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Clinical Advances in Minimally Invasive Urologic Surgery
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Clinical Advances in Minimally Invasive Urologic 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: 15 January 2026 | Viewed by 3015

Special Issue Editors

Dr. Umberto Carbonara

E-Mail Website
Guest Editor
1. Unit of Urology, GVM—Saint Mary Hospital, 70121 Bari, Italy
2. Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70121 Bari, Italy
Interests: urology; uro-oncology; robotic surgery; laparoscopy; prostatectomy; nephrectomy; cystectomy
Dr. Fabio Crocerossa

E-Mail Website
Guest Editor
Division of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
Interests: urology; uro-oncology; robotic surgery; laparoscopy; prostatectomy; nephrectomy; cystectomy
Dr. Savio Domenico Pandolfo

E-Mail Website
Guest Editor
1. Department of Urology, University of L’Aquila, 67100 L’Aquila, Italy
2. Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
Interests: urology; oncology; robotic surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Minimally invasive surgery has undergone significant advancements in urology, fundamentally transforming patient care. These innovations, including laparoscopy, robotic-assisted surgery, and endourology, have redefined surgical approaches by offering patients less invasive alternatives, characterized by a reduction in postoperative discomfort, shorter hospital stays, and accelerated recuperation periods, especially when compared with traditional open surgeries. Through these techniques, urologists can execute more and more challenging procedures with precision while also minimizing tissue trauma. Consequently, the spectrum of treatable conditions using minimally invasive strategies, spanning from prostate cancer to urinary incontinence, has substantially expanded. As technology continues to progress and surgical expertise evolves, the horizon of urologic surgery holds promise for further enhancements using minimally invasive approaches. In this Special Issue, we welcome authors to submit papers on the clinical advancements in minimally invasive urologic surgery across the entire field of urological surgery.

Dr. Umberto Carbonara
Dr. Fabio Crocerossa
Dr. Savio Domenico Pandolfo
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

  • urology
  • uro-oncology
  • uro-gynecology
  • robotic surgery
  • laparoscopy
  • robot-assisted
  • artificial intelligence

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Published Papers (3 papers)

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Research

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12 pages, 397 KB  
Article
Association Between Baseline Neutrophil-to-Lymphocyte Ratio and Short-Term Urinary Quality of Life During BCG Induction in Male Patients with Non-Muscle-Invasive Bladder Cancer: A Prospective Observational Study
by Lorenzo Spirito, Simone Tammaro, Paola Coppola, Celeste Manfredi, Lorenzo Romano, Carmine Sciorio, Antonio Di Girolamo, Luigi Napolitano, Francesco Bottone, Carmelo Quattrone, Vittorio Imperatore, Ferdinando Fusco, Davide Arcaniolo and Marco De Sio
J. Clin. Med. 2025, 14(19), 6908; https://doi.org/10.3390/jcm14196908 - 29 Sep 2025
Viewed by 487
Abstract
Background/Objectives: Intravesical Bacillus Calmette–Guérin (BCG) is the standard adjuvant treatment for high-risk non-muscle-invasive bladder cancer (NMIBC), but treatment-related urinary toxicity may compromise quality of life (QoL) and adherence. The neutrophil-to-lymphocyte ratio (NLR), a marker of systemic inflammation, has been linked to oncologic outcomes [...] Read more.
Background/Objectives: Intravesical Bacillus Calmette–Guérin (BCG) is the standard adjuvant treatment for high-risk non-muscle-invasive bladder cancer (NMIBC), but treatment-related urinary toxicity may compromise quality of life (QoL) and adherence. The neutrophil-to-lymphocyte ratio (NLR), a marker of systemic inflammation, has been linked to oncologic outcomes in bladder cancer, but its association with urinary symptom burden during BCG therapy remains unclear. We aimed to assess whether baseline NLR is associated with early deterioration in urinary symptoms and urinary QoL following BCG induction. Methods: This prospective study included male patients with NMIBC treated with intravesical BCG. Baseline demographics, comorbidities, laboratory parameters, and urinary symptoms were recorded. Patients were stratified into two groups according to baseline NLR (<3 vs. ≥3). Urinary outcomes were assessed at baseline and 8 weeks using the International Prostate Symptom Score (IPSS) and the IPSS-related QoL item. Univariable and multivariable linear regression analyses were performed. Results: A total of 96 patients were analyzed. Median baseline NLR was 2.6 (IQR: 2.1–3.8). Patients with NLR ≥ 3 (n = 34) and NLR < 3 (n = 62) had comparable baseline characteristics and urinary scores. At 8 weeks, patients with NLR ≥ 3 experienced a greater worsening of urinary symptoms (median IPSS 24 vs. 21, p = 0.02; median change +5 vs. +2, p = 0.01) and QoL (median 5 vs. 4, p = 0.03). Univariable regression confirmed the association of NLR ≥ 3 with worse QoL (β = +0.74; p = 0.003) and higher IPSS (β = +2.20; p = 0.021). Modeled as a continuous variable, each one-unit increase in NLR corresponded to a +0.20 worsening in QoL (p = 0.008). In the multivariable analyses adjusted for baseline IPSS and concomitant CIS, NLR remained independently associated with QoL decline. Conclusions: Baseline NLR was independently associated with worsening urinary symptoms and QoL during BCG induction in NMIBC patients. NLR may represent a simple and accessible biomarker for early risk stratification during BCG induction, warranting validation in larger, longer-term prospective trials. Full article
(This article belongs to the Special Issue Clinical Advances in Minimally Invasive Urologic Surgery)
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12 pages, 2082 KB  
Article
Prostate Artery Embolization (PAE) in the Treatment of Benign Prostatic Hyperplasia: A Case Series and Narrative Review
by Vincenzo Iossa, Ernesto Punzi, Savio Domenico Pandolfo, Gianluca Spena, Pierluigi Russo, Carlo Giulioni, Achille Aveta, Lorenzo Spirito, Giulio Lombardi and Vittorio Imperatore
J. Clin. Med. 2025, 14(11), 3775; https://doi.org/10.3390/jcm14113775 - 28 May 2025
Cited by 1 | Viewed by 1630
Abstract
Background/Objectives: Prostatic artery embolization (PAE) has emerged as a minimally invasive alternative for treating lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), particularly in high-risk surgical candidates. This study aims to evaluate the efficacy, safety, and clinical outcomes of PAE, [...] Read more.
Background/Objectives: Prostatic artery embolization (PAE) has emerged as a minimally invasive alternative for treating lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), particularly in high-risk surgical candidates. This study aims to evaluate the efficacy, safety, and clinical outcomes of PAE, combining a retrospective case series with a narrative review of the literature. Methods: A single-center retrospective analysis was conducted on 10 patients aged ≥ 70 years with moderate-to-severe LUTS due to BPH who underwent PAE between January 2021 and January 2024. Inclusion criteria included IPSS > 18, Qmax < 12 mL/s, prostate volume > 45 cc, and resistance to medical therapy. Embolization was performed using 300–500 µm tris-acryl gelatin microspheres via the PErFecTED technique. Follow-up included IPSS, Qmax, prostate volume (PV), PSA levels, and complications. A narrative review of 18 studies (n = 1539 patients) was also conducted to contextualize findings. Results: Technical success was achieved in all patients (100%), and clinical success (IPSS reduction ≥ 50%) in 90%. At 12 months, the following significant improvements were observed: mean IPSS decreased from 24 to 12 (p < 0.0001), Qmax increased from 8.7 to 12.6 mL/s (p < 0.0001), PV reduced from 66.4 to 49.4 cc (p < 0.0001), and PSA from 5.0 to 3.4 ng/mL (p < 0.0001). Outcomes remained stable up to 36 months. Two patients developed transient post-procedural fever; no major complications were recorded. Conclusions: PAE is a safe and effective treatment for LUTS related to BPH, offering durable symptom relief and minimal morbidity, particularly in elderly and comorbid patients. While the evidence supports its role as an alternative to TURP, larger prospective trials are necessary to confirm its long-term efficacy and optimize patient selection. Full article
(This article belongs to the Special Issue Clinical Advances in Minimally Invasive Urologic Surgery)
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Review

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11 pages, 3583 KB  
Review
Critical Care and Surgical Management of Vascular Complications in Minimally Invasive Urological Reconstructive Surgery
by Lucía Polanco-Pujol, Jorge Caño-Velasco, Rui Miguel Duarte Pedrosa, Claudia Fernandes and Luis López-Fando
J. Clin. Med. 2025, 14(19), 6740; https://doi.org/10.3390/jcm14196740 - 24 Sep 2025
Viewed by 364
Abstract
Background: Despite the benefits of minimally invasive pelvic floor reconstructive surgery, serious life-threatening complications have been described. The most serious complications are vascular and intestinal. This review discusses the incidence, diagnosis, management and prevention of vascular complications in minimally invasive pelvic floor [...] Read more.
Background: Despite the benefits of minimally invasive pelvic floor reconstructive surgery, serious life-threatening complications have been described. The most serious complications are vascular and intestinal. This review discusses the incidence, diagnosis, management and prevention of vascular complications in minimally invasive pelvic floor reconstructive surgery (sacrocolpopexy and artificial urinary sphincter). Objectives: We aimed to determine the incidence and management of vascular complications in minimally invasive pelvic floor reconstructive surgery. Methods: This narrative literature review on the incidence and management of vascular complications at sacrocolpopexy and artificial urinary sphincter was performed after the search of relevant manuscripts indexed in PubMed, EMBASE and Scielo published in English between January 2011 and June 2025. The keywords used were “vascular”, “complication”, “sacrocolpopexy”, and “artificial urinary sphincter”. We selected 19 manuscripts for comprehensive review. Conclusions: Dissection of the sacral promontory during sacrocolpopexy requires an exquisite knowledge of pelvic anatomy and adequate preoperative planning to avoid vascular injuries and find alternatives for mesh fixation if it cannot be performed in the usual anatomical location. Full article
(This article belongs to the Special Issue Clinical Advances in Minimally Invasive Urologic Surgery)
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