Background: Tumour volume percentage (TVP) is considered an important pathological parameter, particularly in prostate cancer, representing the ratio of tumour volume to the total gland, and it can be used to measure the quantity of malignancy. Previous reports have already demonstrated that an elevated tumour volume percentage is associated with unfavourable factors, including extraprostatic extension, positive surgical margins, and lymph node metastasis. The independent value of TVP, especially in high-risk prostate cancer treated by radical prostatectomy, remains an area of active research, despite established prognostic factors such as PSA, ISUP grade, and TNM stage. Materials and Methods: We retrospectively analyzed the records of 159 high-risk prostate cancer patients who underwent open or laparoscopic radical prostatectomy between January 2016 and January 2025 at the Clinic of Urology of Targu Mures. High-risk patients were defined as those with ISUP grade 4–5 or PSA >20 ng/mL or clinical stage ≥T2c or stage cT3–4 and/or lymph node metastasis. Tumour volume percentage was calculated from the final pathology result and was determined as the proportion of prostate cancer volume relative to the total prostate volume. Clinical and pathological features, including PSA, ISUP grade, TNM stage, surgical margin, and lymph node involvement, were reported. To assess TVP as an indicator of tumour aggressiveness, univariate and multivariate regression analyses were performed. A p-value < 0.05 was considered statistically significant. Results: A total of 159 high-risk prostate cancer patients (100%), with a median age of 66 years, who underwent open or laparoscopic radical prostatectomy were included. The median tumour volume percentage was 7.6%, and the median prostate volume was 43.8 cc. On univariate analysis, patients with extraprostatic extension (p < 0.001), positive surgical margins (p = 0.005), a higher ISUP grade (p < 0.001), and lymph node metastasis (p = 0.006) exhibited higher TVP compared to their counterparts. A significant correlation was also observed between TVP and the number of positive biopsy cores (p < 0.001), a higher PSA value (p = 0.005), and a younger age (p = 0.041). Conversely, no correlation was identified between TVP and perioperative factors such as hospital stay, surgery duration, ICU days, type of approach, or positive urine culture. Two regression models on multivariate analyses were performed with TVP as the dependent variable. In the continuous variable model (Adjusted R² = 0.43, p < 0.001), independent predictors of higher TVP were the number of positive biopsy cores (B = 0.54, p < 0.001), the number of positive lymph nodes (B = 2.59, p < 0.001), and surgical margin dimension (B = 1.19, p < 0.001). Age, PSA, and perioperative variables showed no significant correlation with TVP on multivariate analysis. In the categorical regression model (Adjusted R² = 0.438), statistical significance was confirmed (F-test, p < 0.001). Independent predictors of increased tumour volume percentage included ISUP grade 5 in the effect-coded model (B = +6.60, 95% CI: 0.96–12.25, p = 0.022), and pathological TNM stage pT4 (B = +24.70, 95% CI: 17.69–31.70, p < 0.001). ROC analysis showed limited-to-moderate discrimination for positive surgical margins (AUC = 0.655; 95% CI 0.565–0.744; p = 0.001) and stronger discrimination for pN1 (AUC = 0.793; 95% CI 0.650–0.936; p = 0.002). The Youden-derived cut-offs were 4.90% for positive surgical margins and 5.77% for lymph-node metastasis. Conclusions: Tumour volume percentage is significantly associated with several adverse pathological features in high-risk prostate cancer. Rather than a standalone biomarker, its association with adverse pathological features underscores its potential role in risk stratification models, and the incorporation into pathology reports and prognostic nomograms may improve clinical decision-making.

Hydronephrosis caused by malignant ureteral obstruction or radiotherapy-induced ureteral stenosis is a frequent complication in patients with cervical cancer. Effective management requires continuous urinary drainage, which can be achieved either internally through ureteral stent placement or externally via percutaneous nephrostomy. Among available devices, the Allium^TM fully covered nitinol mesh ureteral stent is designed to treat ureteral or urethral strictures while allowing safe and easy removal. However, serious complications have been reported, including uretero-enteric, uretero-arterial, and uretero-vaginal fistulas, pseudoaneurysm, ureteral perforation and sepsis. We report the case of a 44-year-old woman diagnosed in 2020 with stage IIIC1 cervical cancer (FIGO classification) who underwent surgery followed by adjuvant radiotherapy. In 2021, a right metallic ureteral stent was placed to treat ureteral obstruction. Two years later, she presented with right lumbar pain, and abdominal ultrasonography revealed grade III right hydronephrosis. CT scan demonstrated migration of the metallic ureteral stent into the rectal wall. Endoscopic extraction of the migrated stent was successfully performed via colonoscopy. Retrograde pyelography and CT imaging confirmed the presence of a recto-ureteral fistula. A 6 Ch/26 cm double-J ureteral stent was subsequently placed with good positioning and drainage. At the six-month follow-up, replacement of the double-J stent was performed. Imaging studies showed only minor residual hydronephrosis. Although metallic ureteral stents are effective for managing malignant ureteral obstruction, particularly in complex oncologic cases, they are not free of severe complications. The risk appears increased in patients who have undergone radiotherapy, emphasizing the need for careful monitoring and long term follow-up.

Introduction: Post-prostatectomy urinary incontinence represents a major determinant of postoperative quality of life. Functional magnetic stimulation (FMS) is a non-invasive pelvic floor rehabilitation modality used in the conservative management of post-prostatectomy urinary incontinence; however, rehabilitation-related factors influencing treatment response remain insufficiently defined. The objective of this study was to evaluate real-world outcomes after an FMS protocol and to identify clinical and therapeutic factors associated with an investigator-defined exploratory response. Materials and Methods: This retrospective, single-center cohort study included 67 men treated with functional magnetic stimulation for urinary incontinence after radical prostatectomy. The primary endpoint was the post-FMS response score, assessed using an investigator-defined, non-validated 0–5 ordinal clinical response scale. Clinical, oncological, surgical, and rehabilitation-related variables were analyzed. Associations with treatment response were evaluated using univariable analyses and primary multivariable ordinal logistic regression. Results: A total of 67 patients were included, with a median age of 67 years [IQR: 63–70], a median PSA of 9.0 ng/mL [IQR: 6.45–14.08], a median number of FMS sessions of 11 [IQR: 8–13], and a median time from prostatectomy to first FMS session of 48 days [IQR: 30–83]. Any improvement was observed in 56 patients (83.6%), while investigator-defined exploratory response threshold was achieved in 28 patients (41.8%) and good/excellent response in 21 patients (31.3%). Patients aged ≤65 years had higher response scores than those aged >65 years (3 [IQR: 2–4] vs. 2 [IQR: 0.75–3], p = 0.025). Timing of FMS initiation was not associated with response when analyzed as a continuous variable. No statistically significant associations were detected between post-FMS response scores and PSA, ISUP grade group, EAU risk classification, or surgical approach in this cohort; however, clinically relevant associations cannot be excluded given the modest sample size. In the primary multivariable ordinal logistic regression model, older age was independently associated within the fitted model with lower odds of achieving a higher post-FMS response category (OR = 0.927, 95% CI: 0.859–0.999, p = 0.048), while the number of completed FMS sessions was independently associated within the fitted model with higher odds of achieving a higher response category (OR = 1.093, 95% CI: 1.009–1.184, p = 0.029). FMS initiation after 120 days was not independently associated with response category (OR = 0.447, 95% CI: 0.096–2.081, p = 0.305). Conclusions: Subjective functional improvement was observed after FMS in this retrospective outcome-evaluable cohort; however, because standardized baseline continence severity and a comparator group were unavailable, treatment efficacy cannot be established. Younger age and a greater number of completed FMS sessions were associated with higher post-FMS response categories in the exploratory multivariable analysis. However, the association with session number should not be interpreted as evidence of a causal dose–response relationship. Timing of FMS initiation was not associated with response when analyzed continuously. Exploratory 120-day and 180-day threshold analyses produced nominal subgroup differences but should be considered potentially data-dependent and hypothesis-generating only.