Background/Objectives: Penile fractures are a rare urological emergency, defined as the traumatic rupture of the tunica albuginea. They are classically diagnosed on clinical grounds, requiring urgent operative repair, most commonly by penile degloving. Magnetic resonance imaging (MRI) has emerged as a promising tool in the management of penile fractures. Often recommended in the setting of equivocal clinical diagnoses, MRI can help diagnose, as well as localise, the site of injury. Furthermore, it also holds potential in differentiating penile fractures from mimicking conditions, thereby possibly preventing unnecessary surgical procedures. This study is aimed at evaluating the diagnostic accuracy of MRI for penile fractures. Furthermore, it seeks to explore MRI’s effectiveness in guiding the surgical approach through precise localisation of the injury site. Methods: The PubMed, Embase, and Cochrane databases were searched from January 1995 to December 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and a total of 246 cases from 32 studies were identified. Results: Pooled results for MRI use in penile fracture diagnosis resulted in a positive predictive value of 97.8%, a negative predictive value of 87.0%, a sensitivity of 98.6%, and a specificity of 80%. MRI can accurately guide localised incisions, due to its ability to accurately identify the exact site of injury, with no additional reported complications or conversions to degloving. Considerable heterogeneity was observed within MRI parameters and protocols used in the studies identified. Conclusions: This review suggests that MRI is an accurate imaging modality for penile fractures and should be considered as a first-line investigation for equivocal cases. Its application may refine clinical management by avoiding unnecessary surgeries in cases mimicking penile fractures and improve pre-operative planning through precise injury localisation. This study is limited by heterogeneity in MRI protocols and the small sample sizes and retrospective nature of many included studies. The future standardisation of MRI protocols could enhance its utility and reliability in the clinical setting. Additionally, further research is needed to evaluate the long-term outcomes following the repair of small fractures detected on MRI and following MRI-guided localised incisions during surgical repair. Level of Evidence: 2.

When localised prostate cancer recurs after treatment, it occurs predictably in sites such as the prostatic bed, pelvic lymph nodes, spine, lung, and liver. Urethral metastasis of prostate cancer is exceedingly rare. We report a case of urethral recurrence of prostate cancer presenting as new lower urinary tract symptoms in an 82-year-old male 10 years after robotic radical prostatectomy with a very low PSA level of 0.05μg/L. This rare case highlights the need to maintain a degree of suspicion for prostate cancer recurrence in patients with a late onset of or changing lower urinary tract symptoms after radical prostatectomy.

Background/Objectives: Infant male circumcision (IMC) is a long-established religious practice in Jewish, Muslim, and some Orthodox Christian communities. Since 2007, access to non-therapeutic request IMC in Australia has gradually shifted from the public healthcare system to the private sector. However, the equity implications of this shift, particularly for socio-economically disadvantaged religious families, have received limited scholarly attention. This study explores the potential equity impacts of this policy environment, with a focus on low-income families in the Greater Sydney region. Methods: A desk-based Equity-Focused Health Impact Assessment (EFHIA) was conducted using publicly accessible data from the Australian Bureau of Statistics (ABS) and Medicare Benefits Schedule (MBS). Suburbs in the Greater Sydney region with the highest proportion of Jewish, Muslim, and Orthodox Christians were identified and the proportion of households with children experiencing financial vulnerability were compared across these suburbs. Findings were discussed using an equity and healthcare-access lens. Results: Suburbs with higher proportions of Muslim residents consistently demonstrated a higher proportion of households living with financial vulnerability compared with suburbs with higher proportions of Jewish and Orthodox Christian households. These findings suggest greater potential exposure to financial barriers when accessing private IMC services among Muslim-majority suburbs. In turn, such barriers may increase reliance on lower-cost, unaccredited circumcision providers, with possible risk of complications. Conclusions: The privatisation of request IMC in Australia is likely to disproportionally affect socio-economically disadvantaged religious families, particularly within Muslim communities, potentially generating an inequitable barrier to safe circumcision. Policy responses should focus on mitigating access barriers and safety risks through accredited provider registries, standardised parental information, regulatory oversight, and targeted community-based financial support mechanisms.

Bladder diverticula are herniations of the bladder mucosa through the muscular layer and can be congenital or acquired. Acquired bladder diverticula are almost always associated with bladder outlet obstruction. Bladder diverticula are uncommon and often asymptomatic, however, can present with non-specific lower urinary tract symptoms, haematuria, or urinary tract infection. We report a rare case of a large bladder diverticulum causing extrinsic left ureteric compression in a 37-year-old male with a high bladder neck presenting as left flank pain and hydronephrosis. A bladder neck incision successfully resolved voiding symptoms and decompressed the diverticulum leading to resolution of ureteric obstruction.

Emphysematous pyelonephritis (EPN) is a potentially life-threatening infection of the renal parenchyma and perinephric tissues by gas-forming organisms. Historically, open surgical drainage or nephrectomy was the standard of care, however, in recent years percutaneous drainage as a minimally invasive approach has become popular. However, whether percutaneous drainage can be successful in more severe cases of EPN is less clear. We report a case of severe Class IIIb EPN managed successfully with multiple staged percutaneous drainage procedures guided by interval re-assessment of clinical, biochemical, and radiological progress in a 52-year-old male with poorly controlled Type 2 Diabetes.