Background: Renal cell carcinoma (RCC) is the most common malignant tumor of the kidney and accounts for the majority of renal malignancies. The detection of small RCCs has increased in recent years, largely owing to advances in imaging techniques. To date, few studies have investigated the diagnostic value of contrast-enhanced ultrasound (CEUS) in differentiating clear cell renal cell carcinomas (ccRCCs) from non-clear cell renal cell carcinomas (non-ccRCCs) when smaller than 4cm. In this study, we aimed to retrospectively explore the value of conventional ultrasound combined with CEUS in differentiating the two main RCC subtypes.

Methods: Altogether, 84 RCC cases were included, comprising 62 ccRCCs and 22 non-ccRCCs. All patients underwent conventional ultrasound and CEUS before surgery. To determine the independent predictors of small ccRCC, we conducted univariate and multivariate logistic regression analyses on the clinical data and ultrasound imaging features of the patients. Receiver operating characteristic (ROC) curve analysis was performed to assess diagnostic performance.

Results: Multivariate logistic regression identified cystic change (odds ratio (OR) = 5.959; p = 0.017), parenchymal phase isoenhancement (reference: hypo-enhancement; OR = 6.411; p = 0.007), and hyperenhancement (reference: hypo-enhancement; OR = 15.770; p < 0.001) as independent predictors for distinguishing between small ccRCC and non-ccRCC. Routine ultrasound combined with CEUS demonstrated good evaluation efficacy, with an area under the curve (AUC) of 0.823 (95% confidence interval: 0.733–0.914).

Background: Studies examining anatomical changes in the prone position during endourological procedures lack predictive formulas for estimating the renal pelvis-to-skin distance (KSD). Furthermore, existing equations for renal depth—an important parameter for accurate glomerular filtration rate (GFR) assessment—are based on supine measurements. This study aimed to develop predictive formulas for estimating renal depth in the prone position for patients undergoing percutaneous renal access.

Methods: A total of 86 healthy volunteers (46 men, 40 women) were enrolled in a prospective study conducted at the 2nd Department of Urology, Papageorgiou General Hospital between June and September 2020. Participants completed a questionnaire on medical history, demographic, and somatometric characteristics. Renal KSD was measured ultrasonographically in the prone position using a convex probe placed parallel and 1 cm below the 12th rib, with the posterior axillary line as a landmark. The biopsy line targeted the midpoint of the renal pelvis. Distances were analyzed in relation to clinical and anthropometric variables, and predictive equations were generated for each kidney.

Results: The following equations were derived: left kidney: distance = 1.5 + 0.272 × body mass index (BMI) − 0.452 × gender; right kidney: distance = 1.619 + 0.259 × BMI − 0.457 × gender (BMI: gender coded as 0 = male, 1 = female). Mean renal depth was 7.81 cm for the right kidney and 8.23 ± 1.47 cm for the left. Distances were significantly greater in men (p = 0.004 right; p = 0.005 left). A strong positive correlation was observed between right and left kidney depths (r = 0.859, p < 0.001), as well as with body weight and waist circumference. In men, greater right kidney depth was associated with hypertension, low high-density lipoprotein (HDL), and metabolic syndrome (p < 0.05). 

Conclusions: These formulas provide a simple and reliable method for estimating renal depth in the prone position, potentially improving procedural accuracy and patient safety during percutaneous renal access.

Background: Bladder cancer exhibits substantial molecular heterogeneity, and adverse epithelial programs remain incompletely characterized at single-cell resolution. This study aimed to identify candidate epithelial programs and derive genes supporting prognostic modeling.

Methods: Single-cell RNA sequencing data were analyzed to annotate epithelial subtypes and infer malignant populations. Bulk transcriptomic cohorts were used for Cox regression, risk-model construction, pathway analysis, immune characterization, and cell-cell communication inference. Stearoyl-CoA desaturase (SCD) was experimentally assessed in bladder cancer cells.

Results: We identified 14 epithelial subtypes with cell-level differences across pathological T stages. C05 Epithelial-S100A9 showed basal-like features, proliferative signaling, and adverse program-level survival associations. GSE130001 showed broad C05-signature activity but no discrete C05-like subpopulation. From this program, we derived a four-gene signature comprising epoxide EPHX1, SCD, LDLR, and TSPAN8. High-risk tumors were enriched for epithelial-mesenchymal transition, collagen-associated pathways, immune-checkpoint expression, and fibroblast-related signaling. SCD knockdown reduced proliferation and migration.

Conclusions: This study characterizes a candidate S100A9-associated epithelial program and a single-cell-informed prognostic framework linked to stromal and immune features. These findings suggest potential prognostic relevance, but independent single-cell analyses, mechanistic studies, and prospective validation remain required.

Background: Urosepsis is a life-threatening complication of urinary tract infection (UTI) associated with high mortality. Early identification of patients at high risk of poor outcomes remains challenging due to the limited predictive value of single biomarker.

Results: The levels of hsCRP, PCT, Scr, β2-MG, and u-ORM/u-CREAT were significantly higher in the poor prognosis group than in the favourable prognosis group (all p < 0.001). Multivariable analysis identified hsCRP >85.3 mg/L, PCT >5.7 ng/mL, Scr>132 µmol/L, andu-ORM/u-CREAT>18.5 mg/mmol as independent predictors of poor prognosis (all p <0.05). Acombined model of hsCRP, PCT, Scr, and u-ORM/u-CREAT achieved the highest predictive performance, with an area under the ROC curve of 0.923, sensitivity of 86.9% sensitivity and specificity of 84.3%, and outperformed individual marker (all p < 0.05).

Background: Hemorrhaging continues to be a significant issue in endoscopic procedures for benign prostatic hyperplasia (BPH). Tranexamic acid (TXA) has garnered heightened scrutiny for its ability to mitigate bleeding-associated problems during transurethral prostate procedures. We performed a comprehensive meta-analysis to assess the effectiveness and safety of TXA in individuals having endoscopic procedures for BPH, acknowledging that the existing data primarily originated from transurethral resection of the prostate (TURP).

Methods: PubMed,WebofScience, CochraneLibrary, Embase, CNKI, Wanfang,Clinical Trials.gov, and ICTRP were examined from the beginning of their databases until April 2026. Pooled mean differences (MDs) and risk ratios (RRs) together with 95% confidence intervals (CIs) were computed utilizing RevMan 5.4. Sensitivity analyses and assessment of publication bias were performed using R version 4.4.2.

Results: Fifteen randomized controlled studies with 1,310 people were qualified. Compared to the control group, TXA significantly reduced operational time (MD =–6.49 minutes, 95% CI:–10.79 to–2.20) and intraoperative blood loss (MD =–66.68 mL, 95%CI:–123.84 to–9.51). TXA also led to significantly less hemoglobin loss at 24 hours (MD =–0.58 g/dL, 95% CI:–0.88 to–0.29) and decreased irrigation fluid volume (MD =–0.45 L, 95% CI:–0.80 to–0.10). However, there were no significant differences between groups in duration of continuous bladder irrigation, catheterization time, length of stay, weight of resected adenoma, blood transfusion requirements, incidence of deep vein thrombosis (DVT) or quality of endoscopic.

Conclusions: TXA correlated with less intraoperative hemorrhage, decreased hemoglobin depletion after 24 hours, reduced irrigation fluid usage, and shortened surgical duration in endoscopic procedures for BPH. These results should be regarded primarily as evidence from TURP, demonstrating consistent effects across both monopolar and bipolar subgroups. Evidence outside TURP was limited to a single holmium laser enucleation of prostate RCT, which contributed data only to operative time among the statistically significant outcomes. Reported DVT were rare, and the available evidence remains underpowered to determine the thromboembolic safety profile of TXA. Additional RCTs are necessary to elucidate the function of TXA in various surgical methodologies and among patients with an elevated risk of hemorrhage.

The PROSPERO Registration: The study was registered on https://www.crd.york.ac.uk/prospero/ (registration number: CRD420251044211; registration link: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251044211).

Objective: The most common genitourinary complication of brucellosis is Brucella epididymo-orchitis (BEO), which, if not promptly diagnosed and treated, may lead to severe testicular complications. The present study aimed to evaluate the frequency, clinical characteristics, laboratory findings, and treatment outcomes of BEO in an endemic region.

Methods: This retrospective cohort study included male patients diagnosed with brucellosis between August 2017 and October 2022 at a tertiary referral center. We identified patients with BEO based on clinical, laboratory, and ultrasonographic findings and analyzed the demographic characteristics, clinical presentation, laboratory parameters, microbiological findings, treatment regimens, and follow-up outcomes.

Results: Among 278 male patients with brucellosis, 16 patients (5.75%) were diagnosed with BEO. The median age was 42 (32–55) years. All patients had scrotal pain and scrotal swelling. The most predominant clinical form was acute brucellosis (68.75%). Bilateral testicular involvement was observed in one patient (6.25%). Brucella Coombs and Rose Bengal tests were positive in all patients, while blood culture positivity was detected in 37.50% of cases. Patients who had BEO had significantly higher white blood cell counts than those who did not have BEO (p = 0.038). All patients received combined antimicrobial therapy. Relapse occurred in five patients (31.25%), all of whom responded favorably to modified antibiotic regimens. No patient required orchiectomy or developed severe complications during the follow-up period.

Conclusions: BEO remains a significant complication of brucellosis in endemic regions and should be taken into account in the differential diagnosis of epididymo-orchitis (EO). Early diagnosis and prompt combined antimicrobial therapy appear highly effective in preventing severe complications and unnecessary surgical intervention.

Methods: This retrospective study included 213 patients aged 45–85 years who underwent prostate mpMRI between May 2020 and May 2025. A deep learning AI system was used to analyse the mpMRI images to obtain parameters of the primary prostate lesion. Using pathological results as the gold standard, the diagnostic value of mpMRI parameters in prostate cancer was analysed.

Results: Among the 213 patients, 72 had prostate cancer (clinically significant prostate group) and 141 did not (non clinically significant prostate group). The mean age was (72.7 ± 7.4) years, and the mean body mass index was (25.7 ± 3.9) kg/m². Compared with the non-clinically significant prostate cancer (non-csPCa) group, the clinically significant prostate cancer group had significantly lower ellipsoid volume and segmented prostate volume (p < 0.05). Pearson analysis showed negative correlation between PSA level and segmented prostate volume in all patients with prostate cancer (r = −0.449, p < 0.01). PSA level, apparent diffusion coefficient (ADC), maximum lesion diameter, peripheral-zone signal intensity, and the prostate-specific antigen density (PSAD) derived from mpMRI exhibited strong predictive value for prostate cancer (p < 0.05).

Conclusions: The AI-based mpMRI can enhance diagnostic value for clinically significant prostate cancer and provide valuable insights into tumour invasiveness, potentially guiding more informed clinical decisions and reducing unnecessary biopsies.

Background: Same-day discharge and early telehealth follow-up are increasingly combined after minimally invasive benign gynecologic and urogynecologic surgery, but pathway-level evidence is limited. We evaluated the observed combination of same-day discharge and a completed telehealth contact within 48–72 hours in relation to 30-day healthcare utilization, direct institutional cost, recovery, and adverse events.

Results: The combined pathway was completed by 142 of 212 eligible patients (67.0%). In the primary weighted comparison with no same-day discharge/no telehealth, it was not associated with lower 30-day healthcare utilization (risk ratio 0.72, 95% confidence interval 0.47–1.09; p = 0.122). A binary comparison with all other pathways was also null (risk ratio 1.00, 95% confidence interval 0.68–1.48; p = 0.987). Pairwise augmented inverse probability weighting and targeted maximum likelihood estimation both yielded a risk ratio of 0.61 (95% confidence interval 0.41–0.81; p < 0.001), but residual imbalance remained, estimates varied by method, and these pairwise estimates are susceptible to exposure-timing bias and are not interpreted as causal. Mean nominal direct cost was 56,601 versus 69,882 Turkish lira (cost ratio 0.87, 95% confidence interval 0.83–0.91; p < 0.001). Because the ratio compares contemporaneous groups, it was robust to inflation across the study period. Median time to return to normal activity was 13.25 versus 16.4 days and was descriptive only. Any 30-day safety event occurred in 15.5% versus 28.9% (penalized odds ratio 0.45, 95% confidence interval 0.19–1.02; p = 0.057).

Conclusions: The observed same-day-discharge-plus-telehealth pathway was consistently associated with lower direct institutional cost across analytic approaches, whereas evidence for a reduction in 30-day healthcare utilization was not robust across methods. Given the observational design, potential exposure-timing bias, limited effective sample size, and residual confounding, these associations should not be interpreted as causal effects of the pathway on healthcare utilization or clinical outcomes. No clear excess of short-term adverse events was identified, although safety equivalence was not established. Prospective multicenter studies should account explicitly for the timing of telehealth completion.