Urological Practice Research Articles

Varicocele management in Tunisia: Overview of practices and comparison with latest international guidelines.

Varicocele has a detrimental effect on testicular growth and spermatogenesis, hence the importance of its management. This management remains controversial among Tunisian urologists; diagnostic and therapeutic choices tend to vary from one urologist to another. The aim of this survey is to evaluate the practices of Tunisian urologists regarding varicocele management compared to the latest international guidelines. A cross-sectional study was conducted among Tunisian urologists, members of the Tunisian Association of Urology, using a computerized questionnaire available online. The response rate was 51.6%. Approximately 80% of Tunisian urologists reported that they diagnose and manage patients with varicocele at least once a week. Half of the Tunisian urologists use a grading system for classification. Over 75% of Tunisian urologists believe that scrotal ultrasound and semen analysis should be systematically requested. Half of them consider treatment starting from Dubin and Amelar grade 2, while the other half treat from Dubin and Amelar grade 3. The majority agreed that the results of varicocele repair are controversial, with 10% never performing bilateral varicocele repair. The vast majority planned surgical treatment (95%), with sub-inguinal approach and magnification used in only 16% of cases; 25% never froze sperm before varicocele repair. Recent recommendations had clear messages to promote in terms of diagnosis, therapeutic indications, and modalities. This work highlights the existence of gaps between recommendations on certain aspects of varicocele management, suggesting a review of continuous medical education modalities regarding this pathology in particular.

Emerging strategies in tackling antimicrobial resistance in urology: Narrative review and expert opinion

Urinary tract infections (UTIs) are highly prevalent and frequently treated with antibiotics, making antimicrobial stewardship (AMS) crucial in this field to benefit both individual patients and society. This narrative review examines recent advancements in managing urinary tract infections, focusing on AMS and antimicrobial resistance (AMR). AMS is essential in urology, where antibiotics are frequently prescribed for UTI. AMS promotes optimal antibiotic use to improve patient outcomes, control AMR, and safeguard public health. Key AMS practices in urology include selecting antibiotics at the appropriate dose and duration, especially for uncomplicated UTIs, asymptomatic bacteriuria, and catheter-associated infections. Following evidence-based guidelines, such as those from EAU and the IDSA, helps prioritize narrow-spectrum antibiotics and discourage empirical broad-spectrum use. Regular audits and feedback on antibiotic use help align practices with AMS goals, reducing inappropriate prescriptions. Multidisciplinary AMS teams, including urologists, microbiologists, and pharmacists, enhance treatment precision and antibiotic optimization in complex cases. Reassessing antibiotic therapy based on culture results after 48–72 h enables clinicians to refine treatment, minimizing unnecessary broad-spectrum use and strengthening AMS efforts in urology. In conclusion, addressing AMR in urology requires a careful approach that combines evidence-based antibiotic use, attention to local resistance patterns, and patient-specific factors. Non-antibiotic strategies for recurrent UTI prevention, judicious catheter management, and tailored treatment for complex infections are key AMS components. Emerging technologies in diagnostics and precision medicine offer tools for targeted, personalized therapy, enhancing AMS efforts, and helping to reduce reliance on broad-spectrum antibiotics.

Radiomics in urolithiasis: a systematic review of current applications, limitations and future directions.

The above analysis of studies available in the international literature shows that the use of radiomics in urolithiasis is a rapidly developing area in medical science. From the total number of studies included in this review, it is evident that mainly diagnostic applications that are associated with radiological diagnostics are close to implementation in urological practice, while in many studies the authors argued that the function of their proposed model can be further optimized after entering more data. Texture analysis of stone images has significantly improved the accuracy of kidney stone type prediction. Such advances in medical imaging technologies and machine learning are likely to be more widely used in routine clinical management of urolithiasis in the near future. However, there is still room for further improvement of machine learning algorithms to improve the sensitivity and specificity of automatic classification methods. Keywords: urolithiasis, radiomics, texture analysis, machine learning, artificial intelligence.

Emerging Use of Social Media in Clinical Urology Practice in the 21st Century: Survey Study.

Social media (So-Me) platforms are valuable resources for health care professionals and academics to discover, discuss, and distribute current advances in research and clinical practices, including technology trends. This study aims to assess the role of So-Me in urological practice in Saudi Arabia. It explores the influence of digital platforms on patient interaction, professional communication, decision-making, and education. The survey was conducted among 145 urologists from July 2021 to July 2022 following institutional review board approval. A questionnaire designed using the SurveyMonkey platform examined urologists' knowledge of So-Me. The survey was conducted using the CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guidelines and was open for 17 weeks. Data analysis was performed using SPSS 21.0. Of the 145 participants, 70% (n=102) were Saudi Arabians. The most common age groups were 30-40 (n=68, 46.8%) and 41-50 (n=61, 42.2%) years, with a gender distribution of 44.8% (n=65) women and 55.2% (n=80) men. A total of 61.5% (n=89) of urologists reported using So-Me accounts for professional purposes, with 54.9% (n=80) sharing health-related information. Social media enhanced patient connections beyond clinic visits for 55.8% (n=81) of respondents, while 57.2% (n=83) used it to provide educational resources. Additionally, 56.5% (n=82) believed So-Me facilitated patient feedback and improved their practice. In terms of professional communication, 60.6% (n=88) of urologists agreed that So-Me facilitated collaboration with colleagues, while 63.3% (n=92) used it to stay updated on the latest advances in urology. Furthermore, 62% (n=90) followed professional societies or journals on So-Me, and 63.3% (n=92) used it for continuing medical education. A majority (n=94, 64.7%) reported that So-Me influenced treatment decisions based on new research findings, and 85.3% (n=124) learned about novel technologies and treatment options through these platforms. Regression analysis showed a significant positive correlation between gender and social media usage patterns (R=0.653, R2=0.426), indicating that approximately 42.6% of the differences in usage patterns can be attributed to gender. However, the Pearson χ2 analysis showed that gender did not significantly affect most aspects of social media use, except information sharing and participating in online discussions (both P<.05). This study highlights the widespread use of So-Me among urologists in Saudi Arabia, underscoring its role in enhancing patient interaction, professional development, and clinical decision-making. Strategically designed health care programs using social media could improve and modernize professional and patient-centered care in Saudi Arabia through legislative assistance and guidelines.

Observations and Reflections from Sub-Saharan Africa. Comment on Shahait, M. Urology Practice in Low- to Middle-Income Countries. Soc. Int. Urol. J. 2024, 5, 374–375

Observations and Reflections from Sub-Saharan Africa. Comment on Shahait, M. Urology Practice in Low- to Middle-Income Countries. Soc. Int. Urol. J. 2024, 5, 374–375

Oncological Safety of MRI-Informed Biopsy Decision-Making in Men With Suspected Prostate Cancer

The magnetic resonance imaging (MRI) pathway for diagnosing clinically significant prostate cancer (csPCa; defined as International Society of Urological Pathology grade group ≥2) uses multiparametric MRI (mpMRI) for prostate biopsy (PB) decision-making. However, the intermediate impact on patient outcomes in men with negative MRI results avoiding PB and men with positive MRI results without PCa remains unknown. To assess the feasibility and safety of a community-based MRI diagnostic strategy in men with suspected PCa using 3-year active monitoring. This multisite, longitudinal cohort trial took place across 54 community-based urology practices and 2 radiology imaging centers at a referral academic institution in Berlin, Germany. Eligible participants aged 18 to 75 years with clinically suspected PCa were enrolled between September 2016 and December 2017 and monitored for 3 years. Final analysis was reported on December 23, 2023. Participants underwent 3-T mpMRI. Men with findings suspected to be PCa were recommended for targeted PB (diagnostic phase). Men with negative mpMRI results or positive mpMRI results with benign findings at PB were systematically monitored for 3 years (monitoring phase). Clinical visits were recommended every 6 months. The total proportion of men avoiding PB and those with csPCa. A total of 593 men (median [IQR] age, 64 [58-70] years) underwent mpMRI, with 286 (48%) having negative MRI results, 261 (44%) avoiding PB initially, and 242 (41%) avoiding PB over 3 years. csPCa was detected in 161 (27%) men after immediate PB, increasing to 172 (29%) men after 3 years. Seven men with negative MRI results were diagnosed with PCa by immediate PB (including 4 cases of csPCa), while 279 entered monitoring. Three-year monitoring was completed by 233 (84%) men, with 7 diagnoses of csPCa. Of 307 men with positive MRI results, 58 (19%) showed no PCa after immediate PB, of which 41 (71%) completed monitoring and 4 (7%) were diagnosed with csPCa. In this cohort study, men with negative mpMRI results avoiding biopsy were not at elevated risk of csPCa. The study confirms the oncological safety of the prebiopsy MRI strategy of avoiding an immediate PB after negative MRI results when a programmatic safety net is in place.

Assessment of Urological Knowledge and Practice Among Emergency and Primary Health Care Physicians

Assessment of Urological Knowledge and Practice Among Emergency and Primary Health Care Physicians

Artificial Intelligence in Urology: New Technologies with Major Potential

&lt;p dir="ltr"&gt;&lt;span&gt;The present paper described how Artificial intelligence (AI) is revolutionizing urology, with applications in diagnosis, treatment planning, and patient monitoring. This review highlights AI's role in key urological areas, such as cancer detection, robotic-assisted surgeries, and personalized patient care. These advancements significantly enhance clinical decision-making and treatment outcomes. Thus, we can clearly state that AI has immense potential to redefine urological practice, fostering accuracy, efficiency, and patient-centered care. However, the integration of these technologies requires addressing challenges like data security, ethical concerns, and regulatory validation. Future efforts should focus on developing robust, evidence-based AI tools to ensure their safe and effective deployment in clinical settings.&lt;/span&gt;&lt;/p&gt;&lt;div&gt;&lt;span&gt;&lt;br /&gt;&lt;/span&gt;&lt;/div&gt;

Use of Multiplex Molecular Panels to Diagnose Urinary Tract Infection in Older Adults

Multiplex molecular syndromic panels for diagnosis of urinary tract infection (UTI) lack clinical data supporting their use in routine clinical care. They also have the potential to exacerbate inappropriate antibiotic prescribing. To describe the frequency of unspecified multiplex testing in administrative claims with a primary diagnosis of UTI in the Medicare population over time, to assess costs, and to characterize the health care professionals (eg, clinicians, laboratories, physician assistants, and nurse practitioners) and patient populations using these tests. This cohort study used Centers for Medicare & Medicaid Services (CMS) claims data for Medicare beneficiaries. The study included older community-dwelling adults and nursing home residents with fee-for-service Medicare Part A and Part B benefits from January 1, 2016, to December 31, 2023. Multiplex syndromic panels were identified using carrier claims (ie, claims for clinician office or laboratory services). The annual rate of claims was measured for multiplex syndromic panels with a primary diagnosis of UTI per 10 000 eligible Medicare beneficiaries. The performing and referring specialties of health care professionals listed on claims of interest and the proportion of claims that occurred among beneficiaries residing in a nursing home were described. Between 31 110 656 and 36 175 559 Medicare beneficiaries with fee-for-service coverage annually (2016-2023) were included in this study. In this period, 1 679 328 claims for UTI multiplex testing were identified. The median age of beneficiaries was 77 (IQR, 70-84) years; 34% of claims were from male beneficiaries and 66% were from female beneficiaries. From 2016 to 2023, the observed rate of UTI multiplex testing increased from 2.4 to 148.1 claims per 10 000 fee-for-service beneficiaries annually, and the proportion of claims that occurred among beneficiaries residing in a nursing home ranged from 1% in 2016 to 12% in 2020. In addition to laboratories or pathologists, urology was the most common clinician specialty conducting this testing. The CMS-assigned referring clinician specialty was most frequently urology or advanced practice clinician for claims among community-dwelling beneficiaries compared with internal medicine or family medicine for claims among nursing home residents. In 2023, the median cost of a multiplex test in the US was $585 (IQR, $516-$695 for Q1-Q3), which was more than 70 times higher than the median cost of $8 for a urine culture (IQR, $8-$16 for Q1-Q3). This cohort study of Medicare beneficiaries with fee-for-service coverage from 2016 to 2023 found increasing use of emerging multiplex testing for UTI coupled with high costs to the Medicare program. Monitoring and research are needed to determine the effects of multiplex testing on antimicrobial use and whether there are clinical situations in which this testing may benefit patients.

Plasma transurethral enucleation of prostate adenoma measuring 640 cm&lt;sup&gt;3&lt;/sup&gt;

A case report of successful plasma transurethral enucleation of a giant prostate adenoma (640 cm3) is presented. The short term postoperative follow-up showed the absence of functional and organic complications. The comparison was made with the results of surgical treatment of giant prostate adenoma by classical transurethral prostate enucleation methods obtained at “RZD Meditsina” Nizhny Novgorod Urological Clinic in 2015, it revealed a decrease in the intraoperative period by 55 minutes without an increase in intraoperative blood loss and surgical complications. The results obtained demonstrate the prospects for the widespread introduction of plasma methods of transurethral surgery into urological practice.

Gender-Specific Differences in Urethral Swabs: A Retrospective Single-Centre Analysis

Introduction: Sexually transmitted infections (STIs) are on the rise globally, yet accurate data regarding infection rates remain scarce. There is the assumption that STIs among women with chronic urinary tract infections (UTIs) have been underestimated. This may arise from the reliance on specialised cultivation or nucleic acid amplification techniques for detection, which are more costly than standard urine culture and are typically only conducted by specialists like urologists. Methods: A retrospective, observational, single-centre study using medical records of patients who received a urethral swab in a German urological practice in the past 5 years has been conducted. Results: 55% of patients had a STI requiring treatment. People with recurrent UTIs had a STI in 35% of the cases. Younger age is associated with the detection of STIs. The female gender is significantly associated with a positive swab result. Conclusion: Distinguishing between cystitis and urethritis, particularly in women with recurrent UTIs experiencing dysuria, presents a clinical challenge. The prevalence of asymptomatic infections suggests that the true burden of urethritis, particularly STIs, may be substantially higher in the general population than currently reported. This underscores the urgency of establishing guidelines for referral and diagnostic evaluation as delayed or inadequate treatment may contribute to escalating infection rates and antibiotic resistance.

Commercial prices and their influence on urology practices: Prostate cancer care among men with Medicare.

For men with prostate cancer, there is substantial variation in the use of conservative management, such as active surveillance. Commercial prices, which vary across urology practices, may afford incentives that foster physician behaviors associated with utilization. Such behaviors may "spillover" to the Medicare population and affect quality. This study evaluated the effects of practice-level commercial prices on health care utilization and quality in men with prostate cancer insured by traditional Medicare. From a 20% Medicare sample, the authors identified men with newly diagnosed prostate cancer between 2014-2019 (n=44,653). Using commercial payments from the MarketScan database, they developed a practice-level commercial price index (ratio of commercial prices to Medicare prices). They examined the association of the price index with price standardized spending, overtreatment (treatment among those with >50% noncancer mortality within 10 years), and underuse of diagnostic testing in active surveillance (at least one prostate-specific antigen test and one confirmatory test-MRI, prostate biopsy, genomic test-within 12 months of diagnosis). Practice-level commercial price indices varied from 1.34 (134% of Medicare prices), for practices in the bottom decile, to 3.00, for practices in the top decile. Increasing price index was associated with lower odds of overtreatment (odds ratio, 0.86; 95% confidence interval, 0.76-0.97; p=.01), but not price standardized spending or underuse of diagnostic testing in active surveillance. Commercial prices vary markedly across urology practices. Among newly diagnosed men with traditional Medicare, those managed by practices with higher commercial price indices had lower odds of overtreatment, suggesting improved prostate cancer care quality.

Assessing the Efficacy and Clinical Utility of Artificial Intelligence Scribes in Urology

Objectives:To assess the quality of artificial intelligence scribes and to evaluate their impact on urologic practice. Methods:Standardized reference consultation notes were created for common urologic referrals (urolithiasis, benign prostate hyperplasia, and prostate specific antigen screening) were created. Audio recordings of these simulated patient encounters were played for five freely accessible AI scribes. The outputs generated by these scribes were evaluated using a standardized survey completed by Canadian urology faculty and trainees across two academic sites. Results:Twenty urologists responded, of which 75% reported clinical documentation as a significant source of burnout. 90% expressed openness to using AI scribes to facilitate documentation. Among the AI tools assessed, Nabla was ranked the most effective, with a favorable composite score of 68% and lowest critical error composite score (28%). Three-quarters of respondents indicated a willingness to implement AI scribes in their current form, and 89% believed AI scribes would significantly alter their practice in the future. ConclusionsAI scribes have the potential to substantially alleviate the administrative burden associated with clinical documentation, thereby reducing burnout. However, challenges remain, particularly in ensuring accuracy, and addressing medicolegal and privacy concerns.AI scribes represent a valuable tool for reducing the documentation burden and improving patient-clinician interactions. However, they should complement, rather than replace, clinician-led documentation to maintain the quality and safety of patient care.

Updated Research Publication Standards and Expectations for Successful Matching in Urology Residency Following Step 1 Scoring Changes

ObjectivesTo analyze the research productivity of 2024 urology residency applicants and its impact on match outcomes following the transition of the Step 1 exam to a Pass/Fail scoring system. MethodsWe conducted a retrospective review of PubMed-indexed publications for 98 applicants matched to the top 25 urology residency programs, as ranked by Doximity. Metrics such as the number of publications, citations, journal impact factors, and authorship rank were analyzed. Statistical comparisons of publication rates between top-ranked and lower-ranked programs were made using independent samples t-tests. ResultsThe average number of publications per applicant was 5.95, with those entering top-ranked programs exhibiting higher research outputs. Most publications were found in journals like "Urology" and "Urology Practice." A significant portion of the research was published in the final year of medical school, indicating a push for paper acceptances prior to the urology application deadline date. DiscussionThe increase in research output among applicants reflects the shifting weights of factors important for residency competitiveness following the Step 1 Pass/Fail scoring changes. Early engagement and mentorship in research have been shown to increase the research output of students. The findings of this study clarify the research expectations of matching successfully into a top urology program and can be used by both medical students and program directors in the current and upcoming cycles.

Evaluating the Importance of Practice-Level Factors on Adherence to Prostate Cancer Treatment Guidelines in Urology

ObjectiveTo evaluate adherence to treatment guideline recommendations across the continuum of prostate cancer care by US community urologists using several prostate cancer (PCa) specific performance indicators (PIs). Additionally, to determine which practice-related factors, such as having a designated PCa patient champion, active patient management in a patient portal, and in-office dispensing of medications, were associated with improved PI performance. MethodsElectronic medical record data was collected retrospectively from the PPS Analytics Patient Population Health Management Platform. The cohort consisted of adult patients with a PCa-related service visit during the period 7/1/2019 to 6/30/2022. Five PIs were reviewed: dual-energy x-ray absorptiometry (DEXA) scanning with androgen deprivation therapy (ADT), systemic therapy in metastatic PCa, external beam radiation therapy (EBRT) concurrent with ADT, image monitoring, and regular testosterone testing and monitoring. ResultsA total of 101,186 patients were identified from 95 urology practices. PI adherence rates ranged from a low of 13.6% for a DEXA scan within 6-months of ADT initiation to a high of 72.3% for EBRT concurrent with ADT in intermediate/high risk localized PCa. The results also demonstrated that several practice-related features were associated with better PI adherence. ConclusionsThe findings suggest there exists a wide range in PI adherence rates for urologists in the delivery of community urology care in the Unites States compared to clinical guideline recommendations. Future research should examine the factors associated with PI nonadherence and promote implementation of interventions that enhance guideline concordant care.

Häufigkeit von sexuell übertragbaren Infektio-nen in deutschen Facharztpraxen

The aim of this study is to analyze the incidence of sexually transmitted infections (STI) in dermatological, urological, and gynecological practices in Germany. Data from the nationwide IQVIA Disease Analyzer database was used for this study. This cross-sectional study included 6,535 patients in 2014 and 6,491 patients in 2023 with an insured diagnosis of a sexually transmitted disease in 69 dermatology, 148 gynecology and 55 urology practices. The number of patients treated for sexually transmitted diseases in these practices changed only minimally between 2014 and 2023. On average, each dermatology practice treated 31 patients with STIs in 2023, each gynecology practice treated 21 patients and each urology practice treated 23 patients. Anogenital warts were the most commonly diagnosed STI in all specialties, with prevalence varying by specialty. Interestingly, the number of patients per practice with anogenital warts increased slightly in dermatology and urology practices between 2014 and 2023, while it decreased in gynecology practices. The average age of patients treated for STDs increased between 2014 and 2023 In summary, this study highlights that despite vaccination efforts and awareness campaigns in various medical specialties, STI patient numbers remain almost the same and thus STI continues to be a persistent and increasing challenge in the ageing patient population. The findings call for further initiatives in the public health sector and an adjustment of everyday practice to the special needs of these patient groups.

Omission of intraoperative drain placement during robotic partial nephrectomy and robotic radical prostatectomy is safe: an analysis of 18,000 patients

PurposePlacement of a drain during robotic assisted partial nephrectomy (RAPN) and robotic assisted radical prostatectomy (RARP) is standard practice for many urologists and can aid in assessment and management of complications such as urine leak, lymphocele, or bleeding. However, drain placement can cause discomfort and delay patient discharge, with questionable benefit. We aim to assess the correlation between drain placement with post operative complications.MethodsThe NSQIP targeted database was queried for patients who underwent RAPN or RARP from 2019 to 2021. Our primary outcomes included 30-day complication rates stratified by intraoperative drain placement. Secondary outcomes included procedure-specific complications, length of stay (LOS), and readmissions. Multivariable regression analyses, with Bonferroni correction, were performed for each post-operative complication.ResultsWe identified 4738 and 13,948 patients who underwent RAPN and RARP, respectively. Drains were not placed in 2258 (47.7%) and 6700 (48%) patients, respectively. On adjusted multivariable analysis in the RAPN cohort, omission of drain placement was associated with decreased LOS (β -0.45; 99.58% CI [-0.59, -0.32]) but no difference in overall complication rates. After adjusted analysis in the RARP cohort, omission of drain placement was associated with decreased risk of any complication (OR 0.73 [0.62–0.87]), infectious complication (OR 0.66 [0.49–0.89]), and LOS (β -0.30 [-0.37, -0.24]).ConclusionsUsing a large contemporary database, this study demonstrates that omission of drains during RAPN and RARP was safe without increased risk of postoperative complications. Despite inherent selection bias in this cohort, our data suggests that routine drain placement is not necessary for these procedures.

Exploring Condition-Specific Variability in the Ureteral Stent Microbiome.

(1) Background: Indwelling ureteral stents are commonly used urological devices to maintain ureteral patency, yet they have been associated with complications such as infections. Some studies have shown that bacteria adhere to and create an antimicrobial-resistant biofilm on stents. One factor that may impact biofilm formation is the original condition informing stent placement, such as kidney stones and renal allografts. Both kidney stones and renal allografts are independently associated with infection, yet the differential stent microbiomes of these populations remain poorly characterized. Our objective was to characterize these microbiomes in order to inform urological health practice and help prevent ureteral stent-associated infections. (2) Methods: Stents were collected from kidney stone and renal transplant recipients undergoing routine cystoscopic stent removal. Microbial DNA was extracted from stents and analyzed using 16S Next Generation Sequencing. Descriptive statistics, alpha diversity, and beta diversity methods were used for statistical analysis. (3) Results: The microbiome of ureteral stents in kidney stone and transplant patients is composed of unique species, each with different biofilm-forming abilities. (4) Conclusions: Our findings demonstrate that the microbiome of stents differs based on preceding condition. It is important to conduct future studies that explore this microbiome further to understand what type of stent-associated infection someone may develop based on their initial condition.

Urology Practice in Low- to Middle-Income Countries

The global burden of urological diseases is rising, particularly in low- and middle-income countries (LMICs) undergoing rapid demographic and epidemiological changes [...]

Advanced Imaging for Localized Prostate Cancer

Background/Objectives: Prostate cancer is a prevalent malignancy often presenting without early symptoms. Advanced imaging technologies have revolutionized its diagnosis and management. This review discusses the principles, benefits, and clinical applications of multiparametric magnetic resonance imaging (mpMRI), micro-ultrasound (microUS), and prostate-specific membrane antigen positron emission tomography–computed tomography (PSMA PET/CT) in localized prostate cancer. Methods: We conducted a comprehensive literature review of recent studies and guidelines on mpMRI, microUS, and PSMA PET/CT in prostate cancer diagnosis, focusing on their applications in biopsy-naïve patients, those with previous negative biopsies, and patients under active surveillance. Results: MpMRI has demonstrated high sensitivity and negative predictive value in detecting clinically significant prostate cancer (csPCa). MicroUS, a newer technology, has shown promising results in early studies, with sensitivity and specificity comparable to mpMRI. PSMA PET/CT has emerged as a highly sensitive and specific imaging modality, particularly valuable for staging and detecting metastatic disease. All three technologies have been incorporated into urologic practice for prostate cancer diagnosis and management, with each offering unique advantages in different clinical scenarios. Conclusions: Advanced imaging techniques, including mpMRI, microUS, and PSMA PET/CT, have significantly improved the accuracy of prostate cancer diagnosis, staging, and management. These technologies enable more precise targeting of suspicious lesions during biopsy and therapy planning. However, further research, especially randomized controlled trials, is needed to fully establish the optimal use and inclusion of these imaging modalities in various stages of prostate cancer care.