Male infertility is an under-recognized global health burden. Accumulating evidence position the intestinal microbiota as a pivotal regulator of testicular function, underpinning the emerging gut microbiota–testis axis. This narrative review introduces the conceptual term “androbactome”, referring to gut microorganisms and microbial genes that are hypothesized to influence androgen biosynthesis, spermatogenesis, and broader reproductive endocrinology. The documented worldwide decline in sperm concentration heightens the urgency of clarifying microbe-mediated influences on male reproductive capacity. The synthesis of preclinical and clinical findings reveals four principal pathways by which dysbiosis compromises fertility: systemic inflammation, oxidative stress, endocrine disruption, and epigenetic alteration. Lipopolysaccharide-driven cytokinaemia, reactive oxygen species generation, hypothalamic–pituitary–gonadal axis suppression, and aberrant germ cell methylation collectively impair sperm quality and hormonal balance. Short-chain fatty acids, secondary bile acids, and indole derivatives emerge as pivotal messengers within this crosstalk. Therapeutic approaches targeting the androbactome, namely dietary optimization, probiotic or prebiotic supplementation, and fecal microbiota transplantation, have demonstrated encouraging improvements in sperm parameters and testosterone levels, yet the causal inference is constrained by predominantly cross-sectional designs and limited long-term safety data. Recognizing the androbactome as a modifiable determinant of male fertility may open new avenues for personalized diagnosis, risk stratification, and adjunctive therapy in regard to idiopathic infertility. The integration of multi-omics platforms to characterize microbial and metabolomic signatures promises to enrich diagnostic algorithms and guide precision interventions, but rigorously controlled longitudinal and interventional studies are required to secure a translational impact.

Male infertility is a prevalent condition affecting approximately 15% of couples worldwide. Recent evidence indicates that, beyond its immediate reproductive implications, male infertility may reflect broader health concerns. Large-scale cohort studies consistently show that men with poorer semen parameters have elevated all-cause mortality compared to fertile counterparts, with a dose-dependent pattern whereby more severe abnormalities correlate with a higher risk of early death. Proposed mechanisms linking infertility to reduced life expectancy encompass genetic, hormonal, and lifestyle factors. For instance, Klinefelter syndrome exemplifies a genetic cause of azoospermia that also predisposes to metabolic syndrome, diabetes, and certain malignancies. Low testosterone, a frequent finding in testicular dysfunction, is implicated in obesity, insulin resistance, and cardiovascular disease, all of which can shorten lifespan. Additionally, psychosocial stress and depression—commonly reported among infertile men—may contribute to health-compromising behaviors. Environmental exposures and socioeconomic factors further compound these risks. Collectively, these data underscore the importance of recognizing male infertility as an early indicator of potentially modifiable health vulnerabilities. A comprehensive evaluation of infertile men should therefore extend beyond fertility assessments to include screening for chronic diseases, hormonal imbalances, and mental health issues. Targeted surveillance for specific cancers (e.g., testicular and prostate) and early interventions—such as lifestyle modifications, appropriate hormonal therapies, and psychosocial support—can improve both reproductive outcomes and long-term well-being. Given these insights, male fertility assessment may serve as a valuable gateway to broader men’s healthcare, prompting proactive strategies that mitigate associated risks and potentially enhance longevity.

Background/Objectives: Benign prostatic hyperplasia (BPH) is a common urological condition that can significantly impair quality of life in aging men by causing lower urinary tract symptoms (LUTS), including nocturia, weak stream, and incomplete emptying. While pharmacotherapy and surgical approaches such as transurethral resection of the prostate (TURP) remain cornerstone treatments, minimally invasive surgical therapies (MISTs) have emerged to bridge the gap between long-term medication use and invasive surgery. This narrative review assesses Rezūm therapy (water vapor thermal therapy, WVTT) by examining its mechanism of action, clinical efficacy, safety profile, and place in the BPH treatment algorithm. Methods: This narrative review synthesizes evidence from randomized controlled trials (RCTs), prospective studies, real-world cohorts, and published systematic reviews with meta-analyses to provide a comprehensive evaluation of Rezūm therapy for BPH. Key outcomes assessed include changes in International Prostate Symptom Score (IPSS), urinary flow rates, retreatment rates, adverse events, and sexual function preservation. Results: Across multiple studies, Rezūm significantly reduces IPSS (typically by ≥50%) and increases peak urinary flow by 4–5 mL/s. These improvements are durable, with five-year follow-up data showing low retreatment rates of approximately 4–5% and sustained symptom relief. The procedure, performed under local or minimal anesthesia, has a favorable safety profile: most adverse events are mild or transient, and notable complications, such as bleeding requiring transfusion or persistent sexual dysfunction, are rare. Importantly, Rezūm preserves both erectile and ejaculatory function in most patients, setting it apart from many traditional surgical interventions associated with higher sexual side effect rates. Conclusions: Rezūm is an effective and minimally invasive alternative for men with moderate prostatic enlargement who desire durable symptom improvement while avoiding the morbidity and sexual side effects associated with more invasive surgery. Future research should aim to further refine patient selection and assess long-term outcomes in broader populations.

Objective: To determine the attitudinal change for urologic surgery in Greece since the introduction of the da Vinci Surgical System (DVS). We describe contemporary trends at public hospital level, the initial Greek experience, while at the same time Greece is in economic crisis and funding is under austerity measures. Materials and Methods: We retrospectively analyzed annualized case log data on urologic procedures, between 2008 (installation of the DVS) and 2013, from “Laiko’’ Hospital in Athens. We evaluated, using summary statistics, trends and institutional status regarding robot-assisted surgery (RAS). We also analyzed the relationship between the introduction of RAS and change in total volume of procedures performed. Results: 1578 of the urological procedures performed at “Laiko’’ Hospital were pooled, 1342 (85%) being open and 236 RAS (15%). We observed a 6-fold increase in the number of RAS performed, from 7% of the total procedural volume (14/212) in 2008 to 30% (96/331) in 2013. For radical prostatectomy, in 2008 2% were robot-assisted and 98% open while in 2013, 46% and 54% respectively. Pyeloplasty was performed more often using the robot-assisted method since 2010. RAS-dedicated surgeons increased both RAS and the total number of procedures they performed. From 86 in 2008 to 145 in 2013, with 57% of them being RAS in 2013 as compared to 13 % in 2008. Conclusions: Robot-assisted surgery has integrated into the armamentarium for urologic surgery in Greece at public hospital level. Surgical robot acquisition is also associated with increased volume of procedures, especially prostatectomy, despite the ongoing debate over cost-effectiveness, during economic crisis and International Monetary Fund (IFN) era.

The relationship between chronic kidney disease (CKD) and renal cell carcinoma (RCC) is both bidirectional and multifactorial. Several risk factors, including hypertension, diabetes mellitus, obesity, and smoking, have been associated with an increased risk for the development of CKD and RCC. CKD may predispose individuals to RCC through various mechanisms, including renal cystic diseases or induced oxidative stress effects. Conversely, RCC can induce CKD through the direct effects of the tumor, after surgeries for the management of the tumor (either partial or radical nephrectomy), and through perioperative acute kidney injury. Furthermore, medical interventions, including immunotherapy or targeted therapies, may precipitate acute kidney injury, potentially leading to the development of CKD. The expression of several genes in renal tissues has been related to the remodeling of kidneys during end-stage kidney disease and with an increased risk of the development of preneoplastic lesions and tumors. The aim of this review is to update the knowledge of these relationships, highlight the pathophysiologic mechanisms, and identify the genes and molecular expressions involved in this pathway.

Background and objective The purpose of our study was to assess the expression of cannabinoid type 1 receptor (CB1R) and cannabinoid type 2 receptor (CB2R), including positivity, intensity, percentage, site of distribution, and immunohistochemical score, in renal cell carcinomas (RCCs) and explore their correlation with various clinicopathological aspects. Methodology We retrospectively obtained data and specimens from 87 patients diagnosed with RCC after partial or radical nephrectomy, and the CB1R and CB2R expression was assessed immunohistochemically on paraffinembedded tissues. The results were statistically analyzed uni- and multi -factorial along with clinicopathological parameters. Results CB1R was not expressed at all, and CB2R was highly expressed in 78 (89.7%) patients with RCC. In unifactorial analysis, no statistical significance was found in any of the analyzed parameters. However, in the multifactorial analysis, we found that patients with a papillary histologic type (P < 0.0005) were associated with a lower likelihood of expression of the CB2R in the membranous compared with those with clear -cell and were also associated with a higher likelihood of moderate or strong expression of CB2R immunohistochemical score compared with those with clear -cell (P = 0.03). Patients with stage T2 (P = 0.010) had more enhanced expression (grade 3 CB2R intensity) compared with those with stage T1. Males (beta coefficient +/- standard error [SE] 13.70 +/- 7.04; P = 0.056) and patients with chromophobe histologic type (beta coefficient +/- SE 23.45 +/- 9.86; P = 0.020) were associated with a higher percentage of CB2R expression. Conclusions Our data suggest that although the CB1R was not expressed in RCCs, CB2R was expressed in almost every patient and enhanced expression was noted in correlation with specific clinicopathological aspects of the patients. Thus, following well -designed studies, especially CB2R could be used as a prognostic marker or even as a potential therapeutic target in RCC.