Advanced techniques of reconstructive urology are gradually reaching their limits in terms of their ability to restore urinary tract function and patients’ quality of life. A tissue engineering-based approach to urinary tract reconstruction, utilizing cells and biomaterials, offers an opportunity to overcome current limitations. Although tissue engineering studies have been heralding the imminent introduction of this method into clinics for over a decade, tissue engineering is only marginally applied. In this review, we discuss the role of tissue engineering in reconstructive urology and try to answer the question of why such a promising technology has not proven its clinical usability so far.

Objective: The study aims to evaluate the correlation between 68Ga-PSMA uptake in PSMA PET/CT in primary prostate cancer (PC) and its histopathological grading (Gleason Score and ISUP grade). Additionally, we compared preoperative biopsy histopathological findings with definitive pathology results in radical prostatectomy (RP) specimens. Methods: We retrospectively analyzed 86 patients who underwent 68Ga-PSMA PET/CT for primary PC staging, of which 40 patients later underwent radical prostatectomy. PET/CT results, including SUVmax values, were correlated with GS and PSA concentrations. Histopathology reports were analyzed and compared between biopsy and final pathology results following RP. Results: A significant positive correlation was observed between SUVmax and ISUP grades (Pearson's ρ = 0.34, p < 0.001), with higher SUVmax values associated with more advanced grades. A cut-off SUVmax value of 5.64 was determined to predict upstaging in patients, yielding a sensitivity of 76% and a specificity of 60% (AUC = 0.82, 95% CI: 0.70–0.94). Additionally, 57.5% of patients experienced a grade shift following RP, with a 35% upgrade and 22.5% downgrade in ISUP grades. Conclusion: 68Ga-PSMA PET/CT demonstrated high sensitivity in detecting high-risk prostate cancer, particularly in patients with GS > 7 or PSA levels ≥ 10 ng/ml. The findings suggest that this imaging modality may be less effective for staging of patients with lower GS or PSA values, that is low-risk PCa. Further prospective studies are necessary to validate these results.

Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography (Ga-68 PSMA-PET/CT) is a diagnostic tool used in urology to detect oligometastatic disease in patients with prostate cancer (PC). Although increasingly popular and extensively studied, it is not considered a standard diagnostic tool for primary PC staging, because it lacks validation when compared to mpMRI.Numerous studies have suggested its promising role in PC diagnostics. Our objective was to comprehensively review and summarize the existing literature on the potential and feasibility of utilizing Ga-68 PSMA-PET/CT as the sole method for primary PC staging and to compare it with currently employed diagnostic tools (mainly mpMRI). The main goal of the study was to consolidate the data on the sensitivity and specificity of PSMA-PET for PCa staging when compared with other diagnostic tools. The use of PSMA-PET/CT as the only diagnostic tool of primary PC in the future might potentially reduce diagnostic time and costs. In addition, we examined the limitations of its use. Ga-68 PSMA-PET/CT demonstrates encouraging outcomes during the initial assessment of PC, potentially leading to a transformative leap in PC diagnosis and treatment, due to the utilization of Ga-68 PSMA, with high affinity to prostate cells.