Artificial Intelligence Is Transforming Urology

Innovations in Urology | Spring 2026

Data. We are awash in it. The volume of data available in just the healthcare sector alone is overwhelming. According to a January 2024 report by the World Economic Forum, nearly 30 percent of the world’s data arises from healthcare and an estimated 97 percent of all global data produced annually by hospitals goes unused.

Spyridon Basourakos, MD

Jonathan Shoag, MD

Buried in all this data are opportunities for urologists to provide faster, better diagnoses; more precise, individualized treatments; and the freedom for providers to focus on what they do best: care for patients. Given concerning trends in the urology field – decreasing numbers of urologists in private practice, declining urologist-to-population ratios, and the fact that more than 60 percent of U.S. counties do not have a practicing urologist –  means the time is right to right to capitalize on the use of Artificial Intelligence (AI) where it makes sense.

Furthermore, AI is transforming data generation and extraction, moving technology out of the IT realm and into the hands of clinicians and researchers who can use it to deliver better outcomes for point-of-care medical decision making and quality improvement over time.

Simplification and Improved Efficiency

“One of the biggest limitations of clinical research is acquiring primary patient information from charts and other sources, such as imaging results,” says Spyridon Basourakos, MD, a urologist with the University Hospitals Urology Institute. “Historically, we’ve used residents, medical students or outsourced resources to create databases with relevant variables and to extract the specific data we need. It’s painfully time consuming and carries the potential for errors.”

Part of the problem is that the format of healthcare data varies widely, and data systems were not initially designed to communicate with each other. For example, pathology are structured (have standard fields), but a provider’s notes are not, explains Jonathan Shoag, MD, a urologist with the UH Urology Institute and Director, Prostate Cancer Program, UH Cleveland Medical Center. Both structured and unstructured data are necessary for making medical decisions.

“Even if we could extract data from structured reports using an algorithm, there was still an expectation that we still conduct a manual review to check for errors,” Dr. Shoag says. “This has been the historical standard for a very long time. AI allows us to have data available immediately, versus months, maybe even years. If we determine AI is 100 percent accurate –  and this is likely to be true in the near future –  we won’t need a manual review. So, in theory, we can make very large datasets that are automatically curated and that can be reliably used by AI.”

Meaningful Integration

“At UH, we’re in the process of building tools for our own internal use to track outcomes and patients and, ultimately, for quality improvement, which is a tremendously valuable place for us to utilize AI,” Dr. Shoag says. “As a quality improvement initiative, it’s also important to have this live data extraction for use in research as well, eliminating the time-consuming step of creating reliable databases, particularly in the cancer realm.”

Real-time Decision Making

One area in which the UH Urology Institute has incorporated AI into patient care is prostate cancer.

Leonardo Kayat Bittencourt, MD, PhD, Vice Chair of Innovation at University Hospitals, oversees the AI Radiology Center in the UH Urology Institute and has received major funding to use AI on MRI Fingerprinting to better treat prostate cancers with more reliability and less variability. AI allows clinicians to stratify men with prostate cancer based on quantified risk, reducing the concern of overtreatment and identifying opportunities for targeted therapies based on individual tumor characteristics.

More than Just Data Extraction

In some cases, AI is also generating data.

“At UH we're piloting AI scribes to write notes and to then see if other tools can extract that information and use it for quality improvement and research,” Dr. Shoag says. “Ultimately, that’s probably what will happen. We’ll have ‘and-then’ ability to go from start to finish where all the data is used for all possible purposes.”

Dr. Basourakos says AI ultimately will make it easier to quickly create databases that have all the data needed, including any variable or any outcome, in a very organized fashion, and in a method to facilitate processing and analyzing data at a granular level.

“More accurate data means better research, higher quality information regarding diseases and better information to individual patients about their treatment options and potential outcomes,” he says.

Drs. Basourakos and Shoag published an editorial discussing their work in the NEJM in May 2025.

For more information, call Dr. Basourakos at 440-827-2765.

Contributing Experts:
Spyridon Basourakos, MD
Urologist
University Hospitals Urology Institute
University Hospitals Cleveland Medical Center
Assistant Professor
Case Western Reserve University School of Medicine

Jonathan Shoag, MD
Urologist
University Hospitals Urology Institute
Director, Prostate Cancer Program
University Hospitals Cleveland Medical Center
Associate Professor
Case Western Reserve University School of Medicine