Urologia Journal最新文献

{"title":"Totally tubeless percutaneous nephrolithotomy versus standard percutaneous nephrolithotomy in the treatment of renal stones: An updated systematic review and meta-analysis.","authors":"Mudasar Nisar, Rabia Javed Iqbal, Muhammad Mujtaba Rasool, Noor Ul Ain Saleem, Ahmed Raza, Anum Zia Khan, Bhopesh Kadian, Muhammad Fakhir Iftikhar Rana, Preety Prasad, Naveen Kumar","doi":"10.1177/03915603261445139","DOIUrl":"10.1177/03915603261445139","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous nephrolithotomy (PCNL) is a standard surgical procedure for kidney stone removal. Totally tubeless PCNL is a variation in technique in which neither an indwelling ureteric stent nor a nephrostomy tube is placed postoperatively. This meta-analysis compares the efficacy and safety of totally tubeless PCNL with standard PCNL.</p><p><strong>Methods: </strong>PubMed, Scopus, Cochrane Library, and clinicaltrials.gov databases were searched until January 2025. The primary outcomes were stone-free rate, operative time and hospital stay while secondary outcomes were hemoglobin (Hb) drop, total complication rates and blood transfusion. Effect sizes were calculated using fixed and random-effects models, expressed as mean difference (MD) or risk ratio (RR) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>21 studies with 2837 patients were included in this study. Totally tubeless PCNL was associated with significantly shorter operative time (WMD) = -7.96, 95% CI = -12.95 to -2.98, <i>p</i> < 0.01) and reduced hospital stay (WMD = -1.53, 95% CI = -2.12 to -0.93, <i>p</i> < 0.01). The stone-free rate was comparable between the two techniques (RR = 1.02, 95% CI = 0.95-1.10, <i>p</i> = 0.51). A significant reduction in total complications was observed in the totally tubeless group (RR: 0.63, 95% CI: 0.44-0.90, <i>p</i> = 0.02). However, no significant differences were observed in terms of hemoglobin drop (WMD: -0.36, 95% CI: -0.79 to 0.08, <i>p</i> = 0.11) or blood transfusion rates (RR: 0.77, 95% CI: 0.45-1.32, <i>p</i> = 0.30). Meta-regression suggested that stone size was not a significant predictor of procedural success or duration.</p><p><strong>Conclusion: </strong>Compared to standard PCNL, totally tubeless PCNL shortens operation time and hospital stay and lowers complication rates, with equivalent stone-free efficacy. These findings support its use as a preferred technique for appropriately selected patients.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"573-590"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectrum of genital findings in ART-conceived male neonates: A blinded case series analyzing parental reproductive history.","authors":"Yuriy N Solontsov, Vasily V Nikolaev, Tatiana A Nazarenko","doi":"10.1177/03915603261457789","DOIUrl":"10.1177/03915603261457789","url":null,"abstract":"<p><strong>Background and objectives: </strong>An increase in genital abnormalities in boys born via assisted reproductive technologies (ART) is possibly linked to either the technical aspects of ART or parental health, regardless of the type of ART procedure. This study aimed to describe the spectrum and prevalence of genital findings in ART-conceived male infants and to identify potential modifiable factors associated with genital development in this subpopulation.</p><p><strong>Methods: </strong>An observational, exploratory/hypothesis-generating case series was conducted from August 2006 to July 2007. A total of 294 consecutively born male neonates were examined by a single urologist blinded to conception method. From this cohort, 71 infants conceived via ART were identified. Obstetrician-gynecologists retrieved detailed data on parental reproductive history and newborn health status. A nested comparative analysis was performed within the ART group, using the adjusted Wald-method and the two-sided Fisher's exact test.</p><p><strong>Results: </strong>Forty boys (56%) in the study group had normal genitalia, whereas 31 (44%) displayed abnormalities. Singleton pregnancy was a significant protective factor for normal genitalia (<i>p</i> = 0.004), while a non-significant trend was observed for the absence of maternal abnormalities other than obstructive infertility (<i>p</i> = 0.282). Hypospadias prevalence (4.2%), in contrast to cryptorchidism and inguinal hernia, exceeded general population rates (0.06%-0.7%) and was an order of magnitude higher than in Denmark and Sweden (0.3%-0.4%). This increased prevalence was associated with male factor infertility (<i>p</i> = 0.041) and with maternal subfertility in the form of preterm labor (<i>p</i> = 0.032). The complex of penile malformations were linked to maternal endocrine infertility (<i>p</i> = 0.033), dizygotic twins (<i>p</i> = 0.014), and preterm labor (<i>p</i> = 0.017), with non-significant trend for threatened miscarriage (<i>p</i> = 0.107).</p><p><strong>Conclusion(s): </strong>This blinded case series reveals a distinct spectrum of genital findings in ART-conceived neonates, with high hypospadias prevalence. Penile development appears primarily linked to parental fertility issues and preterm labor. Singleton pregnancy is likely a strong protective factor. These findings indicate underlying parental subfertility as the potential determinant of genital malformation risk, with ART procedures as a possible confounder.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"830-837"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing forgotten double J stents: Lessons learned from a tertiary care center.","authors":"Devashish Kaushal, Viswas Raghavendra Marathi, Kumar Madhavan, Amrut Phonde, Shushant Shandilya","doi":"10.1177/03915603261447148","DOIUrl":"10.1177/03915603261447148","url":null,"abstract":"<p><strong>Introduction: </strong>Double-J (DJ) stents find extensive use in Endourology. Nevertheless, occurrence of forgotten stents is not uncommon. This retrospective study details our encounters in handling forgotten stents and outlines the measures we have implemented to mitigate morbidity associated with DJ stents.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of hospital records of cases with Forgotten DJ stents from Jan 2021 to Jan 2025. The details reviewed included age, sex, indication for stenting, duration of the indwelling stent, presenting complaints, management, and complications.</p><p><strong>Results: </strong>Of the total of 35 patients, the mean patient age was 46.8 years (14-70 years). The male-to-female ratio was 4:3 (20 males and 15 females). The mean indwelling time was 35.8 months. Flank pain was the commonest symptom (72.7%), followed by storage lower urinary tract symptoms (54.5%) and dysuria (50%). Complicated stents were noted in 17 patients (48.5%), whereas uncomplicated stents were noted in 18 patients (51.5%). All 18 \"uncomplicated\" stents could be removed cystoscopically, while complicated stents were removed by the combination of endourological techniques mainly, while two patients underwent laparoscopic nephrectomy in which one of them needed open cystolithotomy also.</p><p><strong>Conclusion: </strong>The issue of forgotten DJ stents remains a prevalent problem in developing countries, causing significant morbidity and financial burdens for patients. Stent registers and electronic stent extraction reminders helps us to minimize the incidence of forgotten stents.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"744-752"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical study of NLRP3 inflammasome, IL-18 and some biochemical markers in patients with chronic kidney diseases (CKD).","authors":"Nada Hussain Alwan, Hadeel Rashid Faraj","doi":"10.1177/03915603261448982","DOIUrl":"10.1177/03915603261448982","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a major global health concern associated with high morbidity, mortality, and healthcare costs. Inflammation and electrolyte imbalances play critical roles in the progression of CKD. The NLRP3 inflammasome and interleukin-18 (IL-18) are key inflammatory mediators implicated in renal damage.</p><p><strong>Objectives: </strong>This study aimed to evaluate serum levels of circulating NLRP3 (soluble NLRP3, sNLRP3), IL-18, and selected electrolytes (sodium, potassium, calcium, chloride, and phosphate) in patients with CKD compared to healthy individuals. Additionally, correlations between these parameters were assessed.</p><p><strong>Methods: </strong>A total of 90 patients with CKD (defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m², corresponding to CKD stages 3-4) and 85 age- and sex-matched healthy controls (aged 30-75 years) were enrolled. Serum levels of circulating NLRP3 protein (reflecting activation of the NLRP3 inflammasome pathway), IL-18, and electrolytes were measured and analyzed using appropriate biochemical and immunoassay methods. Statistical comparisons and correlation analyses were conducted.</p><p><strong>Results: </strong>Patients with CKD showed significantly elevated serum levels of circulating NLRP3, IL-18, potassium, chloride, and phosphate compared to controls (<i>p</i> < 0.05). In contrast, serum sodium and calcium levels were significantly decreased in CKD patients (<i>p</i> < 0.05). A significant correlation was found between NLRP3 inflammasome levels and the concentrations of measured electrolytes and IL-18.</p><p><strong>Conclusions: </strong>The findings suggest that activation of the NLRP3 inflammasome pathway, as reflected by increased circulating NLRP3 levels is associated with systemic inflammation and electrolyte disturbances in CKD. These parameters may serve as potential biomarkers for monitoring disease progression and inflammation in CKD patients.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"653-658"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum micronutrient levels in men with prostate carcinoma: An observational study at a tertiary care health facility.","authors":"Nitish Pareek, Nachiket Vyas, Shivam Priyadarshi, Neeraj Agarwal","doi":"10.1177/03915603261450687","DOIUrl":"10.1177/03915603261450687","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate cancer is the second most commonly diagnosed cancer and the fifth leading cause of cancer-related mortality among men worldwide. The role of trace elements in prostate cancer remains a subject of ongoing research, with elements like selenium and zinc potentially protective, whereas copper, iron, and calcium may contribute to carcinogenesis.</p><p><strong>Objective: </strong>To assess serum micronutrient levels in newly diagnosed prostate cancer patients and compare them with healthy controls.</p><p><strong>Materials and methods: </strong>This hospital-based comparative observational study was conducted in the Department of Urology, at a tertiary care facility, Jaipur over two years after obtaining ethical approval. A total of 80 prostate cancer patients and 80 controls were included. Exclusion criteria included smoking, chronic alcohol consumption, diabetes, and recent antioxidant or illicit drug use. Clinical parameters, including BMI and PSA levels, were recorded. Serum concentrations of copper, magnesium, zinc, iron, calcium, and selenium were analyzed using standardized laboratory methods.</p><p><strong>Results: </strong>Prostate cancer patients exhibited significantly lower serum selenium (82.50 ± 16.76 mcg/L) and zinc (56.98 ± 15.25 mcg/dl) levels compared to controls (<i>p</i> < 0.05). Conversely, serum copper (129.13 ± 22.41 mcg/dl), iron (145.44 ± 39.41 mcg/dl), and calcium (9.50 ± 1.01 mcg/dl) were significantly elevated in cases (<i>p</i> < 0.05). Magnesium levels were slightly higher in cases but not statistically significant.</p><p><strong>Conclusion: </strong>The findings indicate significant alterations in serum micronutrient levels in prostate cancer patients, with lower selenium and zinc levels and elevated copper, iron, and calcium concentrations. Further large-scale, multicentric studies are warranted to validate these findings and explore the potential role of micronutrient supplementation.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"694-698"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective cohort study to assess the diagnostic accuracy of VI-RADS score in a tertiary center in central India.","authors":"Sagar Yadav, Kumar Madhavan, Aakash Yadav, Udit Khurana, Manoj Yadav, Shubham Singh Bais","doi":"10.1177/03915603261450690","DOIUrl":"10.1177/03915603261450690","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate preoperative differentiation between non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) is critical for selecting appropriate therapy. We prospectively evaluated the diagnostic performance of multiparametric MRI (mpMRI) using the Vesical Imaging-Reporting and Data System (VI-RADS) for predicting pathological muscle invasion in patients with suspected bladder tumors.</p><p><strong>Methods: </strong>In this prospective cohort study, 102 consecutive adults with suspected bladder mass were enrolled; 53 patients formed the final analytic cohort (24 MIBC, 29 NMIBC). mpMRI was performed on a 3T scanner; the highest VI-RADS score was used for patients with multiple lesions. Two blinded radiologists assigned VI-RADS scores. The reference standard was histopathology obtained after Transurethral resection of bladder tumor. Diagnostic performance metrics were calculated with 95% confidence intervals, and area under curve (AUC) analysis was performed.</p><p><strong>Results: </strong>All mpMRI scans were interpretable, with no serious adverse events. Muscle invasion was observed in 37.5% of VI-RADS 4 lesions and 94.7% of VI-RADS 5 lesions. At VI-RADS ⩾ 3, sensitivity was 100% and specificity 37.9% (accuracy 66.0%; AUC 0.69). At VI-RADS ⩾ 4, sensitivity remained 100% with improved specificity 62.1% (accuracy 79.2%; AUC 0.81). Using VI-RADS 5 as positive yielded specificity 96.6% with sensitivity 75% (accuracy 86.8%; AUC 0.86).</p><p><strong>Conclusion: </strong>VI-RADS on mpMRI demonstrated excellent sensitivity for ruling out MIBC at lower thresholds, while higher thresholds improved specificity for ruling in muscle invasion. These findings support VI-RADS-guided preoperative risk stratification, with larger multicenter validation warranted.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"682-687"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of selective arterial embolization in giant renal angiomyolipoma: A retrospective single-center study.","authors":"Uday Pratap Singh, Kunj B Patel, Ashish Ranjan, Arpan Yadav, Sanchit Rustagi, Sanjoy Kumar Sureka","doi":"10.1177/03915603261450679","DOIUrl":"10.1177/03915603261450679","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the long-term outcomes of selective trans-arterial embolization (SAE) in patients with giant (⩾10 cm in size) renal angiomyolipomas (AMLs) at our tertiary referral center.</p><p><strong>Patients and methods: </strong>This retrospective, single-center study included 44 patients who underwent SAE for AMLs of ⩾10 cm size between July 2018 and June 2024. Collected data included demographics, tumor characteristics, clinical symptoms, type of intervention, tumor size before and after embolization, and renal function. Outcomes assessed were tumor size reduction, preservation of renal function, reintervention rates during follow-up and complications following SAE.</p><p><strong>Results: </strong>The study included 46 tumors in 44 patients. Mean patient age was 40.4 years (range: 23-60), with 86.3% being females. Mean follow-up duration was 25.2 months (range: 6-70 months). Eleven patients (25%) were associated with TSC, and all were offered Everolimus postoperatively. The mean tumor size decreased significantly from 13.2 ± 3.12 cm pre-embolization to 10.3 ± 2.45 cm post-embolization (<i>p</i> = 0.003). Renal function remained stable during follow-up, with no significant changes in serum creatinine (<i>p</i> = 0.6) and eGFR (<i>p</i> = 0.8). The overall success rate was 84.7%, with 13.6% experiencing re-intervention. Complications included post-embolization syndrome (43.1%) and allergic reactions (6.8%), while one patient required nephrectomy due to a perinephric abscess.</p><p><strong>Conclusion: </strong>Selective Trans-arterial Embolization is a safe and effective treatment for giant renal AMLs, resulting in significant tumor size reduction, symptom relief, and preservation of renal function. It offers a minimally invasive alternative to traditional surgical approaches, particularly for patients with high surgical risk or those requiring nephron-sparing procedure.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"659-668"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiomics empowers predictive drug resistance in advanced prostate cancer.","authors":"Abhimanyu Agrawal, Archit Goel, Suresh Kumar Goyal, Mintu Pal","doi":"10.1177/03915603261457521","DOIUrl":"10.1177/03915603261457521","url":null,"abstract":"<p><p>Prostate cancer (PCa) remains a leading cause of cancer-related morbidity and mortality among men worldwide, with advanced stages often exhibiting resistance to standard therapies. Drug resistance in advanced prostate cancer is a multifactorial process influenced by genetic mutations, hereditary factors, epigenetic alterations, lifestyle choices, and dietary habits. Understanding this complex interplay is crucial for developing effective predictive and therapeutic strategies. In this context, a multiomics approach integrating genomics, transcriptomics, proteomics, metabolomics, and epigenomics offers a comprehensive framework to dissect the molecular mechanisms driving drug resistance.Current challenges include tumor heterogeneity, limited access to longitudinal patient data, and insufficient representation of diverse populations in omics datasets. This study highlights the novel application of multiomics integration to stratify patient subgroups based on molecular signatures, enabling early prediction of therapy resistance. We also emphasize key biomarkers and signaling pathways associated with treatment failure, including alterations in androgen receptor signaling, PI3K-AKT-motor pathways, and metabolic rewiring. The integration of these datasets not only enhances diagnostic precision but also aids in identifying actionable therapeutic targets. It also opens up new avenues for developing targeted therapies by integrative profiling and quantifying a broad spectrum of biomolecular features across distinct subtypes of malignant cells.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"713-729"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Premature ejaculation: A comprehensive urological review of current evidence-based management strategies.","authors":"Maachi Youssef, Slaoui Amine, Karmouni Tariq, Koutani Abdellatif, Elkhader Khalid","doi":"10.1177/03915603261454170","DOIUrl":"10.1177/03915603261454170","url":null,"abstract":"<p><p>Premature ejaculation (PE), acquired or lifelong, is a ubiquitous male sexual dysfunction with profound psychosexual morbidity. Accurate diagnosis requires integration of symptom timing, perceived ejaculatory control, partner perspective, and comorbidities, notably erectile dysfunction, alongside validated patient-reported outcomes; IELT, while a useful objective metric for severity grading, is insufficient as a standalone diagnostic criterion. Initial therapy is on-demand topical anesthetics and dapoxetine, with enhanced durability when combined with psychosexual therapy. Off-label SSRIs produce a modest but clinically meaningful delay in ejaculatory latency, limited by side effects and poor long-term adherence. PDE5 inhibitors demonstrate increasing efficacy particularly in combination with co-existing erectile dysfunction and combination treatment regimens optimize overall outcomes. No surgical intervention is currently endorsed by international guidelines, though frenulectomy may increase IELT in selected cases and selective dorsal neurectomy remains investigational. Device-based approaches including perineal transcutaneous electrical stimulation and pelvic floor rehabilitation show early promise in peer-reviewed trials, but remain investigational pending larger controlled studies. The literature was systematically searched across PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science (January 2005 to October 2025). Harmonized definitions, inclusive diagnostic criteria, and standardized outcome measures remain high priorities for future research.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"621-633"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of AI in prostate cancer care: Assessing the role of chatbots versus urologists in patient communication and empathy.","authors":"Loris Cacciatore, Antonio Minore, Pierangelo Contessa, Gianluigi Raso, Antonio Rosario Iannello, Rocco Papalia, Francesco Esperto","doi":"10.1177/03915603261446425","DOIUrl":"10.1177/03915603261446425","url":null,"abstract":"<p><strong>Objective: </strong>To date, the integration of artificial intelligence (AI) in healthcare has expanded rapidly, offering new tools for patient education and communication. In prostate cancer (PCa), where information needs are high and emotionally sensitive, AI-driven chatbots (CB) may enhance patient engagement. This study aims to compare the performance and perceived quality of responses from CB versus urologists (URO) to common PCa-related inquiries.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 20 frequently asked PCa general questions. Responses were generated by two AI-based CB and four certified URO in a simulated clinical messaging setting, without direct patient interaction. Expert reviewers first assessed each response for medical accuracy and completeness. Then, five blinded non-medical evaluators rated the responses using Likert scales to evaluate completeness (1-5), empathy (using a five-item adaptation of the Jefferson Scale), and overall preference.</p><p><strong>Results: </strong>A total of 600 responses were evaluated. Accuracy and completeness scores were comparable between CB and URO responses, according to experts' evaluations (<i>p</i> = 0.45 and <i>p</i> = 0.12). However, CB responses scored significantly higher in completeness and empathy (both <i>p</i> < 0.001) for non-medical evaluators. Moreover, a statistically significant preference for overall CB-generated responses over those from urologists, was demonstrated (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>While CB responses were as accurate as those from URO, they outperformed in completeness and empathy. These results suggest that AI-based CB could serve as effective tools in enhancing patient communication and satisfaction and may be a valuable complement to urologist-led care in clinical practice.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"688-693"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}