Radical nephroureterectomy vs kidney sparing surgery for upper tract urothelial carcinoma in solitary kidney patients: a multi-institutional analysis of the ROBUUST 2.0 registry.

Purpose: Radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) in solitary kidney patients is a rare and underreported scenario. This study aims to compare the outcomes of UTUC solitary kidney patients becoming anephric after RNU to those of patients undergoing kidney-sparing surgery (KSS).

Methods: Data from patients with a solitary kidney were retrieved from the ROBUUST 2.

Prognostic Impact of Adjuvant Immunotherapy in Patients with High-Risk Upper Tract Urothelial Cancer: Results from the ROBUUST 2.0 Collaborative Group.

: The impact of adjuvant immunotherapy (IO) on the prognosis of patients with upper tract urothelial carcinoma (UTUC) remains unclear. This study examines the association of adjuvant IO with oncologic outcomes in patients with high-risk UTUC. : This retrospective study reviewed patients with high-risk UTUC treated with adjuvant IO using the ROBotic surgery for Upper tract Urothelial cancer STudy (ROBUUST) database.

Enhanced prognostic value of four-tier hybrid grading system in Ta non-muscle-invasive bladder cancer.

Objectives: To compare the predictive performance of the World Health Organization (WHO) 1973, WHO 2004/2022, the three-tier (low grade [LG]/Grade 1 [G1]-G2, high grade [HG]/G2, and HG/G3), and four-tier (LG/G1, LG/G2, HG/G2, and HG/G3) hybrid grading systems in Ta non-muscle-invasive bladder cancer (NMIBC), by evaluating recurrence-free survival (RFS) and progression-free survival (PFS).

Patients And Methods: This retrospective multicentre study included 1233 patients with pTa NMIBC treated with transurethral resection of bladder tumour, eventually followed by intravesical instillations as determined by their physicians, between 2010 and 2023, across 18 Italian hospitals. Pathologists graded resected tissues using the WHO 1973, WHO 2004/2022 classifications, and hybrid three-tier (LG, HG/G2, HG/G3) and four-tier (LG/G1, LG/G2, HG/G2, HG/G3) systems.

Sexual function outcomes in men undergoing minimal invasive ablative techniques for prostate cancer: a ESRU/YAU urotech systematic review and pooled analysis.

Introduction: In the latest years the advent of minimally invasive focal treatment for prostate cancer (PCa) has gained a wide diffusion. Different platforms and sources of energy have been developed (HIFU, cryotherapy, focal brachytherapy…) and reported to be able to effectively treat PCa with minimal impact on sexual function. The aim of this systematic review is to summarize, evaluate and compare the impact of these focal therapies on the sexual function (erectile and ejaculatory function) of men harboring low to intermediate risk PCa.

Urinary Outcomes of Minimally Invasive Treatments for Prostate Cancer-A Systematic Review by Young Academic Urologists' Urotechnology Working Group.

Minimally invasive treatments (MITs) have emerged as viable treatment options for carefully selected patients with localized disease. Their major advantage is that MITs enable the preservation of nearby healthy prostate tissue and critical structures such as the urethral sphincter and neurovascular bundles without compromising oncologic outcomes. The aim of the current review is to describe the impact of different MITs for prostate cancer (PCa) on urinary continence.

Harnessing Advanced Imaging Technologies in Robotic Urological Surgery Requires Specialized and Structured Training.

Unlabelled: In recent years, the integration of advanced technologies in surgery has transformed health care, with urology consistently pioneering these innovations. Unlike the structured drug development process, surgical advancements follow a distinct pathway, exemplified by the Innovation, Development, Exploration, Assessment, and Long-term follow-up (IDEAL) framework, which supports safe, evidence-based innovation. Complementary technologies, including three-dimensional (3D) models and augmented reality (AR), have emerged as transformative tools in robotic urological surgery, particularly for complex cases.

GPT-4 generates accurate and readable patient education materials aligned with current oncological guidelines: A randomized assessment.

Introduction And Aim: Guideline-based patient educational materials (PEMs) empower patients and reduce misinformation, but require frequent updates and must be adapted to the readability level of patients. The aim is to assess whether generative artificial intelligence (GenAI) can provide readable, accurate, and up-to-date PEMs that can be subsequently translated into multiple languages for broad dissemination.

Study Design And Methods: The European Association of Urology (EAU) guidelines for prostate, bladder, kidney, and testicular cancer were used as the knowledge base for GPT-4 to generate PEMs.

Single bladder instillation of gemcitabine versus mitomycin C after minimally invasive radical nephroureterectomy: A propensity-score match analysis from the ROBUUST 2.0 collaborative group.

Objective: Radical nephroureterectomy (RNU) is considered the standard of care for patients with high-risk upper tract urothelial carcinoma. Current literature reveals a deficit in direct comparative studies evaluating the efficacy of different chemotherapeutic agents administered in single postoperative instillation following RNU. The primary aim of this study was to compare the bladder recurrence (BR) rates between patients receiving a single instillation of mitomycin C (MMC) versus gemcitabine (Gem) after RNU.

New Insights into Upper Tract Urothelial Carcinoma: Lessons Learned from the ROBUUST Collaborative Study.

Upper tract urothelial carcinoma (UTUC) is a rare malignancy, representing only 5-10% of urothelial carcinoma. The mainstay of treatment for high-risk patients is radical nephroureterectomy. Given the aggressive behavior of this disease, additional treatments could be required perioperatively in terms of chemotherapy (CHT), either in a neoadjuvant or adjuvant setting.

Waterjet ablation therapy vs. urethral-sparing robot-assisted simple prostatectomy for large prostate volumes (>80 mL): results of a retrospective multicentric series according to the standardized BPH6 achievement.

Background: The introduction of minimally invasive techniques for BPH treatment aimed to balance de-obstruction with maintenance of ejaculatory function. The aim of this multicentric series was to compare outcomes of waterjet ablation therapy (WAT) versus urethral-sparing robot assisted simple prostatectomy (us-RASP) for large prostate volumes (PV>80 mL) according to BPH-6 metric.

Methods: Four institutional BPH datasets were matched and queried for "PV>80 mL" (N.

A systematic review assessing the reliability of studies focusing on urological content on YouTube.

Introduction: In recent years, several publications have focused on analyzing the quality of medical content on YouTube. The current systematic review aimed to summarize and analyze the available studies examining YouTube video content in the urological field.

Evidence Acquisition: This is a systematic review including studies examining urological content uploaded on the YouTube platform published before November 2023.

Combined neoadjuvant and adjuvant therapy versus adjuvant therapy in high-risk upper tract urothelial carcinoma: a propensity matched multicenter analysis (ROBUUST 2.0 International Collaborative Group).

Introduction: The efficacy of combined neoadjuvant and adjuvant therapy (CNAT) in upper tract urothelial carcinoma (UTUC) remains unclear despite its demonstrated potential in bladder urothelial carcinoma. High-risk features- clinical stage ≥ T3, node-positive disease, multifocality, high-grade pathology, hydronephrosis, and large tumor size - are associated with poor prognosis in UTUC. We investigated the oncological outcomes of CNAT versus adjuvant therapy (AT) alone in high-risk UTUC patients.

Awareness and use of generative AI-powered tools: results of one-year follow-up prospective cross-sectional global survey.

Background: Generative AI (GenAI) frameworks, such as generative pre-trained transformer (GPTs) and large language models (LLMs), promise to transform clinical and research practices. Informed human opinion is key to guiding appropriate technological development and task refinement. Detailed data on how GPTs/LLMs powered-Chatbots usage, perceived risks and benefits among physicians has evolved over time and their impact on clinical and academic activities remain unclear.

A pretreatment nomogram to predict muscle-invasiveness in high-risk upper tract urothelial carcinoma (ROBUUST 2.0 collaborative group).

Background: The ability to predict muscle invasion in the final pathology of upper tract urothelial carcinoma (UTUC) patients after radical nephroureterectomy (RNU) potentially influences the selection of the most appropriate treatment modality. The present study aims to develop a model predicting muscle-invasive status in high-risk UTUC.

Methods: The ROBUUST (RObotic surgery for Upper tract Urothelial cancer - UTUC - STudy) 2.

3D anatomical digital twins: New generation virtual models to navigate robotic partial nephrectomy.

Objective 3D virtual models have gained interest in urology, particularly in the context of robotic partial nephrectomy. From these, newly developed "anatomical digital twin models" reproduce both the morphological and anatomical characteristics of the organs, including the texture of the tissues they comprise. The aim of the study was to develop and test the new digital twins in the setting of intraoperative guidance during robotic-assisted partial nephrectomy (RAPN).

Nephrometry Scores Based on Three-dimensional Virtual Models Improve the Accuracy of Predicting Postoperative Complications After Robotic Partial Nephrectomy: Results from a Collaborative ERUS Validation Study.

Background And Objective: The aim of our study was to compare assessment of PADUA and RENAL nephrometry scores and risk/complexity categories via two-dimensional (2D) imaging and three-dimensional virtual models (3DVM) in a large multi-institutional cohort of renal masses suitable for robot-assisted partial nephrectomy (RAPN), and evaluate the predictive role of these imaging approaches for postoperative complications.

Methods: Patients were prospectively enrolled from six international high-volume robotic centers, calculating PADUA and RENAL-nephrometry scores and their relative categories with 2D-imaging and 3DVMs. The concordance of nephrometry scores and categories between the two approaches was evaluated using χ tests and Cohen's κ coefficient.

Comparing different 3D virtual models generations for the planning of robotic partial nephrectomy: the added value of perfusion volumes implement.

Introduction: The aim of the study is to evaluate the role of a new generation of 3D virtual models (3DVM) implemented with perfusion volumes algorithm, in influencing perioperative and functional outcomes after robotic partial nephrectomy (RAPN).

Methods: A perfusion volume 3DVM was built using Voronoi diagram-based algorithm for all the organ-confined renal masses candidate for RAPN from 12/2019 to 12/2022. On its basis, a selective or super-selective clamping was planned.

TYTOCARE™ home telemonitoring device after radical cystectomy to optimise postoperative outcomes.

Objectives: To evaluate the role of the TYTOCARE™ telemedicine programme for home telemonitoring during the early postoperative period following radical cystectomy (RC) in a prospective single-centre study.

Materials And Methods: The study included patients aged <80 years with internet access who underwent RC at our institution between March 2021 and August 2023. Upon discharge, patients were monitored at home using the TYTOCARE™ telemedicine system.

Metaverse surgical planning for robotic surgery: preliminary experience and users' perception.

Background: The 3D models' use for surgical planning has recently gained an ever-wider popularity, in particular in the urological field. Different ways of fruition of this technology have been evaluated over the years. Today, new technological developments allow us to enjoy 3D models in the metaverse.

Assessing Micturition, sexual function, and endoscopic outcomes one year after Aquablation: a single center prospective study.

Introduction: Morphological changes in the prostatic urethra and bladder cavity resulting from Aquablation treatment are still unknown. This study aims to assess the safety and efficacy of Aquablation within one-year post-surgery, focusing on both functional and endoscopic outcomes.

Methods: Prospective enrollment of patients undergoing Aquablation (10/2018-04/2023) included those with baseline International Prostate Symptom Score (IPSS) ≥ 10, prostate volume from 40 to 80 mL, and Qmax ≤ 12 mL/s.

Hyper accuracy three-dimensional virtual anatomical rainbow model facilitates surgical planning and safe selective clamping during robot-assisted partial nephrectomy.

Objective: To highlight the role of hyper accuracy three-dimensional (3D) reconstruction in facilitating surgical planning and guiding selective clamping during robot-assisted partial nephrectomy (RAPN).

Methods: A transperitoneal RAPN was performed in a 62-year-old male patient presenting with a 4 cm right anterior interpolar renal mass (R.E.