The impact of clinically insignificant residual fragments following endourological management of urolithiasis: a systematic review of complications and re-intervention rates.

Introduction: Achieving stone-free status (SFS) is a key goal of endourological treatment, yet definitions of SFS and clinically insignificant residual fragments (CIRF) remain controversial. While CIRF is frequently defined as residual fragments ≤4 mm, there is no consensus on its clinical significance regarding complications and re-intervention needs. We evaluate the risk of complications and the need for re-intervention associated with the presence of CIRF following endourological treatment for urolithiasis.

Impact of ureteroscopy on renal function in solitary kidneys: a systematic review.

Purpose: This study aimed to assess ureteroscopy's impact on renal function in patients with a solitary kidney (SK), where nephron preservation is paramount. With the rising prevalence of SKs due to congenital anomalies or acquired conditions, understanding the safety profile of ureteroscopy, particularly its effects on renal function, seems essential.

Methods: A literature search following PRISMA guidelines was conducted to identify reports published until May 2024.

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.

Size matters: an in vitro evaluation of flexible vacuum-assisted ureteral access sheaths.

Suction in retrograde-intrarenal surgery (RIRS) has been the focus of ongoing innovation. Expanding ranges of flexible vacuum-assisted ureteric access sheaths (FV-UAS) combined with single-use digital flexible ureteroscopes (SU-DFU) produce many potential combinations. This study aims to evaluate the efficacy of these combinations in clearing stone fragments.

Stone dust in endourology: a systematic review of its definition, management, and clinical impact.

Objective: To evaluate and synthesise the existing literature on stone dust (DUST) in endourology, focusing on its definition, creation methods, and removal techniques.

Methods: A comprehensive electronic literature search was conducted using the PubMed/Medline, Web Of Science, and Embase databases to identify reports published until October 2024. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed to identify eligible studies.

High-frequency in laser lithotripsy: do we truly know what it means?

Introduction And Objective: High frequency (HF) in laser lithotripsy lacks a consistent definition, potentially impacting clinical outcomes and patient safety. This review aims to analyze available evidence on the definition of HF.

Materials And Methods: A comprehensive literature search of MEDLINE, Scopus, and Cochrane databases identified English-language studies published up to November 2024.

Long-term results of retrograde endopyelotomy: a narrative review.

Purpose: Retrograde endopyelotomy has emerged as a minimally invasive alternative for treating ureteropelvic junction obstruction (UPJO), characterized by impaired urinary transport due to intrinsic or extrinsic factors. This narrative review evaluates the long-term outcomes of retrograde endopyelotomy, focusing on effectiveness, safety, complications, and reoperation requirements.

Methods: A systematic search of PubMed, Google Scholar, and Scopus from 1990 to March 2024 identified 29 studies comprising 1238 adult patients.

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.

The use of a virtual reality device (HypnoVR®) during extracorporeal shockwave lithotripsy for urinary stones: A case-control study.

Introduction: Extracorporeal shockwave lithotripsy (SWL) is a standard of care for the management of urinary stones up to 2cm. Although it is generally well-tolerated, ESWL can be a painful procedure for some patients. Virtual reality devices (VRDs) have recently proven to be useful in reducing patient-reported pain during SWL.

Evaluating Noise Emissions of Endourological Lasers: A Comparative Analysis of Ho:YAG, Tm:YAG, and Thulium Fiber Laser Systems.

Objective: To evaluate the noise levels of Holmium:YAG (Ho:YAG), Thulium Fiber (TFL), and pulsed Thulium:YAG (p-Tm:YAG) lasers across various settings, focusing on compliance with safety thresholds and potential impact on communication in the operating room (OR).

Materials And Methods: Noise measurements were taken in an empty OR using sound meters placed 1 m from the laser source. Ambient noise, standby, ready, and lasering modes at three settings (0.

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.

A bench-top evaluation of the Ily® robotics assisted tele console system in ureteroscopy by medical students, residents and urologists: does prior videogaming experience help shape the learning curve?

Purpose: Previous studies have demonstrated an association between video-gaming experience (VGE) and improved robotics skills. We aimed to evaluate the initial learning curve for the Ily® robotics system (Sterlab, Sophia Antipolis, France) when applied to flexible ureteroscopy (FU) among both medical students and urology surgeons.

Methods: There were two groups, surgeons and students.

3D virtual models and augmented reality for radical prostatectomy: a narrative review.

Background And Objective: The increasing popularity of three-dimensional (3D) virtual reconstructions of two-dimensional (2D) imaging in urology has led to significant technological advancements, resulting in the creation of highly accurate 3D virtual models (3DVMs) that faithfully replicate individual anatomical details. This technology enhances surgical reality, providing surgeons with hyper-accurate insights into instantaneous subjective surgical anatomy and improving preoperative surgical planning. In the uro-oncologic field, the utility of 3D virtual reconstruction has been demonstrated in nephron-sparing surgery, impacting surgical strategy and postoperative outcomes in prostate cancer (PCa).

Visual extended reality tools in image-guided surgery in urology: a systematic review.

Purpose: The aim of this systematic review is to assess the clinical implications of employing various Extended Reality (XR) tools for image guidance in urological surgery.

Methods: In June 2023, a systematic electronic literature search was conducted using the Medline database (via PubMed), Embase (via Ovid), Scopus, and Web of Science. The search strategy was designed based on the PICO (Patients, Intervention, Comparison, Outcome) criteria.

Development of Machine Learning Algorithm to Predict the Risk of Incontinence After Robot-Assisted Radical Prostatectomy.

Predicting postoperative incontinence beforehand is crucial for intensified and personalized rehabilitation after robot-assisted radical prostatectomy. Although nomograms exist, their retrospective limitations highlight artificial intelligence (AI)'s potential. This study seeks to develop a machine learning algorithm using robot-assisted radical prostatectomy (RARP) data to predict postoperative incontinence, advancing personalized care.

Initial experience with robot-assisted ureteroscopy with Ily® Robot.

The aim of this study is to present the first Italian experience with robotic-assisted retrograde intrarenal surgery (rRIRS) using the Ily platform. Procedures were performed for renal stones using the Ily Robot (STERLAB, Vallauris, France), which is a ureteroscope holder with multiple degrees of freedom that can be controlled remotely through a wireless controller. In March 2023, consecutive patients with indications for rRIRS were included in the study.

Development of Bleeding Artificial Intelligence Detector (BLAIR) System for Robotic Radical Prostatectomy.

Background: Addressing intraoperative bleeding remains a significant challenge in the field of robotic surgery. This research endeavors to pioneer a groundbreaking solution utilizing convolutional neural networks (CNNs). The objective is to establish a system capable of forecasting instances of intraoperative bleeding during robot-assisted radical prostatectomy (RARP) and promptly notify the surgeon about bleeding risks.

Predictors of mid-term functional outcomes for robot-assisted Madigan simple prostatectomy: results of a multicentric series according to the BPH-6 achievement.

Background: BPH-6 achievement remains an objective far to be evaluated for every technique currently available for the surgical management of bladder outlet obstruction (BOO) with the goal of preserving ejaculatory function. The aim of this study was to evaluate predictors of BPH-6 achievement of urethral-sparing robot assisted simple prostatectomy (us-RASP) on a large series performed at two tertiary-care centers.

Methods: Two institutional us-RASP datasets were merged, considering eligible all patients with a follow-up >12 months.

Metaverse Surgical Planning with Three-dimensional Virtual Models for Minimally Invasive Partial Nephrectomy.

The recent integration of new virtual visualization modalities with artificial intelligence and high-speed internet connection has opened the door to the advent of the metaverse in medicine. In this totally virtual environment, three-dimensional virtual models (3DVMs) of the patient's anatomy can be visualized and discussed via digital avatars. Here we present for the first time a metaverse preoperative clinical case discussion before minimally invasive partial nephrectomy.