative peripheral blood levels of NLR, PLR, and MLR were independent prognostic factors for NMIBC recurrence (p < 0.05). Compared with the NMIBC patients without recurrence, 3.490%, 177.575% and 3.175% were determined as the optimum prognostic cutoffs for NLR, PLR, and MLR, respectively. ROC curve was used to evaluate the sensitivity, specificity, and area under the curve (AUC) of NLR, PLR, MLR, and combinations. In contrast to NLR, PLR, or MLR, the combination of NLR, PLR, and MLR (AUC 0.758, sensitivity 66.70%, specificity 89.80%,Youden index 0.565) improved the prognostic performance in the discrimination of NMIBC patients with recurrence from thosewithout recurrence.

Conclusions: The preoperative peripheral blood levels of NLR, PLR, and MLR, which were closely related to the grade and recurrence of NMIBC, were easy to detect and inexpensive. Moreover, these three factors showed the potential for auxiliary prognostic evaluation of NMIBC, wherein the combination than individual values exhibited better prognostic performance.

Objective: To study the prognosticvalues of preoperative neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) for patients with muscle-invasive bladder cancer (MIBC) undergoing radicalcystectomy. Methods: The clinical data of 186 MIBC patientsreceiving radical cystectomy from January 2013 toOctober 2015 were collected. Receiver operating characteristic(ROC) curves were plotted based on preoperativeNLR, PLR and LMR as well as survival of patientswithin 5 years after surgery. The NLR, PLR and LMRvalues of patients with different clinicopathologicalcharacteristics were described by frequencies.Recurrence-free survival curve was plotted using theKaplan-Meier method, and survival curves were comparedby the log-rank test. Independent risk factorsfor recurrence were explored by multivariate logistic regression analysis. NLR, PLR and LMR were utilizedto establish the recurrence risk scoring model, and theaccuracy for predicting recurrence was assessed byROC curves. Results: NLR groups had significantly differentpathological grade, T stage, lymph node metastasisand tumor number. The differences in age,pathological grade, T stage, lymph node metastasisand tumor number were significant between PLRgroups. Gender, pathological grade, T stage, lymphnode metastasis, tumor number and tumor sizehad significant differences between LMR groups(Pfree survival rate between NLR≥2.45 andNLRand PLRLMR≥3.72 and LMR33.61%) (Ptumor number, lymph node metastasis, NLR, PLRand LMR were independent risk factors for MIBCpatients. After these factors were included into therecurrence risk scoring model, the area under ROCcurve was 0.821. Conclusions: Preoperative NLR, PLR and LMRare potential biomarkers for determining the prognosisof MIBC patients, and the combination of independent risk factors may work better for prognosticevaluation.

PSA is the most widely used diagnosticand prognostic biomarker in prostate cancer (PCa).However, its lack of specificity has generated the needto search for new complementary markers. In thisscenario, blood plasma constitutes one of the sourcesof search for new markers, which have been tried tobe combined with PSA and other clinical variables inorder to develop tests that increase their diagnosticspecificity.This narrative review of the literature provides anoverview of commercially available plasma biomarkers and tests for use in different clinical settingsfor PCa. The most studied markers to help select theappropriate patients for initial and / or repeat biopsyhave been: PHI, 4K, STHLM3. These markers havebeen oriented towards the diagnosis of the so-calledclinically signifi cant PCa, trying to validate and calibratetheir algorithms in different populations. Giventhe development and evolution in the diagnosis of PCa,there is still a lack of evidence of the impact of magneticresonance imaging (MRI) when used in combinationwith these new markers, as well as its possiblerole in the screening of the disease and not only in theearly diagnosis process. Furthermore, there are only asmall number of studies that have directly comparedthese tests with each other and with PSA, so there isnot enough evidence to know which test has the bestproperties in each clinical scenario. In order to clarifythe true diagnostic role of these new biomarkers, newprospective, comparative studies in different populationsare absolutely necessary to evaluate their clinicalutility in combination with MRI and fusion biopsy.