Background: Undifferentiated pleomorphic sarcoma (UPS) of the prostate is an extremely rare and malignant tumour, accounting for only 0.1%–0.24% of all prostate neoplasms. Reclassified as a malignant fibrous histiocytoma by the World Health Organization in 2002, UPS predominantly affects men aged 50–70 years. Diagnosis is difficult due to nonspecific symptoms, such as acute urinary retention (AUR) and haematuria, along with normal prostate-specific antigen levels, which often lead to confusion with benign prostatic hyperplasia.

Methods: This case report discusses the clinical presentation, diagnostic process and management of an 82-year-old man who presented with AUR. Imaging studies, such as transrectal ultrasound, computed tomography and magnetic resonance imaging, were used to evaluate the tumour. Histological examination and immunostaining were performed after transurethral resection to confirm the diagnosis of UPS.

Results: The images revealed a large, irregular, invasive tumour within the prostate, leading to a radical cystoprostatectomy. Histological analysis showed atypical spindle cells and positive immunostaining for histiocytic markers, such as vimentin and CD68 (a marker of monocyte/macrophage lineage), confirming the diagnosis of UPS. Surgical margins were negative, and no residual disease was detected in the postoperative period.

Conclusions: The rarity of prostatic UPS underscores the ongoing debate about its optimal management. This case contributes to the limited literature on prostatic UPS, highlighting the importance of early detection and complete surgical removal to improve prognosis. More research is needed to establish a consensus on adjuvant therapies.

Aims: The quality of life for patients with advanced cancer declines, tending to deteriorate further as they approach the end of their lives. This retrospective study aimed to evaluate the potential benefits of incorporating early palliative care into routine care for patients with advanced or metastatic bladder cancer.

Methods: A total of 97 patients with advanced or metastatic bladder cancer from January 2022 to May 2024 were included. Amongst them, 46 received routine treatment and early palliative care (observation group) and 51 received routine treatment only (control group). Assessments using Functional Assessment of Cancer Therapy-General (FACT-G), Brief Pain Inventory (BPI), Cancer Fatigue Scale (CFS), Hospital Anxiety and Depression Scale (HADS) and Family Satisfaction with Advanced Cancer Care-2 (FAMCARE-2) were conducted before and at 3 and 6 months after initiating early palliative care. Generalized estimating equation analysis was used for statistical analysis.

Results: The indicators in the observation group showed improvement within 6 months after initiating early palliative care. Notably, the quality of life in the observation group significantly improved over this period (p = 0.013), whereas changes in pain scores were not statistically significant in either group (p > 0.05). The level of fatigue in the observation group decreased to its lowest point at 6 months (p = 0.001), whereas changes in fatigue levels in the control group were not significant (p > 0.05). Compared with the control group, the observation group experienced a significant reduction in depression and anxiety levels within 6 months (p < 0.001). The nursing satisfaction in the observation group increased over time, with statistical significance (p = 0.006). Notably, significant interaction effects were observed between time and group, particularly in fatigue and psychological distress.

Conclusions: Early palliative care improves quality of life and reduces fatigue and psychological distress in patients within 6 months, without notable changes in pain scores. Integration of early palliative care into routine management is recommended to enhance patient well-being and satisfaction.

Background: Glucose metabolism plays a critical role in the development and progression of kidney renal clear cell carcinoma (KIRC). This study aimed to identify glucose metabolism-related biomarkers (GRBs) and therapeutic targets for KIRC diagnosis and prognosis using bioinformatics and machine learning.

Methods: Gene expression data from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases, along with glucose metabolism-related genes from multiple sources, were analyzed. Differentially co-expressed glucose metabolism-related genes (DCGLGs) were identified through differential expression analysis and weighted gene co-expression network analysis. Functional enrichment analysis and protein-protein interaction network construction were performed on the DCGLGs. Machine learning algorithms identified GRBs, evaluated for diagnostic value via receiver operating characteristic (ROC) curve analysis. Further analyses included enrichment, immune infiltration, drug sensitivity, clustering, and Kaplan–Meier survival analysis of GRBs.

Results: Among 884 glucose metabolism-related genes, 39 DCGLGs were identified. Ten GRBs were highlighted, all exhibiting high diagnostic value (area under the ROC curve (AUC) >0.85). GRBs were linked to immune cell infiltration, including endothelial cells and CD4+ T cells. Drug sensitivity analysis revealed significant correlations between Phosphofructokinase platelet (PFKP) and multiple chemotherapeutic agents. Clustering based on GRBs stratified patients into two clusters, with cluster 2 showing poorer prognosis. Kaplan–Meier survival analysis validated the prognostic significance of GRBs.

Conclusions: GRBs, including PFKP, pyruvate dehydrogenase kinase 1 (PDK1), and solute carrier family 2 member 1 (SLC2A1), demonstrated strong diagnostic and prognostic potential. PFKP emerged as a key therapeutic target, offering novel insights into predictive and treatment strategies for KIRC.

Background: Transrectal ultrasound (TRUS) is a non-invasive and accurate imaging technique that plays a crucial role in evaluating the progression and pathological changes of benign prostatic hyperplasia (BPH). This study aimed to explore the relationship between TRUS parameters and BPH clinical progression, as well as the indications for invasive treatment, to provide more evidence for clinical decision making.

Methods: This retrospective study included 648 BPH patients diagnosed and treated in our hospital between January 2021 and October 2023. All patients underwent TRUS, and parameters including prostate volume (PV), transition zone volume (TZV), transition zone index (TZI), and intravesical prostatic protrusion (IPP) were recorded. Patients were followed for 1 year, and data on clinical progression and invasive treatment were collected. Univariate and multivariate regression analyses were performed to evaluate the predictive value of TRUS parameters for clinical progression and treatment selection.

Results: A total of 648 patients were included. During the 1-year follow-up, 75 patients experienced clinical progression, and 30 patients underwent invasive treatment. Univariate regression analysis revealed that TRUS parameters such as PV, TZV, and IPP were significantly associated with clinical progression and invasive treatment (p < 0.05). Multivariate regression analysis indicated that PV, TZV, and IPP were independent predictors of clinical progression, with an odds ratio (OR) of 1.114 (95% CI: 1.079–1.150) for PV, 1.062 (95% CI: 1.032–1.093) for TZV, and 1.427 (95% CI: 1.241–1.640) for IPP. Similarly, PV, TZV, and IPP were independent predictors for the occurrence of invasive treatment, with an OR of 1.064 (95% CI: 1.037–1.091) for PV, 1.030 (95% CI: 1.018–1.042) for TZV, and 1.135 (95% CI: 1.015–1.269) for IPP.

Conclusions: TRUS parameters can effectively predict the clinical progression and need for invasive treatment in BPH patients. Clinicians can use these parameters to develop more accurate and personalised treatment plans for patients.

Background: Postpartum urinary retention (PUR) poses a risk of uterine contraction issues and postpartum vaginal bleeding. This research sought to examine the factors associated with PUR in primiparous women.

Methods: This study was case-control one involving all first-time mothers in our hospital between June 2022 and June 2024. The study cohort comprised 338 mothers with PUR, whereas the control cohort included 338 mothers without PUR. By conducting univariate analysis and logistic regression analyses, we identified the independent factors contributing to PUR in primiparous women. The discriminative ability of each risk factor, individually and in combination, in predicting the occurrence of PUR amongst first-time mothers was assessed through the receiver operating characteristic (ROC) curve and the area under the curve (AUC).

Results: Univariate analysis results displayed notable variances between the observation and control groups concerning the percentage of patients receiving labour analgesia, the duration of the second stage of labour, the incidence of episiotomy, the utilization of forceps delivery, the occurrence of manual rotation of the foetal head, average self-rating anxiety scale (SAS) score, and numeric rating scale (NRS) score (p < 0.05). Logistic regression analysis unveiled that labour analgesia (OR (95% confidence interval (CI)) = 1.528 (1.070–2.317)), prolonged second stage of labour (OR (95% CI) = 1.022 (1.009–1.034)), undergoing episiotomy (OR (95% CI) = 1.609 (1.313–1.803)), using forceps delivery (OR (95% CI) = 1.499 (1.182–2.718)), and higher NRS scores (OR (95% CI) = 1.387 (1.181–2.201)) all emerged as significant independent risk factors for PUR in primiparas. ROC analysis demonstrated that the AUC for the individual and combined predictive capacities of factors for predicting PUR in primiparas were 0.583, 0.607, 0.574, 0.558, 0.571, and 0.896. The combined prediction method had notably superior efficacy compared with the individual prediction using each factor.

Conclusions: The risk of PUR in primiparas is closely associated with the receipt of labour analgesia, a prolonged second stage of labour, episiotomy, the use of forceps delivery, and higher NRS scores. For primiparas with the above high-risk factors, early intervention during pregnancy and the perinatal period should be considered to reduce the incidence of PUR.

Background: Kidney stones are a prevalent urological issue globally, with risk factors like obesity, hypertension and metabolic disorders driving an increase in incidence rates. Metabolic syndrome (MetS), characterised by hypertension, obesity, hyperglycaemia and dyslipidaemia, has been increasingly linked to nephrolithiasis. This study investigates the association between metabolic syndrome and nephrolithiasis risk in a large Chinese cohort.

Methods: A cohort of 36,811 adults who underwent health screenings from 2018 to 2023 was analysed. Cox proportional hazards models assessed the influence of MetS and its components on nephrolithiasis risk. Stratified analyses examined variations by gender, age and renal function (glomerular filtration rate). Incidence density was calculated per 1000 person-years across follow-up.

Results: During 93,966 person-years of follow-up, 573 participants developed kidney stones, with a higher incidence in males. Individuals with MetS had a 60.5% increased nephrolithiasis risk (hazard ratio = 1.61). Obesity and hypertension were identified as significant risk factors, whereas hyperglycaemia and dyslipidaemia showed no clear association. Higher glomerular filtration rate, older age and male gender were correlated with increased risk amongst those with MetS.

Conclusions: MetS, obesity and hypertension are independent predictors of nephrolithiasis, particularly in males. The findings underscore the importance of targeted interventions to reduce kidney stone incidence in populations with high MetS prevalence, highlighting public health benefits in addressing modifiable metabolic risks.

Background: Drug-related problems (DRPs) are prevalent among older cancer patients. This study aimed to investigate the impact of pharmaceutical services on DRP, disease knowledge, health-related quality of life, and satisfaction among older patients with prostate cancer (PCa).

Methods: The clinical data of 86 elderly patients with PCa admitted during June 2021–June 2024 were retrospectively analyzed. Descriptive statistics and univariate analysis were used to evaluate the effectiveness of the clinical application of the pharmacy service carried out in our hospital, including the incidence of DRP, knowledge of disease, health-related quality of life score, and satisfaction. The general content of pharmaceutical services is as follows: Arrange hospital pharmacists to directly participate in patient treatment, conduct drug reviews, identify DRPs, and discuss with prescribing doctors based on problems to optimize medication plans. At the same time, it provides disease knowledge education, medication consultation, and primary care guidance.

Results: At admission, 55 patients (63.95%) had DRP, with the most common classification being drug selection, with an incidence rate of 36.36% (20/55). At discharge, the proportion of DRP in patients receiving pharmaceutical services was lower than that in patients refusing pharmaceutical services, and the DRP status was better than that of patients refusing pharmaceutical services (p < 0.05). Patients who received pharmaceutical services had higher level of disease knowledge mastery (p < 0.001), Short-Form-36 (SF-36) score in some dimensions (p < 0.05), and satisfaction (p < 0.05) than those who refused pharmaceutical services.

Conclusions: Hospital pharmaceutical services can effectively reduce the occurrence of DRP during hospitalization of elderly patients with PCa, help them to acquire knowledge of the disease and health-related quality of life, and have high patient satisfaction.

Objective: This study aims to evaluate the diagnostic effectiveness of prostate biopsies using transperineal colour ultrasound with magnetic resonance imaging (MRI) against transrectal colour ultrasound with MRI in treating prostate cancer (PCa) and oxidative stress injuries in patients.

Methods: We conducted a backward-looking study on the medical records of 65 individuals suspected of having PCa who underwent prostate biopsies at our hospital from March 2022 to March 2024. In the transrectal prostate biopsy (TRPB) group, 32 patients underwent TRPB, whereas the transperineal prostate biopsy (TPPB) group utilised TPPB for 33 patients. Every patient received an MRI scan to verify the location of the puncture prior to it. The length of the puncture, the amount of biopsy cores collected and confirmed as positive and any negative responses postprocedure were thoroughly documented. The indices of oxidative stress injuries in both groups were assessed postpuncture, and the effectiveness levels of TPPB and TRPB in diagnosing PCa were compared.

Results: No significant statistical variance existed between the two groups in the count of biopsy and positive biopsy cores (p > 0.05). However, compared with the duration of puncture in the TRPB group, that in the TPPB group was extended (p < 0.05). No significant variance in oxidative stress damage postpuncture existed amongst the groups (p > 0.05), and the TPPB group experienced fewer negative reactions than the TRPB group (p < 0.05). In terms of diagnostic effectiveness, TPPB’s sensitivity, specificity and accuracy in detecting PCa stood at 84.62%, 85.00% and 84.85%, respectively, surpassing those of TRPB in Kappa value. Additionally, the overall prostate-specific antigen levels in the TPPB group’s genuinely positive patients were notably less than those in the TRPB group (p < 0.05).

Conclusions: The combination of transperineal colour ultrasound and MRI is highly efficient in PCa diagnosis and is advised as the primary option in clinical settings.

Objective: Prostate cancer is a common global health concern, and enhancing patient outcomes and quality of life is essential. This study aimed to investigate the impact of an internet-supported home-based rehabilitation program on quality of life, psychological well-being, and treatment adherence in patients who had undergone radical prostatectomy.

Methods: A total of 103 patients who underwent radical prostatectomy in our hospital from April 2020 to December 2023 were categorized into control and research groups based on whether they received an internet-supported family rehabilitation plan. The control group, consisting of 53 patients, received standard discharge instructions, while the research group, comprising 50 patients, received additional home rehabilitation care as part of their routine discharge instructions. The Generic Quality of Life Inventory-74 (GQOLI-74) is a comprehensive questionnaire used to assess and compare the two groups’ quality of life before and after nursing care. The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) assessed and compared mental health status pre- and post-nursing intervention. Treatment compliance, nursing satisfaction, and complications were monitored and compared between the groups.

Results: There were no significant differences in age, Body Mass Index (BMI), disease duration, tumour stage, and other clinical variables between the two groups (p > 0.05). Before nursing care, GQOLI-74 scores did not differ significantly between the groups (p > 0.05). However, following nursing care, the research group exhibited substantially higher scores (p < 0.05) across all items than the control group. Similarly, there was no considerable difference in SDS and SAS scores between the two groups (p > 0.05) before nursing care. Post-intervention, SDS scores in the research group were significantly lower than those in the control group (p < 0.05), and treatment compliance scores were substantially higher in the research group (p < 0.05). Moreover, the incidence of complications was significantly lower in the research group compared to the control group (p < 0.05).

Conclusions: The internet-derived family rehabilitation program significantly improved patients’ quality of life, psychological well-being, and treatment compliance, indicating its potential for clinical implementation.

Background: Prostate cancer is a remarkable health concern in men, particularly in middle-aged and elderly men, with androgen deprivation therapy (ADT) being a common treatment approach for this malignancy. However, ADT is associated with adverse effects on bone health, including accelerated bone loss and decreased bone mineral density, leading to increased fracture risk. As a result, exploring interventions to mitigate ADT-induced bone loss is needed.

Methods: This retrospective study analysed clinical data from middle-aged and elderly patients with prostate cancer undergoing ADT. Patients were divided into the routine treatment and aerobic exercise therapy groups on the basis of whether they participated in an aerobic exercise programme. Laboratory measurements included baseline and 4-month follow-up assessments of calcium, vitamin D, osteocalcin, cyclophosphamide (CTX) and bone density parameters analysed by using dual-energy X-ray absorptiometry.

Results: This study involved 126 patients, including 62 patients receiving routine treatment and 64 patients participating in an aerobic exercise programme. At the 4-month follow-up, the aerobic exercise therapy group demonstrated significant improvements in calcium levels (8.94 ± 0.45 mg/dL vs. 8.68 ± 0.51 mg/dL, p = 0.003) and vitamin D levels (32.89 ± 6.17 ng/mL vs. 29.58 ± 5.68 ng/mL, p = 0.002) compared with the routine treatment group. No significant differences were observed in bone turnover markers at 4 months. At 4 months, the aerobic exercise therapy group showed significant increases in bone density in the lumbar spine, femoral neck, total hip, radius and whole body compared with the routine treatment group (p < 0.05). Correlation analysis revealed that the aerobic exercise programme had positive correlations with calcium level, vitamin D level, osteocalcin and bone density at various anatomical sites in the study population.

Conclusions: This study provided compelling evidence of the beneficial effects of aerobic exercise programmes on bone density and related serum biomarkers in middle-aged and elderly patients with prostate cancer undergoing ADT.

Objectives: This study assessed the use of inflammatory biomarkers in the prediction of malignancy in patients with asymptomatic microscopic haematuria.

Methods: In this prospective study, patients between 18 and 65 years old with asymptomatic microscopic haematuria who presented at our urology clinic within 2 years were included. The patients had no urological complaints and had applied to other clinics for other reasons. Microscopic haematuria was detected, and the patients were referred to the urology clinic for investigation. The participants were included in a 6-month and 1-year follow-up protocol. All investigations and follow-ups were conducted by the same experienced doctor. The patients were divided into malignancy and non-malignant groups according to the definitive diagnosis after the necessary examinations (laboratory tests, medical imaging and pathological examination if necessary). Inflammatory parameters were compared statistically between the two groups. Receiver operating characteristic curve analysis was applied to inflammatory parameters to detect malignancy.

Results: Asymptomatic microscopic haematuria was detected in 294 patients (242 males, 52 females). Malignancies in 98 of 294 patients were determined with various imaging and laboratory methods. The detected malignancies were confirmed with pathological examination. In addition, 196 of 294 age-matched and gender-matched patients without malignancy but with haematuria were used as the non-malignant group. Red blood cell distribution width, neutrophil-to-lymphocyte ratio, mean platelet volume, serum C-reactive protein and erythrocyte sedimentation rate of patients in the non-malignant group were lower than those with malignancy. Receiver operating characteristic curve analysis suggested that the optimum red blood cell distribution width cut-off point for patients with malignancy was 14.45, with a sensitivity and a specificity of 75% and 65%, respectively.

Conclusions: Patients with high inflammatory biomarkers value, especially high red blood cell distribution width, should be evaluated in detail and carefully. Further large collective studies should be conducted to confirm the use of red blood cell distribution width in the prediction of malignancy in patients with asymptomatic microscopic haematuria. Patients with microscopic haematuria who have high erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio and C-reactive protein are at a high risk of malignancy and therefore should be followed up attentively.

Background: Bladder cancer, primarily urothelial carcinoma, is an important global health issue given its high recurrence and poor prognosis. Tumour invasion into the muscularis propria is a crucial prognostic indicator, distinguishing muscle-invasive bladder carcinoma (MIBC) from non-muscle-invasive carcinoma. Epithelial-mesenchymal transition (EMT) promotes tumour aggressiveness and metastasis and is marked by key transcription factors, such as SNAIL, SLUG and TWIST. This study investigates the association between the expression of EMT markers and histopathological features of bladder carcinoma.

Materials and Methods: This retrospective study included 36 newly diagnosed cases of urothelial carcinoma at a tertiary care centre. Immunohistochemistry was conducted to assess SNAIL-SLUG and TWIST expression. Scoring was performed on the basis of staining intensity and extent. Statistical analysis was conducted to evaluate the associations amongst EMT markers, tumour grade, muscle invasion and clinical stage.

Results: MIBC was present in 58.3% of cases, with 80.6% of cases having high-grade tumours. TWIST expression was significantly higher in MIBC (p = 0.0001) and high-grade tumours (p = 0.03), particularly in advanced T-stages, than in other tumours. SNAIL-SLUG expression was significantly associated with muscle invasion (p = 0.005) but not with tumour grade. EMT markers were not correlated with lymphovascular invasion.

Conclusions: Elevated TWIST expression is correlated with high-grade and muscle-invasive urothelial carcinoma, suggesting its prognostic importance.

Background: Chronic obstructive pulmonary disease (COPD) is a disease that can be associated with other diseases and has systemic effects. The effects of the disease may lead to disruptions in the working mechanisms of other systems. In our study, we aimed to investigate the effects of COPD on sexual function and related psychological status in men.

Materials and Methods: The study included 60 male patients diagnosed with COPD in our hospital between March 2023 and May 2024. A control group consisting of 60 healthy individuals was also formed. Spirometry was performed in all patients. Assessment was performed using the COPD Assessment Test and the modified Medical Research Council scale, and three groups—Global Initiative for Chronic Obstructive Lung Disease (GOLD) A, GOLD B and GOLD E—were formed by combining the spirometric grading of COPD patients according to symptom level and exacerbation history. These three groups were evaluated by using the Beck Depression Inventory and International Index of Erectile Function (IIEF) tests, and the results were recorded. Blood samples were tested to measure asymmetric dimethylarginine levels. The results were statistically compared.

Results: The mean values of forced expiratory volume in the first second of forced expiration (FEV₁) %, forced vital capacity (FVC) % and FEV₁/FVC % of the control group were statistically significantly higher than those of the patient group (p < 0.001). The Beck Depression scale score, moderate and severe depression rates were higher than those of the control group (p = 0.004). The IIEF and ejaculatory function scores were statistically significantly lower than those of the control group (p < 0.001 and p = 0.001, respectively).

Conclusions: COPD is a disease that affects other systems aside from the respiratory system. The presence of COPD can have negative effects on sexual function.

Introduction: Radionuclide cystography is a commonly used examination technique for managing vesicoureteral reflux (VUR). Our aim was to compare direct radionuclide cystography (DRC) with indirect radionuclide cystography (IRC) and study the evolution of patients who tested negative for VUR using either test.

Material and Methods: A retrospective observational study was conducted by collecting all radionuclide cystography scans performed in our centre to detect VUR among paediatric patients over 5 years old. Subgroup analysis was also performed on DRC or IRC scans negative for VUR to study the occurrence of infectious complications in these patients during follow-up.

Results: A total of 62 DRC and 46 IRC scans were collected from the patients with an average age of 65.4 ± 52.6 months at the time of the exam. Among the 62 DRC and 46 IRC cases, 38 and 34 tested negative for reflux, respectively. The IRC group showed a higher percentage of reinfection (62.5% vs. 37.5% of DRC, p = 0.16) and a greater number of visits to the emergency room due to infection (60% vs. 40% of DRC, p = 0.26) but a lower percentage of readmissions due to infection (33.3% vs. 66.7% of DRC, p = 0.47) than the DRC group. Among the remaining studied variables, only constipation was associated with an increased risk of admission due to infection (odds ratio (OR) = 29.62, p = 0.03) in these patients.

Conclusions: Patients with IRC negative for VUR had a higher percentage of reinfections during follow-up than those with DRC negative for VUR, although the difference did not reach statistical significance. Furthermore, paediatric patients with a negative radionuclide cystography for VUR and who suffer from constipation have an increased risk of admission for infectious complications.

Background: Urogenital tuberculosis (UGTb) is the second most common form of extrapulmonary Tb. We aimed to evaluate the clinical consequences in our 20-year experience of UGTb.

Methods: We retrospectively reviewed the files of consecutive patients diagnosed with UGTb through microbiological methods between January 2001 and April 2021 in our centre. Clinical and demographic data of the patients were assessed. Surgical procedures during the disease course were also noted.

Results: A total of 46 patients (26 males) having a median age of 48.5 (16–82) years were diagnosed with UGTb. The most frequent complaint at admission was lower urinary tract symptoms (LUTS), followed by nonspecific symptoms, macroscopic hematuria, flank pain, scrotal swelling, and infertility. A history of pulmonary Tb was present in 10 patients. The kidney was the most affected organ, followed by ureter, bladder, and testis/epididymis. Bladder involvement and admission with LUTS was significantly higher in elderly patients (≥60 years), whereas the rate of nonspecific symptoms was significantly higher in younger patients (≤40 years). Eleven patients required surgical interventions including nephrectomy (n = 5), nephroureterectomy (n = 2), orchiectomy (n = 1), epididymectomy (n = 1), distal ureterectomy + ureteroneocystostomy (n = 1), and epididymovasostomy (n = 1). Among the 32 patients with at least 12 months of follow-up (median 114 months, range: 12–180) four had ongoing LUTS, 5 had chronic kidney disease, one had end-stage renal disease, and one had azoospermia.

Conclusions: UGTb affected the upper urinary tract with a fair chance of renal function deterioration in addition to LUTS and infertility. These conditions may impair the patient’s long-term quality of life. Elderly patients were also more prone to bladder involvement, and approximately one-quarter of patients with UGTb required surgical intervention.

Background: Extracellular microRNA (miRNA) (exosomal miRNA) embedded in exosomes plays a vital role in the progression of calcium oxalate disease. This study aimed to identify dysregulated miRNA expression profiles and their biological functions in the urinary exosomes of patients with calcium oxalate.

Methods: Ultrahigh-speed centrifugation and Illumina high-throughput sequencing were used to isolate and detect the expression levels of exocrine miRNAs in urine samples from 10 patients with calcium oxalate stones and 10 matched normal persons, and construct their differential expression profiles. Bioinformatics analysis of differentially expressed genes was carried out to determine the main biological functions of differentially expressed miRNAs and their possible signal pathways.

Results: Compared with normal people, 38 miRNAs in the urinary exosomes of patients with calcium oxalate stones showed significantly abnormal expression levels, of which 18 were up-regulated and 20 were down-regulated. Gene Ontology (GO) enrichment analysis showed that the differentially expressed miRNAs were related to biological processes such as calcium transport, inflammation, injury, oxidative stress and adhesion. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that the differentially expressed miRNAs may participate in the occurrence and development of calcium oxalate stones through cytokines and inflammatory response-related signalling pathways such as chemokine signalling pathway, phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K)-protein kinase B (AKT) signalling pathway, mitogen-activated protein kinases (MAPK) signalling pathway and Rat sarcoma (RAS) signalling pathway.

Conclusions: The expression profile of miRNA in the urine exosomes of patients with calcium oxalate stones changed significantly. miRNAs, such as miR-130b, miR-192, miR-194 and miR-499, may play important roles in the occurrence and development of calcium oxalate stones through cytokines and inflammatory response-related signal pathways, including chemokine, PI3K-AKT, MAPK and RAS.

Background: Bladder cancer is a common malignancy that arises from the urothelium. Treatment options for advanced bladder cancer remain limited, particularly in patients who have progressed after first-line therapy. Immunotherapy with programmed death-ligand 1 (PD-L1) inhibitors, such as durvalumab, has shown promise in improving outcomes in these patients. Radiotherapy (RT) is another modality that can be integrated to enhance local tumour control. This study explored the efficacy and safety of combining durvalumab with RT as a second-line treatment for patients with advanced bladder cancer, aiming to provide insights into its potential therapeutic benefits. Bladder cancer is a type of malignant tumour that arises from the epithelial lining of the bladder and commonly manifests as haematuria and frequent urination.

Methods: A total of 58 patients who were diagnosed with advanced bladder cancer and treated at our hospital between January 2020 and June 2022 were retrospectively analysed. Patients were divided into two groups: A control group (n = 33) receiving durvalumab monotherapy and an observation group (n = 25) receiving durvalumab combined with RT. The remission rates, two-year survival rates, median survival times, serum tumour marker levels and adverse events of the two groups were compared.

Results: Before treatment, the differences in the serum tumour marker levels between the two groups (p > 0.05) were not significant. Compared with the control group, the observation group presented significantly lower serum tumour marker levels (p < 0.05). Furthermore, compared with the control group, the observation group had a higher overall clinical objective response rate (96.00% vs. 75.76%) and a better two-year survival rate (40.00% vs. 15.15%). Additionally, progression-free survival (PFS) was longer in the observation group (18 months vs. 16 months, p = 0.001).

Conclusions: Durvalumab combined with RT as a second-line treatment for advanced bladder cancer effectively reduces the expression of tumour markers and improves two-year survival and PFS, offering valuable clinical insights.

Background/Purpose: Addressing perioperative anxiety, pain and restlessness and promoting family involvement through the family-centred care (FCC) model and video education may lead to improved postoperative outcomes. This study aimed to evaluate the effect of combining the FCC model with video education on the postoperative recovery of paediatric patients who underwent urological surgery.

Methods: This prospective randomised controlled study enrolled 200 paediatric patients who were undergoing general anaesthesia and recovery in the post-anaesthesia care unit at The First Affiliated Hospital of Sun Yat-sen University from January to April 2024. They were randomly assigned to Group A (routine care), Group B (routine care + video education), Group C (routine care + FCC model) and Group D (routine care + video education + FCC model), with 50 cases in each group. Various indicators, including recovery trajectory, agitation and pain scores, psychological states and treatment compliance, were assessed and compared amongst the groups.

Results: In the analysis of recovery trajectories, no significant differences were found amongst the groups in terms of time to resume breathing and extubation duration (p > 0.05). However, a notable distinction was observed in the recovery time of anaesthesia across the groups (p < 0.001). Compared with Groups B and C, Group D exhibited significant improvement in agitation and pain scores (p < 0.05). In addition, Group D had significantly lower anxiety level and higher treatment compliance than Groups B and C (p < 0.05).

Conclusions: The combined approach of the FCC model and video education may improve postoperative recovery outcomes in paediatric patients who underwent urological surgery. Hence, this approach is worth promoting and applying in clinical practice.

Objective: This study explored an infection control management mode effect that prevents catheter-associated urinary tract infection (CAUTI) in an intensive care unit (ICU).

Methods: A retrospective cohort study was conducted on patients who received indwelling catheters from February 2020 to February 2022 in the ICU ward. Patients were categorised into two groups, including the study (implemented the infection control management model) and reference groups (received the usual clinical management protocols), based on different clinical management protocols. The CAUTI results at different moments of the patients’ lives were examined, and the groups were compared in terms of CAUTI incidence, catheter retention time, Family Satisfaction with Care in the Intensive Care Unit-24 (FS-ICU-24) and Acute Physiology and Chronic Health Evaluation II (APACHE-II).

Results: A total of 102 patients were included in this study, with 48 and 54 allotted to the study and reference groups, respectively. No significant difference in the CAUTI control rate was found between the groups at 2 and 5 days (p > 0.05), whereas the CAUTI control rate at 7 days in the study group was significantly lower than that in the reference group (p < 0.05). The FS-ICU-24 score of the study group was significantly higher than that of the reference group, whereas the APACHE-II score was significantly lower (p < 0.001). The study group’s catheter retention and ICU treatment times were significantly lower than those of the reference group (p < 0.001).

Conclusions: The implementation of infection control management mode can effectively reduce the incidence of CAUTI in ICU patients, improve clinical satisfaction and shorten catheter retention time, and thus, it exhibits a certain clinical application value.

Background: Percutaneous nephrolithotomy (PCNL) has become a standard surgical procedure for treating complex renal calculi. This study aims to explore the effect of ultrasound combined with computed tomography (CT) image fusion technology and to guide PCNL for treating complex renal calculi.

Methods: A total of 130 patients with complex renal calculi who were admitted in our hospital from April 2021 to April 2023 were selected. After excluding four cases who did not meet the inclusion criteria, 126 cases were finally included. Based on the different treatment paths of PCNL, patients were divided into two groups. Among them, 60 patients who received CT guidance combined with ultrasound image fusion technology were selected as the observation group, and 66 patients who received routine guidance were included in the control group. The perioperative parameters and postoperative complications of patients in both groups were compared.

Results: The observation group had shorter operation time and lower reoperation rate than the control group (p < 0.05). The first calculi clearance rate of the observation group was 88.33%, which was distinctly higher than that of the control group (71.21%, p < 0.05). However, no significant difference in length of hospital stay after surgery was found between the two groups (p > 0.05). The establishment time of a single channel and the average number of puncture channels were lower in the observation group than in the control group (p < 0.05). The success rate of establishing an initial channel in the observation group was 93.33%, which was significantly higher than that in the control group (80.30%, p < 0.05). The observation group had a significantly higher postoperative hemoglobin level than the control group (p < 0.05). No significant difference in serum creatinine level was found between the two groups (p > 0.05). The postoperative incidence of complications in the observation group was 6.67%, which was distinctly lower than that in control group (19.70%, p < 0.05).

Conclusions: The combination of CT and ultrasound image fusion technology for PCNL in the treatment of complex renal calculi demonstrates good clinical efficacy and high safety.

Objective: This study aims to explore the effects of traditional Chinese medicine (TCM) emotional care on improving the urinary incontinence symptoms and quality of life of patients after transurethral resection of the prostate (TURP).

Methods: This retrospective cohort study included urinary incontinence patients who underwent TURP at our hospital from June 2021 to August 2023. The patients were divided into an observation group (receiving TCM emotional care) and a control group (receiving conventional care). Urinary incontinence symptoms, quality of life and psychological status were assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the Incontinence Quality of Life Questionnaire (I-QOL), the Hamilton Depression Scale (HAMD) and the Hamilton Anxiety Scale (HAMA). Differences between the two groups were analysed using t-tests and repeated measures Analysis of Variance (ANOVA).

Results: A total of 119 patients with post-TURP urinary incontinence were included in this study. In the observation group, the ICIQ-SF score decreased significantly (p < 0.001), whilst the control group also demonstrated improvement (p < 0.001). The I-QOL score in the observation group increased significantly (p < 0.001) compared with the control group (p < 0.001). For psychological health, the HAMD score improved in the observation group (p = 0.012), whilst the control group showed less improvement (p = 0.012). The HAMA score decreased significantly in the observation group (p = 0.029) compared with in the control group (p = 0.029).

Conclusions: TCM emotional care significantly improves outcomes in patients with post-TURP urinary incontinence. It effectively reduces the severity of urinary incontinence, enhances quality of life and alleviates depressive and anxious symptoms.

Background: In clinical practice, the prevalence of upper urinary tract uric acid stones is increasing. This research seeks to pinpoint the factors that contribute to the development of upper urinary tract uric acid stones and create a predictive model for this condition.

Methods: In this study, we retrospectively analysed the clinical records of 267 patients diagnosed with urinary calculi from our hospital’s Department of Urology from January 2019 to May 2024. Patients were categorised into two groups: The uric acid stone in the upper urinary tract group (n = 43) and the other types of stones in the upper urinary tract group (n = 224). We collected general clinical characteristics, urinary test results, liver and kidney function parameters and glucose and lipid metabolism indicators for multivariate logistic regression and receiver operating characteristic (ROC) analysis.

Results: The uric acid stones in the upper urinary tract group showed a substantially higher average body mass index (BMI), a greater proportion of obese patients and more patients with diabetes than the other types of stones in the upper urinary tract group (p < 0.05). Conversely, the urine pH and total protein levels in the former were lower than those in the latter. Moreover, the levels of blood urea nitrogen (BUN), serum creatinine (SCr), uric acid (UA), fasting blood glucose (FBG), total cholesterol (TC) and triglyceride (TG) in the former were higher than those in the latter (p < 0.05). Logistic regression identified BMI, BUN, SCr, UA, FBG and TC as risk factors for uric acid stone formation, with urine pH as a protective factor (p < 0.05). ROC analysis confirmed the high predictive value of these factors (p < 0.05).

Conclusions: BMI, obesity, diabetes, markers of renal function and the indicators of glucose and lipid metabolism play crucial roles as risk factors in the prediction of upper urinary tract uric acid stones. Regularly monitoring these parameters can aid in the prompt detection of upper urinary tract uric acid stones.

Objective: This meta-analysis evaluates the effect of immune checkpoint inhibitors (ICIs) on advanced prostate cancer, assessing efficacy and safety profiles compared with non-ICI regimens.

Methods: We searched PubMed, Web of Science, Embase and Cochrane Library for pertinent studies, including randomised controlled trials and nonrandomised controlled trials on immunotherapy for prostate cancer. R software was employed for meta-analysis to assess hazard ratios (HRs) for median survival, overall survival (OS), objective response rate (ORR) and serum prostate-specific antigen (PSA) response rate. Egger test, funnel plot analysis and sensitivity analysis were performed to evaluate the results. Heterogeneity sources were explored via meta-regression.

Results: Our study included 19 studies with 3661 participants. Findings indicated no significant improvement in OS (HR = 1.04, 95% confidence interval (CI) = 0.9–1.18), progression-free survival (HR = 0.95, 95% CI = 0.83–1.09) or response rates (PSA = 0.12, 95% CI = 0.08–0.18; ORR = 0.12, 95% CI = 0.08–0.18), with substantial variation in outcomes (I² ≥60%). The rates of adverse events (AEs) varied, with notable incidences of Grade ≥3 reactions. The incidence rates for immune-related AEs were Grade ≥3 AEs, and all-grade AEs 0.37 (95% CI = 0.12–0.72, I² = 96%, p < 0.01), 0.90 (95% CI = 0.83–0.94, I² = 92%, p < 0.01) and 0.38 (95% CI = 0.28–0.49, I² = 94%, p < 0.01). In the meta-regression analysis of confounding factors, only therapy was determined to be significant in PSA response rate.

Conclusions: ICI therapy exhibits potential efficacy in some patients with prostate cancer. However, its widespread application is limited by its uncertain efficacy and potential adverse reactions. Future research should focus on optimising patient selection through biomarkers and improving ICI treatment strategies to enhance efficacy and safety.

Objectives: The current research focuses on a systematic analysis of the expression patterns of the apolipoprotein B editing complex 3 (APOBEC3) gene family in clear cell renal cell carcinoma (ccRCC) and their impact on disease progression, prognosis, and somatic gene mutations associated with ccRCC.

Methods: A differential expression analysis was performed using the R “limma” package, while a survival analysis was performed using Kaplan–Meier and log-rank tests. A Gene Set Enrichment Analysis performed by the R “clusterProfiler” package compared the high- and low-expression groups. The 10 genes with the highest tumor mutation frequency in the patients with ccRCC were evaluated and presented using the R “maftool” package. The Tumor Immune Estimation Resource (TIMER) algorithm was utilized to predict the immune cell infiltration levels in ccRCC.

Results: All members of the APOBEC3 gene family members were found to be upregulated in ccRCC tumor tissues versus adjacent normal tissues. Higher expressions of APOBEC3A, APOBEC3B, APOBEC3C, APOBEC3D, APOBEC3G, and APOBEC3H were associated with a poorer prognosis for ccRCC. Conversely, higher APOBEC3F expression was associated with a more favorable ccRCC prognosis. Mutation frequencies of genes VHL, PBRM1, TTN, SETD2, and BAP1 genes were higher in the high-expression group of various APOBEC3 compared to the low-expression group. Multiple APOBEC3 gene family (particularly APOBEC3C, APOBEC3D, APOBEC3F, APOBEC3G, and APOBEC3H) also correlated with immune cell infiltration in the ccRCC.

Conclusions: These study findings suggest that APOBEC3 genes are commonly overexpressed in ccRCC, and their expression levels are associated with poor prognosis in ccRCC, somatic gene mutations, cancer immunomodulation, and immune cell infiltration levels in the tumor microenvironment.

Background: This study aimed to investigate the impact of Watson’s Caring Model in Nursing (WCMN) on self-esteem, depression, resilience, quality of life, and patient satisfaction as well as determine potential outcome differences between patients receiving this personalised nursing care model and those provided with standard nursing care.

Methods: This retrospective study included 113 patients who underwent radical prostatectomy at our hospital from January 2023 to June 2023. According to the type of care received, the patients were categorised into a traditional nursing group (n = 67) and a WCMN group (n = 46). Data collected from the patients included demographic information and the measurements of self-esteem (Self-Esteem Scale), depression (Hamilton Depression Rating Scale), resilience (Connor-Davidson Resilience Scale), and quality of life (Short Form 12) at baseline and 1 week post-surgery.

Results: The WCMN group showed a significant increase in follow-up self-esteem scores compared to those in the traditional nursing group (t = 2.547, p = 0.012). Additionally, the WCMN group exhibited significantly lower follow-up depression scores (t = 2.035, p = 0.044) and higher resilience scores (t = 2.046, p = 0.044) and quality of life scores (t = 2.100, p = 0.038) than the traditional nursing group. Lastly, patient satisfaction scores, including overall satisfaction, nursing care satisfaction, information satisfaction, emotional support satisfaction, and involvement satisfaction scores, were significantly higher in the WCMN group than in the traditional nursing group (p < 0.05).

Conclusions: WCMN has a beneficial effect on self-esteem, depression, resilience, quality of life, and patient satisfaction in patients who undergo radical prostatectomy for prostate cancer.

Objective: Approximately one-third of individuals diagnosed with prostate cancer (PCa) experience biochemical recurrence (BCR) following their initial curative therapy. BCR significantly increases the risk of distant metastases and is associated with higher mortality rates, particularly in patients with poor prognostic indicators. This study aims to investigate the strong correlation between positive surgical margins (PSMs) and BCR after radical prostatectomy, offering foundational insights and guidance for predicting patient survival and optimising postoperative intervention strategies.

Methods: A retrospective analysis was conducted on the clinical data of 498 patients who underwent laparoscopic radical prostatectomy between January 2015 and January 2021 at Ningbo Yinzhou No.2 Hospital. Pathological specimens and medical records were reviewed. Of these, 127 patients with PSMs and 279 patients with negative surgical margins (NSMs) were included in the statistical analysis. The analysis incorporated clinical and pathological parameters, including primary tumour characteristics, PSMs, pathological tumour staging, surgical margin status, Gleason grade group, and other relevant factors, with BCR-free survival as the primary endpoint.

Results: During the follow-up period of this study, 129 cases of BCR were identified among the 406 patients. Of these, 34 cases occurred in patients with PSMs, accounting for approximately 26.8% (34/127), and 95 cases occurred in patients with NSMs, accounting for approximately 34.1% (95/279). The difference in recurrence between the two groups was statistically significant (p < 0.001). The median time to BCR was 19.2 months for patients with PSMs, compared to 28.2 months for patients with NSMs, with this difference also reaching statistical significance (p < 0.001). The Gleason grading group in patients with PSMs was a stronger predictor of recurrence than the primary tumour characteristics.

Conclusions: The presence of PSMs is a significant independent predictor of BCR in patients undergoing radical prostatectomy for PCa. Early detection and timely intervention for patients with PSMs are crucial for improving postoperative outcomes.

Objective: This study aimed to investigate the effectiveness, safety and outcomes of the combination therapy of low-intensity extracorporeal shockwave therapy (Li-ESWT) and platelet-rich plasma (PRP) for the treatment of chronic-phase Peyronie’s disease.

Methods: The clinical outcomes of patients diagnosed with Peyronie’s disease and treated with Li-ESWT combined with PRP at our clinic between January 2018 and January 2024 were retrospectively reviewed and analysed. Twenty-three patients were excluded based on inclusion criteria, leaving 26 patients for the retrospective analysis. Each patient received three sessions of PRP and six sessions of Li-ESWT. The treatment regimen involved sessions administered twice weekly over a period of 3 weeks, followed by 1-week post-treatment follow-up. The patients were then monitored for 24 weeks.

Result: After treatment, no significant reduction in average plaque size was observed. However, a statistically significant average improvement of 10° was noted for penile curvature. Among the patients, 14 (53.8%) reported satisfaction with the treatment outcome, and 12 (46.2%) expressed dissatisfaction. No significant adverse effects were observed at the injection sites or in the areas subjected to Li-ESWT post-procedure.

Conclusions: The combination of Li-ESWT and PRP is effective and safe for the treatment of chronic-phase Peyronie’s disease.

Background: We aimed to investigate the effect of the difference in apnoea severity on the degree of lower urinary tract symptoms (LUTS) and of erectile dysfunction (ED) in patients diagnosed with obstructive sleep apnoea (OSA).

Materials and Methods: Between March 2019 and June 2024, 81 patients diagnosed with OSA were included in the study. Polysomnography (PSG) reports were analysed, and patients were divided into three groups according to the apnoea-hypopnea index. PSG parameters were recorded. Patients were evaluated by urologic examination, ultrasonography, uroflowmetry and blood tests. Scales such as the International Prostate Symptom Score (IPSS), quality of life (QoL) related to urinary symptoms and International Index of Erectile Function (IIEF) were used for scoring. Intergroup comparisons were made using the Kruskal–Wallis test and Chi-square test.

Results: Age, smoking, prostate-specific antigen and number of periodic leg movements per hour were not correlated with apnoea severity. Body mass index (BMI), prostate volume, minimum and maximum partial oxygen pressure, uroflowmetry parameters, IPSS, QoL, bladder wall thickness and IIEF score were correlated with OSA severity.

Conclusions: Determining the factors associated with the severity of sleep apnoea could provide insights into mitigating the adverse effects associated with OSA. Increased severity of OSA leads to increased severity of LUTS and ED.

Background: A multitude of options can be used to image the prostate, but transrectal ultrasound and magnetic resonance imaging are the mainstays. Accuracy in prostate measurements is key to the preoperative planning of any surgical intervention planned on the prostate such as tissue resection or prostatectomy. Some evidence exists that magnetic resonance imaging is the most accurate modality, but given its cost, the clinical significance remains uncertain. This study aimed to compare transrectal ultrasound and magnetic resonance imaging prostate volumes with prostate gross specimens in men having tissue-confirmed prostate cancer who underwent robotic-assisted radical prostatectomy to determine accuracy in sizing.

Methods: This study was a retrospective analysis conducted on men who underwent robotic prostatectomy for prostate cancer and had a preoperative transrectal ultrasound and magnetic resonance imaging prostate size measurement (147 men in total) between 2012–2024. Patients were required to undergo robotic prostatectomy ≤2 months from the time of transrectal ultrasound and magnetic resonance imaging prostate-size determination.

Results: Mean transrectal ultrasound was significantly smaller on average than magnetic resonance imaging prostate volume (–4.8 mL; p < 0.001). Transrectal ultrasound (–14.4 mL) and magnetic resonance imaging (–9.5 mL) were significantly smaller than actual prostate weight (p < 0.001). The mean difference between transrectal ultrasound volume and prostate weight was significantly greater from the mean difference between magnetic resonance imaging volume and prostate weight (p < 0.001). Participants with high-grade (Gleason grade ≥8) and non-high-grade cancer (Gleason grade <8) did not differ in actual prostate weight after robotic radical prostatectomy or in estimated prostate volume (p > 0.05).

Conclusions: Although transrectal ultrasound appears to be less accurate than magnetic resonance imaging in estimating prostate size, the difference is small, and it remains an adequate imaging modality in patients with prostate cancer.