Background/Objectives: Artificial intelligence (AI), particularly natural language processing (NLP) models such as ChatGPT, presents novel opportunities for patient education and informed consent. This study evaluated ChatGPT’s use as a support tool for informed consent before penile prosthesis implantation (PPI) in patients with erectile dysfunction (ED) following radical prostatectomy. Methods: ChatGPT-4 answered 20 frequently asked questions across four categories: ED and treatment, PPI surgery, complications, and postoperative care. Three senior urologists independently rated information quality using the DISCERN instrument on a Likert scale ranging from 1 (poor quality) to 5 (good quality). Readability was assessed using the Flesch Reading Ease (FRE) and Flesch–Kincaid Grade Level (FKGL) formulas, and inter-rater reliability was measured using intraclass correlation coefficients. Results: The inter-rater reliability coefficient was 0.76 (95% CI 0.71–0.80). Mean DISCERN scores indicated moderate quality: 2.79 ± 0.92 for ED and treatment, 2.57 ± 0.98 for surgery, 2.65 ± 0.86 for complications, and 2.74 ± 0.90 for postoperative care. High scores (>4) were achieved for clarity and relevance, while complex issues, such as risks and alternative treatments, scored the lowest (<2). The FRE scores ranged from 9.8 to 28.39, and FKGL scores ranged from 14.04 to 17.41, indicating complex readability suitable for college-level comprehension. Conclusions: ChatGPT currently provides variable and often inadequate quality information without sufficient comprehensibility for informed patient decisions, indicating the need for further improvements in quality and readability.

Background: Large language models (LLMs) such as ChatGPT, Google Gemini, and Microsoft Copilot are increasingly used by patients seeking medical information online. While these tools provide accessible and conversational explanations, their accuracy and safety in emotionally sensitive scenarios—such as an incidental cancer diagnosis—remain uncertain. Objective: To evaluate the quality, completeness, readability, and safety of responses generated by three state-of-the-art LLMs to common patient questions following the incidental discovery of a kidney tumor. Methods: A standardized use-case scenario was developed: a patient learns of a suspicious renal mass following a computed tomography (CT) scan for back pain. Ten plain-language prompts reflecting typical patient concerns were submitted to ChatGPT-4o, Microsoft Copilot, and Google Gemini 2.5 Pro without additional context. Responses were independently assessed by five board-certified urologists using a validated six-domain rubric (accuracy, completeness, clarity, currency, risk of harm, hallucinations), scored on a 1–5 Likert scale. Two statistical approaches were applied to calculate descriptive scores and inter-rater reliability (Fleiss’ Kappa). Readability was analyzed using the Flesch Reading Ease (FRE) and Flesch–Kincaid Grade Level (FKGL) metrics. Results: Google Gemini 2.5 Pro achieved the highest mean ratings across most domains, notably in accuracy (4.3), completeness (4.3), and low hallucination rate (4.6). Microsoft Copilot was noted for empathetic language and consistent disclaimers but showed slightly lower clarity and currency scores. ChatGPT-4o demonstrated strengths in conversational flow but displayed more variability in clinical precision. Overall, 14% of responses were flagged as potentially misleading or incomplete. Inter-rater agreement was substantial across all domains (κ = 0.68). Readability varied between models: ChatGPT responses were easiest to understand (FRE = 48.5; FKGL = 11.94), while Gemini’s were the most complex (FRE = 29.9; FKGL = 13.3). Conclusions: LLMs show promise in patient-facing communication but currently fall short of providing consistently accurate, complete, and guideline-conform information in high-stakes contexts such as incidental cancer diagnoses. While their tone and structure may support patient engagement, they should not be used autonomously for counseling. Further fine-tuning, clinical validation, and supervision are essential for safe integration into patient care.

Kidney transplant recipients (KTRs) have an increased risk of developing genitourinary cancers, including prostate cancer (PCa), which is expected to become more prevalent due to an aging KTR population. Thus, knowledge of surgical outcomes, including treatment of PCa, within this unique cohort is required. Data of 62 KTRs undergoing radical prostatectomy (RP) between 2006 and 2023 at nine urologic transplant centers were analyzed. Complications were assessed using the Clavien-Dindo classification. Perioperative outcomes were evaluated, and a follow-up was conducted. Overall survival (OS), biochemical recurrence-free survival (BRFS), and death-censored graft survival were determined via the Kaplan-Meier method and log-rank testing. Overall, 50 open radical retropubic RPs and 12 robot-assisted RPs (RARPs) were included. The intraoperative blood loss was lower after RARP, but operative time was longer. Of the patients, 50% experienced no postoperative complication, and grade ≥3 complications were observed in 14.5%. There was no graft loss related to RP. A histopathologic analysis revealed pN1 in 8.1% and positive surgical margins in 25.8% of the cases. At a median follow-up of 48.5 mo, the median OS was 128 (95% confidence interval [CI] 71.2-184.8) mo, BRFS was 106 (95% CI 55.8; 156.2) mo, and graft survival was 127 (95% CI 66.7-187.3) mo. Limitations include the retrospective design, and variations between groups and centers. Our findings support RP as a feasible and safe treatment option for localized PCa in KTRs with acceptable oncologic outcome. Special care is required in screening and awareness for the risk of understaging. This study analyzed the safety and effectiveness of two prostate cancer surgery methods-open and robot-assisted surgery-in the special group of kidney transplant recipients. Both surgical methods were performed safely with acceptable oncologic outcomes; however, sample size was too small to draw definite conclusions between the two operative methods.

Background/Objectives: Kidney transplantation is associated with an increased risk of renal cell carcinoma (RCC). This study aimed to evaluate the outcomes of de novo RCC in kidney transplant recipients (KTRs). Methods: We retrospectively identified 50 de novo RCC cases among 4012 KTRs transplanted from 2005 to 2024. Data on patient characteristics and outcomes were collected. Propensity score matching (PSM) compared 34 localized RCC cases in KTRs with 34 non-transplant RCC cases. The statistical analyses used Kaplan–Meier estimates, the log-rank test, and the Cox regression. Results: The RCC incidence was 0.64 per 1000 person-years, with a standardized incidence ratio of 4.40 (95% CI: 3.33–5.80). In the KTR cohort, clear cell RCC was present in 42%, and papillary RCC was present in 42%. RCC developed predominantly in native kidneys (92%). UICC stage I was present in 74%. The treatment for the non-metastatic RCC was nephrectomy in the majority of cases (91%). For the metastatic RCC, 71% received a tyrosine kinase inhibitor (TKI). In the KTR cohort, the 3- and 5-year overall survival (OS) rates were 85% and 72%, respectively, with a median OS of 199 months; the synchronous metastasized (M1) patients had a median OS of 14 months. Rejection, age, advanced UICC stage, higher pT stage, clinical positive lymph nodes, M1, and higher grade were significantly associated with poor OS. The 5-year OS (96% vs. 84%, p = 0.72) and MFS (92% vs. 93%, p = 0.61) were comparable in the PSM cohort between the KTRs and the non-KTRs in the localized RCC. Conclusions: KTRs have a higher risk of RCC and present at a localized stage with comparable OS rates to non-transplant RCC patients. Adverse tumor characteristics, including synchronous metastases, significantly affect the prognosis, highlighting the need for surveillance and individualized treatment, particularly for metastatic RCC.

Background: IgA nephropathy (IgAN) is a common primary glomerulonephritis leading to end-stage renal disease. Living donor kidney transplantation (LDKT) is considered a favorable treatment option, but IgAN recurrence rates and the impact on outcome is unclear. In the present study, we retrospectively analyzed the rate of IgAN recurrence, risk factors and clinical outcomes in LDKT recipients. Methods: We analyzed 193 adult patients who received a LDKT between 2011 and 2017 of which 32 (16.7%) had IgAN as underlying disease. Demographic data and clinical outcomes, especially regarding IgAN recurrence, were evaluated. Mean follow-up period was 102.13 months in the IgAN group vs. 97.27 months in the control group. Results: Among the IgAN cohort, five (15.63%) experienced IgAN recurrence. Patients with IgAN underwent LDKT at a significantly younger age (p < 0.001). No significant differences were observed in demographic factors, HLA-mismatches, or AB0-compatibility. Patients receiving an immunosuppressive regimen including Cyclosporine A (60% vs. 7.4%) instead of Tacrolimus (40% vs. 92.6%) were significantly more likely to develop IgAN recurrences (p < 0.001). Moreover, early post-surgery serum creatinine levels were higher in the recurrence group at one week (4.25 vs. 1.65 mg/dl; p < 0.001), one month (2.13 vs. 1.53 mg/dl; p = 0.027) and two years (2.65 vs. 1.34 mg/dl; p = 0.008). Although graft survival displayed a tendency towards inferior outcomes after recurrence, significance was not reached (p = 0.14, log-rank test). Conclusion: Living donor kidney transplantation continues to be recommended as the preferred treatment option for IgAN patients, despite the potential risk of recurrence and graft loss.