Lower pole stones (LPSs) frequently cause significant morbidity, necessitating effective intervention strategies. We systematically reviewed the evidence for treatment of LPSs with extracorporeal shock wave lithotripsy (ESWL), flexible ureterorenoscopy (FURS), and percutaneous nephrolithotomy (PCNL) previously in 2015. In this update, we have included 16 new randomised controlled trials plus eight from our original review (24 in total). Despite the increase in available trials, the certainty of evidence remains moderate for stone-free rates (SFRs), underscoring the on-going need for more robust trials in this domain. FURS demonstrated superior efficacy in achieving SFRs to ESWL (risk ratio [RR] 1.19, 95% confidence interval [CI] 1.05, 1.35), although the absolute difference remains modest. ESWL may lead to fewer complications, and FURS could result in more unplanned procedures and retreatments. It remains unclear whether there are differences in quality of life and cost estimates vary depending on the country. PCNL offers a marginal yet statistically significant advantage over FURS in terms of SFRs (RR 1.07, 95% CI 1.01, 1.12), but it is unclear whether there are differences in unplanned procedures, retreatments, or complications, and there was conflicting evidence about health status and return to normal activities. SFRs were superior with PCNL to those with ESWL (RR 1.42 95% CI 1.28, 1.58). Unplanned procedures and retreatments were generally fewer for PCNL, and complications were fewer for ESWL. The cost effectiveness of each modality is highly dependent on the health care system and country-specific economic factors. The overall certainty of the evidence remains unchanged, with only moderate improvements in certain domains.

Owing to the "cold" tumor immune microenvironment of prostate cancer, immune-targeting agents have shown limited efficacy in patients with advanced prostate cancer, highlighting the need for new therapies with novel mechanisms of action. In this context, T-cell engagers (TCEs), which induce T-cell-mediated killing of cancer cells by binding the CD3 receptor on T cells and a specific tumor antigen expressed on malignant cells, represent a promising therapeutic option. Multiple studies have explored the use of TCEs in previously treated patients with metastatic castration-resistant prostate cancer, and several ongoing trials are currently assessing novel TCEs either as single agents or in combinatorial regimens with molecules with a distinct mechanism of action (eg, androgen receptor pathway inhibitors and other immune-targeting agents). Although TCEs have shown promising antitumor activity with prostate-specific antigen and radiographic responses, they still face considerable challenges that prevent their implementation into clinical practice. These include their immunogenicity and the development of antidrug antibodies, which could impact their serum drug exposure, as well as their toxicity profile involving cytokine release syndrome and other immune-related adverse events. To improve their efficacy and pending the results of ongoing trials, there could be a role for combinatorial regimens, administration in earlier lines of therapy, and biomarker-driven selection.

To present a summary of the updated 2025 European Association of Urology (EAU) Guidelines on Sexual and Reproductive Health (SRH) on male infertility, providing practical recommendations on the clinical work-up with a focus on diagnosis, treatment and follow-up.

The European Association of Urology (EAU) renal cell carcinoma (RCC) guideline panel has updated their evidence-based guidelines and recommendations for the management of RCC. Here we present a summary of the 2025 RCC guidelines updated with standardised methodology to provide reproducible evidence for the management of RCC.

Standardized nomenclature for clinical trials is required so that the terms phase 1 (first-in-human dose-finding trials), phase 2 (trials to determine the safety and efficacy of a drug and the value of further research), and phase 3 (randomized trials against a standard of care) reflect the actual study design in question.

We present a summary of part II of the 2024 update of the European Association of Urology (EAU)/European Society of Paediatric Urology (ESPU) guidelines on paediatric urology. The summary provides evidence-based standards for management of a number of urological conditions in the paediatric population. The aim is to provide practical recommendations for clinical management of these conditions with a focus on diagnosis, treatment, and follow-up.

We present a summary of the 2025 update for the European Association of Urology (EAU) guidelines for upper urinary tract urothelial carcinoma (UTUC). The aim is to provide practical recommendations on the clinical management of UTUC with a focus on diagnosis, treatment, and follow-up.

This publication represents a summary of the updated 2025 European Association of Urology (EAU) guidelines for muscle-invasive and metastatic bladder cancer (MMIBC). The aim is to provide practical recommendations on the clinical management of MMIBC with a focus on diagnosis, treatment, and follow-up.

Detection of indolent prostate cancer in contemporary practice is an issue that can result in overtreatment for patients and a financial burden for health care systems. Solutions to this problem require a coordinated multidisciplinary approach involving clinicians, radiologists, and pathologists.

Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) in the diagnosis and primary staging of patients with prostate cancer (PCa) has an established role, but recent summative evidence on its actual diagnostic and staging value is still missing. We aimed to collect and analyze published studies reporting the accuracy of PSMA PET for the diagnosis of clinically significant prostate cancer (csPCa) and detection of distant metastases at primary staging before definitive treatment.