Bahadır Şahin

Russo GI, et al. World J Mens Health. 2026 ;44:e86. https://doi.org/10.5534/wjmh.260152

Mahmutoglu AM, et al. World J Mens Health. 2026 ;44:e70. https://doi.org/10.5534/wjmh.260092

Metin Mahmutoglu A, et al. World J Mens Health. 2026 ;44:e57. https://doi.org/10.5534/wjmh.260074

This systematic review and meta-analysis of randomized controlled trials evaluated the effects of low-intensity shock wave therapy (LiSWT) on erectile function (EF) and penile vascular parameters in men with erectile dysfunction (ED), compared with controls receiving sham or no treatment. A systematic search of Scopus, PubMed, and Cochrane databases identified studies assessing LiSWT in men with ED. Primary outcomes were changes in the International Index of Erectile Function (IIEF)-5 and the IIEF-EF domain scores. Secondary outcomes included erection hardness score (EHS), sexual encounter profile (SEP) diary Q2 and Q3, global assessment question (GAQ) scores, and penile Doppler ultrasound parameters-peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI). Changes from baseline to the end of follow-up were compared between LiSWT and control groups. Of 527 retrieved articles, 12 met inclusion criteria. Pooled analysis demonstrated significantly greater improvements in the LiSWT group for IIEF-5 (standardized mean difference [SMD], 1.19; 95% confidence interval [CI], 0.47-1.91; p=0.001) and IIEF-EF (SMD, 1.24; 95% CI, 1.02-1.45; p<0.001) scores compared with controls. No significant differences were found for EHS (p=0.698), SEP-Q2 (p=0.934), SEP-Q3 (p=0.985), GAQ (p=0.993), and penile Doppler ultrasound parameters, including PSV (p=0.855), EDV (p=0.995), or RI (p=0.818). LiSWT provides modest improvements in IIEF scores but fails to produce significant changes in other functional or vascular parameters. These findings suggest that while LiSWT may offer some benefit, the clinical relevance is limited for most patients. Current evidence does not support its routine inclusion in ED treatment algorithms. Future research should focus on identifying patient subgroups most likely to experience significant and sustained improvements from this therapy.

Agarwal A, et al. World J Mens Health. 2026 Jan;44:e3. https://doi.org/10.5534/wjmh.250290

Shah R, et al. World J Mens Health. 2025 Jun;43:e41. https://doi.org/10.5534/wjmh.250039

Palani A, et al. World J Mens Health. 2025 Jun;43:e37. https://doi.org/10.5534/wjmh.250008

Mahmutoglu AM, et al. World J Mens Health. 2025 Apr;43:e22. https://doi.org/10.5534/wjmh.250006

Objective: To evaluate widely used chatbots’ accuracy, calibration error, readability, and understandability with objective measurements by 35 questions derived from urology in‐service examinations, as the integration of large language models (LLMs) into healthcare has gained increasing attention, raising questions about their applications and limitations.Materials and Methods: A total of 35 European Board of Urology questions were asked to five LLMs with a standardised prompt that was systematically designed and used across all models: ChatGPT‐4o, DeepSeek‐R1, Gemini, Grok‐2, and Claude 3.5. Accuracy was calculated by Cohen's kappa for all models. Readability was assessed by Flesch Reading Ease, Gunning Fog, Coleman–Liau, Simple Measure of Gobbledygook, and Automated Readability Index, while understandability was determined by scores of residents’ ratings by a Likert scale.Results: The models and answer key were in substantial agreement with a Fleiss’ kappa of 0.701, and Cronbach's alpha of 0.914. For accuracy, Cohen's kappa was 0.767 for ChatGPT‐4o, 0.764 for DeepSeek‐R, and 0.765 for Grok‐2 (80% accuracy for each), followed by 0.729 for Claude 3.5 (77% accuracy) and 0.611 for Gemini (68.4% accuracy). The lowest calibration error was found in ChatGPT‐4o (19.2%) and DeepSeek‐R1 scored the highest for readability. In understandability analysis, Claude 3.5 had the highest rating compared to others.Conclusion: Chatbots demonstrated various powers across different tasks. DeepSeek‐R1, despite being just released, showed promising results in medical applications. These findings highlight the need for further optimisation to better understand the applications of chatbots in urology.

The objective of this study was to evaluate the effects of ionizing radiation (iR) on corpus cavernosum and the potential of astaxanthin (AST) in preventing radiation-induced erectile dysfunction (RiED). Male Wistar Albino rats (10–12 week, 250–300 g) were divided-into four groups: sham (SH, n = 8), radiotherapy (RT, n = 8), vehicle-administered (olive oil (OO); RT + OO, n = 12), and astaxanthin (RT + AST, n = 12). The RT-group received 12-Gy prostate-targeted iR. The vehicle-administered (OO) group received iR with daily 1 ml OO via oral gavage, while the AST-group received iR with 50 mg/kg AST dissolved in OO. After the treatment-period (12-week), intracavernosal pressure to mean arterial pressure (ICP/MAP) ratios in the RT [0.28(0.14–0.65)] and OO groups [0.26(0.19–0.64)] were significantly lower than in the SH [0.6(0.43–0.72)] and AST [0.53(0.35–0.64)] groups ( p < 0.05). iR caused narrowing of the cavernous sinusoids (RT:95.38 (84.62–110.05) vs SH:132.33 (113.27–155.86), AST:124.44 (112.11–131.97) µm, p < 0.001). Alpha smooth muscle actin (SH:165 (136.25–188.75) vs RT:100 (87.5–112.5), AST:137.5 (107.5–155), p < 0.001), endothelial nitric-oxide synthase (NOS) (SH:127.5 (115–167.5) vs RT:92.5 (81.25–98.75), AST:115 (86.25–128.75), p = 0.002) and neuronal NOS (SH:152.5 (133.75–163.75) vs RT:95 (81.25–103.75), AST:135 (125–140), p < 0.001) were diminished in the RT-group and preserved in the AST-group according to immunohistochemical scoring. Biochemical measurements of the corpus cavernosum revealed that the level of cGMP was significantly higher (93.15 (71.22–103.38) vs 70.8 (65–72.35) pmol/ml) in the AST-group, while lipid peroxidation was significantly higher (32.38 (29.07–36.98) vs 20.14 (17.85–21.04) nmol.mda/g) in the RT-group ( p = 0.004, p < 0.001). This trial showed that AST preserved ICP/MAP values and histopathological-biochemical parameters after exposure to iR.