Background/Objectives: Conventional imaging modalities are often inadequate for evaluating the proximal extent of anterior obliterative urethral strictures. Magnetic Resonance Imaging (MRI), with its superior soft tissue resolution, provides detailed anatomical insights and significantly contributes to surgical planning in such cases. Methods: Four male patients aged 26–63 years with anterior obliterative urethral strictures were evaluated using MRI in addition to conventional imaging. All MRI scans were performed following a modified Joshi protocol. Clinical data, MRI findings, and surgical outcomes were retrospectively reviewed. Results: MRI successfully delineated stricture length, location, periurethral fibrosis, and proximal urethral status in all cases, correlating well with intraoperative findings. Case 1 showed a 2 cm proximal bulbar obliteration, excised with end-to-end anastomosis. Case 2 had a 2.5 cm distal bulbar stricture, managed similarly. Case 3 revealed multi-segmental strictures, treated with a combination of anastomosis, graft, and Kulkarni urethroplasty. Case 4 demonstrated a rare 9 cm distal penile obliteration with preserved proximal urethra, treated with anastomotic repair. MRI provided critical anatomical detail for surgical decision-making. Conclusions: MRI is a valuable imaging modality for the evaluation of anterior obliterative urethral strictures, particularly when the proximal extent of the stricture cannot be visualized with conventional imaging techniques. In our case series, MRI enabled precise delineation of the stricture length and surrounding anatomical structures, which was critical for selecting the most appropriate surgical approach.

Purpose: To evaluate the efficacy, safety, and tolerability of combined low-intensity extracorporeal shock wave therapy and platelet-rich plasma in patients with acute-phase Peyronie’s disease.Materials and methods: This retrospective single-center study included 42 men with acute-phase Peyronie’s disease treated between January 2025 and January 2026. The acute phase was defined as a symptom duration of less than 6 months. All patients received daily tadalafil, six sessions of low-intensity extracorporeal shock wave therapy, and three intralesional platelet-rich plasma injections. Penile curvature, plaque size, penile pain, and erectile function were assessed before treatment and 3 months after treatment. Penile pain was evaluated with a visual analog scale, and erectile function was assessed using the International Index of Erectile Function. Paired comparisons were performed according to data distribution.Results: The median pain score decreased significantly from 7.00 to 3.50 (p<0.001). Erectile function also improved significantly, with the mean score increasing from 16.59±4.51 to 20.88±5.51 (p<0.001). Mean penile curvature decreased from 33.89±10.49 degrees to 31.53±13.26 degrees, but this change was not significant (p=0.058). Mean plaque size changed from 1.58±0.45 cm to 1.56±0.46 cm without statistical significance (p=0.594). No major adverse events were observed. Minor local complications included mild ecchymosis in 11.9% and transient edema in 4.8% of patients.Conclusion: Combined low-intensity extracorporeal shock wave therapy and platelet-rich plasma appears to be a safe and effective conservative treatment option in acute-phase Peyronie’s disease. The protocol provided significant pain relief and improved erectile function, while stabilizing penile curvature and plaque size

Objectives: Transperineal (TP) prostate biopsy is increasingly used because of its lower complication rates compared with the transrectal approach. However, prospective data regarding its effects on erectile and ejaculatory function remain limited. This study prospectively evaluated short-term sexual function outcomes after TP prostate biopsy in sexually active men. Methods: This single-center prospective observational cohort study included men undergoing TP prostate biopsy between 15 April 2025 and 1 September 2025. Indications for biopsy were prostate-specific antigen levels >4 ng/mL, abnormal digital rectal examination findings, or suspicious lesions (PI-RADS ≥ 3) on multiparametric prostate MRI. Sexual function was assessed at baseline and at 1 and 3 months after biopsy using the International Index of Erectile Function (IIEF-5), the Premature Ejaculation Diagnostic Tool (PEDT), and the Male Sexual Health Questionnaire–Ejaculatory Dysfunction Short Form (MSHQ-EjD-SF). Results: Overall, 249 sexually active men were analyzed. No significant changes in erectile or ejaculatory function were observed in the overall cohort at either follow-up point. In contrast, among 132 men diagnosed with prostate cancer, significant declines were observed in IIEF-5, PEDT, and MSHQ-EjD-SF scores at both 1 and 3 months compared to baseline (all p < 0.001). Conclusions: Transperineal prostate biopsy minimally affects sexual function in the general population. However, prostate cancer patients experience notable deterioration in erectile and ejaculatory outcomes, which may be a transient decline, and long-term follow-up is necessary for this subgroup.