We aimed to review the current evidence on surgical and functional outcomes of Transperineal Laser Ablation for LUTS due to BPH. A comprehensive review of the English-language literature was performed using the MEDLINE and Web of Science databases until 1 August 2022, aiming to select studies evaluating TPLA for the treatment of LUTS due to BPH. Additional records were found from Google Scholar. Data were extracted and summarized in Tables. An appropriate form was used for qualitative data synthesis. Seven studies were included in the review, with all being single arm, non-comparative studies. In all studies, functional outcomes were evaluated with uroflowmetry parameters and validated questionnaires, showing a promising effectiveness at short- and mid-term follow-up. There is a lack of standardized pathways for preoperative assessment of patients suitable for TPLA, and even the technique itself has been reported with a few nuances. A good safety profile has been reported by all the authors. Although promising results have been reported by different groups, selection criteria for TPLA and few technical nuances regarding the procedure were found to be heterogeneous across the published series that should be standardized in the future. Further research is needed to confirm these findings.

Background: With the rapid advancement of artificial intelligence (AI), its applications in andrology are expanding across diagnostic assessment, preoperative planning, intraoperative assistance, and postoperative management. This narrative review aims to synthesize current evidence regarding AI applications across the spectrum of andrological surgery. Methods: A comprehensive literature search was conducted using the PubMed, Scopus and Web of Science databases to identify relevant studies published between January 2020 and October 2025. The search strategy utilized combinations of keywords including “artificial intelligence,” “andrology,” “erectile dysfunction,” “male infertility,” “microsurgery,” and “robotic-assisted surgery.” Original research and review articles published in English were selected based on their clinical relevance to surgical practice. Results: AI has shown promise in the evaluation and management of erectile dysfunction (ED), male infertility-related microsurgery, and complex reconstructive procedures. AI-based models can improve risk prediction and diagnosis of ED, standardize semen analysis, support individualized selection of surgical candidates for varicocele repair and other interventions, and augment microsurgery through enhanced visualization and decision support. In the postoperative phase, AI-driven tools are being explored for complication prediction, functional recovery monitoring, and long-term quality-of-life follow-up, enabling more patient-centered, continuous care. Conclusions: AI holds significant promise for advancing precision medicine in andrological surgery by enhancing objective assessment and intraoperative guidance. However, large-scale, standardized datasets and rigorous multi-institutional validation are needed. Establishing robust ethical and legal frameworks will be essential to ensure the safe and effective integration of AI into routine andrological care.

Background: Chronic Prostatitis/Chronic Pelvic Pain syndrome NIH-class III is a widespread condition affecting men universally, with existing treatments showing limited success. This study evaluated the efficacy and safety of a natural supplement, composed of Serenoa repens, Solanum lycopersicum, lycopene, and bromelain, in managing symptoms of this condition among a substantial patient group. Methods: In this prospective study, 245 patients diagnosed with Chronic Prostatitis/Chronic Pelvic Pain syndrome NIH-class III were treated with the aforementioned supplement, alongside lifestyle alterations, such as refraining from spicy foods, alcohol, caffeine, and cycling, for a duration of three months. Patients’ progress was assessed at one and three months using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Prostate Symptom Index (IPSS), quality of life (QoL) scores, and changes in total prostate-specific antigen (PSA) levels. Results: The supplement was well received with no serious adverse events reported. Significant improvements were observed in NIH-CPSI scores, IPSS, QoL scores, and a substantial decrease in total PSA levels at three months compared to baseline, with a positive trend noted from one-month to three-month evaluations. This was consistent in either patients with predominantly voiding or storage urinary symptoms. Conclusions: Our results suggest that this natural supplement in conjunction with lifestyle changes could offer a safe and effective alternative treatment for patients suffering from Chronic Prostatitis/Chronic Pelvic Pain syndrome NIH-class III. However, these findings require validation through further large-scale randomized controlled trials.

Introduction: Surgical management of prostate cancer has evolved significantly over more than a century, transitioning from open procedures to modern robot-assisted techniques. This narrative review traces the historical progression of surgical treatments for localized prostate cancer, from early approaches to the most recent advancements. Materials and Methods: An extensive literature search was conducted from 1 April to 1 June 2025, using PubMed and cross-referencing citations. The search gathered studies on the evolution of prostate cancer surgery, technical aspects, and comparisons between surgical and non-surgical treatments. Keywords included “PROSTATE CANCER”, “PROSTATE CANCER SURGICAL TREATMENT”, “RADICAL PROSTATECTOMY EVOLUTION”, “ROBOT-ASSISTED RADICAL PROSTATECTOMY”, and “FOCAL THERAPY AND PROSTATE CANCER”. Results: A total of 65 manuscripts, including original articles, systematic reviews, meta-analyses, and clinical trials focusing on the surgical treatment of localized prostate cancer, were selected. The review begins with the history of prostatic surgery, chronicling its evolution through laparoscopic and, ultimately, robotic approaches. It highlights how improved visualization and new technologies have led to better functional outcomes and preservation of structures while maintaining oncological safety. A specific focus is placed on the technical evolution of robot-assisted radical prostatectomy, new robotic platforms, and the role of focal therapy as an ultra-minimally invasive technique for localized disease. Conclusions: Robot-assisted radical prostatectomy represents the current reference surgical technique for localized prostate cancer. However, it is crucial to acknowledge RALP’s elevated cost and the need for further long-term, randomized data to establish definitive oncological equivalence compared to non-surgical options.

Objective: To evaluate the early oncological outcomes of patients treated with robot-assisted radical prostatectomy for prostate cancer with multiple PIRADS lesions at baseline mpMRI in a tertiary referral center. Methods: Data of consecutive patients undergoing robot-assisted radical prostatectomy between 2020 and 2022 at a high-volume tertiary referral center were prospectively collected. mpMRI data was evaluated by two expert uro-radiologists at our center. All patients received an MRI–ultrasound fusion biopsy. Results: Overall, 286 patients with multiple PIRADS lesions treated with robot-assisted radical prostatectomy at a tertiary referral center were included. Unilateral and bilateral nerve-sparing were achieved in 63 (22.3%) and 124 (43.1%) patients, respectively. Median age was 69 years (IQR: 64–72), while median Charlson Comorbidity Index was 3 (IQR: 2–4). The presence of two PIRADS lesions was found in the 81.8% of cases, while 18.2% presented with three or more. Bilateral lesions were observed in 67.4% of cases. The dominant lesion was PIRADS 4 in 57.3% and PIRADS 5 in 32.3% of cases, with a median diameter of 12 mm (IQR: 10–17). Pathological upstaging to pT3 occurred in 61% of patients. Overall, 9.8% of cases exhibited positive surgical margins (PSMs), most of them single and limited in extent. Postoperative major complications were recorded in 6.3% of patients. At a median follow-up of 18 months (IQR: 6–29), biochemical recurrence (BCR) occurred in 8% of patients. Patients with PIRADS 5 lesions experienced shorter BCR-free survival compared to those with PIRADS 3–4. On multivariable Cox regression, PIRADS 5 independently predicted biochemical recurrence (HR: 2.52; 95% CI: 1.10–5.80; p = 0.029), after adjustment for age, number of lesions, and nerve-sparing status, with the performance of nerve-sparing not associated with an increased risk of recurrence, including in patients with multifocal disease. Conclusions: Nerve-Sparing Robot-Assisted Radical Prostatectomy in patients with multiple PIRADS lesions achieves encouraging short-term oncologic outcomes, with biochemical recurrence-free survival exceeding 84% at 3 years, despite high rates of multifocality and pathological upstaging.