Analysis of the Application of the Micrometric Substaging System to Predict Recurrence and Progression in a Cohort of Patients with pT1 High-Grade Non-Muscle Invasive Bladder Cancer.

BACKGROUND: The World Health Organization (WHO) classification system for bladder cancer (BC) advocates for the substaging of pT1 disease, which may improve the prediction of cancer recurrence and progression. This study aims to evaluate the application and prognostic significance of a micrometric substaging system, utilising a 1 mm cut-off depth of invasion in patients with pT1 BC. METHODS: We retrospectively reviewed all patients diagnosed with pT1 High-Grade Non-Muscle Invasive Bladder Cancer (NMIBC) at our institution. Lamina propria infiltration was categorised using a 1 mm cut-off to differentiate between Focal (<1 mm) or Extended (≥1 mm) disease, dividing the patients into Focal and Extended groups. RESULTS: The study included 114 patients, with a median (Interquartile Range (IQR)) age of 78 (71-87) and a Charlson Comorbidity Index (CCI) of 6 (5-7). The median follow-up was 33 (20-53) months. Of these, 56 patients (49.0%) were classified as having focal invasive, while 58 (51.0%) had Extended invasion. Demographic and pathological characteristics were evenly distributed between the two groups without significant differences (p > 0.05). However, Extended disease was more prevalent at initial diagnosis (Odds Ratio (OR) 5.44, p = 0.003). Multivariate analysis identified a first diagnosis of BC, pathological Grade 3 (G3), presence of Carcinoma in situ (CIS) and residual tumour at second resection as independent predictors of Extended pT1. Recurrence rates, progression rates and cancer-specific mortality were 41.2%, 5.3% and 1.8%, respectively. There were no statistically significant differences between the Focal and Extended groups in 3-year recurrence-free (58.9% vs 63.8%, p = 0.654), progression-free (92.9% vs 96.5%, p = 0.270) and cancer-specific survival (100% vs 98.3%, p = 0.425) rates. CONCLUSIONS: In this retrospective, single-centre study, substaging by depth of invasion did not predict recurrence, progression or cancer-specific mortality in patients with pT1 NMIBC. The initial diagnosis of pT1 BC, presence of G3, CIS and residual tumour at the second resection were identified as independent predictors of Extended pT1.

Analysis of the Performance and Accuracy of a PSA and PSA Ratio-Based Nomogram to Predict the Probability of Prostate Cancer in a Cohort of Patients with PIRADS 3 Findings at Multiparametric Magnetic Resonance Imaging.

BACKGROUND: PIRADS score 3 represents a challenge in prostate cancer (PCa) detection with MRI. Our study aimed to evaluate the application of a nomogram on a cohort of patients with PIRADS 3. METHODS: We analyzed 286 patients undergoing fusion prostate biopsy from January 2020 to February 2024. Only PIRADS 3 patients were included. Two nomograms, previously developed and based on clinical variables such as age, total PSA (specifically 2-10 ng/mL) and PSA ratio were applied to estimate the probability (Nomograms A and B) for PCa Grade Group (GG) > 3 and GG < 3. RESULTS: Out of the 70 patients available for analysis, 14/70 patients (20%) had PCa, 4/14 were GG 1 (28.6%), 1/14 were GG 2 (7.1%), 5/14 were GG 3 (35.8%), 2/14 were GG 4 (14.3%) and 2/14 were GG 5 (14.3%). The median probability of PCa GG > 3 and GG < 3 was 5% and 33%, respectively. A significant difference (p = 0.033) was found between patients with negative versus positive biopsy for Nomogram B. There was a significant difference (p = 0.029) for Nomogram B comparing patients with GG < 3 and GG > 3. Using a cut-off of 40% for Nomogram B, sensitivity and specificity were 70% and 80%, respectively. CONCLUSIONS: This cohort has a low probability of harboring PCa especially ISUP > 3. Nomogram B has good accuracy for discriminating patients with PCa from those with negative biopsy.

Is imaging accurate enough to detect index lesion in prostate cancer? Analysis of the performance of MRI and other imaging modalities.

Prostate imaging techniques have progressed across the years allowing for a better detection and characterization of prostate cancer (PCa) lesions. These advancements have led to the possibility to also improve and tailor the treatments on the most aggressive lesion, defined as Index Lesion (IL), to reduce morbidity. The IL is, indeed, considered as the entity which encompass the most aggressive features in prostate cancer disease. Multiparametric magnetic resonance imaging (mpMRI) has emerged as the suggested tool to detect the disease and plan treatments, including those under investigation such as focal therapy (FT). Our review aimed to query the literature on the ability of mpMRI in IL detection and to explore the future perspectives in PCa IL diagnosis. A review of the literature was performed from January 2010 to July 2023. All studies investigating the performance of mpMRI and other main imaging techniques able to detect the IL were assessed and evaluated. mpMRI performs well in the detection of IL with a sensitivity which reaches 71% to 94% among the different studies. However, mpMRI seems to have limited sensitivity in the detection of small tumours (<0.5 mL) and low-grade histology lesions. To overcome these limitations other diagnostic imaging techniques have been proposed. Multiparametric Ultrasound has shown results comparable to mpMRI while detecting 4.3% fewer clinically significant PCa (P=0.042). Positron emission tomography-based modalities using PSMA seems to have higher sensitivity than mpMRI, being able to yield from 13.5% to 18.2% additional cancers. MRI has emerged as the recommended tool since most of the IL can be easily identified, and is the imaging of choice while selecting patients for FT. Other imaging modalities has been proposed to improve PCa lesions detection, but results need to be confirmed by ongoing randomized controlled trial.

Single-Use Flexible Ureteroscopes: How Difficult Is It Today to Stay Up to Date? A Pictorial Review of Instruments Available in Europe in 2023.

The invention of the flexible ureteroscope (fURS) and its subsequent spread have revolutionized the surgical management of urolithiasis and upper tract urothelial carcinoma (UTUC). During the last few years, single-use flexible ureteroscopes (su-fURSs) have been developed to improve the limitations of reusable fURSs, namely their cost, durability and risk of device contamination. Since the introduction of the first fully disposable digital fURS, several su-fURSs have been developed by various manufacturers. In this pictorial review, we combined the different physical and technical features of su-fURSs currently available on the market with Food and Drug Administration (FDA) and European Conformity (CE) approval, in order to help surgeons choose the appropriate device according to each case requirement and personal preferences. To the best of our knowledge, 17 su-fURSs with CE and FDA approval have been developed to date.

Three-Dimensional Customized Imaging Reconstruction for Urological Surgery: Diffusion and Role in Real-Life Practice from an International Survey.

Despite the arising interest in three-dimensional (3D) reconstruction models from 2D imaging, their diffusion and perception among urologists have been scarcely explored. The aim of the study is to report the results of an international survey investigating the use of such tools among urologists of different backgrounds and origins. Beyond demographics, the survey explored the degree to which 3D models are perceived to improve surgical outcomes, the procedures mostly making use of them, the settings in which those tools are mostly applied, the surgical steps benefiting from 3D reconstructions and future perspectives of improvement. One hundred responders fully completed the survey. All levels of expertise were allowed; more than half (53%) were first surgeons, and 59% had already completed their training. Their main application was partial nephrectomy (85%), followed by radical nephrectomy and radical prostatectomy. Three-dimensional models are mostly used for preoperative planning (75%), intraoperative consultation and tailoring. More than half recognized that 3D models may highly improve surgical outcomes. Despite their recognized usefulness, 77% of responders use 3D models in less than 25% of their major operations due to costs or the extra time taken to perform the reconstruction. Technical improvements and a higher availability of the 3D models will further increase their role in surgical and clinical daily practice.

Comprehensive overview of ureteral stents based on clinical aspects, material and design.

Ureteral stents are useful devices in urological surgery. The main objective of a ureteric stent is to allow passage of urine and reduce early or late complications related to obstruction in the urinary tract. Despite their widespread use, there is a general lack of knowledge and awareness in stent composition and indication of application. We represented a synthesis of our extensive research over materials, coatings and shapes available on the market and then analyzed the main characteristics and peculiarities of ureteral stents. We have also focused our attention over the side effects and complication that must be considered when placing a ureteral stent. Encrustation, microbial colonization, stent-related symptoms and patient's history must always be evaluated when there is the need for a ureteral stent. The perfect stent should have many characteristics including easy insertion and removal, easy manipulation, resistance to encrustation and migration, lack of complications, biocompatibility, radio-opacity, biodurability, affordability (cost-effectiveness), tolerability and optimal flow characteristics. Nevertheless, further research and studies need to be done to provide more information about stent composition and efficacy in vivo. In this narrative review, we covered the basic information and main characteristics of ureteral stents, in order to help clinicians choose the appropriate device needed for a given situation.

Individual risk prediction of high grade prostate cancer based on the combination between total prostate-specific antigen (PSA) and free to total PSA ratio.

OBJECTIVES: Clinical practice guidelines endorse the stratification of prostate cancer (PCa) risk according to individual total prostate-specific antigen (tPSA) values and age to enhance the individual risk-benefit ratio. We defined two nomograms to predict the individual risk of high and low grade PCa by combining the assay of tPSA and %free/tPSA (%f/tPSA) in patients with a pre-biopsy tPSA between 2 and 10 µg/L. METHODS: The study cohort consisted of 662 patients that had fPSA, tPSA, and a biopsy performed (41.3% with a final diagnosis of PCa). Logistic regression including age, tPSA and %f/tPSA was used to model the probability of having high or low grade cancer by defining 3 outcome levels: no PCa, low grade (International Society of Urological Pathology grade, ISUP<3) and high grade PCa (ISUP≥3). RESULTS: The nomogram identifying patients with: (a) high vs. those with low grade PCa and without the disease showed a good discriminating capability (∼80%), but the calibration showed a risk of underestimation for predictive probabilities >30% (a considerable critical threshold of risk), (b) ISUP<3 vs. those without the disease showed a discriminating capability of 63% and overestimates predictive probabilities >50%. In ISUP 5 a possible loss of PSA immunoreactivity has been observed. CONCLUSIONS: The estimated risk of high or low grade PCa by the nomograms may be of aid in the decision-making process, in particular in the case of critical comorbidities and when the digital rectal examinations are inconclusive. The improved characterization of the risk of ISUP≥3 might enhance the use for magnetic resonance imaging in this setting.

Ischaemic Priapism: A Complication of Self-Administered Hyaluronic Acid Gel as an Injectable Filler for Penile Augmentation.

BACKGROUND: Injectable hyaluronic acid (HA) gel has emerged as a widely used soft tissue filler for surgeries. In penile reconstructive surgery, HA gel has been employed for penile or glans augmentation in selected patients diagnosed with micropenis. This augmentation technique involves injecting the gel into submucosal tissue and increasing the size of the penis for approximately 1 year. A few studies have investigated the possible complications correlated with medically assisted penile injections of HA gel. However, no previous reports have shown the complications of self-administered HA injection. This case report aims to present the first documented case of ischaemic priapism as a complication of self-administered HA injection. CASE PRESENTATION: We present the case of a 43-year-old male who self-administered a 20 mL injection of HA into the dorsal side of his penis. The injected material probably reached the corpora cavernosa, leading to priapism within a few hours. However, the patient did not seek medical attention until 72 h later. The first two initial conservative attempts of blood drainage were unsuccessful because the gel had obstructed vein drainage, causing the penis to remain in a state of priapism. The final treatment approach involved shunting, high enoxaparin doses and oral Effortil administration. CONCLUSIONS: While complications from medically assisted HA injections have been documented, this case report sheds light on the complications arising from self-administered penile injections. Priapism is a severe medical condition that requires immediate treatment to avoid potentially serious long-term consequences. Healthcare providers and patients must acknowledge its symptoms and its appropriate course of treatment, especially in the context of penile medical injections.

Could we safely omit a Repeat Transurethral Resection of the Bladder (re-TURB) after Hexaminolevulinate Photodynamic Diagnostics (PDD)-TURB?

OBJECTIVE: Bladder cancer (BC) is considered one of the malignancies with moderate-high incidence, high rate of recurrence and costly management. Diagnosis and staging are thus important for therapeutic purposes. Considering the risk of residual tumour and understaging, in specific cases, international guidelines recommend performing a second transurethral resection of the bladder (reTURB). Our study aimed to evaluate the impact of hexaminolevulinate Photodynamic Diagnostics (PDD) at first TURB on the rate of residual tumour. MATERIALS AND METHODS: We retrospectively analysed patients undergoing TURB in our centre between 2012 and 2020. Eightytwo patients had a re-TURB after a first complete TURB with a delay < 3 months. Patients who had an incomplete first resection were excluded. We compared patients who underwent standard white light cystoscopy/TURB and then hexaminolevulinate PDDguided reTURB (group A, n = 49) and patients with PDD-cystoscopy/ TURB at the first procedure then white light cystoscopy/reTURB (group B, n = 33). The residual tumour rate at reTURB as well as median recurrence-free survival (RFS) were compared between the two groups. RESULTS: Residual tumour at reTURB was detected in 48.8% of cases in our cohort, with a significant difference between the two groups (71.4% in group A versus 12.5% in group B, p < 0.001). After a median follow-up of 22 months, the median RFS was 15 months in Group A and 32 months in Group B, but this difference was not significant (p = 0.7). CONCLUSIONS: Using PDD at the time of the initial TURB had a statistically significant impact on the rate of residual tumour at the reTURB. Nevertheless, the percentage of residual tumour even with the use of PDD does not allow for safely omitting second resection. Performing a reTURB with PDD for patients who did not have it initially, provides the same benefit in terms of recurrence-free survival.

Correlation Between Long-Term Acetylsalicylic Acid Use and Prostate Cancer Screening with PSA. Should We Reduce the PSA Cut-off for Patients in Chronic Therapy? A Multicenter Study.

Purpose: To evaluate the prostate cancer (PCa) detection rate in men with chronic use of Aspirin and to compare it with the detection rate of non-users. Patients and Methods: Prospectively maintained database regarding patients undergoing prostate biopsy over the last 10 years in five institutions. Patients were divided into two groups according to their exposure to Aspirin. We relied on multivariable linear and logistic regression models to test whether Aspirin administration was associated with lower PSA values at prostate biopsy, higher PCa diagnosis, and higher Gleason Grade Grouping (GGG) at biopsy. Results: Were identified 1059 patients, of whom 803 (76%) did not take Aspirin vs 256 (24%) were taking it. In multivariable log-linear regression analysis, Aspirin administration was associated with lower PSA levels (OR 0.83, 95% CI 0.71-0.97, p = 0.01), after controlling for age, prostate volume, smoking history, associated inflammation at prostate biopsy, presence of PCa at biopsy, and GGG. In multivariable logistic regression analysis, Aspirin administration was not found to be a predictor of PCa at prostate biopsy (OR 1.40, 95% CI 0.82-2.40, p = 0.21) after controlling for age, PSA, smoking history, prostate volume, findings at digital rectal examination and the number of biopsy cores. In patients with PCa at prostate biopsy (n = 516), Aspirin administration was found to predict higher GGG (OR 2.24, 95% CI 1.01-4.87, p = 0.04). Conclusion: Aspirin administration was found to be a predictor of more aggressive GGG. These findings suggest that a lower PSA threshold should be considered in patients taking Aspirin, as, despite low PSA levels, they might harbour aggressive PCa.

Androgen deprivation therapy and cardiovascular risk in prostate cancer.

Androgen-deprivation therapy (ADT), with or without palliative local treatments, is the standard of care for many patients with locally-advanced and/or metastatic prostate cancer. However, the possible cardiovascular (CV) risks associated with gonadotropin-releasing hormone (GnRH) antagonists and agonists continue to be the subject of concern, especially in a patient population that may already be at increased CV risk. The present review provides a narrative summary of the evidence regarding the CV risks associated with GnRH antagonists and agonists from randomized clinical trials (RCTs), real-world evidence, and meta-analyses. From RCTs, it appears clear that there is a direct class effect for CV risk in patients with prostate cancer being administered GnRH agonists and antagonists, with the latter being associated with reduced CV risk. Real-world data and the available meta-analyses largely indicate that CV risk is lower with GnRH antagonists than with GnRH agonists. A review of the pathophysiological mechanisms of gives further support to the possibility that GnRH antagonists are associated with lower CV risk than agonists. It can be highlighted that when treating patients with advanced or metastatic prostate cancer it is important to screen for underlying comorbidities prior to choosing the most appropriate therapy; moreover, patients should be closely monitored for factors associated with CV risk in order to optimize outcomes. Further studies are needed to define the most appropriate treatment according to the individual patient characteristics.

Comparison Between Micro-Ultrasound and Multiparametric MRI Regarding the Correct Identification of Prostate Cancer Lesions.

INTRODUCTION: Multiparametric MRI (mpMRI) has become the standard imaging technique for the diagnosis of prostate cancer. However, mpMRI pathways are depending on experience, expertise, and information transfer from radiology to urology. Micro-ultrasound (Micro-US) is a new system, using high frequency (up to 29 MHz) and high resolution (down to 75 µm) ultrasound images. We evaluated the diagnostic performance of Micro-US in the detection of the prostate cancer index lesion and compared its performance to mpMRI using pathological whole mount sections as the reference. MATERIALS AND METHODS: We retrospectively reviewed the data of 32 patients with diagnosis of prostate cancer and scheduled for radical prostatectomy and who underwent Micro-US before surgery. Still images and cineloops of Micro-US were recorded. Sixteen patients had also mpMRI images with acceptable quality and complete sequences available. For validation purposes each prostate was partitioned into 12 sectors for a total of 192 sectors evaluated. Micro-US and mpMRI images were both scored according to a validated system (PRI-MUS and Pi-RADS) where a score ≥3 was suspicious for both scores. Preoperative and postoperative results regarding the identification of the index lesion, the biggest lesion visible, were then compared and sensitivity, specificity, negative and positive predictive values, and accuracy were calculated. RESULTS: Median age was 67 years, median PSA was 6.2ng/ml, and median cancer volume of the index lesion was 3.1cc. The sensitivity of Micro-US in the index lesion detection was 76.5%, specificity 76.6%, negative predictive value 85.6%, positive predictive value 64.1% and 76.6% of accuracy. The sensitivity of mpMRI was 65.1%, specificity 93.4%, negative predictive value 83.2%, positive predictive value 84.3%, and 81.8% of accuracy (all p> .05). CONCLUSION: Micro-US showed good reliability in identifying prostate cancer index lesions. Its performance is comparable to that of mpMRI.

Segmental Ureterectomy Versus Radical Nephroureterectomy in Older Patients Treated for Upper Tract Urothelial Carcinoma.

INTRODUCTION: The world population is ageing and surgical procedures for older patients are associated with higher perioperative morbidity and mortality rates than in younger patients. Segmental ureterectomy (SU) has been proposed as an alternative to radical nephroureterectomy (RNU) for selected upper tract urothelial carcinomas (UTUC), to reduce post-operative morbidity, and preserve renal function. The aim of this study was to compare RNU and SU in terms of post-operative complications, functional outcomes, and overall survival (OS) in older patients treated for UTUC. MATERIALS AND METHODS: Data of patients aged 75 years or older and treated for UTUC were included. The primary outcome was to compare RNU versus SU according to post-operative complications, the estimated glomerular filtration rate (eGFR) variation, and OS. Complications were defined according to the Clavien-Dindo classification. eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Un-adjusted OS curves were plotted using the Kaplan-Meier method. RESULTS: Overall, 177 patients (150 RNU and 27 SU) were eligible for the analysis. Pre- and post-operative characteristics were similar between the 2 groups. RNU patients showed higher incidence of post-operative complications (34.0% vs. 7.4%, P = .011). The mean post-operative serum creatinine was lower in SU patients in comparison with the RNU ones (1.23 vs. 1.69 mg/dL, P = .046), but no differences were found in terms of eGFR variation (P = .258). At 3 years of follow-up, the OS was comparable between the two surgical techniques (P = .129). CONCLUSION: In older patients diagnosed with UTUC, SU could offer lower rates of post-operative complications without affecting survival.

Ten-year experience with penile prosthetic surgery for the treatment of erectile dysfunction: outcomes of a tertiary referral center and predictors of early prosthetic infection.

We aimed to evaluate ten-year outcomes of penile prosthesis (PP) implantation for the treatment of erectile dysfunction and to assess predictors of early prosthetic infection (EPI). We identified 549 men who underwent 576 PP placements between 2008 and 2018. Univariate and multivariate analyses were used to identify potential predictors of EPI. An EPI predictive nomogram was developed. Thirty-five (6.1%) cases of EPI were recorded with an explant rate of 3.1%. In terms of satisfaction, 82.0% of the patients defined themselves as "satisfied," while partner's satisfaction was 88.3%. Diabetes (P = 0.012), longer operative time (P = 0.032), and reinterventions (P = 0.048) were associated with EPI risk, while postoperative ciprofloxacin was inversely associated with EPI (P = 0.014). Rifampin/gentamicin-coated 3-piece inflatable PP (r/g-c 3IPP) showed a higher EPI risk (P = 0.019). Multivariate analyses showed a two-fold higher risk of EPI in diabetic patients, redo surgeries, or when a r/g-c 3IPP was used (all P < 0.03). We showed that diabetes, longer operative time, and secondary surgeries were the risk factors for EPI. Postoperative ciprofloxacin was associated with a reduced risk of EPI, while r/g-c 3IPP had higher EPI rates without an increased risk of PP explant. After further validation, the proposed nomogram could be a useful tool for the preoperative counseling of PP implantation.

Urology practice during the COVID-19 vaccination campaign.

INTRODUCTION: The current scenario of the COVID-19 pandemic is significantly different from that of the first, emergency phase. Several countries in the world are experiencing a second, or even a third, wave of contagion, while awaiting the effects of mass vaccination campaigns. The aim of this report was to provide an update of previously released recommendations on prioritization and restructuring of urological activities. METHODS: A large group of Italian urologists directly involved in the reorganization of their urological wards during the first and second phase of the pandemic agreed on a set of updated recommendations for current urology practice. RESULTS: The updated recommendations included strategies for the prioritization of both surgical and outpatient activities, implementation of perioperative pathways for patients scheduled for elective surgery, management of urological conditions in infected patients. Future scenarios with possible implementation of telehealth and reshaping of clinical practice following the effects of vaccination are also discussed. CONCLUSION: The present update may be a valid tool to be used in the clinical practice, may provide useful recommendations for national and international urological societies, and may be a cornerstone for further discussion on the topic, also considering further evolution of the pandemic after the recently initiated mass vaccination campaigns.

Repair of a rectovesical fistula following laparoscopic radical prostatectomy with Martius fat pad flap interposition: a proposal of a new technique.

Rectovesical fistula (RVF) is defined as an abnormal communication between the rectum and the urinary bladder, most commonly after an iatrogenic injury during pelvic surgery. Patients with RVF may have various clinical presentations, ranging from fecaluria, pneumaturia, to urine leakage through the anus. The quality of life for patients with this pathology is adversely affected owing to the associated psychological burden. Surgery is the preferred treatment given the low success rates reported for conservative or minimally invasive approaches. Herein, we present a case of a 65-year-old man with RVF after radical prostatectomy successfully treated by a transperineal approach using a modified Martius procedure.

Telehealth in Urology: A Systematic Review of the Literature. How Much Can Telemedicine Be Useful During and After the COVID-19 Pandemic?

CONTEXT: Coronavirus disease 2019 (COVID-19) pandemic has caused increased interest in the application of telehealth to provide care without exposing patients and physicians to the risk of contagion. The urological literature on the topic is sparse. OBJECTIVE: To perform a systematic review of the literature and evaluate all the available studies on urological applications of telehealth. EVIDENCE ACQUISITION: After registration on PROSPERO, we searched PubMed and Scopus databases to collect any kind of studies evaluating any telehealth interventions in any urological conditions. The National Toxicology Program/Office of Health Assessment and Translation Risk of Bias Rating Tool for Human and Animal Studies was used to estimate the risk of bias. A narrative synthesis was performed. EVIDENCE SYNTHESIS: We identified 45 studies (11 concerning prostate cancer [PCa], three hematuria management, six urinary stones, 14 urinary incontinence [UI], five urinary tract infections [UTIs], and six other conditions), including 12 randomized controlled trials. The available literature indicates that telemedicine has been implemented successfully in several common clinical scenarios, including the decision-making process following a diagnosis of nonmetastatic PCa, follow-up care of patients with localized PCa after curative treatments, initial diagnosis of hematuria, management diagnosis and follow-up care of uncomplicated urinary stones and uncomplicated UTIs, and initial evaluation, behavioral therapies, and pelvic floor muscle training in UI patients, as well as follow-up care after surgical treatments of stress urinary incontinence or pelvic organ prolapse. The methodological quality of most of the reports was good. CONCLUSIONS: Telehealth has been implemented successfully in selected patients with PCa, UI, pelvic organ prolapse, uncomplicated urinary stones, and UTIs. Many urological conditions are suitable for telehealth, but more studies are needed on other highly prevalent urological malignant and benign conditions. Likely, the COVID-19 pandemic will give a significant boost to the use of telemedicine. More robust data on long-term efficacy, safety, and health economics are necessary. PATIENT SUMMARY: The diffusion of coronavirus disease 2019 (COVID-19) infections has recently increased the interest in telehealth, which is the adoption of telecommunication to deliver any health care activity. The available literature indicates that telemedicine has been adopted successfully in selected patients with several common clinical urological conditions, including prostate cancer, uncomplicated urinary stones, uncomplicated urinary infections, urinary incontinence, or pelvic organ prolapse. Likely, the COVID-19 pandemic will give a significant boost to the use of telemedicine, but more robust data on long-term efficacy, safety, and costs are necessary.