BACKGROUND AND OBJECTIVE:Urological infections significantly impact individuals' well-being and quality of life due to their widespread occurrence and diverse clinical manifestations. This work aims to provide evidence-based guidance on diagnosing, treating, and preventing urinary tract infections (UTIs) and male accessory gland infections, while addressing crucial public health aspects related to infection control and antimicrobial stewardship. METHODS:For the 2026 Urological Infections Guidelines, new and relevant evidence was identified, collated, and appraised through a structured assessment of the literature. Databases searched included Medline, EMBASE, and the Cochrane Library. Recommendations within the Guidelines were developed by the panels to prioritise clinically important care decisions. The strength of each recommendation is determined by the balance between desirable and undesirable consequences of alternative management strategies, the quality of the evidence (including certainty of estimates), and the nature and variability of patient values and preferences. KEY FINDINGS AND LIMITATIONS:Key recommendations emphasise the importance of thorough medical history and physical examination for patients with urological infections. The guidelines stress the role of antimicrobial stewardship to combat the rising threat of antimicrobial resistance, providing recommendations for antibiotic selection, dosing, and duration based on the latest evidence. Key updates in the 2026 Urological Infections Guidelines summary include: comprehensive restructuring of the guideline framework in alignment with the new classification system for UTIs; the addition of a new chapter on the diagnosis and management of Herpes simplex virus; the addition of a new chapter on the diagnosis and treatment of fungal UTIs; and an update of the evidence and recommendations on periprocedural antibiotic prophylaxis for prostate biopsy. CONCLUSIONS AND CLINICAL IMPLICATIONS:This overview of the 2026 European Association of Urology (EAU) guidelines offers valuable insights into the classification, diagnosis, and treatment of urological infections and is designed to be effectively integrated into clinical practice.

Background/Objectives: Interest in the use of nutraceuticals and phytotherapy for the management of andrological diseases has increased markedly in recent years. In particular, growing attention has been directed toward the treatment of patients affected by erectile dysfunction (ED), male infertility, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and induratio penis plastica (IPP). However, several areas of uncertainty remain. This narrative review aims to examine the role of nutraceuticals and phytotherapeutic agents in the management of andrological disorders. Methods: A narrative review was conducted using PubMed, Scopus, Cochrane CENTRAL, and EMBASE to identify relevant studies published over the past 25 years. Only articles published in English and involving adult populations were included in the analysis. Results: Nutraceuticals and phytotherapeutic compounds have been extensively investigated in the current literature, and certain formulations—particularly specific combinations—have been evaluated in high-quality studies. Conversely, other compounds lack sufficient scientific evidence and therefore should not be recommended in routine clinical practice. In the management of ED, the following compounds, administered either alone or in combination, have demonstrated clinically significant effects: Panax ginseng, Tribulus terrestris, L-arginine, and Withania somnifera. L-carnitine, combined with micronutrients, antioxidants, and various traditional herbal supplements, appears to be an effective therapeutic option for male infertility and subfertility. Pollen extracts play an important role in the management of CP/CPPS, while carnitine, coenzyme Q10, silymarin, bromelain, and curcumin show promising potential in the treatment of IPP. Conclusions: Nutraceuticals and phytotherapeutic agents may provide favorable outcomes in the management of andrological diseases. Although current evidence is encouraging, larger prospective studies employing standardized protocols and treatment schedules are required to confirm long-term efficacy and to optimize therapeutic strategies.

The detection of fungi in urine is common, particularly in nosocomial settings. Nevertheless, diagnostic and treatment approaches are often associated with uncertainty. Accordingly, this review aimed to give a concise overview of fungal urinary tract infection (UTI) as a supplement to the more comprehensive update of the European Association of Urology 2026 Guidelines on Urological Infections.Only 2–11% of fungal isolates in urine are associated with symptoms, and a fungal UTI should only be assumed in such cases. Candida albicans is the most frequently identified pathogen. Diagnosis should include a urine culture with susceptibility testing, especially in non-albicans Candida UTI. Nonantimicrobial measures such as catheter replacement should always be part of the treatment. First-line antimicrobial treatment is fluconazole. In cases of localized bladder infections, intravesical amphotericin B may be considered. Asymptomatic funguria should only be treated in exceptional cases. Urologists should play a key role in treatment decision-making for patients with fungal UTIs.

In recent years we have witnessed increasing interest for the role of microbiota in the pathophysiology and management of prostatic diseases. However, there are several aspects to comprehend. Here, we aim to assess the gut microbiota composition and faecal microbiota-derived short-chain fatty acids production (SCFAs) in the pathogenesis of CP/CPPS. All patients with CP/CPPS attending our urology centre, were enrolled in this study, and underwent urological examination, microbiological evaluation, intestinal microbiota analysis and measurement of interleukins in semen. A cohort of subjects who had undergone intestinal microbiota investigation for various reasons but did not exhibit any symptoms of urological disease, was used as control group. Laboratory data from the two groups were analysed in terms of gut microbiota composition and levels of SCFAs. We enrolled 37 patients and 45 controls. In the CP/CPPS patient group, the mean levels of interleukins were: IL-8 934 pg/ml, IL-10 64 pg/ml, IL-6 871 pg/ml. In this patient group, we found higher levels of Bifidobacteriaceae and Bacteroidaceae and lower levels of Prevotella and Lactobacillus with a Firmicutes/Bacteroides mean ratio at 0.27. The control group had a normal Firmicutes/Bacteroides mean ratio (1.6). The two groups showed a significant difference in total SCFAs levels (p = 0.001) and in particular regarding indole-3-propionic acid (p = 0.003) and butyric acid (p < 0.001). A statistically significant correlation was found between the levels of IL-8 and a decreasing SCFAs production (p < 0.001). A difference in gut microbiota between patients with CP/CPPS and controls, together with a reduction in faecal levels of microbiota-derived short-chain fatty acids and decreased IL-8 levels in semen, might be part of the pathophysiological mechanism in CP/CPPS.

In recent years, healthcare strategies have increasingly emphasized a holistic and comprehensive approach in patient management that extends beyond the treatment of isolated physical symptoms. In this context, the use of nutraceuticals has gained interest as a complementary approach, particularly in managing chronic conditions and age-related disorders, such as lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH). A new dietary supplement, contains a blend of bio-active compounds (Drolessano®)-including lycopene, sulforaphane, silymarin, glutathione, escine, tryptophan, and green tea extract-has been introduced in Italian pharmacopeia as food supplements in urological and andrological diseases. Here, we aim to assess the effects of Drolessano® on serum prostate-specific antigen (PSA) levels and urinary symptoms in individuals with BPH. Fifty-five men presenting with elevated PSA values and mild lower urinary tract symptoms (International Prostate Symptom Score [IPSS] < 7) were recruited in this pilot study. All enrolled patients underwent Drolessano® one tablet daily for 6 months. PSA concentrations and IPSS scores were recorded at baseline (T0), at 3 months (T1), and at the end of the treatment period (T2). Data at the follow-up has been compared with those at baseline. Patients enrolled experienced a statistical significance average PSA declined from 4.8 to 3.7 ng/mL (p < 0.003), as well as in improvement of quality of life, tested by patient reported outcomes. The supplement was generally well tolerated, and no serious adverse effects were reported during the study period. These preliminary data suggest that Drolessano® may offer a supportive benefit in the management of BPH, particularly with respect to reducing PSA levels and improvement quality of life. Otherwise, controlled trials with larger sample sizes are needed to substantiate these findings and to better understand the underlying mechanisms of action.

BACKGROUND:Acute pyelonephritis (AP) and complicated urinary tract infections (cUTIs) are pooled in registrational RCTs of new antibiotics. We assessed whether outcomes differ between subtypes and which component of the composite endpoint drives any difference. METHODS:Across ten registrational RCTs we estimated the AP-versus-cUTI treatment effect on the composite primary endpoint (clinical cure plus microbiologic eradication at test-of-cure) using random-effects risk ratios, with risk-difference, odds-ratio and leave-one-out sensitivity analyses. Between-arm differences in the composite and its components were correlated across trials; operative definitions and stratified-reporting practices were extracted. RESULTS:From 5,971 patients (3,393 AP; 2,578 other cUTI), AP showed higher overall cure at TOC (pooled RR=1.12; 95% CI 1.03-1.23; I2=82%; 95% prediction interval 0.86-1.46). Between-arm differences in the composite correlated strongly with those in microbiologic eradication (r=0.98) but only weakly with those in clinical cure (r=0.30). In the single trial reporting components stratified by infection subtype (ADAPT-PO), the AP-versus-cUTI gap was larger in microbiologic eradication (+15.6 pp) than in clinical response (+3.5 pp); whether this pattern generalizes to the remaining nine trials could not be publicly tested. Risk of bias was overall some concerns in nine of ten trials, mostly for missing outcome data and selection of the reported result. CONCLUSIONS:AP achieved higher cure rates at TOC than other cUTIs. Heterogeneity in operative AP/cUTI definitions and limited stratified reporting of component outcomes reduce interstudy comparability. Future trials should harmonize definitions, prespecify stratification by infection subtype, and disclose clinical and microbiologic outcomes separately.

Background/Objectives: Persistent infections are characterized by recurrent treatment failure and relapse despite apparent antibiotic susceptibility by standard testing, a clinical reality not fully explained by conventional resistance paradigms. Bacterial persister cells, genetically susceptible but phenotypically tolerant subpopulations, survive otherwise lethal antibiotic exposure through reversible physiological adaptations. This review proposes a pharmacological framework linking antimicrobial exposure, bacterial tolerance, persistence, relapse, and the emergence of antimicrobial resistance (AMR). Methods: A structured narrative review was conducted using PubMed/MEDLINE, ClinicalTrials.gov, Centers for Disease Control and Prevention (CDC), and World Health Organization/Global Antimicrobial Resistance and Use Surveillance System (WHO/GLASS) sources (inception to 19 June 2026, priority 2010-2026), following Scale for the Assessment of Narrative Review Articles (SANRA) framework principles. Results: Resistance, tolerance, and persistence are pharmacologically distinct phenotypes. Persistence occurs without minimum inhibitory concentration (MIC) elevation and is shaped by antimicrobial exposure, target-site penetration, biofilm barriers, intracellular localization, and host stress. The review operationalizes persistence prevention exposure (PPE) in relation to minimum duration for killing 99%/99.99% of cells (MDK99/MDK99.99), persister fraction, minimum biofilm eradication concentration (MBEC), and biphasic time-kill modeling. Conclusions: Antimicrobial therapy should evolve from a model centered solely on MIC suppression and killing of actively growing bacteria toward one that also includes the prevention and eradication of persister reservoirs. Persistence prevention may reduce relapse, repeated antibiotic exposure, and the evolutionary path toward stable AMR.

Background/Objective: Parastomal hernia (PSH) following radical cystectomy (RC) with ileal conduit represents a significant late complication. Preventive strategies have been described but are not yet routinely incorporated into clinical practice. We conducted a systematic review of the current literature to assess the efficacy of PSH preventive techniques for ileal conduit. Methods: A literature search of PubMed/MEDLINE, Scopus, CENTRAL, and Web of Science databases was conducted from 2010 to December 2024 following PRISMA guidelines. Inclusion criteria were patients undergoing RC with ileal conduit, evaluation of at least one PSH preventive strategy and reporting of PSH incidence or relevant postoperative outcomes. Eligible designs included RCTs and non-randomized cohort studies. Exclusion criteria included urinary diversions other than ileal conduit, non-bladder-related indications, non-extractable outcome data, and non-original publications. Results: Three randomized controlled trials (RCTs) and nine non-randomized studies were included in the analysis. Studies investigating both mesh and non-mesh preventive techniques were considered. Clinical PSH recurrence rates following mesh placement ranged from 0.0% to 11.1% among the included studies. RCTs using mesh placement reported conflicting conclusions regarding its protective effects. For non-mesh preventive strategies, clinical PSH recurrence rates ranged from 0.0% to 11.5%. The only RCT focusing on non-mesh approaches reported positive protective effects for the experimental group. All procedures were safe, with no significant increase in complication rates compared to conventional interventions. Conclusions: The low quality of current evidence prevents definitive conclusions regarding the protective effects of both mesh and non-mesh preventive approaches. High-quality evidence is needed to make conclusive statements on this topic. Patients at high risk for PSH development should be offered personalized preoperative counselling and the opportunity to participate in ongoing RCTs.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has a significant negative impact on people’s quality of life. Aims: the objective of this study was to evaluate the efficacy and the safety of a new device that uses Top Flat Magnetic stimulation to treat hypertonia in men affected by CP/CPPS condition. 20 male patients affected by CPPS underwent 8 treatment sessions which were conducted twice weekly for four consecutive weeks. Data were collected at baseline and 1-month follow-up (1MFU) after the last treatment session. The Italian version of The National Institute of Health Chronic Prostatitis Symptom Index (NIHCPSI) was administered to all patients. The mean “pain” score, “urinary symptoms” and patient’s quality of life (“QL”) were evaluated at baseline and 1MFU after the last treatment session. The mean pain score was also assessed using the Pain Intensity Visual Analog Scale (VAS). In addition, The International Index of Erectile Function (IIEF) was provided before and 1MFU after the last treatment session. All possible side effects were evaluated. Changes in the total mean NIHCPSI score significantly decreased from 31.5 (±2.9) at baseline to 12.75 (±3.5) at 1MFU after the last treatment session showing an improvement in CP/CPPS symptoms. The total mean IIEF score significantly increased from 21.3 (±2.7) at baseline to 24.3 (±0.5) at 1MFU after the last treatment session, showing better erectile functioning. Finally, also the mean VAS score significantly decreased from 7 (±1.0) at baseline to 3 (±0.9) at 1MFU after the last treatment session. Based on the study results, this technology could represent a new treatment option for CP/CPPS conditions. none.

In the Archivio Italiano di Urologia e Andrologia, Zeki Bayraktar presented the results of a review of all published research on the quality of life, satisfaction, patient-reported outcomes, and short- and long-term problems of patients who had gender-affirming surgery (GAS)...

Background/Objectives: Buccal mucosa graft (BMG) is increasingly utilized in reconstructive urological surgeries due to its versatility, robust integration, histological characteristics and low morbidity at the donor site. Initially employed in urethral surgery, BMG use has expanded to complex ureteral and penile reconstructive procedures. This narrative review examines BMG applications in various urological surgeries, comparing its outcomes to other graft types, with a focus on surgical techniques and patient outcomes. Methods: A narrative review was conducted using PubMed and Scopus to identify relevant studies published over the last three decades on the use of BMG in urological reconstructive surgery. Articles in English addressing BMG harvesting, applications and functional outcomes were analyzed. Results: BMG has demonstrated high success rates in every field of its application, especially in urethral reconstruction with an 83–91% efficacy rate in intermediate follow-up. Studies have also reported positive outcomes in complex ureteral and penile curvature surgeries, with patient satisfaction rates reaching up to 85%. Conclusions: BMG is an adaptable tissue graft for urological reconstructive surgeries, offering favorable outcomes with minimal morbidity. Although the current results are encouraging, larger prospective studies with standardized protocols are necessary to fully validate its long-term efficacy and optimize treatment approaches for complex urological reconstructions.

Genital herpes (GH) is a prevalent, lifelong, sexually transmitted infection caused by herpes simplex virus types 1 and 2. Although traditionally managed by dermatologists and infectious disease specialists, GH is increasingly relevant to urologists owing to its clinical complexity and psychosocial impact. This mini-review by the European Association of Urology Guidelines Panel for Urological Infections summarizes updated evidence on GH epidemiology, diagnosis, treatment, and prevention strategies. Diagnosis remains challenging because of atypical presentations; polymerase chain reaction is the preferred diagnostic test. Management mainly relies on nucleoside analogs, with new therapies under investigation. Suppressive treatment reduces recurrences and transmission. Routine screening of asymptomatic individuals is not recommended. Effective counseling and partner notification are critical components of care. PATIENT SUMMARY: Patients with genital herpes should receive clear information on the nature of the infection, the diagnostic process, and treatment options and preventive strategies. Urologists must play a key role in managing symptoms, reducing the risk of transmission, and supporting patients through education and counseling.

Chronic pelvic pain (CPP), often associated with increased hypertonicity or overactivity of the pelvic floor muscles, affects 6% to 16% of women worldwide. It is characterized by persistent, non-specific pain without a clear clinical cause. This study aimed to assess the efficacy and safety of a new device that utilizes Top Flat Magnetic Stimulation (TFMS) to manage pelvic muscle hypertonia in women with CPP, using validated questionnaires to measure outcomes. Twenty participants underwent eight treatment sessions with a non-invasive electromagnetic therapeutic device. The device generates uniform TFMS, which targets muscle activity to alleviate pain and inhibit hypertonic muscle responses. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) was employed to evaluate improvements, and any side effects were carefully monitored throughout the study. The total mean PISQ-12 score decreased significantly from 29.2 (± 3.3) to 17 (± 2). Behavioral-emotional item scores (questions 1-4) showed a reduction from 12 (± 2) to 7 (± 0.9), indicating an improvement in the emotional and psychological impact of CPP. Physical item scores (questions 5-9) decreased from 10.6 (± 1.8) to 6 (± 1.4), suggesting relief in physical discomfort. The Partner-Related item scores (questions 10-12) also improved, dropping from 6.6 (± 1.6) to 3.9 (± 0.4), indicating enhanced relationship dynamics. The device used in this study demonstrated a significant reduction in pain and muscle hyperactivity, showing promise as a safe and effective treatment option for chronic pelvic pain in women. The consistent improvement across all domains of the PISQ-12 underscores the potential of TFMS for managing CPP, offering both physical relief and improved emotional and relationship well-being for patients. none.

Background: Phosphodiesterase type 5 inhibitors (PDE5i), particularly tadalafil and sildenafil, are the first-line therapies for erectile dysfunction (ED). After the patent expiration of branded tadalafil in 2017, generic formulations became available. Despite equivalent efficacy, skepticism persists regarding the effectiveness and safety of generics. The SHIFT study aimed to evaluate the non-inferiority of a generic tadalafil (Dalerpen) compared with branded and other generic tadalafil in terms of clinical efficacy and patient satisfaction. Methods: A prospective, multicenter study was conducted involving 247 patients treated with tadalafil (either 5 mg or 20 mg) for ED. Patients switched from branded or other generic tadalafil to Dalerpen. Baseline and follow-up assessments included the International Index of Erectile Function—Erectile Function Domain (IIEF-EF) (primary endpoint), Sexual Encounter Profile (SEP-2 and SEP-3), and International Prostatic Symptom Score (IPSS). A one-month follow-up was performed. Results: A total of 247 patients were included in the final analysis. After switching to Dalerpen, significant improvements were observed in both IIEF-EF (18.8 ± 5.6 vs. 16.7 ± 5.4, p < 0.001) and IPSS scores (10.4 ± 6.7 vs. 11.2 ± 6.3, p < 0.001), though the minimal clinically important difference (MCID) was not reached. SEP-3 scores also significantly increased (3 ± 1.2 vs. 2 ± 1.1, p < 0.001). Multivariate analysis identified baseline IIEF, IPSS scores, and post-treatment IPSS as predictors of IIEF-EF improvement (p < 0.001). Switching to Dalerpen was an independent predictor of both IIEF-EF and IPSS improvement. No new adverse events were reported. Conclusions: The SHIFT study demonstrates that Dalerpen is non-inferior to branded tadalafil in terms of clinical efficacy, offering a reliable and cost-effective therapeutic option. Educating patients on bioequivalence and addressing concerns regarding generic drugs are essential to facilitate therapeutic switches.

Background/Objectives: Chronic bacterial prostatitis (CBP) is a prevalent urological condition significantly impacting patients’ quality of life. Accurate diagnosis is essential to differentiate bacterial from non-bacterial prostatitis and to guide appropriate antimicrobial therapy. In the context of antimicrobial resistance (AMR), the Meares and Stamey (M&S) test is a valuable diagnostic tool for targeted antibiotic use and a valuable antimicrobial stewardship (AMS) measure. Despite its clinical relevance, its adoption is limited by practical and logistical challenges. Methods: Relevant databases were searched by using methods recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The keywords used included “Meares and Stamey test,” “antimicrobial stewardship and prostatitis,” and “chronic bacterial prostatitis and Meares.” Results: We enclosed seven studies: one single-center prospective observational comparative study, two national surveys, three cross-sectional studies, and one consensus conference. The M&S test remains the gold standard for diagnosing CBP, offering high specificity in identifying bacterial infections localized within the prostate. The test enables precise pathogen identification and facilitates targeted antimicrobial therapy. Despite its clinical relevance, its adoption is hindered by procedural complexity, patient discomfort, and the apparent need for specialized personnel and facilities. Alternative diagnostic methods, such as the two-glass pre- and post-massage test (PPMT), have demonstrated comparable diagnostic sensitivity while being more practical and time-efficient. Additionally, emerging microbiological techniques are under investigation to increase the M&S test’s sensitivity. Conclusions: The M&S test plays a crucial role in AMS by ensuring targeted antimicrobial therapy in CBP. Overcoming its limitations through patient stratification, clinician education, and the integration of emerging microbiological techniques is essential to enhance its applicability in modern urological practice.

Background/Objectives: Radical cystectomy (RC) is a complex urologic procedure that, when performed using an open surgical approach, carries a high risk of surgical site complications (SSCs), which can lead to prolonged recovery, increased healthcare costs, and higher morbidity. Incisional negative-pressure wound therapy (iNPWT) has demonstrated benefits in enhancing wound healing in various surgical settings, but its effectiveness in the context of RC remains underexplored. This study aimed to evaluate the impact of iNPWT on the incidence of SSCs following RC compared to standard surgical dressings using the PICO® system. Methods: A cohort of 146 patients who underwent RC between 2015 and 2021 was divided into two groups: those treated with standard dressings (Group 1, n = 80) and those who received iNPWT (Group 2, n = 66). Patient-related, surgical, and pathological variables were compared between the groups. Categorical variables were analyzed using the chi-square or Fisher's exact test, while continuous variables were assessed using Student's t-test. Univariate logistic regression models were applied to evaluate the association between iNPWT use and 90-day SSCs, as well as to identify risk factors for complications. Results: Group 2 (iNPWT) had a higher prevalence of chronic comorbidities, including chronic kidney disease, but fewer active smokers compared to Group 1. Higher body mass index, prolonged operative time, and uncontrolled diabetes were significantly associated with the development of SSCs. The incidence of SSCs within 90 days was significantly lower in the iNPWT group (7.6%) compared to the standard dressing group (22.5%) (p = 0.03). iNPWT use was associated with a substantially reduced risk of SSCs (OR: 0.282), demonstrating a protective effect. Conclusions: Prophylactic application of iNPWT following RC significantly reduced the incidence of surgical site complications compared to standard dressing. These findings support the potential of iNPWT as a valuable adjunct in perioperative wound management. While encouraging, these results warrant validation in prospective, randomized studies. Tailored postoperative strategies and identification of patient-specific risk factors remain essential components in SSC prevention and reflect the growing importance of precision medicine in surgical oncology.

Complicated urinary tract infections denote an important research field for new antibiotics against Gram-negative pathogens. There is, however, increasing concern that this disease entity is too vaguely defined, leading to heterogeneous study populations and risk of bias. We analysed researchers' adherence to the US Food and Drug Administration (FDA) guidance on complicated urinary tract infection and assessed risk of bias using a three-step procedure: literature review of full-text articles on complicated urinary tract infection; assessment of the importance of risk factors for treatment failure, including statistical evaluation of how patients with risk factors might skew treatment effects; and a Delphi consensus process in a multidisciplinary group. Our evaluation showed poor adherence to FDA guidance on complicated urinary tract infection and significant heterogeneity in the reporting of study, patient, and pathogen characteristics, leading to a high risk of bias when interpreting and comparing study findings. We therefore question the concept of complicated urinary tract infection as a meaningful entity with its own study guidance.

INTRODUCTION:Genital Lichen Sclerosus (GLS) is a chronic inflammatory disease due to autoimmune events that occurs in anogenital region. It seems to affect mostly women but both the etiology and the prevalence of the disease are largely unknown. The aim of this cross-sectional study was to examine the real-world diagnostic and therapeutic experiences of patients with GLS, focusing on their perceptions and expectations regarding disease management. METHODS:Utilizing Google Forms, we developed a questionnaire consisting of 10 items aimed at examining the diagnostic and therapeutic experiences of patients with GLS. This survey was distributed via email to all members of the Italian Association of Patients with Lichen Sclerosus (LISCLEA), which includes 564 female and 216 male members. The survey was accessible for a period of 48 hours in February 2020. RESULTS:Of the 780 members surveyed, 280 (36.3% response rate) completed the questionnaire, comprising 226 females (80.7%), 53 males (18.9%), and 1 respondent (0.4%) who did not declared her/his gender identity. A significant 34% of respondents waited over five years for a correct diagnosis of GLS. Diagnostic challenges were frequently reported, with a majority (78%) believing that doctors' knowledge about LS is inadequate. Moreover, 63.9% expressed a need for better medical training concerning GLS, supported by calls for more research networks (42.5%) and specialized centers (26.1%). GLS had a severe impact on sexual health and relationships; 57.3% reported anxiety due to GLS, and 39% avoided intercourse because of symptoms like pain and discomfort. The majority (95%) received local treatments, while a small percentage (5%) underwent surgical interventions such as circumcision. The diagnostic and therapeutic process was perceived as difficult by most patients (82%). CONCLUSIONS:GLS profoundly affects patients' quality of life, causing significant anxiety, discomfort, and often hindering sexual activity. The study highlights the commonality of late diagnoses and the insufficient referral of patients to specialists, underscoring the need for greater awareness and expertise among healthcare providers. Enhancing doctor awareness and knowledge could facilitate earlier diagnosis and more effective management of GLS, thereby improving outcomes for those affected by this debilitating condition. This research advocates urgent enhancement in both medical education regarding GLS and the establishment of more specialized care pathways to better address the complexities of this disease.