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2025 World Congress of Endourology and Uro-Technology (WCET) Annual Meeting
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| Analysis of Genetic Testing in Kidney Stone Disease: A Single-Institutional Analysis
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| Anne Roberts, BS
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| This single-institution analysis of 336 high-risk kidney stone patients found that genetic testing identified pathogenic mutations in 15% and revealed a new monogenic diagnosis in 6.8%. Predictors of positive genetic findings included diabetes, CKD, early-onset disease, bilateral stones, and nephrocalcinosis. The study supports incorporating genetic testing and counseling into the management of select high-risk stone formers to improve diagnosis and guide care.
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| The Effect of Decreasing Urinary Uric Acid Concentration on Urinary Crystal Dissolution: The Crucial Role of Alkalinization
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| David Lifshitz, PhD
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| David Lifshitz’s WCET 2025 study showed that lowering urinary uric acid concentration only enhances uric acid stone dissolution when urine pH is above 6.5, with maximal benefit at pH 7.2 and significantly reduced UA levels. This highlights alkalinization as the critical first step for stone dissolution, with UA reduction providing added benefit only in higher pH environments. Clinically, these findings support prioritizing alkalinization therapy, such as Urocit-K, before or alongside other interventions in appropriately selected patients.
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| Diabetic Medications and the Potential for Stone Prevention?
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| Bejamin Canales, MD
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| Benjamin Canales reviews antidiabetic drugs for kidney stone prevention. Pioglitazone showed minimal benefit with increased stone risk, and SGLT2 inhibitors offered only modest, transient reductions in stone risk, not enough for routine use. The most promising results came from phentermine/topiramate, which significantly reduced stone volume and body weight, though long-term safety and risks of shifting toward calcium phosphate stones require further study.
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| Future Perspectives of Artificial Intelligence in Urology
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| Andrew Hung, MD
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| Andrew Hung’s WCET 2025 lecture highlighted how AI is transforming urology by enhancing—not replacing—surgical performance. He showcased applications ranging from gesture-based analysis that predicts erectile function recovery with 85% accuracy, to breakthroughs in image segmentation, augmented reality navigation, and even early demonstrations of autonomous robotic surgery. He concluded by stressing that the next challenge is proving AI’s real-world value for patients in the operating room.
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| Comparing Performance of Automated and Semi-Automated Methods for Measuring Kidney Stone Volumes: Does A.I. Outperform Clinician Annotation?
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| Jackson Cabo, MD
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| Jackson Cabo presented a study comparing AI-based, semi-automated (SA), and manual linear methods for measuring kidney stone burden. AI showed near-perfect agreement with SA measurements and offered a faster, scalable approach, especially useful for larger stones. However, cumulative stone diameter remained the strongest predictor of stone-free outcomes after ureteroscopy, suggesting AI is best suited for research and large datasets, while linear measures remain more clinically practical for patient counseling.
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| The Development of a Computer Vision Model for Predicting Stone Free-Status from Ureteroscopy Videos and Its Evaluation Against Surgeons
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| Kimberly Maciolek, MD
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| Kimberly Maciolek presented a computer vision approach to predict stone-free status from ureteroscopy videos, comparing three models against postoperative CT results and surgeons’ assessments. The transformer model performed best, achieving similar predictive accuracy to seven board-certified urologists. While promising, the model remains preliminary, requiring more high-quality data before clinical application.
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| A Transurethral Robotic Platform: Challenging the Status Quo
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| Jeremy Teoh, MD
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| Jeremy Teoh’s WCET 2025 lecture introduced the Virtuoso Transurethral Robotic Platform as a potential breakthrough in bladder cancer surgery. In the first-in-human trial of six patients, the system enabled precise en bloc resections with 100% technical success, negative margins, and no major complications, earning FDA Breakthrough Device designation. Beyond bladder tumors, the platform shows promise for broader transurethral urologic procedures, positioning it as a disruptive advance in minimally invasive surgery.
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| Empowering Patients Through Augmented Reality: Enhancing Understanding and Confidence in Renal Mass Imaging
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| Aryan Shah
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| Aryan Shah and colleagues demonstrated that augmented reality (AR) can improve patient understanding of renal mass imaging by converting CT scans into interactive 3D models. In a 20-patient study, AR significantly enhanced comprehension of lesion size, location, and treatment options without increasing anxiety, and most patients reported greater confidence and satisfaction. The team concluded AR may strengthen patient-centered care, with future applications planned for prostate imaging and renal stone evaluation.
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| No Difference in Renal Mass Growth on Immunosuppression
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| Declan Carr, BS
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| A Mayo Clinic study presented at WCET 2025 found no significant difference in renal mass growth rates before versus after initiation of immunosuppression in solid organ transplant recipients. With no cases of metastatic progression or RCC-specific mortality observed, the findings support active surveillance as a safe option in carefully selected immunosuppressed patients. These results may also have implications for managing other cancers in transplant populations.
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| The Evolving World of the Microbiome
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| Kait Al, Phd
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| Kait F. Al’s WCET 2025 lecture highlighted the growing importance of the urinary microbiome, once thought sterile, in conditions such as UTIs, incontinence, bladder cancer, kidney stones, and transplant rejection. She emphasized the distinct microbial patterns between men and women, the protective role of lactobacilli, and the impact of microbiome disruptions on disease risk. Looking ahead, strategies like probiotics, phage therapy, and even urinary microbiome transplants hold promise for prevention and treatment, supported by the field’s rapid shift toward interventional research.
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| Combining Prostate Cancer Vaccine with Immune Checkpoint inhibition Synergizes to Eliminate Prostate Cancer
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| Gabriel Leonardo Carreno Galeano, MD
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| Preclinical data from the University of Louisville show that combining a bivalent adenoviral prostate cancer vaccine (Ad-PS2) with anti-CTLA4 immune checkpoint inhibition leads to complete tumor regression and durable immune memory in mouse models of prostate cancer. Unlike anti-PD1 approaches, this combination induced robust CD8+ T-cell infiltration and long-term tumor resistance without added toxicity.
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