Transrectal prostate biopsies under ultrasonography guidance remain the gold standard for the detection of prostate cancer (PCa). Transrectal ultrasonography (TRUS), however, has a limited sensitivity in PCa detection. Prostate elastography (TRES) increases the sensitivity of a TRUS examination. Therefore, the aim of this review is to discuss the usefulness of TRES in prostate gland imaging for the diagnosis and management of prostate cancer based on published literature. The advantages of transrectal elastography were analysed in the context of better diagnostic performance provided by this method. TRES provides additional information for the detection and biopsy guidance concerning prostate cancer, enabling a significant reduction in the number of biopsies.

Purpose: As online health information-seeking surges, concerns mount over the quality and safety of accessible content, potentially leading to patient harm through misinformation. On one hand, the emergence of Artificial Intelligence (AI) in healthcare could prevent it; on the other hand, questions raise regarding the quality and safety of the medical information provided. As laryngeal cancer is a prevalent head and neck malignancy, this study aims to evaluate the utility and safety of three large language models (LLMs) as sources of patient information about laryngeal cancer. Methods: A cross-sectional study was conducted using three LLMs (ChatGPT 3.5, ChatGPT 4.0, and Bard). A questionnaire comprising 36 inquiries about laryngeal cancer was categorised into diagnosis (11 questions), treatment (9 questions), novelties and upcoming treatments (4 questions), controversies (8 questions), and sources of information (4 questions). The population of reviewers consisted of 3 groups, including ENT specialists, junior physicians, and non-medicals, who graded the responses. Each physician evaluated each question twice for each model, while non-medicals only once. Everyone was blinded to the model type, and the question order was shuffled. Outcome evaluations were based on a safety score (1–3) and a Global Quality Score (GQS, 1–5). Results were compared between LLMs. The study included iterative assessments and statistical validations. Results: Analysis revealed that ChatGPT 3.5 scored highest in both safety (mean: 2.70) and GQS (mean: 3.95). ChatGPT 4.0 and Bard had lower safety scores of 2.56 and 2.42, respectively, with corresponding quality scores of 3.65 and 3.38. Inter-rater reliability was consistent, with less than 3% discrepancy. About 4.2% of responses fell into the lowest safety category (1), particularly in the novelty category. Non-medical reviewers' quality assessments correlated moderately (r = 0.67) with response length. Conclusions: LLMs can be valuable resources for patients seeking information on laryngeal cancer. ChatGPT 3.5 provided the most reliable and safe responses among the models evaluated.

Background: A significant number of patients with advanced urothelial cell carcinoma are under- or over-staged. Implementation of clinical variables could be useful for improving the accuracy of clinical staging. Aim: To explore the differences between clinical and pathological diagnosis in patients with UCC, and to identify clinical variables that might play a role in under- or overstating. Materials: A total of 553 patients after radical cystectomy were included in the analysis. Clinical stage of the disease was diagnosed according to CT or MRI in relation to clinical data. Results: Higher clinical stage correlated with a higher pathological stage (p < 0.00005), but in 306 patients did not correspond (142 patients were under-staged and 164 over-staged). Over half (54.2%) of the patients staged as cT1–cT2 were misdiagnosed: 137 patients were under-staged and 133 over-staged. Hydronephrosis was associated with a higher pathological stage (p < 0.000005), mostly pT3–4 (45.13% had pT4 disease) and higher risk of nodal metastasis (p = 0.0028). The highest percentage of PSM was found in patients with pT4 (33.12%). Conclusions: Clinical staging of bladder cancer is poorly executed, with one third of patients under-staged and one third over-staged. To improve accuracy, we recommend a multimodal approach, combining histopathological evaluation with results of imaging studies.

Zinner syndrome (ZS) is a rare disorder that affects only men. It is characterized by a triad of abnormalities, including unilateral renal agenesis, ipsilateral seminal vesicle cysts, and atresia of the ejaculatory tract. Unfortunately, there is no consensus on the best treatment modality. We describe a case of a young male patient with recurrent epididymitis, dysuria, and frequent urination. In the diagnostic evaluation, we found an extended right seminal vesicle in the ultrasound with hyperechoic fluid inside and an absence of the right kidney. We performed magnetic resonance imaging, computed tomography, and semen analysis confirming Zinner syndrome and deteriorated semen parameters. Urethroscopic evaluation and ultrasound-guided puncture of the seminal vesicle were performed. An abscess was excluded. The cytologic evaluation showed hemosiderophages. Tamsulosin was introduced. We found no signs of relapse in a six-month observation, and the patient had no further symptoms. Therefore, minimally invasive treatment is a feasible option in young patients found with early-stage Zinner syndrome.

Aim: Peyronie’s disease (PD) or plastic induration of the penis, require complete evaluation of plaques in order to decide the best therapeutic option for patient. The purpose of this study is to compare the findings of three-dimensional ultrasound (3D US) and two-dimensional ultrasound (2D US) in patients with PD.Materials and methods: Twenty patients with PD aged 30 to 72 years were included in study. The examination was performed with a 12 MHz linear probe, using 2D US and 3D US. Localization and size of plaques were determined and time needed for imagine acquisition was determined in every case.Results: 3D ultrasound permits the visualization of the entire plaque in the coronal plane of plaque with its precise measurements. No statistical difference in plaque dimensions and its surface area assessment using 3D US and 2D US was found (127.72 mm² vs. 128.74 mm², p>0.05). The possibility to perform detailed analysis of the acquired images using generated digital cube reduced the average duration of the acquisition to 69.8 seconds (median 64 seconds) for 3D US vs. 151.25 seconds (median 145.5 seconds) for 2D US (p<0.05). A supplementary plaque was detected using 3D US.Conclusions: 3D US seems to be a valuable complement of 2D US for patients with PD. The acquisition time is significantly reduced using 3D US comparing to 2D US and thus it is more comfortable for the patient.

The Central European Journal of Urology is an open access quarterly-issued journal, which provides a forum for the presentation of original clinical, experimental and other research studies...