Arteriovenous fistula (AVF) is an uncommon presentation of ruptured aortoiliac aneurysm (rAIA). Symptomatic persistence of an AVF fed by a type II endoleak after endovascular aneurysm repair (EVAR) for rAIA is rare, with little in the literature to guide practice. We present a novel transvenous approach to treatment of symptomatic type II endoleak after EVAR for rAIA with AVF. A transvenous approach avoids complex arterial access and the need for stenting in the venous system. This technique should be considered in patients with persistent AVF after EVAR with ongoing symptomatic type II endoleak.

Objectives: Large language models such as ChatGPT have been used to generate text in a conversational manner, and may be of use in providing patient information in a urological setting. This study evaluated the accuracy, presence of omissions, and preferability of traditional patient information to the large language models ChatGPT and Bing Chat. Methods: Eight common questions regarding urolithiasis and prostate cancer were selected from traditional patient information and posed to ChatGPT and Bing Chat. Responses from all sources were then evaluated by seven urologists in a blinded fashion for accuracy, omissions, and preferability. Results: We found that 96.43% of ratings of traditional patient information sources were rated accurate, compared to 94.6% for ChatGPT and Bing Chat; 7.1% of ratings of traditional patient information were rated as containing harmful omissions, compared to 10.71% for ChatGPT and 21.4% for Bing Chat; and 55.4% of rater first preferences were given to ChatGPT, compared to 35.7% for traditional patient information and 8.9% for Bing Chat. Conclusions: ChatGPT provided responses of a similar accuracy and preferability to traditional sources, highlighting its potential as a supplementary tool for urological patient information. However, concerns remain regarding omissions and complexity in model-generated responses.

A 36-year-old male patient is referred for urology review for haematuria following cyclophosphamide and mesna administration for allogeneic stem cell transplant for treatment of acute lymphoblastic leukaemia. Severe haematuria continued despite multiple interventions including continuous bladder irrigation and cystoscopic fulguration, with formation of consolidated clot in the bladder. A successful cystotomy for removal of clot and initiation of alum was performed, leading to resolution of haematuria.

Primary squamous cell carcinoma of the prostate is a rare entity, with limited documented cases in the medical literature. Herein, we present a case of primary prostatic squamous cell carcinoma in a male in his 60s, detailing the clinical presentation, diagnostic workup, histopathological findings and treatment. Our case highlights the diagnostic and therapeutic challenges associated with this uncommon malignancy.

Background/Objectives: To understand the clinical characteristics, risk factors, diagnosis, treatment, and outcomes of xanthogranulomatous prostatitis. Methods: A comprehensive search was conducted across PubMed, Embase, and Medline following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, including case reports and case series. Study quality and risk of bias were assessed using the Oxford Centre for Evidence-Based Medicine (CEBM) document. The systematic review process aimed to gather and synthesize all available research evidence on the topic. Results: We included 24 articles reporting on 33 patients, with a median age of 64 years. The most common presenting symptoms were lower urinary tract symptoms (81.8%), and only one patient was asymptomatic. The mean prostate-specific antigen (PSA) level upon presentation was 6.5 ng/mL. Notably, 51.5% of patients were suspected of harbouring clinically significant prostate carcinoma, and only one patient had concurrent prostate adenocarcinoma. All diagnoses were based on changes associated with xanthogranulomatous prostatitis demonstrated upon histopathological examination. A variety of pathogens were isolated, including Escherichia coli, Pseudomonas aeruginosa, Proteus species, and Enterobacter species. Transurethral resection of the prostate (60.6%) was the mainstay approach to management. In total, 27.3% of patients were successfully managed with non-surgical therapy. Conclusions: The majority of patients were suspected of prostate carcinoma prior to the histopathological diagnosis of xanthogranulomatous prostatitis. One patient underwent unnecessary radical prostatectomy as a result. The management of xanthogranulomatous prostatitis includes transurethral resection of the prostate and conservative management with the use of antibiotics. This outlines the importance of following well-established protocols upon suspicion of prostate carcinoma in order to avoid unnecessary radical prostatectomy.

A man in his late 20s presented with a 7 day history of painless right scrotal swelling. Scrotal ultrasound revealed complete tumour infiltration of the right testis and two-thirds infiltration of the left testis. A right radical orchidectomy and left testicular biopsy confirmed B-lymphoblastic leukaemia/lymphoma. Subsequent bone marrow and peripheral blood tests showed no systemic involvement. Persistent left testicular disease was found following induction chemotherapy, and orchidectomy of the contralateral testis was subsequently conducted. This case highlights the unique nature of bilateral testicular involvement of B-lymphoblastic lymphoma in an adult and provides further data on the management of this rare disease.