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Stress urinary incontinence (SUI) is a prevalent postpartum condition that significantly impacts women’s quality of life and mental health. This systematic review synthesizes current advances in non-pharmacological therapies for postpartum SUI, focusing on pelvic-floor muscle training (PFMT), electrical and magnetic stimulation, acupuncture, and other therapies like Pilates and breathing exercises. Our literature search in PubMed, Cochrane Library, and Web Science identified studies examining these interventions, which are crucial for treating SUI due to their safety and efficacy. PFMT, also known as Kegel exercises, is the cornerstone of SUI treatment, enhancing pelvic-floor muscle strength and function. Electrical and magnetic stimulation is emerging as effective adjuncts to PFMT, improving muscle endurance and urinary control. Acupuncture, a traditional Chinese medicine therapy, shows promise in regulating pelvic-floor muscle function and is particularly appealing due to its safety and reliability. Pilates and breathing exercises are also considered, with evidence suggesting that they improve core strength and urinary incontinence symptoms when combined with PFMT. Despite the variety of treatments available, several questions remain, including the optimal duration of pelvic-floor electrical and magnetic stimulation, the potential synergistic effect of these stimulations with PFMT, and whether prolonged stimulation provides additional benefits. Future research should address patient compliance, long-term treatment effects, and the biological mechanisms underlying these therapies. A multimodal treatment approach may yield synergistic effects and improved outcomes. This review provides evidence to support clinical treatment recommendations and highlights areas for future research, aiming to optimize non-pharmacological treatment programs for postpartum SUI.
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Objective: To assess the stone-free rate (SFR) and safety of our new modified technique of mini-percutaneous nephrolithotomy (mini-PCNL) using counter-irrigation through a separate upper pole access.
Methods: The medical data of 40 patients with kidney stones (<30 mm) and a dilated upper calyx treated with our novel modification of mini-PCNL between August 2020 and October 2021 were prospectively collected and analysed. Stone-free status of the patients was evaluated at 3 days and 1 month post-operatively via abdominal and pelvic non-contrast computed tomography (NCCT).
Results: The mean stone size was 24.68 ± 2.86 mm, and the mean stone density was 931.38 ± 308.92 hounsfield unit (HU). The mean total operative time was 78.8 ± 13.62 min, while the mean time required for placing the upper calyceal nephrostomy tube was 3.76 ± 1.25 min. Immediate overall SFR was 90%, which reached 95% at the 1-month follow-up. The overall complication rate was 10% (four patients), including fever (38 °C) that required antipyretics in two (5%), fever (38 °C) that necessitated hydration and IV antibiotics in one (2.5%), and persistent mild haematuria that improved with coagulants and excess fluid intake in one (2.5%).
Conclusions: Counter-irrigation in mini-PCNL for a renal pelvic stone with a dilated upper calyx is an encouragingly safe and effective option. This novel technique provides a potentially high SFR and acceptable safety profile via enhanced intra-operative visualisation, decreased stone migration, and better washout of stone fragments.
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Background: Insulin resistance resulting in endothelial dysfunction is related to erectile dysfunction. The triglyceride and glucose index is a low-cost, practical, and easily accessible parameter for determining insulin resistance. We aimed to reveal the relationship between the triglyceride and glucose index and the severity of erectile dysfunction.
Methods: Medical records of 974 patients admitted to our clinic complaining of erectile dysfunction between January 2021 and June 2023 were scanned retrospectively from the database programme. According to the scores obtained from the simplified 5-item International Index of Erectile Function questionnaire, patients were classified into four groups: Group 1 (patients with severe erectile dysfunction), group 2 (patients with moderate erectile dysfunction), group 3 (patients with mild-to-moderate erectile dysfunction), and group 4 (patients with mild erectile dysfunction). We compared the fasting serum glucose, triglyceride, total cholesterol levels, and triglyceride and glucose indices (formula 1: Ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)]/2), and formula 2: Ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]) of the patients in the groups.
Results: No statistically significant differences in the mean age and serum total testosterone levels existed amongst the four groups (p = 0.695 and 0.074, respectively). A statistically significant difference was found in fasting serum glucose, triglyceride, and total cholesterol levels amongst the groups (p < 0.001). Significant negative correlations were found between the simplified 5-item International Index of Erectile Function questionnaire score and fasting serum glucose, triglyceride, total cholesterol, and triglyceride and glucose index (all p values < 0.001). The triglyceride and glucose index level was related to the risk of severe erectile dysfunction. Receiver operating characteristic curve analysis showed that the cutoff values were 5.05 for the triglyceride and glucose index by formula 1 and 9.43 for the triglyceride and glucose index by formula 2 in predicting severe erectile dysfunction.
Conclusions: The triglyceride and glucose index may be associated with erectile dysfunction and also its severity.
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Background: ETS-related gene (ERG) rearrangement and tensin homolog (PTEN) deletion are common molecular alterations in prostate cancer. Their prognostic significance for biochemical recurrence (BCR) after radical prostatectomy is not fully understood. This study aimed to conduct a systematic review and meta-analysis to assess the association between ERG and PTEN status and BCR risk.
Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for studies on ERG/PTEN status and BCR following radical prostatectomy. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using fixed-effects and random-effects models to determine the risk associated with these biomarkers.
Results: The meta-analysis showed that ERG positivity was linked to a 35.38% increased risk of BCR (HR = 1.3538 (0.9517; 1.9256), p = 0.0920) with significant heterogeneity (I2 = 69.3%, p = 0.0001). In subgroup analysis, ERG positivity was associated with increased BCR risk in both Asian (HR = 2.2538) and Caucasian (HR = 1.4387) populations. PTEN loss was associated with an 83.73% higher BCR risk (HR = 1.8373, 95% CI: 1.6469–2.0496, p < 0.0001) with low heterogeneity (I2 = 16.3%, p = 0.2974).
Conclusions: Both ERG rearrangement and PTEN deletion are associated with an increased risk of BCR after radical prostatectomy. While these biomarkers may improve prognostic stratification, the prognostic value of ERG status varies across different populations, suggesting a need for personalized management strategies in prostate cancer based on molecular markers.
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Objective: This study aims to retrospectively analyse factors affecting recurrence in children with Wilms’ tumour (WT) and establish a nomographic model for predicting WT recurrence 12 months after operation.
Methods: Children with Wilms’ tumour admitted to our hospital from January 2020 to January 2022 were retrospectively analysed. According to the recurrence of children recorded in the medical record system, they were divided into case group and control group. General demographic data and disease characteristics were collected, and multivariate logistics regression analysis was used to evaluate recurrence factor 12 months after operation. A nomogram model was constructed to predict the recurrence factors of WT, and an ROC (receiver operating characteristic) curve was drawn to verify the predictive efficacy of the nomogram model. Calibration and decision curves were constructed.
Results: A total of 119 children with WT were selected and divided into case group (25 children with recurrence) and control group (94 children without recurrence). Multivariate logistic regression analysis showed that clinical stage, histological risk group, Ki-67, tumour volume, capsule rupture and incomplete resection were all risk factors for the recurrence of WT (odds ratio (OR) >1, p < 0.05). The R package rms was used to draw a nomogram for the risk of recurrence. The C-index of clinical stage, histological risk group, Ki-67, tumour volume, capsule rupture and incomplete resection was 0.885 (95% CI: 0.810–0.956). The accuracy of the nomogram model in predicting the risk of recurrence was verified. The ROC curve showed that the Area Under Curve (AUC) value of the model was 0.911 (95% CI: 0.854–0.969; p < 0.05). The calibration and reference curves of the risk prediction model were similar, which proved the high consistency between the predicted risk and the actual risk of the recurrence of WT. The net benefit rate of the prediction model in the threshold range was high.
Conclusions: Clinical stage, histological risk group, Ki-67, tumour volume, capsule rupture and incomplete resection were risk factors for the recurrence of WT. A predictive nomogram model was constructed using these factors to screen children with WT with a high risk of recurrence for early intervention.
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Background: Stress urinary incontinence (SUI) is a prevalent chronic condition that significantly impacts the quality of life in middle-aged and older women. However, controversy persists regarding the factors influencing SUI in this population. This study aimed to investigate the prevalence and determinants of SUI in middle-aged and older women through a meta-analysis.
Methods: Cross-sectional, case-control, and cohort studies related to the prevalence and determinants of SUI in women aged ≥40 years were meticulously retrieved from databases such as Public Medical Database (PubMed), Web of Science, Excerpta Medica Database (Embase), Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and Viper Information Products (VIP), covering data until March 31, 2024. Two researchers independently conducted literature screening, data extraction, and quality assessment. Meta-analysis was conducted utilising Review Manager (RevMan) 5.3 software.
Results: Thirteen studies with a total sample size of 19,283 were included. The meta-analysis indicated that the prevalence of SUI among middle-aged and older women was 27%. Identified risk factors for SUI included age ≥50 years, body mass index (BMI) ≥24 kg/m2, low educational attainment, history of pelvic organ prolapse, previous pelvic surgery, constipation, urinary tract infections, hypertension, vaginal delivery, parity ≥2, and menopause.
Conclusions: SUI is prevalent among middle-aged and older women, affecting over a quarter of this population. Recognising the risk factors associated with SUI is crucial for strengthening the assessment, intervention, and overall quality of life in these women.
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Background: The Omaha System, recognised for its comprehensive approach that encompasses physical, psychosocial, and environmental factors, has shown promise in improving patient outcomes across various healthcare settings. This study aimed to investigate the impact of preoperative visits conducted using the Omaha System on patients undergoing transurethral resection of the prostate (TURP), with a specific focus on sleep quality and negative psychological aspects.
Methods: A retrospective cohort study was conducted, including patients scheduled for TURP between March 2022 and March 2024. Patients were categorised into two groups based on the preoperative visit methods: Traditional preoperative visits and those utilising the Omaha System. A total of 120 patients were included in the study, with 68 patients experiencing traditional preoperative visits and 52 patients receiving visits using the Omaha System. Various parameters, including sleep quality, psychological aspects, and clinical characteristics, were assessed and analysed both preoperatively and postoperatively.
Results: Preoperatively, there were no significant differences in sleep quality parameters or negative psychological aspects between the two groups. However, postoperatively, the group that received preoperative visits using the Omaha System demonstrated significant improvements in sleep quality, including the Pittsburgh Sleep Quality Index (PSQI) global score (p = 0.015), sleep latency (p = 0.043), sleep duration (p = 0.002), sleep efficiency (p = 0.004), and sleep disturbances (p = 0.004). Additionally, reductions in anxiety (p = 0.006), depression (p = 0.028), stress (p = 0.025), fear related to the surgery (p = 0.009), and uncertainty (p = 0.005) were observed postoperatively in the Omaha System group compared to the traditional visit group.
Conclusions: The implementation of preoperative visits using the Omaha System significantly improved postoperative sleep quality and reduced negative psychological aspects among patients undergoing TURP.
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Objective: Clinically, prostate cancer (PCa) is a common cancer among males, with the primary treatment being radical prostatectomy, which, nevertheless, has side effects. Multidisciplinary team (MDT) care, a new nursing method, could facilitate accurate diagnosis and individualized treatment. This study explored the perioperative nursing effect of MDT on patients undergoing da Vinci robot-assisted radical prostatectomy.
Methods: A total of 146 patients underwent radical resection of prostate cancer in The First Affiliated Hospital, Sun Yat-sen University from January 2023 to February 2024. They were divided into the MDT group (n = 77) and conventional care group (CC group, n = 69) according to the care modes; The data collected during the nursing period were collected and compared.
Results: The baseline characteristics of the two groups before care were similar, showing no significant difference (p > 0.05). After the implementation of care, resuscitation chamber dwell time and the quality of life and anxiety scores at each stage were better in the MDT than in the CC group, and the difference was statistically significant (p < 0.05).
Conclusions: Patients with radical resection of prostate cancer exhibit a high need for physical and psychological nursing. The implementation of a multidisciplinary nursing team led by nurses plays a major role in improving the anesthetic resuscitation effect while assisting in improving quality of life and anxiety.
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Objective: This study aimed to evaluate the clinical efficacy and safety of transurethral cystolithotripsy (TUCL) and percutaneous cystolithotomy (PCCL) in treating 20–30 mm bladder stones in male children.
Methods: Data on 62 male children of ≤16 years of age who were admitted to our hospital with bladder stones between January 2020 and December 2023 were retrospectively collected. The patients were categorised into a TUCL group (TUCL, n = 32) and a PCCL group (PCCL, n = 30) according to the employed surgical method. Operative time, stone-free rate (SFR), complication incidence, and general information of the patients were compared between the two groups.
Results: No significant differences in age, stone size, composition, and other general medical history were observed between the two groups (p > 0.05). SFR was 100% in both groups, but the operative time in the TUCL group was significantly longer than that in the PCCL group (p < 0.05). Furthermore, catheter indwelling time in the TUCL group was significantly shorter than that in the PCCL group (p < 0.05). No significant difference in the overall complication incidence was found between the two groups (p > 0.05), whereas the number of urinary retention cases was higher in the TUCL group than in the PCCL group.
Conclusions: TUCL and PCCL are effective surgical methods for treating 20–30 mm bladder stones in male children. Compared to TUCL, PCCL may be the preferred option owing to its relatively shorter operative time and lower complication rate.
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Background: Patients undergoing laparoscopic radical nephrectomy (LRN) for renal cancer face multifaceted challenges that can affect their physical, psychological, and emotional well-being. This study aimed to evaluate the impact of nursing based on Peplau’s theory on the recovery outcomes of patients treated with LRN for renal cancer, focusing on their nutritional status, spiritual well-being, and quality of life (QOL) after the surgical procedure.
Methods: A total of 148 patients with renal cancer who underwent LRN at our hospital between January 2023 and January 2024 were initially selected and grouped according to the type of postoperative nursing approach. Among the 75 patients receiving routine nursing, three with thrombosis of the renal vein or inferior vena cava and two with multiple renal tumours were excluded. Ultimately, 70 patients were included in the control group. Along with the routine nursing interventions, 73 patients received nursing care based on Peplau’s interpersonal relationship theory. A total of 70 patients were categorised in the Peplau nursing group after excluding two with multiple renal tumours and one with a history of laparoscopic partial nephrectomy (LPN). Data on demographic characteristics, disease features, nutritional indices, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp) scores, and QOL scores were collected and analysed using statistical tests.
Results: The haemoglobin (p < 0.001), albumin (p = 0.002), prealbumin (p = 0.013), and transferrin levels (p < 0.001) after nursing in the Peplau nursing group showed a significant increase compared to those in the control group. Moreover, the Peplau nursing group demonstrated significantly higher FACIT-Sp (p < 0.001) and QOL scores (p < 0.001) after nursing than the control group.
Conclusions: Nursing grounded in Peplau’s interpersonal relationship theory may have a beneficial effect on the nutritional status, spiritual well-being, and QOL of patients undergoing LRN for renal cancer.
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Background: The present study aims to determine the relationship between the expression levels of serum and urine biomarkers, and the composition of urinary calculi, in order to provide additional background information on the disease.
Methods: A total of 80 patients with urinary calculi, who were admitted to our hospital from January 2022 to June 2023, were selected as the study objects. In addition, 80 healthy subjects, who were admitted to our hospital during the same period, were selected as the control group. Patients with urinary calculi were further divided into two groups: Calcium oxalate calculi group and uric acid carbonate calculi group. The serum and urine biomarker levels of subjects in each group were compared by enzyme-linked immunosorbent assay. The correlation among calculi composition, clinical indicators, and protein biomarker levels was determined by single-factor and multi-factor analyses. The value of protein biomarkers in predicting calculi composition was evaluated using the receiver operating characteristic curve.
Results: There were significant differences in the expression levels of Lipocalin-2, matrix metalloproteinase 8, matrix metalloproteinase 9, angiopoietin-like 3, Dickkopf-4, interleukin 10 receptor alpha, interleukin 1 receptor 5, interleukin 2 receptor subunit gamma chain, and interleukin 28 A between the experimental and control groups. Furthermore, serum and urine Dickkopf-4, urine interleukin 10 receptor alpha, and microscopic red blood cell levels in urine were higher in patients with calcium oxalate calculi, when compared to patients with uric acid carbonate calculi (p < 0.05). The receiver operating characteristic curve analysis revealed that the area under curve for the four indicators was 0.854, with a cut-off value of 0.742. Thus, this can be used to predict the calcium oxalate composition in calculi.
Conclusions: Serum and urine protein biomarkers Dickkopf-4 and urine interleukin 10 receptor alpha, and microscopic red blood cells in urine can be used to predict the calculi composition. Patients with calcium oxalate calculi are more likely to have hematuria, when compared to patients with calculi of other compositions.
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Objective: Nephrotic syndrome (NS) is a common disorder in children that significantly affects their health. Children with NS often suffer from urinary tract infections (UTIs), which are common complications that not only complicate treatment but also worsen prognosis. The aim of this study was to analyze the factors associated with UTIs in children with NS and investigate potential intervention strategies.
Methods: Ninety-four pediatric patients with NS who were admitted to our hospital from January 2023 to October 2023 were selected. Among these patients, 34 children with UTIs were included in the research group, and the remaining 60 with NS alone were included in the control group. The children’s clinical data, such as age, sex, and NS course, were collected. Factors affecting the occurrence of UTIs in children with NS were analyzed via logistic regression, and future treatment strategies were discussed. Furthermore, children with UTIs were analyzed for the presence of pathogenic bacteria to summarize the clinical profile of these pathogens.
Results: Logistic regression analysis revealed that the duration of hormone use (odds ratio (OR): 3.841, 95% CI: 2.141–5.862), type of antibiotics used (OR: 1.841, 95% CI: 1.541–5.249), length of hospital stay (OR: 1.461, 95% CI: 1.124–1.667), albumin (ALB; OR: 0.623, 95% CI: 0.384–0.857, p = 0.015), immunoglobulin G (IgG; OR: 0.534, 95% CI: 0.264–0.836, p = 0.005), and 24-hour urine protein concentration (24 h Pro; OR: 6.242, 95% CI: 2.642–10.645) were independent relevant factors for UTIs in children with NS (p < 0.05). The analysis of pathogenic bacteria revealed that gram-negative bacteria were the most prevalent bacteria in children with UTIs (28 out of 34).
Conclusions: In the future, in the clinical treatment of pediatric NS patients, it is necessary to strictly control the dosage of hormones and antibiotics and pay attention to the dynamic changes in the ALB, IgG, and 24 h Pro levels to prevent UTIs.
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Background/Purpose: Prostate cancer is a prevalent malignancy with high incidence and mortality rates. Multiparametric magnetic resonance imaging (mpMRI) at 3.0Tesla (3.0T) offers high-resolution imaging to visualise tumour characteristics. This study aims to evaluate the diagnostic and staging utility of 3.0T mpMRI in prostate cancer.
Methods: In this retrospective study, patients suspected of having prostate cancer and admitted to our hospital between March 2022 to March 2024 underwent 3.0T mpMRI and prostate biopsy. Patients were staged in accordance with TNM classification (Groups I–II and III–IV). The diagnostic accuracy of mpMRI was assessed using Prostate Imaging Reporting and Data System (PI-RADS) Version 2.1 scores, tumour characteristics, signal intensities, radiomic features and biomarker levels. Least absolute shrinkage and selection operator (LASSO), multivariate logistic regression and joint model analyses were employed to identify factors influencing cancer progression.
Results: Amongst the 110 patients, 74 were in Groups I–II, and 36 in Groups III–IV. The diagnostic accuracy and sensitivity of mpMRI exceeded 90%. Significant differences were observed in Gleason scores, tumour size, location, volume, signal intensities, PI-RADS scores, radiomic features and biomarker levels (p < 0.05). LASSO regression analysis identified nine key variables, and logistic regression analysis revealed that Gleason scores, tumour size, PI-RADS score, apparent diffusion coefficient (ADC) values and prostate-specific antigen (PSA) levels were significantly associated with prostate cancer staging (p < 0.05). A predictive model was developed based on the five variables, and the receiver operating characteristic of 0.976 demonstrated excellent discriminatory power for the model. The calibration curve closely aligns with the diagonal line, indicating excellent calibration. Decision curve analysis shows net benefits across various threshold probabilities, highlighting its potential for informing clinical decision-making.
Conclusions: This study developed a predictive model for prostate cancer staging using multiparametric MRI, radiomic features and clinical data, showing strong potential for early diagnosis and prognostic evaluation. Future advancements in imaging technology and machine learning techniques may further enhance its clinical impact.
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Background: Adrenal tissue can be found in different organs or systems of the body owing to developmental abnormalities. They may be functional or non-functional and are often discovered incidentally during imaging studies for other conditions. When located within or near the kidney, ectopic adrenal tissue can mimic renal cell carcinoma (RCC), posing a diagnostic challenge for clinicians.
Methods: We reported the case of a 65-year-old male who presented with an asymptomatic renal mass mimicking RCC on preoperative imaging. Owing to the radiological suspicion of malignancy, laparoscopic partial nephrectomy was performed to ensure appropriate management.
Results: The pathological examination of partial nephrectomy material showed findings compatible with adrenal tissue, and a diagnosis of ectopic intrarenal adrenal tissue was made. Immunohistochemical analysis confirmed the adrenal origin, with markers such as Melan-A and alpha-inhibin differentiating the lesion from RCC.
Conclusions: The ectopic location of adrenal tissue, which is usually asymptomatic and benign, complicates diagnostic and therapeutic approaches. In cases with ambiguous imaging findings, intraoperative frozen biopsy may be considered, but surgery is often preferred when malignancy cannot be ruled out. This case highlights the importance of considering ectopic adrenal tissue in the differential diagnosis of renal masses, particularly when imaging findings are inconclusive. Therefore, multidisciplinary collaboration is essential to avoid unnecessary surgical interventions and ensure optimal patient care.
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