Background: No regenerative approach has thus far been shown to be effective in skeletal muscle injuries, despite their high frequency and associated functional deficits. We sought to address surgical trauma‐related muscle injuries using local intraoperative application of allogeneic placenta‐derived, mesenchymal‐like adherent cells (PLX‐PAD), using hip arthroplasty as a standardized injury model, because of the high regenerative and immunomodulatory potency of this cell type.Methods: Our pilot phase I/IIa study was prospective, randomized, double blind, and placebo‐controlled. Twenty patients undergoing hip arthroplasty via a direct lateral approach received an injection of 3.0 × 10⁸ (300 M, n = 6) or 1.5 × 10⁸ (150 M, n = 7) PLX‐PAD or a placebo (n = 7) into the injured gluteus medius muscles.Results: We did not observe any relevant PLX‐PAD‐related adverse events at the 2‐year follow‐up. Improved gluteus medius strength was noted as early as Week 6 in the treatment‐groups. Surprisingly, until Week 26, the low‐dose group outperformed the high‐dose group and reached significantly improved strength compared with placebo [150 M vs. placebo: P = 0.007 (baseline adjusted; 95% confidence interval 7.6, 43.9); preoperative baseline values mean ± SE: placebo: 24.4 ± 6.7 Nm, 150 M: 27.3 ± 5.6 Nm], mirrored by an increase in muscle volume [150 M vs. placebo: P = 0.004 (baseline adjusted; 95% confidence interval 6.0, 30.0); preoperative baseline values GM volume: placebo: 211.9 ± 15.3 cm³, 150 M: 237.4 ± 27.2 cm³]. Histology indicated accelerated healing after cell therapy. Biomarker studies revealed that low‐dose treatment reduced the surgery‐related immunological stress reaction more than high‐dose treatment (exemplarily: CD16+ NK cells: Day 1 P = 0.06 vs. placebo, P = 0.07 vs. 150 M; CD4+ T‐cells: Day 1 P = 0.04 vs. placebo, P = 0.08 vs. 150 M). Signs of late‐onset immune reactivity after high‐dose treatment corresponded to reduced functional improvement.Conclusions: Allogeneic PLX‐PAD therapy improved strength and volume of injured skeletal muscle with a reasonable safety profile. Outcomes could be positively correlated with the modulation of early postoperative stress‐related immunological reactions.

Purpose of Review: In the setting of kidney transplantation, the ureter is a common source for complications. As a result, prevention of ureteral complications and their management is of crucial importance. In this context, the purpose of this review is to summarize recent literature on the ureter in the kidney transplant setting with a special focus on new findings. We conducted a PubMed and Medline search over the last 10 years to identify all new publications related to ureteroneoimplantations, stents and management of complications in the kidney transplant setting. Recent Findings: Performance of the “Lich-Gregoir” technique for ureteroneocystostomy seems to be favourable in regard to postoperative complications when compared with other methods described in the literature. Moreover, major urologic complications can be further reduced by ureteral stenting. Summary: A new approach for management of ureteral strictures in renal transplants is presented. We discussed the usage of a ureteral stent covered with a biostable polymer aiming to prevent tissue ingrowth into the lumen as a new option for management of ureteral stricture in the kidney transplant setting.

Background/Objectives: Artificial intelligence (AI), particularly natural language processing (NLP) models such as ChatGPT, presents novel opportunities for patient education and informed consent. This study evaluated ChatGPT’s use as a support tool for informed consent before penile prosthesis implantation (PPI) in patients with erectile dysfunction (ED) following radical prostatectomy. Methods: ChatGPT-4 answered 20 frequently asked questions across four categories: ED and treatment, PPI surgery, complications, and postoperative care. Three senior urologists independently rated information quality using the DISCERN instrument on a Likert scale ranging from 1 (poor quality) to 5 (good quality). Readability was assessed using the Flesch Reading Ease (FRE) and Flesch–Kincaid Grade Level (FKGL) formulas, and inter-rater reliability was measured using intraclass correlation coefficients. Results: The inter-rater reliability coefficient was 0.76 (95% CI 0.71–0.80). Mean DISCERN scores indicated moderate quality: 2.79 ± 0.92 for ED and treatment, 2.57 ± 0.98 for surgery, 2.65 ± 0.86 for complications, and 2.74 ± 0.90 for postoperative care. High scores (>4) were achieved for clarity and relevance, while complex issues, such as risks and alternative treatments, scored the lowest (<2). The FRE scores ranged from 9.8 to 28.39, and FKGL scores ranged from 14.04 to 17.41, indicating complex readability suitable for college-level comprehension. Conclusions: ChatGPT currently provides variable and often inadequate quality information without sufficient comprehensibility for informed patient decisions, indicating the need for further improvements in quality and readability.

Background: Large language models (LLMs) such as ChatGPT, Google Gemini, and Microsoft Copilot are increasingly used by patients seeking medical information online. While these tools provide accessible and conversational explanations, their accuracy and safety in emotionally sensitive scenarios—such as an incidental cancer diagnosis—remain uncertain. Objective: To evaluate the quality, completeness, readability, and safety of responses generated by three state-of-the-art LLMs to common patient questions following the incidental discovery of a kidney tumor. Methods: A standardized use-case scenario was developed: a patient learns of a suspicious renal mass following a computed tomography (CT) scan for back pain. Ten plain-language prompts reflecting typical patient concerns were submitted to ChatGPT-4o, Microsoft Copilot, and Google Gemini 2.5 Pro without additional context. Responses were independently assessed by five board-certified urologists using a validated six-domain rubric (accuracy, completeness, clarity, currency, risk of harm, hallucinations), scored on a 1–5 Likert scale. Two statistical approaches were applied to calculate descriptive scores and inter-rater reliability (Fleiss’ Kappa). Readability was analyzed using the Flesch Reading Ease (FRE) and Flesch–Kincaid Grade Level (FKGL) metrics. Results: Google Gemini 2.5 Pro achieved the highest mean ratings across most domains, notably in accuracy (4.3), completeness (4.3), and low hallucination rate (4.6). Microsoft Copilot was noted for empathetic language and consistent disclaimers but showed slightly lower clarity and currency scores. ChatGPT-4o demonstrated strengths in conversational flow but displayed more variability in clinical precision. Overall, 14% of responses were flagged as potentially misleading or incomplete. Inter-rater agreement was substantial across all domains (κ = 0.68). Readability varied between models: ChatGPT responses were easiest to understand (FRE = 48.5; FKGL = 11.94), while Gemini’s were the most complex (FRE = 29.9; FKGL = 13.3). Conclusions: LLMs show promise in patient-facing communication but currently fall short of providing consistently accurate, complete, and guideline-conform information in high-stakes contexts such as incidental cancer diagnoses. While their tone and structure may support patient engagement, they should not be used autonomously for counseling. Further fine-tuning, clinical validation, and supervision are essential for safe integration into patient care.

Purpose: To determine oncological and functional outcomes and side effects after focal therapy of prostate cancer (PCa) with high-intensity focused ultrasound (HIFU). Methods: This retrospective single-center study included 57 consecutive patients with localised PCa. Aged 18–80 with ≤2 suspicious lesions on mpMRI (PIRADS ≥ 3), PSA of ≤15 ng/mL, and an ISUP GG of ≤2. HIFU was performed between November 2014 and September 2018. All men had an MRI/US fusion-guided targeted biopsy (TB) combined with a TRUS-guided 10-core systematic biopsy (SB) prior to focal therapy. HIFU treatment was performed as focal, partial, or hemiablative, depending on the prior histopathology. Follow-up included Questionnaires (IIEF-5, ICIQ, and IPSS), prostate-specific antigen (PSA) measurement, follow-up mpMRI, and follow-up biopsies. Results: The median age of the cohort was 72 years (IQR 64–76), and the median PSA value before HIFU was 7.3 ng/mL (IQR 5.75–10.39 ng/mL). The median follow-up was 27.5 (IQR 23–41) months. At the time of the follow-up, the median PSA value was 2.5 ng/mL (IQR 0.94–4.96 ng/mL), which shows a significant decrease (p < 0.001). In 17 (29.8%) men, mpMRI revealed a suspicious lesion, and 19 (33.3%) men had a positive biopsy result. Only IIEF values significantly decreased from 16 (IQR 10.75–20.25) to 11.5 (IQR 4.5–17) (p < 0.001). The rate of post-HIFU complications was low, at 19.3% (11 patients). The limitation of this study is the lack of long-term follow-up. Conclusions: HIFU as a therapy option for nonmetastatic, significant prostate cancer is effective in the short term for carefully selected patients and shows a low risk of adverse events and side effects.

Background/Objectives: Kidney transplantation is associated with an increased risk of renal cell carcinoma (RCC). This study aimed to evaluate the outcomes of de novo RCC in kidney transplant recipients (KTRs). Methods: We retrospectively identified 50 de novo RCC cases among 4012 KTRs transplanted from 2005 to 2024. Data on patient characteristics and outcomes were collected. Propensity score matching (PSM) compared 34 localized RCC cases in KTRs with 34 non-transplant RCC cases. The statistical analyses used Kaplan–Meier estimates, the log-rank test, and the Cox regression. Results: The RCC incidence was 0.64 per 1000 person-years, with a standardized incidence ratio of 4.40 (95% CI: 3.33–5.80). In the KTR cohort, clear cell RCC was present in 42%, and papillary RCC was present in 42%. RCC developed predominantly in native kidneys (92%). UICC stage I was present in 74%. The treatment for the non-metastatic RCC was nephrectomy in the majority of cases (91%). For the metastatic RCC, 71% received a tyrosine kinase inhibitor (TKI). In the KTR cohort, the 3- and 5-year overall survival (OS) rates were 85% and 72%, respectively, with a median OS of 199 months; the synchronous metastasized (M1) patients had a median OS of 14 months. Rejection, age, advanced UICC stage, higher pT stage, clinical positive lymph nodes, M1, and higher grade were significantly associated with poor OS. The 5-year OS (96% vs. 84%, p = 0.72) and MFS (92% vs. 93%, p = 0.61) were comparable in the PSM cohort between the KTRs and the non-KTRs in the localized RCC. Conclusions: KTRs have a higher risk of RCC and present at a localized stage with comparable OS rates to non-transplant RCC patients. Adverse tumor characteristics, including synchronous metastases, significantly affect the prognosis, highlighting the need for surveillance and individualized treatment, particularly for metastatic RCC.