Background/Objectives: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition characterized by pelvic pain, urinary symptoms, and reduced quality of life, with limited effective treatment options. Regenerative approaches using adipose-derived mesenchymal stromal cells (MSCs) have shown promising preclinical results. This study aimed to evaluate the feasibility, safety, and preliminary efficacy of transurethral implantation of autologous micronized adipose tissue (MAT) in patients with refractory IC/BPS. Methods: We conducted a single-center retrospective observational pilot study including 20 patients with refractory IC/BPS treated between April and October 2024. Adipose tissue was harvested via liposuction and mechanically processed using a closed system (Matrigen device) to obtain minimally manipulated micronized adipose tissue. The product was injected transurethrally into the bladder submucosa. Patients were evaluated at baseline and at 1, 3, and 6 months using validated questionnaires (ICSI/ICPI, SF-36, MOS Sexual Function), verbal rating scale (VRS) for pain and urgency, urodynamic parameters, and cystoscopic findings. Changes over time were assessed using paired non-parametric tests. Results: At 6 months, 65% of patients met responder criteria, defined as ≥50% improvement in pain and/or urgency or a positive global response. Significant improvements were observed in IC Problem Index, SF-36, MOS scores, and VRS urgency, while VRS pain improved significantly at 6 months. Urodynamic parameters showed increased bladder capacity (median 275 to 325 mL, p < 0.001) and reduced post-void residual volume (80 to 40 mL, p < 0.001). Cystoscopic findings demonstrated improvement in bladder mucosal appearance. The procedure was well tolerated, with no serious adverse events or immunological complications observed. Conclusions: In this exploratory pilot study, transurethral implantation of autologous micronized adipose tissue was associated with improvements in symptoms, bladder function, and cystoscopic findings in patients with refractory IC/BPS. These results support the feasibility and potential role of minimally manipulated adipose-derived therapies in this setting. Given the small sample size and absence of a control group, findings should be considered exploratory. Larger controlled studies are warranted to confirm efficacy and evaluate long-term outcomes.

Introduction: Post-prostatectomy incontinence (PPI) remains a major functional concern after robot-assisted radical prostatectomy (RARP). Posterior musculofascial reconstruction (PMFR) has been shown to facilitate early urinary continence (EUC), but variations in technique may further improve outcomes. We evaluated whether a modified vesicourethral anastomosis (VUA) incorporating simultaneous PMFR with a single barbed suture [pontine VUA (P-VUA)] may facilitate continence recovery compared with the standard Van Velthoven anastomosis (ST-VUA). Materials and Methods: This prospective study included patients undergoing RARP between January 2021 and December 2023. Allocation was based on surgeon preference. UC was defined as the use of no pads or one dry safety pad per day and was assessed at 10, 30, 90, 180, and 365 days after catheter removal. Multivariable logistic regression was performed to evaluate factors associated with 30-day continence. Time to continence was additionally analyzed using Kaplan-Meier methods. Results: This prospective comparative study included 157 patients undergoing robot-assisted radical prostatectomy (RARP) between January 2021 and December 2023 (76 ST-VUA, 81 P-VUA). Baseline and pathological characteristics were comparable between groups. Catheterization time was significantly shorter in the P-VUA group (5.0 ± 1.1 vs. 6.7 ± 1.4 days, p < 0.001). Continence rates were higher in the P-VUA group at 10 days (72.8% vs. 55.3%, p = 0.03), 30 days (84.0% vs. 68.4%, p = 0.035), 90 days (92.6% vs. 76.3%, p = 0.007), 180 days (93.8% vs. 82.9%, p = 0.044), and 365 days (97.5% vs. 86.8%, p = 0.015). Kaplan-Meier analysis demonstrated a shorter time to continence in Group P (log-rank p = 0.0037). In multivariable analysis, P-VUA was independently associated with higher odds of 30-day continence (OR 6.38, 95% CI 2.08-19.63, p = 0.001). Conclusions: The study suggests that the P-VUA technique was associated with faster recovery of urinary continence compared with ST-VUA in this prospective, non-randomized cohort. These findings support the hypothesis that integrating anatomical reconstruction principles into the anastomotic step may enhance functional outcomes after RARP. However, the results should be interpreted with caution, given the study design and sample size, and require confirmation in larger, preferably randomized studies.

This study aims to evaluate the impact of through-and-through (T-T) guidewire positioning versus conventional guidewire positioning in percutaneous nephrolithotomy (PCNL) with endoscopic combined intrarenal surgery (ECIRS) on complication rates (CR), surgical outcomes, and predictors of post-operative complications. We analyzed data from patients who underwent PCNL in our institution. Patients were divided into the T-T group (guidewire positioned through the urethral meatus) and the No-T-T group (guidewire positioned within the renal pelvis or down the ureter). Pre-, peri-, and post-operative data were collected, including demographics, clinical characteristics, stone parameters, and surgical outcomes. Statistical analyses, including t-tests, chi-square tests, and logistic regression, were performed to compare outcomes and identify complication predictors. The T-T group exhibited a lower overall CR (28.57

Background/Objectives: Radical cystectomy (RC) is the standard treatment for muscle-invasive and high-risk non-muscle-invasive bladder cancer, but it often results in significant functional impairments, including sexual and urinary dysfunction, adversely affecting quality of life (QoL). Sexual-sparing robotic-assisted radical cystectomy (RARC) has been introduced to mitigate these effects. This review evaluates the oncological and functional outcomes of sexual-sparing RARC in male and female patients. Methods: A systematic literature search identified 15 studies including 793 patients who underwent sexual-sparing RARC using techniques such as nerve-sparing, capsule-sparing, and pelvic organ-preserving approaches. Data on oncological and functional outcomes were analyzed. Results: Sexual-sparing RARC achieves oncological outcomes comparable to open RC, with negative surgical margin (NSM) rates exceeding 95% in most studies. RFS and CSS rates were robust, often surpassing 85% at intermediate follow-ups. Functional outcomes were also favorable, with continence rates exceeding 90% and erectile function recovery surpassing 70% in well-selected male patients. Female patients undergoing pelvic organ-preserving techniques demonstrated improved continence, preserved sexual function, and enhanced QoL. Patient selection emerged as critical, favoring those with organ-confined disease and good baseline function. Conclusions: Sexual-sparing RARC offers a promising balance between oncological control and functional preservation, making it an effective option for selected patients. Further research is needed to refine techniques and establish standardized protocols for broader adoption.

Background/Objectives: The optimal surgical approach for kidney stones (KS) measuring 15-20 mm remains debated. RIRS and mini-PCNL are both effective options, but they differ in invasiveness, resource use, and cost. This study aimed to compare perioperative outcomes and hospital costs of RIRS and mini-PCNL using a micro-costing approach. Methods: This retrospective study included patients with KS > 15 mm in diameter who were treated between January 2021 and December 2023 at the Department of Urology, Sapienza University of Rome-Polo Pontino. Clinical parameters, operative time (OT), length of stay (LoS), complications, and stone-free rate (SFR) were compared. Costs were estimated using a micro-costing method, including disposable materials, operating room (OR) time (3.9 EUR/min), imaging, and hospitalization (334 EUR/day). The total cost per treated and per SF patient was calculated for both techniques. Results: A total of 119 patients were analyzed: 62 underwent RIRS, and 57 underwent mini-PCNL. Mean OT was shorter for RIRS (87 vs. 113 min; p < 0.001), and LoS was longer for mini-PCNL (2.24 vs. 1.22 days; p = 0.008). Final SFR was higher for mini-PCNL (94.7% vs. 88.7%; p = 0.043). Complication rates were comparable, with most events classified as Clavien-Dindo I-II. Disposable materials represented the main cost driver (EUR 1097 for RIRS vs. EUR 806 for mini-PCNL). The total cost per treated patient was EUR 3689 for RIRS and EUR 3154 for mini-PCNL (p = 0.009). The cost per SF patient was EUR 4159 for RIRS and EUR 3331 for mini-PCNL (p = 0.007). Conclusions: Both RIRS and mini-PCNL are safe and effective for the management of KS ≥ 15 mm. Mini-PCNL achieves higher SFR and greater cost-efficiency than RIRS. These findings support the use of mini-PCNL as the preferred option in centers with adequate expertise and resources.

Seminal vesicle neoplasms are extremely rare. Schwannoma is a benign tumor of the peripheral nerve sheath composed of Schwann cells. Most of these tumors are silent and become symptomatic with compression of adjacent organs and nerves. We present a case of a 65-year-old man with a history of predominant storage lower urinary tract symptoms. Prostate-specific antigen was within normal ranges, and imaging documented a nodular lesion in the prostate, one in the left seminal vesicle and another one adjacent to the right bladder wall. We successfully performed a prostate biopsy and a trans-urethral resection of the bladder to excise and typify the lesion. Histopathology investigation revealed the final diagnosis of schwannoma.

N6-methyladenosine (m6A) is one of the most abundant mRNA modifications established by the activity of three classes of enzymes: writers, readers, and erasers. The relevance of m6A in the regulation of gene expression implies its key role in normal biological processes and cancer development. Given the little knowledge about the involvement of m6A in clear cell Renal Carcinoma (ccRCC), our analysis should be regarded as a pilot study aimed at investigating the expression of m6A enzymes in tissues and urine specimens of ccRCC patients. The expression of m6A enzymes was validated by quantitative reverse-transcription PCR and immunohistochemistry, comparing normal and tumoral tissues. Quantification of m6A levels in urine specimens of healthy and cancer patients was performed by colorimetric Urine m6A assay. We observed the upregulation and nuclear localization of the m6A demethylase FTO in tumoral tissues compared with their respective normal counterparts. The nuclear expression of FTO decreases with an increase in tumor grade. Moreover, we identified a decrease in m6A levels in cancer samples. These findings might represent novel evidence to further investigate the issue, to reveal new diagnostic markers for tumorigenesis, leading to a potential m6A-targeted therapy in ccRCC.

Prostate cancer (PCa) remains the most common non-cutaneous cancer among men in Europe, with treatment advances improving mortality outcomes. Radical prostatectomy (RP) is a key treatment option for localized PCa, anyway complications such as urinary incontinence and erectile dysfunction can influence patient satisfaction and decision regret. This multicenter study aims to identify factors that can assist urologists in improving preoperative counseling through levels of satisfaction or regret, with the goal of increasing patient awareness regarding the potential risks and complications associated with RP. A prospective analysis was conducted on 590 patients undergoing RP across 4 Italian centers (from 2019 to 2022). Decision regret was assessed using the validated Decision Regret Scale (DRS). The mean score of the five items of the DRS was calculated and then converted to a 100-points scale, with a cutoff score of 25 distinguishing low from high regret. Logistic regression analysis evaluated predictors of treatment regret. At a median follow-up of 23 months, 79