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Clinical Advancements in Urologic Surgery
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Clinical Advancements in 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: closed (30 May 2025) | Viewed by 273

Special Issue Editor

Dr. Francesco Trama

E-Mail Website
Guest Editor
Urology Complex Unit, ASL Napoli 2 Nord ‘Santa Maria delle Grazie’ Hospital, 80078 Pozzuoli, Italy
Interests: urologic oncology; urinary incontinence; endourology; urodynamics; prostate cancer; neurourology; erectile dysfunction

Special Issue Information

Dear Colleagues,

Urological surgery is one of the most complex and multifaceted branches in the global surgical landscape. In fact, the urologic discipline deals with both benign diseases such as benign prostatic hyperplasia, urinary incontinence, andrology, and urinary lithiasis that often require increasingly minimally invasive surgical treatment, as well as oncologic diseases of the urinary tract in which robotic surgery is constantly and steadily growing from 3D platforms to single-port robots. In addition, artificial intelligence is making its mark in preoperative study, thanks to which surgeons are aided in the recognition of the structures and lesions to be removed. Still, it is possible for the technology applied to urology to help in the diagnosis and treatment of diseases whose pathogenesis and therapeutic indications remain unclear, such as in the field of neurourology.

The purpose of this Special Issue is to investigate the technological advances that can be applied to urological surgery.

Dr. Francesco Trama
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

  • urologic oncology
  • urinary incontinence
  • endourology
  • urodynamics
  • prostate cancer
  • neurourology
  • erectile dysfunction

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Published Papers (1 paper)

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Research

10 pages, 515 KB  
Article
Metastatic Potential of Very Small (≤2 cm) Renal Cell Carcinoma: Insights from a Single-Center Experience and Review of the Literature
by Lorenzo Giuseppe Luciani, Tommaso Ceccato, Tommaso Cai, Stefano Chiodini, Simone Botti, Valentino Vattovani, Marco Puglisi, Andrea Abramo and Daniele Mattevi
J. Clin. Med. 2025, 14(19), 6781; https://doi.org/10.3390/jcm14196781 - 25 Sep 2025
Abstract
Background/Objectives: Small renal masses (SRMs) are being detected more often due to the increasing use of imaging techniques. Many of these lesions are benign or grow slowly, but a small proportion can exhibit aggressive behavior. Several reports have shown that synchronous metastases may [...] Read more.
Background/Objectives: Small renal masses (SRMs) are being detected more often due to the increasing use of imaging techniques. Many of these lesions are benign or grow slowly, but a small proportion can exhibit aggressive behavior. Several reports have shown that synchronous metastases may occur even in small renal cell carcinomas (RCCs). Our aim is to assess the malignant potential and the metastatic risk of very small RCCs (≤2 cm). Methods: We reviewed consecutive patients who underwent partial nephrectomy for SRMs at our tertiary referral center between 2005 and 2024, focusing on those with a maximum pathologic diameter ≤ 2 cm. Clinical and pathological data were collected, and cases with aggressive features were described. In addition, a literature search on the Medline/PubMed database was performed to identify previously published cases of RCC ≤ 2 cm and to assess their risk of synchronous metastases (SM). Results: Among 578 patients who underwent partial nephrectomy, 116 patients (20%) had tumors ≤ 2 cm, 90 (77.5%) of which were malignant, whereas 22.5% were benign (oncocytoma = 13%; angiomyolipoma = 5%). Median age and tumor size were 51 yrs and 1.7 cm, respectively. Histology showed clear cell (72.2%), papillary (20%), chromophobe (6.6%), and mixed (0.9%). Two patients (2.2%) experienced aggressive disease: one with synchronous metastases and one with recurrence and later progression. From the literature, we identified 16 additional cases of RCC ≤ 2 cm with synchronous metastases and found an important heterogeneity of results regarding the metastatic potential of SRMs. Conclusions: Although uncommon, synchronous metastases can occur in RCCs even smaller than 1–2 cm. Reported rates for SM of SRMs across the literature range between 1% and 13%, with higher risk observed in tumors larger than 3 cm, but without an absolute safe cutoff. Tumor size alone is therefore insufficient to exclude aggressive potential. Clinical decision-making should consider histology, grade, patient age, radiologic features, and emerging molecular markers to guide surveillance and treatment in this growing patient population. Full article
(This article belongs to the Special Issue Clinical Advancements in Urologic Surgery)
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