Purpose The study examines the microbial compositions of patients with lichen sclerosus (LS) compared to control group, and individuals with other penile conditions. The aim is to address the critical question regarding the etiology of penile LS and to explore the potential involvement of the microbiome in its pathogenesis. Methods In this prospective single-centre study, 73 uncircumcised male patients undergoing circumcision for phimosis were enrolled between January 2023 and April 2024. Foreskin and urethral swabs were obtained prior to surgery to isolate Candida, aerobic, and anaerobic microorganisms and sexually transmitted pathogens. Patients were categorised into LS (n = 44) and non-LS (n = 29) groups based on histopathological findings. Additionally, a control group, which consisted of patients with healthy foreskin, has been specified to conduct further analysis. Results No statistically significant differences were observed in the prevalence of specific bacterial or viral pathogens between the LS and non-LS groups and between the LS/non-LS and control group. The most common commensal organisms were Staphylococcus coagulase-negative (48% and 34% respectively) and Corynebacterium spp. (27% and 17% respectively), whereas Enterococcus faecalis (14%) and Escherichia coli (16%) were the most frequent pathogens in LS group, and Streptococcus agalactiae (21%) was the most abundant pathogen in non-LS group. HPV was detected in 5% of patients with LS and in 14% of patients without LS. There were no statistically significant differences in CRP levels and BMI. In exploratory multivariable models adjusting for age and BMI, the presence of Streptococcus agalactiae was associated with lower odds of LS (OR 0.19; 95% CI 0.04–0.92; p = 0.04; FDR = 0.07); however, given limited power, these results should be interpreted cautiously. Conclusions Our study demonstrated no significant association between specific microbial or viral profiles and penile lichen sclerosus. However, due the fact that the culture-based approach employed in this study may underestimate the diversity of the penile microbiome, further research is warranted.

Background: Kidney cancer accounts for approximately 2% of all diagnosed cancers and fatalities worldwide, and a notable increase in its incidence has been observed in recent years. Previous studies have identified various risk factors for renal cell carcinoma (RCC), including age, gender, smoking, hypertension, overweight, and obesity. However, limited information is available regarding the correlation between RCC risk factors and tumor lateralization. Objectives: To investigate the relationship between body mass index (BMI) and the lateralization of kidney tumors in patients undergoing surgery for renal cell carcinoma. Moreover, we aim to evaluate the impact of lateralization of malignant kidney tumors on overall survival (OS) and cancer-specific survival (CSS). Materials and Methods: This single-center study included 287 patients who underwent surgical treatment for kidney tumors between January 2016 and December 2019. The patients were allocated into the following groups based on their BMI: normal (18.5–24.99 kg/m²), overweight (25–29.99 kg/m²), or obese (≥30 kg/m²). The study collected demographic and histopathological data, as well as patient history, including risk factors such as smoking and hypertension. Results: Right-sided kidney tumors occurred more frequently (55.05%, n = 158) than left-sided ones (44.95%, n = 129). A statistically significant relationship (p = 0.04731) was observed between BMI and the frequency of right-sided kidney tumors in the overweight group (70 vs. 43 cases). There was no correlation between BMI and the occurrence of kidney tumors in the normal BMI and obesity groups. Furthermore, the analysis revealed no association between the lateralization of kidney tumors, smoking, and hypertension. The 5-year survival rate was 62%, with a mean follow-up duration of 104 months (approximately 8.5 years). No statistically significant difference was observed between the right- and left-sided cancer groups, with survival rates of 58% and 66%, respectively (p = 0.652). Conclusions: This study highlighted that right-sided kidney tumors occurred significantly more frequently in overweight individuals in our cohort of patients. No association was observed between lateralization of kidney cancer and overall survival (OS) or cancer-specific survival (CSS).

Background and Objectives: To evaluate the long-term efficacy of bariatric surgery in ameliorating urinary incontinence in women with obesity. Additionally, to assess the impact of comorbidities on the persistence of symptoms and compare the effectiveness of two types of bariatric interventions. Materials and Methods: This prospective, single-centre study included 124 women with preoperative urinary incontinence (UI). A total of 92 (74.19%) responded to follow-up and underwent laparoscopic sleeve gastrectomy (LSG) (n = 52; 56.52%) or one anastomosis gastric bypass (OAGB) (n = 40; 43.48%). The cohort was divided into stress urinary incontinence (SUI) (n = 57; 61.96%), mixed urinary incontinence (MUI) (n = 33; 35.87%), and urge urinary incontinence (UUI) (n = 2; 2.17%). Before surgery, patients were assessed for comorbidities and completed the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) (score range 0–21) and the Urogenital Distress Inventory (UDI-6) (score range 0–100) questionnaires. After 5 years, the patients completed the same questionnaires again for the final assessment. Results: Bariatric surgery demonstrated a statistically significant reduction in UI symptoms (p < 0.001), with a more pronounced improvement in SUI than in MUI, and with complete resolution in patients experiencing UUI. LSG was more effective than OAGB at alleviating UI (p < 0.001 vs. p = 0.017). Notably, childbirth, particularly vaginal delivery, was associated with a higher risk of persistent UI after surgery (p = 0.025). The correlation between postoperative BMI and improvement in UI symptoms was not statistically significant (p = 0.64). Conclusions: Bariatric surgery provides a beneficial secondary effect on urinary incontinence (UI) in women with obesity who undergo the procedure for obesity. The LSG method is superior to OAGB when considering the improvement in incontinence symptoms. Furthermore, the LSG procedure should be considered the primary choice for women with obesity experiencing UI with a history of vaginal delivery.

Background/Objectives: Optimal surgical margin management in penile squamous cell carcinoma remains debated because organ-preserving surgery must balance oncological control with functional preservation. Historically, wide excision margins have been recommended; however, subsequent evidence has challenged this threshold, shifting practice towards narrower margins without a demonstrated increase in local recurrence. We evaluated whether invasive positive surgical margins and minimal negative margin widths were associated with local recurrence and survival after surgery for penile squamous cell carcinoma. Methods: We retrospectively analysed 157 consecutive men who underwent surgical treatment at a single centre between 2011 and 2024. Time-to-event analyses were performed in 131 patients with invasive non-metastatic disease after excluding those with penile intraepithelial neoplasia (PeIN)-only lesions (n = 23) and distant metastases (n = 3) at diagnosis. The margins were classified as either invasive-negative or invasive-positive. Among histologically negative-margin cases, minimal margin width was grouped a priori as 5 mm. Results: The median follow-up was 25 months (interquartile range [IQR], 10–52). In the invasive (M0) cohort, 101/131 patients had invasive-negative margins and 30/131 had invasive-positive margins; local recurrence occurred in 42/131 patients. Margin status was not independently associated with recurrence-free, overall, or cancer-specific survival rates. Non-sparing surgery was associated with a lower hazard of local recurrence, whereas grade 3 (G3) histology independently predicted worse recurrence-free, overall, and cancer-specific survival. Advanced stage according to the Tumour, Node, Metastasis (TNM) classification independently predicted worse cancer-specific survival. Conclusions: Among patients with histologically negative margins, outcomes did not differ significantly across the predefined margin-width categories. These findings support tissue-preserving surgery aimed at histologically negative margins within a structured surveillance framework.

Background: Severe obesity is a chronic condition that adversely affects physical health and quality of life, including sexual function. However, its impact on multidimensional psychosexual outcomes remains unexplored. This study aimed to assess changes in erectile function, genital self-image, and psychological distress in men who underwent bariatric surgery. Methods: This prospective cohort study involved 50 male participants undergoing primary bariatric surgery who were evaluated within 30 days prior to the surgical procedure and at a minimum of 12 months postoperatively. Standardised questionnaires were used, including the International Index of Erectile Function-5 (IIEF-5), Male Genital Self-Image Scale (MGSIS-7), and Hospital Anxiety and Depression Scale–Modified (HADS-M). Secondary outcomes encompassed parameters of weight loss, sexual activity, and selected aspects of sexual behaviour, such as the utilisation of various sexual positions, their associated pleasure, and frequency. Results: Significant postoperative improvements were observed in BMI reduction from 42.8 kg/m² to 31.7 kg/m² (p < 0.001), erectile function (IIEF-5 improved from 16.3 to 19.6; p < 0.001), genital self-image (MGSIS-7 improved from 19.1 to 21.9; p < 0.001), and psychological distress (HADS-M reduction from 13.3 to 8.7; p < 0.001). Glycated haemoglobin decreased significantly (5.89% to 5.31%; p < 0.001), obstructive sleep apnoea severity improved (p < 0.001), and remission or clinically meaningful improvement of at least one major metabolic comorbidity was documented in 24 of 37 participants (64.9%). Sexual activity increased from 37/50 (74.0%) to 43/50 (86.0%), although this change was not statistically significant (p = 0.114). After FDR correction, frequency increased for 3 of the assessed positions, whereas pleasure increased only for one of them. Weight loss magnitude was not significantly correlated with changes in the IIEF-5 or MGSIS-7 scores. A greater reduction in the HADS-M score correlated with a greater improvement in the IIEF-5 score (ρ = −0.307, p = 0.030). Conclusions: Bariatric surgery was associated with improvements in erectile function, genital self-image, and psychological distress, alongside marked glycaemic and sleep-related recovery. Because the psychosexual changes were not statistically associated with the magnitude of weight loss and of metabolic and respiratory improvement, and because the design was uncontrolled, these exploratory findings indicate association rather than causation and support the incorporation of psychosexual and mental health assessment into postoperative bariatric care.

Female sexual dysfunction and urinary incontinence are common among women with obesity. Bariatric surgery may improve sexual health, but long-term data are