Objectives: To assess YouTube™ videos’ quality on prostate checks, especially on the digital rectal exam (DRE), and to investigate if they can inform patients correctly and eradicate their beliefs and myths.Methods: A search using as keywords “digital rectal exam for prostate cancer” was performed on the YouTubeTM platform. We selected the first 100 videos. To assess video quality content, Patient Education Materials Assessment Tool for audio-visual content (PEMAT A/V) and Misinformation tool were used.Results: Seventy-three videos were suitable for the analyses. The median PEMAT A/V Understandability score and PEMAT A/V Actionability score were 46.2% (interquartile range [IQR]: 30.8-76.9) and 50.0% (IQR: 25.0-75.0), respectively. The medi-an PEMAT A/V Understandability and Actionability scores were 69.2% (IQR: 46.2-88.5) vs 46.2% (IQR: 30.8-61.5) (p = 0.01) and 100.0% (IQR: 87.5-100.0) vs 25.0% (IQR: 25.0-68.8)(p < 0.001), for healthcare workers vs patients, respectively. According to the Misinformation tool, the median misinforma-tion score of the overall videos was 2.2 (IQR:1.7-2.8). According to the target audience, the misinformation score was 2.8 (IQR: 2.4-3.5) vs 2.0 (IQR: 1.5-2.8) (p = 0.02), for healthcare workers vs patients, respectively. Conclusions: Currently, based on our analyses, YouTubeTM videos’ quality on DRE resulted unsatisfactory according to the PEMAT A/V score and the Misinformation tool. Videos targeted to healthcare workers got higher quality scores if compared to videos targeted to patients. Therefore, YouTubeTM videos’ may not be considered a reliable source of information on DRE for patients.

The management of ureter hydronephrosis and urolithiasis during pregnancy has been changed by the adoption of ureteric stents. Despite their broad use for several other conditions, from emergency to elective settings, their complications cannot be ignored. Being most prevalent during pregnancy, urinary tract infections and stent encrustations are particularly common and can affect either fetal growth or maternal–fetal homeostasis, leading to obstetric complications. The main concern associated with ureteric stents is the indwelling time, which could represent the potential trigger of those complications. However, to ensure the optimal management of a ureteric stent during pregnancy, factors such as the grading of encrustations and the presence, size, and location of stones should be evaluated in pre-operative planning. As a consequence, a multimodal approach, including obstetrics, gynecologists, urologists, and nurses, is essential to ensure a complication-free procedure and successful ureteric stent removal. Finally, future research should focus on utilizing biodegradable and biocompatible materials to reduce and even eliminate the complications related to forgotten stents in order to reduce the financial burden associated with stent replacement and the management of stent-encrustation-related complications.

Background/Objective: The grade of recommendation for renal cell carcinoma (RCC) salvage treatment options is weak. The aim of the current study is to summarize available evidence about the surgical, oncological, and functional outcomes of salvage renal options after previous treatments for RCC. Methods: A systematic search (PROSPERO: CRD42024618629) was performed according to the PRISMA statement. A pooled analysis was performed to quantify the effect size (ES) for an overall postoperative Clavien–Dindo (CD) grade ≥ III and postoperative and intraoperative complications for either partial or radical nephrectomy (PN or RN) subgroups. Results: Overall, 11 studies involving 331 patients were included in the final analysis. The median age ranged from 44 to 75 years. Primary treatments for RCC included 267 (80.6%) PNs, 40 (12.0%) radiofrequency ablations (RFAs), 23 (6.9%) cryotherapies, and 1 (0.3%) stereotactic radiotherapy. Overall, the median time of local recurrence for RCC patients was from 25 to 99 months for PNs, 13 months for RFA and cryotherapy, and 6 months for stereotactic radiotherapy. The overall pooled analysis was associated with an ES of 0.28 for overall postoperative complications and of 0.11 for CD ≥ III postoperative complications (all p < 0.001). Within subgroup analyses, RN was invariably associated with less complications (the ES ranged from 0.05 to 0.17). Conclusions: The profile of oncological safety as well as the morbidity and mortality of salvage treatment options for RCC may justify considering such procedures in a salvage setting.

Background and Clinical Significance: Percutaneous ablation is an increasingly used nephron-sparing treatment for small renal masses (SRMs). Although generally considered safe, tumor seeding along the applicator tract is rare (<0.1%) and may be underreported. This study reviews the existing literature to synthesize patterns, potential risk factors, and clinical presentation of this complication following percutaneous thermal ablation of renal cell carcinoma (RCC). Case Presentation: We report the case of an 84-year-old man who developed late subcutaneous abdominal-wall tumor seeding more than ten years after nephron-sparing surgery for a T1a renal mass and following three sessions of percutaneous cryo- and microwave ablation for recurrent clear-cell renal cell carcinoma (ccRCC). The lesion was surgically excised, and histology confirmed ccRCC with negative margins. A descriptive literature review was conducted using PubMed and ScienceDirect to identify English-language case reports and case series (CS) documenting tumor seeding after RCC percutaneous ablation. Eight studies involving nine patients met the inclusion criteria. The median age was 66 years (interquartile range [IQR] 64–74; range 47–84). The median follow-up duration was 11 months (IQR, 4.5–18.5; range 3–60), and the median interval to tumor seeding was 11 months (IQR, 6–18.5; range 3–60). Management included surgical excision (50%), repeat cryoablation (25%), and systemic therapy or supportive care (25%). Conclusions: Tumor tract seeding following percutaneous ablation for RCC is rare, with variable latency and presentation. Procedural factors such as the absence of tract ablation, multiple probe passes, and intra-procedural biopsy may increase risk. Awareness of this complication and long-term surveillance should be incorporated into follow-up protocols. Despite this risk, percutaneous ablation remains a safe and effective option for appropriately selected patients.

Background and Clinical Significance: Malignant priapism is a rare manifestation of advanced malignancy caused by malignant infiltration of the corpora cavernosa. We report a case of persistent and refractory priapism associated with penile carcinoma and extensive metastatic disease, with a suspected pulmonary primary. Case Presentation: An 81-year-old man with a history of prostate cancer treated by radical prostatectomy and persistently undetectable PSA levels developed persistent low-flow priapism. Despite aspiration and irrigation, followed by distal and proximal shunting procedures, the condition recurred with progressive corporal induration and severe pain. Cavernous biopsy was initially interpreted as moderately differentiated squamous carcinoma, while total penectomy performed for refractory pain showed poorly differentiated carcinoma with morphological adenosquamous features. CT and PET/CT demonstrated a pulmonary mass and widespread metastatic disease, although bronchoscopy was non-diagnostic and no histological confirmation of the pulmonary lesion was obtained. A focused review of the literature identified 32 published cases of malignant priapism; bladder cancer was the most frequently reported primary malignancy (37.5%), followed by prostate cancer (18.8%) and renal cell carcinoma (9.4%), while penectomy was performed in 34.4% of cases. Conclusions: Persistent or recurrent priapism associated with corporal induration, progressive or atypical pain, failure of conventional treatment, or discordant imaging findings should raise suspicion of malignant infiltration and prompt consideration of repeat imaging and tissue sampling. In the present case, carcinoma involving the penile structures was histologically confirmed, whereas pulmonary origin remained a clinicoradiological suspicion; penectomy provided immediate pain relief in the setting of extensive refractory local disease.

Background/Objectives: Multiparametric magnetic resonance imaging (mpMRI)-targeted biopsy has become central to prostate cancer (PCa) diagnosis. While cognitive and software-based fusion targeting have already been compared, the use of high-resolution micro-ultrasound as a real-time guidance platform for cognitive translation of MRI-defined lesions remains incompletely characterized. This study prospectively compared mpMRI-transrectal ultrasound (TRUS) fusion-guided transperineal (TP) biopsy with cognitive MRI-targeted TP biopsy under real-time ExactVu^® micro-ultrasound guidance. Methods: We conducted a prospective, observational, comparative study including 58 consecutive patients with suspected PCa and at least one lesion on pre-biopsy mpMRI with a Prostate Imaging Reporting and Data System (PI-RADS) score ≥ 3. Twenty-nine patients were included in each group. The analysis used a standardized 16-core TP biopsy set comprising four targeted cores from the MRI-defined index lesion and 12 systematic cores. The primary endpoint was clinically significant PCa (csPCa) detection, defined as International Society of Urological Pathology (ISUP) Grade Group (GG) ≥ 2. Results: Overall, PCa detection was 65.5% in the fusion-guided biopsy group and 55.2% in the cognitive MRI-targeted biopsy group (absolute risk difference, 10.3 percentage points; 95% CI, −14.1 to 33.2; p = 0.592). csPCa detection was identical in the two groups (37.9% each; absolute risk difference, 0.0 percentage points; 95% CI, −23.6 to 23.6; p = 1.000). In exploratory multivariable logistic regression, biopsy technique was not associated with csPCa detection after adjustment (adjusted OR 0.73, 95% CI 0.22–2.40; p = 0.605), whereas prostate-specific antigen density (PSAD) showed an association with csPCa detection in the exploratory multivariable model (adjusted OR 1.96 per 0.1-unit increase, 95% CI 1.04–3.71; p = 0.039). Conclusions: Cognitive MRI targeting under real-time micro-ultrasound guidance showed the same observed csPCa detection rate as software fusion within a standardized targeted-plus-systematic biopsy pathway. Wide confidence intervals preclude conclusions regarding equivalence or non-inferiority.