It is not surprising that the leaders in our field have left their mark by developing many of the technologic innovations that we use today. There are a number of technologies on the horizon that have the potential to further change our field. In our text some of the technologies that we have mentioned such as histotripsy, nanotechnology and tissue bioengineering are still early in their evolution.

Advances in radiology and imaging continue to have a significant impact on our field. The move towards decreased radiation exposure has led us to low dose computed tomography [1, 2]. Image fusion technology has already begun to make its mark in our field as we have begun to utilize MRI-fusion prostate biopsies for improved detection of prostate cancer in patients with an initial negative biopsy [3–5]. Image-augmented intraoperative navigation technology is in the process of being utilized for a number of applications in urology from marker based endoscopic tracking during robotic radical prostatectomy and partial nephrectomy to puncture of the collecting system for percutaneous renal access [6–8].

Three-dimensional (3-D) printing, used to create 3-D objects from computer-aided design (CAD) , has found utility in the creation of models for surgical education and training, and has been used in the creation of ureteral stents customized to fit the size of a patient’s ureter. While 3-D printing holds much promise for personalized healthcare it is still in its infancy [9, 10]. 3-D printing is also being applied in the printing of living tissues (bioprinting) for tissue and organ bioengineering. The future hope of bioprinting is that it can be used in the construction of functional solid organs. However, bioprinting is still in its early stages of development. Many challenges will still need to be overcome and much testing done, before it can be used in urology patients [9].

Further advances in robotics have led to more widespread application for robotic technologies for other surgical procedures. The flexible Sensai^® robotic catheter system (Hansen Medical System, Mountain View, CA), initially used for cardiac and vascular procedures, has been applied for robotic flexible ureteroscopy [11, 12]. The Avicenna Roboflex™, a robotic external manipulator that can be used to stabilize any commercially available flexible ureteroscope, has been used clinically to perform flexible ureteroscopy where the surgeon manipulates the ureteroscope using a joystick at a console [13]. Robotic ultrasound and needle guidance for prostate biopsy as well as an MRI-safe robot has also been developed for targeted transrectal prostate biopsy [14, 15].