Objective: Prostate cancer, the second most diagnosed cancer among men, requires precise diagnostic techniques to ensure effective treatment. This review explores the technological advancements, optimal application conditions, and benefits of targeted prostate biopsies facilitated by multiparametric magnetic resonance imaging (mpMRI). Methods: A systematic literature review was conducted to compare traditional 12-core systematic biopsies guided by transrectal ultrasound with targeted biopsy techniques using mpMRI. We searched electronic databases including PubMed, Scopus, and Web of Science from January 2015 to December 2024 using keywords such as “targeted prostate biopsy”, “fusion prostate biopsy”, “cognitive prostate biopsy”, “MRI-guided biopsy”, and “transrectal ultrasound prostate biopsy”. Studies comparing various biopsy methods were included, and data extraction focused on study characteristics, patient demographics, biopsy techniques, diagnostic outcomes, and complications. Conclusion: mpMRI-guided targeted biopsies enhance the detection of clinically significant prostate cancer while reducing unnecessary biopsies and the detection of insignificant cancers. These targeted approaches preserve or improve diagnostic accuracy and patient outcomes, minimizing the risks associated with overdiagnosis and overtreatment. By utilizing mpMRI, targeted biopsies allow for precise targeting of suspicious regions within the prostate, providing a cost-effective method that reduces the number of biopsies performed. This review highlights the importance of integrating advanced imaging techniques into prostate cancer diagnosis to improve patient outcomes and quality of life.

Background and Objectives: We aimed at evaluating the impact of Controlling Nutritional Status (CONUT) score on clinically significant decline in estimated glomerular filtration rate (eGFR) in patients with non-metastatic Clear Cell Renal Cell Carcinoma (ccRCC) undergoing radical nephrectomy (RN). Materials and methods: We retrospectively analyzed a multi-institutional cohort of 140 patients with ccRCC who underwent RN between 2016 and 2018 at three Urological Centers. The CONUT score was calculated with an algorithm including serum albumin, total lymphocyte count, and cholesterol. Clinical and pathologic features were analyzed using Fisher’s exact test for categorical variables and a Mann–Whitney U test for continuous variables. To define the independent predictors of clinically significant eGFR decline, univariable (UVA) and multivariable (MVA) binomial logistic regression analyses were performed in order to assess the Odds Ratio (OR) with 95% Confidence Intervals (CIs). Results: The optimal cut-off value to discriminate between a low and high CONUT score was assessed by calculating the ROC curve. The area under the curve (AUC) was 0.67 (95%CI 0.59–0.78) with the most appropriate cut-off value at 2 points. Overall, 46 patients (32.9%) had a high CONUT score (>2). Statistically significant variables associated with eGFR decline at 24 months were age ≥ 70 (OR 2.01; 95%CI 1.17–3.09; p 0.05), stage II–III chronic kidney disease (CKD) (OR 6.05; 95%CI 1.79–28.3; p 0.001), and a high CONUT score (OR 3.98; 95%CI 1.58–10.4; p 0.004). Conclusions: The CONUT score is a low-time-consuming, cost-effective, and promising tool able to preoperatively screen patients at risk of developing CKD after a RN.

Background: Bladder leiomyomas are rare benign tumors (<0.5% of all bladder tumors) arising from the bladder wall’s smooth muscle. Only 250 cases of this condition have been reported worldwide so far. While some leiomyomas present with irritative or obstructive symptoms, hematuria, or nonspecific abdominal pain, others are asymptomatic and are diagnosed incidentally. The surgical approach is based on the leiomyoma’s size and location. Given this tumor’s rarity, standardized management guidelines do not exist; however, transurethral resection of bladder tumor (TURBT), partial or radical cystectomy, or laparoscopic/robotic enucleation are viable therapeutic options. Case history: We report the case of a 64-year-old female presenting with recurrent colic and pelvic pain. An abdominal CT scan showed a 3 cm mass protruding from the posterior bladder wall toward the right vaginal fornix. A transvaginal ultrasound-guided through-cut biopsy confirmed the diagnosis of a bladder leiomyoma. Due to the tumor’s size and location, robotic enucleation was chosen to minimize the risk of bladder perforation. The mass was successfully excised via a transvesical approach. Results: The procedure was completed in 210 min without complications, with 50 mL blood loss. The patient recovered well, with resolution of symptoms and no recurrence at eighteen-month follow-up. Histopathological examination on the surgical specimen confirmed the diagnosis of bladder leiomyoma. Conclusions: This case highlights the feasibility and safety of robotic enucleation for large bladder leiomyomas, emphasizing minimal invasiveness, limited pelvic dissection, and preservation of bladder function. Further research and standardized guidelines are needed for managing this rare condition.