The molecular mechanisms of obesity-induced cancer progression have been extensively explored because of the significant increase in obesity and obesity-related diseases worldwide. Studies have shown that obesity is associated with certain features of prostate cancer. In particular, bioactive factors released from periprostatic adipose tissues mediate the bidirectional communication between periprostatic adipose tissue and prostate cancer. Moreover, recent studies have shown that extracellular vesicles have a role in the relationship between tumor peripheral adipose tissue and cancer progression. Therefore, it is necessary to investigate the feedback mechanisms between prostate cancer and periglandular adipose and the role of exosomes as mediators of signal exchange to understand obesity as a risk factor for prostate cancer. This review summarizes the two-way communication between prostate cancer and periglandular adipose and discusses the potential role of exosomes as a cross-talk and the prospect of using adipose tissue as a means to obtain exosomes in vitro. Therefore, this review may provide new directions for the treatment of obesity to suppress prostate cancer.

Erectile dysfunction refers to the inability of men to achieve or maintain sufficient erection during sexual activity, which significantly impacts their quality of life and mental health. The causes of erectile dysfunction are complex, involving multiple systems such as vascular, neural, endocrine, and psychological factors. Current treatment methods for erectile dysfunction have significant limitations in addressing organic lesions, particularly penile fibrosis and hypoxic microenvironments. However, the latest stem cell-derived nanovesicle technology has been found to significantly reverse cellular fibrosis and alter the cellular microenvironment, potentially offering a new therapeutic approach for erectile dysfunction. Additionally, extracellular vesicles derived from stem cells can exert stem cell-like regenerative effects while overcoming challenges associated with cell therapy, making them excellent tools for regenerative repair. Therefore, this paper summarizes the potential of extracellular vesicles from different stem cell sources in the treatment of erectile dysfunction and analyzes their engineered preclinical studies to facilitate their translation from the laboratory to clinical applications.

Background: Genitourinary cancers, including prostate, bladder, and kidney cancers, represent significant global health burdens. Their early diagnosis and effective treatment continue to pose substantial clinical challenges. Traditional diagnostic methods often suffer from invasiveness or insufficient accuracy, whereas liquid biopsy technologies—particularly the analysis of tumor-derived extracellular vesicles (TDEVs)—offer transformative potential for non-invasive diagnosis and precision medicine. Objectives: This review comprehensively examines the biological functions, diagnostic utility, therapeutic potential, current challenges, and future directions of TDEVs in genitourinary cancers, aiming to bridge the gap between mechanistic understanding and clinical translation. Methods: A systematic literature search was conducted across PubMed, Embase, and Web of Science databases to collect studies published between 2018 and 2024 on TDEVs in prostate, bladder, and kidney cancers, with a focus on molecular mechanisms, clinical applications, and technological advances. Following PRISMA guidelines, we established predefined inclusion and exclusion criteria, conducted dual independent screening of search results, and performed quality assessment of included studies. A narrative review approach was employed to synthesize the evidence. Key Findings: TDEVs exhibit a dual nature in genitourinary cancers: they function as “architects” of tumor progression by remodeling the tumor microenvironment, inducing metastasis, and conferring therapeutic resistance, while simultaneously serving as “multifunctional allies” in cancer treatment. Clinically, TDEV-based liquid biopsy markers demonstrate superior performance compared to conventional detection methods, with engineered TDEVs emerging as promising platforms for targeted drug delivery and immunotherapy. However, significant challenges remain in standardization of isolation protocols, characterization methods, and efficient targeting strategies. Conclusion: TDEVs represent a paradigm shift in precision oncology for genitourinary malignancies. With advancing technologies in isolation methods, multi-omics integration, and artificial intelligence applications, TDEVs are poised to become indispensable tools for early tumor detection, real-time monitoring, and personalized therapeutic strategies, heralding a new era in uro-oncological practice.

Superparamagnetic iron oxide nanoparticles (SPIONs) have emerged as transformative theranostic platforms in urological oncology. This review systematically synthesizes literature from PubMed, Web of Science, and Scopus (2010–2024) to evaluate SPION-based strategies for bladder cancer (BCa) and prostate cancer (PCa). We highlight their role in enhancing diagnostic precision (e.g., PSMA-targeted MRI, sentinel lymph node navigation) and enabling innovative therapies (e.g., magneto-photothermal synergy, ferroptosis immunomodulation). Key advantages include superior targeting, multimodal imaging capability, and the ability to overcome physiological barriers such as the blood-prostate and blood-urine barriers. While preclinical results are promising, clinical translation requires addressing biosafety, scalable production, and regulatory hurdles. SPIONs represent a robust alternative to conventional therapeutics, particularly in settings requiring precision and combinatory approaches.

Background: Bladder cancer, particularly non-muscle-invasive bladder cancer (NMIBC), poses significant clinical challenges due to its high recurrence rate. Traditional diagnostic approaches such as cystoscopy and urine cytology have limitations, including invasiveness and insufficient sensitivity. Gold nanoparticles (AuNPs) offer unique opportunities to address these challenges with their surface plasmon resonance effect, biocompatibility, and ease of functionalization. Methods: Through critical review of recent literature, this paper outlines the application principles, achievements, and mechanisms of AuNPs in bladder cancer, including in vitro diagnostics, multimodal molecular imaging, photothermal therapy, targeted drug delivery, radiotherapy sensitization, and tumor immune microenvironment remodeling. Main Findings: AuNPs are driving a paradigm shift in bladder cancer management. In diagnostics, AuNP-based biosensors enable ultra-sensitive detection of urinary biomarkers. In imaging, they serve as effective contrast agents for enhanced visualization. For therapy, AuNP-mediated photothermal therapy enables precise tumor ablation, and as drug carriers, they help overcome chemoresistance. Additionally, AuNPs demonstrate potential in remodeling the immunosuppressive microenvironment through modulation of signaling pathways and tumor-associated macrophages. Conclusion: Gold nanoparticles are transforming bladder cancer toward precision, minimally invasive, and personalized treatment models. However, it is important to acknowledge that most current findings remain in the preclinical stage, and significant translational barriers—particularly long-term biosafety and standardized production—must be addressed before widespread clinical adoption.

Hepatocellular carcinoma (HCC) remains a major cause of cancer mortality, and the development of safer and more effective delivery systems remains an impor