In this special endourology issue of UroPrecision, we take a closer look into minimally invasive endoscopic surgery, also known as endourology. This urology subspecialty has grown tremendously in the last few decades, improving outcomes and decreasing morbidity for patients. Endourology is no longer limited to the treatment of nephrolithiasis, but has expanded into other areas of urological practice, such as benign prostatic hyperplasia (BPH), laparoscopic and robotic surgery, endoscopic treatment of urothelial malignancies, and many other minimally invasive therapies that are now routine in urological practice. The practice of endourology is not restricted to fellowship‐trained urologists, as there are a variety of diseases that can be managed with such techniques, which brings special interest to new technologies, treatment options, and outcomes for most practicing urologists.
The articles in this special issue of UroPrecision explore essential aspects of daily endourology practice, with a focus on unique approaches to patient management. These manuscripts demonstrate the importance of patient‐reported outcomes, healthcare costs, the impact of delays in care, and unique disease presentations now seen with the incorporation of new surgical techniques.
Palasi et al.[
1] presented original research illustrating the financial impact of delays in care for patients who underwent percutaneous nephrolithotomy for the treatment of nephrolithiasis. This fascinating article showed that a delay of six months in care could lead to a more than 30% increase in costs, more required radiology tests, and an increase in additional interventions.
Pereira et al.[
2] analyzed, in a cross‐sectional study, the symptom satisfaction of patients who underwent urological procedures with ureteral stent placement. The authors utilized questionnaires to evaluate postoperative symptoms and correlate them with indwelling time. They found that ureteral stent symptoms are present in more than 90% of patients, even if the indwelling time is less than seven days. Despite the symptoms, a little over 50% of the patients were satisfied with the stent, as they understood its role in their treatment. Understanding symptoms and better explaining the purpose of ureteral stents to patients can significantly improve patient expectations and satisfaction. Educating urology providers about this common procedure can help improve patient outcomes.
Teles et al.[
3] described in a video article membranous and prostatic urethral calcifications due to
Corynebacterium urealyticum infection in a patient with a history of prostate and bladder cancer who underwent radiation therapy and multiple endourological procedures for bladder cancer management. These calcifications have also been described in Holmium Laser Enucleation of the Prostate when associated with urinary infections caused by the same bacteria. Managing such infections and calcifications requires additional surgical therapy for resection of the calcifications alongside antibiotic therapy. With the increase in minimally invasive procedures for the management of BPH and bladder tumors, this video provides important insights for managing this condition and can help providers identify similar lesions in clinical practice.
Freires et al.[
4] described a rare case of vesical paraganglioma of the bladder. In this manuscript, they detailed the treatment of an incidentally found bladder mass on prostate ultrasound. The patient had some nonspecific symptoms of excess catecholamines. Also known as pheochromocytomas, these lesions can be extra‐adrenal in 10%–20% of cases. Surgical management of these tumors required specific perioperative measures and can significantly improve catecholamine‐related symptoms if treated.
de Amorin et al.[
5] will present an innovative surgical technique for antegrade endoscopic renal access for percutaneous nephrolithotomy, utilizing a new device. The authors presented the detailed surgical technique, accompanied by a video of the procedure. The technique uses endoscopic skills familiar to urologists for treating renal stones to establish access to PCNL, which is challenging for contemporary urologists due to limited training. The new technique may allow urologists to avoid relying on interventional radiologists for access, obtain more appropriate access for stone treatment, and, most importantly, reduce the need for multiple procedures, associated costs, radiation exposure, and possibly complications for patients.
This special issue showcases how advancements in technology and surgical techniques are reshaping urological practice. We hope that the insights presented in these articles will not only inform readers but also inspire further exploration into the minimally invasive approaches that continue to improve patient care.
2024 The Author(s). UroPrecision published by John Wiley & Sons Australia, Ltd on behalf of Higher Education Press.
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