While cancer, and especially testicular cancer and Hodgkin's disease, affects male fertility in many ways, the current increase of survival of male cancer patients of reproductive age or earlier has emerged as a new challenge to their subsequent ability to father children. Cancer treatments, including surgery, radiotherapy and chemotherapy, can have a transitory as well as a permanent detrimental impact on male fertility. Gonadotoxic effects and the length of time for sperm recovery after radiotherapy depends not only on initial semen quality, but also on gonadal dosage and the delivery method after chemotherapy, on the type of regimens and dosages and on the spermatogenesis phase that each drug impacts. Combination treatment with radiotherapy and chemotherapy will induce more gonadotoxicity than either modality alone. Although efforts to prevent gonadal toxicity in cancer treatment are routinely applied, sperm cryopreservation remains the gold standard to maintain male fertility after cancer survival. Fertility preservation for prepubertal boys presents the greatest problem due to the absence of mature sperm in their gonads. In this area, research efforts are concentrated on cryopreservation of immature gametes and, in particular, techniques for their maturation and proliferation after thawing.

Severe persistent stress incontinence following radical prostatectomy for prostate cancer treatment, although not very common, remains the most annoying complication affecting patient’s quality of life, despite good surgical oncological results. When severe incontinence persists after the first postoperative year and conservative treatment has been failed, surgical treatment has to be considered. In these cases it is generally accepted that artificial urinary sphincter is the gold standard treatment. AUS 800 by American Medical Systems has been successfully used for more than 35 years. Recently three more sphincter devices, the Flow-Secure, the Periurethral Constrictor, and the ZSI 375, have been developed and presented in the market. A novel type of artificial urinary sphincter, the Tape Mechanical Occlusive Device, has been inserted in live canines as well as in human cadavers. These new sphincter devices are discussed in this paper focusing on safety and clinical results.

To provide a comprehensive review on the existing research and evidence regarding artificial intelligence (AI) applications in the assessment and management of urinary stone disease. A comprehensive literature review was performed using PubMed, Scopus, and Google Scholar databases to identify publications about innovative concepts or supporting applications of AI in the improvement of every medical procedure relating to stone disease. The terms ‘‘endourology’’, ‘‘artificial intelligence’’, ‘‘machine learning’’, and ‘‘urolithiasis'’ were used for searching eligible reports, while review articles, articles referring to automated procedures without AI application, and editorial comments were excluded from the final set of publications. The search was conducted from January 2000 to September 2023 and included manuscripts in the English language. A total of 69 studies were identified. The main subjects were related to the detection of urinary stones, the prediction of the outcome of conservative or operative management, the optimization of operative procedures, and the elucidation of the relation of urinary stone chemistry with various factors. AI represents a useful tool that provides urologists with numerous amenities, which explains the fact that it has gained ground in the pursuit of stone disease management perfection. The effectiveness of diagnosis and therapy can be increased by using it as an alternative or adjunct to the already existing data. However, little is known concerning the potential of this vast field. Electronic patient records, containing big data, offer AI the opportunity to develop and analyze more precise and efficient diagnostic and treatment algorithms. Nevertheless, the existing applications are not generalizable in real-life practice, and high-quality studies are needed to establish the integration of AI in the management of urinary stone disease.

To determine statistically significant parameters that influence shockwave lithotripsy (SWL) outcome and to develop a mathematical equation to predict the possibility of a successful outcome. Radiopaque ureteral and renal stones (1997) underwent SWL in a single center using the Siemens Lithostar Plus lithotripter. Investigated variables were stone size and location; presence of multiple stones; patient sex, age, body mass index (BMI), and ureteropelvic junction (UPJ) diameter; and Double-J catheter presence. The investigation included intravenous urography or ultrasonography and plain radiography of the kidneys, ureters, and bladder (KUB). Ten percent of the patients also underwent unenhanced CT to determine stone volume and density. Patients were evaluated 3 months postoperatively by plain radiography of the KUB. Student t test, chi-square test, and multiple logistic regression analysis were used to determine statistically significant variables and to create predictive mathematical equations. Kidney, ureter, total stone-free rate, and re-treatment rate were 71%, 80.9%, 74.9% and 18%, respectively. Complications included two perirenal hematomas, one significant cardiac arrhythmia, and 3.7% stein-strasse. Statistically significant variables were patient age, sex, BMI, stone size, volume, density, multiple lithiasis, and UPJ diameter. By using statistical analysis, coefficients were calculated for each significant variable. The mathematical model calculating the probability (P) of success with a mean predictive value of about 80% is: P = 1/1 + e(-z) where e is the base of the natural logarithm and z = ct + the total of products of each coefficient multiplied by each variable value. Using the described method, similar predictive equations can be created for different lithotripters and used by computer software to aid both patient counseling and doctor decision and ensure an optimal combination of maximum efficacy and safety and minimum cost.