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.

Robot-assisted surgery is the gold standard of treatment in many fields of urology. In this systematic review, we aim to report its usage in andrology and to evaluate any advantages. A systematic search of the PubMed and Cochrane Library databases was conducted to identify articles referring to robotic-assisted microsurgery in andrology. The search strategy was in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook. The articles were then reviewed by two authors. A qualitative analysis of the articles that met the inclusion criteria was performed. Thirty-one articles that met the inclusion criteria were reviewed. The first results for robot-assisted vasovasostomy (RAVV) are encouraging as excellent patency rates, short operative times, and learning curves were achieved. Interestingly, patency rates were greater in some case series for RAVV than for microsurgical vasovasostomy, with a statistically significant difference. In addition, robot has been shown to be of great use in bypassing fibrotic changes in cases of iatrogenic vasal injuries, difficulties encountered with traditional microsurgery. In addition, the feasibility of robot-assisted microsurgery has been proven for varicocelectomy and microsurgical denervation of the spermatic cord, with acceptable improvement in sperm parameters and pain, respectively. The current evidence suggests that there are potential advantages of the use of robots in andrology. However, for robotic surgery to become incorporated into the daily use of the andrologists, large, multicenter randomized trials are needed. As robotics systems are becoming standard in urology practice, it is reasonable for one to believe that they will also find their place in andrology.

Introductions: The process of determining thromboprophylaxis decisions in urologic surgery entails assessing the risk of venous thromboembolism (VTE) in comparison to the risk of bleeding. Risk assessment models (RAMs) have been created to systematically calculate an individual’s risk of VTE. In our study, we evaluated the risk of VTE in urologic inpatients using two RAMs specifically designed for urology by the European Association of Urology (EAU) and the American Urological Association (AUA), the Caprini score, and the CHA2DS2-VASc score. Methods: The study group consisted of 236 inpatients within the urology department. Data from medical records included information on various factors, such as age, gender, body mass index, personal and family history of the patients. The risk of VTE was determined using the RAMs provided by EAU and AUA, the Caprini score, and the CHA2DS2-VASc score. Results: Chemical prophylaxis was advised for 48 (35.3%) patients according to the EAU model, 47 patients (34.6%) according to the AUA model, 128 (94.1%) patients based on the Caprini score, and 80 (58.8%) patients according to the CHA2DS2-VASc score. Limitations of the study include a small sample size and lack of post-surgery venous thromboembolic events recording. Conclusions: The VTE RAMs developed by the EAU and AUA provide consistent recommendations for thromboembolism prophylaxis in urologic patients, while the Caprini model's strict adherence may lead to excessive prophylaxis recommendations. The EAU approach is user-friendly but urologists must judiciously weigh bleeding and VTE risks on an individual basis, ensuring optimal prophylaxis use.

Background: The widespread adoption of holmium laser enucleation of the prostate (HoLEP) has led to a growing number of men subsequently diagnosed with localized prostate cancer requiring radical prostatectomy (RP). However, anatomical alterations after HoLEP may increase surgical complexity and affect outcomes. This systematic review aimed to synthesize current evidence on perioperative, oncological, and functional outcomes of RP following HoLEP. Methods: A systematic literature search was conducted in PubMed, CENTRAL, and ClinicalTrials.gov through to September 2025 in accordance with PRISMA 2020 guidelines (PROSPERO CRD420251134483). Eligible studies included patients undergoing RP after HoLEP with reported perioperative, oncologic, or functional data. Methodological quality was assessed using the ROBINS-I tool, and results were synthesized narratively. Results: Eight retrospective studies comprising 202 patients were included. RP after HoLEP was technically feasible across open, laparoscopic, and robotic approaches. Operative time and the need for bladder-neck reconstruction were increased, reflecting post-enucleation fibrosis, but major complication rates (<5%) and blood loss were comparable to primary RP. Oncological outcomes were preserved, with positive surgical margin rates of 6–20% and biochemical recurrence rates of 7–15%, similar to those of primary RP. Functional recovery, particularly urinary continence, was slower initially but generally equivalent at 12 months. Erectile function outcomes were variable but satisfactory when nerve-sparing was feasible. Conclusions: Radical prostatectomy after HoLEP is a technically demanding yet safe procedure that achieves oncologic and long-term functional outcomes comparable to primary prostatectomy. Prior HoLEP should not preclude curative surgical management of prostate cancer, provided the operation is performed by experienced surgeons in high-volume centers.

Purpose: Venous thromboembolic (VTE) complications contribute substantially to perioperative morbidity and mortality. The decision for mechanical and/or chemo-prophylaxis is currently based on VTE risk assessment models since conventional laboratory assays of coagulation usually fail to detect changes indicating hypercoagulability. Rotational thromboelastometry is a novel assay of coagulation, that it could potentially be used in objectively selecting patients at risk for VTE, who should indisputably undergo prophylaxis. We evaluated the association of conventional and novel assays of coagulation and VTE risk.Methods: VTE risk was preoperatively assessed in 45 patients scheduled for endoscopic, open and laparoscopic urologic surgery, including transurethral resection of prostate, transurethral resection of bladder tumor, endoscopic vesical or ureteral stone lithotripsy, open prostatectomy, open cystectomy and urinary diversion, open or laparoscopic radical or partial nephrectomy, between March 2021 and October 2022, using three different risk assessment models (RAMs): the European Association of Urology (EAU) RAM, the American Urological Association (AUA) RAM, and the Caprini model. Patients under antiplatelet or anticoagulation agents were excluded. Patients’ coagulation profile was determined by measuring PT, fibrinogen, aPTT, and rotational thromboelastometry analysis. For rotational thromboelastometry analysis, extrinsic rotational thromboelastometry and fibrinogen rotational thromboelastometry were examined in every patient. Statistical analysis was performed with ANOVA test and χ2 test.Results: Mean values of all rotational thromboelastometry variables did not vary significantly among different EAU VTE categories. In extrinsic rotational thromboelastometry assessment, a significant difference was observed in the mean values of the Clotting time (CT) between the different risk groups based on AUA RAM. In the comparison between the risk groups defined based on the Caprini score, statistically significant differences were observed in the extrinsic rotational thromboelastometry clot formation time (CFT). In fibrinogen rotational thromboelastometry analysis, significant differences were identified in the clot amplitude after five minutes (A5) and maximum clot firmness (MCF) indices between the AUA risk groups, along with a significant difference in the mean clot formation rate (CFR) value between the risk groups defined based on the Caprini score.Conclusions: Rotational thromboelastometry can provide a detailed evaluation of the hemostatic status in patients undergoing urologic surgery that can be used as an adjunct to the VTE risk assessment models and thus, help to offer prophylaxis on a rather personalized basis. Future studies should assess the utility of thromboelastometry in identifying patients at high risk for VTE after major urological procedures.

Renal cell carcinoma (RCC) is the predominant solid lesion of the kidney. Among the various subtypes of RCC, chromophobe RCC (chRCC) is relatively rare, and it is characterized by an indolent clinical course and a favourable prognosis. We present a rare case of a 40-year-old patient who developed a retroperitoneal metastasis four years after undergoing radical nephrectomy for chRCC. The patient was under surveillance for another six years before surgical excision of the recurrence was performed. This case underscores the potential for late recurrence in chRCC and highlights the importance of long-term surveillance, even in patients with an initially favourable prognosis.