The first single-cell penile cancer atlas identified 83 682 single cells within 14 major cell types and 65 cell subpopulations, offering unprecedented insights into penile cancer biology. TP53 mutations might be a driver of worse prognosis, irrespective of human papillomavirus (HPV) status, challenging the currently used stratification by HPV only. Our work reveals key molecular pathways underlying poor prognosis and therapy resistance. These insights might facilitate patient selection for clinical trials and enable development of personalized therapies, sparing patients from the currentl ..read more

We are grateful for the thoughtful comments from Dr. Giannakodimos on our article [1] and the opportunity to reply. There are several “real-world” challenges to conducting an interim analysis to obtain the “real” incidence of infectious complications in both the transrectal and transperineal biopsy arms of the study. For example, a strength of the PREVENT study is the participation of ten sites [1] to reflect the significant variation in antibiograms and prostate biopsy risks from site to site, and conducting high-quality surgical randomized trials is challenging and costly ..read more

We read with great interest the article by Hu and colleagues [1] presenting results from the PREVENT trial. The authors report an infection rate of 1.4% among patients who received rectal swab–directed antibiotic prophylaxis and underwent transrectal prostate biopsy (TRBx) versus zero infections among patients who received no antibiotic prophylaxis and underwent transperineal biopsy (TPBx). While we eagerly await results for an expanded cohort and from the TRANSLATE trial, findings from PREVENT and from the ProBE-PC trial [2] suggest that TPBx is at a minimum equivalent to TRBx with respect to ..read more

Darolutamide led to deep and durable prostate-specific antigen (PSA) responses and a higher proportion of patients with undetectable PSA in comparison to placebo when combined with androgen deprivation therapy and docetaxel, regardless of disease volume. Achievement of undetectable PSA was associated with longer survival and longer times to castration-resistant prostate cancer and PSA progression ..read more

1. Detrusor underactivity (DU) is a urodynamic diagnosis and underactive bladder is a terminology that should be reserved for describing symptoms and clinical features related to DU.2. Invasive urodynamics is the only widely accepted method for diagnosing DU.3. In patients with persistently elevated postvoid residual (ie, >300 ml), intermittent catheterization is indicated and preferred over indwelling catheters.4. Medical and surgical therapies are discussed, but the level of evidence is low ..read more

Simulation-based training curricula involving objective assessment of proficiency and progressive improvements in competence have been introduced to standardize trainee outcomes in urology. Although their educational impact has been demonstrated, clinical validation is still needed ..read more

Since its release in November 2022, ChatGPT, a large language model (LLM) from OpenAI, has been widely discussed and used across various domains. Its impressive capabilities have sparked considerable interest in applications in health care [1]. We have carefully reviewed the groundbreaking work by Eppler and colleagues [2] in the field of urology and acknowledge their commendable contribution. We would like to offer some suggestions to further enrich the discussion in this domain ..read more

Eapen and colleagues [1] report results from the phase 1/2 LuTectomy trial, which investigated neoadjuvant radioligand therapy with the prostate-specific membrane antigen (PSMA)-targeted radiopharmaceutical [177Lu]Lu-PSMA-617 before robotic radical prostatectomy in patients with high-risk localised prostate cancer (HRLCP). High tumour uptake of [68Ga]Ga-PSMA-11 on positron emission tomography/computed tomography was a prerequisite for inclusion. Cohort A (n = 10) received one cycle and cohort B (n = 10) received two cycles of [177Lu]Lu-PSMA-617 (5 GBq) followed by surgery 6 ..read more

Artificial intelligence (AI) chatbot models have become a hot topic with their emergence as valuable tools for both doctors and patients seeking health advice and support [1]. Musheyev and colleagues [2] comprehensively assessed responses from four major AI chatbots (ChatGPT, Perplexity, Chat Sonic, and Microsoft Bing AI) to top search queries related to the four most prevalent urological malignancies (prostate cancer, bladder cancer, kidney cancer, and testicular cancer). This study has significant value in furthering our understanding of the potential and limitations of AI chatbots in dissem ..read more

In this issue of European Urology, Hu et al [1] report results from PREVENT, a randomized controlled trial comparing infectious complications of transperineal prostate biopsy (TPBx) without antibiotic prophylaxis and transrectal biopsy (TRBx) with a rectal swab and targeted prophylaxis among men receiving a first biopsy for suspicion of prostate cancer. The infectious complication rates were 0% in the TPBx arm and 1.4% in the TRBx arm (p = 0.059). The authors concluded that both approaches can be performed in an office setting under local anesthesia and result in similar infectious c ..read more