Roxana Andra Coman,1,2 Florin Ioan Elec,3,4 Dana Monica Iancu,1,5 Selcuk Guven,6 Theodoros Tokas,7 Patrick Juliebø-Jones,8 Lazaros Tzelves,9 Bhaskar Kumar Somani10 1Department of Anatomy, Fundamental Discipline, Faculty of Nursing and Health Sciences, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania; 2Department of Urology, MedLife Humanitas Hospital, Cluj-Napoca, Romania; 3Department of Urology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania; 4Department of Urology, Clinical Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania; 5Department of Surgery, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, Cluj-Napoca, Romania; 6Department of Urology, Necmettin Erbakan University, School of Medicine, Konya, Türkiye; 7Department of Urology, Medical School, University General Hospital of Heraklion, University of Crete, Heraklion, Greece; 8Department of Urology, Haraldsplass Deaconess Hospital, Bergen, Norway; 9Department of Urology, University of Athens, Athens, Greece; 10Department of Urology, University Hospital Southampton NHS Trust, Southampton, UKCorrespondence: Roxana Andra Coman, Department of Anatomy, Fundamental Discipline, Faculty of Nursing and Health Sciences, “Iuliu Hațieganu” University of Medicine and Pharmacy, Victor Babes Street Number 8, Cluj-Napoca, 400347, Romania, Email dr.roxanacoman@yahoo.comAbstract: Prostate cancer (PCa) is a highly heterogeneous disease with variable clinical outcomes. Advances in next-generation sequencing have enabled comprehensive genomic profiling, generating large-scale datasets that require sophisticated analytical tools. Machine learning (ML) has emerged as a powerful approach for extracting clinically relevant insights from these datasets. This narrative review examines current ML applications in PCa genomics, focusing on mutation signature analysis, biomarker discovery, and clinical prediction models. We also discuss the integration of genomic and clinical data, the limitations of current approaches, and how ML-driven methods can be translated into clinical practice.Keywords: prostate cancer, machine learning, genomics, mutation signatures, biomarkers, artificial intelligence
Bingfeng Zhang,1,* ZhiHuang Wu,2,* Yuanteng Qiu,3,* Kailiang Chen,4,* Zhiwei Huang11Department of Urology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, 362000, People’s Republic of China; 2Department of Urology, The Second Hospital of Longyan, Longyan, Fujian, 364000, People’s Republic of China; 3Department of Intensive Care Unit, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, People’s Republic of China; 4School of Basic Medical Science, Guizhou Medical University, Guiyang, Guizhou, 550000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhiwei Huang, Department of Urology, The Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan North Road, Quanzhou, Fujian, 362000, People’s Republic of China, Email huangzwdoctor@163.comPurpose: This study evaluated the associations of post-ESWL hydration habits with single-session ESWL success and 7-day stone-free status and examined whether these associations varied according to stone size.Methods: This single-center retrospective cohort study included 570 patients who underwent ESWL for ureteral stones at the Second Affiliated Hospital of Fujian Medical University between June 2024 and December 2025. Hydration habits were classified as early concentrated hydration (≥ 2 L within the first 8 hours after waking) or distributed daily hydration (total daily fluid intake ≥ 2 L but < 2 L within the first 8 hours after waking). Primary outcomes were single-session ESWL success and 7-day stone-free status. Multivariable logistic regression was used to evaluate associations between hydration habits, stone size, their interaction, and study outcomes.Results: Baseline characteristics were comparable between groups. Stone size was inversely associated with single-session ESWL success and 7-day stone-free status. Significant interactions were observed between hydration habits and stone size for single-session ESWL success (interaction OR=1.42, 95% CI: 1.09– 1.84) and 7-day stone-free status (interaction OR=1.99, 95% CI: 1.41– 2.81). Model-based probability curves crossed at approximately 6.82 and 7.30 mm, respectively; these values represent model-derived crossing points rather than validated clinical thresholds. In a post hoc exploratory analysis of patients with stones ≥ 7 mm, early concentrated hydration was associated with higher odds of single-session ESWL success (OR=1.90, 95% CI: 1.12 ~ 3.20) and 7-day stone-free status (OR=2.26, 95% CI: 1.36 ~ 3.75).Conclusion: Early concentrated hydration was associated with more favorable ESWL outcomes, particularly among patients with larger stones.Keywords: extracorporeal shock wave lithotripsy, ureteral calculi, hydration habits, fluid intake, outcomes
Suzuna Sakai,1,2 Sakurako Ohno,1 Terumi Morita,1 Kenji Sawase,1 Akihiro Maekawa,1 Junichiro Hashiguchi,1 Takahiro Takazono,3 Ryoichi Imamura,2 Satoshi Funakoshi11Nagasaki Kidney Hospital, Nagasaki, Japan; 2Department of Urology, Nagasaki University Hospital, Nagasaki, Japan; 3Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanCorrespondence: Suzuna Sakai, Nagasaki Kidney Hospital, 5-1 Kozenmachi, Nagasaki City, Nagasaki, 850-0032, Japan, Tel +81-95-824-1101, Email suzuna.s@nagajin.jpPurpose: In patients on maintenance hemodialysis, urine culture is often not obtained because urine collection is difficult and urinary symptoms are indistinct. We examined how urinary tract infection (UTI) presents, and what a positive urine culture signifies, when cultures are obtained in routine practice.Patients and Methods: In this single-center retrospective study, 131 urine culture events obtained between January 2016 and April 2026 from 95 of 435 patients on maintenance hemodialysis were analyzed at the patient level. True UTI-related disease was defined as a final diagnosis of UTI, acute cystitis or infected renal cyst.Results: Sixty of 95 patients (63.2%) had true UTI-related disease, of whom 11 (18.3%; 95% confidence interval [CI] 9.5– 30.4) had no urinary symptoms or attributable fever; an event-level analysis gave 18.5%. Final diagnoses were made by the attending physician and incorporated the culture result, so this proportion describes routine practice rather than a diagnosis of asymptomatic UTI. Bacteriuria or pyuria not treated as acute infection accounted for 17 patients (17.9%; 95% CI 10.8– 27.1), of whom only 4 (23.5%) received antimicrobial agents. Among 81 culture-positive patients, Escherichia coli accounted for 39 (48.1%; 95% CI 36.9– 59.5), remaining between 44.3% and 48.1% across three alternative aggregation rules. All 11 extended-spectrum β-lactamase (ESBL)-producing isolates were resistant to levofloxacin, yet 4 of these patients received a quinolone.Conclusion: A substantial minority of patients diagnosed with UTI in routine practice lacked urinary symptoms and attributable fever, while about one in six patients undergoing urine culture had bacteriuria or pyuria not treated as acute infection. The microbial distribution differed markedly from that of uncomplicated UTI, raising the possibility that empirical regimens developed for uncomplicated UTI may not provide adequate coverage; because susceptibility was not evaluated in all isolates, this inference rests on organism distribution rather than susceptibility data.Keywords: hemodialysis, end-stage renal disease, dialysis, urine culture, urinary tract infection, asymptomatic bacteriuria
Aleksandra Pečovnik,1 Luka Jerebic,2 Mark Šink,2 Metka Volavšek31Department for Pathology and Cytopathology, General Hospital Celje, Celje, 3000, Slovenia; 2Clinical Department for Urology, University Clinical Center Ljubljana, Ljubljana, 1000, Slovenia; 3Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, 1000, SloveniaCorrespondence: Metka Volavšek, Institute of Pathology, Faculty of Medicine, University of Ljubljana Korytkova 2, Ljubljana, 1000, Slovenia, Tel +386 1 543 7148, Fax +386 1 543 7104, Email metka.volavsek@mf.uni-lj.siPurpose: Myopericytomas are rare perivascular tumors, typically occurring in superficial soft tissues. The intravascular variant is extremely uncommon, particularly within the genitourinary tract.Case Presentation: We report a unique case of an intravascular myopericytoma located within the spermatic cord of a 73-year-old male with painless swelling of the left hemiscrotum of nine months duration, gradually increasing over previous six months. Surgical excision was performed. Histological evaluation revealed a well-circumscribed, multinodular tumor entirely confined to the venous channels of the spermatic cord, composed of oval-to-spindled cells concentrically arranged around vessels and embedded in myxoid stroma. Immunohistochemically, spindle cells showed diffuse positivity for SMA and h-caldesmon, focal desmin positivity, highlighting endothelial cells with CD31 and CD34.Conclusion: This case adds to the limited literature on intravascular myopericytomas and represents the first reported case involving the spermatic cord.Keywords: intravascular tumor, perivascular myoid differentiation, perivascular neoplasm, spermatic cord
Ismahil Adekunle Adeniyi,1 Umar Uthman Shehu,1 Emmanuel Orire Ikuomola,1 Tagwa Norain Mahmoud,1 Victor Bassey Archibong,2 Ibe Michael Usman21Department of Physiology, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Bushenyi, Uganda; 2Department of Anatomy, School of Medicine and Pharmacy, University of Rwanda, Huye, RwandaCorrespondence: Ismahil Adekunle Adeniyi, Department of Physiology, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Bushenyi, Uganda, Email aaismahil@kiu.ac.ugIntroduction: Male infertility is an important component of the global burden of infertility and remains an under-addressed reproductive health concern in sub-Saharan Africa (SSA). The increasing number of men living with Human Immunodeficiency Virus (HIV) following expanded access to antiretroviral therapy (ART) has heightened the need to address their reproductive goals and fertility-related needs. However, the intersection of HIV, male infertility, and access to fertility care remains inadequately characterized in the region. This review examined the biological, clinical, sociocultural, economic, and health-system factors influencing the management of male infertility among men living with HIV (MLWH) in SSA and identified key gaps in evidence and service delivery.Methods: A structured literature search was conducted in PubMed, Scopus, Web of Science, Google Scholar, and African Journals Online (AJOL) for studies published between 2000 and 2026. English-language studies addressing male infertility in the context of HIV, including biological, clinical, sociocultural, economic, or health-system factors, were considered. Studies were screened by title and abstract followed by full-text assessment. Findings were thematically synthesized across biological and ART-related reproductive effects, diagnostic and treatment limitations, sociocultural barriers, economic constraints, and health-system challenges. Due to substantial heterogeneity in study designs, populations, outcomes, and settings, findings were synthesized narratively.Results: The review identified interacting biological, social, economic, and health-system factors that complicate infertility management among MLWH in SSA. HIV infection has been associated with alterations in semen quality and reproductive function, although findings are heterogeneous and do not establish that HIV or ART uniformly causes male infertility. Evidence regarding ART remains inconsistent and may vary according to regimen, treatment duration, and study population, with limited evidence from contemporary regimens and few longitudinal male-focused studies from SSA. Major barriers to care include HIV- and infertility-related stigma, gendered perceptions of infertility, limited male engagement in reproductive healthcare, fragmented HIV and fertility services, inadequate diagnostic and laboratory capacity, shortages of trained healthcare professionals, limited availability and affordability of assisted reproductive technologies, and substantial out-of-pocket costs. Inadequate policy integration further limits access to comprehensive fertility care.Conclusion: Male infertility among MLWH in SSA reflects interacting biological and structural challenges. Current evidence does not support the assumption that ART generally impairs male fertility, while regimen-specific evidence remains limited. Strengthening integrated HIV and reproductive health services, improving diagnostic and workforce capacity, reducing financial and stigma-related barriers, and generating longitudinal male-focused evidence from SSA are essential for improving reproductive care and supporting the reproductive rights of MLWH.Keywords: male infertility, HIV/AIDS, sub-Saharan Africa, anti-retroviral therapy
