Penile fracture is a rare urological emergency. It occurs due to the penis being subjected to force during intercourse or other causes. Treatment is usually surgical. Urethral injury accompanies 10–20% of cases. In this case, a complete urethral rupture accompanying a penile fracture is aimed to be presented. A 45-year-old male patient presented to the emergency department with complaints of a snapping sound, pain, and sudden loss of erection during sexual intercourse. After a while, bleeding from the external meatus and inability to urinate were added to his complaints. Physical examination showed typical signs of penile fracture along with urethrorrhagia. The penile doppler ultrasound result was reported to be consistent with a penile fracture and uretral injury. Approximately one hour after presenting to the emergency department, the patient underwent surgery. Considering the possibility of urethral rupture, a urethroscopy was performed before fracture repair, revealing a urethral defect approximately 8 cm proximal to the external meatus. Surgical repair found a near-complete bilateral rupture of the corpus cavernosum and a complete urethral rupture. The urethral rupture and fracture area were repaired according to surgical procedure standards. No additional complaints or new pathologies were observed in the early postoperative follow-up. The patient was discharged with a catheter on postoperative day 3. On the 14th postoperative day, the patient’s catheter was removed. At the 3-month follow-up, the patient had no urinary complaints, and the uroflowmetry test showed a Qmax of 35. No pathology was detected in the urethrography performed. At the one-year follow-up, the patient’s International Index of Erectile Function (IIEF) score was 26, indicating no additional complaints. Complete urethral rupture and bilateral corpus cavernosum rupture are rare urological emergencies, typically resulting from trauma applied to an erect penis. A physical examination, ultrasonography, and, when necessary, imaging techniques such as cystoscopy are the diagnostic modalities employed in such cases. Early surgical treatment has been shown to improve functional outcomes and reduce long-term complications. Early surgical intervention in the treatment of penile fractures not only preserves sexual function but also significantly reduces long-term complications. Urethral rupture should always be considered in fractures accompanied by urethrorrhagia and hematuria.

Large language models (LLMs) are increasingly utilized as decision-support tools in medicine. However, their clinical reliability and applicability remain

Active surveillance (AS) is an established strategy for managing low-risk prostate cancer (LRPCa), aiming to reduce overtreatment while maintaining oncological safety. This retrospective cohort study included 102 patients diagnosed with LRPCa between 2015 and 2025, managed with serial prostate-specific antigen (PSA) testing, digital rectal examination, multiparametric MRI (mpMRI), and confirmatory biopsies. Transition criteria included Gleason score upgrading, PSA progression, lesion progression on mpMRI, or patient preference. The median follow-up was 16 months (range: 6–123), while the estimated median surveillance duration was 36 months (95% confidence interval: 30–42). Retention rates at 2 and 5 years were 72% and 50%, respectively. A total of 35.3% (36/102) of patients discontinued AS, most frequently due to patient preference (61.1%), followed by PSA progression (25.0%) and histopathological upgrading (13.9%). Only 25.5% (26/102) of patients underwent confirmatory biopsy during follow-up, reflecting suboptimal adherence that may have contributed to an underestimation of true pathological progression. Multivariate analysis revealed that higher final PSA levels (odds ratio [OR]: 1.559, P = .001), abnormal digital rectal examination findings (OR: 11.079, P < .001), and Prostate Imaging-Reporting and Data System 4 to 5 lesions on mpMRI (OR: 5.482, P < .001) were independently associated with transition to definitive treatment. These findings suggest that AS remains a feasible and effective management strategy for LRPCa, though confirmatory biopsies and structured psychological support are essential to optimize adherence and prevent overtreatment. Future studies should investigate the integration of biomarkers and AI-assisted imaging in refining AS protocols.

Urinary stone disease is a common urological disorder, particularly among middle-aged individuals. Extracorporeal Shock Wave Lithotripsy (ESWL) is often the first-line treatment for kidney and ureteral stones. Traditionally, fluoroscopy is used for stone targeting in ESWL, but it exposes patients and clinicians to radiation and cannot visualize non-opaque stones. Ultrasonographic targeting eliminates these issues. This study compares the advantages and disadvantages of fluoroscopy and ultrasound-targeted ESWL. At Düzce University Hospital, 100 patients with radio-opaque stones indicated for ESWL between February 2023 and February 2024 were divided into two groups. Group A underwent ESWL with fluoroscopic targeting, while Group B used ultrasonographic targeting. Patient demographics, stone size (measured by CT), and stone locations were recorded. The number of shocks per session, energy intensity (kV), and fluoroscopy time were noted for Group A. One week after each ESWL session, patients were evaluated by ultrasound or direct radiography. Success was defined as being stone-free or having ≤ 4 mm asymptomatic residual stones after up to four sessions. Failure was defined as no results after two sessions or the need for additional treatment. The procedure success rate was 66% for men and 78% for women, with no statistically significant gender difference (p > 0.05). Stone locations were similar in both groups. Success rates were 66% in Group A and 74% in Group B, with no significant difference (p > 0.05). Successful procedures were associated with an average patient weight of 76.6 kg, stone size of 8.9 mm, and total energy of 12.2 kV, with significant differences compared to unsuccessful procedures (p < 0.04, p < 0.04, p < 0.001, respectively). No significant differences were found between Group A and Group B in terms of age, height, BMI, stone density (HU), and number of sessions (p > 0.05). Ultrasonography is as effective as fluoroscopy for imaging and focusing during ESWL treatment. It enhances the success of ESWL for non-opaque stones and reduces radiation exposure disadvantages.

Objectives: To compare the effectiveness and safety of two antibiotic prophylaxis regimens, ciprofloxacin plus gentamicin and ceftriaxone plus cefixime, in preventing infectious complications after transrectal ultrasound‐guided prostate biopsy. Methods: The study retrospectively reviewed 705 consecutive patients who underwent transrectal ultrasound‐guided prostate biopsy between January 2020 and January 2024. Group 1 ( n = 374) received ciprofloxacin plus gentamicin, and Group 2 ( n = 331) received ceftriaxone plus cefixime. All patients underwent standard rectal preparation with povidone‐iodine, and needle‐tip disinfection with formalin. The primary outcome was the development of post‐biopsy infectious complications, while secondary outcomes included sepsis and infection‐related hospitalization. Results: The two groups were comparable in terms of age, body mass index, prostate‐specific antigen levels, and comorbidities. The overall rate of post‐biopsy infection was 1.4%, occurring in 1.1% patients in Group 1 and 1.8% patients in Group 2 ( p = 0.61). The incidence of complicated urinary tract infection was 0.3% versus 0.9%, and infection‐related hospitalization occurred in 0.5% versus 0.3% of patients in Group 1 and Group 2, respectively, with no cases of sepsis observed. In univariable analyses, diabetes mellitus, histopathological chronic prostatitis, and pre‐biopsy antibiotic use were not significantly associated with post‐biopsy infection. Conclusion: The combination of ceftriaxone and cefixime showed a safety profile broadly consistent with the combination of ciprofloxacin and gentamicin for biopsy prophylaxis. Considering increasing fluoroquinolone resistance and growing restrictions, this cephalosporin‐based regimen may be considered a feasible option for transrectal ultrasound‐guided prostate biopsy when implemented together with strict antiseptic measures.