Abstract:

Background/Objectives: Surgical refinements in robot-assisted partial nephrectomy (RAPN) aim to reduce morbidity and optimize renal function preservation, particularly in patients with high-complexity renal tumours. This study describes the no-touch adaptive technique for RAPN and compares its perioperative outcomes, postoperative complications, and early renal function with those of the conventional approach. Methods: A cohort of 72 consecutive patients with high-complexity renal tumours undergoing RAPN was evaluated. The study group included 38 patients treated with the no-touch adaptive technique, while 34 patients underwent the conventional approach. The no-touch adaptive technique consisted of sutureless, off-clamp simple tumour enucleation with incremental haemostasis and the option to shift to arterial clamping, tumour enucleoresection, or renorrhaphy as needed. The conventional technique involved on-clamp minimal enucleoresection with double-layer renorrhaphy. Outcomes assessed included completion of a fully no-touch procedure, perioperative metrics, 90-day postoperative complications, and 3-month renal function change from baseline. Results: Baseline characteristics were comparable between groups. A fully no-touch RAPN was achieved in 30/38 (79%) patients. Adaptation was required in eight cases: shift to main arterial clamping (n=2), renorrhaphy (n=5), or both (n=1), with one conversion to total nephrectomy due to intractable bleeding. Estimated blood loss was similar between groups (study: 150 ml [IQR 75–250] vs. control: 180 ml [IQR 100–400]). Length of stay was significantly shorter in the study group (3 days [IQR 3–4]) compared with controls (5 days [IQR 6–8]). Any-grade 90-day complications were significantly lower with the no-touch technique (21% vs. 56%, p<0.01). Clinically significant 3-month eGFR decline occurred in 14% of controls versus 0% of study patients (p = 0.02). Conclusions: The no-touch adaptive RAPN technique is feasible in high-complexity renal tumours and provides reduced morbidity and superior early renal function preservation compared with the conventional approach.

Abstract: In synthetic aperture radar (SAR), low-power radiofrequency measurements from different antennae are combined to emulate a larger aperture. In the near-field below 6 GHz, SAR exploits the dielectric contrast between urine and the surrounding pelvic tissues to estimate bladder volume (BV). Herein, we describe and technically ground a wearable belt-SAR for contactless monitoring in urology and robotic surgery. The flexible belt carries 12–16 radiofrequency modules with time-division multiple-input/multiple-output frequency-modulated continuous-wave acquisition. Per-channel range spectra are fused with near-field back-projection or time-reversal, followed by segmentation and ellipsoidal model-fitting to estimate BV. Motion and posture are handled with inertial-measurement-unit gating. Benchwork relies on layered pelvic dielectric phantoms referenced to standard tissue-property datasets; clinical evaluation is planned versus handheld three-dimensional ultrasound with predefined BV thresholds. Belt-SAR may yield feasible axial and lateral resolution for centimeter-depth targets and stable reconstructions under breath-gated acquisition. It is designed to meet a BV absolute-error target of ≤80 mL over 100–600 mL. Use-case analyses suggest applicability in urinary-retention pathways, prostate-radiotherapy setup, community/long-term care, and intraoperative monitoring during robot-assisted urologic procedures. Belt-SAR may complement ultrasound for BV assessment, offering benefits in workflow, infection-prevention strategies, and patient experience. Regulatory compliance and prospective clinical validation are the next milestones.

Abstract: Sarcopenia is characterized by the progressive loss of muscle mass and function, and it represents a significant and prevalent condition in patients undergoing peritoneal dialysis (PD). However, limited research has been conducted to document techniques for the early detection of sarcopenia in PD patients. This review addresses the pathophysiology, prognostic implications, and various assessment techniques for sarcopenia, including creatinine kinetics, anthropometry, imaging techniques (computer tomography, magnetic resonance imaging, and ultrasound sonography), bioimpedance spectrometry, and the modified creatinine index. Each of these techniques presents unique strengths and limitations, necessitating careful consideration of the most appropriate assessment method based on specific clinical conditions. By synthesizing current knowledge, this review aims to evaluate the strengths and limitations of available muscle-assessment techniques and assist in the development of improved diagnostic strategies for sarcopenic PD patients.

Abstract: Background: Assisted reproductive therapy (ART) has been utilized as an effective therapeutic strategy for addressing infertility worldwide, and one of the key determinants of ART success is the acquisition of high-quality embryos through in vitro fertilization (IVF). We investigated here which male factors were associated with embryo formation and quality in conventional IVF (cIVF). Methods: This study was an exploratory sub-analysis of a trial conducted to examine the associations of clinical and lifestyle factors with sperm abnormalities in 41 men of infertile couples without identifiable male factors. From the original cohort, 21 men whose partners underwent cIVF were included for blastocyte outcome assessment. Semen samples were evaluated for standard sperm parameters and DNA fragmentation index (DFI). Blood biochemical parameters and lifestyle habits were also evaluated. Blastocysts were assessed 5 days after cIVF, and implantation success was determined 10 days after embryo transfer. Results: All participants showed normozoospermia with mild sperm DFI in 76%. Blastocysts were formed in 32% of the oocytes following cIVF, with good blastocyst development and quality observed in 71% and 39%, respectively. The implantation success and live birth rates after embryo transfer was 53% and 43%, respectively. Regression analysis identified sperm DFI as the only variable inversely associated with all blastocyst outcomes. In contrast, no parameters were associated with implantation success or live birth rates. Conclusions: The present findings suggest the hypothesis that sperm DNA fragmentation may negatively affect high-quality embryo formation in cIVF, even among normozoospermic men with non-severe levels of sperm DFI.

Abstract: Chronic kidney disease (CKD) is a growing global health burden for which there are no curative treatments; therefore, it is essential to implement preventive and kidney-protective strategies. The renal kallikrein-kinin system (KKS) is a vasodilator, anti-inflammatory, and antifibrotic pathway located in the distal nephron, whose decline contributes to hypertension and CKD progression. A thorough evaluation of both experimental and clinical data was undertaken to ascertain the interactions between dietary potassium, renal KKS activity, and kidney protection. A particular focus was placed on animal models of proteinuria, tubulointerstitial damage, and salt-sensitive hypertension, in conjunction with human studies on potassium intake and renal outcomes. Experimental models show that potassium-rich diets stimulate renal kallikrein synthesis, increase urinary kallikrein activity, and up-regulate kinin B₂ receptor expression, leading to reduced blood pressure, oxidative stress, apoptosis, inflammation, and fibrosis. These effects are lost with B₂ receptor blockade. In humans, higher potassium intake enhances kallikrein excretion and lowers cardiovascular and renal risk, independently of aldosterone, and low potassium intake has the potential to exacerbate CKD progression. Notwithstanding the concerns that have been raised regarding the potential necessity of increasing potassium intake in cases of advanced CKD, extant evidence would appear to indicate that potassium excretion persists until late disease stages. Activation and preservation of the renal KKS through a potassium-rich diet represents a rational, low-cost renoprotective strategy. Combined with sodium reduction and nutritional education, this approach could mitigate CKD progression and improve cardiovascular health on a population scale.

Abstract: Background: Arteriovenous fistula (AVF) occlusion remains a major cause of vascular access failure in hemodialysis patients. Early identification of high-risk patients may help prevent complications and improve outcomes. Methods: This retrospective cohort study included 1,498 adult patients who underwent AVF creation between 2015 and 2025 at Daegu Catholic University Medical Center. Clinical, surgical, and laboratory variables were used to develop machine learning (ML) models for predicting AVF occlusion. Five algorithms—LightGBM, CatBoost, XGBoost, Random Forest, and Logistic Regression—were trained and evaluated using stratified 5-fold cross-validation. Model performance was assessed using area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and calibration. SHAP (Shapley Additive Explanations) analysis was used to interpret variable importance. Results: Among the 1,498 patients, 381 (25.4%) experienced AVF occlusion. LightGBM achieved the best performance (AUC = 0.887, accuracy = 0.858, specificity = 0.950), followed by CatBoost (AUC = 0.882) and XGBoost (AUC = 0.879). Calibration analysis demonstrated strong agreement between predicted and observed outcomes. SHAP analysis identified ferritin, hemoglobin, neutrophil percentage, and C-reactive protein as the most influential predictors, highlighting the role of inflammation and hematologic status in AVF failure. Conclusions: Gradient boosting–based ML models, particularly LightGBM and CatBoost, accurately predict AVF occlusion using routine clinical data. Explainable AI methods enhance interpretability, enabling early identification of high-risk patients and supporting precision vascular access management in hemodialysis care.

Abstract: Background/Objectives: Prostate cancer is the most prevalent malignancy in men and remains a leading cause of cancer-related mortality worldwide. Conventional imaging modalities exhibit limited sensitivity, particularly in the context of disease recurrence and advanced disease. Methods: A narrative review was conducted of studies published between 2015 and 2025, identified through PubMed, Embase, and Cochrane. Eligible publications addressed advanced imaging techniques, PSMA-targeted diagnostics and therapies, radiogenomics, liquid biopsy approaches, and artificial intelligence applica-tions and personalized medicine. Preclinical studies, single case reports, and conference abstracts without full text were excluded. Results: PSMA PET/CT outperforms conven-tional imaging for detection, and restaging, influencing clinical management across disease stages. Lutetium-177–PSMA-617 has become the standard radioligand therapy for metastatic castration-resistant prostate cancer, whereas alpha-emitting agents remain under clinical investigation. Radiogenomics and liquid biopsy assays (ctDNA, CTCs, AR-V7) provide complementary molecular insights. Artificial intelligence enhances imaging interpretations, standardization, and reproducibility, while multimodal data integration supports individualized risk stratification. Integrative models combining imaging, genomic, and liquid biopsy data pave the way toward precision oncology and personalized therapeutic decision-making. Conclusions: Advances in imaging and theragnostics are reshaping prostate cancer management, bridging the gap between molecular biology and clinical practice to enable precision oncology.

Abstract: Background: Recurrent urinary tract infections (rUTIs) in children are increasingly complicated by antimicrobial resistance, leading to limited treatment options and chal-lenging prophylactic management. Continuous local monitoring of resistance trends is essential for evidence-based stewardship. Methods: This retrospective study analysed 130 episodes of recurrent paediatric UTI recorded between 2020 and 2024 at a tertiary hospital in Romania. Data were extracted using the ICD-10 code N39.0 and included demographic, clinical, and microbiological variables. Antimicrobial susceptibility testing followed CLSI standards. Associations between multidrug resistance (MDR) and clinical factors were assessed with χ² tests and Cramer’s V, and predictors of MDR were evaluated by multivariable logistic regression. Temporal trends in resistance were examined using logistic regression with year as a continuous variable, and results were validated with the non-parametric Cochran–Armitage linear-by-linear χ² trend test to strengthen analytical rigor. Proportions are presented with Wilson 95% confidence intervals (CIs). Results: MDR occurred in 48.5% of isolates (95% CI, 40.2–56.9) and ESBL in 20.9% (95% CI, 14.9–28.5). MDR was significantly associated with urinary tract malformations (χ² = 5.78, p = 0.016) and continuous antibiotic prophylaxis (χ² = 4.23, p = 0.040). Neither logistic nor Cochran–Armitage trend analyses demonstrated a significant temporal increase in MDR (OR per year = 0.94; 95% CI 0.75–1.17; p = 0.566; χ² = 0.89; p = 0.346). Conclusions: MDR and ESBL rates among children with recurrent UTIs remain high but stable. The combined use of parametric and non-parametric trend analyses confirmed the absence of a significant upward trajectory, underscoring the need for ongoing surveillance and stewardship to maintain antibiotic effectiveness in paediatric care.

Abstract: Over recent decades, percutaneous nephrolithotomy (PCNL) has risen as a primary treatment method, firmly establishing itself as the cornerstone approach for handling large kidney stones. Postoperative bleeding commonly stems from arteriovenous fistula (AVF), which is a connection formed between a damaged artery with high flow and a damaged vein with low flow, and pseudoaneurysm (PA), which involves arterial blood leaking into the tissue, causing a localized hematoma. The preferred technique for addressing such vascular complications is selective trans-arterial angioembolization, widely regarded as the gold standard. In this article, we present the case of a 42-year-old woman who experienced delayed bleeding eight years after PCNL and a previous angi-oembolization. The patient presented macroscopic hematuria, and further investigations, such as cystoscopy, contrast-enhanced abdomino-pelvic CT, and angiography, were performed. To stop the bleeding, we identified and performed selective angioembolization (SAE) with the embolization of a small arterial vessel arising from an inferior branch of the right renal artery. To the best of our knowledge, this is the initial documented instance of delayed bleeding manifesting eight years post-PCNL and angioembolization. This occurrence is exceptionally uncommon, given that the patient displayed no urological signs or symptoms throughout the intervening years, and no predictive or risk factors were identified.

Abstract: Background: Non-muscle invasive bladder cancer (NMIBC) has limited therapeutic op-tions and high recurrence rates. Photoimmunotherapy (PIT) enables targeted tumor abla-tion using antibody–photosensitizer conjugates and light activation. We evaluated EGFR, Nectin-4, and TROP-2 as PIT targets using cysteine-modified antibodies conjugated to the photosensitizer WB692-CB2. Methods: Antibodies derived from Cetuximab (Cmb, an-ti-EGFR), Enfortumab (Enf, anti-Nectin-4), and Sacituzumab (Sac, anti-TROP-2) were en-gineered with T120C and D265C mutations in the heavy chains for site-specific dye con-jugation. Binding and light-induced cytotoxicity of the conjugates, alone or in combina-tion, were assessed in BC cells by flow cytometry and viability assays following irradia-tion. Results: Cysteine-modified antibodies were produced as intact IgG molecules and ef-ficiently conjugated with WB692-CB2 without loss of antigen specificity. SacT120C/D265C-WB692-CB2 showed the highest target binding and achieved near-complete cell killing at a red light dose of 32 J/cm². CmbT120C/D265C-WB692-CB2 required a fourfold higher light dose for comparable efficacy, while EnfT120C/D265C-WB692-CB2 showed lower potency. No cytotoxicity was observed in antigen-negative cells. Combined treatment en-hanced cytotoxicity, indicating additive phototherapeutic effects. Conclusions: SacT120C/D265C-WB692-CB2 represents a highly effective PIT conjugate for NMIBC. Our find-ings support PIT as a promising, targeted, and minimally invasive therapeutic option for BC, potentially adaptable for combinatorial or personalized strategies.

Abstract: Background: Patients on chronic hemodialysis (HD) have significantly higher mortality rates than the general population, which is aggravated by diabetes (DM). Suboptimal extracellular fluid management increases the CV risk in HD patients. We aimed to study the effect of ultrafiltration volume variability on CV events and mortality in diabetic and non-diabetic chronic HD patients. Materials and methods: The study included 173 chronic HD patients (median age: 63±13 years; 53% men), of whom 36 (21%) had diabetes. The standard deviation (UVSD) and coefficient of variation (UVCV) of UV variability were calculated and used as indices of UV variability. The effect of ultrafiltration volume (UV) variability was retrospectively analysed over a 24-month period. Results: Patients were categorised by diabetes status and median UVSD (< 568 ml for low and ≥ 568 ml for high) as well as UVCV (< 0.29 for low and ≥ 0.29 for high). Diabetic patients with high UVSD showed significantly higher all-cause mortality (p = 0.028) compared to non-diabetic patients with low UVSD. The diabetes group with high UVCV had also increased mortality rates (p = 0.007) versus non-diabetics. Major adverse cardiovascular events (MACE) were considerably elevated in the high UVSD diabetic group (p = 0.002) compared to low UVSD non-diabetics, while those with high UVCV showed even higher MACE rates (p < 0.001). Cardiovascular mortality did not differ significantly between groups. Logistic regression identified the following factors affecting all-cause mortality: DM (OR: 3.781; p = 0.002), high UVSD (OR: 1.51; p = 0.008), high UVCV (OR: 1.302; p = 0.046) and elevated phosphate levels (OR: 1.107; p = 0.032). For MACE, the key factors were DM (OR: 3.066; p = 0.03), low hemoglobin (OR: 3.026; p = 0.037) and high CRP levels (OR: 2.107; p = 0.002). Conclusion: Chronic HD patients with diabetes and high UVSD or UVCV have increased all-cause mortality and MACE rates. Diabetes and cardiovascular changes caused by increased UF volume variability during HD may contribute to higher CV morbidity and mortality rates in these patients.

Abstract: Background/Objectives:  The strategy of targeting endotoxins and circulating histones to alleviate excessive inflammation and tissue damage has been proposed as an important immunoregulatory strategy against sepsis. However, the development of a multifunctional hemoperfusion adsorber that simultaneously removes endotoxins and histones remains an unmet clinical need in sepsis management. Methods: We synthesized chitosan-cellulose composite (CSCE) microspheres utilizing phase inversion technology, while heparin-grafted chitosan-cellulose composite (CSCEHEP) microspheres were developed by grafting heparin onto CSCE microspheres through the carbodiimide coupling method. In our experimental design, we allocated healthy New Zealand rabbits into four distinct groups: a healthy control group, a lipopolysaccharides (LPS) group, a CSCE group, and a CSCEHEP group. Following the administration of LPS for 12 hours, septic rabbits underwent extracorporeal hemoperfusion with either CSCE or CSCEHEP microspheres for a duration of 2 hours, notably without the inclusion of heparin in the blood circuits. Post-hemoperfusion, we conducted an analysis of thrombus formation and total protein adsorption on the column. Concurrently, blood samples were collected from the venous side to evaluate LPS levels, histone presence, inflammatory cytokine concentrations, and to perform histopathological assessments of liver and kidney injury. Results: Our in vivo experiments demonstrated that CSCEHEP microspheres for extracorporeal circulation could achieve 2 hours hemoperfusion session in septic rabbits without the need for continuous anticoagulation with heparin. CSCEHEP column turn into a very light red color (almost original white) and no obvious contamination or clotting was observed after the 2 hours hemoperfusion. Moreover, CSCEHEP microspheres effectively reduced the concentration levels of leukocyte, serum IL-6 and TNF-α, mitigated pathological damage to the liver and kidneys, and removed over 70% of LPS and nearly 50% of histone H3 from the blood of septic rabbits during hemoperfusion. In conclusion, hemoperfusion utilizing CSCEHEP microspheres exhibits excellent self-anticoagulation capabilities, remarkable anti-inflammatory performance, efficient endotoxin adsorption and histone antagonism properties, rendering it both effective and safe for use in septic rabbits.

Abstract: Background/Objectives: Whole-gland surgery or radiotherapy for localized prostate cancer (PCa) can cure the disease but often impair urinary and sexual function. Focal therapy with high-intensity focused ultrasound (HIFU) seeks to eradicate the tumor while sparing uninvolved tissue. We prospectively evaluated oncological control, functional outcomes and safety of MRI-guided focal HIFU in patients with low- or intermediate-risk PCa. Methods: In this prospective, single-arm, phase II trial (three Austrian centres, 2021-2024; ethics GS4-EK-3/162-2020), treatment-naïve patients with D’Amico low/intermediate-risk, PSA ≤ 15 ng/mL, clinical stage ≤ T2 and MRI-targeted, biop-sy-confirmed index lesions underwent lesion-targeted HIFU (Focal One™). A 9 mm safety margin was applied; procedures were performed under general anaesthesia. The pri-mary endpoint was failure-free survival (FFS: absence of salvage whole-gland or systemic therapy, metastasis or PCa-specific death). Secondary endpoints included biopsy-proven cancer, PSA, patient-reported symptoms as International Prostate Symptom Score (IPSS), 5-item International Index of Erectile Function (IIEF), Gaudenz Incontinence Question-naire and adverse events (Clavien–Dindo). Planned follow-up was 24 months with PSA every 3 months, mpMRI and biopsies at 12 months, and imaging- or PSA-triggered biopsies thereafter. Results: Fifty-two patients were enrolled; one violated eligibility criteria, leaving 51 in the per-protocol cohort (median age 67 years, median PSA 7.55 ng/mL). Median treated volume was 12 mL; median procedure time 85 min. At 24 months, FFS was 94.1 %: 3/51 patients (5.9 %) required salvage radiotherapy. Among 31 patients who underwent follow-up biopsy, 26 (83,9 %) had no cancer; the five positives included three ISUP 1, one ISUP2 and one ISUP 4 lesion. Mean PSA fell 69 % at 3 months (to 2.3 ng/mL) and remained ≤ 3 ng/mL thereafter. Transient acute urinary retention occurred in 11/51 (21.6 %); no Clavien–Dindo grade ≥4 events were reported. IPSS returned to or improved beyond baseline, erectile function largely recovered by 6-12 months, and only one new case of grade 2 incontinence was observed. Conclusions: MRI-guided focal HIFU achieved high two-year failure-free survival with low morbidity and preserved quality of life in care-fully selected patients with low- or intermediate-risk PCa. These data support further randomized and longer-term investigations of focal HIFU as an organ-sparing alternative to whole-gland treatment.

Abstract: Bladder cancer is a prevalent malignancy with high mobility and mortality, particularly when diagnosed at an advanced stage. Early detection is critical, as it significantly improves prognosis and the patient's outcome. Bladder cancer also has a high recurrence rate, necessitating long-term surveillance. While cystoscopy remains the gold standard for diagnosis and monitoring. It is invasive and costly. Urine cytology, though widely used, has high specificity for detecting high-grade urothelial carcinoma but suffers from low sensitivity, limited its effectiveness as a stand-alone diagnostics tool. Urinary biomarkers offer a promising, noninvasive alternative for early detection and disease surveillance. This review examines FDA–approved urinary biomarkers tests, including NMP 22, UroVysion, and BTA, highlighting their clinical utility and limitations. Additionally, we explore emerging biomarkers such as DNA methylation assays, genomic alterations, and proteomic signatures. Along with advanced technologies like next-generation sequencing and machine learning-based platforms. These innovations have the potential to enhance diagnostic accuracy, risk stratification, and recurrent monitoring. Ultimately improving early detection and long-term disease management. By evaluating both established and emerging urinary biomarkers, this review aims to provide clinicians and researchers with insights into evolving tools for bladder cancer diagnosis and surveillance.

Abstract: Acid–base analysis is a high-load diagnostic skill that many medical students struggle to master when taught using traditional text-based flowcharts. This multi-institution mixed-methods study evaluated a novel visual mnemonic algorithm that integrated Medimon characters, symbolic imagery, and pop-culture references into the standard acid–base diagnostic framework. First-year medical students (N = 273) at six distributed WWAMI campuses attended an identical lecture on acid–base physiology. Students at five control campuses received the original text-based algorithm, while students at one experimental campus received the Medimon algorithm in addition. Achievement was measured with a unit exam (9 focal items, day 7) and a final exam (4 focal items, day 11). A Differences-in-Differences approach compared performance on focal items versus baseline items across sites. Students at the experimental campus showed no significant advantage on the unit exam (DiD = +1.2%, g = 0.12) but demonstrated a medium-to-large effect on the final exam (DiD = +11.0%, g = 0.85). At the experimental site, 39 students completed the Situational Interest Survey for Multimedia (SIS-M), revealing significantly higher triggered, maintained-feeling, maintained-value, and overall situational interest scores for the Medimon algorithm (all p &lt; .001). Thematic analysis of open-ended responses identified four themes: enhanced clarity, improved memorability, increased engagement, and barriers to interpretation. Collectively, the findings suggest that embedding visual mnemonics and serious-game characters into diagnostic algorithms can enhance learner interest and may improve long-term retention in pre-clinical medical education.

Abstract: Background and Objectives: Benign prostatic hyperplasia (BPH) is one of the most common chronic conditions in older men, significantly affecting quality of life (QoL) by causing lower urinary tract symptoms (LUTS). 5-alpha-reductase inhibitors (5-ARIs) such as finasteride and dutasteride remain a cornerstone of pharmacotherapy for BPH; however, comparative real-world data are limited. The aim of the present study was to compare the therapeutic outcomes of finasteride and dutasteride in patients diagnosed with BPH. Materials and Methods: This retrospective clinical study analyzed patients with BPH treated by either finasteride or dutasteride. Clinical parameters, including the Interna-tional Prostate Symptom Score (IPSS), QoL index, and International Index of Erectile Function-5 (IIEF-5) score; urodynamic outcomes, including maximum urinary flow rate (Qmax), average flow rate (Qave), and post-void residual urine volume (PVR); and bi-ochemical markers, including prostate-specific antigen (PSA) and creatinine levels, were assessed at baseline and after at least 6 months of continuous therapy and underwent cross-sectional statistical analysis, with significance set at p < 0.05. Results: Both treatment groups demonstrated significant improvements in clinical and urodynamic outcomes. Compared with finasteride, dutasteride was associated with greater reductions in the prostate volume and PSA levels as well as a greater im-provement in “IPSS”. Erectile function (IIEF-5) was comparable. Renal function param-eters remained stable in both groups. Predictive analysis revealed that higher body mass index and older age correlated with worse IIEF-5 scores in the finasteride group, whereas the baseline prostate volume was the key differentiating factor in the dutasteride group. Conclusions: Both 5-ARIs effectively reduced the severity of LUTS and improved uro-dynamic parameters in patients with BPH. Dutasteride showed superiority in reducing the prostate volume and PSA levels, while the overall safety profiles of both drugs were comparable. These findings highlight the importance of individualized therapy tailored to patient-specific clinical characteristics.

Abstract: Prostate adenocarcinoma is mainly diagnosed based on serum PSA levels, but elevated PSA levels can also be caused by BPH, which weakens its specificity. Recent scientific studies have demonstrated that specific microRNAs regulate cancer cell proliferation by modulating the Wnt/β-catenin pathway. To date, no published literature has provided a comprehensive assessment of the interactions between miR-106a-5p and miR-375-3p and components of the Wnt/β-catenin pathway in prostate cancer. Therefore, the aim of the present study was to perform a pilot evaluation of the expression of miRNAs 106a-5p and 375-3p, as well as β-catenin, Fzd8, Wnt5a, and cyclin D1 in prostate adenocarcinoma compared with BPH. The study material consisted of samples collected from 30 patients with prostate cancer and 30 with BPH. Protein expression was analyzed using IHC and qRT-PCR methods, while miRNA levels were quantified by dPCR. Our study results revealed lower immunoreactivity and expression of genes encoding β-catenin, Fzd8, Wnt5a and cyclin D1, and significantly higher fluorescence intensity of miRNA 106a-5p and 375-3p with prostate adenocarcinoma compared BPH. Interactions between miR-106a-5p and miR-375-3p and the Wnt/β-catenin pathway highlight distinct molecular differences between prostate cancer and BPH and indicate new perspectives for the development of diagnostic biomarkers in prostate diseases.

Abstract: Background: Anejaculation (AE) and premature ejaculation (PE) are clinically distinct but mechanistically complex disorders. While both contribute substantially to male sexual health burden, their comparative profiles have not been systematically delineated in large cohorts. Methods: We retrospectively analyzed 542 men (AE = 249, PE = 293) at a tertiary andrology clinic. All participants underwent vibration perception threshold (VPT) testing at ten standardized sites, spinal MRI reviewed by blinded radiologists, expressed prostatic secretion microscopy with supportive ultrasound for prostatitis, and validated psychological assessments (PHQ-9, GAD-7, SDI-2). Statistical comparisons used Mann–Whitney U tests, chi-squared tests, and multivariate analysis of variance (MANOVA). Results: AE patients exhibited higher composite VPT thresholds than PE (7.12 ± 1.75 vs 6.60 ± 1.26, p<0.001), with MANOVA confirming distinct sensory profiles (Wilks’ λ=0.907, p<0.001). Cervical-only abnormalities were markedly more frequent in PE (33.4% vs 2.8%), whereas AE more often showed either no abnormality (45.8% vs 28.0%) or combined cervical–lumbar involvement (14.5% vs 7.5%; overall χ²=84.46, p<0.001). Chronic prostatitis was present in nearly half of AE cases but only one fifth of PE (47.4% vs 20.1%, p<0.001). Depressive symptoms were modestly higher in AE (PHQ-9: 8.31 ± 5.96 vs 7.15 ± 5.65, p=0.024), while sexual desire and anxiety scores did not differ significantly. Conclusions: AE and PE display distinct clinical signatures. AE was linked to higher vibration thresholds, greater prevalence of prostatitis, and elevated depressive symptoms, while PE was predominantly associated with isolated cervical spine abnormalities.Recognizing these patterns may refine clinical assessment and guide more individualized management.

Abstract: Background/Objectives: Pain is common among patients undergoing hemodialysis (HD), and palliative care (PC) aims to improve their quality of life. This study investigates the incidence, nature, and treatment of pain in chronic HD patients in Hungary, along with factors influencing pain intensity and the benefits of PC. Methods: A cross-sectional study involved 159 chronic end-stage kidney disease (ESKD) patients receiving HD at the National Dialysis Center in Pécs, Hungary. Pain was assessed using a “PQRST” questionnaire. Statistical analyses were per-formed on clinical and laboratory data to identify potential pain triggers. We also reviewed the latest literature on PC for patients with ESKD undergoing HD. Results: Approximately 57% of patients reported pain, with 88% indi-cating moderate to severe pain levels. While 64% used regular pain medication, only 29% experienced complete pain relief. Non-pharmacological methods, along with adjuvant agents and strong opioids were underutilized. Pain intensity was notably different based on parathyroid hormone (PTH) and C-reactive protein (CRP) levels. Key fac-tors affecting pain included body mass index (BMI), hypertension (HT), diabetes mellitus (DM), and PTH levels. Research shows that PC is rarely used for patients on HD in many countries, even though it is effective for manag-ing symptoms. Conclusion: PC, along with pain assessment and multidisciplinary management, reduces the symp-tomatic burden for patients with ESKD. Effective management of mild pain should be handled by a nephrologist experienced in PC, while severe, therapy-resistant pain should be managed by PC specialists. Therefore, imple-menting PC is essential in the treatment of these patients.

Abstract: The incidence of kidney diseases has been increasing in the last decade due to extended lifespan, which is often related to polymorbidity. Chronic kidney disease (CKD) and acute kidney injury (AKI) are associated with high morbidity and mortality, elevated costs for renal replacement therapy and heavy psychosomatic burden. At the same time, therapeutic options are limited to prophylactic and renoprotective medications and measurements, and they often cannot restore the impaired kidney function. With the development of cellular therapies new perspectives arise on the horizon whit promising potential- mesenchymal stem cells (MSCs) and induced pluripotent cells (iPSCs). Here we review the current possibility of both cell types in the field of nephrology and assess their cost implication.