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Clinical Trends and Prospects in Urology Surgery
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Clinical Trends and Prospects in Urology 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 June 2025 | Viewed by 2597

Special Issue Editors

Dr. Lazaros Tzelves

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Guest Editor
2nd Department of Urology, National and Kapodistrian University of Athens, Sismanogleion Hospital, 11526 Athens, Greece
Interests: urolithiasis; robotic surgery; prostate cancer; kidney cancer; bladder cancer
Prof. Dr. Bhaskar K. Somani

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Guest Editor
University Hospital Southampton NHS Trust, University of Southampton, Southampton, UK
Interests: endourology; urinary tract infections; benign prostate disorders
Special Issues, Collections and Topics in MDPI journals
Dr. Patrick Juliebø-Jones

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Guest Editor
1. Department of Urology, Haukeland University Hospital, 5021 Bergen, Norway
2. Department of Clinical, Medicine University of Bergen, 5021 Bergen, Norway
3. European Association of Urology, Young Academic Urologists, Urolithiasis Group, NL-6803 Arnhem, The Netherlands
Interests: urolithiasis; robotic surgery; prostate cancer; kidney cancer; bladder cancer

Special Issue Information

Dear Colleagues,

The field of urological surgery is rapidly changing due to technological advances occurring at a fast pace. Robotic surgery has already been in the game for at least 20 years, but during the last two years, many new robotic platforms have appeared for oncologic and benign surgery, such as stones. In addition, the miniaturization of scopes, the introduction of suction technology, and improved lithotripsy devices and settings have revolutionized minimally invasive surgery for stones and urothelial tumors. Artificial intelligence seems to be a game-changer as well, with a growing number of platforms integrating AI-based algorithms for analyzing data and providing navigation and assistance to the clinician/surgeon for improved outcomes. For all these reasons, we believe that this Special Issue can be quite attractive since it can incorporate all of these technological advances in urological surgery.

Dr. Lazaros Tzelves
Prof. Dr. Bhaskar K. Somani
Dr. Patrick Juliebø-Jones
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. 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

  • robotic surgery
  • laparoscopic surgery
  • endourology
  • minimally invasive surgery
  • artificial intelligence

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Published Papers (3 papers)

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Research

11 pages, 432 KiB  
Article
Perioperative Outcomes and Trends of Surgical Correction of Male Urethral Strictures: Results from the GRAND Study
by Robert Bischoff, Julian Marcon, Gerald Bastian Schulz, Christian G. Stief, Patrick Keller, Lennert Eismann, Philipp Weinhold and Nikolaos Pyrgidis
J. Clin. Med. 2025, 14(7), 2171; https://doi.org/10.3390/jcm14072171 - 22 Mar 2025
Viewed by 306
Abstract
Background: While various techniques for the surgical correction of urethral strictures exist, data on their trends and perioperative outcomes are limited. Methods: Data from the German Nationwide Inpatient Data (GRAND) registry (2005–2023) were used to estimate the trends, baseline characteristics, and [...] Read more.
Background: While various techniques for the surgical correction of urethral strictures exist, data on their trends and perioperative outcomes are limited. Methods: Data from the German Nationwide Inpatient Data (GRAND) registry (2005–2023) were used to estimate the trends, baseline characteristics, and perioperative outcomes of the surgical techniques for urethral stricture correction. Results: A total of 500,937 patients underwent surgery. Internal urethrotomy was the most frequently performed procedure (n = 413,095, 82%), followed by urethral dilatation (n = 39,619, 8%), meatoplasty (n = 30,774, 6%), urethroplasty with buccal mucosa (n = 12,351, 2%), urethral excision with primary anastomosis (n = 3428, 0.7%), urethroplasty with preputial skin (n = 1585, 0.3%), and drug-coated balloon dilatation (n = 85, <0.1%). In recent years, internal urethrotomy declined; urethroplasty was relatively stable, and drug-coated balloon dilatation emerged as a promising treatment modality. Internal urethrotomy and urethral dilatation were predominantly performed in older patients (median age of 71 years), while urethroplasty was performed in younger (56 years). Preputial skin urethroplasty had a shorter hospital stay compared to buccal mucosa (−0.4 days, p = 0.02), with no significant differences in transfusion or sepsis rates. Conclusions: Internal urethrotomy remains the most frequently used technique despite declining utilization. Preputial skin urethroplasty presents similar perioperative outcomes compared to buccal mucosa urethroplasty. Full article
(This article belongs to the Special Issue Clinical Trends and Prospects in Urology Surgery)
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10 pages, 563 KiB  
Article
Impact of Intraoperative Opioid Use and a Combined Anesthesia Regimen in Patients Undergoing Radical Prostatectomy for Prostate Cancer in a Single-Center Cohort
by Julian Marcon, Robert Bischoff, Kaspar Rattenhuber, Michael Chaloupka, Darjusch Askari, Jan-Friedrich Jokisch, Armin J. Becker, Paulo L. Pfitzinger, Patrick Keller, Elena Berg, Christian G. Stief, Daniel Siegl, Christian Kowalski, Alexander Buchner, Nikolaos Pyrgidis and Philipp Weinhold
J. Clin. Med. 2024, 13(24), 7506; https://doi.org/10.3390/jcm13247506 - 10 Dec 2024
Viewed by 649
Abstract
Introduction: Higher intraoperative opioid doses may be associated with worse long-term oncological outcomes after radical prostatectomy (RP) for prostate cancer. We aimed to evaluate the impact of higher doses of intraoperative opioids and type of anesthesia on biochemical recurrence (BCR) and mortality after [...] Read more.
Introduction: Higher intraoperative opioid doses may be associated with worse long-term oncological outcomes after radical prostatectomy (RP) for prostate cancer. We aimed to evaluate the impact of higher doses of intraoperative opioids and type of anesthesia on biochemical recurrence (BCR) and mortality after RP in a high-volume tertiary center. Methods: All patients underwent RP at our center between 2015 and 2021. The role of major intraoperative opioid agents, such as sufentanil remifentanil, and morphine milligram equivalents (MMEs), as well as the type of anesthesia [total intravenous anesthesia (TIVA), versus a combination of TIVA and epidural anesthesia, versus solely epidural anesthesia], was assessed in predicting BCR and survival after RP. Results: A total of 1137 patients who had a median age of 66 years (interquartile range: 61–72) were included. Overall, 1062 (93%) patients received TIVA, 37 (3%) received TIVA and epidural anesthesia, and 41 (4%) only epidural anesthesia. At a median follow-up of 431 days (interquartile range: 381–639) from RP, 257 (24%) patients developed a BCR. Accordingly, at a median follow-up of 500 days (interquartile range: 450–750), 33 (2.9%) patients died. The type of anesthesia, as well as the dosage or type of the selected intraoperative opioid agents, did not affect either BCR or long-term overall survival. Conclusions: These findings suggest that intraoperative opioid application during RP has no negative oncological impact in the short and long term in patients with localized prostate cancer. Accordingly, combined TIVA and epidural anesthesia, as well as solely epidural anesthesia were associated with similar short- and long-term outcomes compared to TIVA. Full article
(This article belongs to the Special Issue Clinical Trends and Prospects in Urology Surgery)
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8 pages, 531 KiB  
Article
Perioperative Outcomes and Trends in Transurethral Resection of Bladder Tumors with Photodynamic Diagnosis: Results from the GeRmAn Nationwide Inpatient Data Study
by Nikolaos Pyrgidis, Marco Moschini, Lazaros Tzelves, Bhaskar K. Somani, Patrick Juliebø-Jones, Francesco Del Giudice, Laura S. Mertens, Renate Pichler, Yannic Volz, Benedikt Ebner, Lennert Eismann, Marie Semmler, Benjamin Pradere, Francesco Soria, Christian G. Stief and Gerald B. Schulz
J. Clin. Med. 2024, 13(12), 3531; https://doi.org/10.3390/jcm13123531 - 17 Jun 2024
Cited by 1 | Viewed by 1131
Abstract
Background: Photodynamic diagnosis (PDD) during transurethral resection of bladder tumor (TURBT) is guideline recommended, as it improves bladder cancer detection rates. However, the extent to which PDD is implemented in everyday clinical practice has not been thoroughly assessed. We aimed to evaluate the [...] Read more.
Background: Photodynamic diagnosis (PDD) during transurethral resection of bladder tumor (TURBT) is guideline recommended, as it improves bladder cancer detection rates. However, the extent to which PDD is implemented in everyday clinical practice has not been thoroughly assessed. We aimed to evaluate the current trends and major perioperative outcomes of TURBT with PDD. Methods: The present study evaluated the GeRmAn Nationwide inpatient Data (GRAND) from 2010 (the year when PDD started to be coded separately in Germany) to 2021, which were made available from the Research Data Center of the German Bureau of Statistics. We undertook numerous patient-level and multivariable logistic regression analyses. Results: Overall, 972,208 TURBTs [228,207 (23%) with PDD and 744,001 (77%) with white light] were performed. Patients offered PDD during TURBT were younger (p < 0.001), presented fewer comorbidities (p < 0.001) and were discharged earlier from hospital (p < 0.001). PDD was associated with additional costs of about EUR 500 compared to white-light TURBT (p < 0.001). The yearly TURBT cases remained relatively stable from 2010 to 2021, whereas utilization of PDD underwent a 2-fold increase. After adjusting for major risk factors in the multivariate regression analysis, PDD was related to lower rates of transfusion (1.4% vs. 5.6%, OR: 0.29, 95% CI: 0.28 to 0.31, p < 0.001), intensive care unit admission (0.7% vs. 1.4%, OR: 0.56, 95% CI: 0.53 to 0.59, p < 0.001) and 30-day in-hospital mortality (0.1% vs. 0.7%, OR: 0.24, 95% CI: 0.22 to 0.27, p < 0.001) compared to white-light TURBT. On the contrary, PDD was related to clinically insignificant higher rates of bladder perforation (0.6% versus 0.5%, OR: 1.3, 95% CI: 1.2 to 1.4, p < 0.001), and reoperation (2.6% versus 2.3%, OR: 1.2, 95% CI: 1.1 to 1.2, p < 0.001). Conclusions: The utilization of PDD with TURBT is steadily increasing. Nevertheless, the road toward the establishment of PDD as the standard of care for TURBT is still long, despite of the advantages of PDD. Full article
(This article belongs to the Special Issue Clinical Trends and Prospects in Urology Surgery)
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