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Advancements and Challenges in Reconstructive Urology and Urethral Surgery
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Advancements and Challenges in Reconstructive Urology and Urethral Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 30 October 2025 | Viewed by 938

Special Issue Editor

Dr. Francesco Chierigo

E-Mail Website
Guest Editor
Department of Urology, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
Interests: reconstructive urology; urologic oncology; prostate cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Reconstructive urology and urethral surgery are pivotal fields in modern urology, addressing complex functional and structural abnormalities of the urinary tract. Despite significant advancements in surgical techniques, biomaterials, and postoperative management, many challenges remain, including high recurrence rates, patient-reported outcomes, and long-term functional success. This Special Issue aims to highlight recent innovations, emerging technologies, and best practices in reconstructive urology, particularly in urethral surgery, with the goal of improving patient outcomes and advancing the field.

We invite original research articles, systematic reviews, and meta-analyses that explore novel surgical techniques, tissue engineering approaches, minimally invasive solutions, and long-term follow-up data in reconstructive urology. Studies assessing the impact of robotic-assisted surgery, patient-centered outcomes, and complications management are particularly encouraged. Additionally, contributions focusing on multidisciplinary approaches integrating urology, plastic surgery, and regenerative medicine will be welcomed.

We encourage researchers, clinicians, and experts in urology, andrology, and surgical innovation to submit their work, fostering a comprehensive and collaborative discussion on the future of reconstructive urology and urethral surgery.

Dr. Francesco Chierigo
Guest Editor

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. Journal of Clinical Medicine 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

  • reconstructive urology
  • urethral surgery
  • urethroplasty
  • minimally invasive surgery
  • robotic-assisted surgery
  • urinary tract reconstruction
  • surgical innovation
  • patient-reported outcomes

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Published Papers (2 papers)

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Research

12 pages, 991 KiB  
Article
Seeing the Stricture Clearly: Independent Determinants of Sonourethrography Precision in Urethral Stricture Disease
by Kevin Miszewski, Jakub Krukowski, Laura Miszewska, Jakub Kulski, Roland Stec, Katarzyna Skrobisz and Marcin Matuszewski
J. Clin. Med. 2025, 14(13), 4453; https://doi.org/10.3390/jcm14134453 - 23 Jun 2025
Viewed by 273
Abstract
Background: Urethral stricture disease involves fibrotic scarring that narrows the urethral lumen and can occur at any site. Sonourethrography (SUG) is increasingly used because it depicts both luminal anatomy and periurethral fibrosis, yet little is known about patient or lesion features that [...] Read more.
Background: Urethral stricture disease involves fibrotic scarring that narrows the urethral lumen and can occur at any site. Sonourethrography (SUG) is increasingly used because it depicts both luminal anatomy and periurethral fibrosis, yet little is known about patient or lesion features that influence its diagnostic performance. Methods: We conducted a prospective single-center study of 170 men who underwent SUG before anterior urethroplasty between May 2016 and May 2021. Anthropometric data, comorbidities, and detailed ultrasonographic measurements were recorded and compared with intra-operative findings, which served as the reference standard. Accuracy was analyzed with Wald chi-square testing and Spearman correlation. Results: SUG length estimates matched intra-operative measurements in 139/170 strictures (81.8%). Length accuracy was higher in patients ≥ 60 years (89.2% vs. 77.0%, p = 0.03) and in those with type 2 diabetes (92.3% vs. 80.9%, p = 0.02) in conditions associated with pronounced spongiofibrosis that enhances echo contrast. Among stricture-specific factors, proximal location (63.6% vs. 84.5%, p = 0.01) and complete luminal occlusion (68.8% vs. 84.8%, p = 0.02) reduced precision, largely because deeper anatomy and absent saline flow hinder acoustic delineation. The Chiou ultrasonographic grade was the strongest determinant of performance; higher grades yielded clearer margins and better length estimation (p < 0.001). Conclusions: SUG is a reliable bedside technique for assessing anterior urethral strictures, but its accuracy varies with age, diabetes status, stricture site, degree of occlusion, and fibrosis grade. Recognizing these determinants allows clinicians to judge when SUG alone is sufficient and when complementary imaging or heightened caution is warranted. The findings support tailored imaging protocols and underscore the need for multi-center studies that include operators with diverse experience to confirm generalisability. Full article
(This article belongs to the Special Issue Advancements and Challenges in Reconstructive Urology and Urethral Surgery)
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Graphical abstract

13 pages, 1239 KiB  
Article
Impact of Urethroplasty on Erectile Function: A Multicenter Analysis of the International Index of Erectile Function Score Changes Across Different Etiologies of Urethral Stricture
by Mikołaj Frankiewicz, Łukasz Białek, Marta Rydzińska, Michał Skrzypczyk, Rafał Pęksa, Marcin Folwarski, Adam Kaftan, Jakub Krukowski, Adam Kałużny, Marcin Matuszewski and Trauma and Reconstructive Urology Working Party of the European Association of Urology Young Academic Urologists
J. Clin. Med. 2025, 14(9), 2936; https://doi.org/10.3390/jcm14092936 - 24 Apr 2025
Viewed by 436
Abstract
Background/Objectives: Urethral stricture disease, characterized by narrowing of the urethra due to scar tissue, affects urinary and sexual health. While urethroplasty is the standard treatment, its impact on erectile function is less understood. This study examines changes in International Index of Erectile [...] Read more.
Background/Objectives: Urethral stricture disease, characterized by narrowing of the urethra due to scar tissue, affects urinary and sexual health. While urethroplasty is the standard treatment, its impact on erectile function is less understood. This study examines changes in International Index of Erectile Function (IIEF) scores post-urethroplasty across various stricture etiologies, identifies predictors of erectile function outcomes, and explores recovery trajectories following surgery. Methods: This multicenter retrospective study included 103 patients who underwent urethroplasty between 2017 and 2023. Preoperative and postoperative IIEF scores at 3 and 6 or 12 months were analyzed. Stricture etiologies included pelvic fracture urethral injury, transurethral resection, catheterization, idiopathic, and hypospadias. The Wilcoxon signed-rank test and multivariate regression models were used to assess changes in IIEF scores and identify significant predictors. Results: Preoperative erectile function and patient age were significant predictors of postoperative outcomes. Younger patients and those with higher baseline IIEF scores experienced better erectile function post-surgery. Long-term outcomes (6 to 12 months) were significantly worse for strictures involving both penile and bulbar regions. Multivariate analysis showed higher pre-surgery IIEF scores and younger age were associated with better outcomes both short-term (R2 = 0.562) and long-term (R2 = 0.507). Diabetes was associated with worse erectile function outcomes at 3 months post-surgery. Conclusions: Younger patients and those with higher baseline IIEF scores have better erectile function outcomes following urethroplasty. Complex strictures involving both penile and bulbar regions adversely affect long-term outcomes. Additionally, the presence of diabetes is correlated with diminished erectile function in the short-term postoperative period. Full article
(This article belongs to the Special Issue Advancements and Challenges in Reconstructive Urology and Urethral Surgery)
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