Background: The incidence of urinary tract infections (UTIs) after radical cystectomy (RC) with urinary diversion (UD), the typical pathogens, and associated patient risk factors have not been well documented. In this study, we examined the incidence of post-op UTIs after RC to identify associated risk factors. Methods: Single-center, retrospective case series of 386 patients with bladder cancer who underwent RC with UD between 2012 and 2024. The primary objective was UTI incidence, defined by the frequency of patients with urine culture with >10⁵ colony-forming units per high-powered field, spanning from post-op day 0 (POD0) to 90 days after discharge. Isolated pathogens were reported. Risk factors for UTIs were assessed. Results: The average age was 69 years old at surgery, and patients were predominantly male (80%). The cumulative incidence of post-op UTIs was 14%, among which 12 patients had more than one UTI. The UTI incidence was 2%, 8%, and 7% during the immediate post-op period, within 30 days, and within 31–90 days, respectively. Isolated pathogens included Escherichia coli (26%), Enterococcus faecalis (24%), Klebsiella pneumoniae (21%), and Pseudomonas species (21%). In the immediate post-op period, female sex was the only significant risk factor. At 31 to 90 days, cutaneous ureterostomy UD was the predominant risk factor for UTIs. For ileal conduit patients, those with a Wallace ureteral anastomosis were associated with UTI 31–90 days from discharge for RC. Conclusions: Our retrospective data suggests the incidence of UTIs and their causative pathogens after RC differ based on post-operative time points and vary according to different patient risk factors.

Focal therapy for prostate cancer (PCa) provides approaches to treat PCa patients in a less invasive manner than traditional whole-gland surgical or radiation modalities. This manuscript provides a case series of high-intensity focused ultrasound (HIFU), cryoablation, and irreversible electroporation (IRE) for PCa at a single institution and cost analysis with a review of the literature. All patients who underwent HIFU, cryoablation, or IRE for localized PCa were retrospectively reviewed, excluding patients who received whole-gland therapy. Functional outcomes were erectile dysfunction and lower urinary tract symptoms. Cost data were collected. A total of 45 patients were included in the study with focal therapy ranging from 2023 to 2025 (4 HIFU, 20 cryoablation, 21 IRE). A total of 30 patients had focally treated lesions, and 15 patients had hemi-gland treatment. The mean preoperative PSA was 7.7 ng/mL. On the paired sample t-test, there was no significant difference between pre-focal and post-focal therapy PSA. Three patients experienced biochemical recurrence requiring prostate biopsy after focal treatment. Mean cost was USD 3804.50 and not significantly different by focal treatment. No metastatic events occurred nor deaths at a median follow-up of 6 months. Patients in this series had largely unaltered functional outcomes. Cost analysis in contemporary publications is lacking. Although follow-up was short, cancer control was adequate.

Purpose: With multi-institutional collaboration, the purpose of this study was to analyze geographical differences of renal cell carcinoma with tumor thrombus between patients in North America, Central/South America, and South Korea. Materials and methods: Patients with renal cell carcinoma and a tumor thrombus who underwent nephrectomy plus thrombectomy were retrospectively analyzed. Patients were from North America, Central/South America, and South Korea. All comparisons were done based on the region where a patient had their surgery and follow-up. Chi-squared test, analysis of variance, Kaplan-Meier survival with log-rank test, and Cox regression analysis were used. Results: A total of 478 patients were included, 212 from North America, 209 from Central/South America, and 57 from South Korea. Of note, thrombus level was different using the Neves classification system between regions (p<0.001), with a greater thrombus level in Central/South America. Surgical approach differed, with laparoscopic cases done most often in Central/South America and robotic in North America (p<0.001). Tumor grade was lowest in South Korea (p<0.001) and stage (p<0.001) greatest in Central/South America. Overall survival was greater in South Korea compared to Central/South America (p=0.026). Cancer-specific survival was greater in South Korea relative to North America and Central/South America (p=0.026). Conclusions: Patients from North America, Central/South America, and South Korea diagnosed with renal cell carcinoma and tumor thrombus do not present the same and have different outcomes peri-/post-operatively. This includes important variables which have impacts on patient morbidity and mortality. Considering increased efforts on health equity in urology,

Background/Objectives: Salvage radical prostatectomy (SRP) is a potentially curative option for recurrent localized prostate cancer after primary radiation or focal therapy, historically limited by technical complexity and poor functional outcomes. This study characterizes contemporary perioperative, oncologic, and functional outcomes of salvage robotic-assisted radical prostatectomy (sRARP) at a single institution over two decades. Methods: We retrospectively reviewed patients undergoing SRP from 01/01/2004 to 06/30/2026, identified via institutional database queries and natural language processing keyword searches with chart confirmation; analysis was restricted to the robotic-assisted subset. Complications within 90 days were graded by the Clavien–Dindo classification. Biochemical recurrence-free survival (bRFS) required freedom from PSA persistence and recurrence (PSA ≥ 0.2 ng/mL, with biochemical recurrence documented in the medical record) and is reported as a proportion. Results: Of 4002 records identified, 30 patients met inclusion criteria; 24 (80%) underwent sRARP. Extraprostatic disease was present in 54% (13/24) and positive margins in 43% (10/23). Within 90 days, 43% (10/23) had a complication (13% grade ≥ III); 30% (7/23) had a later complication, and 4% (1/24) required later urinary diversion. At a median follow-up of 32.1 months, bRFS was 39% (9/23), and 33% (8/24) had PSA persistence. Incontinence rose from 18% (3/17) at diagnosis to 87% (20/23) post-SRP; at longer-term follow-up (27.3 months), 79% (11/14) used ≥1 pad/day. Erectile dysfunction was present in 82% (14/17) at 22.0 months. Additional cancer-directed therapy was given in 50% (12/24). Conclusions: In this small, descriptive series, sRARP was feasible, but only 39% of patients were free of biochemical recurrence and functional burden was substantial. sRARP may represent a treatment option for carefully selected patients with recurrent localized prostate cancer; however, individualized counseling and further multicenter evaluation are essential.

Background/Objectives: Salvage radical prostatectomy (SRP) is a potentially curative option for recurrent localized prostate cancer after primary radiation or focal therapy, historically limited by technical complexity and poor functional outcomes. Advances in robotic surgery have prompted re-evaluation of SRP. This study characterizes contem-porary perioperative, oncologic, and functional outcomes of salvage robotic-assisted radical prostatectomy (sRARP) at a single institution over two decades. Methods: We retrospectively reviewed patients undergoing SRP at our institution from 01/01/2004 to 06/30/2026, identified via combined institutional database query and natural language processing (NLP) keyword search with individual chart confirmation; analysis was re-stricted to the robotic-assisted subset. Clinicodemographic, perioperative, pathologic, and functional data were collected at diagnosis, recurrence, and following SRP, with conti-nence and erectile function also assessed at last follow-up. Descriptive statistics were reported as median (interquartile range, IQR) or n/N (%). Results: Of 4,002 records identified, 30 patients met inclusion criteria; 24 (80%) underwent sRARP. Extraprostatic disease was present in 54% (13/24) and positive margins in 43% (10/23). A postoperative complication occurred in 22% (4% Clavien-Dindo IIIa); bladder neck contracture devel-oped in 18% (4/22), and 8% (2/24) progressed to urinary diversion. At a median follow-up of 32.1 months, 70% (14/20) remained biochemically recurrence-free. Incontinence rose from 18% (3/17) at diagnosis to 83% (19/23) post-SRP; at longer-term follow-up (27.3 months), 79% (11/14) used ≥1 pad/day. Erectile dysfunction was present in 82% (14/17) at a median follow-up of 22.0 months. Additional cancer-control therapy, predominantly androgen deprivation therapy, was given in 33%. No deaths were attributed to an SRP-specific cause. Conclusions: In this study, sRARP achieved perioperative and high-grade complication rates comparable to the broader robotic salvage literature, with a 70% biochemical recurrence-free rate, supporting its role as a potentially curative option in selected patients. A substantial functional burden, particularly incontinence, and se-vere complications including urinary diversion underscore the need for refined patient selection, thorough counseling and further multi-institutional study.