Advancements in technology have been at the heart of endourology for decades. With the introduction of new and novel technologies, endourology is rapidly changing. This review aims to address the recent innovations and technological advances in endourology by addressing four different areas where tangible outcome improvements are being seen: (1) diagnostic and detection methods; (2) intraoperative optimisation and procedural automation; (3) prediction of treatment outcomes; and (4) the use of generative Artificial Intelligence (AI) and Large Language Models (LLMs) for patients’ education and monitoring. AI applications in endourology consistently demonstrate high diagnostic accuracy, with stone detection rates exceeding 95
To assess the diagnostic accuracy of novel imaging modalities in working up invasive bladder cancer prior to surgical management and their potential role in guiding treatment decisions. Multiple new imaging modalities, including VI-RADS and Biparametric MRI have been developed to better guide management of invasive bladder cancer. There lacks a comprehensive review of these modalities and their diagnostic performance. We performed a systematic review following PRISMA guidelines. PubMed, Embase, and Scopus were searched through 2025. Studies reporting sensitivity and specificity of novel imaging for muscle invasion detection or nodal staging were included. Quality assessment used the QUADAS 2 tool. Thirty three studies encompassing 4,689 patients were included. Twenty three studies evaluated the Vesical Imaging Reporting and Data System for muscle invasion detection, achieving median sensitivity of 94
This review article will examine the current literature on recent advances made in the field of pediatric endourology, specifically regarding pediatric urolithiasis. In this article, we will review the most recent data evaluating pediatric-specific outcomes utilizing new advances in ureteroscopic devices and laser technology. Pediatric urolithiasis (PU) is an increasingly prevalent condition globally. Endourology has seen numerous breakthrough studies and technology advances in recent years, uniquely addressing the needs of pediatric patients. In this review, we will explore how advances in laser technology and instrument design have allowed pediatric urologists to deliver improved care to patients. We will also discuss emerging technologies that have the potential to increase our standards for procedural efficiency and safety.
To synthesize current evidence on the role of 29-MHz micro-ultrasound (microUS) in prostate cancer (PCa) detection and to define its position relative to multiparametric MRI (mpMRI) across the diagnostic pathway. We conducted a narrative review of prospective, comparative, and randomized studies, with clinically significant prostate cancer (csPCa) detection as the primary endpoint. MicroUS provides 70-µm axial resolution and enables real-time PRI-MUS–based risk stratification. Across head-to-head studies, microUS achieves diagnostic performance comparable to mpMRI. Evidence supports utility in biopsy-naïve patients, selected MRI-negative men with persistent clinical suspicion, repeat-biopsy settings, active surveillance, and local tumor staging, while combined mpMRI–microUS approaches have been shown to maximize yield of csPCa detection. Key limitations include operator dependence, interobserver variability, lack of validated biopsy-avoidance thresholds, and reduced sensitivity in anterior lesions. MicroUS is a practical, high-resolution platform that complements mpMRI and may enhance accessibility, efficiency, and precision in prostate cancer care.
Peripheral neuropathy affecting the lumbosacral plexus (LSP) is a potential contributor to "idiopathic" lower urinary tract dysfunction (LUTD), yet objective methods to assess peripheral nerve integrity in vivo remain limited. This narrative review evaluates the feasibility of diffusion tensor imaging (DTI) in assessing LSP microstructural integrity and explores what this may tell us about lower urinary tract dysfunction. Twelve studies met inclusion criteria from 91 screened abstracts. All studies successfully imaged and quantified sacral nerve microstructure using DTI parameters including fractional anisotropy (FA), mean diffusivity (MD), and apparent diffusion coefficient (ADC), demonstrating the technical feasibility of DTI across independent centres. Five case-control studies were identified, of which 4/5 included populations with pathologies known to result in LUTD and demonstrated significant differences in DTI parameters between patient and control groups within individual studies. However, findings are limited by small study cohorts, heterogeneous imaging protocols, and a lack of standardised lower urinary tract outcome measures across included studies. DTI can quantify the microstructural properties of peripheral nerves in the LSP and demonstrates consistent differences between patients with LUT dysfunction and controls. Therefore, this work supports a potential role for DTI to evaluate the contribution of peripheral neuropathy in patients with "idiopathic" LUT symptoms.
