While programmes such as the European Basic Laparoscopic Urological Skills have made strides in foundational training, a significant gap exists for intermediate and advanced laparoscopy education. Our objective is to develop and validate the European laparoscopic intermediate urological skills (LUSs2) curriculum, which will establish uniformity in the training of urological laparoscopic procedures and facilitate proficiency among practitioners. The study combines a literature review, cognitive task analysis development by a steering group, and a two-round Delphi survey involving international experts in urological laparoscopy. Consensus was defined as agreement of ≥70% among experts. The survey included statements on various laparoscopic procedures, assessed on a Likert scale from 1 (strongly disagree) to 9 (strongly agree). The Delphi process achieved consensus on 85% (235/275) of statements, indicating a strong agreement on the curriculum's content. Areas covered include renal hilum dissection, major vessel injury management, enucleation and renorrhaphy, vesicourethral anastomosis, and pyeloplasty. Limitations include the nonsystematic nature of the literature review and potential biases inherent in expert-based consensus methods. The LUSs2 curriculum significantly advances the standardised training of laparoscopic urological skills. It offers a detailed, consensus-validated framework that addresses the need for uniformity in surgical education and aims to enhance surgical proficiency and patient care. This study presents the development of a new standardised training curriculum for urological laparoscopic surgery. We intend this curriculum to improve the quality of surgical training and ensure high-quality patient care.
The official "Zeitschrift für Urologie" was not the only journal in the field of Urology in Germany at the beginning of the 20th century. The Berlin-based "Folia Urologica" was at least as influential and important and probably the better known journal. It relied on international exchange, disputes, and interdisciplinary work. With the outbreak of World War I in 1914, the international discourse ended. Die Zeitschrift für Urologie war in den ersten Jahren ihrer Existenz nicht konkurrenzlos. Auf internationaler Ebene war die in Berlin erscheinende Folia Urologica mindestens ebenbürtig, wenn nicht gar das bekanntere Journal. Auf internationalen Austausch und Interdisziplinarität ausgelegt, wurde ihr durch den Ersten Weltkrieg die Existenzgrundlage entzogen.
The advancements of technological devices and software are putting mixed reality in the frontline of teaching medical personnel. The Microsoft® HoloLens 2® offers a unique 3D visualization of a hologram in a physical, real environment and allows the urologists to interact with it. This review provides a state-of-the-art analysis of the applications of the HoloLens® in a medical and healthcare context of teaching through simulation designed for medical students, nurses, residents especially in urology. Our objective has been to perform a comprehensively analysis of the studies in PubMed/Medline database from January 2016 to April 2023. The identified articles that researched Microsoft HoloLens, having description of feasibility and teaching outcomes in medicine with an emphasize in urological healthcare, have been included. The qualitative analysis performed identifies an increasing use of HoloLens in a teaching setting that covers a great area of expertise in medical sciences (anatomy, anatomic pathology, biochemistry, pharmacogenomics, clinical skills, emergency medicine and nurse education, imaging), and above these urology applications (urological procedures and technique, skill improvement, perception of complex renal tumors, accuracy of calyx puncture guidance in percutaneous nephrolithotomy and targeted biopsy of the prostate) can mostly benefit from it. The future potential of HoloLens technology in teaching is immense. So far, studies have focused on feasibility, applicability, perception, comparisons with traditional methods, and limitations. Moving forward, research should also prioritize the development of applications specifically for urology. This will require validation of needs and the creation of adequate protocols to standardize future research efforts.
Even though certain technical limitations associated with the small size of the patients were taken for granted in the advent of pediatric robotic surgery, we could now be facing a paradigm shift challenging these old beliefs. A retrospective study of patients undergoing Da-Vinci-Xi(IS4000)-assisted urological surgery from May 2022 to October 2023 was carried out. Patients were divided into two groups -Group A < 15 kg and Group B ≥ 15 kg. Operating times, hospital stay, and intra- and postoperative complications were compared. 17 patients (9 in Group A, 8 in Group B) underwent surgery. Median age was 29 months (A) and 109 months (B) (p< 0.001). Median weight was 12.0 kg (A) and 31.5 kg (p< 0.001). Operating time was 162 min (A) and 130 min (p= 0.203). Console time was 99 min (A) and 70 min (B) (p= 0.065). Mean hospital stay was 2 days (A) and 3 days (B) (p= 0.41). No differences were found in terms of intraoperative (p= 0.453) or postoperative (p= 0.485) complications. Even though operating on younger children seemed more complicated than on older ones in the advent of robotic surgery, the results in our series were similar. The fact patients under 12 months of age were not included means larger studies are required to prove this. Aunque en los inicios de la cirugía robótica pediátrica solíamos asumir la existencia de ciertas limitaciones técnicas asociadas al pequeño tamaño de nuestros pacientes, podríamos encontrarnos ante un cambio de paradigma y cuestionar estas antiguas creencias. Estudio retrospectivo que incluye los pacientes a los que se les practicó una cirugía urológica asistida por robot Da Vinci Xi (IS4000), entre mayo de 2022 y octubre de 2023. Se dividieron en dos grupos: A < 15 kg, B ≥ 15 kg. Se compararon tiempos quirúrgicos, estancia hospitalaria y complicaciones intra y postoperatorias. Intervenimos 17 pacientes (9 A, 8 B). Edad mediana 29 (A) y 109 meses (B) (p < 0,001). Peso mediano A: 12 kg, B 31,5 kg (p < 0,001). Tiempo quirúrgico A 162 min, B 130 min (p= 0,203). Tiempo de consola A 99 min, B 70 min (p= 0,065). Estancia media A 2, B 3 días (p= 0,41). No se encontraron diferencias en la tasa de complicaciones intraoperatorias (p= 0,453) ni postoperatorias (p=0,485). A pesar de que al comienzo de la cirugía robótica se pensaba que sería más complicado operar a los niños pequeños que a los más mayores, en nuestra serie los resultados son similares. Por no incluir menores de 12 meses, necesitamos estudios más extensos para probar estas afirmaciones.
Despite the arising interest in three-dimensional (3D) reconstruction models from 2D imaging, their diffusion and perception among urologists have been scarcely explored. The aim of the study is to report the results of an international survey investigating the use of such tools among urologists of different backgrounds and origins. Beyond demographics, the survey explored the degree to which 3D models are perceived to improve surgical outcomes, the procedures mostly making use of them, the settings in which those tools are mostly applied, the surgical steps benefiting from 3D reconstructions and future perspectives of improvement. One hundred responders fully completed the survey. All levels of expertise were allowed; more than half (53%) were first surgeons, and 59% had already completed their training. Their main application was partial nephrectomy (85%), followed by radical nephrectomy and radical prostatectomy. Three-dimensional models are mostly used for preoperative planning (75%), intraoperative consultation and tailoring. More than half recognized that 3D models may highly improve surgical outcomes. Despite their recognized usefulness, 77% of responders use 3D models in less than 25% of their major operations due to costs or the extra time taken to perform the reconstruction. Technical improvements and a higher availability of the 3D models will further increase their role in surgical and clinical daily practice.
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Competency-based and standardised surgical training has become essential in urological education. The European School of Urology (ESU) established the Standardisation in Surgical Education initiative to develop a validated, competency-based surgical training. The ESU Laparoscopic Workgroup aims to develop two intermediate-level laparoscopic simulation modules, Partial Nephrectomy (PN) and Major Vessel Injury (MVI), and develop standardised performance metrics and scoring criteria for the intermediate laparoscopic ESU curriculum. Modules were evaluated during hands-on training courses across multiple European congresses. PN was completed by 27 participants (four experts, 23 residents); MVI by 41 participants (29 experts and 12 residents). Predefined performance parameters were derived from a previously published Delphi consensus defining the ESU Laparoscopic Urological Skills 2 curriculum and included procedure time, tissue handling, technical precision, completeness of resection/closure, haemostasis, and functional outcome. Completion times were assessed using the Mann-Whitney U test for continuous variables. Qualitative performance parameters were recorded as criterion-referenced educational indicators and summarised descriptively. Observed performance patterns, together with expert consensus, were used to inform the development of candidate scoring frameworks. Experts completed both modules in shorter median times compared with residents, for both modules (PN: 21:36 [interquartile range {IQR} 17:49-26:21] min vs 42:00 [IQR 36:35-43:26] min, p = 0.001; MVI: 5:24 [IQR 4:57-8:04] min vs 16:48 [IQR 11:12-27:15] min, p < 0.001). Qualitative categorical parameters (tissue handling, resection completeness, and haemostasis) showed descriptive patterns favouring expert participants and were reported narratively. Informed by these observed performance patterns and the underlying Delphi consensus, structured, domain-based candidate scoring frameworks were proposed for both modules to support future validation and curriculum implementation. This study supports the feasibility and educational relevance of two intermediate laparoscopic simulation modules within the ESU LUS2 curriculum. Building on a previously established Delphi consensus and informed by observed performance patterns, we propose preliminary, consensus-informed scoring frameworks intended to guide structured assessment and feedback. These findings should be regarded as a foundational step toward future validation and refinement in larger cohorts prior to formal implementation.
Male cancer survivors may develop sexual dysfunction (SD) even many years after recovery from cancer. We aimed to evaluate the prevalence of and the clinical characteristics of cancer survivors among men seeking medical help for SD (any) in the real-life setting of an andrological tertiary-referral centre. Complete data from 2712 men consecutively assessed for new-onset SD between 2005 and 2022 were analysed. All patients were assessed with a comprehensive sexual and medical history, including history of any non-metastatic cancer (i.e., urological cancers, non-urological solid cancers, haematological malignancies). All patients were invited to complete the International Index of Erectile Function (IIEF). The IIEF-Erectile function (IIEF-EF) domain was categorized according to Cappelleri's criteria. Of all, 239 (8.8%) patients primarily assessed for SD reported a history of non-metastatic cancers. Among cancer survivors, the most frequent complaint was ED (76.2%), followed by Peyronie's disease (PD) (13.8%), low sexual desire/interest (LSD/I) (13.4%), premature ejaculation (PE) (6.7%), and delayed ejaculation (DE) (2.1%), respectively. Of all, prostate cancer (PCa) and colorectal cancer (CRC) survivors accounted for 36.0% and 10.5% of all cancer survivors, respectively. Men with a history of PCa and/or CRC more frequently complained of ED [104(93.7) vs. 78(60.9) men; p = 0.002] and had lower median (IQR) IIEF-EF scores [7(3-10.5) vs. 11(7-21); (p < 0.001)], compared to patients with a history of other malignancies, whom conversely reported higher rates of PE [4(3.6%) vs. 12(9.4%) men; p = 0.04] and PD [10(9.0%) vs. 23(18.0%) men; p = 0.009]. Almost one out of ten men seeking first medical help for SD in a tertiary-referral andrology centre are cancer survivors. Following the improvement of survivorship rates in male patients, an andrological assessment should always be included over the follow-up of cancer survivors.
Background/Objectives: In an attempt to combine the benefits of the Holmium:YAG (Ho:YAG) laser and Thulium Fiber Laser (TFL), the "Magneto" mode lowers the peak power of the Ho:YAG laser, generating longer duration pulses. The purpose of this study is to compare the effect of the standard virtual basket (VB) Ho:YAG laser, Magneto Ho:YAG laser and TFL on soft tissue in an ex vivo model. Methods: Two renal units from a female pig were used for the current experiment. Sixteen distinct areas were defined. Each area included three parallel lines, which were made with the three different laser technologies. The VB Ho:YAG laser was used for the first line and the Ho:YAG laser in the "Magneto mode" was used to generate the second line, while the third line was performed with a TFL in short pulse mode. The same laser settings (1 J/10 Hz/10 W) and the same fiber diameter (200 μm) were used for all three laser incisions. The same surgeon performed all incisions with a standardized and repeatable technique, controlling hand speed and distance of laser fiber from kidney surface using the stabilization setup. Sections of the selected areas produced distinct paraffin blocks, each one containing three parallel laser lines. Two independent pathologists evaluated the incision depth, incision width, coagulation depth and carbonization effect of the three different lasers. Results: Although the incision depth and the carbonization effect were comparable between the three lasers, incision width and coagulation depth showed a statistically significant difference. Median incision width was 1.17 (1.04, 1.99) mm for the VB Ho:YAG laser, 1.05 (0.89, 1.50) mm for the Magneto Ho:YAG laser and 0.82 (0.65, 0.88) mm for the TFL (p = 0.001). The coagulation depth was 0.49 (0.41, 0.56) mm for the VB Ho:YAG laser, 0.51 (0.39, 0.59) mm for the Magneto Ho:YAG laser and 0.18 (0.17, 0.23) mm for the TFL (p < 0.001). During post hoc analysis for the three comparisons, the differences between the VB Ho:YAG laser and TFL and between the Magneto Ho:YAG laser and TFL were statistically significant for both parameters. Conclusions: Both the VB and Magneto Ho:YAG lasers produced laser incisions with statistically significant greater incision width and coagulation depth than the TFL on the ex vivo model. Overall, the Magneto Ho:YAG laser was associated with the greatest median coagulation depth. Post Hoc Man-Whitney tests for the three comparisons revealed statistically significant differences only between the VB Ho:YAG laser and TFL and between the Magneto Ho:YAG laser and TFL. This finding could potentially be translated into better haemostasis during endourological soft tissue surgery. The implementation of additional studies, both experimental and clinical ones, is of outmost importance to draw safer conclusions.
Focal therapy (FT) has emerged as an intermediate therapeutic strategy between active surveillance (AS) and radical treatments for the management of localized prostate cancer (PCa) in patients with clinically significant disease and a well-defined index lesion (IL). The development of ablative and imaging techniques has enabled the selective treatment of the IL, preserving healthy tissue and reducing adverse effects. o review the current evidence on FT in localized PCa, including technological modalities, selection criteria, diagnostic tools, post-treatment surveillance strategies, and barriers to its clinical implementation in the Spanish healthcare setting. A structured narrative review was conducted through a search in PubMed, Scopus, and Web of Science, including studies published up to April 2025. Original articles, reviews, clinical guidelines, and meta-analyses focusing on FT for localized PCa were selected. Prospective and comparative studies addressing oncological and functional outcomes, as well as associated technologies such as fusion biopsy, multiparametric magnetic resonance imaging (mpMRI), prostate-specific membrane antigen positron emission tomography (PSMA-PET), and artificial intelligence (AI), were prioritized. FT offers encouraging short- and medium-term oncological outcomes, with notable functional preservation. Modalities such as high-intensity focused ultrasound (HIFU) and cryotherapy are currently the most widely used and have the longest clinical trajectory, while irreversible electroporation (IRE) stands out among emerging techniques with results. Surveillance after FT should be multifactorial and include serial PSA monitoring, systematic and targeted biopsies, as well as imaging techniques such as mpMRI. Specific tools such as PI-FAB (Prostate Imaging after Focal Ablation) and TARGET (Transatlantic Recommendations for MRI Evaluation after Focal Therapy) systems allow for standardized interpretation of mpMRI after FT. In Spain, its adoption remains limited, reinforcing the need for specific guidelines and multicenter registries.
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Prostate cancer is frequently managed with radical prostatectomy (RP), which can offer excellent oncological control but with significant genitourinary morbidity. High-intensity focused ultrasound (HIFU) has emerged as a less-invasive alternative. We performed a systematic review and meta-analysis to compare the oncological, functional, and safety outcomes of HIFU versus RP in men with localized prostate cancer. Following PRISMA guidelines, we searched Medline, Embase, and Cochrane through December 2024 for comparative studies of HIFU and RP. Fourteen studies (including two randomized trials) met inclusion criteria. The primary endpoint was salvage therapy-free survival (STFS). Secondary outcomes included biochemical recurrence, metastasis-free survival, functional outcomes, and complications. Random-effect models were applied, and meta-regression explored sources of heterogeneity. Overall, HIFU was associated with lower STFS (odds ratio [OR]: 0.65, p = 0.02) although biochemical recurrence and metastasis-free survival did not differ significantly between treatments. Focal HIFU showed fewer major complications (OR: 0.36) and significantly better erectile function preservation (OR: 6.03), but minor complications were slightly more frequent. High heterogeneity was partly explained by study design and follow-up duration. Limitations include substantial heterogeneity, variable definitions of outcomes, and relatively short follow-ups in some studies. For selected patients, biochemical recurrence and metastasis-free survival did not differ significantly between treatments although HIFU was associated with lower STFS. Particularly as focal therapy, it shows the potential to achieve oncologic outcomes comparable to radical prostatectomy while enhancing erectile function preservation, urinary continence, and reducing major complications. Further long-term prospective studies are warranted to solidify these findings.
Lengthening corporoplasty is recommended for Peyronie's disease (PD) patients with severe (>60°) or complex curvature and preserved erectile function. This study aimed to evaluate lengthening corporoplasty outcomes using a graft of collagen fleece in Portugal. A multicentric retrospective study included PD patients who underwent the procedure between 2016 and 2024 at four Portuguese hospitals. Among 88 patients, the median age (IQR) was 59.0 (56.0-63.0) years, International Index of Erectile Function-5 (IIEF-5) score 22.5 (22.0-23.0), stretched penile length (SPL) 13.0 (12.0-14.0) cm, and curvature angle 80.0° (78.8-90.0)°. Dorsal curvature was most common (65.9%) and the median surgery duration was 92.5 (80.0-106.3) min. Early postoperative hematoma occurred in 8.0% of cases, and 2.3% had surgical site infections. No surgical reinterventions were needed. After a median follow-up of 31 months, complications included erectile dysfunction (38.6%), residual curvature (19.3%), reduced penile length (9.1%), penile pain (8.0%), and glans hypoesthesia (5.7%). SPL was 13.8 (12.5-15.0) cm immediately postoperative and 14.0 (13.0-15.0) at 1 month. New-onset erectile dysfunction treatments included phosphodiesterase type 5 inhibitors (34.1%), intracavernous alprostadil (1.1%), and penile prosthesis (3.4%). This study demonstrates effective curvature correction but high rates of postoperative erectile dysfunction, often requiring treatment.
Perioperative and postoperative complications after major urologic oncologic surgeries are common and clinically significant. Standardised complication grading and reporting are critical for benchmarking, quality improvement, and patient counselling. Our aim was to provide a comprehensive global assessment of complications following radical cystectomy (RC), radical and partial nephrectomy (RN and PN), radical prostatectomy (RP), radical nephroureterectomy (RNU), and retroperitoneal lymph node dissection (RPLND). This international, multicentre observational study included 130 034 procedures (29 098 RC, 75 001 RP, 24 476 major kidney surgery, 1459 RPLND) from 180 centres in 33 countries worldwide. Complications were graded using the Clavien-Dindo classification and quantified via the Comprehensive Complication Index, with descriptive analysis of complications at 30 d and 90 d. Complication rates varied by procedure. RC had the highest morbidity, with 30-d grade I-II complication in 40% and grade III-V in 16%, and a 90-d mortality rate of 2.3%. RP had low complication rates (grade I-II: 10-15%; grade III-V: 5-8%; mortality <0.05%), although extended pelvic lymph node dissection increased the incidence of high-grade events to 10%. Morbidity and mortality were generally low after PN; 90-d mortality was higher with open RN, reaching 1.7%. RNU and RPLND had moderate rates of major complications (up to 14%) and low mortality (<1%). Retrospective data collection, potential heterogeneous reporting of complications between centres, and incomplete follow-up in some cases may affect the generalisability of the results. This standardised global data set is the largest assessment of perioperative morbidity across urologic oncologic procedures to date, and provides important real-world evidence. RC remains the most morbid procedure, while RP had markedly lower complication rates. Standardised reporting and international benchmarking are essential to improve surgical safety and guide quality improvement worldwide.
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Single-port robot-assisted partial nephrectomy (SP-RAPN) is an emerging minimally invasive technique that integrates all instruments through a single multichannel port. Despite its increasing international use, European experience remains limited and no prior clinical series have been reported in Spain. This study aims to assess the feasibility, perioperative safety, and early outcomes of SP-RAPN in the first Spanish institutional experience. Prospective observational study including the first eight consecutive patients undergoing SP-RAPN at a high-volume RAPN centre. Surgical approach was selected according to tumour location. Perioperative parameters, postoperative recovery, renal function at 3 months, and pathological outcomes were collected. All procedures were completed successfully without conversion. Mean tumour size was 33 mm and mean RENAL score 7. Access was transperitoneal in 50%, pure retroperitoneal in 25%, and SARA/LAA in 25% of cases. Mean warm ischemia time was 19 min and mean operative time 123 min. Estimated blood loss was low (125 mL), and no transfusions were required. Only one minor complication (Clavien I) occurred. Serum creatinine remained stable postoperatively and at 3 months. Final pathology confirmed renal cell carcinoma in 7 patients, with negative surgical margins in 87.5%. Early recurrence-free survival was 100%. SP-RAPN is a feasible, reproducible, and safe procedure for localized T1 renal tumours. Perioperative, functional, and oncologic outcomes were favourable and within the ranges reported for RAPN in contemporary series. The versatility of transperitoneal, retroperitoneal, and SARA/LAA approaches may further expand its indications. Future multicentre studies with larger cohorts and long-term follow-up will be essential to confirm the durability and clinical benefits of this promising technique.
While mitomycin C (MMC) is widely used for intravesical therapy, the optimal maintenance regimen for non-muscle invasive bladder cancer (NMIBC) remains unclear. This study assessed the impact of MMC maintenance on recurrence-free survival (RFS) in patients with intermediate-risk Ta NMIBC and aimed to identify the optimal number of instillations for improved outcomes. We conducted a retrospective multicenter analysis of patients with Ta NMIBC treated with transurethral resection and adjuvant MMC across 13 Italian centers (2010-2023). Patients were grouped based on MMC maintenance duration: no maintenance, short-term (≤ 6 instillations), and long-term (> 6 instillations). Kaplan-Meier curves, Cox regression, and CART analysis were used to evaluate RFS and high-grade RFS (HG-RFS). Among 292 patients included, maintenance therapy significantly improved 2-year and 3-year RFS compared to no maintenance (78% vs. 55% and 67% vs. 30%, respectively; p < 0.001). CART analysis identified > 6 instillations as the threshold for optimal benefit. Long-term maintenance was associated with a lower risk of recurrence (HR 0.23 vs. no maintenance; HR 0.39 vs. short-term; both p < 0.001). No significant difference in HG-RFS was observed between no maintenance, long-term, and short-term groups. Long-term MMC maintenance (> 6 instillations) significantly prolongs RFS in patients with Ta NMIBC. These findings suggest that extended MMC regimens may improve patients' outcomes and should be considered in clinical practice. Prospective studies are needed to confirm these results and guide evidence-based treatment strategies.
Congenital penile curvature is a rare condition identified by an abnormal penile curvature present from birth. Surgical intervention is currently the most effective treatment and is generally deferred until after puberty; however, early correction is recommended by some due to its impact on psychosexual development. This systematic review aims to evaluate the literature on surgical techniques for congenital penile curvature correction, focusing on their efficacy, safety, and patient-reported outcomes. Conducted in accordance with PRISMA guidelines and registered with PROSPERO (ID: CRD42024526737), the review includes 59 studies meeting inclusion criteria. The findings indicate that numerous surgical techniques have been documented over the past decades, predominantly focusing on shortening procedures such as Nesbit, Yachia, tunica albuginea plication, and Essed-Schröder. These historically utilized methods remain effective for correcting congenital penile curvature, but they may result in side effects like penile shortening and erectile dysfunction. The review emphasizes the necessity for well-designed studies to better compare the benefits of various surgical techniques.
To evaluate the oncological outcomes and safety of chemoablation and Active Surveillance for non-muscle invasive bladder cancer. A systematic review was performed by accessing the following bibliographic databases: PubMed, Scopus, Embase and the Cochrane central register of controlled trials were searched. A total of 29 studies (1847 patients) met the inclusion criteria. The vast majority of patients included had Active Surveillance (n = 7, 582) and chemoablation (n = 21, 1265). Regarding chemoablation, Mitomycine C (MMC) was used in 14 studies, Epirubicin in 2 studies, Bacillus Calmette-Guerin (BCG) in one study and Gemcitabine in 5 studies (weekly or single dose). Follow-up ranged from 2 weeks to 39 months (Mean 16.8 months). The mean timing of initial assessment was 4.2 (range: 1 day to 27 weeks), and the pooled complete response (CR) rate was 52.3%. For the AS protocol, the pathological findings before observation were Ta (n = 583, 86%), low (n = 462, 60.1%) and high grade (n = 138, 42.1%). Mean follow up was 47 months ranged from 25 to 72 months, the mean duration of AS was 13.4 months. The mean AS failure rate was 64%. Grade progression, stage progression and progression to muscle-invasive bladder cancer (MIBC) were 68 (16.5%), 35 (8.5%) and 5 (1%) of cases, respectively. Patients with selected inclusion criteria based on the review can be referred for active Surveillance or chemoablation protocol, with a minimal risk of progression in either grade or stage for AS and a good complete response for chemoablation.
Although failures are undesirable, they offer valuable learning opportunities that drive progress through necessary changes. This concept holds particularly true in the history of urethral reconstruction. A comprehensive literature review was conducted using PubMed, focusing on the history of the urethral stricture and current trends based on national and international guidelines for urethral stricture management. Urethral strictures are among the oldest known urological conditions, with initial treatments centred around dilatation. These palliative measures proved disappointing. The advent of reconstructive urology has transformed this pathology into a treatable condition, notably through Excision and Primary Anastomosis (EPA) and one-stage augmentation urethroplasty using buccal grafts. Urethroplasty is the gold standard treatment for urethral strictures, and ongoing refinements aim to further reduce morbidity.