Therapeutic Advances in Urology最新文献

{"title":"Cost-effectiveness of PSMA-PET imaging technology in diagnosing and staging of prostate cancer: a systematic review.","authors":"Chiranjeev Sanyal, Ricardo Rendon","doi":"10.1177/17562872261436874","DOIUrl":"10.1177/17562872261436874","url":null,"abstract":"<p><strong>Background: </strong>Prostate-specific membrane antigen (PSMA) PET is becoming the preferred imaging technique for prostate cancer (PCa) because of its superior sensitivity and specificity compared to traditional imaging methods. This article evaluates the methodological and reporting quality of literature regarding the cost-effectiveness of PSMA-positron emission tomography (PET)/computed tomography (CT) or MRI for detecting and staging PCa.</p><p><strong>Objective: </strong>To describe the methodological and reporting quality of the published cost-effectiveness studies on PSMA-PET.</p><p><strong>Methods: </strong>MEDLINE and EMBASE were searched from inception to December 05, 2025. Two researchers independently screened all retrieved articles according to inclusion and exclusion criteria. Studies were appraised for methodological quality using the Quality of Health Economic Studies checklist and for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards checklist.</p><p><strong>Results: </strong>A total of seven studies were examined, representing both private and public healthcare systems. Overall, these studies demonstrate high methodological and reporting quality. When compared to existing imaging technologies or standard care practices, PSMA-PET/CT or MRI is cost-effective within country-specific willingness-to-pay thresholds.</p><p><strong>Conclusion: </strong>Cost-effectiveness evaluations may not be widely generalizable due to significant variability among geographical regions concerning resource availability, costs, morbidity and mortality, and standards of practice. As PSMA-PET/CT imaging technology becomes more widely available in additional countries in the coming years, we expect to generate more country-specific data.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"18 ","pages":"17562872261436874"},"PeriodicalIF":3.5,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of large language models in interpreting urological clinical guidelines: a comparative study with expert evaluation.","authors":"Ángel Borque-Fernando, Denis Navarro, Manuel Doblare, Luis M Esteban, Daniel Perez-Fentes, Mario Álvarez-Maestro, Rafael A Medina-López, Oscar Rodríguez Faba, José Rubio-Briones, Sergio Fernández-Pello, Jesús María Fernández-Gómez, Tomás Fernández Aparicio, Félix Guerrero Ramos, Laura Izquierdo, José Luis Álvarez-Ossorio Fernández","doi":"10.1177/17562872261436905","DOIUrl":"10.1177/17562872261436905","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) are increasingly being explored to supporting evidence-based decision-making in urology, but their accuracy in interpreting and applying clinical guidelines remains uncertain.</p><p><strong>Objectives: </strong>We aimed to evaluate the ability of LLMs to interpret and apply clinical guidelines across the full spectrum of major urological cancers.</p><p><strong>Design: </strong>This expert-validated study evaluated six configurations of three top LLMs (Claude, Gemini, and ChatGPT) using 25 structured questions for each of the seven major urological cancers: prostate cancer, upper tract urothelial carcinoma, muscle-invasive and non-muscle-invasive bladder cancer, renal cell carcinoma, penile cancer, and testicular cancer.</p><p><strong>Methods: </strong>Both simple and rephrased prompts were used to assess the impact of prompt engineering on response quality. All figures and tables from the English-language EAU guidelines were systematically converted into plain, structured text and peer reviewed by multidisciplinary experts before evaluating the LLM responses. Each response was independently rated by 9-11 uro-oncology specialists using a five-point Likert scale (1: incorrect/unacceptable, 5: optimal), resulting in 10,500 evaluations.</p><p><strong>Results: </strong>Claude achieved the highest overall accuracy, with 45.9% of responses rated as optimal (Likert 5) and 87% as optimal/acceptable (Likert 4-5). Tumor-specific performance peaked in muscle-invasive bladder (56.7% optimal, 93% optimal/acceptable), penile (49.5%, 95%), and testicular cancer (60.9%, 94%). Gemini and ChatGPT showed lower optimal rates but acceptable performance (68%-70% optimal/acceptable). Rephrased prompts did not consistently outperform simple versions. All models showed acceptable accuracy, but the results should be interpreted cautiously due to recency bias and fast LLM tech evolution.</p><p><strong>Conclusion: </strong>This study demonstrates the value of rigorous plain language adaptation and expert validation in benchmarking LLMs, supporting their potential as decision-support tools in uro-oncology.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"18 ","pages":"17562872261436905"},"PeriodicalIF":3.5,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of poor kidney function in patients with emphysematous pyelonephritis: a retrospective observational study.","authors":"Anupam Choudhary, Kasi Viswanath Gali, Surag K R, Anshuman Singh, Abhijit Shah, Krishnakanth A V B, Sunil Pillai, Padmaraj Hegde","doi":"10.1177/17562872261429824","DOIUrl":"10.1177/17562872261429824","url":null,"abstract":"<p><strong>Background: </strong>Emphysematous pyelonephritis (EPN) is a well-known clinical condition characterized by an aggressive, gas-forming infection of the kidney caused by uropathogenic bacteria. There is growing interest in identifying the effects of EPN on long-term renal function and the factors that can help predict its impact.</p><p><strong>Objectives: </strong>This study evaluated risk factors for the development of poorly functioning kidneys (PFK) in patients diagnosed with EPN.</p><p><strong>Design: </strong>A retrospective study was conducted at a university teaching hospital on patients with EPN from January 2019 to December 2024.</p><p><strong>Methods: </strong>Data were collected from the prospectively maintained patient records, and patient demographics, comorbidities, clinical presentation, laboratory investigations, imaging characteristics, and interventions were analyzed. PFKs were defined as those with less than 15% differential function on radionuclide renography performed at follow-up. Data were analyzed using SPSS version 23 (IBM Corp.). A <i>p</i>-value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 151 patients met the eligibility criteria. PFK was present in 23 patients (15.2%) on follow-up. Univariate analysis revealed random blood sugar (RBS) at presentation >200 mg/dL (<i>p</i> < 0.0001), >50% parenchymal involvement on imaging (<i>p</i> < 0.00001), Huang-Tseng Class 3b (<i>p</i> < 0.00001), and persistence of gas in the renal parenchyma on follow-up imaging (<i>p</i> < 0.0001) to be significantly associated with the development of PFK. Multivariate Analysis revealed that >50% parenchymal involvement on initial imaging was an independent and significant predictor of PFK.</p><p><strong>Conclusion: </strong>EPN is a fulminant renal infection with a high risk of renal functional deterioration. Renal parenchymal involvement of >50% on initial imaging emerged as the most significant and independent predictor of poor renal function. Additional contributory factors included RBS >200 mg/dL, Huang-Tseng Class 3b, and persistence of gas in the renal parenchyma on follow-up. Recognizing these clinical and radiological predictors can support early risk stratification, guide patient counseling, and inform individualized management strategies aimed at preserving renal function.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"18 ","pages":"17562872261429824"},"PeriodicalIF":3.5,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of the inflammatory burden index for disease-specific mortality and intensive care need in Fournier's gangrene.","authors":"Serkan Ozcan, Enis Mert Yorulmaz, Mertcan Dama, Kursad Donmez, Osman Kose, Sacit Nuri Gorgel, Yigit Akın","doi":"10.1177/17562872261430104","DOIUrl":"10.1177/17562872261430104","url":null,"abstract":"<p><strong>Background: </strong>Fournier's gangrene (FG) is a rapidly progressive necrotizing infection with high mortality. Early recognition of high-risk patients is critical for improving outcomes.</p><p><strong>Objectives: </strong>To evaluate the prognostic value of the Inflammatory Burden Index (IBI)-a composite marker derived from C-reactive protein, neutrophil, and lymphocyte counts-for predicting mortality, intensive care requirements, and clinical course in FG.</p><p><strong>Design and methods: </strong>This retrospective cohort included 130 patients diagnosed with FG and treated at a tertiary referral center between 2015 and 2025. Demographic, clinical, and laboratory data were collected at admission. IBI was calculated using first-draw laboratory values. Primary outcomes were disease-specific mortality and intensive care unit (ICU) admission; secondary outcome was length of hospital stay. Univariable and multivariable logistic regression analyses were performed, and discriminatory capacity was evaluated using receiver operating characteristic analysis.</p><p><strong>Results: </strong>Nonsurvivors exhibited significantly higher IBI values than survivors (<i>p</i> = 0.001). On multivariable analysis, IBI independently predicted in-hospital mortality (<i>p</i> = 0.017), disease-specific mortality (<i>p</i> = 0.004), and ICU admission (<i>p</i> = 0.008). Higher IBI was also associated with prolonged hospitalization (<i>p</i> = 0.012). Discriminative performance was acceptable, with an area under the curve of 0.757 for overall mortality and 0.856 for disease-specific mortality.</p><p><strong>Conclusion: </strong>Admission IBI is an independent predictor of mortality, ICU requirement, and hospital stay in FG. As a simple, cost-effective, and rapidly available biomarker, IBI may support early risk stratification and decision-making in clinical practice.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"18 ","pages":"17562872261430104"},"PeriodicalIF":3.5,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergy of PET and MR imaging in the local and regional staging of bladder cancer.","authors":"Mark C Xu, Maxwell L Sandberg, David D Childs, Turgut Bora Cengiz, Colton H Walker, Soroush Rais-Bahrami","doi":"10.1177/17562872261430967","DOIUrl":"10.1177/17562872261430967","url":null,"abstract":"<p><p>The prognosis and optimal management of bladder cancer are closely dependent on accurate clinical staging. Traditional staging has relied on transurethral resection for T-staging in combination with cross-sectional imaging for N and M-staging. Computed tomography (CT) is the most accessible and common cross-sectional imaging modality to assess for local and distant spread of disease. However, CT alone lacks the contrast resolution to distinguish between non-muscle-invasive and muscle-invasive disease and has known difficulty distinguishing metastatic from normal lymph nodes (LNs). Magnetic resonance imaging (MRI) and positron emission tomography (PET) have been increasingly used in the workup of bladder cancer to address the shortcomings of CT imaging. MRI using the multiparametric combination of T2-weighted, dynamic contrast-enhanced, and diffusion-weighted imaging can more clearly delineate the extent of tumor involvement in the bladder. PET can use a variety of metabolically active radiotracers to visualize cancerous tissue, allowing the identification of metastases that may not be readily visible on CT. PET scans can also detect disease in normally sized LNs that do not meet conventional CT size thresholds. The combination of MRI and PET scans has not been explored in detail with respect to bladder cancer workup but may theoretically combine the strengths of both approaches to provide the most comprehensive, noninvasive tool for preoperative staging, with improved sensitivity and accuracy compared to other modalities. This narrative review uses a systematic search of the <i>PubMed</i> database from 2000 to 2025 to analyze MRI and PET, both separately and in synergy, for the local and distant staging of bladder cancer, as well as key technical advancements in these imaging technologies. Synergy of the imaging modalities potentially increases efficacy in bladder cancer staging.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"18 ","pages":"17562872261430967"},"PeriodicalIF":3.5,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New-onset renal impairment following radical nephrectomy for renal cell carcinoma: a retrospective cohort study of clinical, intraoperative, and postoperative risk factors.","authors":"Raouf M Seyam, Alhasan M Abduldaem, Omar N Alfehaid, Abdulrhman M Almaslamani, Fatimah S Alghsham, Noora M Alassaf, Nora M Alghanam, Ahmed G Sayed, Aya I Elnegali, Andrew M Norris, Hassan M Alzahrani","doi":"10.1177/17562872261429816","DOIUrl":"10.1177/17562872261429816","url":null,"abstract":"<p><strong>Background: </strong>Radical nephrectomy is a recommended treatment for localized renal cell carcinoma when partial nephrectomy is not feasible. This approach is typically applied to patients with a normal contralateral kidney and no preexisting chronic kidney disease (CKD).The primary concern with surgery is its potential long-term impact on renal function.</p><p><strong>Objectives: </strong>To assess the risk of development of chronic kidney disease after radical nephrectomy.</p><p><strong>Design and methods: </strong>This is a retrospective cohort study of patients with normal preoperative renal function and contralateral kidney who underwent radical nephrectomy for cancer. At the last follow-up, patients were categorized according to CKD-EPI guidelines as having normal renal function grades G1-2 or impaired renal function grade ⩾G3a. Univariable and multivariable Cox regression analyses were used to identify the significant risk factors for CKD-free survival.</p><p><strong>Results: </strong>We included 135 patients, 49.1 SD 12.9 years old, 62 women (45.9%), and 73 men (54.1%). Preoperative weight was 81 SD 18 kg, and eGFR was 99.2 SD 19.2 mL/min/1.73 m². The last follow-up 32.8 SD 16.8 months later showed that 38 (28.1%) patients developed renal impairment. Univariable analysis showed that preoperatively age in years, age ⩾65, male gender, hypertension, Charlson Comorbidity score, cerebrovascular disease, low preoperative eGFR, serum creatinine, and baseline CKD EPI grade G2 were significant predictors of last follow-up renal impairment. Intraoperatively, anesthesia duration, surgery duration, and postoperatively, within the first 48 hours lower eGFR, creatinine, and CKD-EPI category G3-5 were significant risk factors predicting CKD. After exclusion of colinear risk factors, multivariable analysis, however, indicated that preoperative eGFR (<i>p</i> < 0.027), lower intraoperative nadir MAP (<i>p</i> = 0.006), and postoperative within 48-hour eGFR (<i>p</i> = 0.003) were independent predictors of CKD-free survival at the last follow-up.</p><p><strong>Conclusion: </strong>Significant risk factors for renal impairment after radical nephrectomy were a decreased preoperative eGFR, intraoperative hypotension and, within 48h, postoperative eGFR. No other preoperative or intraoperative risk factor independently predicted CKD.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"18 ","pages":"17562872261429816"},"PeriodicalIF":3.5,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current approaches and innovations in the management of female stress urinary incontinence: presentations from the first International Functional and Reconstructive Urology Update conference.","authors":"Cole Ossian, Sasha Vereecken, Karen Doersch, Suzette E Sutherland","doi":"10.1177/17562872261423774","DOIUrl":"10.1177/17562872261423774","url":null,"abstract":"","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"18 ","pages":"17562872261423774"},"PeriodicalIF":3.5,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical entity of multiple ureteral fibroepithelial polyps with annular stenosis and tortuosity: clinical features and management considerations.","authors":"Xinfei Li, Xiaoteng Yu, Liqing Xu, Fangzhou Zhao, Honggang Ying, Zihao Tao, Xiang Wang, Lianghao Zhang, Zhihua Li, Kunlin Yang, Liqun Zhou, Gang Wang, Xuesong Li","doi":"10.1177/17562872261422952","DOIUrl":"10.1177/17562872261422952","url":null,"abstract":"<p><strong>Background: </strong>Ureteral fibroepithelial polyps (FEPs) are rare. The management of multiple polyps presents unique challenges, particularly when combined with other variants. These complex cases warrant individualized surgical planning.</p><p><strong>Objective: </strong>To characterize a distinct subset of complex ureteral FEPs defined by the triad of multiple annular stenosis, tortuous ureter, and multiple polyps-collectively termed \"MASTUMP,\" and to investigate its clinical, pathological, genetic features, and management considerations.</p><p><strong>Design: </strong>Single-center retrospective study.</p><p><strong>Methods: </strong>This study included nine patients treated for complex ureteral polyps between December 2019 and October 2024. Inclusion criteria required the presence of multiple FEPs (⩾3), ureteral tortuosity, and annular stenosis (⩾50% luminal narrowing). Clinical characteristics, imaging findings, surgical details, histopathology, and whole-exome sequencing (WES) were collected. Surgical outcomes and follow-up data were analyzed.</p><p><strong>Results: </strong>The cohort (77.7% male, mean age 35.1 ± 13.1 years) presented with bilateral (55.5%) or left-sided (44.4%) polyps, with a median lesion length of 4 (range 1-6) cm. All patients had a history of failed endoscopic or surgical management. According to the society of fetal urology grading system, hydronephrosis was classified as grade 1 in one case, grade 2 in three cases, grade 3 in four cases, and grade 4 in one case, with a mean anterior posterior diameter of 2.43 ± 0.88 cm. WES identified mutations in NRIP1 and TSC2 in two patients. Surgical management included segmental ureterectomy with reconstruction via ureteroureterostomy (two cases), pelvic flap (one case), lingual mucosal graft (one cases), and ileal ureter replacement (five cases). Over a median follow-up of 46.3 (range 11.5-75.4) months, no recurrences were observed.</p><p><strong>Conclusion: </strong>MASTUMP syndrome represents a clinical entity within complex ureteral polyps, potentially associated with congenital anomalies of the kidney and urinary tract. Endoscopic treatment carries a high risk of recurrence and should be approached with caution. Surgical resection with individualized reconstructive strategies offers durable outcomes. Further genetic studies and multicenter validation are essential to refine diagnostic criteria and treatment strategies.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"18 ","pages":"17562872261422952"},"PeriodicalIF":3.5,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness, use, and perceived barriers to artificial intelligence in pediatric urology: a multicenter survey.","authors":"Kursat Kucuker, Aykut Akinci, Mesut Berkan Duran, Melike Guzeller, Okan Turktur, Sinan Celen, Yusuf Ozlulerden, Berk Burgu","doi":"10.1177/17562872261422939","DOIUrl":"10.1177/17562872261422939","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) and large language models (LLMs) are increasingly integrated into healthcare, yet their adoption in pediatric urology remains insufficiently explored. Pediatric urology, with its complex and rare conditions, may particularly benefit from AI-based innovations.</p><p><strong>Objectives: </strong>This study aimed to assess pediatric urologists' awareness, usage patterns, and perceptions regarding AI and LLMs, while also identifying potential applications, barriers, and educational needs.</p><p><strong>Design: </strong>A cross-sectional, descriptive survey was conducted among pediatric urologists.</p><p><strong>Methods: </strong>Between May and July 2025, a 21-item questionnaire was distributed via professional networks and mailing lists. Items addressed demographics, knowledge of AI, frequency and purpose of AI and LLM use, perceived clinical and surgical applications, ethical concerns, and interest in AI training. Descriptive statistics were used for analysis.</p><p><strong>Results: </strong>Of 368 invited pediatric urologists, 103 (28%) responded. Most reported moderate (35.0%) or low (29.1%) knowledge of AI, yet more than half (51.5%) used AI tools daily. LLMs had been used by 96.1% of participants, mainly for scientific writing (78.8%), language editing (54.5%), and text summarization (46.5%). Surgical simulation (46.6%), imaging-based strategy planning (40.8%), and preoperative planning (36.9%) were identified as promising clinical applications. Barriers included lack of trust (52.4%), ethical concerns (43.7%), and insufficient knowledge (35.0%). A strong interest in structured AI training was expressed by 81% of participants. Although responses were obtained from multiple countries, the majority of participants were based in Turkey, and the findings should be interpreted accordingly.</p><p><strong>Conclusion: </strong>Pediatric urologists demonstrate substantial engagement with AI in academic work, while clinical integration is still limited. The findings highlight a strong demand for AI education and emphasize the need for regulatory clarity, ethical frameworks, and validated tools to enable safe and effective use of AI in pediatric urology.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"18 ","pages":"17562872261422939"},"PeriodicalIF":3.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12907479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary mucinous adenocarcinoma of the urethra: a diagnostic conundrum - two case reports and literature review.","authors":"Elspeth Jamieson, Amit Goel, Nicola Lancaster, Amanda Clarke, Sanjeev Madaan","doi":"10.1177/17562872261424118","DOIUrl":"10.1177/17562872261424118","url":null,"abstract":"<p><p>Primary mucinous adenocarcinoma (PMAC) of the urethra is an exceptionally rare subtype of primary urethral carcinoma, with limited published data to guide diagnosis or treatment. Most literature consists of isolated case reports, and the non-specific presentation often delays diagnosis. This report presents two further cases and a review of the literature with a view to expand current understanding. We report two cases of PMAC. The first involves a 67-year-old male with progressive lower urinary tract symptoms initially treated as benign prostatic hyperplasia. Histology following a transurethral resection of the prostate revealed invasive mucinous adenocarcinoma with enteric features. He underwent radical prostatectomy, chemotherapy and radiotherapy for metastatic disease. The second case is a 52-year-old female with chronic urinary symptoms and a urethral mass initially misattributed to being from gynaecological origin. However, a biopsy later confirmed mucinous adenocarcinoma of the urethra. She underwent chemotherapy and radiotherapy, with partial response, but later developed further metastatic spread and is now undergoing palliative chemotherapy. PMAC is aggressive, often presents with non-specific urinary symptoms and lacks standardised diagnostic or treatment protocols. These cases highlight the importance of early detection through biopsies, immunohistochemical analysis and a multidisciplinary approach. Broader awareness and further reporting of cases are essential to develop evidence-based diagnostic and treatment guidelines for this rare malignancy.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"18 ","pages":"17562872261424118"},"PeriodicalIF":3.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12907476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}