The current landscape of single-port robotic surgery in urology.

The advent of the purpose-built da Vinci single-port robotic platform marks a pivotal advancement in minimally invasive urological surgery. Designed to overcome the ergonomic and technical limitations of prior single-site approaches, the single-port system enables complex procedures through a single incision, with enhanced dexterity, optimized use of confined spaces and improved cosmetic and peri-operative outcomes. The single-port system has been increasingly used across a wide range of urological indications, including robot-assisted radical prostatectomy, partial nephrectomy, nephroureterectomy and reconstructive surgeries such as pyeloplasty and ureteral re-implantation.

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.

Robotic partial nephrectomy to treat large (T2) cystic renal cell carcinoma: a multi-institutional analysis (ROSULA Collaborative Group).

Purpose: To investigate the feasibility and safety of robot-assisted partial nephrectomy (RAPN) to treat large (T2) cystic renal-cell carcinoma.

Methods: A multinational study was conducted worldwide. Patients with renal tumors larger than 7cm who underwent partial nephrectomy between December 2007 and July 2017 were recruited retrospectively.

Rare case of urinary tract infection caused by in a 93-year-old patient in southern Italy.

is a rare Gram-negative bacterium that has been infrequently associated with human infections. It is a non-encapsulated, facultative anaerobic organism that grows well in nonselective laboratory media and exhibits variable resistance patterns. Although has been identified as a pathogen since 2006, reports of its clinical significance remain scarce, particularly in Europe.

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.

Towards Defining Follow-up Strategies for Patients with Primary Intermediate-risk Non-muscle-invasive Bladder Cancer.

Background And Objective: The current European Association of Urology (EAU) guidelines on non-muscle-invasive bladder cancer (NMIBC) categorize patients into four risk groups. In 2024, a specific follow-up schedule was introduced for intermediate-risk (IR) disease. However, recommendations are based on expert opinion and restricted to patients with IR-NMIBC who have primary low-grade or high-grade/grade 2 disease.

Predictors of Inguinal Lymph Node Metastasis in Penile Squamous Cell Carcinoma: Insights from a Single-Center Retrospective Study.

Squamous cell carcinoma (SCC) of the penis accounts for approximately 95% of penile cancers and is associated with substantial morbidity and mortality. SCC typically develops in uncircumcised men, most commonly affecting the foreskin or glans. While slow-growing, early detection is crucial to improve survival outcomes.

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.

Urobiome and Inflammation: A Systematic Review on Microbial Imbalances and Diagnostic Tools for Urinary Disorders.

Objective: To synthesize current knowledge on urobiome alterations, innovative diagnostic advancements, and emerging therapeutic strategies targeting urobiome dysbiosis in inflammatory urinary tract disorders, including urinary tract infections, nongonococcal urethritis, and interstitial cystitis.

Methods: A systematic review was conducted by screening the most important scientific databases. The search included the keywords: (microbiome) OR (microbial) OR (bacteria) OR (bacterial profile) AND (urine) OR (urinary) AND (first-morning sample) OR (first void).

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.

Preoperative platelet-to-lymphocyte ratio as a predictor of inguinal lymph node metastasis in penile cancer.

Background: Penile cancer (PC) is a rare malignancy with poor prognosis. To date, reliable preoperative biomarkers for lymph node status and prognosis are still lacking. This study aims to explore the potential role of preoperative platelet-to-lymphocyte ratio (PLR) as a predictor of inguinal lymph node invasion in PC patients.

Neoadjuvant chemotherapy prior to radical nephroureterectomy: Survival outcomes and recurrence patterns by pathologic node status.

Purpose: To evaluate survival outcomes and recurrence patterns by pathologic nodal status in upper tract urothelial carcinoma (UTUC) patients receiving neoadjuvant chemotherapy (NAC) prior to radical nephroureterectomy (RNU) and lymph node dissection (LND).

Materials And Methods: Using the international ROBUUST 2.0 database, a retrospective analysis of UTUC patients who underwent robotic/laparoscopic RNU+LND±NAC was performed.

Single-Port Robot-Assisted Post-Chemotherapy Unilateral Retroperitoneal Lymph Node Dissection: Feasibility and Surgical Considerations.

Introduction: Retroperitoneal lymph node dissection (RPLND) is indicated for testicular cancer patients with residual masses post-chemotherapy or stage I-II non-seminomatous germ cell tumors (NSGCT) (1, 2). Open RPLND remains the standard but carries significant morbidity. The laparoscopic approach, while minimally invasive, presents notable technical challenges (3).

Cumulative smoking exposure impacts oncologic outcomes of upper tract urothelial carcinoma.

Background: The impact of cumulative smoking exposure (CSE) on oncologic outcomes for upper tract urothelial carcinoma (UTUC) remains understudied. We examined the effect of this factor on oncologic outcomes in UTUC patients undergoing radical nephroureterectomy utilizing a large contemporary multicenter, multinational cohort.

Methods: Multicenter review of 1,730 patients across 17 institutions.

Advancing Surgical Management of Penile Cancer: Single Port Bilateral Inguinal Lymph Node Dissection.

Introduction: Penile cancer is a rare but aggressive malignancy, with inguinal lymph node involvement representing a key prognostic indicator (1, 2). NCCN guidelines recommend prophylactic inguinal lymph node dissection (ILND) for intermediate-to-high-risk patients (pT1b, ≥T2) with non-palpable nodes, aiming for early staging and improved outcomes (3). The SP-approach employs a single incision and advanced robotic instrumentation to enhance maneuverability, reduce morbidity, and optimize recovery.