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Introduction: Transperineal laser ablation (TPLA) of the prostate is a new, minimally invasive technique for benign prostatic hyperplasia (BPH) with promising effectiveness and safety outcomes. This systematic review aims to provide an update of existing literature. Methods: A literature review was performed in Pubmed/MEDLINE, Embase, Cochrane Library, and clinicaltrials.gov from January 2000 up to April 2023. Data extraction and risk of bias were performed independently by three authors. Results: A total of 11 studies were included, among which 9 were observational, 1 randomized controlled trial, 1 animal study, while 2 of them were comparative (1 with prostatic artery embolization and 1 with transurethral resection of the prostate). Functional outcomes were improved in the majority of studies both for objective (maximum flow rate and post-void residual) and subjective outcomes (improvement of International Prostate Symptom Score and quality of life). Complication rates ranged between 1.9% and 2.3% for hematuria, 3.7% and 36.3% for dysuria, 1.9% and 19% for acute urinary retention, 0.6% and 9.1% for orchitis/urinary tract infections, and 0.6% and 4.8% for prostatic abscess formation. Regarding sexual function, >95% of patients retained their ejaculation while erectile function was maintained or improved. Conclusion: TPLA of the prostate is an innovative, minimally invasive technique for managing patients with BPH. Existing studies indicate an effective technique in reducing International Prostate Symptom Score and quality of life scores, post-void residual reduction, and increase in Qmax, albeit the measured improvements in terms of Qmax are not equal to transurethral resection of the prostate. Although sexual function is maintained, the mean catheterization time is 7 days, and no long-term data are available for most patients.

Robot-assisted surgery has transformed the landscape of genitourinary cancer treatment, offering enhanced precision, reduced morbidity, and improved recovery compared to open or conventional laparoscopic approaches. As the field matures, a new generation of technological innovations is redefining the boundaries of what robotic systems can achieve. This narrative review explores the integration of artificial intelligence, advanced imaging modalities, augmented reality, and connectivity in robotic urologic oncology. The applications of machine learning in surgical skill evaluation and postoperative outcome predictions are discussed, along with AI-enhanced haptic feedback systems that compensate for the lack of tactile sensation. The role of 3D virtual modeling, intraoperative augmented reality, and fluorescence-guided surgery in improving surgical planning and precision is examined for both kidney and prostate procedures. Emerging tools for real-time tissue recognition, including confocal microscopy and Raman spectroscopy, are evaluated for their potential to optimize margin assessment. This review also addresses the shift toward single-port systems and the rise of telesurgery enabled by 5G connectivity, highlighting global efforts to expand expert surgical care across geographic barriers. Collectively, these innovations represent a paradigm shift in robot-assisted urologic oncology, with the potential to enhance functional outcomes, surgical safety, and access to high-quality care.

Background and Objectives: Aquablation, a robot-assisted, heat-free resection technique, has emerged as a promising minimally invasive surgical therapy (MIST) for benign prostatic hyperplasia (BPH). Its precision and potential for preservation of sexual function distinguish it from traditional surgical options. This systematic review aimed to evaluate the safety profile of Aquablation, with emphasis on perioperative complications and functional outcomes. Materials and Methods: We systematically searched PubMed/MEDLINE, Scopus, and the Cochrane Library through June 2025 in accordance with PRISMA 2020 guidelines (PROSPERO CRD420251074479). Eligible studies included randomized and non-randomized trials of Aquablation in men with BPH, reporting adverse events by type, frequency, or severity. Risk of bias was assessed with ROB-2 and ROBINS-I tools. Results: Forty-seven studies were included, spanning randomized controlled and prospective observational designs. Most complications were minor (Clavien-Dindo grade 1–2). Bleeding was the most frequent perioperative event, with transfusion required in 1–8% of cases, more often in large prostates. Severe complications (grade ≥ 3) were uncommon and usually related to bleeding or urinary retention. Long-term sequelae such as strictures or bladder neck contracture were rare. Compared with transurethral resection of the prostate, Aquablation yielded lower rates of ejaculatory dysfunction (10% vs. 36%), with continence and erectile function largely preserved. Outcomes were comparable to holmium laser enucleation, but Aquablation demonstrated superior ejaculatory preservation. Conclusions: Aquablation demonstrates a favorable safety profile across prostate sizes, with its greatest advantage being preservation of sexual function. While bleeding remains the principal perioperative concern, life-threatening events are rare. Further independent, long-term comparative studies are warranted.

Abstract Background: In routine urological practice, pigtails are frequently utilized to relieve blockage. Early signs of pigtail problems include pain, lower urinary tract symptoms, pain, hematuria (54%) and fever. Seventy percent of patients experience irritable voiding symptoms, and 80% of patients or even more report pain interfering with everyday activities. Methods: This article's goal is to evaluate the various polymeric stents that are currently on the market. In addition, a review of their fundamental bioqualities is conducted, and a connection between their physical attributes (length, size, and composition) and stent-related issues is looked into. For this review, extensive Medline, PubMed, and literature research from 1987 to January 2023 was conducted. Lower urinary tract complaints, ureteral stents, \"pigtail,\" \"materials,\" \"characteristics,\" or \"properties\" were the search terms employed. Results: The reviews and publications that are now accessible linking certain materials to stent-related symptoms offer contradictory conclusions, and the majority of research do not specify the precise properties of the materials utilized. The results of the studies on the relationship between stents length and diameter and symptoms connected to stents are likewise inconclusive, despite the fact that there are several studies on this topic in the literature. Conclusion: Numerous studies imply a connection between the various types and properties of the utilized stents and stent-related complaints. However, the available data did not fully support this claim, necessitating additional research.

While urolithiasis in children is rare, the global incidence is rising, and the volume of minimally invasive surgeries being performed reflects this. There have been many developments in the technology, which have supported the advancement of these interventions. However, innovation of this kind has also resulted in wide-ranging practice patterns and debate regarding how they should be best implemented. This is in addition to the extra challenges faced when treating stone disease in children where the patient population often has a higher number of comorbidities and for example, the need to avoid risk such as ionising exposure is higher. The overall result is a number of challenges and controversies surrounding many facets of paediatric stone surgery such as imaging choice, follow-up and different treatment options, for example, medical expulsive therapy, shockwave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy. This article provides an overview of the current status of paediatric stone surgery and discussion on the key topics of debate.

The evolution of robotic surgery in urologic oncology has led to the emergence of single-port (SP) robotic systems as a potential alternative to the widely adopted multi-port (MP) platforms. This narrative review provides a comprehensive comparison between SP and MP robotic systems, the former of which received FDA approval in 2018 and CE marking in 2024, focusing on their application across radical prostatectomy, partial and radical nephrectomy, and radical cystectomy. Drawing from the most current literature, we examine perioperative outcomes, oncologic efficacy, postoperative recovery, and complication rates. The review highlights the technical challenges unique to SP surgery, including restricted triangulation, limited instrumentation, and a defined learning curve, while also emphasizing innovations such as transvesical prostatectomy and the Supine Anterior Retroperitoneal Access (SARA) approach. Additionally, we explore the potential impact of emerging technologies—such as artificial intelligence, augmented reality, and telesurgery—on the future of SP platforms. Despite early limitations, SP systems have demonstrated comparable safety and effectiveness in selected cases and may offer unique advantages in specific anatomical scenarios. Continued innovation, structured training, and robust long-term outcome data will be essential for the broader adoption and integration of SP robotic surgery in clinical practice.

Muscle-invasive bladder cancer (MIBC) is a biologically aggressive disease with high recurrence rates, despite advances in surgical and systemic therapies. Circulating tumor DNA (ctDNA), a tumor-specific fraction of cell-free DNA, has emerged as a promising non-invasive biomarker for the real-time assessment of tumor burden, treatment response, and minimal residual disease (MRD). This review explores the biological basis, detection technologies, and clinical utility of ctDNA in MIBC, highlighting its role in preoperative risk stratification, postoperative surveillance, and personalized decision-making for adjuvant and systemic therapies. We critically examine current evidence from pivotal trials and ongoing studies that support ctDNA’s prognostic and predictive value. Additionally, we discuss emerging applications, including ctDNA-guided immunotherapy, integration with imaging and molecular data, and potential to inform bladder-sparing strategies. While ctDNA presents technical and logistical challenges, its incorporation into prospective clinical workflows promises to enhance precision oncology and improve outcomes in patients with MIBC.