BACKGROUND:Serum levels of microRNA-371a-3p (M371) represent a novel serum tumour marker of testicular germ cell tumours (GCTs). Little is known about its utility for assessing regional lymph nodes in chemotherapy-naïve patients. We measured M371 levels before lymphadenectomy (LND) and correlated expression rates with histologic findings. METHODS:Fifty-seven chemotherapy-naïve patients had M371 measurements before LND. Median M371 levels and M371 expression rates were compared across the postoperative histological subgroups of seminoma [SE], vital nonseminoma [VN], teratoma [TE], no malignancy tumour [pN0], and controls, between subgroups of tumour sizes, and between pre- and postoperative levels. M371 performance characteristics were calculated, including receiver operating characteristic curves. RESULTS:M371 levels were elevated in 17 (85%) of 20 patients with SE at LND, 16 (100%) with VN, none in 13 with TE, and 1 in 8 with pN0. The sensitivity, specificity, positive predictive value, and area under the curve of the M371 test for identifying lymph node metastases was 67.3%; 87.5%; 97.1%; 0.833, respectively, and 60.6%; 100%; 100%; 0.884 in VN, and 81.3%; 50%; 92.9%; 0.656 in SE. In SE cases, frequency and extent of M371 level elevation were significantly associated with the size of metastases. Postoperatively, M371 serum levels significantly decreased in VN and SE. CONCLUSIONS:Elevated M371 levels are predictive for lymph node metastases in 100% and in 92% of patients with primary testicular nonseminomas and SEs, respectively. TE does not express M371. Small volume SE is detected in only 50% of cases. Despite weaknesses, the test can aid in diagnosing marker-negative lymphadenopathies in GCTs.

Die Integration künstlicher Intelligenz (KI) in die urochirurgische Robotik befindet sich derzeit in einer dynamischen Entwicklungs- und Validierungsphase. Minimalinvasive, standardisierte und videobasierte Eingriffe schaffen besonders datenreiche Operationsumgebungen mit klar definierten Arbeitsschritten und bieten damit ideale Voraussetzungen für die Entwicklung KI-basierter Systeme. Ziel dieser Arbeit ist es, den aktuellen Stand der KI-Integration in der urochirurgischen Robotik darzustellen, bestehende klinisch verfügbare Anwendungen einzuordnen und die Perspektive autonomer Systeme kritisch zu bewerten. Dabei sollen technologische, regulatorische und klinische Aspekte gleichermaßen berücksichtigt werden. Es erfolgte eine Analyse aktueller Literatur sowie eine systematische Betrachtung klinisch verfügbarer robotischer Plattformen und experimenteller Systeme. Berücksichtigt wurden sowohl bereits zugelassene medizinische Geräte mit integrierten KI-Funktionalitäten als auch präklinische Entwicklungen im Bereich teilautonomer und autonomer chirurgischer Module. Zusätzlich wurden internationale Forschungsinitiativen zur Förderung autonomer chirurgischer Systeme einbezogen. Der Schwerpunkt der gegenwärtigen Entwicklung liegt auf unterstützenden Systemen wie Environment Modeling und AR (Augmented-Reality)-Navigation. Klinisch zugelassene Plattformen profitieren zunehmend von datenbasierter Leistungsanalyse, optimierter Behandlungsplanung und verbesserten teleoperativen Strukturen. Mit zunehmendem Autonomiegrad steigen zugleich die Anforderungen an Validierung, Regulierung und Haftungsrahmen. Die urochirurgische Robotik steht somit vor einem Paradigmenwechsel: von der rein teleoperativen Assistenz hin zu adaptiven, teilautonomen Systemen. Dies wird nicht nur durch technologische Innovation, sondern auch durch internationale Forschungs- und Investitionsprogramme maßgeblich vorangetrieben und erfordert eine strukturelle Anpassung chirurgischer Ausbildung, Qualitätskontrolle und rechtlicher Rahmenbedingungen.

Objectives:This work aimed to document four new cases with giant testicular germ cell tumour (GCT) and to evaluate their relative incidence and clinical characteristics based on a literature survey. Despite the well-established trend over time towards declining tumour sizes in testicular GCTs, giant testicular tumours (>15 cm in diameter) are still reported in present times. Patients Methods:GCT patients treated during 2010-2025 were retrospectively evaluated with tabulating the following data: size of primary tumour (mm), age (years), histology, side and clinical stage (CS). The following parameters were calculated: relative frequency of giant GCTs; median tumour size in all GCTs and in various subgroups. A literature survey was conducted to identify previously published giant testicular GCTs followed by a descriptive evaluation of those cases. Results:Four (0.5%) giant GCTs were identified among 860 GCT patients, two seminomas and two nonseminomas, all having CS3 disease, two of whom were cured. The median tumour size was 32 mm in all GCTs, and 30 mm and 35 mm in seminomas (n = 541) and nonseminomas (n = 319), respectively. Median tumour size was significantly smaller in CS1 cases than in those with CS > 1 (32 mm vs. 38 mm). Of the 40 cases identified with the literature survey, 24 were nonseminomas, 62% were left-sided, median age was 36 years, and 80% were cured. Diagnostic delay is the most frequent cause of excessive tumour growth. Conclusions:Giant testicular tumours are observed in 0.5% of all GCT patients while the median tumour size of 32 mm observed herein is consistent with current reports. In most cases of giant GCT, personal misapprehension of the swelling, lack of knowledge or shame appears to be the key element causing diagnostic delay and consequently, extraordinary tumour growth. Information campaigns including individuals from socioeconomically underprivileged groups could help to increase men's awareness of genital diseases.

Chylous ascites (CA) is the accumulation of chylous lymphatic fluid within the abdominal cavity, usually resulting from laceration of the cisterna chyli or one of its major tributaries during retroperitoneal surgery. If left untreated, CA may become life-threatening. Current treatment recommendations favor a stepwise approach, beginning with conservative measures, followed by percutaneous interventions and, in refractory cases, surgical shunting procedures. Conservative management typically consists of dietary restriction of long-chain triglycerides, escalation to total parenteral nutrition (TPN), and adjunctive pharmacotherapy with somatostatin analogues. In most reported cases, these measures result in cessation of chylous leakage within several days. We report a case of CA after robotic-assisted retroperitoneal lymph node dissection (RPLND) in a 35-year-old male with testicular seminoma. Conservative management included paracentesis with drain insertion, TPN, and pharmacotherapy with octreotide. Ascitic fluid analysis confirmed CA with a triglyceride level of 420 mg/dL. Because chylous leakage did not cease after 60 days of hospital-based management, home-based TPN via a central venous port was initiated. Chylous leakage finally resolved after 80 days of conservative treatment. One year later, the patient remained well and had experienced no recurrence of either CA or seminoma. This case demonstrates that conservative treatment of CA may occasionally require a prolonged course and considerable patience from both the patient and the treating team.

Since 2016, more than 26,000 patients have used the online prostate cancer (PC) decision aid “Entscheidungshilfe Prostatakrebs”. Because a large, randomized, controlled evaluation trial failed to show effects regarding the primary and secondary outcomes after 4 weeks, we used postmarket surveillance data for further analyses. The aim of this study was to analyze the immediate effects of using a PC decision aid on decisional conflict, distress, and knowledge. A total of 2,245 patients used the PC decision aid between 05/2023 and 01/2024. We applied identical validated instruments before and after use to record immediate effects in an intra-individual comparison; the endpoints were decisional conflict (Decisional Conflict Scale, DCS), distress (Distress Thermometer), and objective knowledge (Decision Quality Worksheet). Complete data were available for 880 patients (39.2

Cerebral stroke secondary to cisplatin-based chemotherapy in young patients undergoing chemotherapy for testicular germ cell tumour (GCT) has been reported only sporadically. Here, we report a 49-year-old man undergoing adjuvant chemotherapy with one cycle of bleomycin, etoposide, and cisplatin for nonseminomatous testicular GCT clinical stage 1b. On the sixth day of treatment, a sudden onset of right-sided hemiparesis and aphasia prompted computed tomography and angiography. An occlusion of the left middle cerebral artery was detected. The patient recovered after immediate thrombolytic therapy, but minor neurological deficits were present 9 months after the event. Among 221 GCT patients undergoing cisplatin-based chemotherapy during 2017-2025, one stroke occurred, revealing a relative incidence of 0.45% in this cohort. A literature survey yielded 31 previous GCT cases with a median age of 35 years, most of them were caused by occlusion of brain supplying arteries. Thrombotic occlusions of brain-supplying arteries secondary to cisplatin-based chemotherapy can arise in otherwise healthy young men with no risk factors for vascular disease. Care givers of GCT patients must be cognizant of such events upon counselling patients before chemotherapy, because this complication of treatment may foil the attempts of restoring health in a basically well curable disease.

Large language models (LLMs) mark a structural turning point in digital medicine, as they are now capable not only of processing medical information but of conveying it in ways that are context-sensitive, linguistically coherent, and tailored to the needs of specific audiences. In urology, a specialty defined by high communication demands, explanation-intensive disease entities, and complex organizational interfaces, the central question is no longer one of technical feasibility but of the fundamental repositioning of clinical communication. This article analyzes the role of LLMs as a communication and organizational infrastructure within urologic care, grounded in current empirical evidence. Systematic comparisons demonstrate that artificial intelligence (AI)-generated responses to patient questions are perceived in most studied contexts as equivalent or superior to physician responses, particularly with respect to clarity, empathy, and overall satisfaction, while revealing a pronounced divergence between patient-centered and professional evaluative standards. Urology-specific data on the automated generation of layperson summaries further show that LLMs can achieve significantly improved readability and formal quality without compromising factual accuracy. At the same time, studies on AI-assisted documentation and ambient scribe systems underscore that gains in efficiency and reductions in documentation burden remain inseparable from the need for physician oversight and institutional governance. These findings are not interpreted as a substitution of medical expertise but as the emergence of a new mediating layer between clinical knowledge, organizational requirements, and patient perception. The integration of generative AI, thus, becomes a professional and institutional challenge that extends beyond the deployment of individual tools and shapes the future communication architecture of urology.

BACKGROUND:The integration of artificial intelligence (AI) into urological robotic surgery is currently in a dynamic phase of development and validation. Minimally invasive, standardized, and video-based procedures create highly data-rich operative environments with clearly defined workflow steps, thereby providing ideal conditions for the development of AI-based systems. OBJECTIVE:The objective of this work is to present the current state of AI integration in urological robotic surgery, to classify existing clinically available applications, and to critically evaluate the perspective of autonomous systems. Technological, regulatory, and clinical aspects are considered in equal measure. MATERIALS AND METHODS:An analysis of the current literature was conducted, along with a systematic review of clinically available robotic platforms and experimental systems. Both approved medical devices with integrated AI functionalities and preclinical developments in the field of semi-autonomous and autonomous surgical modules were included. In addition, international research initiatives aimed at advancing autonomous surgical systems were taken into account. CONCLUSION:Current developments primarily focus on supportive systems such as environment modeling and augmented reality (AR) navigation. Clinically approved platforms increasingly benefit from data-driven performance analytics, optimized treatment planning, and enhanced teleoperative structures. As the level of autonomy increases, the requirements for validation, regulation, and liability frameworks also become more demanding. Urological robotic surgery is therefore undergoing a paradigm shift-from purely teleoperated assistance toward adaptive, semi-autonomous systems. This transition is driven not only by technological innovation but also by international research and investment programs, and it necessitates structural adaptations in surgical training, quality control, and legal frameworks.

Telemedizin findet breite Anwendung in der Urologie, wird allerdings in Leitlinien bisher nicht ausreichend berücksichtigt. Es wurde ein zweistufiger Expertenkonsensus durchgeführt, wobei in zwei Runden Statements von Experten aus der Urologie evaluiert wurden. Zwischen den Runden erfolgten entweder virtuelle oder vor Ort Besprechungen. Statements mit 75

OBJECTIVE:To evaluate the feasibility of hyperaccuracy three-dimensional (HA3D) virtual models with augmented reality (AR) in robot-assisted retroperitoneal lymph node dissection (R-RPLND) for testicular cancer. METHODS:A 35-year-old male with 4 cm interaortocaval seminoma recurrence underwent unilateral template R-RPLND. A patient-specific HA3D model was generated from contrast-enhanced CT using Avatar Medical software and integrated into preoperative planning and intraoperative AR navigation. RESULTS:HA3D modeling enabled precise preoperative identification of a critical renal arterial branch adjacent to the tumor, facilitating safe dissection. R-RPLND was completed in 76 min with minimal blood loss (30 mL) and no complications. Pathology confirmed 4.5 cm viable seminoma metastasis. Nine-month follow-up showed no recurrence. CONCLUSION:This proof-of-concept case demonstrates successful integration of HA3D virtual models and AR into R-RPLND workflow, potentially enhancing anatomical visualization, surgical planning, and procedural safety. Multicenter prospective studies are needed to validate reproducibility and clinical benefit.

Clear and accessible lay summaries are essential for enhancing the public understanding of scientific knowledge. This study aimed to evaluate whether ChatGPT-4 can generate high-quality lay summaries that are both accurate and comprehensible for prostate cancer research in Current Oncology. To achieve this, it systematically assessed ChatGPT-4's ability to summarize 80 prostate cancer articles published in the journal between July 2022 and June 2024 using two distinct prompt designs: a basic "simple" prompt and an enhanced "extended" prompt. Readability was assessed using established metrics, including the Flesch-Kincaid Reading Ease (FKRE), while content quality was evaluated with a 5-point Likert scale for alignment with source material. The extended prompt demonstrated significantly higher readability (median FKRE: 40.9 vs. 29.1, p < 0.001), better alignment with quality thresholds (86.2% vs. 47.5%, p < 0.001), and reduced the required reading level, making content more accessible. Both prompt designs produced content with high comprehensiveness (median Likert score: 5). This study highlights the critical role of tailored prompt engineering in optimizing large language models (LLMs) for medical communication. Limitations include the exclusive focus on prostate cancer, the use of predefined prompts without iterative refinement, and the absence of a direct comparison with human-crafted summaries. These findings underscore the transformative potential of LLMs like ChatGPT-4 to streamline the creation of lay summaries, reduce researchers' workload, and enhance public engagement. Future research should explore prompt variability, incorporate patient feedback, and extend applications across broader medical domains.

INTRODUCTION:Half of all patients with testicular germ cell tumors (GCTs) present with metastases to retroperitoneal lymph nodes or visceral organs. Inguinal metastases (I/Ms) are very rare. We aimed to evaluate the relative frequency and clinical features of I/Ms and look for predisposing factors. METHODS:A cohort of 740 GCT patients treated between 2010 and 2022 was analyzed. The frequency of I/M and their clinical features were statistically compared among the subgroups. RESULTS:Eight patients had I/M, with a median age of 55 years, all of whom had primary seminoma and six had previous groin surgery. The relative frequency of I/M is 1.1% and 8.3% in the GCT patient cohort and the metastasized seminoma subgroup, respectively. All patients were cured, six underwent surgery and additional chemotherapy, and two received cisplatin-based chemotherapy alone. DISCUSSION:I/Ms occur in approximately 1% of GCT patients. Prior groin surgery, bulky retroperitoneal metastases, and possibly histology of seminoma represent risk factors for I/M. The presence of I/M does not adversely affect prognosis, and all cases can be cured with standard therapeutic measures. Lymph node excision may be required to establish the diagnosis. In patients with risk factors, follow-up examinations should include the groins.

Abstract Purpose microRNA-371a-3p (M371) is considered a highly sensitive and specific serum biomarker of testicular germ cell tumours (GCTs). However, little is known about the expression of M371 in nontesticular malignancies (NTMs), so far. As knowledge about the expression of the marker in other malignancies is a prerequisite for the clinical application of the test we aimed to explore the M371 expression in other cancers. Methods M371 serum levels were measured in 137 patients with NTM of 12 different neoplastic entities using the IVDR-certified M371-Test for quantitative real-time PCR. Median M371 serum levels and percentages of M371 level elevations were calculated for the entire NTM group and for entity-specific subgroups. The results were compared with GCT patients (n = 20) and with tumour-free male controls (n = 20) using descriptive statistical methods. Results Eight patients with NTMs had M371 serum level elevations, corresponding to a false-positive rate (FPR) of 5.84% (95% confidence intervals (CIs) 2.55–11.18%). Expression rates in GCTs and controls were 100% and zero, respectively. Thus, the specificity of the M371-Test for GCT is 94.90% (95% CI 90.21–97.77%) when all NTMs and tumour-free controls are considered. Remarkably, three out of 5 patients with multiple myeloma had elevated M371 levels. Conclusion The false-positive rate of the M371-Test in other malignancies than GCT is very low, and almost identical with that in healthy males, corresponding to a high specificity of 94.9% for detection of GCT. The surprising finding of M371 elevations in patients with multiple myeloma needs further investigation.

Background/Purpose: Retroperitoneal lymph node dissection (RPLND) plays a crucial role in the surgical management of testicular cancer. However, RPLND is associated with a high risk of morbidity. Currently, open RPLND (O-RPLND) is considered the gold standard for surgical treatment. The use of minimally invasive techniques has increased significantly over the last few years. This study aimed to compare the safety and oncological outcomes of open (O-RPLND) and robotic (R-RPLND) retroperitoneal lymph node dissection for testicular cancer. Materials and Methods: We retrospectively analyzed all the patients who underwent RPLND at our testicular cancer center. Standard O-RPLND was performed with the usual equipment, and R-RPLND was performed with the Da Vinci X/Xi surgical system. The pre- and perioperative parameters and the postoperative complications (Clavien–Dindo classification), anejaculation, and the relapse rate were recorded. The association between the clinicopathological variables and the complications and relapse was assessed using regression analyses. Results: Sixty-five patients underwent RPLND during 2017–2024 due to testicular cancer (TC), with thirty-one (47.7%) receiving R-RPLND, including seventeen patients post-chemotherapy (55%). Meanwhile, 34 (52.3%) underwent O-RPLND, comprising 31 patients post-chemotherapy (91%). R-RPLND demonstrated excellent results compared to O-RPLND in terms of the operative time (OT) (p < 0.00001). The R-RPLND group had two (6.5%) high-grade (Clavien–Dindo III–V) complications, while four (11.8%) high-grade complications were noted in the O-RPLND group. R-RPLND was linked to a shorter OT (p < 0.00001). The hospital stay for R-RPLND was, on average, 2.7 days shorter. In logistic regression analysis, R-RPLND was non-inferior to O-RPLND for overall complications (p = 0.6) and low-grade Clavien–Dindo (I-II) (p = 0.2) and high-grade Clavien–Dindo (≥III) complications (p = 0.7). The median follow-up was 13 months for R-RPLND and 38 months for O-RPLND. Two relapses were observed in the R-RPLND group (6.5%), and two in the O-RPLND group (5.9%). One patient who underwent R-RPLND developed field-edge recurrence. No significant differences in the relapse and anejaculation rates were found between R-RPLND and O-RPLND (p = 0.9 and p = 0.8, respectively). Conclusions: In conclusion, R-RPLND is a feasible procedure with a low complication rate and an acceptable oncological outcome. It has proven to be significantly shorter to O-RPLND in relation to the lengths of HS and OT. However, R-RPLND is a demanding procedure with a considerable learning curve.

BACKGROUND:Retroperitoneal lymph node dissection (RPLND) is an established treatment modality for nonseminomatous germ cell tumours (NSGCT) and selected seminomas. The advent of minimally invasive techniques, particularly robot-assisted RPLND (R-RPLND), involves the prospects of reducing procedure-related morbidity while maintaining oncologic efficacy. MATERIALS AND METHODS:We performed a narrative review comparing contemporary data on R‑RPLND and open RPLND (O-RPLND) across different clinical settings (primary, clinical stages I-II, and postchemotherapy). Guideline recommendations are reviewed regarding results from prospective and retrospective studies, as well as recent meta-analyses. RESULTS:R‑RPLND consistently demonstrated advantages in perioperative outcomes, including reduced blood loss, shorter length of hospital stay, and faster convalescence. High-grade complication rates (Clavien-Dindo ≥ III) were comparable or lower than with O‑RPLND. Oncologic outcomes, including recurrence-free survival, were noninferior across all stages. In the postchemotherapy setting, R‑RPLND was associated with lower morbidity, though surgical feasibility is highly dependent on tumour size, location, and prior abdominal surgery. CONCLUSION:R‑RPLND represents a safe and effective alternative to O‑RPLND in selected patients when performed in high-volume centres. Its perioperative advantages, coupled with equivalent short-term oncologic outcomes, render R‑RPLND an attractive option. However, high-quality randomised trials with long-term follow-up are required to confirm oncologic equivalence and to refine patient selection criteria.

BACKGROUND:Poor semen quality is a well-known feature in patients with testicular germ cell tumours (GCTs) at the time of diagnosis but the underlying biological reasons are incompletely understood. OBJECTIVES:This study aimed to identify GCT-specific clinical factors that are involved with poor semen quality in GCT patients. MATERIALS AND METHODS:Pre-orchiectomy ejaculate volume (EV), total sperm count (TSC), and proportion of progressive motility (PPM) were retrospectively analysed in 163 consecutive GCT patients. Their possible associations with the following clinical factors were evaluated: patients age, GCT histology, clinical stages, tumour size, serum levels of tumour markers and of follicle stimulating hormone (FSH) and luteinizing hormone (LH). Statistical methods involved comparisons of various stratified subgroups of clinical characteristics by employing multivariable statistical analyses. RESULTS:Patients > 40 years had significantly inferior results than patients < 30 years with respect to median EV (2 mL vs. 3.1 mL) and median PPM (25% vs. 40%). The median TSC was 75-80 million in mildly elevated levels of beta human chorionic gonadotropin (bHCG) opposed to only 22 million in greatly elevated levels. Elevated FSH indicated low sperm counts. GCT histology, tumour-size, and elevations of alpha fetoprotein levels were not associated with semen quality. The effect of clinical staging remained equivocal due to small numbers. DISCUSSION AND CONCLUSION:Greatly elevated bHCG levels and age > 40 years are significantly associated with poor semen quality in GCT patients. The inverse association of age with semen quality is a novel finding in GCT patients that mirrors the physiological decline of male reproductive function with age but that still needs confirmation. As these two features are present in only a small proportion of patients, other factors such as the postulated testicular dysgenesis syndrome may be involved in the pathogenesis of poor semen quality in the majority of GCT patients.

Background The increasing volume and complexity of biomedical literature pose challenges for making scientific knowledge accessible to lay audiences. Lay summaries, now widely encouraged or required by journals, aim to bridge this gap by promoting health literacy, patient engagement, and public trust. However, many are written by scientists without formal training in plain-language communication, often resulting in limited clarity, readability, and consistency. Generative large language models such as ChatGPT-4 offer a scalable opportunity to support lay summary creation, though their effectiveness within specific clinical domains has not been systematically evaluated at scale. Objective This study aimed to assess ChatGPT-4’s performance in generating lay summaries for prostate cancer studies. A secondary objective was to evaluate how prompt design influences summary quality, aiming to provide practical guidance for the use of generative artificial intelligence (AI) in scientific publishing. Methods A total of 204 consecutive articles on prostate cancer were extracted from a high-ranking oncology journal mandating lay summaries. Each abstract was processed with ChatGPT-4 using 2 prompts: a simple prompt based on the journal’s guidelines and an extended prompt refined to improve readability. AI-generated and original summaries were evaluated using 3 criteria: readability (Flesch-Kincaid Reading Ease [FKRE]), factual accuracy (5-point Likert scale, blinded rating by 2 clinical experts), and compliance with word count instructions (120‐150 words). Summaries were classified as high-quality as a composite outcome if they met all 3 benchmarks: FKRE >30, accuracy ≥4 from both raters, and word count within range. Statistical comparisons used Wilcoxon signed-rank and paired 2-tailed t tests (P<.05). Results ChatGPT-4-generated lay summaries showed an improvement in readability compared to human-written versions, with the extended prompt achieving higher scores than the simple prompt (median FKRE: extended prompt 47, IQR 42-56; simple prompt 36, IQR 29-43; original 20, IQR 9.5‐29; P<.001). Factual accuracy was higher for the AI-generated lay summaries compared to originals (median factual accuracy score: extended prompt 5, IQR 5-5; simple prompt 5, IQR 5-5; original 5, IQR 4-5; P<.001) in this dataset. Compliance with word count instructions was greater for both AI-generated summaries in comparison to originals (wrong number of words; extended prompt 39 (19%), simple prompt 40 (20%), original 140 (69%); P<.001). Between simple and extended prompts, there were no significant differences in accuracy (P=.53) and word count compliance (P=.87). The proportion rated as high-quality was 79.4% for the extended prompt, 54.9% for the simple prompt, and 5.4% for original summaries (P<.001). Conclusions With optimized prompting, ChatGPT-4 produced lay summaries that, on average, scored higher than author-written versions in readability, factual accuracy, and structural compliance within our dataset. These results support integrating generative AI into editorial workflows to improve science communication for nonexpert audiences. Limitations include focus on a single clinical domain and journal, and absence of layperson evaluation.

Abstract Background Sperm cryopreservation in patients with testicular germ cell tumours (GCTs) is traditionally performed after orchiectomy. But, some evidence suggests preoperative semen quality to be superior. We aimed to clarify the optimal time-point of cryopreservation.In a retrospective study, semen quality of 163 patients analysed preoperatively was compared with 242 patients analysed shortly after orchiectomy. Descriptive statistical methods with standard tests for comparisons were employed along with stratified analyses regarding the influence of clinical factors. Results All major semen parameters were significantly better in the preoperative group: median ejaculate volume (3 ml preoperatively vs. 2 ml postoperatively); median total sperm count (56.9 x106vs.13 x 106), median progressive motility (40% vs. 25%); azoospermia (4.9% vs. 14.9%). Stratified analysis of subgroups did not reveal significant impact of particular clinical factors on the superiority of preoperative semen quality. Limitations relate to the design of group comparison rather than intraindividual longitudinal comparisons and to selective inclusion of patients opting for cryopreservation. Conclusions In GCT patients, semen quality before orchiectomy is significantly superior to that found immediately after surgery. This superiority encompasses all major semen quality parameters. Of particular note is a threefold increase of azoospermia postoperatively. GCT patients are best advised to have cryopreservation performed before orchiectomy.

INTRODUCTION:Subfertility is a well-known aftermath of treatment of testicular germ cell tumours (GCTs). Growing evidence suggests reduced semen quality also before therapy. The present study aimed to evaluate pre-orchiectomy semen parameters in GCT patients and to compare the results with controls. METHODS:GCT patients providing semen for cryopreservation before orchiectomy during 2012-2023 were retrospectively enrolled (TT cohort). Controls consisted of healthy volunteers for sperm donation (HD), and of patients with other malignancies (OMs). The following parameters were recorded in each participant: ejaculate volume (EV; ml), total sperm count in ejaculate (TSC), and proportion of progressive motility (PM) (%). Descriptive statistical methods were used to compare the 3 populations with each other. RESULTS:A total of 664 subjects were included, thereof 163 TT, 289 HD, and 212 OM. Median EV was 3.0 mL, 3.5 mL, and 3.4 mL; median TSC was 56.9 × 106, 207 × 106, and 152 × 106; median PM was 40%, 40.2%, and 43% in TT, HD, and OM, respectively. TSC, EV, and several secondary parameters of semen quality observed in TT were significantly worse than those in the two control cohorts. HD and OM were within normal limits with regard to TSC and PM and were different in only a few secondary parameters. CONCLUSION:This study confirmed significantly lower pre-orchiectomy semen quality in GCT patients in comparison to healthy males and to patients with OM. Subfertility is an intrinsic feature of GCT preceding treatment that needs to be considered by care-givers.

Die abundanten Möglichkeiten resultierend aus den verschiedenen Anwendungen künstlicher Intelligenz beeinflussen auch schrittweise die akademisch-wissenschaftliche Kommunikation. Diese Studie untersucht die Eignung von ChatGPT‑4 zur Erstellung von Laienzusammenfassungen (LZ) für wissenschaftliche Artikel, die in den vier Zeitschriften der European-Urology-Familie veröffentlicht wurden, und vergleicht dann die Qualität dieser neu generierten LZ mit den Originaltexten. Insgesamt wurden 327 Artikel zum Prostatakarzinom, veröffentlicht zwischen dem 1. Januar 2023 und dem 30. Juni 2024, analysiert. ChatGPT‑4 generierte Patientenzusammenfassungen auf Basis eines einfachen sowie eines erweiterten Eingabebefehls, letzterer speziell optimiert für eine verbesserte Lesbarkeit. Diese wurde mihtilfe etablierter Indizes gemessen, während die inhaltliche/fachliche Qualität von zwei verblindeten Gutachtern anhand einer 5‑Punkte-Likert-Skala bewertet wurde. Ergänzend wurden Lesbarkeit, inhaltliche/fachliche Qualität und die Einhaltung der Zeitschriftenrichtlinien gesamtheitlich in einem Score beurteilt. Der erweiterte Eingabebefehl führte zu einer signifikant besseren Lesbarkeit im Vergleich zum einfachen Eingabebefehl (p < 0,001) und zu den originalen LZ (p < 0,001). Die inhaltliche/fachliche Qualität war zwischen den beiden ChatGPT-4-Befehlen vergleichbar (p = 0,665), jedoch höher als bei den Originalzusammenfassungen (p = 0,001 bzw. p = 0,002). Beide Befehle zeigten eine stärkere Einhaltung der Zeitschriftenrichtlinien (p < 0,001), wobei die Rate fehlerfreier LZ bei 29,4