Kaposi's sarcoma (KS) is a rare angioproliferative disorder of the vascular endothelium. The development of KS requires Human Herpes Virus 8 (HHV-8) infection. An associated HIV infection is usually seen. Isolated scrotal KS has rarely been reported. In this article, we present a case of KS that primarily involved the scrotum in a HIV negative patient. A 71-year old male patient admitted to the outpatient department due to nodular lesions on the scrotum. The patient declared that these lesions were present for nearly 5 years. Past medical history revealed that he underwent left thoracotomy and upper lobectomy in 2006 for adenosquamous lung carcinoma. Then, he received a single cycle of adjuvant chemotherapy consisted of docetaxel and cisplatin. Physical examination revealed 3 black small nodules on the scrotum. The anti-HIV test was negative. All scrotal lesions were surgically excised. The pathological investigation revealed KS of the lymphangioma-like type. The pathogenesis of KS has still not been clearly elucidated. However, it is known that all forms of KS are associated with HHV-8 infections. A defect in immune system was almost always necessary. Therefore, KS is usually associated with HIV infection. KS of the penis has been reported in HIV negative patients. Very few cases of scrotal KS have been presented. In a recent review, only 1 patient had scrotal KS out of 32 cases with HIV negative KS. In our case, the patient received a cycle of chemotherapy that might affect his immune system. The lymphangioma-like type is a common morphological sub-type. While lymph edemas are commonly observed in this sub-type, no edema in the lymphs was present in our case. Classical KS is generally observed in the lower extremities, it can rarely affect scrotal skin as isolated lesions. Therefore, a careful physical examination should also include scrotum for these patients.

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.

Optimizing Prostate Cancer Diagnosis: A Prospective, Randomized Comparison of 12-core vs. 20-core Biopsy for Detection Accuracy and Upgrading Risk - Journal of Urological Surgery