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Introduction: Renal primitive neuroectodermal tumour (rPNET) is a rare entity, typically affecting young adults. The diagnosis is usually confirmed through histopathology. A multidisciplinary approach to treatment is essential due to its poor prognosis.
Materials and Methods: A systematic literature review was conducted, and a descriptive analysis of significant variables from 128 cases is presented.
Results and Discussion: The literature review indicated a slightly higher incidence in females (54.2%), with a mean age at presentation of 33 years (range: 16–73 years). The most common symptoms were acute flank pain (46%) and haematuria (33%). Tumour thrombus in the vena cava and metastatic dissemination were frequent (30.5% and 50.4%, respectively). In the systematic review, 98% of cases were cluster of differentiation 99 (CD99)-positive and 62.7% showed EWSR1 rearrangement. Nephrectomy was performed in 90% of cases, and 64.8% received adjuvant chemotherapy (CT). The mean follow-up was 24.8 months (range: 0.5–150 months). The median CSS was 11.5 months (interquartile range (IQR): 6–32.3), and the median OS was 9 months (IQR: 5.25–24).
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Background: Urological cancers, such as prostate, bladder and renal cell carcinoma, contribute substantially to the global cancer burden. Their management remains challenging due to extensive molecular and clinical heterogeneity. Conventional single-omics approaches (e.g., genomics and transcriptomics) have led to important discoveries but provided only partial views of tumour biology, which limit the robustness of biomarkers and therapeutic precision. Multi-omics integration offers a systems-level perspective that captures the complex regulatory networks underlying tumour initiation, progression and treatment resistance.
Conclusions: Multi-omics integration is rapidly evolving from an exploratory research tool into a cornerstone of precision urology. Through mechanistically grounded, clinically interpretable models of disease, multi-omics holds the potential to improve individualised diagnosis, prognostication and therapy selection. Translation of multi-omics into routine clinical practice will hinge on overcoming current limitations through standardisation, collaborative consortia and explainable artificial intelligence.
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Background: Pelvic floor dysfunction (PFD) affects all aspects of life in women. The Pelvic Floor Bother Questionnaire (PFBQ) is a comprehensive questionnaire that objectively assesses how PFD affects a patient’s quality of life (QoL). However, owing to the absence of a Spanish version of this questionnaire, it cannot be used in Spanish-speaking countries.
Methods: A cross-cultural adaptation process was performed in five steps in accordance with the International Test Commission Guidelines. Subsequently, a validation study of the Spanish version of the PFBQ (PFBQ-Sp) was conducted. Reliability, internal consistency and validity were analysed using the Urogenital Distress Inventory, EuroQol 5-Dimension Health Questionnaire (EuroQoL-5D), 12-Item Short Form Health Survey (SF-12), Female Sexual Function Index and measures of error and responsiveness. A total of 243 women participated in this study, and data were collected between March and December 2022.
Results: A total of 243 women were enrolled. The instrument showed good reliability, as indicated by a Cronbach’s α of 0.915 and test-retest reproducibility (intraclass correlation coefficient: 0.773–0.868). Measurement error, expressed as the standard error of measurement, was 1.155, and the corresponding minimal detectable change at 90% confidence was 2.695.
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Background: Urinary incontinence (UI) is highly prevalent in older women and is closely associated with pelvic floor muscle (PFM) dysfunction. Impaired pelvic–trunk control may affect postural stability and increase fall risk. However, evidence directly relating PFM strength to balance in this population remains limited. The purpose of this study was to determine the association among PFM strength, UI severity and balance in community–dwelling older women.
Methods: A cross–sectional study was conducted including 92 older women aged ≥ 60 years. Data were collected prospectively between January and February 2025 at a single time point. The strength and function of PFM were assessed using the modified Oxford scale and the PERFECT scheme. UI severity and impact were measured with the International Consultation on Incontinence Questionnaire–Short Form (ICIQ–SF). Balance and mobility were evaluated using the Romberg test, One–Leg Standing, Functional Reach and Timed Up and Go (TUG) tests. Gait speed and fear of falling were assessed with 4–Meters Walk Test and the Short Falls Efficacy Scale (Short FES). Descriptive and correlation analyses (Pearson or Spearman) were performed.
Results: Women (mean age 70.23 ± 5.75 years) with high maximal PFM strength exhibited significantly reduced UI severity and impact across all ICIQ–SF domains (p < 0.05). Within the PERFECT scheme, endurance strength was related to low UI severity (frequency: ρ = –0.339; p = 0.001; quantity: ρ = –0.271; p = 0.010; impact on daily life), whereas fast contractions showed no association. In addition, increased PFM strength and endurance were correlated with improved balance, with more consistent links for dynamic tests (notably TUG: ρ = –0.254, p = 0.008; ρ = –0.229, p = 0.028, respectively) than for static outcomes. No association was observed between strength and gait speed, but increased endurance strength was linked to reduced fear of falling (ρ = –0.506, p=0.016).
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Methods: A retrospective, two-centre, single-arm clinical study with a quantitative exploratory and documentary approach was designed. Seventy patients diagnosed with NMIBC who were non-responders to appropriate BCG were evaluated between January 2001 and August 2022, with a minimum follow-up duration of one year. All patients completed an induction regimen of KLH and at least three maintenance treatments, which involved the intravesical administration of 20 mg of KLH in 60 mL of physiological saline weekly for six weeks during the induction phase, followed by monthly maintenance with the same dose. Cystoscopic controls were performed every three months during the first year and every three to four months in the second and third years. All suspicious lesions were completely resected, and cytological samples were systematically collected.
Conclusions: The use of KLH in patients with NMIBC who are non-responders to BCG therapy shows favourable outcomes in terms of disease-free survival and exhibits an excellent safety profile. These findings support KLH as a potential treatment option for this challenging patient population.
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Objective: The diagnostic value of urodynamic investigation, which is used to characterise the underlying pathophysiology of lower urinary tract symptoms, varies depending on the appropriateness of its clinical indications. This study aimed to assess the correlation between urodynamic indications and findings and identify the clinical factors associated with this relationship.
Materials and Methods: Adult patients who underwent urodynamic evaluation between December 2023 and June 2025 at the Urology Department of the University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital were retrospectively evaluated. All assessments were conducted in accordance with the International Continence Society “Good Urodynamic Practice” guidelines. Demographic characteristics, laboratory data, ultrasonographic findings and uroflowmetry parameters were recorded. Concordance was defined as the detection of any clinically relevant urodynamic abnormality capable of explaining the patient’s presenting symptoms or the indication for testing, and its association with clinical and urodynamic variables was statistically analysed.
Results: A total of 144 patients were included in the study. The overall concordance rate between clinical indications and urodynamic findings was 66%. Neurological disorders (neurogenic lower urinary tract dysfunction, NLUTD) were present in 40.3% of patients, and concordance was significantly elevated in this group (p = 0.002). Patients with upper urinary tract involvement also demonstrated increased concordance (p = 0.005). Reduced maximum flow rate (Qmax), decreased voided volume and elevated post-void residual (PVR) volume were significantly associated with concordance (p = 0.005, p = 0.007 and p = 0.001, respectively).
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Background/Aim: Immune checkpoint pathways are central to tumor immune evasion, and genetic variants of programmed death-1 (PD-1) may influence cancer susceptibility. This study evaluates the association between the PD-1.5 (rs2227981) polymorphism and the risk of bladder cancer (BC) in the Turkish population.
Materials and Methods: The study included 151 participants, consisting of 53 patients with BC and 98 healthy control individuals. Genotyping of the PD-1.5 (C/T) polymorphism was carried out using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Genotype and allele distributions were compared between groups, and logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
Results: The CC, CT, and TT genotypes were observed in 33.96%, 43.40%, and 22.64% of patients and in 48.98%, 40.82%, and 10.20% of controls, respectively. The recessive model (TT vs. CC + CT) differed significantly between cases and controls (p = 0.023), and the C allele was less frequent in patients (p = 0.039). In univariate logistic regression, carriage of the T allele showed a borderline association with increased BC risk (OR = 1.867, 95% CI = 0.934–3.732; p = 0.077), whereas carriage of the C allele was significantly associated with reduced risk (OR = 0.388, 95% CI = 0.155–0.972; p = 0.043). In multivariate models adjusted for age, sex, and smoking status, the C allele remained an independent protective factor (adjusted OR = 0.319, 95% CI = 0.112–0.906; p = 0.045), while older age, male sex, and smoking were independently associated with an elevated risk of BC.
Conclusions: The PD-1.5 (rs2227981) polymorphism appears to influence bladder cancer susceptibility in the Turkish population, with the TT genotype conferring increased risk and the C allele providing protection. These findings highlight the potential role of PD-1.5 as a genetic marker for BC risk, although validation in larger and more diverse cohorts is required. Article
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Background: This study aimed to compare maximum stone length and stone volume as predictors of stone-free (SF) status after extracorporeal shock wave lithotripsy (SWL) for ureteral stones.
Methods: Data from 236 patients treated with SWL for solitary radiopaque ureteral stone (5–15 mm) between January 2022 and March 2024 were retrospectively analysed. Stone length and volume were measured on noncontrast computed tomography. SF status was determined on radiography and ultrasonography 4 weeks after the last SWL session and defined as no residual stone or < 4 mm residual fragments. Binary logistic regression models were used to evaluate potential predictors of SWL outcome in univariable and multivariable analyses.
Results: The overall SF rate was 68%. The non-SF group had significantly higher body mass index (BMI), Hounsfield unit, maximum stone length, stone volume, skin-to-stone distance and proximal ureteral diameter (all p < 0.05) compared with the SF group. Multivariate analysis revealed maximum stone length (p = 0.004) and BMI (p = 0.009) as independent predictors of SWL outcome, whilst stone volume lost statistical significance (p = 0.2).
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Background: Pediatric urolithiasis is an increasingly important health concern, and affected children and their families require information that is both accurate and easily understandable. Artificial intelligence (AI)-powered chatbots have become widely used sources of health information; however, the readability, quality, and reliability of their outputs remain insufficiently evaluated. This study aimed to assess the effectiveness and reliability of AI chatbots in providing patient-oriented information on pediatric kidney stone disease and to identify factors influencing the quality and readability of their responses.
Methods: Four AI chatbots (ChatGPT-5, Google Gemini, Claude 3 Opus, and DeepSEEK) were queried with 30 standardized questions related to pediatric kidney stones. Readability was evaluated using the Average Reading Level Consensus (ARLC), Automated Readability Index (ARI), and Simple Measure of Gobbledygook (SMOG). Response quality and reliability were asssessed using the Ensuring Quality Information for Patients (EQIP) tool and Modified DISCERN score. Statistical analyses included one-way analysis of variance ANOVA, Kruskal-Wallis tests, and appropriate post hoc comparisons.
Results: Readability differed significantly among the chatbots. Google Gemini demonstrated the highest reading levels across all metrics (ARLC: 14.93, ARI: 16.2, and SMOG: 13.32), whereas ChatGPT, Claude, and DeepSEEK produced less complex test (p < 0.001; large effect sizes, η² = 0.195–0.512). EQIP scores did not differ significantly between models (p = 0.491, ε² = 0.021, negligible effect), indicating comparable informational quality. In contrast, reliability varied significantly: ChatGPT and Google Gemini achieved higher Modified DISCERN scores (median 4.00) than Claude and DeepSEEK (median 3.00; p = 0.001, ε² = 0.318, large effect). Subgroup analyses by question category revealed notable differences in performance, highlighting model-specific strenghts and limitations.
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Background: This study aimed to describe the clinicopathological characteristics of renal cell carcinoma (RCC) in young adults (≤ 40 years) and reclassify tumour subtypes in accordance with the 2022 World Health Organization (WHO) classification, with exploratory assessment of outcome-related associations.
Methods: Individuals aged 40 years or younger who had been diagnosed with RCC were retrospectively evaluated. All cases were re-evaluated using the current WHO 2022 classification criteria and immunohistochemical markers. Demographic data; histological subtypes; surgical treatment methods; and patient outcomes, including recurrence and mortality, were reviewed.
Results: Clear-cell RCC was the most common subtype (65.8%), followed by chromophobe RCC (20%) and papillary RCC (11.4%). A rare case of mucinous tubular and spindle cell carcinoma was identified. Tumour size and pathological stage significantly influenced the surgical modality; partial nephrectomy was more frequently performed in smaller tumours. Recurrence and mortality were primarily observed in patients treated with radical nephrectomy and those with adverse histologic features such as tumour necrosis and lymphovascular invasion.
Conclusions: This study provides a clinicopathological overview of RCC in young adults on the basis of 2022 WHO classification. Despite the exploratory nature of survival analyses due to limited events, the findings highlight the histological diversity and clinical features of RCC in this population. Article
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Objective: This study aimed to evaluate whether a Healthcare Failure Mode and Effect Analysis (HFMEA)-based nursing plan improves surgical outcomes for patients undergoing emergency extracorporeal shock wave lithotripsy (ESWL) for urinary tract stones.
Methods: A retrospective analysis was conducted on 127 patients who underwent ESWL between July 2024 and June 2025. According to the nursing protocol received, the patients were divided into a control group (n = 67) receiving routine emergency perioperative care and an observation group (n = 60) receiving HFMEA nursing. Postoperative recovery indicators, pain levels (at 12, 24 and 48 hours), psychological state, follow-up outcomes and disease knowledge were compared.
Results: The two groups had comparable baseline characteristics (p > 0.05). Although the time to first flatus was similar between groups (p > 0.05), stone expulsion time was significantly shorter in the observation group (p < 0.05). Regarding pain, Visual Analog Scale (VAS) scores at 12 hours postoperatively were not significantly different (p > 0.05). However, the observation group reported lower VAS scores at 24 and 48 hours (p < 0.05). Hospital Anxiety and Depression Scale scores decreased in both groups after treatment, with lower scores in the observation group (p < 0.05). No significant difference in 1-month stone clearance rate was found (p > 0.05), but the observation group experienced fewer postoperative complications and demonstrated higher disease knowledge (both p < 0.05).
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Background: This study aimed to compare the efficacy of retrograde intrarenal surgery (RIRS) combined with super-mini percutaneous nephrolithotomy (SMP) versus microchannel percutaneous nephrolithotomy (MPCNL) for complex renal stones (CRSs) and identify prognostic factors.
Methods: A retrospective analysis was conducted on 156 patients with CRS (January 2022–January 2025), divided into the RIRS + SMP group (n = 85) and MPCNL group (n = 71). Perioperative indicators, inflammatory stress, renal function, postoperative pain and complications were compared. A 60-day follow-up categorised prognosis into poor (n = 23) and normal (n = 133) groups, with logistic regression analysing poor prognosis factors.
Results: The RIRS + SMP group had a longer operative time but significantly less intraoperative blood loss, shorter postoperative hospital stay and earlier ambulation (p < 0.05) than the MPCNL group. Stone-free rates were comparable and showed no significant difference (p > 0.05). At 3 days postoperatively, inflammatory markers (procalcitonin (PCT), high-sensitivity Creactive protein (hs-CRP), cortisol (Cor) and malondialdehyde (MDA)) and renal function indicators (blood urea nitrogen (BUN), urinary creatinine (UCr) and cystatin C (Cys-C)) were lower in the RIRS + SMP group (p < 0.05) than in the MPCNL group. Visual Analog Scale (VAS) scores were consistently lower at 6, 12, 24 and 48 h postoperatively (p < 0.05), with a reduced overall complication rate (p < 0.05). Multivariate logistic regression identified surgical approach, diabetes mellitus and indwelling catheterisation time as independent poor prognosis risk factors (p < 0.05).
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Objective: Safety and efficacy were compared between dexmedetomidine and propofol for sedation during transurethral ureteroscopic holmium laser lithotripsy of the renal pelvis under combined spinal-epidural anaesthesia (CSEA).
Methods: A total of 200 patients who underwent transurethral ureteroscopic holmium laser lithotripsy of the renal pelvis from March 2022 to March 2025 were selected. According to the administration methods, they were divided into the propofol group (intravenous propofol injection) and dexmedetomidine group (intravenous dexmedetomidine injection), with 100 cases in each group. Depth of sedation (Ramsay score, bispectral index (BIS) and anaesthesia tendency index (NTI)), hemodynamic parameters (heart rate (HR), mean arterial pressure (MAP) and blood oxygen saturation (SpO2)), postoperative recovery time (respiratory recovery time, eye- opening time and extubation time), doctor satisfaction and incidence of adverse reactions were recorded for the two groups.
Results: The dexmedetomidine group had significantly higher Ramsay score at the beginning and 30 minutes after the surgery and significantly lower BIS and NTI indicators than the propofol group (p < 0.001). The fluctuation amplitude of HR and MAP was smaller, and the SpO2 level was higher (p < 0.05). Recovery time of breathing, eye-opening time and extubation time after the operation were all shorter in the dexmedetomidine group than in the propofol group (p < 0.001). The satisfaction rate of doctors was 96.00%, significantly higher than 82.00% of the propofol group (p < 0.05), and the incidence of adverse reactions was 9.00%, lower than 20.00% of the propofol group (p < 0.05).
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Background: Kidney transplantation remains the optimal treatment for end-stage renal disease. Perioperative management is crucial for short-term recovery and long-term graft outcomes. The Rosenthal effect demonstrates how positive expectations enhance results via self-fulfilling predictions, exhibiting advantages in healthcare settings; however, it remains understudied in transplant care. This study evaluated an innovative multi-disciplinary perioperative nursing model incorporating the Rosenthal effect for kidney transplant recipients compared with standard care.
Methods: A retrospective cohort study included 144 kidney transplant recipients (July 2021–May 2025) divided into the innovative care (n = 74) and standard care (n = 70) groups. The innovative care group received multi-disciplinary team support with Rosenthal effect-based psychological care protocols, Enhanced Recovery After Surgery protocols and 3-month digital follow-up. The primary outcomes were graft survival and acute rejection rates. The secondary outcomes included psychological status (anxiety and depression), quality of life, medication adherence, 36-Item Short-Form Health Survey (SF-36) and Pittsburgh Sleep Quality Index. Statistical analysis included independent t-tests, chi-square tests and Kaplan–Meier survival analysis.
Results: The innovative care group achieved superior 1-year graft survival (97.30% vs 91.43%, p = 0.042), reduced acute rejection (10.81% vs 24.29%, p = 0.031), lowered anxiety scores (40.34 ± 4.32 vs 44.36 ± 4.15, p < 0.001) and improved quality of life with higher SF-36 physical (48.76 ± 8.12 vs 42.34 ± 9.45, p < 0.001) and mental component scores (68.44 ± 8.91 vs 63.75 ± 9.12, p = 0.002).
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Background: Although burst-wave lithotripsy (BWL) and ultrasound-guided extracorporeal shock wave lithotripsy (US-guided ESWL) are used for ureteral stones, direct comparative evidence to guide optimal clinical choice between them is limited.This work aimed to compare the efficacy differences between BWL and US-guided ESWL in treating 5–10 mm ureteral stones.
Methods: This retrospective study included 100 patients with 5–10 mm ureteral stones treated between January 2022 and January 2024. The patients were divided into two groups of 50 patients each on the basis of treatment modality: the BWL group and the US-guided ESWL group. Baseline characteristics were balanced and comparable between groups (p > 0.05). The efficacy and safety of the two therapies were systematically evaluated by comparing various indicators across both groups.
Results: For ureteral stones measuring 5–10 mm, BWL demonstrated superior outcomes in terms of stone clearance rate (88.0% vs. 64.0%), reduced retreatment rates (6.0% vs. 24.0%) and treatment costs compared with US-guided ESWL. The BWL group also demonstrated greater improvements in postoperative pain, stone passage time and quality of life (85.5 ± 5.2 vs. 80.3 ± 6.7 points, all p < 0.05). Although the procedure duration of BWL was longer, no statistically significant difference was found in the complication rates between the two groups.
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Background: This study aimed to analyse the distribution characteristics of urinary calculi components in patients from Jiaxing region and explore their relationship with gender, age and the location of calculi, thereby providing a scientific basis for the prevention and treatment of local urolithiasis.
Methods: Clinical data and stone specimens from 607 patients with urinary calculi admitted to a hospital in Jiaxing region between August 2023 and August 2024 were retrospectively collected (the study design is a cross-sectional study). The SUN-3G infrared spectroscopy automatic analysis system was used to determine stone composition. The distribution differences of stone components across different genders, ages and locations were statistically analysed.
Results: Amongst the 607 patients, 403 (66.4%) were male and 204 (33.6%) were female, with a male-to-female ratio of 1.95 : 1. The distribution of calcium oxalate, carbapatite and uric acid stones did not show statistically significant differences between male and female patient groups (p > 0.05). However, the distribution of other stone components showed statistically significant differences between genders (p < 0.05). Calcium oxalate stones were the most prevalent, found in 427 cases (70.35%). Amongst them, mixed-component stones accounted for 268 cases (44.15%), primarily characterised by calcium oxalate monohydrate + carbapatite, followed by calcium oxalate monohydrate + calcium oxalate dihydrate + carbapatite. Pure-component stones accounted for 339 cases (55.85%), predominantly composed of calcium oxalate monohydrate. The 41–60 years age group had the highest incidence (297 cases, 48.93%), and stone component distribution varied significantly by age. Upper urinary tract stones accounted for 99.18% (602 cases), with no significant difference in component distribution by location (p > 0.05). Seasonal analysis showed calcium oxalate monohydrate being the dominant component in all seasons, with male cases predominating, and significant seasonal differences in stone occurrence (p < 0.05).
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Objective: This study aimed to describe the etiological profile of postoperative urinary tract infection (UTI) in elderly patients with upper urinary tract calculi and construct a risk factor prediction model.
Methods: The clinical data of elderly patients with upper urinary tract calculi who underwent surgery in our hospital from January 2024 to March 2025 were retrospectively analysed. The patients were divided into an infection group and a control group according to whether they developed UTI. The risk factors for secondary UTI in elderly patients after upper urinary tract calculi surgery were also examined. A multivariate logistic regression analysis was used to establish a risk prediction model, and a receiver operating characteristic (ROC) curve was drawn. All patients were randomly divided into a training set and a validation set at a ratio of 7:3 to evaluate the stability of the prediction model.
Results: Among the 233 elderly patients, 54 (23.18%) developed postoperative UTI. Univariate analysis identified hydronephrosis severity, age, hospital stay, preoperative serum albumin and postoperative daily water intake as associated with UTI (p < 0.05). In the multivariate model, age and hydronephrosis severity remained independent risk factors, whilst high postoperative water intake and preoperative albumin were independent protective factors. An ROC model based on these four variables showed an area under the curve (AUC) of 0.85 (95% CI 0.78–0.93) in the training set (specificity 0.820, sensitivity 0.752) and 0.81 (95% CI 0.71–0.91) in the validation set (specificity 0.813, sensitivity 0.762). Hosmer–Lemeshow test indicated good model fit.
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Background: Diabetic kidney disease is a major cause of end-stage renal disease, and patients undergoing maintenance haemodialysis are at high risk of urolithiasis due to metabolic disorders. Sevelamer hydrochloride alone has limited efficacy in preventing urolithiasis, whilst the combined effect of cinacalcet and sevelamer hydrochloride lacks sufficient evidence-based support.
Methods: The clinical data of 120 patients in our hospital from January 2020 to December 2023 were retrospectively collected. The patients were divided into a combined group (n = 60, cinacalcet + sevelamer hydrochloride) and a control group (n = 60, sevelamer hydrochloride alone), and their baseline data were collected. The incidence, recurrence rate, maximum stone diameter, urinary pH, 24-hour urine volume and urinary calcium were compared at 6 and 12 months of treatment.
Results: No statistically significant differences in baseline data were found (p > 0.05), indicating comparability. At 6 and 12 months, urolithiasis incidence (11.67%, 18.33%) and recurrence rate (11.11%, 33.33%) in the combined group were significantly lower than those in the control group (30.00%, 50.00% and 45.45%, 72.73%, respectively; p < 0.05). The combined group also exhibited higher urine pH and 24-hour urine volume, lower urinary calcium levels and smaller maximum stone diameter compared with the control group (p < 0.05).
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Objective: Traumatic urethral injuries (TUI) represent a critical urological emergency. This study aims to compare the efficacy and complications of urethral realignment and primary urethral anastomosis in the management of TUI.
Methods: A retrospective analysis was conducted on patients treated at Fuyang People’s Hospital between January 2022 and December 2024. The patients were categorised into urethral realignment and primary anastomosis groups according to the surgical procedure performed. Outcomes assessed included operative time, blood loss, hospital stay, catheterisation duration, pain (Visual Analogue Scale), inflammatory markers (C-reactive protein, interleukin-6 and tumour necrosis factor-α), functional parameters (maximum urinary flow rate, Qmax; post-void residual volume; International Index of Erectile Function-5, IIEF-5) after 3 months of follow-up and postoperative complications within 6 months.
Results: Among 129 eligible patients, 71 underwent urethral realignment and 58 underwent primary urethral anastomosis. The realignment group had a shorter average operative time (98.43 ± 23.67 vs. 143.27 ± 31.85 min, p < 0.001), less blood loss (87.62 ± 28.41 vs. 152.89 ± 45.73 mL, p < 0.001), lower pain scores (3.62 ± 0.89 vs. 4.28 ± 1.13, p < 0.001) and reduced inflammatory markers (all p < 0.01). The anastomosis group showed better urinary flow (Qmax: 22.47 ± 3.88 vs. 18.93 ± 4.26 mL/s, p < 0.001), lower residual volume (18.59 ± 9.46 vs. 26.84 ± 12.73 mL, p < 0.001), higher IIEF-5 scores (19.42 ± 2.39 vs. 18.27 ± 2.23, p = 0.006) and a lower stricture rate (5.17% vs. 18.31%, p = 0.024).
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Background: To explore the diagnostic value of a multiparametric model based on pelvic floor ultrasound for postpartum stress urinary incontinence (SUI).
Methods: Between November 2023 and December 2024, 102 postpartum SUI patients (SUI group) and 96 healthy controls (control group) were enrolled. After 1:1 propensity score matching (caliper width = 0.02), 60 cases per group were analysed. Pelvic floor ultrasound was used to measure posterior urethrovesical angle at rest (Ar)/angle during Valsalva (As), urethral rotation angle (URA), bladder neck mobility (BNM), and bladder neck funnel formation. A multiparametric model was onstructed using logistic regression and evaluated using receiver operating characteristic (ROC) curves.
Results: The SUI group exhibited significantly higher URA, BNM, and bladder neck funnel formation rates than the control group (all p < 0.05). These three parameters were identified as independent SUI predictors with no multicollinearity (variance inflation factor (VIF) < 5). The multiparametric model achieved an area under the ROC curve of 0.863 (95% confidence interval (CI): 0.798–0.927), significantly higher than any single parameter (p < 0.05), with a sensitivity of 78.50% and a specificity of 89.80% at the optimal cut-off value.
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Objective: This study aimed to construct a predictive model for assessing the risk of peripherally inserted central catheter (PICC) tip migration in patients with bladder cancer, facilitating early detection and tailored management of high-risk cases through comprehensive risk stratification.
Methods: A total of 280 patients with bladder cancer who underwent PICC placement for chemotherapy at our institution between January 2021 to May 2023 were retrospectively enrolled and randomly allocated into a training set (n = 196) and a validation set (n = 84) in a 7:3 ratio. Independent risk factors were identified through univariate analysis, variable compression via Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression. Subsequently, random forest, support vector machine and K-nearest neighbour models were constructed. The optimal model was selected based on the area under the curve (AUC), calibration curves and decision curve analysis (DCA). Visualisation and interpretability were further assessed using a nomogram and SHapley Additive exPlanations (SHAP) values.
Results: The baseline characteristics were balanced between the training and validation sets (p > 0.05). Multivariate logistic regression analysis further confirmed that body mass index (BMI), abnormal catheter tip position, catheter indwelling duration, number of puncture attempts and range of motion in the limb with the catheter were independent risk factors for PICC tip migration (p < 0.05). The random forest model demonstrated optimal performance, with an AUC of 0.768 in the training set and 0.738 in the validation set. SHAP analysis indicated that the range of motion in the limb with the catheter, BMI and catheter indwelling duration were primary positive contributors.
