Surgical intervention for benign prostatic hyperplasia (BPH) can lead to postoperative stress urinary incontinence. Pelvic floor muscle exercises (PFME) are proposed as a non‐invasive strategy to mitigate symptoms, but their efficacy and optimal timing remain unclear. A systematic review of six studies (five randomized controlled trials and one prospective cohort) was conducted, evaluating PFME in men undergoing BPH surgery. Three studies investigated preoperative PFME, and three evaluated postoperative interventions. Outcomes included incontinence rates, lower urinary tract symptoms (LUTS), pelvic floor muscle strength, and quality of life. Evidence for preoperative PFME was mixed; one trial (n = 70) demonstrated significantly reduced incontinence at 3 months (3% vs. 26%; p = 0.01), while another (n = 49) found improved muscle endurance without clinical benefits. In contrast, postoperative PFME showed more consistent improvements. One randomized controlled trial (RCT) (n = 61) reported significantly better LUTS at 12 weeks (IPSS: 3.32 vs. 6.33; p < 0.001) and better quality of life. Another (n = 58) noted fewer incontinent episodes at 1–3 weeks (p < 0.01). However, a large multicenter randomized controlled trial (n = 442 TURP patients) found no long‐term benefit in incontinence rates at 12 months (65% vs. 62%). In conclusion, PFME may enhance the postoperative recovery of continence and LUTS, particularly when initiated early and performed consistently. Preoperative PFME shows promise but requires further validation. Heterogeneity in study designs highlights the need for standardized, large‐scale trials to define optimal PFME protocols for this population.

High‐intensity focused ultrasound (HIFU) has emerged as a widely adopted, minimally invasive treatment for localized prostate cancer (PC). Although originally applied for whole‐gland treatment, recent advancements in imaging and technology have facilitated the adoption of HIFU as a focal therapy modality, targeting clinically significant prostate cancer (CSPC) while preserving surrounding functional structures. Recently, transrectal prostate compression during HIFU has been developed to improve treatment precision by reducing intraoperative prostatic swelling and minimizing target displacement. This method improves the ultrasound propagation path, enhances cavitation, and mitigates the heat‐sink effect by reducing blood flow within the prostate. Clinical outcomes using HIFU with compression in 240 patients demonstrated high biochemical and pathological disease‐free survival rates across low‐, intermediate‐, and high‐risk groups (93.7%/92.2%, 88.5%/91.6%, and 84.8%/86.6%, respectively), with radical treatment‐free survival >94% in all groups. Complication rates were low, with no cases of recto‐urethral fistula reported. The rate of CSPC detection in follow‐up biopsies was significantly lower than in previous studies, suggesting improved local control. These findings support the efficacy and safety of focal HIFU therapy with intraoperative compression as a promising treatment for localized PC.

Prostatic stromal tumor of uncertain malignant potential (STUMP) is a rare neoplasm arising from specialized prostatic stromal cells with a broad range of histologic patterns and unpredictable clinical behavior. It is often challenging to distinguish STUMP from prostatic stromal sarcoma due to morphological similarities, necessitating specific microscopic criteria and immunohistochemical analysis. Owing to its rarity and variable presentation, there is no clear consensus on its classification, clinical course, or management. This review aims to analyze the demographic, clinical, and pathological features of STUMP, along with available treatment strategies and outcomes. This comprehensive literature review was conducted using PubMed and Google Scholar databases, focusing on cases of pure STUMP. Selected studies were assessed for clinical presentations, pathological findings, diagnostic procedures, and treatments. This scoping review was conducted following the Joanna Briggs Institute methodology and reported according to the PRISMA‐ScR checklist. Case reports were further assessed using the Murad et al. quality assessment tool. An analysis of 84 patients across 14 studies revealed a mean age at diagnosis of 58.9 years. Common clinical presentations included lower urinary tract symptoms (39.3%) and urinary retention (29.8%). Immunohistochemical markers such as vimentin, estrogen receptor, smooth muscle actin (SMA), and progesterone receptor were frequently expressed. Initial management strategies varied: 34.5% of patients were managed with observation, while others underwent interventions such as transurethral resection of prostate (TURP) or prostatectomy. During follow‐up, 19 patients (22%) experienced disease progression, with a higher recurrence rate observed in non‐prostatectomy groups (34.5%). In contrast, no recurrence was noted among those who underwent prostatectomy or enucleation. Among the patients with progression, 89.5% required further intervention, most commonly repeat TURP or prostatectomy. In conclusion, Prostatic STUMP is a rare tumor with diverse histologic patterns and clinical behaviors. Given its potential for progression and risk of sarcomatous transformation, complete surgical excision is the recommended management strategy.

Background: ChatGPT, an interactive natural language processing model, is becoming increasingly used for medical information gathering. The objective of this study is to investigate the appropriateness of ChatGPT's responses to common urological questions compared to the Canadian Urological Association (CUA) guideline recommendations.

Methods: A list of 10 urological questions were developed from the CUA guidelines and patient information materials. Each question was asked three times in ChatGPT (Version 4), totaling 30 ChatGPT‐generated responses. Responses were assessed by three reviewers using a 4‐point Likert scale (0–3) to score appropriateness with CUA guidelines as a reference. The median values and variance of answer scores were calculated to form a consensus score to determine model reliability.

Results: Forty percent (n = 12/30) of ChatGPT answers were deemed appropriate. The overall mean ± standard deviation score was 1.64 ± 0.85 (between “Some correct and some incorrect” and “Correct but inadequate”). When comparing question difficulty, “Easy” questions had an overall score of 1.87 ± 1.01, compared to “Medium” questions with a score of 1.31 ± 0.47. ChatGPT generated the most appropriate responses in the domains of prostate cancer (3.00 ± 0.25), erectile dysfunction (3.00 ± 0.28), andrology (3.00 ± 0.78), and kidney cancer (3.00 ± 1.00). The average variance between responses was 0.27, demonstrating strong model reliability.

Conclusion: This study examined the utility of ChatGPT in answering questions based on CUA clinical guidelines. Although promising, ChatGPT underperforms in answering common urological questions despite showing high levels of repeatability.

Background: Para‐testicular rhabdomyosarcoma (RMS) is a rare and aggressive malignancy primarily affecting children and adolescents, with peak incidence between ages 2 and 5 years. Of the histological variants of RMS, the spindle cell type of RMS is particularly uncommon, accounting for approximately 5% of cases. Effective management typically involves a combination of surgery, chemotherapy, and sometimes radiation therapy, with prognosis influenced by factors such as tumor stage and genetic profile. Early diagnosis is essential for improving survival rates and reducing recurrence risk.

Case Presentation: We present the case of a 17‐year‐old male with scrotal swelling following trauma. Ultrasound revealed a large hypoechoic mass in the left hemi‐scrotum. A left radical orchiectomy was performed. Histopathology showed a spindle cell tumor with a mutation in NRAS mutation (Q61L) and positive for skeletal muscle markers including Myogenin, MyoD1 (myogenic differentiation 1), Desmin, Vimentin, and Actin. Staging imaging showed an enlarged left para‐aortic lymph node and a small pleural nodule. The patient was scheduled for three cycles of chemotherapy as initial management and regular follow‐up with imaging.

Conclusion: Spindle cell RMS necessitates prompt diagnosis and intervention to reduce morbidity and mortality. This case highlights the importance of accurate assessment, diagnosis and management to minimize recurrence risk.

Background: Foreign bodies (FBs) in the urogenital tract are considered surgical emergencies due to the risk of complications such as perforation, infection, and obstruction. FBs can be introduced into the urethra and migrate into the bladder. Various FBs, including pens, jump ropes, magnetic ball chains, and needles have been reported in the literature. This case report aims to discuss the management of an older adult who self‐inserted a FB into his urethra, which subsequently broke and lodged in the bladder.

Case Presentation: A 71‐year‐old man with a history of urethral stricture following transurethral resection of the prostate (TURP) presented to the emergency department after attempting self‐catheterization using a silicone rubber rod. His medical history included stone formation, benign prostatic hyperplasia, and coronary artery disease managed with aspirin. He had undergone percutaneous cystolithotripsy, coronary artery bypass grafting, and TURP. Physical examination was unremarkable. Laboratory results showed hemoconcentration, elevated inflammatory markers, and a urinary tract infection caused by extended‐spectrum beta‐lactamase Escherichia coli. Computed tomography (CT) scan confirmed the presence of the FB in the bladder. The FB was successfully extracted using cystoscopy, a minimally invasive procedure, where it was crushed into smaller pieces with a Myomayer and removed with Crocodile forceps.

Conclusion: This case illustrates the successful use of minimally invasive cystoscopy for the extraction of a FB from the urinary bladder. The approach emphasized the importance of tailored surgical interventions and advanced imaging to ensure effective preoperative planning and minimize complications.

Background: In Zinner syndrome (ZS), surgical intervention is recommended for pediatric patients with symptomatic disease. It is generally believed that cyst aspiration alone may lead to symptom recurrence. Although comprehensive surgical excision is often advocated to prevent recurrence, a combined approach of cyst aspiration and maximal cyst wall ablation may also provide lasting symptom relief.

Case Presentation: A 14‐year‐old boy with a long‐standing history of voiding difficulties presented with acute urinary retention. Pelvic magnetic resonance imaging revealed a 5 cm × 4 cm × 3.5 cm cystic lesion arising from the right posteroinferior prostate and compressing the bladder. Transurethral laser ablation of the ejaculatory duct cyst was performed using a holmium:YAG laser (0.8 J, 10 Hz). The patient recovered uneventfully and was discharged on postoperative Day 1. At the 1‐year follow‐up, he remained asymptomatic with normal uroflowmetry findings and only a small residual cyst visible on ultrasound.

Conclusion: For the management of large seminal vesicle cysts in ZS, combining cyst aspiration with cyst wall ablation provides an effective, safe, and durable therapeutic approach.

Background: Metastatic prostate cancer tumor seeding within a percutaneous biopsy tract is rare. While reports of tumor seeding following perineal and transrectal prostate biopsies exist, no cases of prostate cancer tumor seeding along a metastatic percutaneous bone biopsy tract detected by prostate specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) have been reported.

Case Presentation: We describe a rare case of intramuscular and subcutaneous prostate cancer recurrence along and adjacent to the site of a previous percutaneous metastatic rib biopsy tract. The role of PSMA PET/CT in the early detection of such cases is highlighted. In this case, PSMA PET played a crucial role in achieving both early diagnosis and early targeted management, optimizing the oncological outcome for the patient.

Conclusion: We hope to increase awareness of this rare presentation and emphasize the need for consensus on management approaches when encountering similar cases of prostate cancer tumor seeding in the future.

Background: Nephrolithiasis is a common urologic condition, with increasing prevalence in the United States. This can often present with flank pain and hematuria; however, sequelae such as hydroureteronephrosis, forniceal rupture, and pyelonephritis can lead to more severe complications.

Case Presentation: This case report describes a 43‐year‐old female who presented to the hospital with left upper quadrant pain, fever, nausea, and vomiting. Imaging revealed an obstructive 0.7 cm kidney stone at the right ureterovesical junction with severe hydroureteronephrosis resulting in mass effect on the duodenum and upstream gastric dilation. Percutaneous nephrostomy placement resolved both the hydroureteronephrosis and the secondary gastrointestinal obstruction.

Conclusion: This case study highlights the rare complication of bowel obstruction caused by obstructive nephrolithiasis, underscoring the diverse clinical presentations of nephrolithiasis and the importance of timely, conservative management to avoid clinical decompensation.

Background: As senior urology residents explore potential fellowship opportunities, they often turn to the official websites of accredited fellowship programs. However, the information available on these websites is often inconsistent and lacking.

Methods: The list of accredited fellowship programs on each subspecialty society's official website was utilized to document all available programs (i.e., Endourological Society—EUS; Society of Genitourinary Reconstructive Surgeons—GURS; Male Infertility/Andrology—MIA; Societies for Pediatric Urology—SPU; Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction—SUFU; Society of Urologic Oncology—SUO). Fifteen pre‐specified factors were assessed on each of the websites in September 2024. χ² tests and z‐scores were calculated.

Results: There were 140 total fellowship training programs. Information on research opportunities and current faculty profiles was widely available (both 88.6% overall). However, information pertaining to wellness initiatives (7.1% overall) and salary/benefits (13.6% overall) were not commonly included. SUO and SPU programs were more likely to feature information about research opportunities than SUFU and GURS programs. SPU websites were more likely than all others to feature information regarding training sites. Additionally, SUO websites were more likely to contain profiles on current fellows than all but SUFU websites.

Conclusion: A significant lack of standardization exists among both various urology subspecialties' websites and the websites of individual programs within a single subspecialty. Standardization of these websites would allow applicants to make better, more informed decisions regarding where to complete fellowship training.