World journal of urologyBurak Akgul, Selcuk Guven, Gernot Ortner, Hakan Akdere, Bhaskar Somani, Vineet Gauhar, Steffi Kar Kei Yuen, Panagiotis Kallidonis, Thomas Rw Herrmann, Udo Nage…
PURPOSE: Ureteral stents are widely used following ureteroscopy (URS), yet several aspects of their management remain non-standardized despite contemporary EAU and AUA guideline recommendations. This study evaluated contemporary international practices and identified gaps in ureteral stent use among endourologists. METHODS: A cross-sectional international survey consisting of 58 items across nine domains was distributed via social media, major urological meetings, and the EAU Endourology Section. Only fully completed responses were analyzed. Descriptive statistics were used, with continuous variables reported as medians and categorical variables as frequencies and percentages. RESULTS: A total of 121 respondents from 48 countries were included. Stent placement remained common after uncomplicated ureteroscopy and was nearly universal in complicated cases. Pre-stenting was applied selectively, most commonly after failed ureteroscopy and for ureteral dilatation. A 6 Fr stent and polyurethane material were the preferred choices. Stent-related symptoms were frequent, with urgency and frequency predominating, followed by hematuria. Pharmacologic management varied, and conservative treatment was commonly used for post-stenting infections. Notably, 45% of respondents did not use a structured stent-tracking system and 71.8% had never used a validated symptom-assessment tool such as the USSQ. Exploratory subgroup analyses identified differences according to geographic region, institution type, and endourological training background in selected aspects of stent management, including pre-stenting duration, long-term stent exchange protocols, pharmacologic management, and follow-up systems. CONCLUSION: International ureteral stent practices show substantial variability. Although core practices were broadly comparable across regions, important gaps remain in stent tracking and symptom assessment, highlighting opportunities to improve patient safety and standardize care.
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologicaAlberto Trinchieri, Rodofo Montironi
Systems of digital pathology are used to enhance diagnostic consistency and reduce workload. They cannot replace pathologists but can serve as tireless and intelligent assistants. Artificial intelligence (AI) excels at high-volume and repetitive tasks, freeing pathologists to focus on complex cases and final diagnostic decisions. The other advantages of digitization include reducing interobserver variability, use as second reader tools and for triage negative biopsies. Digital images can be used for remote consultation, external quality assessment, and education. Despite these favorable results, it must be kept in mind that AI is merely a tool to assist in pathological diagnosis and treatment that cannot replace human expertise. Ethical and legal implications must be considered in order to establish legal frameworks and ensure transparency and ethical use of AI-based tools.
World journal of urologySelcuk Erdem, Daniele Amparore, Chiara Re, Samed Verep, Umberto Capitanio, Alessandro Larcher, Eduard Roussel, Tobias Klatte, Riccardo Bertolo, Stijn Muselaers…
BACKGROUND AND OBJECTIVE: Renal cell carcinoma (RCC) is a common manifestation in Von-Hippel Lindau (VHL) syndrome, accounting for almost 30% of the patients. However, since VHL syndrome is relatively rare, there are no clear guidelines regarding the approach to VHL patients with RCC. This article aims to provide evidence-based insights for diagnosis, treatment, and surveillance in VHL patients with RCC. METHODS: The articles indexed between 1977 and 2025 in PubMed was searched. Only articles in English were included. RESULTS: Renal cysts are quite common in VHL patients and these cysts predispose for RCC. VHL patients are characterized with early-onset, multifocal and/or bilateral, recurrent and clear cell subtype RCC. Patients should be monitored at regular intervals. Due to recurrent characteristics of RCC, nephron-sparing surgeries should be prioritized with the aim of life-long kidney function preservation, whenever it is feasible. Focal treatments should be considered in patients for whom surgery is not suitable. In addition, belzutifan treatment has shown promising results in selected patients. CONCLUSION: In VHL patients with RCC, kidney function should be preserved whenever possible to ensure a long and high-quality life. Since these patients may develop lesions in other organs beyond kidney, surveillance with multidisciplinary approach in tertiary centers should be recommended.
The Canadian journal of urologyTyler Overholt Daniel, David Thole, Randy Casals, Anthony Atala, Steve Hodges, Marc Colaco
OBJECTIVES: Day of surgery cancellations present several workflow challenges that result in delay of care for patients and revenue loss for physicians. This study aimed to further understand same-day pediatric urology surgical cancellations, and the authors assessed identifiable trends for quality improvement over a one-year time period. METHODS: Same-day surgical cancellations were prospectively identified at a single tertiary care center, Atrium Health Wake Forest Baptist, from 01 October 2022 to 30 September 2023. Reasons for cancellation were recorded per the parent/legal guardian and categorized as an avoidable or unavoidable cause. Demographic data, surgical rescheduling, and lost operating room time were also recorded. Descriptive and bivariate analyses were performed as indicated. RESULTS: Of 2351 scheduled cases, 51 (2.2%) were cancelled the day of surgery. The most common cancellation type was a complete no-show with no reason provided from the family (39.2%). Of those with reported reasons, 54.8% were cancelled for avoidable causes. Of those cancelled, 66.7% were for patients of a minority race, with 11.8% of families indicating a need for translation services during visits. There was no difference in terms of race/ethnicity, distance lived from the hospital, or surgical type when comparing cancellation reason (p > 0.05). Only 51.0% of cases were rescheduled with a median delay of 38 days. A total of 59.3 h of operating room time was lost due to these cancellations. CONCLUSIONS: Same-day cancellations were identified in 2.2% of planned pediatric urology cases over a one-year period, with the majority of patients cancelled for avoidable reasons. Of cancelled cases, only 51.0% were rescheduled by the family, with a median delay of over one month. Additionally, 2/3rd of patients identified as a minority race, with 11.8% requiring translation services. This represents a vulnerable population who may require additional counseling for optimal patient and provider outcomes.
World journal of urologyVineet Gauhar, Deepak Ragoori, Mallikarjuna Chiruvella, Steffi Kar-Kei Yuen, Olivier Traxer, Bhaskar Somani, Daniele Castellani
OBJECTIVE: Flexible ureteroscopy (F-URS) with suction technology has become a minimally invasive surgery for the management of renal stones. While the Flexible and Navigable Suction Ureteral Access Sheath (FANS) and Direct In-Scope Suction (DISS) ureteroscopes individually have proven benefits and restrictions, there is no dedicated research if integrating both these technologies can complement the limitations of each to improve suction F-URS outcomes. This audit introduces the Flexible Integrated Retrograde Suction-Ureteroscopy Technique (FIRST) procedure, which integrates FANS with a DISS ureteroscope, and compares its outcomes against DISS combined with a conventional ureteral access sheath (C-UAS). METHODS: This prospective audit enrolled 64 adult patients undergoing F-URS with a DISS ureteroscope between August 2024 and October 2025 at 2 institutions. Patients were allocated to DISS with FANS (Group 1, n = 37) or DISS with C-UAS (Group 2, n = 27) based on surgeon discretion and device availability. The primary outcome was 30-day stone-free rate (SFR) assessed by non-contrast CT scan (single fragment up to 2 mm). Secondary outcomes included perioperative complications, renal function, and 3-month residual fragment rate, and the surgeon-reported ergonomics of procedures. RESULTS: Despite significantly greater stone burden in Group 1, the FIRST procedure achieved a superior 30-day SFR of 83.8% versus 70.4% in Group 2, with zero-residual-fragment status in 72.9% versus 48.1% of patients, respectively (p < 0.001). At three months, zero residual fragments were detected in all patients in Group 1 compared to 22.2% in Group 2 (p < 0.01), translating into zero reinterventions in Group 1. Surgeon-reported ergonomics, intraoperative visibility, and simultaneous DISS-laser manipulation were rated significantly superior in Group 1. Overall 30-day complication rates were comparable between groups (18.9% vs. 22.2%), with no high-grade (Clavien ≥ 3) complications and preserved renal function in either cohort. CONCLUSIONS: The FIRST procedure using this integrated suction technique can potentially give 100% SFR with significantly improved ergonomics with negligible complications. These findings support further investigation of the integrated FIRST procedure in routine and anatomically complex renal stone disease.
Current urology reportsEric S Giannaris, Aaron M Brant, Joseph P Alukal
PURPOSE OF REVIEW: To review recent evidence on effective mentorship practices in urology fellowship training, with emphasis on mentorship qualities, structured programs, and equity considerations. RECENT FINDINGS: While few studies have examined mentorship specifically within urology fellowship, available evidence suggests that effective mentorship is dynamic and characterized by accessibility, alignment with mentee goals, and reciprocal engagement. Access to formal mentorship may reduce burnout and improve trainee well-being. Structured surgical mentorship programs have been associated with shortened learning curves and successful surgical outcomes. Diversity-focused initiatives have demonstrated success in improving representation in urology, yet disparities in mentorship access remain for women and underrepresented groups. Mentorship in urology fellowship can improve trainee well-being, foster career development, and support equitable representation. Collaborative efforts across subspecialty societies to expand structured mentorship models and establish standardized evaluation may strengthen training outcomes and reduce disparities in mentorship access and quality.
Archivos espanoles de urologiaCarolina de la Pinta, Alberto Artiles Medina
Artificial intelligence (AI) is redefining modern medicine and urology. Its applications range from natural language processing (NLP) systems that streamline clinical documentation and reduce administrative burden to generative AI models capable of producing actionable data to support clinical decision-making and enable precision treatment selection. In Spain, the healthcare system has undergone an accelerated digital transformation, during which AI has evolved from an experimental concept to an operational component of routine clinical practice. This review provides an overview of the current implementation of AI in urology in Spain, highlighting actively deployed AI-based systems across different centers. The review is based on a structured search of publicly available information from news databases, institutional repositories, and independent monitoring initiatives focused on AI adoption in the Spanish healthcare system. These tools demonstrate substantial clinical benefits in areas such as diagnostic imaging, automated coding, digital pathology, radiotherapy planning, and patient follow-up. Their integration has improved diagnostic accuracy, optimized workflow efficiency, reduced reporting times, and facilitated more personalized treatment approaches. At the international level, the steadily growing number of Food and Drug Administration (FDA)- and CE-approved AI tools further illustrates the expanding clinical adoption of AI in urology. Overall, these advances indicate that AI has become a cornerstone of precision medicine, rather than a distant future prospect.
Urologiia (Moscow, Russia : 1999)A Korneyev I, I Apolikhin O, Yu Babenko A, V Bogolyubov S, A Bozhedomov V, V Vinogradov I, A Gazimiev M, I Gamidov S, R Gvasalia B, V Grebenkin E, A Epanchint-…
The practical use of terms presented in the Russian Society of Urology clinical guidelines "Male Infertility" is discussed in the article. Male infertility is caused by conditions that lead to impaired reproductive function and inability to conceive: sexual dysfunction and anatomical defects that prevent sperm delivery, azoospermia, cryptozoospermia, functional insufficiency of spermatozoa and of the genetic material they contain, such as 100%- astheno-, necro-, and globozoospermia, etc. Signs of insufficient reproductive function (reproductive dysfunction) in partners may include relative infertility in a couple, miscarriage in the spouse, and failure of treatment using assisted reproductive technologies. Male fertility can be negatively affected by risk factors including diseases, lifestyle factors, and environmental exposures; the probability of conception can be judged by continuously distributed values of reproductive function indicators characterizing sexual activity, ejaculate parameters, functional competence of spermatozoa, and the quality of the genetic material they contain. Unified views on terminology ensure standardization of diagnostic and treatment approaches and provide a basis for interdisciplinary interaction in couple infertility.