Knowledge map
Save
Peyronie’s disease (PD) is a fibrotic disorder that leads to plaque formation in 2%–9% of adult men. It causes a penile curvature that may hamper sexual intercourse. Treatment for PD may be challenging for urologists because of the multiplicity of treatment options available. Several clinical trials and case series have reported significant benefits in the treatment of PD. However, despite continuous updates to recommendations by international organisations, the available data remain limited due to the lack of randomisation, small cohort sizes, and poor patient adherence to therapy. Consequently, the level of evidence supporting recommendations for the andrology community remains low. This review aims to provide a comprehensive, evidence-based overview of current non-invasive treatment modalities for PD and highlights recent clinical practices and relevant clinical trials. We reviewed current clinical practice and ongoing clinical trials for the management of PD. Current treatment options for PD include oral drugs, topical approaches, intralesional injections, traction therapy and penile surgery which remains the gold standard. Intralesional therapy delivers the best evidence for non-invasive treatment. Collagenase Clostridium Histolyticum (CCH) is the only Food and Drug Administration (FDA)-approved treatment available, and its withdrawal has removed a promising first-line treatment option for PD. Emerging evidence suggests that penile traction therapy may enhance treatment outcomes and is a promising complementary approach in future therapeutic strategies.
Knowledge map
Save
Background and Purpose: With the advances in imaging technology that have enabled the widespread adoption of nephron-sparing surgical techniques, the incidence of renal tumours has concurrently risen. Current guidelines recommend partial nephrectomy for all tumours smaller than 7 cm and, when feasible, even for larger lesions. However, the increasing use of nephron-sparing surgery and advancements in imaging have highlighted the substantial variability in renal hilar anatomy, which poses challenges during surgical procedures. Three-dimensional (3D) imaging technology integrated into preoperative planning has been proposed as a complement to conventional radiological studies to address this complexity. This study aims to evaluate the impact of preoperative 3D imaging and printing on the surgical management of renal cancer.
Methods: A prospective cohort study was conducted involving 37 patients managed according to standard clinical protocols. The patients were divided into two groups: One group underwent preoperative 3D tumour reconstruction and printing, and the other did not. Key surgical outcomes, including operative time, intraoperative blood loss, need for transfusion and status of surgical margins on pathological examination, were assessed. All 3D models were reconstructed and printed using polylactic acid (PLA) by the same urologist to ensure consistency.
Results: The group that received preoperative 3D reconstruction demonstrated remarkable reductions in intraoperative blood loss and operative time, with no cases of positive surgical margins. No significant differences in tumour size, renal nephrometry index or surgery performed were observed between the two groups.
Conclusions: The incorporation of 3D printing and reconstruction into the surgical planning of renal tumours offers tangible benefits, including reduced intraoperative blood loss, short operative duration and enhanced oncological outcomes by minimising the risk of positive margins. These findings support the potential of 3D technology as a valuable adjunct to traditional preoperative assessment in oncological renal surgery.
Knowledge map
Save
Background: Metabolic syndrome (MetS) is a significant health issue linked to male infertility through mechanisms such as aromatisation, hormonal imbalance, increased scrotal temperature, decreased testicular blood flow and increased DNA damage. This study evaluated the serum hormone levels and sperm parameters in men with idiopathic infertility on the basis of the presence or absence of MetS.
Methods: Infertile men were included. Height, weight and waist circumference were measured, and body mass index (BMI) was calculated. Blood pressure and biochemical parameters, including serum hormone levels, blood sugar, lipid profiles and semen analysis after 3–5 days of abstinence, were assessed. Participants were divided into two groups on the basis of the International Diabetes Federation criteria: Those with MetS (group I) and those without MetS (group II). Parameters were statistically compared between groups. Risk factors were assessed using logistic regression.
Results: A total of 518 infertile men were included, of whom 227 (43.8%) had MetS (group I) and 291 (56.2%) did not (group II). Significant differences were observed in all MetS criteria except low-density lipoprotein levels (p = 0.240). Serum testosterone levels were significantly lower in group I (p = 0.001). Although sperm parameters were lower in group I, but the differences were not statistically significant (p > 0.05). Age (odds ratio (OR): 1.075; 95% confidence interval (CI): 1.042–1.109; p < 0.001), medication use (OR: 1.675; 95% CI: 1.131–2.481; p = 0.01) and ejaculate volume (OR: 0.869; 95% CI: 0.772–0.978; p = 0.02) were found to be risk factors for MetS in regression analysis.
Conclusions: MetS may negatively influence the male reproductive system through various mechanisms. Further research is required to clarify the effect of MetS on male infertility.
Knowledge map
Save
Background: This study aims to explore the development and improvement of the ability of young urologists for the basic teaching skills competition through a ‘three-stage and three-level’ (three-stage: The preclass stage, the class stage and the postclass stage; Three-level: Establishing rules, distinctive features and improvement) progressive preparation strategy.
Methods: Lecture videos from our researcher and six young urologists were selected. The videos before and after the ‘three-stage and three-level’ progressive preparation strategy was implemented were submitted to expert judges and students for scoring, and the course scores (100 points) including lesson plan evaluation (30 points), expert judge evaluation (45 points), student judge evaluation (20 points) and teaching reflection evaluation (5 points) were compared. A scoring scale was used to evaluate the professional identity and occupational burnout of young urologists before and after the strategy was adopted.
Results: After the ‘three-stage and three-level’ progressive preparation strategy was implemented, the course scores of the researcher and other urologists were significantly higher than the preimplementation scores (p < 0.001). In addition, the professional identity scores of young urologists were significantly higher than those before implementation (p < 0.01). Amongst young urologists, the scores of emotional exhaustion, depersonalisation and personal achievement after implementation were statistically different (p < 0.05) from those before implementation.
Conclusions: A ‘three-stage and three-level’ progressive preparation strategy can significantly improve the ability of young urologists for the basic teaching skills competition, enhance their professional identity and significantly alleviate occupational burnout.
Knowledge map
Save
Objective: Wilms tumour is more common in children and ranks first amongst paediatric kidney tumours. This study aimed to evaluate the analgesic efficacy and safety of hydromorphone hydrochloride in postoperative pain management in children undergoing Wilms tumour operation.
Methods: A retrospective analysis was conducted to collect data on patients who were initially diagnosed and treated in the Paediatric Surgery Department of Yantai Yuhuangding Hospital from January 2020 to June 2024. According to the different postoperative analgesic methods, the children were divided into an observation group (n = 79, intravenous hydromorphone hydrochloride, 3 µg/(kgꞏh)) and a control group (n = 75, intravenous morphine hydrochloride, 15 µg/(kgꞏh)). The mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2), face, legs, activity, cry, and consolability (FLACC) pain score, and Ramsay Sedation Scale (RSS) were evaluated at four time nodes after Post-Anaesthesia Care Unit (PACU), 6 h after operation, 24 h after operation, and 48 h after operation.
Results: Repeated measures analysis of variance (ANOVA) showed a significant interaction effect between time and group on FLACC and RSS scores (p < 0.001), with significant main effects of time and group on FLACC and RSS scores (p < 0.001). The observation group had lower FLACC and RSS scores than the control group at 6 and 24 h postoperatively (p < 0.001). Additionally, a significant interaction effect existed between time and group on RR (p = 0.008), with significant main effects of time and group on HR and RR (p < 0.001). Time had a significant main effect on MAP and SpO2 (p < 0.05). The observation group had lower HR and RR values than the control group at 6 and 24 h postoperatively (p < 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group during the observation period at 48 h after surgery (p < 0.05).
Conclusions: Hydromorphone hydrochloride can be used for postoperative pain management in paediatric patients with Wilms tumour. It has a good effect on postoperative pain improvement, sedation, and safety assurance in children.
Knowledge map
Save
Background: Ureteral stones are a common urological disorder that often requires surgical intervention. However, preoperative anxiety is a prevalent issue among surgical patients and can negatively affect their postoperative recovery. As a form of nursing intervention, preoperative visits have been shown to effectively alleviate preoperative anxiety; However, research on their effect on patients undergoing ureteral stone surgery is limited. This study aims to assess the effect of preoperative visits on preoperative anxiety in patients undergoing ureteral stone surgery.
Methods: This retrospective cohort study involved patients who underwent ureteral stone surgery at Changxing Hospital of Zhejiang Medical and Health Group between January 2022 and November 2024. The patients were divided into an observation group (48 cases) and a control group (59 cases) according to whether they received a preoperative visit. Preoperative anxiety was assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Univariate and multivariate linear regression analyses were used to evaluate the effect of preoperative visits.
Results: The observation group showed significantly lower total anxiety scores, total information demand scores and overall APAIS scores 48 hours before surgery compared with the control group (p < 0.05 for all). Multivariate regression analysis revealed that preoperative visits had a significant impact on the APAIS anxiety score (β = –1.560, p < 0.001), APAIS information demand score (β = –1.058, p = 0.002) and overall APAIS score (β = –2.610, p < 0.001). Female patients, rural residents and patients with low education levels had high anxiety scores and may require additional support.
Conclusions: Preoperative visits are effective in reducing preoperative anxiety in patients undergoing ureteral stone surgery, particularly for female patients, rural residents and those with low educational levels. Preoperative visits should be widely implemented in clinical practice.
Knowledge map
Save
Objective: The early and accurate diagnosis of prostate cancer (PCa) bone metastases is of great importance for formulating the best treatment plan and improving the prognosis of patients. This work aimed to compare and analyse the application value of 18F-fludeoxyglucose (FDG) and 18F-prostate-specific membrane antigen-1007 (18F-PSMA-1007) positron emission tomography/computed tomography (PET/CT) in the diagnosis of PCa bone metastases.
Methods: Data from the pathological specimens from patients diagnosed with PCa admitted to the Xingtai People’s Hospital from October 2021 to October 2024 were retrospectively collected. These patients underwent 18F-FDG PET/CT and 18F-PSMA-1007 PET/CT scans, with an interval not exceeding 3 days between the two examinations. The sensitivity, specificity, negative and positive predictive values and diagnostic coincidence rate of the two imaging methods were evaluated by comparing the lesion count and anatomical distribution of prostatic bone metastases after the two examinations. The pathological diagnosis results of prostate lesion needle biopsy or radical PCa resection specimens were taken as the gold standard.
Results: Seventy-eight patients with PCa were admitted during the study. A total of 418 positive lesions, 78 primary prostatic lesions, 340 bone metastases and 12 negative lesions were detected by prostate lesion biopsy as the gold standard. A total of 410 positive foci were found in 18F-PSMA-1007, including 78 primary prostatic foci and 332 bone metastases. A total of 376 positive lesions, 76 prostate lesions and 300 bone metastases were found in 18F-FDG. 18F-PSMA-1007 detected more PCa bone metastases in different bone regions than 18F-FDG, but the difference was not statistically significant (p > 0.05). The sensitivity, specificity, positive and negative predictive values and diagnostic coincidence rate of 18F-PSMA-1007 were significantly higher than those of 18F-FDG (p < 0.01).
Conclusions: 18F-PSMA-1007 PET/CT has high sensitivity and diagnostic coincidence rate and is expected to become a new standard for the diagnosis of PCa bone metastases.
Knowledge map
Save
Background: Radical hysterectomy effectively treats cervical cancer and extends patient survival but may cause postoperative urinary retention. This study examined the effect of early pelvic floor muscle exercise after radical hysterectomy for cervical cancer on reducing urinary retention and influencing urodynamic aspects.
Methods: The study focused on patients who underwent radical hysterectomy for cervical cancer at the First Affiliated Hospital of Bengbu Medical University between January 2021 and December 2024. Clinical data, urinary retention, catheter replacement, dysuria, residual bladder urine volume, self-perception and comfort levels were compared. Logistic regression analysed the significance of early exercises on urinary retention risk.
Results: A total of 202 patients with cervical cancer after radical operation were included, with 92 in the intervention group and 110 in the control group. After propensity score matching, 83 patients with early postoperative pelvic floor muscle exercise were in the intervention group, and 83 clinically-matched non-exercising patients were in the control group. We found no significant differences in general characteristics (p > 0.050). The intervention group had lower urinary retention, dysuria rates and less residual urine volume (p < 0.050) than the control group, with no significant differences in catheter replacement rate or incontinence prevalence (p > 0.050). At 1 and 2 weeks post-operation, patients had lower Self-Perceived Burden Scale (SPBS) scores and higher Kolcaba General Comfort Questionnaire (GCQ) scores than pre-treatment, with the intervention group having significantly lower SPBS and higher GCQ scores than the control group (p < 0.050). Significant inter-group, time-related and interaction effects were found for SPBS and GCQ score changes (p < 0.050). Univariate analysis showed a high proportion of clinical stages IB and IIA in patients with urinary retention and few post-operative exercise-doers in the retention group (p < 0.050). Multivariate regression indicated that early exercises protected against urinary retention (odds ratio (OR) (95% CI) = 0.329 (0.129–0.839), p = 0.020).
Conclusions: Early postoperative pelvic floor muscle exercise can enhance bladder function, reduce urinary retention risk and improve patient comfort after radical hysterectomy for cervical cancer.
Knowledge map
Save
Objective: To investigate the efficacy and safety of different anaesthetic drugs in prostate biopsy.
Methods: The study included patients who underwent prostate biopsy at our hospital from January 2023 to January 2024. All patients received ultrasound-guided transrectal prostate biopsy. The mean arterial pressure (MAP) and heart rate (HR) of the two groups were observed at seven time points: Entering the operating room (T0), starting drug injection (T1), 3 min (T2), 5 min (T3) after drug injection, the end of the operation (T4), entering the PACU (T5) and leaving the PACU (T6). The time from induction to loss of consciousness (A1), the time from induction to bispectral index (BIS) dropping to 60 or lower (A2), the time from drug withdrawal to eye opening (A3), the length of postoperative post-anaesthesia care unit (PACU) stay (A4) and the operation time (A5) were observed. Moreover, the safety of the two groups was compared.
Results: A total of 76 patients were enrolled and divided into two groups: The remimazolam combined with sufentanil (RS) group (n = 37) and the propofol combined with sufentanil (PS) group (n = 39). No significant differences were observed in general data, A1, A2, A3, A4 or A5 between the groups (p > 0.05). Repeated measures analysis of variance (ANOVA) demonstrated significant interaction effects between measurement time and group on MAP and HR (p < 0.05). In addition, significant main effects were observed for time and group (p < 0.05). Simple effect analysis showed no significant differences in MAP and HR at T0 and T1 (p > 0.05). At T2, T3, T4, T5 and T6, the MAP in the RS group was higher than in the PS group (p < 0.05). The HR in the RS group was higher at T2, T3 and T4 (p < 0.05), but exhibited no differences at T5 and T6 (p > 0.05). In terms of safety, the RS group had lower incidences of injection pain and low blood pressure than the PS group (p < 0.05).
Conclusions: Remimazolam combined with sufentanil provides more stable vital signs and improved safety in elderly men undergoing prostate biopsy, rendering it worthy of promotion.
Knowledge map
Save
Objective: Renal cell carcinoma (RCC) is a typical malignant lesion of kidney with high recurrence rate and high mortality. MYB proto-oncogene-like 2 (MYBL2) is significantly expressed in cancer cells and closely linked to cancer development and poor prognosis. This study aimed to investigate the role and possible mechanisms of MYBL2 in renal cancer.
Method: MYBL2 was silenced and overexpressed in A498 kidney cancer cells. The ability of A498 cells to migrate and proliferate was analysed by 5-ethynyl-2′-deoxyuridine staining, colony formation assay, Transwell assay and cell counting kit-8 assay. Endoplasmic reticulum stress was assessed by boron-dipyrromethene (BODIPY) staining, and the messenger ribonucleic acid (mRNA) levels of endoplasmic reticulum (ER) stress markers were determined. Cholesterol levels in A498 cells were analysed by measuring total cholesterol, free cholesterol and Filipin III staining. Sphingomyelin levels were measured, and cholera toxin subunit B (CT-B) staining was used to analyse the stability of lipid rafts. The relationship between MYBL2 and ER stress was confirmed using the ER stress inhibitor 4-phenylbutyric acid.
Results: MYBL2 promotes the proliferation and migration of A498 cells (p < 0.01), inhibits the glucose regulated protein 78kD (GRP78)-protein kinase r-like endoplasmic reticulum kinase (PERK)-eukaryotic initiation factor 2 alpha (eIF2α)-activating transcription factor 4 (ATF4)-C/EBP-homologous protein (CHOP) axis (p < 0.01) and ER stress (p < 0.001), upregulates cholesterol levels and increases lipid raft stability (p < 0.001).
Conclusions: This study highlights the potential of MYBL2 as a therapeutic target for renal cancer. It is a novel oncogene that stimulates the growth of renal cancer cell A498 by reducing ER stress and triggering lipid raft regulation.
Knowledge map
Save
Objective: This systematic review and meta-analysis aimed to determine the impact of nerve-sparing radical cystectomy (NS RC) on genitourinary function and oncologic outcomes in patients with bladder cancer (BCa).
Methods: We conducted a systematic search for literature related to the treatment of BCa with NS RC and non-NS RC in PubMed, Cochrane Library, Web of Science, and China National Knowledge Infrastructure. Two independent researchers screened the literature according to pre-established inclusion and exclusion criteria and had the literature assessed for quality. After extracting data from eligible ones, the research team performed a meta-analysis using Review Manager (RevMan) 5.4.1. They further conducted Begg’s test using Stata 17 to assess publication bias.
Results: A total of 261 articles were retrieved. Nine studies met the inclusion criteria, and 740 patients were enrolled in the study. The surgical procedures in the intervention group included prostate capsule sparing cystectomy, prostate-sparing cystectomy, and NS RC. Five studies evaluated urinary incontinence after surgery. After excluding one with a significant source of heterogeneity, the pooled risk ratio (RR) of the four studies was 0.56 (95% confidence interval (CI) (0.35–0.89), p = 0.01). Four studies evaluated erectile dysfunction after surgery. After excluding one with obvious heterogeneity, the pooled RR of the three studies was 0.54 (95% CI (0.36–0.83), p = 0.005). Four studies evaluated the cancer survival rate, and the pooled RR of the four studies was 1.08 (95% CI (0.97–1.21), p = 0.16). Two studies evaluated incisal positive, and the pooled RR of the two studies was 0.83 (95% CI (0.28–2.46), p = 0.74). Four studies evaluated recurrence or metastasis, and the pooled RR of the four studies was 0.54 (95% CI (0.25–1.14), p = 0.10).
Conclusions: NS RC can reduce the risk of urinary incontinence and erectile dysfunction in patients with BCa after surgery, and it has no significant effect on oncologic outcomes.
Knowledge map
Save
Objective: This study was designed to evaluate the impact of mobile app-based pelvic floor combined with hip muscle training on female stress urinary incontinence (SUI).
Methods: The clinical data of female patients with SUI treated in our hospital from January 2021 to December 2023 were retrospectively collected. They were divided into the control group and combined group according to the difference in treatment style. The control group received conventional pelvic floor muscle training (PFMT) treatment, and the combined group received mobile app-based PFMT combined with hip muscle training treatment.
Results: A total of 113 patients were included (55 in the control group and 58 in the combination group). Their general data were comparable (p > 0.05). Repeated measures analysis of variance (ANOVA) revealed a significant interaction between measurement time and group on International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) (p < 0.05), with significant main effects of time and group (p < 0.001). Simple effect analysis showed no significant ICIQ-SF difference between the groups before training (p > 0.05). At 8 and 12 weeks, the combination group had a lower ICIQ-SF than the control group (p < 0.05). Before exercise, we found no significant difference in 1-hour PAD between the groups (p > 0.05); After exercise, the combination group outperformed the control group (p < 0.05). Post-exercise, the combination group had a lower incontinence episode frequency (IEF) and higher electromyography parameters than the control group (p < 0.05). The combination group’s treatment compliance was significantly better than the control group’s (p < 0.05).
Conclusions: Mobile application-based pelvic floor and hip muscle training can effectively reduce urinary incontinence symptoms, improve disease severity, decrease incontinence frequency, enhance pelvic floor function and ensure high treatment compliance in female patients with SUI, making it a promising clinical approach.
Knowledge map
Save
Background: Prostate cancer surgery is gradually increasing amongst the elderly. This study aims to compare the effect of intraspinal anaesthesia with that of general anaesthesia on elderly patients undergoing laparoscopic radical prostatectomy (LRP).
Methods: A total of 131 elderly patients receiving laparoscopic radical prostatectomy in our hospital from June 2020 to May 2023 were selected for retrospective analysis. A total of 59 patients receiving intraspinal anaesthesia were included in the observation group. After three patients were excluded, 56 patients were included. A total of 72 patients who received general anaesthesia were classified as the reference group. After two patients were excluded, 70 patients were finally included in the reference group. Perioperative indicators, stress response, P300 (P3) latency and amplitude parameters and adverse reaction incidence were compared between the two groups.
Results: Operation, anaesthesia onset and anaesthesia recovery times in the observation group were significantly shorter than those in the reference group (p < 0.05). However, no difference was found in anaesthesia observation times between the two groups (p > 0.05). No distinct difference in levels of serum epinephrine (E), norepinephrine (NE) and cortisol (Cor) immediately before skin incision was found between the two groups (p > 0.05). The observation group had significantly lower levels of serum E, NE and Cor than the reference group at 1 h after the beginning of surgery, immediately after surgery and 2 h after surgery (p < 0.05). P3 latency and amplitude parameters did not significantly differ between the two groups before and 12 h after surgery (p > 0.05). The observation group had a significantly lower P3 latency at 1 and 6 h after surgery and significantly higher P3 amplitude parameters than the reference group (p < 0.001). The incidence of adverse reactions did not differ between the observation (8.93%) and reference (18.57%) groups (p > 0.05).
Conclusions: In elderly patients, intraspinal anaesthesia can shorten anaesthesia recovery time after LRP, reduce perioperative systemic stress response, and reduce the effect on the brain, which is helpful for patients’ recovery after surgery.
Knowledge map
Save
Knowledge map
Save
