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.

Benign prostatic hyperplasia (BPH) represents the histological entity of prostate cell proliferation, which inflicts a gradually increasing obstruction of the bladder outlet and is accompanied by a progressing manifestation of lower urinary tract symptoms (LUTS). BPH management algorithm includes conservative measures, pharmaceutical agents, and surgical procedures. A comprehensive literature review was performed using PubMed, Scopus, and Google Scholar databases to identify publications written in English, analyzing BPH pharmaceutical treatment. The search was conducted from January 2000 to January 2023. Six main drug classes can be administered, either as monotherapy or in combination. Furthermore, the authors provide current direction of research on future medications, which focuses on a more etiological interference to the BPH pathophysiological mechanism. The available medications represent an effective first-line step of BPH/LUTS therapy. Currently, the administration of BPH medications is tailored to patient/disease characteristics and entails long-time adherence to therapy. The emergence of new surgical modalities, which combine significantly lower morbidity compared to standard procedures and more durable effects than the available medications, seems to challenge the current treatment algorithm. More direct comparisons and the increasing experience with these surgical modalities will delineate the switch points between various therapy levels along the BPH management sequence.

Background: Lower urinary tract symptoms (LUTS) caused by benign prostatic obstruction (BPO) and bladder tumors may co-exist, especially among elderly patients. Transurethral resection of bladder tumors (TURBT) and endoscopic surgery for benign prostatic obstruction in the same setting are avoided by many surgeons due to concerns for tumor cell seeding and recurrences in the prostatic urethra. Aim: The aim of this study was assess the effect of concomitant TURBT and endoscopic BPO surgery on oncological safety and patient quality of life via systematic review and meta-analysis. Methods: We searched the PubMed, Cochrane Library, EMBASE, Scopus, and Clinicaltrials.gov databases and sources of grey literature published before June 2021 for relevant studies. We performed a random-effects meta-analysis of odds ratios (ORs) or weighted mean differences (WMD) to compare concomitant TURBT and BPO surgery versus TURBT alone in terms of recurrence and progression rates. Accordingly, we undertook multiple subgroups and sensitivity analyses (PROSPERO: CRD42020173363). Results: Three randomized and twelve retrospective observational studies with 2421 participants were included. Across studies with good methodological quality, no statistically significant differences were demonstrated regarding overall bladder tumors recurrence rates between concomitant endoscopic BPO surgery and TURBT versus TURBT alone (OR: 0.81, 95% CI: 0.60–1.09, I² = 42%). Similarly, no significant differences were observed in recurrences located at the bladder neck and/or prostatic urethra (OR: 1.06, 95% CI: 0.76–1.47, I² = 0%), time to first recurrence (WMD: −0.2 months, 95% Cl: −2.2–1.8, I² = 48%), and progression rate (OR: 1.05, 95% CI: 0.67–1.64, I² = 0%). Subgroup analyses based on tumor grade, number of tumors, and utilization of single-instillation chemotherapy post-TURBT did not detect any significant differences in overall bladder tumor recurrence. The level of evidence was estimated as low for all outcomes. Concomitant surgery improved lower urinary tract symptoms. Conclusion: Concomitant endoscopic BPO surgery and TURBT are oncologically safe and improve LUTS-related quality of life.

The aim of this narrative review is to provide a comprehensive overview of penile prostheses (PPs) for the treatment of erectile dysfunction (ED), exploring their historical evolution, types, key advancements, clinical outcomes, and future directions. A comprehensive literature search of studies published in English was conducted between January 2000 and April 2024, using databases including PubMed, MEDLINE, Embase, and the Cochrane Library. Search terms included “penile prosthesis”, “penile implants”, “malleable penile implant”, “inflatable penile prosthesis”, “two-piece IPP”, “three-piece IPP”, and “penile implant advancements”. The included studies focused on the development, effectiveness, and complications of penile prostheses. These studies are clinical trials, randomized controlled trials, observational studies, systematic reviews, and meta-analyses. Data were synthesized qualitatively and quantitatively. Penile prostheses have significantly evolved since their invention, with notable advancements in both malleable and inflatable models. Malleable prostheses, known for their simplicity and reliability, offer a semirigid state that is beneficial for patients with limited hand dexterity or those undergoing salvage procedures. Inflatable penile prostheses (IPPs), particularly the three-piece models, have seen substantial technological improvements, including enhanced mechanical reliability, reduced infection rates due to antibiotic coatings, and better patient satisfaction. Key innovations include the development of hydrophilic coatings, parylene microcoatings, and antibiotic-impregnated implants, which have collectively reduced complications.

Background: The leakage of urine during sexual arousal, known as climacturia, is an under-recognized clinical condition often overshadowed by erectile dysfunction in men who have undergone radical prostatectomy. Objectives: This study aims to determine and evaluate the role of the Mini-Jupette technique and its alternatives in the treatment of climacturia. Data sources and methods: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. We searched Medline via PubMed, Scopus, and the Cochrane Library databases until October 2022. Results: We included seven studies involving 120 patients with climacturia. Different types of grafts were used, ranging from synthetic mesh to autologous grafts. In all seven studies, the use of the Adrianne Mini-Jupette (AMJ) and its alternatives showed a high percentage of improvement in climacturia, with reported complete resolution ranging from 65% to 93%. Regarding postoperative complications, one study reported the highest sling explantation rate at 11% (4/38), while other studies reported complications ranging from subjective symptoms such as dysuria and perineal pain to the need for subsequent artificial urinary sphincter placement. Conclusion: The AMJ sling and its variations are low-cost, time-efficient, and relatively safe procedures with high patient satisfaction rates among those treated for climacturia.

Lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) constitute a significant health concern worldwide, particularly among aging male populations