Background/Objectives: Audio and audiovisual distraction can be effective additive tools to reduce anxiety and pain in patients receiving outpatient procedures (OP). Audiovisual distraction tools already showed positive effects on pain perception in some urological procedures. To identify the effects of audio and audiovisual distraction on pain and anxiety in patients receiving perineal prostate biopsy (PPB), we performed a prospective randomized controlled study. Methods: We recruited 168 male patients undergoing PPB which were randomized into three groups: a control group (CG), an audio distraction group (ADG) and an audiovisual distraction group (AVDG). The CG received no intervention, while the ADG received audio distraction and the AVDG received audiovisual distraction while PPB was performed. The primary endpoint was pain perception, measured in the Numeric Rating Scale (NRS) and Visual Analogue Scale (VAS). Secondary endpoints were subjective and objective procedure time (SPT/OPT), heart rate, blood pressure, cortisol blood levels and scores in the State-Trait Anxiety Inventory (STAI) questionnaire. Results: Demographics of each group were similar (CG = mean age (a) = 69.5; ADG a = 67 years; AVDG a = 67). We did not find any significant difference regarding our primary endpoint, pain perception (p = 0.384). In contrast, we examined a highly significant difference between SPT and OPT, comparing AVDG to CG (p < 0.001) and AVDG to ADG (p < 0.001), but not for ADG to CG (p = 0.348). There was no significant difference in the secondary endpoints, heart rate, blood pressure, STAI scores and willingness to repeat the procedure. Conclusions: Our study shows that audiovisual distraction can significantly shorten SPT for patients receiving PPB, which may represent their comfort throughout the procedure. To accelerate the wider implementation of audiovisual distraction as a cost-efficient tool in outpatient urological procedures, further studies should examine its effect on different OPs with a more heterogeneous patient group.

Background/Objectives: Genetic testing (GT) is essential for precision therapy in prostate cancer (PC). Implementation in routine outpatient cancer care remains heterogeneous. We assessed real-world data on GT practices among German Outpatient Urologists (GOUs) to identify strategies for improvement. Methods: A nationwide, multi-center survey was conducted among GOUs in Germany (02–06/2025), assessing demographics, qualifications, and GT behavior. Cochran-Armitage test for trend and Fisher’s exact test were used to assess associations; odds ratios with 95% confidence intervals were estimated using binary logistic regression. Results: In total, 117 GOUs participated, all practiced in outpatient settings. GT differed by disease stage: in localized prostate cancer, 6.0% reported ordering somatic testing (SoT) and 8.5% germline testing (GeT), compared to 67.5% and 42.7%, respectively, in metastatic disease. Overall, 29.1% reported not ordering GT of any kind. Ordering SoT for metastatic disease was significantly lower among senior physicians compared to early- and mid-career physicians (43% vs. 78% and 74%; OR 0.46 per career stage, 95% CI 0.27–0.79, p = 0.004). GeT did not differ significantly by experience (OR 0.90 per career stage, 95% CI 0.56–1.46, p = 0.67). Neither gender (OR 0.74, 95% CI 0.31–1.74), nor having a qualification in urological cancer-specific genetic counseling (26.5% of respondents; OR 0.81, 95% CI 0.33–1.98) was significantly associated with testing. BRCA1 and BRCA2 were recognized by 96.6% of respondents. Knowledge of other PC-associated genes was much lower. Conclusions: Despite guideline recommendations, GT, particularly GeT, remains underutilized in PC care in Germany. Senior physicians tested significantly less, and gene knowledge beyond BRCA1/2 was limited.

Introduction: To evaluate the need for structured feedback in urological residency training, we compared two assessment tools – Global Rating Scale (GRS) and Global Assessment of Urological Endoscopic Skills (GAUES) – during the 2024 Endo-Workshop of the German Society of Residents in Urology (GeSRU). Methods: The workshop included simulation training on ureterorenoscopy (URS), transurethral resection of the bladder (TURB), and transurethral resection of the prostate (TURP). Feedback was provided using GRS and GAUES. An online survey assessed the need for structured feedback. Descriptive statistics and Spearman correlation were used. Results: Among 15 participants, 53% were female, and 60% were early-stage residents. All expressed a desire for feedback, though only 73% had previously received unstructured feedback. Mean scores on GRS were 26 (URS), 28 (TURB), and 25 (TURP); on GAUES: 32, 37, and 33 (max 58). GRS and GAUES scores correlated positively (URS: ρ = 0.85; TURB: 0.5; TURP: 0.54). Post-workshop, 93% rated structured feedback as helpful. Most participants found GAUES (86%) and GRS (79%) specific and useful for training. Conclusion: Structured assessments like GRS and GAUES show strong potential to improve endourological training. GAUES demonstrates value as a task-specific tool. Continuous evaluation of such tools is essential for high-quality surgical education and patient care.