Next-Generation Endourology in Urolithiasis: Technology, Techniques, and Outcomes

Endourology has become the backbone of contemporary urolithiasis management, offering less invasive and highly effective treatment options for a growing burden of urinary stone disease. Significant advances in optical systems, laser technology, robotics, and digital navigation have allowed surgeons to push the limits of stone clearance while minimizing patient morbidity. However, with the fast pace of innovation, surgeons face increasing questions regarding the optimal use of emerging tools, ranging from laser platforms and miniaturized access techniques to suction-assisted systems, robotic-assisted ureteroscopy and PCNL, and artificial intelligence.The comparative benefits of modalities such as thulium fiber laser versus Ho:YAG, the practicality and long-term outcomes of single-use ureteroscopes, and the surgical ergonomics of mini-, ultra-mini-, and micro-PCNL procedures remain dynamic areas of study. Alongside these, growing attention is being paid to the wider context in which these technologies are deployed — the environmental footprint of disposable platforms, the patient experience and quality-of-life trajectory after intervention, and the learning curves clinicians must navigate to use new tools safely. While the evidence base is expanding, the translation of these technologies into routine surgical practice requires critical evaluation of their safety, efficiency, reproducibility, sustainability, and overall patient benefit.This Research Topic aims to guide the next generation of urologists and surgical specialists through the evidence supporting new endourological technologies and operative techniques. It seeks to define how innovation can refine patient management pathways, improve intraoperative control, and advance surgical precision. The goal is to establish a clinically grounded framework for surgeons to assess emerging technologies, evaluating factors such as visibility and irrigation dynamics, stone fragmentation performance, system durability, infection prevention, and the broader implications for training and resource use. By integrating clinical experience with scientific evidence, this initiative will help identify which advances truly enhance surgical outcomes and which require further validation in real-world settings.This Research Topic will focus on surgical innovation, technique optimization, and outcome-oriented research within endourology, excluding non-surgical or purely diagnostic interventions. Contributions from practicing urologists, surgical innovators, and clinician-scientists are particularly encouraged.To gather further insights into next-generation endourology from a surgical perspective, we welcome articles addressing, but not limited to, the following themes:Practical and clinical comparisons between thulium fiber laser and Ho:YAG laser lithotripsyPerformance and cost-effectiveness of single-use vs. reusable ureteroscopesAdvances and outcomes in miniaturized PCNL techniques (mini-, ultra-mini-, micro-PCNL)Integration of suction-assisted systems (FANS, intelligent pressure control) for improved irrigation and visibilityRobotic and digitally assisted ureteroscopy and PCNLArtificial intelligence applications for intraoperative decision support, stone detection, composition prediction, and personalized procedural planningEnvironmental sustainability and resource utilization in disposable vs. reusable endourological systemsPatient-reported outcomes, recovery metrics, and quality-of-life assessment following endourological interventionsSurgeon ergonomics, surgical learning curves, competency assessment, simulation, and training tools in advanced endourologyPostoperative outcomes, complication reduction, and optimization of operative workflow Topic editors: Senol Tonyali, Hakan Bahadir Haberal, Esteban Emiliani Source: https://www.frontiersin.org/research-topics/80628/next-generation-endourology-in-urolithiasis-technology-techniques-and-outcomes