Background: Artificial intelligence (AI) chatbots, such as ChatGPT, have made significant progress. These chatbots, particularly popular among health care professionals and patients, are transforming patient education and disease experience with personalized information. Accurate, timely patient education is crucial for informed decision-making, especially regarding prostate-specific antigen screening and treatment options. However, the accuracy and reliability of AI chatbots’ medical information must be rigorously evaluated. Studies testing ChatGPT’s knowledge of prostate cancer are emerging, but there is a need for ongoing evaluation to ensure the quality and safety of information provided to patients. Objective: This study aims to evaluate the quality, accuracy, and readability of ChatGPT-4’s responses to common prostate cancer questions posed by patients. Methods: Overall, 8 questions were formulated with an inductive approach based on information topics in peer-reviewed literature and Google Trends data. Adapted versions of the Patient Education Materials Assessment Tool for AI (PEMAT-AI), Global Quality Score, and DISCERN-AI tools were used by 4 independent reviewers to assess the quality of the AI responses. The 8 AI outputs were judged by 7 expert urologists, using an assessment framework developed to assess accuracy, safety, appropriateness, actionability, and effectiveness. The AI responses’ readability was assessed using established algorithms (Flesch Reading Ease score, Gunning Fog Index, Flesch-Kincaid Grade Level, The Coleman-Liau Index, and Simple Measure of Gobbledygook [SMOG] Index). A brief tool (Reference Assessment AI [REF-AI]) was developed to analyze the references provided by AI outputs, assessing for reference hallucination, relevance, and quality of references. Results: The PEMAT-AI understandability score was very good (mean 79.44%, SD 10.44%), the DISCERN-AI rating was scored as “good” quality (mean 13.88, SD 0.93), and the Global Quality Score was high (mean 4.46/5, SD 0.50). Natural Language Assessment Tool for AI had pooled mean accuracy of 3.96 (SD 0.91), safety of 4.32 (SD 0.86), appropriateness of 4.45 (SD 0.81), actionability of 4.05 (SD 1.15), and effectiveness of 4.09 (SD 0.98). The readability algorithm consensus was “difficult to read” (Flesch Reading Ease score mean 45.97, SD 8.69; Gunning Fog Index mean 14.55, SD 4.79), averaging an 11th-grade reading level, equivalent to 15- to 17-year-olds (Flesch-Kincaid Grade Level mean 12.12, SD 4.34; The Coleman-Liau Index mean 12.75, SD 1.98; SMOG Index mean 11.06, SD 3.20). REF-AI identified 2 reference hallucinations, while the majority (28/30, 93%) of references appropriately supplemented the text. Most references (26/30, 86%) were from reputable government organizations, while a handful were direct citations from scientific literature. Conclusions: Our analysis found that ChatGPT-4 provides generally good responses to common prostate cancer queries, making it a potentially valuable tool for patient education in prostate cancer care. Objective quality assessment tools indicated that the natural language processing outputs were generally reliable and appropriate, but there is room for improvement.

Introduction: There has been a surge in robotic surgery research publications over the past 20 years. However, to date there has been no characterisation of urology’s contribution to the robotic field, and there is a lack of bibliometric literature to guide future investigation. We conducted this bibliometric analysis to characterise the distributions and characteristics of robotic surgery research in the urological field, with sub-analysis of the top 100 articles. Materials and Methods: The Web of Science Core Collection of the ISI Web of Science (WOS) was searched and analysed to determine distributions and characteristics of robotic urological surgery research. The top 100 articles were categorized by urological subfield and organ of pathology, with a level of evidence rating system applied (adapted from the Center of Evidence Based Medicine). Results: The total number of articles retrieved was 1294 from 1999 – 2018. The number of articles published in the last decade has increased by 845.75%, with 153 articles published in the preceding decade. The USA leads countries in publication with 699 (54.02%) articles across the field, and 71 within the top 100 articles. The Journal of Endourology published most articles (n = 292, 22.57%) within the field, while European Urology published most (n = 36) within the top 100 articles. Top 100 articles where generally associated with cancer (n = 76), with prostate cancer dominating literature (n = 38). The most common level of evidence for top 100 articles was that of a level 3 study (n = 31). Conclusions: This analysis of research activity has the potential to guide future robotic surgery research trends in the field of urology. There has been an explosion in robotic surgery urological research activity over the last decade, with level 3 evidence dominating the top 100 articles of the field.

This systematic review (PROSPERO ID: CRD42022226375) aimed to identify the eHealth literacy of men with prostate cancer, and their caregivers. 8 databases (MEDLINE, SCOPUS, EMBASE, Web Of Science, PsycINFO, ERIC, CINAHL, Cochrane CENTRAL) and grey literature sources (e.g. Google Scholar) were searched from inception to December 2023. Articles were included if assessing eHealth/digital literacy of men with prostate cancer, or their carers', and health outcome associations. Formats such as case reports, and review papers were excluded. Records and full texts underwent independent screening and data extraction. Author disagreements were resolved by discussion. The Mixed Methods Appraisal Tool (MMAT) was used to appraise included literature, with narrative synthesis of results. 21,581 records were retrieved, with 7 articles satisfying inclusion criteria. A heterogenous field was characterised with lack of modern eHealth literacy measurement tools identified. Results suggest novice eHealth literacy using web 1.0 technologies. Non-validated measures of literacy demonstrate mixed results, while health outcome effects limited in scope and reliability. Prostate cancer survivors' eHealth literacy levels is likely novice, and requires further investigation. Digital technologies/resources implemented as part of patient communication practices should be vetted for quality, and tailored to patients' eHealth literacy abilities and/or needs.

The purpose of this study is to conduct the first bibliometric analysis which examines eHealth communication technologies in prostate cancer care, and the utilization of internet-based health information and communication technology by men with prostate cancer. Original articles were extracted from the Science Citation Index Expanded (SCI-E) on Web of Science (WOS) and analyzed concerning their distributions. Quantitative guidance directed investigation of findings from previous studies and trending issues within the field. The WOS, VOSViewer and CiteSpace IV were used for information analysis. 302 articles were included in the final analysis. There has been a 165 % increase in productivity over the past decade. The leading country by publication was the USA (145 articles = 48.02 %). Journals which published the highest number of original articles were the Journal of Medical Internet Research (6.95 %), and Patient Education and Counseling (4.64 %). The field of research which examines utilization and impacts of internet-based health information on men with prostate cancer is growing and diverse. Research frontiers are 'Information quality and diversity', 'eHealth literacy', 'decision making', and 'survivorship and advanced disease'. Clinicians should be aware of several significant limitations which exist within the current field of research.

Paraneoplastic bullous pemphigoid is a rare paraneoplastic syndrome. Rash is pruritic, with erythematous eruption of large subepidermal bullae over skin and often mucosal surfaces. We present an 84y woman with a three week history of erythematous rash, and 48hrs of bullae. A left clear cell renal cell carcinoma was identified on CT imaging during the presentation. Subsequent removal of the tumour resulted in resolution of bullous pemphigoid symptoms. This first-of-kind case and successful result strengthens the association between renal cell carcinoma and paraneoplastic bullous pemphigoid, arguing for a high degree of clinical suspicion in unexplained presentations of bullous pemphigoid.

Objective: To describe a novel RoboSling technique performed at the time of robot‐assisted radical prostatectomy (RARP) and its utility for enhancing urinary function recovery postoperatively.Materials and Methods: The surgical technique involves harvesting a vascularised, fascial flap from the peritoneum on the posterior aspect of the bladder. Following completion of prostatectomy, the autologous flap is tunnelled underneath the bladder and incorporated into the rectourethralis and vertical longitudinal detrusor fibres at the posterior bladder neck with a modified Rocco suture. After urethra‐vesical anastomosis is completed, the corners of the flap are hitched up to Cooper's ligament bilaterally with V‐Loc sutures, tensioned and secured creating a bladder neck sling. A prospective, longitudinal cohort study was performed of 193 consecutive patients undergoing RARP between December 2016 and September 2019. The first 163 patients underwent standard RARP, and the last 30 patients had the RoboSling technique performed concurrently. Continence outcomes were the primary outcomes assessed using pad number and Expanded Prostate Cancer Composite (EPIC)‐urinary domain questionnaire. Operative time (OT), estimated blood loss (EBL), complications and oncological outcomes were secondary outcomes.Results: The two groups were comparable for demographics and clinicopathological variables. At 3 months, zero pad usage (p = 0.005) and continence rates, defined as EPIC score ≥ 85 (p = 0.007), were both higher in the RoboSling group. EBL, complication rate and positive surgical margin rate did not differ between the two groups. Superior zero pad usage was observed at 1 year in the RoboSling group (p = 0.029). The RoboSling technique added on average 16 min to OT.Conclusions: The RoboSling procedure at the time of RARP was associated with earlier return to continence without negatively impacting other postoperative outcomes. This improvement in continence outcomes was maintained long term.