Background: Kidney transplantation (KT) is a complex clinical process requiring accurate risk stratification, timely decision-making, and individualized management across all stages of care. Traditional clinical scores and center-specific algorithms often fail to capture the multidimensional interactions among donor, recipient, and procedural factors. In this context, artificial intelligence (AI) and machine learning (ML) have emerged as promising tools to support precision medicine in KT. Materials and Methods: We conducted a narrative review of the literature published between 2010 and 2024, focusing on AI and ML applications in KT. Studies addressing pretransplant evaluation, surgical assistance, posttransplant outcomes, and immunosuppressive therapy optimization were included and qualitatively synthesized. Results: Artificial intelligence and ML models have demonstrated improved performance compared with conventional approaches across multiple stages of KT. In the pretransplant setting, ML-based models outperform traditional risk scores in donor–recipient matching and graft survival prediction, with the potential to reduce organ discard. Deep learning techniques applied to preimplantation biopsies enhance histopathologic assessment and reproducibility. Intraoperatively, AI-driven imaging and surgical data science tools support anatomic visualization and decision-making. Posttransplant, ML models enable earlier detection of acute rejection, prediction of delayed graft function, and noninvasive assessment using laboratory, imaging, and molecular data. Furthermore, AI-based pharmacokinetic models facilitate personalized immunosuppressive dosing, improving time within therapeutic ranges and reducing toxicity. Conclusions: Artificial intelligence represents a powerful adjunct to clinical expertise in KT, offering data-driven decision support across the transplant continuum. However, most available models remain retrospective and lack prospective multicenter validation, limiting immediate clinical implementation. Prospective multicenter studies and responsible implementation strategies are essential to translate AI-driven tools into routine clinical practice and improve transplant outcomes.
Cavernous nerve injury-induced erectile dysfunction (CNIED) is a common complication of pelvic surgery such as radical prostatectomy. Regenerative medicine, capable of achieving the regeneration and repair of penile cavernous tissue through multiple mechanisms, offers diverse and promising therapeutic options for the long-term alleviation of CNIED. Here, various current regenerative therapy strategies for the treatment of CNIED are summarized, and their respective mechanisms of action, research progress, and practical challenges are described. PubMed and Google Scholar were searched for relevant articles published through July 2025. Keyword searches included regenerative therapies, stem cell therapy, tissue engineering, biomaterials, erectile dysfunction, and other related terms. This article primarily summarizes the current therapeutic strategies and their underlying regenerative mechanisms for CNIED, encompassing stem cell therapy, platelet-rich plasma therapy, microenergy therapy, tissue engineering and biomaterials, small-molecule drugs, and photobiomodulation. Additionally, it further elaborates on the current research progress, developmental directions, and practical challenges of each therapeutic strategy. At present, regenerative therapy still faces multiple challenges in mechanistic research, clinical translation, and standardization. In the future, deeper mechanistic research on relevant therapies and interdisciplinary collaborations to advance their clinical translation and application are needed.
Advances in renal transplantation have improved patient survival, but aging donor and recipient populations have increased the complexity of transplant care. Urologic malignancies and complications are increasingly important in this population: the reported risk of renal cell carcinoma is 2- to 10-fold higher and bladder cancer incidence is approximately 2- to 4-fold higher than in the general population. Urinary tract complications occur in 1% to 30% of recipients, highlighting the expanding role of urologists in transplant care. This comprehensive literature review summarizes the current role of urology in renal transplantation, focusing on the epidemiology and management of urologic malignancies relative to the general population, common posttransplant urologic complications and their management, and urologic strategies for expanding the donor pool. As the number and complexity of kidney transplant recipients continue to increase, transplant surgeons and general urologists need to understand these unique challenges. A multidisciplinary and individualized approach is essential to optimize outcomes, preserve graft function, and safely expand access to transplantation.
Interstitial cystitis/bladder pain syndrome is a heterogeneous chronic condition with variable guideline-based diagnoses and treatments. Herein, we compared the guidelines of the American Urological Association, European Association of Urology, and Canadian Urological Association to identify discrepancies and develop a practical framework. A structured narrative synthesis of the three guidelines was conducted alongside selected peer-reviewed studies and expert consensus. Diagnostic and treatment approaches were compared and reconciled using a phenotypic framework. The Canadian Urological Association adopts phenotype-based management, the European Association of Urology supports European Society for the Study of Interstitial Cystitis subtyping, and the American Urological Association emphasizes individualized non-tiered care. Phenotype-aligned consensus supports endoscopic therapy for Hunner lesion (HL) disease and pelvic floor therapy for myofascial dysfunction, while cystoscopy timing, glycosaminoglycan therapy, neuromodulation, botulinum toxin, and central sensitization strategies vary. A phenotype-based framework comprising HLs, bladder-centric non-HLs, pelvic floor dysfunction, and systemic or central sensitization may harmonize divergent diagnosis and treatment guidelines.
Background: Evidence on low-intensity pulsed ultrasound (LIPUS) for severe erectile dysfunction, particularly regarding long-term outcomes, remains limited. We assessed short-term within-group changes after LIPUS and respondent-reported outcomes at 3 years. Materials and methods: In this single-arm prospective observational study, 52 men commenced an 8-session LIPUS course; 43 completed treatment and had paired baseline and 8-week data. The primary endpoint was change in International Index of Erectile Function–Erectile Function. Erection Hardness Score and other exploratory secondary outcomes were analyzed with false discovery rate control. Three-year outcomes were summarized for 20 telephone respondents, with extreme-case analyses for 23 nonrespondents. Results: Mean International Index of Erectile Function–Erectile Function increased from 6.98 to 14.53 (mean change, 7.56; 95% confidence interval, 5.38–9.73; p < 0.001); 22/43 participants met the ≥7-point minimum clinically important difference (51.2%; 95% confidence interval, 36.8%–65.4%), or 22/52 (42.3%) when 9 discontinuers were classified as nonresponders. Erection Hardness Score improved in 31/43 participants ( p < 0.001). No adverse events were recorded among 43 participants with available safety data. Among 20 three-year respondents, positive responses were 80.0% for Sexual Encounter Profile question 2, 65.0% for Sexual Encounter Profile question 3, 70.0% for perceived erectile function improvement, and 55.0% for sexual satisfaction; corresponding worst-case proportions among all 43 participants were 37.2%, 30.2%, 32.6%, and 25.6%. Conclusions: Low-intensity pulsed ultrasound was associated with short-term within-group improvement in erectile function; however, the uncontrolled design, incomplete safety ascertainment, and substantial long-term nonresponse preclude causal inference or conclusions about durable benefit. Randomized, sham-controlled trials using consistent objective endpoints are warranted.
