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Objectives: The quality of life in patients undergoing radical cystectomy and urinary diversion is gaining importance. Nowadays a broad consensus about the best urinary diversion does not exist. This study presents an all‐round analysis of the impact of two types of urinary diversion on life's psycho‐social aspects in patients undergoing radical cystectomy. Methods: This is an observational, single‐centre, prospective study. Eligible participants underwent radical cystectomy and urinary diversion for bladder cancer in our department from January 2020 and February 2024. Of 130 included patients, 90 (45 with Bricker's ureteroileocutaneostomy and 45 received orthotopic bladder replacement) patients were matched and the study groups were well balanced for the baseline‐matched variables. Patients completed 4 questionnaires (EORTC QLQ‐C30, PGWBI, HADS, PSQI) at three different times: before the surgical procedure, and at 3 and 12 months. Results: Time shows a statistically significant effect (p < 0.0005) on four of the five functional scales explored (Physical Functioning, Role Functioning, Emotional Functioning, Social Functioning), and for all the nine symptoms/items' scales (p < 0.0005) and the Global Health Status (p = 0.003) in EORTC QLQ‐C30. Neobladder's group shows a statistically significant improvement on the scales of Physical Functioning, Role Functioning, and Social Functioning, and for symptoms of nausea (p = 0.0027), pain (p = 0.0005), dyspnea (p = 0.012), insomnia (p = 0.004), constipation (p = 0.003). Conclusion: We do not find a better urinary diversion in absolute terms. Neobladder obtained better results only for specific items and features. The urinary diversion's choice must be made in concert by the patient, the caregiver, and health professionals with adequate counseling. [ABSTRACT FROM AUTHOR]

Background/Objectives: A comprehensive comparison of intraoperative, oncological, and functional outcomes of RARP performed with different robotic surgical platforms is critically needed. Our aim is to compare the oncological and functional outcomes of RARP performed using the novel Hugo™ RAS system with those from the daVinci system, the reference standard, at a high-volume robotic center, with an extended follow-up period (one year). Methods: We analyzed the data of 400 patients undergoing RARP ± pelvic lymph node dissection between 2021 and 2023, using propensity score (PS) matching to correct for treatment selection bias. All procedures were performed by three surgeons with HugoTM RAS or daVinci. This analysis extends the follow-up period to 1 year, focusing on specific functional and oncological outcomes, building on our previous 3-month evaluation of perioperative outcomes. The primary outcome was the trifecta rate, defined as freedom from biochemical recurrence, continence, and erectile function recovery. Secondary outcomes included detailed assessments of oncological outcomes (PSA levels) and functional outcomes (continence and erectile function). Results: The propensity score-matched cohort included 99 matched pairs (198 patients), balanced for all covariates. No significant differences were found in trifecta rates between the two platforms at 1-year follow-up (Hugo: 25.25%, daVinci: 27.27%, p = 0.743). Both groups showed improved trifecta rates when considering only nerve-sparing procedures (Hugo: 36.84%, daVinci: 35.59%, p = 0.889). Continence rates were similar (Hugo: 87.9%, daVinci: 89.9%, p = 0.327), as were the undetectable PSA rates (Hugo: 92.9%, daVinci: 88.8%, p = 0.158). Also, the erectile function recovery rate did not differ significantly between the groups. Conclusions: This is the first study comparing 1-year functional and oncological outcomes of RARP performed with Hugo™ RAS and daVinci surgical robotic systems using PS matching. Functional and oncological outcomes of RARP were comparable between the two robotic platforms. These findings confirm that the transition to the Hugo™ platform does not compromise surgical proficiency or patient outcomes, even if further long-term studies are necessary to confirm these results. [ABSTRACT FROM AUTHOR]

Simple Summary: This research examines how the loss of the Y chromosome (LoY) in men may contribute to the development and progression of certain cancers, particularly in the urinary system. Traditionally, the Y chromosome was primarily associated with male sex determination and sperm production, but recent studies suggest it plays a wider role in health and disease. LoY appears to disrupt immune function and increase genetic instability, factors that may heighten cancer risk and impact treatment outcomes. Our review highlights that LoY could serve as an early indicator of certain cancers and might help predict cancer behavior. Understanding LoY's role could lead to new diagnostic tools and treatments, especially for cancers where Y chromosome alterations are linked to poorer outcomes. Background: The Y chromosome (ChrY) is essential for male sex determination and spermatogenesis. However, recent studies have revealed its broader role in various physiological processes and disease susceptibility, including cancer. Methods: A comprehensive literature review was conducted using databases like MEDLINE, Scopus, Web of Science, and Google Scholar. The review included clinical and preclinical studies in animals and humans focusing on the role of LoY in urological tumors. Data on the frequency of LoY, its clinical implications, and underlying mechanisms were extracted and analyzed. Results: The evidence suggests that LoY is associated with an increased risk of urologic neoplasms, potentially serving as an early marker of genomic instability. Studies reveal that LoY in urologic cancers correlates with worse survival outcomes and may contribute to tumor progression. LoY may interfere with chromatin structure and epigenetic regulation, suggesting its role as a contributor to early tumorigenesis. Conclusions: LoY appears to be a structural aberration with unique biological and clinical relevance in urologic cancers, possibly serving as a biomarker for genomic instability. Further research is necessary to identify specific Y-linked genes affected by LoY, potentially informing targeted therapies and early diagnostic strategies for these cancers. [ABSTRACT FROM AUTHOR]

Simple Summary: New devices are being developed and proliferated worldwide to perform robotic surgery. The sharing of data resulting from performing a large number of procedures with the HugoTM RAS system aims to demonstrate its reliability and potential use in different scenarios. In our case series, this new device has proven to be reliable in performing robot-assisted radical prostatectomy. We list the solutions we applied to address the technical issues of the system and show that these did not have a significant impact on patients and procedures. Background: Robotic-assisted surgery is the gold standard for performing radical prostatectomy (RARP), with new robotic devices such as HugoTM RAS gaining prominence worldwide. Objective: We report the surgical, perioperative, and early postoperative outcomes of RARP using HugoTM RAS. Design, setting, and participants: Between April 2022 and October 2023, we performed 132 procedures using the Montsouris technique with a four-robotic-arm configuration in patients with biopsy-proven prostate cancer (PCa). Outcome measures: We collected intraoperative and perioperative data during hospitalization, along with follow-up data at predefined postoperative intervals of 3 and 6 months. Results and limitations: Lymphadenectomy was performed in 25 procedures, with a bilateral nerve-sparing technique in 33 and a monolateral nerve-sparing technique in 33 cases. The mean total surgery time was 242 (±57) min, the mean console time was 124 (±48) min, and the mean docking time was 10 (±2) min. We identified 17 system errors related to robotic arm failures, 9 robotic instrument breakdowns, and 8 significant conflicts between robotic arms. One post-operative complication was classified as Clavien–Dindo 3b. None of the adverse events, whether singular or combined, increased the operative time. Positive margins (pR1) were found in 54 (40.9%) histological specimens, 37 (28.0%) of which were clinically significant. At 3 and 6 months post-surgery, the PSA levels were undetectable in 94.6% and 92.1% of patients, respectively. Social urinary continence was regained in 86% after 6 months. Limitations of our study include its observational monocentric case-series design and the short follow-up data for functional and oncological outcomes. Conclusions: Our initial experience highlights the reliability of the HugoTM RAS system in performing RARP. Additionally, we also list problems and solutions found in our daily work. [ABSTRACT FROM AUTHOR]

Simple Summary: The genus Prototheca encompasses unicellular algae that are achlorophyllous and widespread in the environment. The genus is now included in the family Chlorellaceae, belonging to the order Chlorellales, which is included in the class, Trebouxiophyceae. Prototheca have repeatedly been reported to infect vertebrates. Cattle, dogs, and cats are the unique domestic animals in which Prototheca spp. have been reported, despite sporadic detection in goats, horses, and non-domesticated animals. Prototheca spp. have been reported to colonize different districts of the human body. Cats with protothecosis usually display a cutaneous disease, whereas dogs may develop both cutaneous and systemic forms. In this report, we identified molecularly Prototheca spp. in a cat with neurological signs. The animal presented a suspected diagnosis of multifocal lymphoma, and eventual immunological disorders/suppression likely triggered systemic diffusion of the achlorophyllic alga. Despite protothecosis not being regarded as a zoonosis, algal infections of animals should be recognized as indicators or sentinels of environmental risks for humans. Prototheca infections are rare in cats, and they are usually associated with cutaneous or subcutaneous infections by P. wickerhamii, with no evidence of neurological signs or systemic disease. In this study, we report the identification of prototheca in the cerebrospinal fluid (CSF) of a cat with neurological symptoms. Fourteen CSF samples were gathered from cats presented with neurological disease between 2012 and 2014. The inclusion criteria for the samples were an increase in CSF protein and cell number (pleocytosis), suggestive of an infectious inflammatory status of the central nervous system (CNS). Nine samples fulfilled the inclusion criteria (inflammatory samples), while five samples, used as control, did not (non-inflammatory samples). All the samples were screened molecularly for different pathogens associated with CNS disease in cats, including prototheca. Out of 14 CSF samples, only one inflammatory sample tested positive for prototheca. Upon sequence and phylogenetic analysis of the amplicon, the strain was characterized as P. bovis. This report is the first documented evidence of prototheca in the cerebrospinal fluid of a cat with neurological signs. Prototheca should be considered in the diagnostics procedures on the CNS of cats presented with infectious diseases. [ABSTRACT FROM AUTHOR]