European Urology[JOURNAL]

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When the Platform Owns the Procedure: Intellectual Property Rights and Robotic Surgery.

Davies B, Canes D, Trinh QD … +2 more , Simhan J, Kutikov A

Eur Urol · 2026 Jun · PMID 42323242 · Publisher ↗

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The Shifting Geography of Innovation in Endourology.

Scilipoti P, Panthier F, Perri D … +5 more , Goumas IK, Bozzini G, Somani BK, Traxer O, Ventimiglia E

Eur Urol · 2026 Jun · PMID 42321068 · Publisher ↗

The geographic origin of endourological innovation is undergoing a fundamental and measurable transformation. This editorial maps a decisive shift across four domains: suction-integrated ureteroscopy and ureteral access... The geographic origin of endourological innovation is undergoing a fundamental and measurable transformation. This editorial maps a decisive shift across four domains: suction-integrated ureteroscopy and ureteral access sheaths (UASs), single-use flexible ureteroscopes, laser lithotripsy platforms, and robotic flexible ureteroscopy, using four independent indicators: Food and Drug Administration (FDA) regulatory clearances, international patent filings, citation impact, and guideline representation. The turning point for suction-enabled ureteroscopy was 2016, when Well Lead Medical (China) obtained the first FDA 510(k) clearance for a suction-capable UAS, with Chinese manufacturers subsequently dominating new approvals in this category. In single-use ureteroscopy, between 2022 and April 2026, Chinese manufacturers accounted for 47% of FDA 510(k) clearances, matching the USA in absolute count for the first time in the history of the field. In laser lithotripsy, China's share of annual patent filings grew from <10% to >35% between 2015 and 2024. In robotic flexible ureteroscopy, Asian manufacturers are now entering a field previously defined by European and Turkish platforms. Analysis of the EAU Urolithiasis Guidelines 2026 (n = 312 publications, from 2018) reveals that European publications have historically dominated citations (37.8%), followed by Asia (27.9%) and North America (19.2%); strikingly, Asian publications surpassed Europe in annual citation share by 2025, driven by a dramatic rise since 2023. For European and North American stakeholders, the appropriate response is not defensiveness but strategic engagement, through international collaboration, cross-border training, and institutional adaptability, in the shared interest of improving patient care worldwide.

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Re: Transdermal Estradiol Patches in Locally Advanced Prostate Cancer.

Davis ID

Eur Urol · 2026 Jun · PMID 42309924 · Publisher ↗

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Re: Standardizing Time-to-Event Reporting in Single-arm BCG-unresponsive Registration Trials: A Case for Kaplan-Meier.

Zekan D, Correa A

Eur Urol · 2026 Jun · PMID 42309923 · Publisher ↗

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Cystectomy Remains Standard of Care Following Neoadjuvant Therapy in Patients with Muscle-Invasive Bladder Cancer.

Basin MF, Daneshmand S

Eur Urol · 2026 Jun · PMID 42309922 · Publisher ↗

Radical cystectomy remains the standard of care after neoadjuvant therapy for muscle-invasive bladder cancer. While newer regimens (NIAGRA, KEYNOTE-B15/905) achieve impressive pathological complete response rates, the su... Radical cystectomy remains the standard of care after neoadjuvant therapy for muscle-invasive bladder cancer. While newer regimens (NIAGRA, KEYNOTE-B15/905) achieve impressive pathological complete response rates, the survival benefits from these trials were built on consolidative surgery, with a 88% cystectomy rate bladder preservation. Clinical complete response agrees with true pathological complete response only about half the time, meaning current restaging tools cannot reliably identify who is truly disease-free. Bladder preservation trials using systemic therapy alone (RETAIN-1/2, HCRN GU 16-257) have shown concerning rates of recurrence and metastasis even with biomarker selection. Trimodal approaches incorporating radiation (IMMUNOPRESERVE, INDIBLADE) are promising but remain early-phase. Until validated biomarkers and prospective trials prove otherwise, cystectomy should remain part of the curative-intent treatment paradigm.

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Re: Reliability of Urological Telesurgery Compared with Local Surgery: Multicentre randomised controlled trial.

Dasgupta P

Eur Urol · 2026 Jun · PMID 42309921 · Publisher ↗

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Re: Final Overall Survival Results from EORTC 1333/PEACE-3 Trial of Enzalutamide plus Radium-223 in Metastatic Castration-resistant Prostate Cancer.

Francini E

Eur Urol · 2026 Jun · PMID 42303526 · Publisher ↗

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Re: Safety and Efficacy of Tranexamic Acid in Urologic Surgery: Results from the International, Randomized, Placebo-Controlled POISE-3 Trial.

Chen L, Lu W

Eur Urol · 2026 Jun · PMID 42303525 · Publisher ↗

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Re: Neoadjuvant Sacituzumab Govitecan plus Pembrolizumab, Followed by Adjuvant Pembrolizumab, in Patients with Muscle-invasive Bladder Cancer (SURE-02): A Single-arm, Phase 2 Study.

Mertens LS, Mellema JJ, Sridhar S … +1 more , van der Heijden MS

Eur Urol · 2026 Jun · PMID 42303524 · Publisher ↗

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Re: Pembrolizumab in Combination with Gemcitabine and Concurrent Hypofractionated Radiation Therapy as Bladder-sparing Treatment for Muscle-invasive Urothelial Cancer of the Bladder: A Multicenter Phase 2 Trial.

Ma H, Zhou Q

Eur Urol · 2026 Jun · PMID 42303523 · Publisher ↗

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Re: Stereotactic Body Radiation Therapy for Oligoprogressive Disease in Androgen-suppressed Prostate Cancer: Primary Endpoint Analysis of the TRAP Trial.

Yusuf S, Azam A, Sood I … +3 more , Al-Sattar H, Mullassery V, Adeleke S

Eur Urol · 2026 Jun · PMID 42303522 · Publisher ↗

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Re: Aboubacar Kaba, Pratik Kanabur, Jeremie Calais, et al. Performance of [89 Zr]girentuximab PET/CT in Predicting the Presence of Any Renal Malignancy: A Reanalysis of the ZIRCON Trial. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2026.03.003.

Ghoreifi A, Daneshvar M

Eur Urol · 2026 Jun · PMID 42303521 · Publisher ↗

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Radical Prostatectomy in Low-volume Metastatic Prostate Cancer? The Need for New Evidence.

Sooriakumaran P, Bryant RJ, Hamdy FC

Eur Urol · 2026 Jun · PMID 42285837 · Publisher ↗

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What is the Standard Comparator of Minimally Invasive Surgical Therapies (MIST) for Benign Prostatic Obstruction? Medical Versus Surgical Treatment.

Baboudjian M, Nunzio C, Elterman D … +15 more , Creta M, Pyrgidis N, Moris L, Duran MB, Hashim H, Karavitakis M, Malde S, Netsch C, Rieken M, Sakalis V, Schouten N, Tutolo M, Herrmann TR, Cornu JN, European Association of Urology (EAU) Guidelines Panel on Management of Non-neurogenic Male LUTS

Eur Urol · 2026 Jun · PMID 42285836 · Publisher ↗

The choice of comparator critically determines the interpretability and clinical relevance of trials evaluating minimally invasive surgical therapies (MISTs), with sham-controlled studies now considered insufficient for... The choice of comparator critically determines the interpretability and clinical relevance of trials evaluating minimally invasive surgical therapies (MISTs), with sham-controlled studies now considered insufficient for guideline integration. Active comparators, particularly pharmacological therapy and conventional surgery, provide the highest level of evidence, enabling a meaningful positioning of MISTs within the therapeutic algorithm of male lower urinary tract symptoms/benign prostatic obstruction.

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Reply to Alexander Light, Max Peters, Manit Arya, et al's Salvage Focal Therapy vs Radical Prostatectomy for Localized Radiorecurrent Prostate Cancer. JAMA Oncol 2026;12:364-73. https://doi.org/10.1001/jamaoncol.2025.6448.

Covas Moschovas M, Falagario U, Pellegrino F … +2 more , Wiklund P, Patel V

Eur Urol · 2026 Jun · PMID 42276908 · Publisher ↗

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Regulating Innovation: Why the European Union Artificial Intelligence Act Matters for Urologists-Recommendations from the EAU AI Working Group.

Duwe G, Knoll T, Kowalewski KF

Eur Urol · 2026 Jun · PMID 42276907 · Publisher ↗

The key challenge for artificial intelligence (AI) in urology is no longer technical development alone, but safe translation into regulated clinical use. Urologists should use certified, indication-specific AI systems, a... The key challenge for artificial intelligence (AI) in urology is no longer technical development alone, but safe translation into regulated clinical use. Urologists should use certified, indication-specific AI systems, avoid informal grey-zone adoption, and demand clinically workable regulatory pathways.

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Re: Brian F. Chapin, Marc Smaldone, Amado J. Zurita, et al. A Phase 2, Randomized, Controlled Trial of Best Systemic Therapy versus Best Systemic Therapy with Definitive Treatment of the Primary Tumor in Metastatic Prostate Cancer. Eur Urol. In Press. http://dx.doi.org/10.1016/j.eururo.2026.02.011.

Froehner M

Eur Urol · 2026 Jun · PMID 42265042 · Publisher ↗

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Safety, Hemostasis, and Surgical Precision: Reconsidering Tranexamic Acid in Contemporary Urologic Surgery.

Akinsola O, Psutka SP

Eur Urol · 2026 Jun · PMID 42265041 · Publisher ↗

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A Multidisciplinary Approach to Prevention and Treatment of Late Genitourinary Adverse Events After Radiotherapy for Prostate Cancer.

Kishan AU, Francolini G, Murphy DG … +5 more , Eapen RS, Sargos P, Marvaso G, Ost P, Vapiwala N

Eur Urol · 2026 Jun · PMID 42251000 · Publisher ↗

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Corrigendum to "Systematic review and pooled analysis of functional and sexual outcomes of minimally invasive surgical treatments for benign prostatic obstruction" [Eur. Urol. 89 (2026) 318-331].

Franco A, Ditonno F, Manfredi C … +16 more , Bologna E, Licari LC, Orecchia L, Agró EF, Antonelli A, Arlandis S, Autorino R, Tarcan T, Cornu JN, Elterman D, Kaplan S, Lombardo R, McVary K, Secco S, Cindolo L, Nunzio C

Eur Urol · 2026 Jun · PMID 42236391 · Publisher ↗

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European Urology[JOURNAL]

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