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Background: Percutaneous nephrolithotomy (PCNL) is the preferred technique for kidney stones larger than 20 mm in maximum diameter. The objective of this study is to evaluate the effect of the nephrostomy tube technique vs. that of the tubeless technique in patients undergoing supine PCNL, focusing on postoperative complications and hospital stay duration.
Methods: This retrospective observational study was conducted from January 2018 to June 2024. A total of 243 patients underwent supine PCNL. Clinical, surgical and postoperative variables were compared between patients with and without nephrostomy tubes. Complications were classified into clinically relevant categories: Infectious (fever ≥38 °C), haemorrhagic (postoperative haemoglobin drop >1 g/dL within 48 h or the requirement for blood transfusion) and severe (including nephrectomy and mortality). A binary logistic regression model was used to identify independent predictors of complications. Stone-free status was assessed by noncontrast computed tomography (CT) at six weeks. All analyses were performed with IBM SPSS Statistics 26.0.
Results: In 50% of patients, a nephrostomy tube was placed at the end of the procedure. The overall complication rate was 14.4% and was significantly higher in patients with nephrostomy tubes (22.9% vs. 6.7%; p < 0.001) than in those without. Hospital stay was longer in patients with nephrostomy tubes (median 3 days (interquartile range (IQR) 2–4) vs. 1 day (IQR 1–2); p < 0.001) than in those without. Stone-free rate was comparable between groups (80.9% vs. 77.8%; p = 0.529). In multivariate analysis, nephrostomy remained independently associated with complications (odds ratio 4.15; 95% confidence interval 1.72–10.02; p = 0.001).
Conclusions: In this retrospective series, tubeless PCNL was associated with significantly reduced overall complication rates, mainly as a result of a low number of bleeding events, and short hospital stay without compromising stone-free rates. These findings support the safety of a tubeless approach in appropriately selected patients.
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Introduction: Testicular prosthesis placement enhances body image and satisfaction in pediatric patients after orchiectomy due to testicular torsion. However, no standardized guidelines exist for the optimal surgical approach with minimal complications. Our aim is to describe a simple and reliable technique of testicular prostheses in pediatric patients, avoiding the inguinal approach.
Methods: A retrospective multicenter study was conducted on patients under 18 years who underwent prosthesis placement following orchiectomy for testicular torsion between 2016 and 2022 in four hospitals. Prostheses were inserted through a supracrescrotal incision at the penile base, creating a subcutaneous pocket via blunt dissection towards the scrotum. No drains were placed.
Results: A total of 21 patients were included (median age of 14.9 years; interquartile range (IQR) 13.4–15.8 years) with a median time between torsion and prosthesis placement of 14 months (IQR 10–17 months). Regarding the size, 14 prostheses of size 42 × 32 mm and 7 of 37 × 28 mm were placed. Median operative duration was 15 minutes (IQR 12–18 minutes), with no intraoperative complications. All patients were discharged the same day of surgery. After a median follow-up of 41 months (IQR 26–54), no infections, prosthesis extrusions, or complications were reported. Patients experienced no pain or discomfort, and all reported satisfactory outcomes. No prosthesis exchanges were required.
Conclusions: Suprascrotal testicular prosthesis placement appears to be a straightforward and safe procedure for adolescents after testicular torsion, providing excellent cosmetic and satisfaction outcomes with low morbidity in the medium term. Larger prospective studies are needed to confirm these findings.
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Background: This study aimed to compare the outcomes of open partial nephrectomy (OPN) and robot-assisted partial nephrectomy (RAPN) based on preoperative risk assessment using Martini’s nomogram and postoperative trifecta and pentafecta criteria.
Methods: We retrospectively reviewed patients who underwent OPN or RAPN between 2017 and 2021. Renal function was assessed pre- and postoperatively using estimated glomerular filtration rate (eGFR) calculated by the Cockcroft–Gault formula. Baseline renal function was defined in accordance with the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The Martini’s nomogram was used preoperatively to estimate the risk of >25% postoperative eGFR decline; Surgical outcomes were evaluated in accordance with trifecta and pentafecta criteria.
Results: A total of 103 patients were included (OPN: 63; RAPN: 40). The median follow-up was 77 (65–87) months. Median warm ischemia time was significantly lower in the OPN group (20 vs. 27.5 min, p < 0.001). Trifecta and pentafecta achievement rates were higher in the OPN group (65% vs. 25%, p < 0.001; 30.1% vs. 10%, p < 0.05, respectively). Martini’s nomogram showed good discrimination in OPN (area under the curve (AUC) = 0.87) and RAPN (AUC = 0.80). Calibration analyses indicated overestimation in the OPN high-risk stratum, whereas the RAPN high/very-high strata were consistent with predictions.
Conclusions: In this retrospective cohort, OPN was associated with higher trifecta and pentafecta achievement than RAPN. The Martini’s nomogram showed good discrimination but procedure-dependent calibration: Strata-level predictions aligned in RAPN, whereas risk was overestimated in the OPN high-risk stratum. These findings support cautious use for risk ranking and underscore the need for procedure-specific recalibration and further external validation, particularly for OPN.
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Background: This study aims to evaluate long-term surgical outcomes and identify predictive factors associated with urethroplasty failure in patients with anterior urethral strictures.
Methods: A retrospective study was conducted on 419 patients who underwent urethroplasty between January 2009 and December 2024. Eleven different surgical techniques were performed based on the location, length and aetiology of strictures as well as prior interventions. Clinical data including demographics, surgical history, stricture characteristics and complications were analysed. Surgical success was defined as the absence of any further urethral intervention and maximum voiding flow rate above 15 mL/s months or years after the surgery. Statistical analysis included Cox regression, Chi-square and Kaplan–Meier survival analysis.
Results: The overall surgical success rate was 74.7% (313/419 patients), with a complication rate of 10.2%. Recurrence occurred in 25.3% of cases. Univariate analysis revealed that body mass index (BMI), stricture length, number of previous direct vision internal urethrotomies (DVIUs), prior urethroplasty and panurethral strictures (>10 cm) were significantly associated with surgical failure. Multivariate analysis identified increased BMI and number of previous DVIUs as independent predictors of failure (p < 0.05).
Conclusions: History of prior interventions and BMI are key factors influencing outcomes. Early referral for definitive surgical management is recommended to avoid progression and reduce failure risk.
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Background: The identification of reliable biomarkers for prostate cancer remains a pressing need in clinical oncology. Inflammatory and regulatory molecules such as NF-κB p65, apolipoprotein E (ApoE), angiopoietin-1 (Ang-1), forkhead box protein A2 (FOXA2), presenilin enhancer-2 (PEN-2) and β-amyloid precursor protein (β-APP) have been implicated in tumour biology. However, their roles in prostate cancer progression and invasion require further elucidation.
Methods: Serum levels of NF-κB p65, ApoE, Ang-1, FOXA2, PEN-2 and β-APP were measured in five distinct groups: Healthy controls, benign prostatic hyperplasia, non-treated prostate cancer, radical prostatectomy and metastatic prostate cancer. Quantification was performed using validated sandwich enzyme-linked immunosorbent assay (ELISA) kits (Elabscience®, Wuhan, China), with optical density readings at 450 nm. All measurements adhered strictly to manufacturer protocols. Receiver operating characteristic curve was analysed to calculate the area under the curve (AUC) for each biomarker.
Results: ApoE (AUC = 0.83) and Ang-1 (AUC = 0.81) demonstrated the best diagnostic accuracy. PEN-2 (AUC = 0.81), FOXA2 (AUC = 0.79), and β-APP (AUC = 0.79) showed moderate-to-good discrimination, whereas NF-κB p65 (AUC = 0.76) exhibited moderate performance across disease stages.
Conclusions: Ang-1 and ApoE exhibited promising predictive potential in prostate cancer progression, whereas NF-κB p65 and PEN-2 demonstrated modest discriminative performance. FOXA2 showed expression variation across disease stages but lacked sufficient diagnostic value. These results highlight the diverse molecular profiles involved in prostate cancer biology and underline the need for validation in larger cohorts before clinical application.
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Background: The use of anticoagulant (AC) and antiaggregant (AG) medications is increasingly common in elderly patients undergoing urologic surgeries. This prospective observational study aimed to evaluate the influence of AC/AG therapy on bleeding-related complications following transurethral resection of the prostate (TURP), transurethral resection of bladder tumour (TURBT) and open prostatectomy (OP).
Methods: Patients who underwent TURP, TURBT or OP between March 2022 and January 2023 were included in this study. Patients were stratified according to AC/AG usage. Perioperative management details, including low-molecular-weight heparin (LMWH) bridging, were recorded. We evaluated parameters including duration of irrigation, length of stay, episodes of clot retention, transfusion rate and re-admission rate due to haematuria.
Results: Among TURP patients, those using AC/AG therapy had significantly higher rates of transfusion (2.27% vs 0%, p = 0.038), postoperative clot retention (7.57% vs 0.53%, p = 0.008), re-catheterisation (9.09% vs 3.72%, p = 0.046) and re-admission due to haematuria (11.36% vs 3.72%, p = 0.008) compared with those not receiving AC/AG therapy. In the TURBT group, AC/AG use was associated with an elevated rate of rehospitalisation (p = 0.026). OP patients on AC/AG therapy experienced increased transfusion rates (p = 0.030), early postoperative clot retention (p = 0.034) and re-operations (p = 0.016). LMWH bridging was associated with further increases in irrigation volume, early clot retention and rehospitalisation, particularly in TURBT and OP patients.
Conclusions: AC/AG therapy significantly influences bleeding outcomes after TURP, TURBT and OP. LMWH bridging may further exacerbate these risks. This study emphasises the need for caution regarding bleeding-related complications in patients receiving AC/AG therapy.
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Background: Prostate cancer commonly affects older men. There is increasing interest in minimally invasive treatment options such as high-intensity focused ultrasound, which provides oncologic control with reduced side effects and functional preservation. We evaluated the oncologic and functional outcomes of whole-gland high-intensity focused ultrasound therapy for localized prostate cancer at a single tertiary center in Taiwan.
Methods: This retrospective study included 63 patients with primary localized prostate cancer with tumor stage ≤T2 and Grade Group 1–3 who were treated with whole-gland high-intensity focused ultrasound between July 2019 and October 2024. Outcomes included biochemical disease-free survival, prostate-specific antigen kinetics, and complication rates. Biochemical recurrence was defined using the American Society for Therapeutic Radiology and Oncology Phoenix criteria (nadir prostate-specific antigen level + 2 ng/mL). A contemporaneous group of patients that underwent robotic-assisted radical prostatectomy (RaRP) served as control.
Results: The median preoperative prostate-specific antigen level was 8.58 ng/mL. Nadir prostate-specific antigen levels averaged 0.43 ng/mL and were reached after 2.90 months. At a median follow-up of 14.73 months, 20.63% of the patients had experienced disease progression. Higher initial prostate-specific antigen levels, prostate-specific antigen levels at the procedure, and older age were significantly associated with recurrence (p < 0.05). The overall complication rate was 30.16%, without a high Clavien–Dindo grade (4/5). Six patients (9.09%) required high-intensity focused ultrasound twice due to persistent or recurrent disease.
Conclusions: Whole-gland high-intensity focused ultrasound showed comparable short-term oncological outcomes with an acceptable rate of complications in selected patients with localized prostate cancer. Despite positive preliminary results, the lack of standardized surveillance protocols and the variability in outcome definitions require further prospective randomized studies.
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Objective: Catheter-associated urinary tract infection (CAUTI) is a common type of hospital-acquired infection in the emergency intensive care unit (EICU). The aim of this study was to explore effective nursing management programs to reduce the incidence of CAUTI in patients with EICU.
Methods: This retrospective study collected the clinical data of critically ill patients from the Department of Emergency Medicine of Soochow University in China from January 2024 to December 2024. Patients admitted from January to June 2024 were treated in the usual care group, and patients admitted from July to December 2024 were treated in the CAUTI prevention care group. The monthly incidence of CAUTI, the duration of urinary catheter indwelling, the duration of bladder irritation symptoms, the number of days of hospitalisation and the adverse reaction rate of patients in the two time periods were compared.
Results: A total of 833 patients were admitted to the EICU for observation, and they were divided into the usual care group (n = 427) and the CAUTI prevention care group (n = 406). Ninety-seven patients developed CAUTI, with an overall incidence rate of 11.64%. Among them, 64 cases (14.99%) of CAUTI occurred in the conventional nursing group, which was higher than that in the CAUTI prevention care group (33 cases, 8.13%), and the difference was statistically significant (p < 0.05). The duration of urinary catheterisation, duration of bladder irritation, length of hospital stay and incidence of adverse reactions in patients with CAUTI in the CAUTI prevention care group were lower than those in the usual care group (p < 0.05).
Conclusions: Reasonable nursing management program is related to a low incidence of CAUTI in EICU and has a certain effect on its prevention.
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Background: Renal cell carcinoma (RCC) is a radiation-resistant tumor. Eg5, a spindle motor protein, plays a crucial role in centrosome separation and bipolar spindle formation during mitosis. We explored whether Eg5 is an important therapeutic target for treating RCC.
Methods: We selected radiation-resistant 786-O renal carcinoma cells and divided them into four groups: Control, 10 Gy irradiation, Eg5 inhibitor, and 10 Gy + Eg5 inhibitor. The proliferative ability of the tumor cells was assessed using the cell counting kit-8 assay; A transwell assay was employed to evaluate their invasive capacity. A clonogenic assay was performed to assess clonogenic survival. We divided the 786-O renal carcinoma cells into 10 Gy irradiation and 10 Gy + Eg5 inhibitor groups. Flow cytometry, cell cycle analysis, polymerase chain reaction (PCR), and western blotting were conducted to compare radiosensitivity between the two groups and to investigate potential underlying mechanisms.
Results: The levels of cell proliferation, clonogenic survival, and migration in the 10 Gy + Eg5 inhibitor group (0.395 ± 0.007, 119.3 ± 7.513, 24.33 ± 2.333, respectively) were significantly lower than those in the control (0.772 ± 0.005, 294.3 ± 10.710, 83.00 ± 3.786, respectively) and 10 Gy groups (0.667 ± 0.006, 211.7 ± 9.528, 54.33 ± 2.728, respectively) (p < 0.05). Flow cytometry showed that the level of apoptosis in the 10 Gy + Eg5 inhibitor group (16.87 ± 2.476, 17.0%) was significantly higher than in the 10 Gy group (6.319 ± 0.380, 6.0%) (p < 0.05). Flow cytometry analysis further revealed that the proportion of cells in the G1 phase in the 10 Gy + Eg5 inhibitor group (10.037 ± 1.434) was lower than in the 10 Gy group (24.327 ± 2.252) (p < 0.05). PCR results showed that the messenger ribonucleic acid (mRNA) levels of H2AX, TP53BP1, XRCC1, and CDKN1A in the 10 Gy + Eg5 inhibitor group were significantly higher than those in the 10 Gy group (p < 0.05).
Conclusions: Eg5 inhibitors specifically bind to the Eg5 protein and disrupt mitosis, thereby improving the radiosensitivity of RCC by regulating the cell cycle. An Eg5 inhibitor combined with radiotherapy may represent an effective adjuvant therapy for RCC.
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Background: Neurogenic bladder (NB) is a complex bladder dysfunction that arises subsequent to spinal cord injury (SCI), profoundly affecting the quality of life. This study examined the effects of varying intensities of repetitive transcranial magnetic stimulation on NB treatment outcomes.
Methods: Patients admitted because of SCI-induced NB between March 2022 and March 2024 were enrolled. Patients were divided according to the treatment methods they received: 120% resting motor threshold (RMT) and 80% RMT groups. Baseline data, lower urinary tract symptoms and the Neurogenic Bladder Symptom Score (NBSS), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) scores were analysed and compared between the groups.
Results: A total of 128 participants successfully completed the study (120% RMT: n = 68; 80% RMT: n = 60). The groups exhibited similar baseline characteristics and yielded equivalent pre-intervention outcomes (all p > 0.05). After the intervention, significant decreases in daily voiding, leakage frequency and residual urine volume (RUV), NBSS, HAMA and HAMD scores were observed (all p < 0.05 compared with pre-intervention values). The 120% RMT group exhibited more pronounced decreases (p < 0.05). Significant increases in maximum flow rate, single void volume and WHOQOL-BREF (all p < 0.05) and more pronounced advancements were observed in the 120% RMT group (p < 0.05).
Conclusions: This study demonstrates that 120% RMT improves the physical symptoms, psychological well-being and overall quality of life for patients with SCI-induced NB.
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Objective: In this retrospective study, 150 cases of prostate cancer were evaluated to explore the ability of combined magnetic resonance imaging (MRI) features and nonspecific serum markers to distinguish clinically significant prostate cancer (csPCa) from nonclinically significant prostate cancer (ncsPCa) in patients with confirmed prostate cancer and to evaluate their application value in risk stratification.
Methods: This retrospective study analysed 150 patients with prostate cancer treated at our institution between May 2022 and May 2025. The patients were divided into csPCa (Gleason score ≥7) and ncsPCa groups (Gleason score = 6) according to Gleason score of pathology. Baseline clinical data and routine haematological and coagulation markers, including neutrophil count (NEU), lymphocyte count (LYM), fibrinogen (FIB), D-dimer and prostate-specific antigen (PSA) were collected. All patients subsequently underwent prostate-specific MRI following enrolment.
Results: Significant difference in Prostate Imaging Reporting and Data System (PI-RADS) V2.1 score distribution was observed between the two groups (p < 0.05). The csPCa group also had higher neutrophil-to-lymphocyte ratio (NLR), FIB, D-dimer and PSA levels than the ncsPCa group (p < 0.05). Multivariate analysis confirmed these indicators as independent predictors of csPCa (p < 0.05). Receiver operating characteristic curve analysis showed the following area under the curve (AUC) values in diagnosing csPCa: 0.677 (95% confidence interval (CI): 0.571–0.784) for PI-RADS V2.1 score, with an optimal cutoff of 3.00; 0.738 (95% CI: 0.638–0.838) for NLR, with an optimal cutoff of 3.67; 0.769 (95% CI: 0.680–0.858) for FIB, with an optimal cutoff of 4.01; And 0.745 (95% CI: 0.639–0.852) for D-dimer, with an optimal cutoff of 0.595. The combined diagnostic model yielded an AUC of 0.839 (95% CI: 0.757–0.920) for identifying csPCa.
Conclusions: The combined use of prostate-specific MRI features and nonspecific serum markers (NLR, FIB and D-dimer) can effectively improve the diagnostic accuracy of csPCa.
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Background and Aims: Elderly patients with renal calculi face elevated surgical risks due to reduced physiological reserve and comorbidities. Retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) are the primary treatments for this condition, but their efficacy and safety in this population remain unclear.
Methods: This single-centre retrospective study included 144 patients (≥65 years) with renal calculi, divided into RIRS (n = 75) and PCNL (n = 69) groups. Propensity score matching yielded 65 patients per group, comparing stone clearance rate, secondary surgery rate, perioperative safety indicators, Visual Analogue Scale (VAS) pain scores and 36-Item Short Form Health Survey (SF-36) quality of life scores.
Results: The PCNL group had higher stone clearance rates at 2 weeks (84.62% vs. 69.23%) and 1 month (95.38% vs. 84.62%) than the RIRS group (both p < 0.05), but secondary surgery rates did not differ (p > 0.05). The RIRS group showed less intraoperative blood loss (51.54 ± 13.84 vs. 93.87 ± 26.19 mL), shorter operation time (78.69 ± 12.54 vs. 89.85 ± 15.41 min) and hospital stay (5.77 ± 1.09 vs. 7.02 ± 1.18 days; All p < 0.05), lower postoperative VAS scores and higher 2-week SF-36 scores (p < 0.05).
Conclusions: Although PCNL offers higher stone clearance, RIRS is superior in reducing blood loss, shortening hospital stays, alleviating pain and improving quality of life. RIRS may be more suitable for elderly patients with renal calculi.
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Background: Benign prostatic hyperplasia (BPH) is highly prevalent in the aging male population. Transurethral resection of the prostate (TURP), the current gold standard treatment, demonstrates significant efficacy but is associated with complications and high retreatment rates. Extraperitoneal laparoscopic urethra-preserving prostatectomy has emerged as a promising minimally invasive surgical alternative. This study aimed to compare the efficacy and safety of modified extraperitoneal laparoscopic surgery with conventional TURP for BPH treatment.
Methods: Ninety-two patients with BPH who underwent surgical treatment between May 2022 and July 2023 were included in this retrospective study and divided into two groups with 46 each: Transurethral resection of the prostate (TURP) group and extraperitoneal laparoscopic surgery (ELS) group. Preoperative International Prostate Symptom Score (IPSS), maximum urine flow rate (MFR), residual urine volume (RUV) and quality of life (QOL) scores were recorded and compared with those at the 3-month follow-up. Patient age, body mass index (BMI), prostate-specific antigen (PSA), prostate size and complications were also documented and compared between the groups.
Results: Ninety-two patients were included in this study (46 in each group). Baseline characteristics were comparable between the groups. At 3 months, both groups demonstrated significant improvements in IPSS, MFR, RUV and QOL scores (p < 0.001). Compared with the TURP group, the ELS group showed greater improvements in IPSS, MFR, RUV and QOL scores, with fewer postoperative complications (p < 0.001).
Conclusions: Extraperitoneal laparoscopic prostatectomy using the modified urethra-preserving technique was beneficial for restoring urinary continence and improving patients’ quality of life. This approach showed favourable perioperative outcomes and low complication rates. Further studies with large sample sizes and extended follow-up periods are required to confirm these findings and determine the long-term efficacy of this strategy.
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Objective: This study aimed to evaluate the safety and efficacy of a novel transurethral cystolithotripsy device designed to manage bladder calculi.
Methods: Consecutive patients with bladder calculi who underwent transurethral cystolithotripsy at our medical center performed by the same surgical team between January 2014 and July 2019 were included. Patients’ medical records data were evaluated retrospectively. Patients were divided into three groups based on the cystolithotripsy approach used: Conventional transurethral discontinuous flow cystoscope (Group 1); Ureteroscope inserted into a 26 Fr resectoscope sheath (Group 2); And Group 3 received treatment using our redesigned resectoscope incorporating an Fr5 guide catheter replacing the conventional electricity loop (Group 3).
Results: In total, 69 patients were included. Postoperative ultrasonography confirmed complete stone clearance in all groups. The median lithotripsy operation time was significantly shorter in Group 3 (20.00 min, Q1–Q3: 15.00–25.00) compared to Group 1 (40.00 min, Q1–Q3: 40.00–60.00) and Group 2 (27.50 min, Q1–Q3: 15.00–36.25) (p < 0.0001). Group 3 also required the least irrigation fluid (12.00 L, Q1–Q3: 6.00–20.25), compared to Group 1 (33.00 L, Q1–Q3: 27.00–36.00) and Group 2 (39.00 L, Q1–Q3: 29.25–45.75) (p < 0.0001). No vesical perforation occurred in Group 3, while one case occurred in Groups 1 and 2. Postoperative fever was observed in three patients from Group 1 and two from Group 3. No other intraoperative or postoperative complications were noted.
Conclusions: Our redesigned continuous-flow resectoscope is a safe and highly effective modality for treating bladder calculi, reducing operative time and irrigation volume significantly compared to conventional methods, while maintaining a low complication rate. Study findings suggest that this novel approach may serve as a cost-effective and efficient alternative for transurethral cystolithotripsy.
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Objective: The objective of this review was to collate and critically appraise the nascent body of evidence juxtaposing the da Vinci single-port (SP) system with its multiple-port (MP) antecedent, with the goal of ascertaining its surgical efficacy and postoperative outcomes.
Methods: The databases searched included PubMed, Web of Science, and Embase. Two independent reviewers conducted the initial screening for potential inclusion, assessed the quality of the studies via the Newcastle-Ottawa Scale, and extracted relevant data. A third reviewer was responsible for reconciling the data. Random effects models were utilized.
Results: The final meta-analysis included eight studies, encompassing a cohort of 1389 patients, with 502 patients allocated to the SP group and 887 to the multiple-port group. We observed no significant differences in operative duration (WMD: 0.12, 95% confidence interval (CI): –7.44–7.67), blood loss (weighted mean difference (WMD): –11.50, 95% CI: –28.89–5.90), positive surgical margins (odds ratio (OR): 0.80, 95% CI: 0.59–1.08), complications (OR: 1.29, 95% CI: 0.77–2.16), urinary continence (OR: 1.18, 95% CI: 0.86–1.62), or erectile function (OR: 0.84, 95% CI: 0.58–1.24) between the two procedural types. The meta-analysis revealed a mean difference of –0.86 days (95% CI: –1.64 to –0.08), suggesting a tendency toward shorter hospitalization for the SP group.
Conclusions: The da Vinci SP system presents itself as a formidable contender when juxtaposed with its MP counterparts. Notwithstanding the encouraging preliminary data, a more substantial evidence base is needed to ascertain the definitive role of the SP system within the domain of urological surgery.
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Background and Aims: Radical prostatectomy is the key for localised prostate cancer, but postoperative urinary incontinence and chronic pain impair outcomes. Enhancing perioperative care improves prognosis. This single-centre retrospective study evaluated a symptom management theory-based nursing model for radical prostatectomy patients.
Methods: A total of 165 patients were divided into the control (routine care, n = 75) and observation (symptom management nursing, n = 90) groups. After propensity score matching (PSM), 67 patients per group were analysed. Outcomes (pain: Visual Analogue Scale (VAS); Urinary incontinence: International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UISF); Negative emotions: Self-Rating Anxiety Scale (SAS)/Self-Rating Depression Scale (SDS); Quality of life: Functional Assessment of Cancer Therapy-Prostate (FACT-P)) were assessed before treatment, end of 2-week treatment and 1 month post-treatment. Three-month postoperative complications were compared.
Results: At end of treatment and 1-month post-treatment, the observation group had lower VAS, ICIQ-UISF, SAS and SDS scores (all p < 0.05), higher FACT-P scores (all dimensions, p < 0.05) and lower urinary incontinence incidence (p < 0.05). The 3-month complication rate was 7.46% (5/67) vs 19.40% (13/67) in the control (p < 0.05).
Conclusions: Symptom management-based nursing alleviates pain, reduces urinary incontinence, relieves negative emotions, improves the quality of life and lowers complications, with clinical value for postoperative rehabilitation.
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Objective: To investigate the application value of an operating room nursing protocol based on the Enhanced Recovery after Surgery (ERAS) concept in patients with prostate cancer undergoing laparoscopic radical prostatectomy (LRP).
Methods: A retrospective collection was conducted on patients who were scheduled to undergo LRP and admitted to the urology department of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2024 to June 2025. The general preoperative, surgical-related and clinical data of the two groups of patients were collected and compared.
Results: A total of 147 patients with LRP were collected during the study. These patients were divided into the traditional nursing (n = 73) and ERAS (n = 74) groups in accordance with different nursing plans. No significant difference was found in the general data of the two groups before surgery (p > 0.05). In the ERAS group, the moments marking the first discharge and exhaust, along with the lengths of time of urinary catheter indwelling and overall hospital stays, were all markedly shorter than those in the group receiving traditional nursing care, with the disparities between the two groups being statistically significant (p < 0.001). Additionally, the patients in the ERAS group exhibited a notably higher average urinary flow rate than their counterparts in the traditional nursing group (p < 0.001). The first voiding time of the patients in the ERAS group was earlier than that of the patients in the traditional nursing group (p < 0.001). At 8, 12, 24 and 48 h after surgery, the Numerical Rating Scale scores of the patients in the ERAS group were lower than those of the patients in the traditional nursing group (p < 0.001). The results of repeated analysis of variance revealed a significant difference in the time-group main effect (p < 0.001). The Incontinence Quality of Life Questionnaire scores of the patients in the ERAS group were higher than those of the patients in the traditional nursing group at three days after surgery and discharge (p < 0.001).
Conclusions: The operating room nursing protocol based on the ERAS concept has clinical value in patients with prostate cancer undergoing LRP.
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Objective: This study aimed to evaluate the postoperative recovery of urinary continence, complications, metabolic changes and urodynamic parameters in patients with bladder cancer undergoing radical cystectomy combined with orthotopic ileocaecal neobladder reconstruction and to explore the safety and functional feasibility of this surgical approach.
Methods: A retrospective analysis was performed on 45 bladder cancer patients who underwent radical cystectomy with orthotopic ileocaecal neobladder reconstruction at our hospital between January 2020 and January 2025. All patients received standardised postoperative follow-up, including urodynamic evaluations at 6 and 12 months, and rehabilitation training such as pelvic floor exercises, abdominal pressure-assisted voiding, and bladder sensation training. Clinical outcomes were assessed by comparing urinary continence, complications, biochemical parameters, and urodynamic indices at different postoperative time points.
Results: At 3 months postoperatively, urinary incontinence (daytime and nighttime) was higher than at 6 months, indicating gradual improvement over time (p < 0.05). Early complications, mainly urine leakage and infections, were relatively common within 3 months but decreased thereafter, with few patients experiencing enterocutaneous fistula, urinary fistula, or urinary stones (p > 0.05). Postoperative haemoglobin and serum chloride decreased significantly (p < 0.05), while other biochemical parameters remained largely unchanged, except for an increase in blood urea nitrogen. Urodynamic assessments showed that by 12 months, neobladder maximum capacity and urinary flow rate increased significantly (p < 0.05), storage-phase bladder pressure decreased below urethral closure pressure (p < 0.05), voiding-phase pressures were unchanged (p > 0.05), and post-void residual volume was reduced (p < 0.05).
Conclusions: Orthotopic ileocaecal neobladder reconstruction after radical cystectomy is a safe and feasible urinary diversion. With standardised rehabilitation and follow-up, patients achieve satisfactory continence and stable metabolic and bladder function. However, long-term outcomes require validation in larger studies.
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Background: The endoscopic treatment of complete ureteral transections has been reported. However, records on the use of metallic ureteral stents for this purpose are lacking. We present a case of complete ureteral transection successfully treated with ureteral realignment using an Allium ureteral stent.
Case Presentation: A 70-year-old man underwent abdominoperineal amputation due to rectal cancer. Postoperatively, he was diagnosed with a complete right ureteral transection and subsequent urinary leakage. Pyelography revealed that the two ureteral ends of the injured area were not contiguous. A ureteral guidewire was passed through the injured area using a combined antegrade and retrograde approach. Given the severity of the injury, realignment with an Allium ureteral stent was attempted. Following successful placement, the urinary leak resolved, and the affected renal unit remained free of hydronephrosis. The short-term follow-up (2 weeks) does not allow assessment of long-term outcomes, which represents a major limitation of this report.
Conclusions: To the best of our knowledge, this study is among the very few reported cases utilising an Allium stent for the endoscopic realignment of complete ureteral transection. We believe that this stent may be useful in the endoscopic resolution of complete ureteral transections because of its larger diameter and ability to isolate the affected area compared with other catheters such as the double-J stent.
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