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Objective: Circumcision is a practice that is commonly implemented across the globe for reasons pertaining to medical necessity, social attitudes, and religious beliefs. This procedure, when performed on young boys, results in the infliction of harm upon the penis, thereby giving rise to the development of castration anxiety. Castration anxiety can be defined as an overwhelming fear of damaging or losing the penis during the phallic period, which, according to Sigmund Freud’s theory of psychosexual development, occurs between the ages of 3 and 6 years. The present study aims to compare social and sexual measures in later life between individuals who underwent circumcision during and beyond the phallic period.
Patients and Methods: Men who had previously undergone circumcision were included in the study. The participants completed a series of questionnaires designed to assess various aspects of their health and well-being. These included the International Index of Erectile Function, the male genital self-image scale, and the gender role attitudes scale.
Results: A total of 216 male participants who had previously undergone circumcision were included in the study. A notable absence of substantial variance was evident in the domains of sexual functionality, perception of the genital region, and gender roles, among subjects who underwent circumcision during and following the phallic period.
Conclusions: The results of the study refute the hypothesis that circumcision should not be performed during the phallic period, and thus contradict the position of psychiatrists that this procedure should not be carried out during this stage due to the anxiety it would cause.
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Background: The initiation of medical treatment for male patients with lower urinary tract symptoms (LUTSs) depends on their symptom scores, and subjective questionnaire forms must be supported by objective data. Our study aimed to investigate the relevance of post-void residual urine ratio (PVRR) as a marker in identifying patients who need treatment for LUTSs.
Methods: The study analysed the demographic, uroflowmetric, ultrasonographic and biochemical characteristics of 564 patients divided into two groups according to their International Prostate Symptom Scores (IPSSs). Patients with mild symptoms (IPSS = 1–7) were included in group 1; And patients with and moderate-to-severe symptoms (IPSS = 8–35), in group 2.
Results: The mean age of the study cohort was 61.5 ± 8.4 years. The mean IPSSs of groups 1 and 2 were 4.6 ± 1.7 and 18.5 ± 7, respectively. Group 1 had significantly higher maximal flow rate (Qmax) and average flow rate (Qave) but lower PVRRs than group 2 (13.8 ± 6.3 vs. 12.3 ± 5.7, p = 0.011; 8.3 ± 4.2 vs. 7 ± 3.6, p = 0.001; 9.0% (20) vs. 16.7% (29), p < 0.001, respectively). Multivariate logistic regression analysis results showed that only PVRR is the independent predictor of moderate-to-severe symptoms, and the cutoff value was >12.9% (OR 2.67 (1.34–5.3), p = 0.005). The PVRR cutoff value was >12.9%, which predicted moderate-to-severe symptoms with 58.6% sensitivity and 64.7% specificity.
Conclusions: In LUTS evaluation, uroflowmetry is often used after completing the questionnaire forms and weakly correlates with IPSS. Given that the symptom score is the only factor considered when deciding whether to begin therapy, PVRR offers more useful information for making the IPSS objective than traditional instruments.
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Background: Overactive bladder (OAB) is a debilitating condition predominantly affecting women. Whilst onabotulinum toxin A (Botox) injections are an effective surgical treatment, they typically require a full surgical team and an operating theatre and carry the risk of anaesthesia. LiNA OperaScope® offers a novel approach, allowing Botox administration in an outpatient setting with the patient in a supine position, eliminating the need for lithotomy, stirrups or surgical assistance. This paper presents the first UK experience with LiNA OperaScope®, assessing its feasibility, comparing patient tolerability with that of previous cervical smear tests and providing a relatable reference for patient counselling.
Methods: Fifty women with OAB refractory to previous treatments underwent Botox injections under local anaesthesia using LiNA OperaScope® in an outpatient setting. Patient and surgeon feedback, including pain scores and procedural ease, was collected. The pain experienced during the procedure was compared with that of prior smear tests.
Results: The average patient age was 64.8 years (range: 34–88). The cohort was divided into an elderly group (≥75 years) and a younger group (<75 years). The overall pain score for the Botox procedure was 2.2/10, with the elderly group reporting a lower pain score (2.0/10) compared with the younger group (2.3/10). Both groups experienced significantly less pain during the Botox procedure than during smear tests (p < 0.001). The average procedure time was less than 3 min. Two patients developed a urinary tract infection, which was successfully treated with oral antibiotics alone (Clavien-Dindo grade II).
Conclusions: LiNA OperaScope® is a feasible and viable option for delivering Botox treatment in women with OAB. It is well tolerated, with patients reporting lower pain levels than those during prior smear tests, making it a relatable and effective tool for better counselling of patients on the procedure.
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Background: Bladder stones feature multifactorial aetiologies, including bladder outlet obstruction, metabolic or genetic disorders and environmental factors. Bladder calculi occur in approximately 5% of urinary system stones. In addition, giant urinary bladder stones are commonly observed in geriatric patients. This study aimed to compare and evaluate the outcomes of open cystolithotomy, percutaneous and transurethral cystolithotripsy techniques in the surgical treatment of bladder stones in geriatric patients.
Methods: The primary observation metrics comprised stone clearance rate and symptom resolution, and the secondary metrics included complications and recovery time. This study aimed to identify the most suitable technique for this patient group. The medical records of patients who underwent bladder stone surgery between January 2010 and January 2021 were retrospectively reviewed. Geriatric patients aged 65 years and older who had undergone bladder stone surgery were included in this work.
Results: Of the patients, 72 were male, and 4 were female, with a mean age of 72.6 years (range: 65–89). The average stone size was 39.7 × 29.4 mm. Surgical procedures consisted of open suprapubic cystolithotomy in 31 patients, percutaneous cystolithotripsy in 17 patients and transurethral cystolithotripsy in 28 patients. The stone-free rates were 85.7% for the transurethral cystolithotripsy group and 100% for the open cystolithotomy and percutaneous cystolithotripsy groups (p > 0.05). Symptom resolution occurred in 94.7% of cases. No statistically significant differences were observed in the complication rates among the three groups (p > 0.05), with early complications including haematuria (3.9%) and residual stones (2.6%) and late complications comprising fever (1.3%) and urethral stricture (1.3%). The mean hospital stay was 4.3 ± 2.1 days, with no significant differences among groups (p = 0.071). In addition, benign prostatic hyperplasia was present in 84% of male patients, and other conditions included ureteral stones (4 patients), a right-sided hydrocele (1 patient) and a vesicovaginal fistula (1 patient).
Conclusions: All three techniques—open cystolithotomy, percutaneous cystolithotripsy and transurethral cystolithotripsy—can be safely performed in the surgical treatment of bladder stones in geriatric patients. However, large-scale population studies are required to determine the optimal technique.
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Background: Chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS) is a prevalent condition that significantly affects patients’ quality of life, presenting with diverse symptoms and multifactorial etiologies that remain incompletely understood. The Urinary, Psychosocial, Organ-specific, Infection, Neurologic and Tenderness (UPOINT) system categorises CP/CPPS symptoms into six domains, providing a framework for evaluating severity. Emerging evidence suggests that the presence of microorganisms in prostatic fluid may influence symptom severity. This study aimed to investigate the association between microorganisms in prostatic fluid and the severity of symptoms in patients with CP/CPPS by utilising the UPOINT system for classification.
Methods: This retrospective study evaluated patients diagnosed with CPPS. The data collected included demographics, International Prostate Symptom Score (I-PSS), inflammatory and noninflammatory symptoms, International Index of Erectile Function scores and presence of microorganisms in prostatic fluid. Laboratory tests for 26 microorganisms, including microscopic examination and polymerase chain reaction testing (Androflor), were conducted by a blinded expert.
Results: A total of 112 patients aged 20–60 years were included in the study. The study involved patients with a mean age of 37.90 ± 8.10 years and a mean symptom duration of 15.40 ± 8.20 months. The average I-PSS was 8.56 ± 4.10. The reported predominant symptoms were lower abdominal pain, dysuria and urinary frequency. Microorganisms were detected in the prostatic fluid of 29.46% of patients. A statistically significant positive correlation was observed between the presence of microorganisms and I-PSS scores (r = 0.576, p < 0.001). Despite its statistical significance, the clinical relevance of this correlation is limited and requires careful interpretation.
Conclusions: This study identified a significant association between microorganisms in prostatic fluid and symptom severity in patients with CP/CPPS, indicating the need for further research to validate these findings and improve patient care.
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Objective: Postpartum stress urinary incontinence (SUI) seriously affects women’s reproductive health. This study aimed to analyse the clinical effect of a prenatal pelvic floor training programme based on the Internet platform on the prevention of postpartum SUI.
Methods: The clinical data of 186 postpartum women admitted to our hospital from April 2021 to April 2023 were selected for retrospective study. Eight postpartum women who did not meet the inclusion criteria were excluded, and the remaining postpartum women were divided into the reference group (n = 85) and observation group (n = 93) according to different management schemes. The study collected the clinical indicators of the two groups and analysed the effects of different prenatal training programmes on postpartum SUI.
Results: The observation group had higher maximum value of postpartum fast muscle contraction than the reference group (p < 0.001). The observation group had higher maximum bladder pressure measurement volume and maximum flow rate than the reference group (p < 0.05). Compared with the reference group, the observation group had significantly higher Short-Form-36 Health Survey scores (all p < 0.001). The observation group had significantly lower incidence of postpartum SUI than the reference group (p < 0.001).
Conclusions: The implementation of the pelvic floor training programme based on the Internet platform before delivery is helpful to improve pelvic floor muscle function and effectively prevent postpartum SUI.
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Aim: Patients with urological tumours may exhibit varying degrees of physiological and psychological distress during the course of treatment. This study aims to explore the influence of psychological nursing model based on the Rosenthal effect on the mental health and quality of life of patients.
Methods: The clinical data of 120 patients who underwent surgical treatment of urinary system tumours in the department of urology in our hospital from June 2023 to October 2023 were collected retrospectively. The patients were divided into the observation and control groups according to the nursing mode under the Rosenthal effect. Fifty cases were assigned in the observation group, and 70 cases were placed in the control group. The intervention period was 2 weeks and 3 months. The patients were scored and compared according to Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), 36-Item Short-Form (SF-36), and Pittsburgh Sleep Quality Index (PSQI) the day before and after the intervention cycle.
Results: After nursing, the scores of SAS, SDS and PSQI in the two groups were lower than those before nursing. Compared with the control group, the observation group had a higher decrease. The SF-36 score in both groups after nursing was higher than that before nursing, and the score in the observation group after nursing was higher than that in the control group (p < 0.05).
Conclusions: The psychological care model based on the Rosenthal effect can effectively improve the psychological health and quality of life of urological oncology patients in the postoperative period. This intervention is worth to be promoted and practiced in medical institutions and professional fields.
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Background: Urinary tract infection (UTI) in children is a common urinary tract disease in children. We retrospectively analysed the clinical data of children with UTI who were admitted to a hospital in a primary area of China in the past 5 years to understand the distribution of common pathogens and antibiotic-resistance characteristics of UTI patients in these areas.
Methods: We collected and retrospectively investigated the urine-culture results, drug-resistance analysis, positive detection rate, composition ratio, and isolation rate of some pathogenic bacteria in children with UTI in the paediatric department of a primary area hospital in China from January 1, 2019 to December 31, 2023.
Results: Among 366 midstream urine samples collected from paediatric patients with urinary tract infections (UTIs) over a five-year period, 157 cases were found to have pathogenic bacteria, yielding a positive urine-culture rate of 42.90%. Among them, 52 cases (33.12%) were male patients, and 105 cases (66.88%) were female. A total of 94 strains were Gram negative bacteria (59.87%), 62 strains were Gram positive bacteria (39.49%), and 1 case was a fungus (0.64%). Drug-sensitivity testing was conducted on the top three pathogens detected over the past five years (Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Enterococcus faecium) (E. faecium). The isolation rates of these three pathogens showed a declining trend within the five-year period. The constituent ratio of E. coli (35.98%) was higher than that of K. pneumoniae (8.39%) and E. faecium (25.91%). The top two Gram negative bacteria detected were E. coli and K. pneumoniae, whereas the top two Gram positive ones were E. faecium and Staphylococcus hemolyticus. Different pathogens exhibited resistance to various antibiotics.
Conclusions: In the past 5 years, the main pathogens infected by children with UTI in the grassroots areas of China were Gram negative bacilli represented by E. coli and Gram positive cocci represented by Enterococcus faecium. All isolated pathogens had different degrees of resistance to the current commonly used clinical drugs, thereby requiring clinical attention.
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Objective: This study retrospectively analysed the impact of self-care education based on Orem’s self-care deficit theory on elderly male patients with prostate cancer (PCa).
Methods: Medical records of elderly male patients admitted to our hospital for PCa from January 2021 to January 2024 were retrospectively collected. Patients were divided into two groups on the basis of the nursing approach: The Orem group (receiving self-care education that is based on Orem’s self-care deficit theory) and the conventional group (receiving routine nursing care). Self-efficacy, quality of life (QOL), psychological health and nursing satisfaction were compared between the two groups.
Results: A total of 86 male patients with PCa were included in the study (Orem group n = 41, conventional group n = 45), with no statistically significant differences in age, tumour staging, comorbidities nor other general medical history between the two groups (p > 0.05). After 6 months of nursing care, both groups showed improvements in self-efficacy, QOL and psychological health. However, the Orem group demonstrated better scores in all aspects, with statistically significant differences (p < 0.05). The nursing satisfaction rate in the Orem group was 90.24%, which was superior to the 75.56% of the control group, and the difference was statistically significant (p < 0.05).
Conclusions: Compared with the traditional routine nursing care, self-care education based on Orem’s self-care deficit theory can effectively improve the self-efficacy, QOL and psychological health of elderly patients with PCa. It is worth promoting in clinical practice.
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Background: This retrospective study aimed to evaluate the effect of meaning-centred group psychotherapy (MCGP) on patients with advanced urologic cancer.
Methods: A retrospective analysis was conducted on the medical records of patients with advanced urological system tumours who visited our hospital from January 2022 to January 2024. Patients were divided into a conventional group and an MCGP group on the basis of the type of nursing care they received. Both groups underwent nursing care for one month, and the Meaning in Life Questionnaire (MLQ), Herth Hope Index (HHI), Self-Perceived Burden Scale (SPBS) and Hospital Anxiety and Depression Scale (HADS) status of the patients in both groups were assessed before the care, one month after and two months after the care.
Results: A total of 119 patients were enrolled in this study, including 63 patients in the conventional group and 56 patients in the MCGP group. The results of repeated measures analysis of variance (ANOVA) showed that MLQ, HHI, SPBS and HADS had interactive effects on measurement time and grouping (p < 0.01). Further simple effect analysis showed that before nursing, no significant differences in MLQ, HHI, SPBS and HADS scores between the two groups were found (p > 0.05). After 1 month and 2 months of nursing, the MLQ and HHI scores of the MCGP group were higher than those of the conventional group (p < 0.05). The SPBS and HADS scores of the MCGP group were lower than those of the conventional group (p < 0.05).
Conclusions: This study shows that MCGP therapy carried out by a hospice care team can effectively improve the meaning of life and hope level of patients with advanced urinary system tumours, reduce the self-burden level of patients, improve anxiety and depression, and have a positive effect on patients.
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Objective: To investigate the beneficial effects of warm intravenous infusion on core temperature, haemodynamic monitoring and tremors in patients undergoing transurethral resection of the prostate (TURP).
Methods: Clinical data were retrospectively collected from the urology department of Urology Department of Zhujiang Hospital of Southern Medical University between February 2021 and February 2024. Core temperature and haemodynamic parameters were collected from patients at four time points: Before anaesthesia induction, immediately after endotracheal tube insertion, 10 min after the start of surgery (T2) and 10 min after extubation (T3). Additionally, intraoperative tremors and postoperative adverse events occurring within 24 h were recorded.
Results: A total of 122 patients were included. On the basis of intravenous infusion temperature, the patients were divided into the warm intravenous infusion group (G1, n = 60) and room-temperature infusion group (G2, n = 62). Analysis of variance revealed a significant interaction effect between time and group on patients’ core body temperature (p < 0.001), with time and group demonstrating significant main effects (p < 0.001). At T2 and T3, G2 had lower body temperatures than G1 (p < 0.001). Additionally, time had a significant interaction effect on patients’ mean arterial pressure (MAP) (p < 0.05), and significant main effects were observed for patients’ heart rate (HR) across time, group and the time-group interaction (p < 0.05). At T2 and T3, G1 exhibited higher levels of MAP, HR and oxygen saturation than G2 (p < 0.05). During the operation, the tremor rate and duration in G1 were lower than those in G2 (p < 0.05). Within 24 h after surgery, the incidence of adverse reactions in G1 was lower than that in G2 (p < 0.05).
Conclusions: Warm intravenous infusion is beneficial for patients undergoing TURP to maintain intraoperative core body temperature, improve the stability of haemodynamic parameters and reduce the incidence of intraoperative tremors and postoperative adverse reactions.
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Objective: This study aimed to investigate the clinical efficacy of cefoperazone sulbactam sodium in female patients with complicated urinary tract infection and determine its effect on bacterial clearance and improvement of renal function.
Methods: A retrospective collection of medical records related to urinary tract infections was conducted for patients admitted between June 2021 and May 2024. The blood routine renal function indexes, the type culture and positive rate of urine bacteria after treatment and the bacterial clearance rate were compared between the two groups before and after treatment. The improvement in clinical symptoms and the incidence of adverse reactions during treatment were observed.
Results: A total of 211 patients with complicated urinary tract infections were screened as study subjects. Among them, 106 patients received cefoperazone/sulbactam, and 105 patients received levofloxacin. Before treatment, the baseline characteristics of the two groups were similar, with consistent bacterial distribution in urine cultures, rendering them comparable (p > 0.05). Both groups of patients received a 7-day treatment course. After treatment, the white blood cell count and renal function indexes of serum creatinine and blood urea nitrogen in the cefoperazone sulbactam group were lower than those in the levofloxacin group (p < 0.05). After treatment, the positive rate of urine bacterial culture in the cefoperazone sulbactam group was lower than that in the levofloxacin group (p < 0.05). During the treatment period, the disappearance time of clinical symptoms, the time of leukocyte conversion and defervescence in the cefoperazone sulbactam group were shorter than those in the levofloxacin group (p < 0.05). The common adverse reactions in the two groups were nausea, vomiting and rash, and the overall adverse event rate was slightly higher in the levofloxacin group than in the cefoperazone sulbactam group (p > 0.05).
Conclusions: Cefoperazone sodium-sulbactam sodium has shown high efficacy in the treatment of complicated urinary infections in middle-aged women. It can quickly control infection and improve clinical symptoms.
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Objective: This study aimed to analyse stress injury in the treatment of benign prostatic hyperplasia (BPH) by transurethral plasmakinetic resection of the prostate (TUPKP), as well as the related factors affecting patients’ urinary tract infection (UTI) after TUPKP for clinical reference.
Methods: Retrospective analysis was conducted on patients with BPH who were admitted to our hospital from May 2022 to June 2024. Amongst them, the patients treated with TUPKP were the observation group, and the patients treated with electroprostatectomy (EP) were the control group. The surgical parameters, as well as the differences in inflammation, stress responses and urodynamics before and after surgery, were compared between the two cohorts. Subsequently, logistic regression analysis was performed to analyse the relevant factors affecting UTI after TUPKP.
Results: A total of 219 patients were treated with TUPKP (observation group), and another 184 patients were treated with conventional EP (control group). The observation group showed shorter duration of indwelling urethral catheters and postoperative hospital stays as well as less intraoperative blood loss than the control group (p < 0.05). In addition, the inflammation and stress response in the observation group were milder 3 days after surgery, and the urodynamics were more favourable 3 months after surgery (p < 0.05). The incidence of UTI was 20.55% (45/219) in the observation group and 29.35% (54/184) in the control group. Logistic regression analysis demonstrated that diabetes mellitus (odds ratio (OR): 6.362, 95% CI: 2.232–8.132), urethral injury (OR: 5.476, 95% CI: 1.932–5.515), duration of indwelling urethral catheters (OR: 2.164, 95% CI: 1.204–3.889) and bladder irrigation times (OR: 0.051, 95% CI: 0.229–0.809) were independent determinants affecting UTI (p < 0.05).
Conclusions: TUPKP for the treatment of BPH can effectively attenuate postoperative inflammation and stress responses in patients. On the contrary, diabetes, urethral injury, duration of indwelling urethral catheter and bladder perfusion were the factors influencing the development of UTI after TUPKP.
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Background: Ureteroscopic lithotripsy is a common method for treating urinary tract stones. Stone clearance rate and postoperative retreatment incidence are influenced by various factors. Understanding these factors is crucial for improving treatment outcomes and reducing the need for postoperative retreatment.
Methods: This retrospective study analysed patients who underwent ureteroscopic lithotripsy at Ankang Gaoxin Hospital between January 2022 and September 2024. All patients received detailed imaging examinations before surgery and were regularly followed up for one month to evaluate stone clearance. Patient demographics, stone size, location and type, and procedural details were collected. Factors related to stone clearance and postoperative retreatment were analysed by using univariate analysis and multivariate logistic regression.
Results: The stone clearance rate after ureteroscopic lithotripsy was 91.53%. Multivariate logistic regression analysis revealed that stones larger than 10 mm in diameter (odds ratio (OR) = 4.474, p = 0.029) and high stone density (OR = 1.004, p = 0.006) were independent risk factors for stone retention. The incidence of postoperative retreatment was 6.88%. Multivariate logistic regression analysis demonstrated that bilateral stones (OR = 6.531, p = 0.013) and high stone density (OR = 1.004, p = 0.010) were independent risk factors for retreatment.
Conclusions: Ureteroscopic lithotripsy demonstrates a high stone clearance rate. However, stone size and density are important factors affecting clearance. The incidence of postoperative retreatment is closely related to stone location and density. Tailoring treatment in accordance with these factors can further enhance outcomes and reduce the need for retreatment.
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Objective: This study aims to evaluate the clinical efficacy of transurethral thulium laser enucleation of the prostate (ThuLEP) and transurethral bipolar plasma resection of the prostate (B-TURP) in the treatment of male benign prostatic hyperplasia (BPH) through a retrospective study.
Methods: We retrospectively collected the medical records of male patients with BPH who were admitted to our hospital from January 2020 to December 2023. Patients were divided into two groups on the basis of the surgical approach: The ThuLEP group (T group) and the B-TURP group (B group). We compared the operative time, haemoglobin drop, weight of the resected tissue, bladder irrigation time, catheterisation time and hospital stay. The International Prostate Symptom Score (IPSS) and the International Consultation on Incontinence Questionnaire-Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) were collected from patients in both groups in the first and third months after surgery. Information on postoperative complications during hospitalisation and at three months in both groups of patients was collected.
Results: A total of 110 patients with BPH were included in this study (T group n = 56; B group n = 54). No statistically significant differences in age, body mass index (BMI), prostate volume and other general medical history data were observed between the two groups (p > 0.05). Moreover, no statistically significant difference was found in postoperative tube placement time and length of hospitalisation between the two groups of patients (p > 0.05). Patients in the T group had longer operative time and bladder irrigation time, greater weight of the resected prostate and greater haemoglobin drop compared with the B group, with statistically significant differences (p < 0.05). The IPSS and ICIQ-MLUTS scores in the first and third months postoperatively were higher in the B group than in the T group, and the IPSS scores in the third month showed a statistically significant difference between the two groups (p < 0.05). The incidence of complications in the T group was lower than in the B group, but the differences were not statistically significant (p > 0.05).
Conclusions: Although the ThuLEP procedure time is longer, patients have faster postoperative recovery, higher haemoglobin levels and better IPSS score performance in the third month. Therefore, ThuLEP may be a better choice than B-TURP for urologists.
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Background: Immune-related genes (IRGs) are pivotal in orchestrating immune infiltration processes. However, their expression patterns and potential regulatory pathways in patients with chronic antibody-mediated rejection (cABMR) post-kidney transplantation remain poorly understood. This study aimed to elucidate these aspects by analysing single-cell RNA sequencing (scRNA-seq) data of peripheral blood mononuclear cells (PBMCs) derived from patients with cABMR and scrutinising cluster marker genes from PBMCs sourced from the ImmPort database to elucidate the underlying mechanisms.
Methods: PBMCs from patients with cABMR were examined using scRNA-seq to identify gene clusters, and IRG activity was quantified with the AUCell software package. Additionally, a bulk RNA sequencing dataset of kidney tissues was analysed to identify common IRGs between PBMCs and kidney tissue. Relevant regulatory transcription factors (TFs) were subsequently identified using the Human Transcription Factor Database. Finally, a protein-protein interaction network for key TFs was constructed using the STRING database.
Results: We identified six distinct clusters of cells, namely, monocytes, neutrophils, myeloid cells, T cells, B cells and natural killer cells, with monocytes and neutrophils significantly elevated in patients with cABMR. These cells presented the highest IRG activity. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses revealed that the differentially expressed genes were primarily associated with immune responses. Sixteen common IRGs were identified in peripheral monocytes and kidney tissue, and 13 were identified in peripheral neutrophils and kidney tissue. Moreover, three key TFs (STAT1, IRF1 and FOS) associated with IRG expression were identified in these cells.
Conclusions: Our bioinformatic analysis of scRNA-seq and bulk RNA sequencing data suggests that peripheral monocytes and neutrophils may contribute to the inflammatory changes observed in cABMR. Furthermore, STAT1, IRF1 and FOS may play essential roles in the transcriptional regulation of IRGs in monocytes and neutrophils.
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Background: Cowper’s gland syringocele is a rare cystic dilation of the male bulbourethral gland, predominantly observed in children and young adults. The simultaneous occurrence of Cowper’s gland syringocele and ureteropelvic junction obstruction (UPJO) is exceedingly rare, with only two cases reported in literature. This report presents a novel case involving a 6-month-old male infant, highlighting the first instance of combined minimally invasive surgical treatment within a single anesthetic event.
Case Presentation: A 6-month-old male presented with progressive left hydronephrosis and urethral stenosis. Imaging studies confirmed the diagnosis of Cowper’s gland syringocele and left UPJO. A unique approach was adopted, involving simultaneous performance of urethrocystoscopy and laparoscopic pyeloplasty under a single anesthetic. The urethrocystoscopy revealed a bulge in the bulbar urethra consistent with syringocele, which was treated by transurethral incision, followed by a laparoscopic Anderson-Hynes dismembered pyeloplasty using minilaparoscopic instruments. The postoperative course was uneventful, and the patient was discharged on the second day, with follow-up showing preserved renal function, significant reduction in hydronephrosis and resolution of the ureteropelvic junction obstruction. The patient remained asymptomatic after 5 years of follow-up.
Conclusions: This case underscores the feasibility and safety of combining urethrocystoscopy and laparoscopic pyeloplasty in a single anesthetic session, even in an infant. The successful outcome in this patient highlights the potential for minimally invasive surgery to treat complex pediatric urological conditions effectively whilst minimising the burden of multiple surgeries.
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Introduction: Urethral polyps (UPs) are rare benign urethral tumours that may cause significant bladder outlet obstruction or remain asymptomatic for many years. Although uncommon, UPs must be considered in paediatric patients with persistence of lower urinary tract symptoms or mild ultrasound dilation. Thus, we retrospectively reviewed our experience in UP diagnosed in our Paediatric Urology Division.
Case Presentation: We enrolled three paediatric cases of UP, including one associated with Noonan syndrome and one with Down syndrome, underscoring diagnostic challenges in syndromic cases. Patients underwent urinary tract ultrasound and then voided cystourethrogram. Diagnosis was confirmed by urethrocystoscopy performed in the operating room under general anaesthesia. All patients were managed with endoscopic resection. Histological examination revealed fibroepithelial polyp characteristics. Postoperative recovery was uneventful, with complete resolution of urinary symptoms (dysuria, haematuria, urinary retention, intermittent voiding and recurrent urinary tract infections (UTIs)). During the average follow-up period of 2.5 years, no UP recurrence was detected.
Conclusions: This report highlights the need for heightened clinical vigilance for UPs in children with dysfunctional voiding, especially those with syndromic conditions. Furthermore, careful evaluation of minor signs suggestive of urethral abnormalities that can be detected by bladder ultrasound is recommended. Early diagnosis and treatment are critical to prevent long-term renal complications and enhance patient outcomes.
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