Clinical Integration of Artificial Intelligence in Urology with a Focus on Temporal Deep Neural Networks for Emphysematous Pyelonephritis| Chapter 3 | Newer Frontiers in Urology, Volume III

 

Artificial intelligence (AI) is transforming urology by facilitating quick, data-driven analysis in diagnosis and treatment. This chapter explores core AI concepts and their applications in urological conditions like kidney stones, bladder cancer, prostate cancer, and benign prostatic hyperplasia (BPH). Examples of models (such as convolutional neural networks and support vector machines) used in urology are used to teach general AI approaches (machine learning and deep learning). Automated MRI prostate cancer diagnosis (AUC ~0.96), ureteroscopic stone identification (CNN ~90% accuracy), and bladder tumour segmentation are significant achievements.

 

Additionally, the chapter highlights issues with dataset heterogeneity, sample size, and selection bias while briefly discussing the types of datasets used in AI-driven urology research, including imaging, clinical, and longitudinal data. A case study of an emerging multi-task deep neural network (t-MTDNN) for the prediction of emphysematous pyelonephritis (EPN) is included. Feature descriptions (SHAP) are provided for the t-MTDNN architecture and workflow, and its clinical impact and performance metrics are analysed.

 

In conclusion, the strengths and challenges of AI models are compared (Table 1) and prospective opportunities in AI-assisted urology are described with an emphasis on the therapeutic advantages (improved accuracy, efficiency) and limitations (data requirements, interpretability). Instead of replacing clinical judgement, urologists and healthcare organisations view AI as a clinical decision-support tool that can enhance workflow efficiency, support hospital-level adoption through interdisciplinary collaboration, and augment physician expertise.

 

 

Author(s) Details

Roshan Reddy
Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research Chennai, India.

 

Rajan Ravichandran
Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research Chennai, India.

 

Vivek Meyyappan
Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research Chennai, India.

 

Velmurugan Palaniyandi
Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research Chennai, India.

 

Hariharasudhan Sekar
Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research Chennai, India.

 

Sriram Krishnamoorthy
Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research Chennai, India.

 

 

Please see the book here :- https://doi.org/10.9734/bpi/mono/978-93-47485-93-0/CH3

Massive Pneumoureter and Pneumobladder in the Context of Emphysematous Pyelitis | Chapter 11 | Achievements and Challenges of Medicine and Medical Science Vol. 6

Emphysematous urinary tract infections are necrotising infections caused by gas-forming uropathogens. High levels of glucose in the tissue act as a substrate for bacteria such as E.coli (>50%), Klebsiella(21%) and Proteus spp. which in turn ferment the sugars to produce carbon dioxide. Emphysematous pyelitis refers to the collection of gas in the renal collecting system. Although gas is encountered in the pelvicalyceal system, it is quite rare to find a massive accumulation of gas in the ureter and urinary bladder. This is an interesting case of a middle-aged diabetic male who presented with flank pain and lower urinary tract symptoms and his evaluation revealed a massive right pneumo-ureter and pneumo-bladder. Prompt evaluation with computed tomography and early intervention in the form of DJ stenting and catheterisation helped to resolve the massive air pockets in the ureter and the bladder.

 

Author (s) Details

 

Santosh Patil
Department of Urology, BLDE (Deemed to be University) Shri B M Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India.

 

Vinay S. Kundargi
Department of Urology, BLDE (Deemed to be University) Shri B M Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India.

 

Siddanagouda B. Patil
Department of Urology, BLDE (Deemed to be University) Shri B M Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India.

 

Manoj K. Vaidya
Department of Urology, BLDE (Deemed to be University) Shri B M Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v6/3432

Obstructive Uropathy, Uncontrolled Diabetes and Emphysematous Pyelonephritis: A High-Risk Combination Requiring Intervention | Chapter 5 | Newer Frontiers in Urology

Gas-forming organisms induce an acute kidney infection that results in parenchymal damage, which is known as emphysematous pyelonephritis. Renal function will be severely affected if it is not identified or treated. Even while the majority of patients have a very bad prognosis, things grow even worse if there is an active infection or urinary tract obstruction. The prognosis is further altered by fungal septicemia and uncontrolled blood sugar levels. In this case study, the case of a middle-aged man who arrived in the ER with extremely elevated blood sugar, altered sensorium, high temperature, chills, and rigidity, was described. Upon evaluation using an abdominal computed tomography, a 2 cm calculus was found at the uretero-pelvic junction blocking the drainage from the right kidney with class 3b emphysematous pyelonephritis extending to perinephric space and psoas sheath. Numerous studies have reported different prognostic markers and risk stratification methodologies that decide the patient's outcome. As a patient in the intermediate risk group, the patient required immediate glycemic management, correction of the acid-base imbalance, urgent stone disimpaction, and pelvicalyceal system decompression with percutaneous draining of the psoas and perinephric collections. This case study demonstrates how patients with gas-forming kidney infections can die from both blockage and uncontrolled blood sugar levels. To preserve the kidney and save the patient's life, there is a need to be vigilant, and well aware of this deadly combination, and make sure that a timely diagnosis is made, and the patient is prioritized appropriately.

 

Author (s) Details

 

Subash Kaushik TG
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

Nakul Aher
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Velmurugan Palaniyandi
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Hariharasudhan Sekar
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Sriram Krishnamoorthy
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mono/978-93-49238-86-2/CH5

Cutting-Edge Approaches to Emphysematous Pyelonephritis: Diagnosis, Management, and Future Directions | Chapter 3 | Newer Frontiers in Urology

Introduction: Emphysematous Pyelonephritis (EPN) is a life-threatening infection characterized by gas formation within renal tissues, often associated with diabetes and immunocompromised states. Mortality rates were previously high, but advances in imaging, diagnosis, and treatment have improved outcomes.

Aim: This study aims to review recent advancements in EPN management, from early diagnosis to current therapeutic approaches, while identifying areas for future research and innovation.

Results: EPN is predominantly diagnosed in diabetic patients and those with urinary obstruction. Key pathogens include Escherichia coli and Klebsiella pneumoniae. Imaging, especially CT scan (Computed tomography), plays a critical role in classifying and managing EPN, with minimally invasive techniques such as percutaneous drainage emerging as effective interventions. Medical management, including strict glycaemic control and targeted antibiotics, has reduced the need for nephrectomy in lower-grade EPN cases.

Conclusion: Advances in EPN management—diagnostic imaging, minimally invasive interventions, and improved medical therapy—have decreased mortality and morbidity. Future directions include predictive analytics for early diagnosis and novel antibiotics for resistant pathogens.

 

Author (s) Details

 

Arvind Ramachandran
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Benjith Daniel F
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Velmurugan Palaniyandi
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Hariharasudhan Sekar
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

Sriram Krishnamoorthy
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/mono/978-93-49238-86-2/CH3