With the 32nd Annual Meeting of the Urology Association (CUA) about to be held in Dalian, I’m starting over again, revisiting my previous knowledge of urological endoscopy. In all my years of endoscopy, I’ve never seen a single department offer such a wide variety of endoscopes, including optical, electronic, and various specifications. Furthermore, urological endoscopes are rapidly evolving, and domestically, they’re given bold names like “cannonscope” and “aircraft carrier scope.” My initial experience with them was astounding. I’ve previously compiled a list of the appearances and brands of flexible and rigid endoscopes, which serves as a valuable learning experience for my work.
Recently, I have been learning urological endoscopy with a zero-based mentality. I will record it according to the location of the disease. Before learning, I will first understand some basic data.
Data and the number of surgeries required for certain urological conditions
Urology is now divided into upper urinary tract (kidneys and ureters), lower urinary tract (bladder and prostate), and andrology. Furthermore, with an aging population, the incidence of urological diseases is expected to rise. Data source: A study published in Scientific Reports by the Urology Team of the First Affiliated Hospital of Soochow University conducted the first comprehensive analysis of the global burden of BPH (benign prostatic hyperplasia) from 1990 to 2021 based on the GBD 2021 database. A decomposition analysis confirmed that 61% of the global increase in cases was due to population aging, 29% to population growth, and 10% to epidemiological changes.
As of the end of 2024, China’s population aged 60 and above has reached 310.31 million (about 310 million), accounting for 22.0% of the total population; among them, the population aged 65 and above is 220.23 million (about 220 million), accounting for 15.6% of the total population.
Prostate cancer (CA): Ranked first among urinary tract cancers, with an incidence rate of 13.42 per 100,000 people. Based on a city with a population of 5 million, there are 671 new cases annually. According to the 2025 review “Prostate Cancer Epidemiological Trends, Genomic Characteristics, and Future Directions for Optimized Management in China,” approximately 54% of patients in my country have distant metastases at initial diagnosis. Therefore, the number of patients with surgical indications is approximately 671 * 0.46 = 308.
Bladder cancer: The incidence rate is 9.29 per 100,000 people, with an annual new case rate of approximately 465 in a city with a population of 5 million. Based on online data, assuming a 75% NMIBC (Tis, Ta, T1) rate, the annual number of new cases with surgical indications is 348. Laparoscopic renal cancer: The incidence rate is 7.37 per 100,000 people, with an annual new case rate of approximately 368 in a city with a population of 5 million. Based on the pathological characteristics of the “Ten-Year Study on Correlation between Surgical Trends and Clinicopathological Characteristics of Renal Cell Carcinoma” published by Peking University First Hospital, the pT1 stage accounts for 79.6%, resulting in an estimated surgical indication of approximately 293. Laparoscopic benign prostatic hyperplasia (BPH): Based on the above data, by 2024, there will be 310.31 million people in my country aged 60 and over, accounting for 22.03% of the population, of which approximately 48.73% are male (come on, men, you’re not living as long as women). The incidence of BPH in those aged 60 and over is 50%, of which 10% require surgery. The number of people who need BPH treatment in a city with a population of 5 million is: 5 million * 22.03% * 48.73% * 50% * 10% ≈ 26,838 people, which is quite a lot.
Urinary stones: There is no official data available. Based on a 5% incidence rate, 25% require surgical treatment. In a city with a population of 5 million, the annual incidence and treatment is approximately 62,500, which is too much. Of course, this is the upper limit. Extracorporeal lithotripsy, ureteroscopic laser lithotripsy, and percutaneous nephrolithotomy with pneumatic (laser) lithotripsy are used.
From top to bottom by anatomical location
Percutaneous nephrolithotomy
Percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure that creates a channel through the skin to treat kidney stones or lesions. It is primarily used to treat large (>2 cm) or complex kidney stones. Its core advantages lie in minimal trauma, rapid recovery, and high stone-clearance rates. Nephroscopes are becoming increasingly smaller in diameter, with standard channels (24-30 Fr), microchannels (16-22 Fr), and ultrafine channels (<16 Fr). Needle-shaped lithotripsy instruments with diameters around 1.4 mm are now also available. Percutaneous nephrolithotomy is standard equipment in urological lithotripsy centers.
The percutaneous nephroscope has a field of view of 12°, an elliptical sheath, an outer diameter of 8.5 Fr/12 Fr, an effective working length of approximately 250 mm, and a working channel of approximately 6 Fr.
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Post time: Sep-22-2025