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        <title>Frontiers in Surgery | Genitourinary Surgery and Interventions section | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/surgery/sections/genitourinary-surgery-and-interventions</link>
        <description>RSS Feed for Genitourinary Surgery and Interventions section in the Frontiers in Surgery journal | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-05-13T05:32:28.259+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1845237</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1845237</link>
        <title><![CDATA[Risk factors for positive urine culture and antimicrobial resistance in suspected UTI after flexible ureteroscopic lithotripsy]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Hongbo Wang</author><author>Wenzhi Gao</author>
        <description><![CDATA[BackgroundThis study identified independent risk factors for positive urine culture and bacterial resistance in patients with suspected urinary tract infection (UTI) after flexible ureteroscopic lithotripsy (FURL), to provide an evidence-based basis for individualized clinical antimicrobial treatment strategies.MethodsA retrospective cohort study enrolled 864 adult patients with suspected UTI after FURL who underwent urine culture between January 2024 and June 2025. Baseline clinical data were collected, and univariate and multivariate logistic regression analyses were used to identify independent risk factors for positive urine culture, pseudomonas aeruginosa infection, and bacterial resistance.ResultsUnivariate and multivariate logistic regression analysis demonstrated that advanced age, female gender, positive urine nitrite, positive urine glucose, urinary catheterization, hydronephrosis, and ureteral stricture were independent risk factors for positive urine culture in patients with suspected UTI after FURL. Young age and elevated urinary nitrite were identified as independent risk factors for Pseudomonas aeruginosa infection in patients with positive urine culture. Additionally, female gender was an independent risk factor for antimicrobial resistance in patients with positive urine culture, while diabetes mellitus was an independent protective factor for antimicrobial resistance with positive urine culture.ConclusionDistinct high-risk factors correlate with positive urine culture, P. aeruginosa infection and antimicrobial resistance in suspected UTI patients after FURL; stratified clinical assessment by these factors enables individualized antimicrobial therapy to improve treatment precision, reduce irrational antibiotic use and alleviate resistance development.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1804051</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1804051</link>
        <title><![CDATA[Demonstration of anatomical and technical details of robotic laparoscopic radical prostatectomy as described in the current literature]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>J. Rassweiler</author><author>Sara Sander</author><author>Marie-Claire Rassweiler-Seyfried</author>
        <description><![CDATA[BackgroundSince robot-assisted laparoscopic prostatectomy (RALP) has nowadays become widely accepted world-wide, there needs to be an agreement on the most efficient surgical techniques. This should be based on the video-anatomy of the prostate and a summary of the actual literature.Material and methodsUsing video material taken during RALP-procedures performed by the same surgeon (J.R.), the anatomical details of different surgical techniques and operative steps are shown based on the anatomy of the male pelvis applying the standard nomenclature. This was supplemented by a systematic literature search in PubMed focusing on preservation of continence and minimal rates of positive margins. 3,825 publications could be reduced to 604 articles according to the inclusion criteria (randomized controlled trials, meta-analyses, systematic reviews and clinical studies), When expanding the search to encompass individual operation techniques, we identified 27 relevant articles.ResultsCrucial surgical details include preserving the levator fascia, the puboprostatic collar, a long urethral stump with protection of the urethral lissosphincter and posteriorly reconstruction of the rectourethralis with the prostatovesical muscle. Fascial preservation for the M. Levator ani results to one year-continence between 78,0 and 98,3%, preservation of the puboprostatic collar and detrusor apron between 95,6 and 100%, maximal functional urethral length between 90,5 and 97,5%. Posterior reconstruction leads to a 3-months continence between 92,3 and 96,9%. Preserving the Retzius` space and thus the total anterior sphincter apparatus results to a one-year continence of 95,8%, however associated with a higher rate of positive surgical margins (14–42 vs. 10–29%).ConclusionsThe increase of knowledge of the video-anatomy of the prostate and surrounding structures allows translation into novel surgical techniques of RALP. Thereby continence rates could be significantly improved including approaches to spare anatomical structures of the sphincter apparatus, such as preservation of the levator fascia, the puboprostatic collar, the urethral lissosphincter, but also reconstructive techniques, such as posterior reconstruction of the vesico-prostatic and recto-urethralis muscle. Demanding techniques, such as the Retzius-sparing approach result to higher continence rates, but are also associated with a higher rate of surgical margins.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1753503</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1753503</link>
        <title><![CDATA[The evolution of radical prostatectomy: a scoping review on surgical techniques and integration of surgeon-assisting concepts into the surgical workflow]]></title>
        <pubdate>2026-04-30T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Philipp Nick</author><author>Theodoros Tokas</author><author>Selçuk Guven</author><author>Panagiotis Kallidonis</author><author>Eric Barret</author><author>Begoña Ballesta Martínez</author><author>Moaz F. Ismail Abdelrahman</author><author>Andrea Gallioli</author><author>Udo Nagele</author><author>Gernot Ortner</author>
        <description><![CDATA[BackgroundRadical prostatectomy remains a key curative treatment for localized prostate cancer which has undergone continuous transformation. Recent developments in robot-assisted and single-port surgery have followed the concept of minimizing morbidity while maintaining oncologic safety. Furthermore, the integration of artificial intelligence and novel diagnostic tools have transformed the modern surgical workflow. Therefore, the aim of this study is to give an overview of the evolution of surgical techniques, functional and oncological outcomes, and available surgeon-assisting concepts.MethodsWe conducted a non-structured review to summarize the evolution of radical prostatectomy techniques and recent developments in surgeon-assisting tools. Relevant English-language publications were identified through a targeted PubMed search using predefined keywords related to, laparoscopic, robot-assisted, Retzius-sparing, and single-port approaches. Key studies, systematic reviews, and meta-analyses were used and synthesized to provide a comparative overview. Furthermore, studies focusing on integration of artificial intelligence, novel diagnostic tools and targeted surgery are discussed.ResultsLaparoscopic surgery aims to reduce morbidity yet is technically demanding. Robotic-assisted approaches improve visualization and precision, leading to faster recovery and earlier continence recovery. Newer Retzius-sparing and single-port techniques show promising functional results, though evidence is still limited. Novel diagnostic tools including image overlay, targeted surgery, and fast and accurate intraoperative pathological assessment of resection margins are increasingly shaping modern radical prostatectomy.ConclusionRadical prostatectomy has evolved into a minimally invasive, technology-driven procedure with improved recovery and functional outcomes. Advances in robotics, imaging, and artificial intelligence enhance surgical precision. Ongoing innovation and long-term data will define the future of prostate surgery.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1801634</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1801634</link>
        <title><![CDATA[Association of PADUA and RENAL scores with early perioperative outcomes in large renal tumors managed with robot-assisted partial nephrectomy]]></title>
        <pubdate>2026-04-30T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Tunkut Doganca</author><author>Boran Aksakal</author><author>Osman Acar</author><author>Ceyda Buyuker</author><author>Ilter Tufek</author><author>Ali Riza Kural</author>
        <description><![CDATA[IntroductionTumor complexity scoring supports preoperative planning for robot-assisted partial nephrectomy (RAPN), but evidence in larger tumors is limited. We evaluated whether PADUA and RENAL nephrometry scores are associated with early perioperative outcomes in a stage-focused cohort of pathological pT1b or higher renal tumors treated with multiport RAPN.MethodsWe retrospectively reviewed a prospectively maintained single-center database of multiport RAPN cases (2011–2025). Patients with pathological pT1b–pT2a disease were included. The primary endpoint was a 30-day composite adverse outcome: major complications (Clavien–Dindo ≥3) and/or perioperative transfusion. Secondary endpoints were any complication (Clavien 1–5), transfusion, warm ischemia time (WIT; continuous and >25 min), operative time, length of stay, and trifecta achievement. Associations were tested using logistic regression (penalized models for sparse outcomes), linear regression, and AUC; β represents the adjusted change in the outcome per 1-point increase in score.ResultsIn total, 109 patients were included (PADUA available in 108; RENAL in 83). Neither PADUA nor RENAL was independently associated with the composite adverse outcome, and discrimination was limited (PADUA AUC 0.583, 95% CI 0.411–0.733; RENAL AUC 0.563, 95% CI 0.347–0.775; p = 0.738). Both scores were associated with intraoperative metrics. Each 1-point increase in PADUA correlated with longer WIT (β 1.13 min; 95% CI 0.20–2.07; p = 0.019) and operative time (β 4.55 min; 95% CI 0.20–8.90; p = 0.043). Each 1-point increase in RENAL correlated with longer WIT (β 1.33 min; 95% CI 0.25–2.40; p = 0.018) and operative time (β 5.01 min; 95% CI 1.62–8.40; p = 0.005). Trifecta achievement was not significantly associated with either score.ConclusionIn patients with pathological pT1b or higher renal tumors treated with multiport RAPN, PADUA and RENAL scores were not associated with a 30-day composite adverse outcome and had limited discrimination for major morbidity and/or transfusion, but both correlated with WIT and operative time. Larger externally validated cohorts incorporating longitudinal renal function and broader patient-level risk factors are needed to refine preoperative risk assessment in larger renal tumors.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1735378</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1735378</link>
        <title><![CDATA[Pioneering semi-rigid stability: navigating the female pelvis for enhanced precision in binocular vision guidance]]></title>
        <pubdate>2026-04-28T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Tieyuan Sun</author><author>Linna Wei</author><author>Pan Hu</author><author>Xiaolong You</author><author>Lubin Liu</author><author>Mingbo Liu</author>
        <description><![CDATA[PurposeTo overcome the surface marker drift issue in semi-rigid pelvic structures and establish a foundation for the binocular vision navigation targeting semi-rigid anatomical structures within the human body.MethodsThe study was conducted at Chongqing health center for women and children form April to June 2024. Surface markers were placed on 20 volunteers with semi-rigid pelvic anatomy. Respiratory and movement-induced displacement data were collected pre- and post-activity. A hybrid approach integrating a loss function and respiratory compensation algorithm was developed for spatial registration correction.ResultsAfter correction through spatial registration using a mathematical model, the drift range of semi-rigid body surface markers was 0.86 ± 0.11 mm. Specifically, the body surface drift ranges for the left anterior superior iliac spine marker were 0.79 ± 0.12 mm, for the right anterior superior iliac spine marker were 0.85 ± 0.14 mm, and for the pubic symphysis marker were 0.96 ± 0.25 mm. The stability around the umbilicus was relatively poor, with an error range of 1.71 ± 0.91 mm. Among the four markers, three have achieved positioning accuracy meeting the millimeter-level requirements for spatial registration in the current field of medical navigation surgery. The performance complies with the mandated sub-4-millimeter Target Registration Error (TRE) for optical tracking devices in surgical navigation applications.ConclusionsThe first successful mitigation of surface marker drift issues by a mathematical compensation algorithm enabling binocular vision navigation in pelvic floor surgerys, and lays a foundation for future semi-rigid anatomical structure navigations.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1663253</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1663253</link>
        <title><![CDATA[Artificial intelligence model based on CT imaging for predicting infected upper urinary tract calculi]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Shichao Song</author><author>Tao Ma</author><author>Jiandong Wang</author><author>Yonggang Li</author><author>Zhu Wang</author><author>Wenzeng Yang</author><author>Zhenyu Cui</author>
        <description><![CDATA[ObjectiveTo construct an artificial intelligence (AI) model based on Computed Tomography (CT) imaging and evaluate its efficacy in preoperatively predicting infected upper urinary tract calculi.MethodsClinical data from December 2023 to February 2025 for patients diagnosed with urinary tract calculi at the Affiliated Hospital of Hebei University were collected. Postoperative analysis of stone composition defined stones containing more than 25% struvite and/or carbonate apatite as infectious stones, with the remainder being non-infectious stones. Labelimg software was utilized to annotate the stone locations in CT images by manually outlining the stone contours. Stratified random sampling was performed at the patient level to divide the 465 enrolled patients into training, validation, and test sets at a 7:1:2 ratio (326, 47 and 92 patients, respectively), with all CT images of each patient assigned to the corresponding dataset to avoid data overlap. We documented the model's Average Precision (AP), Mean Average Precision (mAP), and Mean Recall (mR). Additionally, CT images from patients diagnosed with urinary tract calculi from December 2021 to February 2023 at our hospital were randomly selected to evaluate the model's clinical efficacy.ResultsOf the 465 patients enrolled, 134 were classified in the infectious stone group and 331 in the non-infectious stone group. The model's mAP for infectious stones in the training and validation sets was 95.3% and 95.0%, respectively. The mAP was lower at 62.4% for stones smaller than 32 × 32 pixels, and 81.3% for stones larger than this size. Of the 935 CT images analyzed from December 2021 to February 2023, the RetinaNet model achieved an accuracy of 85.17%, sensitivity of 72.78%, specificity of 93.09%, and positive and negative predictive values of 87.04% and 84.27%, respectively for predicting infectious stones. The kappa test demonstrated significant consistency between the model and infrared spectroscopy analysis (kappa value of 0.679).ConclusionThe RetinaNet model based on CT imaging shows high specificity for predicting infectious upper urinary tract calculi, supporting its clinical value in identifying suspected cases preoperatively. However, its moderate sensitivity precludes reliable standalone ruling-out of infectious stones. When combined with routine laboratory tests (e.g., urine routine and culture), this AI model acts as a valuable complementary preoperative tool, providing auxiliary guidance for treatment strategy formulation and surgical decision-making in patients with urinary tract calculi.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1807432</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1807432</link>
        <title><![CDATA[Surgical extraction of a metal ring embedded in the penis for five years: a case report]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Brief Research Report</category>
        <author>Chaodong Shen</author><author>Mengqi Shi</author><author>Zhirong Zhu</author>
        <description><![CDATA[IntroductionPenile strangulation represents an uncommon urological emergency that has been increasingly reported in recent literature. However, chronic penile strangulation resulting from subcutaneous embedding of foreign objects is even more rare.Case presentationA male patient presented to the urology outpatient clinic with progressive swelling at the penile base and purulent discharge from the urethral meatus. Clinical evaluation revealed a metal ring that had been placed at the penile base for five years and had gradually become embedded beneath the skin, rendering it invisible to the naked eye. During surgery, an annular metal object was exposed following an incision of the penile skin and successfully removed without urethral injury. At one-month postoperative follow-up, proper wound healing and normal urinary function were observed.ConclusionThis report describes an exceptionally rare case of chronic penile strangulation. Successful surgical removal of the embedded metal ring was achieved with minimal complications.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1816916</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1816916</link>
        <title><![CDATA[Cryopreserved vascular allografts for venous lengthening after robot-assisted living donor nephrectomy: a single institution experience]]></title>
        <pubdate>2026-04-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Vincenzo Li Marzi</author><author>Gianluigi Adani</author><author>Alessio Pecoraro</author><author>Claudia Lucia Catucci</author><author>Giorgio Micheletti</author><author>Riccardo Campi</author><author>Nicoletta Mancianti</author><author>Giulio Bagnacci</author><author>Francesco Sessa</author><author>Guido Garosi</author><author>Sergio Serni</author>
        <description><![CDATA[IntroductionLiving-donor kidney transplantation (LDKT) is the gold standard for end-stage renal disease. Traditionally, the left kidney is preferred for its longer vein. However, the “donor safety first” principle, combined with the transition to laparoscopic and robotic donor nephrectomy, has increased the frequency of using right-sided grafts or encountering “iatrogenically” shortened veins due to mechanical stapling. In this study, we report our preliminary experience evaluating the efficacy of cryopreserved vascular grafts for renal vein lengthening in LDKT to overcome anatomical vascular length limitations.MethodsAll LDKT in this series were performed using a robotic-assisted laparoscopic approach. All procedures were carried out by a dedicated and experienced surgical team thanks to a cross-institutional partnership involving two regional University Hospitals. When necessary, cryopreserved venous allografts were employed to ensure adequate renal vein length. All transplants were carried out using a standard retroperitoneal approach in the iliac fossa.ResultsFrom June 2024 to October 2025, nine living-donor kidney transplants were performed. The donor cohort included 7 females and 2 males with a median age of 58 years (IQR 51–69), while the recipient cohort included 4 females and 5 males with a median age of 39 years (IQR 23–55). Cryopreserved venous allografts were used in 5/9 LDKT (55.5%), following right kidney procurement. Cold ischemia time was higher in grafts requiring vascular extension than in those without elongation (median 139 min [IQR 130–141] vs. 115 min [IQR 107–121], respectively; p < 0.05). Rewarming time was also longer in the vessel extension group (median 38 min [IQR 37–40] vs. 33.5 min [IQR 31–35], respectively; p = 0.6). No intraoperative or high-grade postoperative complications were observed. At a median follow-up of 10 months (IQR 8–17), there were no deaths or graft losses. The median serum creatinine level at last follow-up was 1.6 mg/dL (IQR 1.2–1.7).ConclusionRenal vein lengthening with cryopreserved vascular grafts is a valuable tool in modern transplantation, addressing short veins—common in right-sided grafts and after laparoscopic or robotic stapling—and complex recipient venous anatomy. By enabling safer anastomoses, this technique supports excellent graft function while preserving donor safety.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1799916</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1799916</link>
        <title><![CDATA[Switching lasers: assessing the learning curves of surgeons with different levels of surgical experience when switching from HoLEP to pulsed Thulium YAG lasers for ThuLEP]]></title>
        <pubdate>2026-04-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Leo F. Stadelmeier</author><author>Laurenz Berger</author><author>Philip Nicola</author><author>Philipp Weinhold</author><author>Julian Marcon</author><author>Michael Atzler</author><author>Yannic T. Volz</author><author>Nikolaos Pyrgidis</author><author>Iason Papadopoulos</author><author>Martin Hennenberg</author><author>Christian G. Stief</author><author>Patrick M. Keller</author><author>Alexander Tamalunas</author>
        <description><![CDATA[ObjectivesThis study aims to assess the learning curves associated with pulsed Thulium laser enucleation of the prostate (ThuLEP) among three surgeons with varying levels of experience in Holmium laser enucleation of the prostate (HoLEP) as a treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic enlargement, with pulsed ThuLEP being one of the newest systems for the surgical treatment of male LUTS.MethodsWe conducted a prospective analysis of the first 100 consecutive ThuLEP procedures performed by three surgeons with varying levels of HoLEP experience: one highly experienced (>1,000 prior HoLEP surgeries), one moderately experienced (>200 prior HoLEP surgeries), and one novice surgeon (with no prior HoLEP surgeries) undergoing a structured training program. The evaluation focused on perioperative characteristics, functional results, and safety outcomes.ResultsWhile postoperative functional outcomes were comparable across all groups, experienced surgeons demonstrated a steeper learning curve. The highly experienced surgeon achieved proficiency approximately twice as quickly as the moderately experienced one. Surgeons with prior HoLEP experience reached a performance plateau in enucleation efficiency (g/min) and enucleation time (min) roughly twice as quickly, while requiring only about half the laser energy (kJ). Training a HoLEP-inexperienced surgeon in ThuLEP proved both feasible and safe when conducted within a structured training program.ConclusionsPulsed ThuLEP shows a learning curve comparable to HoLEP for inexperienced surgeons when performed following a structured training program. Switching lasers is safe and feasible for surgeons already experienced in HoLEP.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1717320</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1717320</link>
        <title><![CDATA[Enhanced recovery after surgery nursing improves postoperative outcomes in laparoscopic radical nephrectomy: a cumulative meta-analysis]]></title>
        <pubdate>2026-04-10T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Yan Wang</author><author>Xiaoyan Wang</author><author>Yu Gao</author>
        <description><![CDATA[BackgroundRenal carcinoma is a common malignant tumor of the urinary system worldwide. Given substantial evidence demonstrating the beneficial effects of enhanced recovery after surgery (ERAS) care on recovery following laparoscopic radical nephrectomy for renal cancer, in this study, we conducted a systematic review and meta-analysis to summarize relevant studies and evaluate the application value of ERAS care in this context.MethodsWe searched databases such as PubMed, Embase, The Cochrane Library, Web of Science, OVID, CNKI, Wanfang Data, VIP, and the China Biological Literature Database for clinical studies comparing ERAS care with traditional perioperative care in patients undergoing laparoscopic radical nephrectomy for renal cancer, up to December 2025. Two independent reviewers performed literature screening, data extraction, and quality assessment of the included studies. A cumulative meta-analysis was conducted using Stata version 12.0.ResultsA total of 26 relevant studies were included, comprising 24 randomized controlled studies and two quasi-experimental studies, involving 2,361 patients (1,172 in the ERAS care group and 1,189 in the traditional care group). The cumulative meta-analysis results indicated that patients receiving ERAS care experienced significantly earlier times to first anal exhaust, first feeding, first urination time after surgery, first defecation, catheter encumbrance time, first-time out-of-bed activity, length of hospital stay and removal time of drainage tube postoperatively. Furthermore, and postoperative hospital stay were shorter in the ERAS group. The ERAS group also demonstrated a lower overall incidence of postoperative total complications and higher patient satisfaction.ConclusionThe application of ERAS care in laparoscopic radical nephrectomy for renal cancer can accelerate postoperative recovery, shorten postoperative hospital stay, and reduce the incidence of postoperative complications. However, because of potential heterogeneity among the included studies, these conclusions warrant further validation by more high-quality research.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero, PROSPERO CRD420251159414.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1721410</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1721410</link>
        <title><![CDATA[Do previous percutaneous renal procedures affect the outcome of ultrasound-guided PCNL? A study at a large-volume center]]></title>
        <pubdate>2026-04-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Xue Zeng</author><author>Yang Chen</author><author>Sen Lin</author><author>Yangyang Xu</author><author>Zhichao Luo</author><author>Wenjie Bai</author><author>Jianxing Li</author><author>Bo Xiao</author>
        <description><![CDATA[PurposeThis study aimed to investigate the influence of previous percutaneous renal procedures on the outcome of ultrasound (US)-guided percutaneous nephrolithotomy (PCNL) in patients with upper urinary tract stones.Patients and methodsPatients with a history of percutaneous renal procedures (PCNL/renal nephrostomy) from July 2017 to June 2023 were enrolled in this study as Group 1 (n = 77). Patients who underwent PCNL during the same period and had no history of percutaneous renal puncture surgery were enrolled in Group 2 (n = 160). All the procedures were performed under US guidance. Standard access (22–24 Fr) was achieved in all patients in the prone position. Relevant patient characteristics, operative variables, and postoperative data were collected and analyzed, focusing on the stone-free rate (SFR) and complications.ResultsThe procedure was successful in all patients. The patients’ basic characteristics (gender, age, BMI, and stone size) were similar between the two groups. Puncture time and access creation time were significantly longer in Group 1 than in Group 2 (p = 0.02, p = 0.01). Similarly, Group 1 demonstrated a significantly higher number of access tracts compared to Group 2 (p = 0.02). The final SFR in Group 1 showed no significant difference compared to Group 2 (p = 0.09). Operative duration in Group 1 was longer than in Group 2 (p = 0.1). Postoperative hospitalization, hemoglobin loss, transfusion rate, embolization rate, and overall complication rate were not significantly different between the two groups.ConclusionUltrasound-guided PCNL is safe and effective for patients with prior PCNL history, demonstrating an acceptable SFR. However, these cases exhibited prolonged access creation time, increased operative duration, and required more surgical tracts compared to naive cases.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1799215</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1799215</link>
        <title><![CDATA[Clinical exploration of flexible ureteroscopy combined with holmium laser and intraoperative ultrasound localization for the treatment of stones in non-communicating calyceal diverticula: a single case report]]></title>
        <pubdate>2026-03-30T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Qiang Wang</author><author>Yiwei Xu</author><author>Lang Cheng</author><author>Xiaopeng Chen</author><author>Houbao Huang</author><author>Ping Ao</author>
        <description><![CDATA[ObjectiveTo investigate the value of intraoperative multimodal localization strategies in managing non-communicating calyceal diverticulum stones without preoperative definitive diagnosis in a single clinical case.MethodsA 48-year-old female with a history of open renal stone surgery and cesarean section was enrolled in this single case study. Preoperative CT revealed a calcified lesion (1.5 × 1.2 cm, CT value 1,235 HU) at the right upper renal pole but failed to identify the diverticular structure. Intraoperative exploration identified a ureteral orifice ectopically located on the right posterior bladder wall (23 mm deviation from midline). An innovative “three-step localization protocol” was implemented: 1. CT-anatomical landmark spatial co-registration, 2. Guidewire advancement with tactile feedback validation, 3. Real-time ultrasonographic confirmation of guidewire tip positioning. A 10/12Fr ureteral access sheath was pre-placed in the right ureter to establish a stable operative channel, facilitate irrigation and suction, and reduce ureteral mucosal injury during the surgical procedure. Diverticular neck incision was performed using holmium laser (200 μm fiber, 0.8J/20 Hz) for channel creation, followed by stone fragmentation under negative-pressure suction system guidance.ResultsThe procedure was completed in 90 min with negligible blood loss (<10 mL). Intraoperative ultrasonography confirmed complete stone clearance. No postoperative complications or recurrence was observed during follow-up.ConclusionMultimodal localization technique achieved effective and precise surgical navigation for the non-communicating calyceal diverticulum in this single case. This approach combines the advantages of natural orifice preservation with controlled infection risk and minimized hemorrhagic complications, and may provide a valuable clinical and technical reference for cases with atypical anatomy and inconclusive preoperative imaging.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1791415</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1791415</link>
        <title><![CDATA[Robotic intracorporeal bilateral ileal ureter replacement for the treatment of post-radiation complex ureteral stricture complicated by uretero-arterial fistula]]></title>
        <pubdate>2026-03-27T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Tengfei Gu</author><author>Ting Chen</author><author>Yongtao Pan</author><author>Qinzhou Yu</author><author>Jie Li</author>
        <description><![CDATA[BackgroundRadiotherapy is a crucial treatment modality for gynecological malignancies. However, managing its long-term complications, such as ureteral strictures and uretero-arterial fistulas, is challenging. These complications often lead to recurrent hematuria, infections, and renal function impairment. Traditional ureteral stent placement has limited efficacy, particularly for complex cases involving vascular complications, which frequently necessitate surgical intervention.ObjectiveTo summarize the management of complex cases involving bilateral ureteral strictures combined with iliac artery aneurysms and uretero-arterial fistulas following radiotherapy for cervical cancer, and to explore the feasibility and clinical efficacy of robot-assisted laparoscopic bilateral ileal ureter replacement with bladder anastomosis.Materials and methodsThe patient was a 73-year-old female who presented with bilateral ureteral strictures and recurrent hematuria 9 years after undergoing postoperative radiotherapy for cervical cancer. Previous treatments, including multiple ureteral stent placements and vascular interventions, had been ineffective. Imaging studies revealed strictures in the mid-to-distal segments of both ureters and an iliac artery aneurysm. Following a multidisciplinary team discussion, a robotic total intracorporeal bilateral ileal ureter replacement with bladder anastomosis was performed. A 25-cm segment of ileum was harvested and configured in an inverted “7” shape for the anastomosis, and an anti-reflux procedure was incorporated. Detailed surgical steps are available in the accompanying video.ResultsThe procedure was completed successfully, with a total operative time of 245 min and an estimated blood loss of approximately 80 mL, without conversion to open surgery. The patient recovered well postoperatively, with no complications such as anastomotic leakage or infection. The ureteral stents were removed 2 months after surgery. A follow-up examination at 3 months postoperatively revealed significant improvement: hydronephrosis had markedly decreased, serum creatinine levels had dropped from a preoperative value of 256 µmol/L to 93 µmol/L, urinary function was satisfactory, and the patient's quality of life had significantly improved.ConclusionRobotic total intracorporeal bilateral ileal ureter replacement is a safe and effective method for treating complex post-radiation ureteral strictures complicated by vascular conditions. This approach significantly improves renal function and alleviates clinical symptoms, making it a viable option for complex cases that have failed conventional treatments.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1730936</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1730936</link>
        <title><![CDATA[Prone retroperitoneal robotic-assisted laparoscopic pyeloplasty for ureteropelvic junction obstruction]]></title>
        <pubdate>2026-03-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Xiao Yang</author><author>Haonan Chen</author><author>Hao Yu</author><author>Zhengye Tan</author><author>Lingkai Cai</author><author>Qiang Cao</author><author>Qiang Lu</author>
        <description><![CDATA[ObjectiveTo evaluate the feasibility and preliminary outcomes of prone retroperitoneal robotic-assisted laparoscopic pyeloplasty (prRALP) for ureteropelvic junction obstruction (UPJO), an innovative approach designed to optimize surgical exposure and suturing.MethodsThis retrospective cohort study analyzed four patients who underwent prRALP between September 2023 and May 2024. The surgical technique involved prone positioning and multi-port robotic access, enabling direct posterior exposure of the renal pelvis and proximal ureter. Primary outcomes included operation time (OT), estimated blood loss (EBL), complications (Clavien-Dindo classification), and postoperative renal function (eGFR). Success was defined by radiographic resolution of obstruction, symptom relief, and no need for reintervention.ResultsAll procedures were completed robotically without open conversion and reoperation. Mean OT was 64.6 ± 14.4 min, with minimal blood loss of 27.5 ± 15.0 mL and no transfusions. The mean postoperative hospital stay was 3.3 ± 0.5 days. One minor complication (fever, Clavien 1) occurred (25%). Postoperative eGFR improved by 1.3 ± 14.2 mL/min/1.73 m2 at 90-day follow-up, with all patients achieving obstruction-free recovery and a mean eGFR of 87.2 ± 69.8 mL/min/1.73 m2 being maintained at 1-year postoperatively.ConclusionprRALP demonstrates feasibility and safety, leveraging prone position to enhance retroperitoneal access and suturing precision. Larger prospective studies are warranted to validate its technical benefits and reproducibility.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1761830</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1761830</link>
        <title><![CDATA[Clinical outcomes and quality of life assessment of fully laparoscopic appendiceal flap and tongue mucosa ureteroplasty for complex ureteral strictures]]></title>
        <pubdate>2026-03-10T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yuli Luo</author><author>Hongzhi Fang</author><author>Changjian Shi</author><author>Jie Xu</author><author>Xinyi Li</author><author>Yunfei Li</author>
        <description><![CDATA[PurposeThe main goal of this study is to evaluate the clinical effectiveness of two fully laparoscopic methods. These two methods are appendiceal flap ureteroplasty (AFU) and lingual mucosal graft ureteroplasty (LMGU). They are used to treat complex ureteral strictures (US). This study also analyzes how these methods affect the health-related quality of life (HRQoL) of patients.MethodsWe did a single-center, retrospective cohort study. This study included 22 patients who had complex US. All these patients received fully laparoscopic AFU or LMGU in our hospital. The time of the surgery was from January 2022 to October 2024. We assessed surgical results. We based the assessment on radiographic imaging, renal function tests and patient-reported outcomes. Patient-reported outcomes were longitudinally evaluated using the internationally validated 36-Item Short Form Health Survey (SF-36) at one day before surgery, 6 months, and 12 months postoperatively.ResultsAll 22 patients successfully underwent the fully laparoscopic procedures without conversion to open surgery. The cohort comprised 14 patients who received AFU and 8 who received LMGU. The average length of US in the patients was 4.14 ± 0.68 cm. The average time spent on surgery was 198.86 ± 44.88 min. The median estimated blood loss during surgery was 67.5 ml. The median number of days patients stayed in the hospital after surgery was 8 days. The median follow-up period for the patients was 12 months. Every surgery was successful in terms of technique, so the success rate reached 100%. Patient-reported outcome scores showed obvious improvement. This improvement happened from the baseline to 6 months after surgery, and it also happened at the 12-month postoperative evaluation. Most domains of the scores had this improvement, and the difference was statistically significant (p < 0.05).ConclusionsBoth fully laparoscopic AFU and LMGU are safe and effective for the reconstructive treatment of complex US. We also found that HRQoL improved significantly after the operation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1783135</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1783135</link>
        <title><![CDATA[Hyaluronic acid and chondroitin sulfate in the management of Bacillus Calmette–Guérin–induced cystitis: what we have learned and what is still missing?]]></title>
        <pubdate>2026-03-05T00:00:00Z</pubdate>
        <category>Opinion</category>
        <author>Marilena Gubbiotti</author><author>Stefano Rosadi</author><author>Valentina Giommoni</author><author>Barbara Bigazzi</author><author>Emanuele Rubilotta</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1772261</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1772261</link>
        <title><![CDATA[Risk factors for postoperative febrile urinary tract infection in patients with urolithiasis: a meta-analysis]]></title>
        <pubdate>2026-03-02T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Zimei Mo</author><author>Puzhao Liang</author><author>Yongtong Ruan</author>
        <description><![CDATA[ObjectiveTo identify risk factors for febrile urinary tract infection (FUTI) following surgical intervention for urinary stones.MethodsWe systematically searched seven databases (from CNKI to EMBASE) from inception to May 2025 for cohort and case-control studies investigating risk factors for FUTI. Two investigators independently screened studies, extracted data, and assessed quality (Newcastle-Ottawa Scale). Adjusted odds ratio (OR) with 95% confidence interval (CI) were used as effect measures. Meta-analysis was performed using Stata 12.0.Results16 studies (n = 5,366) revealed FUTI incidence of 17% (95%CI:12.6–21.3%). Ten significant risk factors were identified: (1) General factors: Stone size (OR = 1.29, 95%CI:1.09–1.52) and operative duration (OR = 1.05, 95%CI:1.01–1.10). (2) Comorbidity: Diabetes (OR = 2.18, 95%CI:1.65–2.87), Renal insufficiency (OR = 3.19, 95%CI:2.16–4.70). (3) Preoperative: preoperative hydronephrosis (OR = 2.33, 95%CI: 1.14–4.76), elevated preoperative procalcitonin (OR = 1.08, 95%CI: 1.03–1.13), preoperative pyuria (OR = 4.05, 95%CI:1.88–8.74), preoperative bacteriuria (OR = 2.45, 95%CI: 2.07–2.90), perinephric fat stranding (OR = 5.09, 95% CI:1.71–15.14), and tissue margin sign (OR = 2.84, 95%CI:1.91–4.23).ConclusionDiabetes mellitus, renal insufficiency, preoperative hydronephrosis, elevated procalcitonin, preoperative pyuria, preoperative bacteriuria, perinephric fat stranding, tissue rim sign, operative duration, and stone size are potential independent predictors of FUTI after urinary stone surgery. These findings enable targeted prevention strategies for high-risk urolithiasis patients.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1785032</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1785032</link>
        <title><![CDATA[Editorial: Prevention and treatment of urolithiasis: innovation and novel techniques]]></title>
        <pubdate>2026-02-27T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Steffi Kar Kei Yuen</author><author>Bo Xiao</author><author>Bhaskar Somani</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1769917</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1769917</link>
        <title><![CDATA[Defining the learning curve for thulium Laser en bloc resection of bladder tumors: a single-surgeon retrospective cohort study]]></title>
        <pubdate>2026-02-24T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Xiaodong Qing</author><author>Xiangzheng Wu</author><author>Wenbo Gao</author>
        <description><![CDATA[ObjectiveTo quantitatively analyze the learning curve for thulium laser en bloc resection of bladder tumor (TL-ERBT) performed by a surgeon experienced in conventional transurethral resection of bladder tumor (TURBT).MethodsIn this single-surgeon, retrospective cohort study, the initial 86 consecutive TL-ERBT cases were reviewed. Operation time was used as the primary outcome. Learning curve analysis was performed using moving average and cumulative sum (CUSUM) methods.ResultsAmong 79 successfully completed TL-ERBTs, the mean operation time was 31.6 ± 10.3 min. CUSUM analysis identified a turning point at case 32, separating the Learning phase (cases 1–32) from the Proficiency phase (cases 33–86). Operation time significantly decreased from 37.8 ± 9.2 min in the Learning phase to 27.8 ± 8.1 min in the Proficiency phase (P < 0.001). The conversion rate to conventional TURBT declined from 12.5% to 2.1% (P = 0.038). Detrusor muscle presence in specimens (87.3% overall) and major complication rates were comparable between phases.ConclusionFor a surgeon experienced in conventional TURBT, preliminary evidence from this study suggests that proficiency in TL-ERBT, defined primarily by operative efficiency, may be achievable after approximately 32 procedures, with significant improvements in operative efficiency and technical success; while patient safety was not compromised. These findings provide a practical quantitative benchmark for surgical training and clinical implementation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1718954</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1718954</link>
        <title><![CDATA[Effects of ureteral stent removal using an extraction string following ureteroscopic lithotripsy: a systematic review and meta-analysis of randomized controlled trials]]></title>
        <pubdate>2026-02-19T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Ce Dong</author><author>Hao Zheng</author><author>YuCheng Jiang</author><author>Weijie Chen</author>
        <description><![CDATA[BackgroundUreteral stent removal using an extraction string after lithotripsy is gaining popularity; however, evidence regarding patient outcomes remains limited. This meta-analysis aimed to evaluate pain and complications associated between string-based and cystoscopic stent removal.MethodsA systematic search of PubMed, Web of Science, Embase, the Cochrane Library, and Scopus was conducted up to September 2025. Eligible randomized controlled trials (RCTs) compared string-based stent removal with cystoscopic stent removal. The primary outcome was pain, assessed using the Visual Analog Scale (VAS), with subgroup analyses performed by sex. Secondary outcomes included urinary tract infection (UTI) and other complications. Data synthesis was performed using Review Manager 5.4, and risk of bias and certainty of evidence were assessed using the GRADE approach.ResultsFive RCTs involving 598 patients were included. Compared with cystoscopic stent removal, string-based stent removal significantly reduced pain [mean difference (MD) −2.49, 95% confidence interval (CI) −3.55 to −1.43, p < 0.01], particularly among women (MD −1.66, 95% CI −2.69 to −0.64, p < 0.01), while no significant pain reduction was observed among men (MD −1.05, 95% CI −3.75 to 1.64, p = 0.44). The incidence of UTI did not differ significantly between groups (risk ratio 1.45, 95% CI 0.48–4.42). Sensitivity analyses suggested instability of results, and stent migration could not be quantitatively assessed due to low event rates.ConclusionExtraction string-based removal may be associated with lower pain, especially among female patients, without a clear increase in complications. However, the limited number of studies and substantial heterogeneity result in a low certainty of evidence, and further well-designed RCTs are needed to confirm these findings.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251069187, PROSPERO CRD420251069187.]]></description>
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