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Diagnostics
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Challenges in Urology: From the Diagnosis to the Management
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Challenges in Urology: From the Diagnosis to the Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 7026

Special Issue Editors

Dr. Simone Morra

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Guest Editor
1. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
2. Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
Interests: urologic oncology; bladder cancer; kidney cancer; prostate cancer; epidemiology
Special Issues, Collections and Topics in MDPI journals
Dr. Claudia Collà Ruvolo

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Guest Editor
Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
Interests: prostate cancer
Dr. Gianluigi Califano

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Guest Editor
Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
Interests: social media; immunology; medicine; scientific research
Special Issues, Collections and Topics in MDPI journals
Dr. Francesco Di Bello

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Guest Editor
1. Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
Interests: urologic oncology; bladder cancer; kidney cancer; prostate cancer; testis cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to announce this Special Issue addressing the challenges encountered in the field of urology. Urological conditions present a myriad of complexities, ranging from benign disorders to life-threatening malignancies, necessitating innovative approaches to diagnosis and management.

This Special Issue aims to bring together a collection of articles that shed light on the various challenges faced by urologists worldwide. From the complexities of surgical interventions to the intricacies of medical management, we seek to explore the multifaceted nature of urological challenges and the strategies employed to overcome them.

We invite researchers, clinicians, and experts in the field to contribute original research papers, review articles, and case studies that delve into the diverse challenges encountered in urology. Whether it be navigating the complexities of robotic surgery, addressing the rising incidence of urinary tract infections, or grappling with the psychological impact of urological disorders, we welcome contributions that provide insights and solutions to these challenges.

By fostering collaboration and sharing experiences, we aim to advance the field of urology and improve patient outcomes. Your contributions will play a pivotal role in shaping this special edition into a comprehensive resource for urologists worldwide.

We eagerly anticipate your submissions and look forward to working together to address the challenges in urology.

Dr. Simone Morra
Dr. Claudia Collà Ruvolo
Dr. Gianluigi Califano
Dr. Francesco Di Bello
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • challenges
  • complications
  • rare
  • surgery
  • cancer

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Published Papers (5 papers)

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16 pages, 10413 KiB  
Article
Bladder Endometriosis: Diagnostic, Therapy, and Outcome of a Single-Center Experience
by Elvin Piriyev, Sven Schiermeier and Thomas Römer
Diagnostics 2025, 15(4), 466; https://doi.org/10.3390/diagnostics15040466 - 14 Feb 2025
Viewed by 755
Abstract
Background/Objectives: Endometriosis is a benign condition affecting up to 10% of women at reproductive age. The urinary tract is affected in 0.3–12.0% of women with endometriosis and in 19.0–53.0% of women with deep infiltrating endometriosis. The bladder is the most commonly affected organ [...] Read more.
Background/Objectives: Endometriosis is a benign condition affecting up to 10% of women at reproductive age. The urinary tract is affected in 0.3–12.0% of women with endometriosis and in 19.0–53.0% of women with deep infiltrating endometriosis. The bladder is the most commonly affected organ in the urinary tract. Bladder endometriosis is defined by the presence of endometriosis lesions in the detrusor muscle, with partial or complete thickness involvement. Methods: This was a retrospective study. The study analyzed surgical reports of 11,714 patients who underwent endometriosis laparoscopy, and included only 42 patients with bladder endometriosis. Results: We found that 0.35% of patients with endometriosis had bladder endometriosis. In total, 29 patients underwent phone follow-up. In total, 26 patients (90%) reported a general improvement in their symptoms (e.g., improving the dysmenorrhea, lower abdominal pain), with a 100% improvement in their dysuria. Only two patients (7%) reported no change in symptoms (dysmenorrhea and dyspareunia). Conclusions: Gynecologists can perform laparoscopic surgical treatment of bladder endometriosis in most cases. If ureteroneocystostomy is required or the localization of the endometriosis nodule is unfavorable, an intervention by an interdisciplinary team is recommended. Both laparoscopic partial bladder resection and shaving can be considered effective methods with low complication risk. This surgical approach requires excellent laparoscopic skills. Full article
(This article belongs to the Special Issue Challenges in Urology: From the Diagnosis to the Management)
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14 pages, 2371 KiB  
Article
Association of [68Ga]Ga-PSMA-11 PET/CT Metrics with PSA Persistence Following Radical Prostatectomy in Patients with Intermediate- and High-Risk Prostate Cancer
by Juan J. Rosales, Vicky Betech-Antar, Fernando Mínguez, Edgar F. Guillén, Elena Prieto, Gemma Quincoces, Carmen Beorlegui, María Dolores Fenor de la Maza, Fernando Díez-Caballero, Bernardino Miñana, José Luis Pérez-Gracia and Macarena Rodríguez-Fraile
Diagnostics 2025, 15(3), 301; https://doi.org/10.3390/diagnostics15030301 - 27 Jan 2025
Viewed by 667
Abstract
Background/Objectives: The aim of this study was to determine whether semiquantitative and volume-based metrics obtained from [68Ga]Ga-PSMA-11 PET/CT (PSMA-PET) scans before radical prostatectomy (RP) are associated with PSA persistence after surgery in patients with intermediate- (IR) and high-risk (HR) prostate cancer [...] Read more.
Background/Objectives: The aim of this study was to determine whether semiquantitative and volume-based metrics obtained from [68Ga]Ga-PSMA-11 PET/CT (PSMA-PET) scans before radical prostatectomy (RP) are associated with PSA persistence after surgery in patients with intermediate- (IR) and high-risk (HR) prostate cancer (PCa). Methods: We included 118 consecutive patients (IR = 57; HR = 61) with PCa with a PSMA-PET for initial staging and underwent subsequent RP. Clinical parameters and PSMA-PET metrics in the prostate were obtained to determine the following measurements: SUVmax, SUVmean, Target-to-Background Ratios (TBRs), Prostate Molecular Tumor (pMTV), Prostate Total Lesion Activity (pTLA), Prostate Volume (pV), and Prostate Disease Burden (pDB). The association of PSMA-PET metrics parameters before RP and PSA persistence were analyzed by multivariate logistic regression. Results: SUVmax and volume-based PSMA-PET metrics were significantly higher in patients with ISUP Grade 3–5 vs. ISUP Grade 1–2, and only pMTV, pTLA, and pDB were found to be significantly higher in HR patients, as compared with the IR group. During follow-up, 23 patients showed PSA persistence. pMTV, pTLA, and pDB were significantly higher among patients presenting PSA persistence after RP than in patients with undetectable PSA. Multivariate logistic regression analysis found that lymph node infiltration and pTLA were independent predictors for PSA persistence. A cut-off point of ≥25.1 allowed the best discrimination for PSA persistence (OR: 7.4; IQR: 1.4–39.1; p < 0.05). Conclusions: The identified association between PSA persistence and prostate TLA of PSMA-PET at initial staging highlights its potential as a valuable tool to improve risk prediction in prostate cancer patients. Further research is needed to confirm these results. Full article
(This article belongs to the Special Issue Challenges in Urology: From the Diagnosis to the Management)
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16 pages, 7207 KiB  
Article
Real-Time Dosimetry in Endourology: Tracking Staff Radiation Risks
by Susanne Deininger, Olaf Nairz, Anna Maria Dieplinger, Christian Deininger, Lukas Lusuardi, Christian Ramesmayer, Julia Peters, David Oswald, Maximilian Pallauf, Sophina Bauer, Mathias Christoph Brandt and Peter Törzsök
Diagnostics 2024, 14(16), 1763; https://doi.org/10.3390/diagnostics14161763 - 13 Aug 2024
Cited by 1 | Viewed by 2121
Abstract
Background: To retrospectively investigate scatter radiation (SCR) exposure among staff in the endourology operating theatre. Methods: During surgeries under fluoroscopic guidance, five professional groups (urological surgeon [US], surgical nurse [SN], assistant surgical nurse [ASN], anaesthetist [A], and anaesthesia care [AC]) wore real-time dosimeters [...] Read more.
Background: To retrospectively investigate scatter radiation (SCR) exposure among staff in the endourology operating theatre. Methods: During surgeries under fluoroscopic guidance, five professional groups (urological surgeon [US], surgical nurse [SN], assistant surgical nurse [ASN], anaesthetist [A], and anaesthesia care [AC]) wore real-time dosimeters (Philips DoseAware System) on their head and chest over lead aprons between July 2023 and February 2024. The SCR data were analysed and correlated with procedural and patient factors. Results: In total, 249 procedures were performed, including 86 retrograde intrarenal surgeries and 10 percutaneous nephrolithotomies. Median SCR exposure was 38.81, 17.20, 7.71, 11.58, 0.63, 0.23, 0.12, and 0.15 Microsievert (µSv) for US chest (USC), US head (USH), SN chest (SNC), SN head (SNH), A chest (AC), AC chest (ACC), ASN chest (ASNC), and ASN head (ASNH), respectively. There was a significant correlation between DAP and SCR doses detected by USC, USH, SNC, SNH, AC, and ACC dosimeters (p < 0.05). The median chest-to-eye conversion factor (CECF) was 2.11 for the US and 0.71 for the SN. Conclusions: This study, using real-time dosimetry, is among the first to assess staff occupational SCR exposure in endourology. It highlights a substantial SCR exposure, indicating an occupational health hazard that warrants further investigation. Full article
(This article belongs to the Special Issue Challenges in Urology: From the Diagnosis to the Management)
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9 pages, 400 KiB  
Article
Transition from Transrectal to Transperineal MRI-Fusion Prostate Biopsy Does Not Comprise Detection Rates of Clinically Significant Prostate Cancer at a Tertiary Care Center
by Benedikt Hoeh, Mike Wenzel, Clara Humke, Cristina Cano Garcia, Carolin Siech, Melissa Schneider, Carsten Lange, Miriam Traumann, Jens Köllermann, Felix Preisser, Felix K. H. Chun and Philipp Mandel
Diagnostics 2024, 14(11), 1184; https://doi.org/10.3390/diagnostics14111184 - 5 Jun 2024
Cited by 1 | Viewed by 1461
Abstract
Background: A remarkable paradigm shift has emerged regarding the preferred prostate biopsy approach, favoring the transperineal (TP) over the transrectal (TR) approach due to the reduced risk of severe urinary tract infections. However, its impact on the detection of clinically significant prostate cancer [...] Read more.
Background: A remarkable paradigm shift has emerged regarding the preferred prostate biopsy approach, favoring the transperineal (TP) over the transrectal (TR) approach due to the reduced risk of severe urinary tract infections. However, its impact on the detection of clinically significant prostate cancer (csPCa) remains unclear. Materials and methods: We relied on a prospectively maintained tertiary care database to identify patients who underwent either TP or TR prostate biopsy between 01/2014 and 12/2023. Of those, only patients with suspicious magnetic resonance imaging (MRI) PIRADS lesions (Likert-scale: 3,4,5) received MRI-targeted and systematic biopsies. Detection rates of csPCa (International Society of Urological Pathology [ISUP] ≥ 2) were compared between biopsy approach (TP vs. TR) according to index lesion. Subsequently, uni- and multivariable logistic regression models were applied to investigate the predictive status of the biopsy approach within each subcohort. Results: Of 2063 patients, 1118 (54%) underwent combined MRI-guided and systematic prostate biopsy and were included in the final cohort. Of those, 127 (11%) and 991 (89%) underwent TP vs. TR. CsPCa rates, regardless of differences in patients’ demographics and distribution of index PIRDAS lesions, did not differ statistically significantly and were 51 vs. 52%, respectively (p = 0.8). CsPCa detection rates for PIRDAS-3, PIRADS-4 and PIRADS-5 did not differ and were 24 vs. 23%, 48 vs. 51% and 72 vs. 76% for PIRADS-3, PIRADS-4 and PIRADS-5 subgroups for TP vs. TR, respectively (all p ≥ 0.9) Conclusions: The current results support the available data indicating that TP biopsy approach is comparable to transrectal biopsy approach regarding csPCa detection rates. Full article
(This article belongs to the Special Issue Challenges in Urology: From the Diagnosis to the Management)
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8 pages, 1577 KiB  
Case Report
Arteriovenous Fistula: The Case of a Rare Complication after Minimal Percutaneous Nephrostomy and Brief Review
by Răzvan Alexandru Dănău, Răzvan-Cosmin Petca, Traian Vasile Constantin, Aida Petca, Gabriel Predoiu and Viorel Jinga
Diagnostics 2024, 14(11), 1121; https://doi.org/10.3390/diagnostics14111121 - 28 May 2024
Cited by 1 | Viewed by 1243
Abstract
Percutaneous renal surgery, although much less invasive than other procedures, is subject to several complications, which can occur at any time during the course of treatment, starting from the performance of the minimal nephrostomy procedure. We present an extremely rare vascular complication of [...] Read more.
Percutaneous renal surgery, although much less invasive than other procedures, is subject to several complications, which can occur at any time during the course of treatment, starting from the performance of the minimal nephrostomy procedure. We present an extremely rare vascular complication of percutaneous nephrostomy represented by arteriovenous fistula that occurred in a 24-year-old patient known to have right ureteropelvic junction obstruction operated with the absence of double-J catheter permeability and grade II-III hydronephrosis for which minimal percutaneous nephrostomy was urgently fitted. The arteriovenous fistula was resolved by supraselective artery embolization. Full article
(This article belongs to the Special Issue Challenges in Urology: From the Diagnosis to the Management)
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