Minimally invasive technologies are reshaping urologic care and redefining device opportunities. Interventional urology continues to evolve rapidly as new technologies, disposable devices, and data-driven systems converge with shifting clinical practice patterns. Driven by rising disease prevalence, growing outpatient adoption, and a transition to value-based care, interventional urology in 2025 was characterized by capital equipment innovations, recurring disposable device utilization, and digital integration—all creating fertile ground for medtech and diagnostics manufacturers.

Why This Is Important

Disease burden and clinical need are high. Urologic disease represents a significant and expanding clinical and economic burden in the U.S. (Table 1).

These burdens have translated into millions of patient encounters and procedures, many which are now addressed using interventional approaches rather than traditional surgery.

Shifting Paradigms in BPH Management

Transurethral resection of the prostate (TURP) historically dominated surgical benign prostatic hyperplasia (BPH) care, but contemporary practice shows significant uptake of minimally invasive surgical therapies (Table 2).

Several published analyses suggest that ~40% to 50% of contemporary BPH procedures are now performed via minimally invasive surgical therapies, driven by outpatient settings, patient preference, and favorable recovery profiles.¹ The implications for medical devices are that robust demand exists and will continue for disposable implants, ablation catheters, and image-guided delivery systems, creating a recurring-revenue tail for interventional companies.

Urolithiasis: Technology Innovation Drives Procedure Growth

The economic and clinical burden of kidney stones continues to increase, with higher recurrence and presentations. 

• >1 million emergency department visits annually for stone disease²
• Ureteroscopy (URS) is now the dominant intervention modality, with volumes outpacing shock wave lithotripsy (SWL) 

Flexible URS continues to grow due to superior efficacy and expanded indications. The adoption of single-use disposable ureteroscopes has been spurred by reducing infection risk and maintenance costs (Table 3).

Oncology: Precision and Image-Guided Interventions

Interventional urology intersects oncology, particularly in renal and bladder cancers.

Renal Mass Ablation

Ablative technologies such as cryoablation, radiofrequency, and microwave ablation are increasingly used for small renal masses—particularly in elderly or comorbid patients. Clinical studies report comparable oncologic control for tumors <4 cm with lower morbidity than surgery.⁴

Bladder and Prostate Cancer

• Enhanced cystoscopy (e.g., blue-light and narrow-band imaging) improves early detection.
• Focal therapy approaches (e.g., HIFU, cryotherapy) are growing.
• Robotic platforms continue to dominate radical prostatectomy.

These domains present opportunities for image-guided devices, optical diagnostics, and targeted ablation tools.

Site-of-Care/Payment Shifts Drive Growth 

A major trend in interventional urology is the shift of procedures from inpatient hospital settings to outpatient hospital departments (HOPDs), office-based labs (OBLs), and ambulatory surgery centers (ASCs). This yields lower costs and shorter recovery times, and supports increased procedural throughput.

Beyond shifting to new sites of care, the reimbursement landscape has largely remained unchanged. Most interventional procedures are still procedure-based reimbursements (CPT/DRG driven). Payers increasingly evaluate repeat interventions, patient quality metrics, and outcomes. Devices must demonstrate value, not just safety and efficacy, to be essential for adoption.

Emerging Technologies and Digital Integration

Despite its image as a primarily procedural specialty, urology is rapidly integrating data and imaging analytics such as AI-assisted endoscopy interpretation (e.g., polyp/lesion detectors), integrated procedural planning and navigation platforms, remote monitoring and telehealth follow-ups, and procedure outcome analytics. Medical device developers are now bundling capital systems, disposables, and software subscriptions that are increasingly reminiscent of SaaS-like models tailored to procedure volume and service needs.

Minimally invasive and disposable-enabled procedures continue to grow as a share of total intervention volume (Table 4).

Commercial and Competitive Implications

For medical device manufacturers and diagnostic innovators, interventional urology represents a multi-segment opportunity. In capital equipment, advanced imaging platforms, high-resolution endoscopic systems, and integrated fluoroscopy/ultrasound remain unmet needs rewarded by adoption. In single-use devices, ureteroscopes (single-use and reusable), ablation catheters (laser, radiofrequency, water vapor), embolic materials, and stone retrieval baskets and access sheaths are high-volume-use devices.

Digital Innovations are in demand, such as AI-driven lesion detection, navigation and planning software, procedure outcome tracking, and telehealth and remote monitoring tools. The clinical shift toward outpatient, minimally invasive interventions reduce barriers to adoption and accelerate throughput, increasing demand for disposable-heavy models.

The Medi-Vantage Perspective

Interventional urology is positioned for further expansion, with several underpinning forces. Aging populations with increased urologic disease prevalence will continue to grow over the next 30 years. Expect broader adoption of AI and procedure analytics in parallel with the technological maturation of disposable devices and robotics. Also, continued outpatient site-of-service migration may yield new unmet needs. Have you looked for them? For medical device companies, the opportunity lies not just in hardware or single products, but in creating ecosystems that link capital, disposables, and data, aligning with clinician workflows, payer priorities, and long-term care cost reduction.

References
¹ tinyurl.com/mpo260101
² tinyurl.com/mpo260102
³ Medicare claims volume analyses (AUA Census) 
⁴ National registry data (NCDR, PVI Registry) and published cohort reports on stone disease and minimally invasive procedures. Kutikov A, Uzzo RG. Small renal masses: management options. Urol Clin North Am., American Cancer Society. Cancer Facts & Figures 2024.

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Maria Shepherd has more than 20 years of experience in marketing in small startups and top-tier companies. She founded Medi-Vantage, which provides marketing and business strategy for the medtech industry. She can be reached at mshepherd@medi-vantage.com. Visit her website at www.medi-vantage.com.