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Background: This review focuses on the critical role of human factors in the integration of artificial intelligence (AI) into urology. Whilst AI holds promise for enhancing diagnostics, surgical precision and personalised care, its success depends considerably on the cognitive, physical and psychosocial dimensions of human interaction with these systems.
Objectives: Key human factors, such as cognitive load, trust, collaboration and communication, directly influence the adoption and effectiveness of AI technologies. For instance, clinicians must balance leveraging AI’s insights with maintaining critical thinking to avoid automation bias.
Methods: The design and ergonomics of AI tools, and their seamless integration into clinical workflows, play pivotal roles in optimising efficiency and minimising disruptions. Psychosocial elements like transparency, team dynamics and patient-centric communication are vital to fostering trust and ensuring ethical use of AI in sensitive contexts.
Results: Training and continuous professional development tailored to human factors are essential to empower clinicians to work effectively alongside AI. Ethical considerations, including accountability and fairness, further emphasise the need for transparent processes and diverse datasets to address algorithmic biases.
Conclusions: This review highlights the path toward a responsible and patient-centred integration of AI in urology by prioritising human factors, ultimately bridging the gap between technological innovation and compassionate healthcare delivery.
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Androgen deprivation therapy (ADT) has been a pillar in the management of prostate cancer (PCa) since the 1940s and remains a standard of care across different clinical scenarios of PCa. Gonadotropin-releasing hormone (GnRH) agonists are the most commonly used form of ADT because they have consistently proven to be effective. The arrival of GnRH antagonists, such as degarelix and relugolix, has introduced an alternative to agonists while offering distinct advantages. Antagonists achieve the rapid suppression of testosterone without the initial flare effect observed with agonists. Relugolix, an oral antagonist, has been reported to result in the rapid recovery of normal testosterone levels after treatment discontinuation and may be associated with a potentially lower cardiovascular (CV) risk than agonists. Moreover, antagonists provide an additional therapeutic option that enables an individualised treatment approach, aligning with the growing emphasis on personalised medicine. However, evidence regarding the superiority of antagonists over agonists in terms of clinical outcomes or side effects remains limited and, in some cases, contradictory. The effectiveness of antagonists, particularly in sustaining long-term testosterone suppression, and their safety profile, especially in relation to CV risks, remain debated. Although early studies indicate potential advantages, current clinical evidence is still evolving and requires further validation. This narrative review of the literature aims to provide a comprehensive update on the role of antagonists in PCa management, highlighting their potential benefits and limitations while addressing existing controversies. Despite the apparent advantages of antagonists, long-term prospective studies must be conducted to confirm their efficacy and safety, particularly when combined with other therapies, and to define their role across different disease stages.
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Background: This study aimed to compare the results of flexible ureteroscopy with holmium laser lithotripsy (FURSL) and mini-percutaneous nephrolithotomy (mini-PNL) for the treatment of >2 cm upper calyceal stones.
Methods: The data of patients who underwent FURSL and mini-PNL surgery for kidney stones between May 2011 and June 2023 were retrospectively examined. Patients with single or multiple kidney stones located in the upper calyx and varying in diameter from 2 cm to 4 cm were included in the study. Operation time, hospitalisation time, complication rates and 1 month stone-free rate (SFR) were compared between the two surgical methods. Stone-free status was evaluated by performing non-contrast computed tomography 1 month after the surgery.
Results: A total of 73 (49.3%) and 75 (50.7%) patients were included in the FURSL and mini-PNL groups, respectively. The mean operation time (72.5 vs. 89.7 min) and hospital stay (1.2 vs. 2.1 days) were shorter in the FURSL group (p < 0.001). Although complications were less common in the FURSL group, the difference was not statistically significant (12.3% vs. 21.3%, p = 0.199). The 1 month SFRs were 83.6% and 90.7% in the FURSL and mini-PNL groups, respectively, without statistically significant difference between the groups (p = 0.461).
Conclusions: Both surgical approaches are equally effective and safe for the treatment of >2 cm upper calyceal stones. Short surgery and hospitalisation times are the most important advantages of FURSL. This type of surgery can be recommended as an alternative treatment to mini-PNL, with lower complication rates in selected patients.
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Purpose: This study evaluates the prognostic significance of the inflammatory burden index (IBI) and related systemic inflammatory markers, namely, C-reactive protein-to-albumin ratio (CAR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), and pan-immune inflammation value (PIV), in predicting survival outcomes in patients with nonmetastatic muscle-invasive bladder cancer (MIBC) undergoing radical cystectomy (RC).
Methods: A total of 115 patients treated between January 2014 and January 2023 were included. IBI, CAR, SII, PLR, MLR, SIRI, NLR, and PIV were calculated. Kaplan–Meier, Cox regression, and receiver operating characteristic (ROC) curve analyses were performed to determine the impact of these biomarkers on overall survival (OS) and progression-free survival (PFS).
Results: ROC analysis for OS prediction revealed the highest predictive accuracy for PIV (area under curve (AUC) = 0.784, p < 0.001), followed by SIRI (AUC = 0.751) and IBI (AUC = 0.747). For PFS prediction, IBI demonstrated the strongest predictive value (AUC = 0.672, p = 0.002), followed by CAR (AUC = 0.663, p = 0.003) and PIV (AUC = 0.662, p = 0.003). Multivariate Cox regression analysis identified PIV (hazard ratio (HR) = 3.673, p < 0.001), SIRI (HR = 3.074, p < 0.001), and IBI (HR = 2.209, p = 0.002) as independent predictors of OS. High IBIs were significantly associated with advanced tumor stage (T stage) (p = 0.025), lymphovascular invasion (p = 0.002), and perineural invasion (p = 0.023) but not with lymph node metastasis (p = 0.713).
Conclusions: IBI and associated hematological markers are valuable for predicting survival outcomes in patients with MIBC. The findings support the integration of these biomarkers with other prognostic tools to enhance the accuracy of treatment outcome predictions.
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Objective: To investigate the predictors of postoperative erectile dysfunction (ED) in patients who underwent bilateral nerve-sparing laparoscopic radical prostatectomy (BNLRP).
Materials and Methods: Patients with preoperative ED were excluded. Postoperative erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) at 6 months postoperatively, with a cutoff score of ≤12 to define ED. The diagnostic value of associated factors was assessed using odds ratios (ORs) with 95% confidence intervals (CIs) based on univariate and multivariate logistic regression analyses. Only variables with p < 0.05 in univariate analysis were included in the multivariate model to avoid multicollinearity and overfitting.
Results: A retrospective review was conducted on 79 patients who underwent BNLRP for localised prostate cancer between April 2020 and March 2023. Postoperative ED was observed in 37 (46.8%) patients. Univariate analysis revealed significant associations between ED and age (p < 0.001), diabetes mellitus (p < 0.001), coronary artery disease (p < 0.001), hypertension (p < 0.001), Gleason score (p < 0.001), operative time (p < 0.001) and intraoperative blood loss (p < 0.001). Multivariate logistic regression identified age (OR: 1.136, p = 0.046), diabetes mellitus (OR: 32.706, p = 0.003), Gleason score (OR: 4.749, p = 0.015), operative time (OR: 1.200, p = 0.001) and blood loss (OR: 1.010, p = 0.039) as independent predictors.
Conclusions: ED after BNLRP is associated with patient-related and surgical factors. Identifying these predictors may improve preoperative counselling and support early postoperative rehabilitation strategies. Prospective multicentre studies are necessary to externally validate these findings.
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Background: This study aims to evaluate and compare the transobturator tape and minisling surgical techniques in the treatment of stress urinary incontinence, focusing on their effectiveness and postoperative outcomes.
Methods: This retrospective analysis included 113 patients who underwent midurethral sling surgery for stress urinary incontinence at Islahiye State Hospital between January 2016 and October 2022. The patients were divided into two groups: Those treated with transobturator tape (Group 1, n = 70) and those treated with minisling (Group 2, n = 43). Data were collected from medical records and follow-up interviews. The variables assessed included demographics (age and body mass index), preoperative and postoperative Urinary Incontinence Quality of Life Scale scores, and postoperative pain details. Operative details, such as procedure duration and hospital stay length, were recorded. Patients were also asked about postoperative symptoms, including groin pain and dyspareunia. Additionally, the duration of symptom-free months following surgery was documented. Binary logistic regression analysis was conducted to evaluate the effect of surgical methods on long-term well-being.
Results: The transobturator tape and minisling techniques demonstrated similar improvements in postoperative Urinary Incontinence Quality of Life Scale scores (p = 0.213). However, the minisling procedure had significantly shorter operative time (29.2 min vs. 52.2 min, p < 0.001) and hospital stay (1.33 days vs. 1.96 days, p = 0.003) than transobturator tape. Postoperative complications were notably higher in the transobturator tape group, with significantly more patients reporting groin pain (28.6% vs. 4.7%, p = 0.002) and dyspareunia (20.0% vs. 0.0%, p = 0.002). Logistic regression analysis identified surgical method as the primary predictor of long-term well-being beyond one year (p = 0.040).
Conclusions: While the transobturator tape and minisling surgeries are effective for treating stress urinary incontinence, the minisling method offers advantages, such as shorter operative time, reduced hospital stay, and fewer postoperative complications, over the transobturator tape method. These findings suggest that the minisling approach may provide a more favorable patient experience, particularly due to reduced postoperative pain and quick recovery, than the transobturator tape method.
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Objective: Stress urinary incontinence (SUI) is a common postpartum complication in women. This study aims to evaluate the clinical efficacy of pelvic floor muscle training (PFMT) combined with biofeedback stimulation (BS) in the treatment of postpartum SUI.
Methods: A total of patients with postpartum SUI admitted to our hospital from January 2023 to January 2024 were enrolled in the study. Based on the treatment method, the patients were divided into the following two groups: PFMT + BS group and PFMT group. Both groups received treatment for three months. Pelvic floor muscle strength and pelvic floor ultrasound indices were evaluated at T0 (before treatment) and T2 (three months after treatment). The 1-h pad test, Incontinence Urinary Incontinence Questionnaire Short Form (ICI-Q-SF) and Incontinence Quality of Life Questionnaire (I-QOL) were assessed at T0, T1 (one month after treatment) and T2. Data were analysed using repeated measures analysis of variance (ANOVA).
Results: A total of 105 patients were included in the study, with 58 patients in the PFMT + BS group and 47 patients in the PFMT group. After treatment, the PFMT + BS group demonstrated significantly better pelvic floor muscle strength and ultrasound compared to the PFMT group (p < 0.05). Repeated measures ANOVA revealed significant interaction effects between time and group on the 1-h pad test, ICI-Q-SF and I-QOL (p < 0.05), along with significant main effects for time and group (p < 0.001). Simple effects analysis showed no significant differences between groups at T0 (p > 0.05). However, at T1 and T2, the PFMT + BS group had significantly lower 1-h pad test and ICI-Q-SF scores (p < 0.05) and significantly higher I-QOL score (p < 0.05) compared to the PFMT group.
Conclusions: PFMT combined with BS is more effective than PFMT alone in treating postpartum SUI and thus warrants clinical implementation.
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Background: Prostate cancer is a common malignancy amongst males worldwide. Radical prostatectomy (RP) is a standard treatment, but preoperative anxiety, which affects about 69.5% of patients, negatively affects postoperative outcomes. This study evaluates the effect of preoperative education provided by operating room nurses on the anxiety levels of patients before and after RP.
Methods: A single-centre retrospective cohort study was conducted, including 169 patients who underwent RP between January 2020 and June 2024. The patients were divided into two groups: The control group, which received routine preoperative counselling, and the intervention group, which received enhanced preoperative education. Anxiety levels were assessed at three time points by using the State-Trait Anxiety Inventory (STAI): 24 h before surgery (T1), upon entering the operating room (T2) and 24 h after surgery (T3). Statistical analyses included t-tests, chi-squared tests and repeated measures Analysis of Variance (ANOVA).
Results: The control group included 102 patients, whilst the intervention group included 67 patients. Repeated measures ANOVA revealed no significant differences in the trait-anxiety levels between groups in terms of group effect, time effect or group × time interaction (p > 0.05). Trait-anxiety levels remained stable across all time points. For state-anxiety levels, group effect (p < 0.001) and time effect (p < 0.001) were statistically significant, but group × time interaction effect was not (p = 0.076). A simple effect analysis showed that state-anxiety levels significantly increased at T2 in both groups, but the increase was less pronounced in the intervention group (p < 0.05). At T3, state-anxiety levels significantly decreased in both groups, with a more substantial reduction observed in the intervention group (p < 0.05). Between-group analysis revealed no significant difference in state-anxiety levels at T1 (p > 0.05). At T2 and T3, however, the intervention group exhibited significantly lower state-anxiety levels than the control group (p < 0.05), with the difference being more pronounced at T2.
Conclusions: Preoperative education provided by operating room nurses significantly reduces preoperative and postoperative anxiety levels in patients undergoing RP. These findings suggest that integrating enhanced educational strategies into perioperative care can improve patient outcomes.
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Background: Kidney stones are common in elderly patients, and their high recurrence rate after surgery is a significant clinical issue. This single-centre retrospective study aimed to assess the impact of the knowledge-attitude-practice (KAP) education model on preventing kidney stone recurrence in elderly patients.
Methods: Elderly patients who underwent kidney stone surgery from January 2022 to January 2023 were divided into an intervention group and a control group based on the KAP education model intervention. The recurrence of stones, renal function, calcium and phosphorus metabolism, and urine indices were compared before and 3 months after treatment in the two groups.
Results: The recurrence rates of kidney stones in the intervention group at 6 months, 1 year and 2 years after the surgery were all lower than the control group (p < 0.05). The levels of serum creatinine, blood urea nitrogen, uric acid and cystatin C in both groups 3 months after the intervention were lower than those before the treatment, and the reduction of each renal function index in the intervention group was more significant (p < 0.05). The total 24-hour urine volume in both groups was higher than before treatment, while urinary calcium, urinary oxalate and urinary uric acid (UA) were lower. The improvement of each urine index was more obvious in the intervention group (p < 0.05).
Conclusions: The KAP education model has a significant effect on preventing the recurrence of kidney stones in elderly patients.
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Background: Urinary tract infection (UTI) is common in children. In particular, acute pyelonephritis (APN) may cause irreversible renal scarring (RS). This retrospective study aimed to evaluate the effects of vitamin E (VE) supplementation on children with APN.
Methods: A retrospective analysis was performed on the medical records of children with APN who were admitted to our hospital from January 2022 to January 2024. The patients were divided into two groups according to treatment method: The conventional group (received conventional antibiotic treatment) and the VE group (received vitamin E supplement on the basis of antibiotic treatment). Symptom improvement time, laboratory indices and RS were compared between the two groups.
Results: This study enrolled 86 patients, including 41 in the VE group and 45 in the conventional group. Baseline characteristics were not significantly different between the two groups (p > 0.05). The improvement time of fever and other clinical symptoms in the VE group was shorter than that in the conventional group (p < 0.05). Before treatment, the levels of red blood cells, white blood cells, squamous epithelial cells, bacteria, interleukin-6, interleukin-8 and heparin-binding protein in urine were not significantly different between the two groups (p > 0.05). After treatment, these values in the VE group were lower than those in the conventional group (p < 0.05). After 6 months of follow-up, the incidence of RS in the VE group was significantly lower than that in the conventional group (p < 0.05). Further subgroup analyses showed that vitamin E reduced the incidence of RS in children of all ages and genders (p > 0.05).
Conclusions: Vitamin E can effectively shorten the time to improvement of clinical symptoms and laboratory indicators in children with APN and reduce the incidence of RS.
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Objective: This study aimed to investigate the relationship amongst serum selenoprotein P (SeP), glutathione (GSH) expression and sperm kinetic parameters in patients with asthenospermia.
Methods: A retrospective analysis was conducted on men of reproductive age who underwent preconception testing at the Center for Reproductive Medicine between October 2022 and October 2024. The study subjects were divided into a case group and a healthy group based on the percentage of progressive motile sperm. Comparative analysis was performed to analyse the serum SeP of the two groups, GSH and spermatozoa kinetic parameters.
Results: A total of 147 cases were included in the case group and 151 cases into the healthy group. Significant differences in body mass index (BMI), smoking addicted population, regular drinking behavioural population and daily sleep hours were observed between the two groups (p < 0.001). Forward-moving spermatozoa, sperm concentration and total sperm survival were significantly higher in the healthy group than in the case group, whereas the number of non-anterior motion force was significantly lower in the healthy group than in the case group (p < 0.001). The serum SeP and GSH levels of the case group were significantly lower than those in the healthy group (p < 0.001). SeP was negatively correlated with non-anterior motion force (r = −0.476) and positively correlated with other sperm kinetic parameters (rforward-moving spermatozoa = 0.473/rsperm concentration = 0.485/rTotal sperm viability = 0.518). GSH was negatively correlated with non-anterior motion force (r = −0.601) and positively correlated with other sperm kinetic parameters (rforward-moving spermatozoa = 0.518/rsperm concentration = 0.554/rTotal sperm viability = 0.524), with all correlations being statistically significant (p < 0.001). Multivariate linear regression analyses showed that the BMI (β = −0.217, p < 0.001), daily sleep time (β = 0.236, p < 0.001), SeP (β = 0.253, p < 0.001), GSH (β = 0.325, p < 0.001), presence of smoking addictive behaviours (β = −0.085, p = 0.031) and presence of regular alcohol consumption behaviours (β = −0.083, p = 0.034) were the factors influencing forward-moving spermatozoa. Malondialdehyde showed a negative correlation with SeP and GSH (r = −0.471, −0.543, p < 0.001). SeP and GSH showed good efficacy in the diagnosis of asthenospermia (area under curve (AUC) = 0.824, 0.852).
Conclusions: Serum SeP and GSH levels are closely associated with sperm kinetic parameters in patients with asthenospermia, and the mechanism may be related to an imbalance in the antioxidant defence system and oxidative stress damage.
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Objective: Urinary dry chemistry and urinary sediment microscopy have gradually become important auxiliary methods for the diagnosis of urinary tract infection (UTI). This study aimed to explore the application value of the combination of the two in diagnosing UTI.
Methods: Patients with suspected UTI who were admitted to our hospital from October 2022 to October 2024 were retrospectively collected. All patients underwent urinary dry chemistry and urinary sediment microscopy. The number of red blood cells (RBCs), white blood cells (WBCs) and hyaline casts in the urine samples of the two groups was observed and compared. The diagnostic results of urine bacterial culture were used as the “unified standard” for diagnosis. The positive results of UTI in patients with two test methods and combined test method were compared. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and consistency analysis were compared.
Results: A total of 622 patients were enrolled, and 601 patients were finally included. No significant difference was found in the indices of urine RBCs, WBCs and hyaline casts between the two test methods (p > 0.05). Amongst the 601 patients who underwent urine culture and urine examination, 390 cases were finally confirmed to have UTI by urine culture, with a positive rate of 64.89%. The positive rate of urinary dry chemistry was 88.97%, and the positive rate of urinary sediment microscopy was 83.33%. The positive rate of combined detection was 93.85%, which was high (p < 0.05). According to the results of urine bacterial culture, the sensitivity, accuracy, negative predictive value and positive predictive value of the combined test were significantly higher than those of the single application test (p < 0.05). The diagnostic results of the combined test were highly consistent with the results of urine bacterial culture (κ = 0.795, p < 0.001).
Conclusions: Combined testing has a high value in diagnosing UTI. It can significantly improve the diagnostic efficiency of UTI.
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Background: Lung adenocarcinoma (LUAD) and bladder cancer (BLCA) are two major cancers that have high incidence and mortality worldwide and are particularly exacerbated by smoking, which is a primary risk factor that influences cancer progression through genetic and immune pathways. Temozolomide (TMZ), a chemotherapeutic agent, is often used to treat various cancers, including brain tumours, and is known to induce DNA damage via methylation. This study aims to identify key smoking-related genes, particularly TNFAIP6, and explore their mechanisms in LUAD and BLCA, focusing on their prognostic value, role in cancer progression, immune regulation, and response to TMZ.
Methods: Bayesian colocalisation and pan-cancer differential analyses identified 14 key genes, including TNFAIP6. Pan-cancer survival and clinical stage analyses were performed using The Cancer Genome Atlas (TCGA) data. TNFAIP6’s functional role in cancer stages, smoking status, immune infiltration and its effect on TMZ resistance was analysed through statistical tests, gene set enrichment analysis (GSEA) and gene set variation analysis (GSVA). Laboratory experiments were conducted to assess TNFAIP6’s influence on cell proliferation, apoptosis, epithelial-mesenchymal transition (EMT) markers, oxidative stress and TMZ-induced post-translational modifications (PTMs).
Results: TNFAIP6 was significantly upregulated in LUAD and BLCA and linked to poorer prognosis, especially in smokers. High TNFAIP6 expression was associated with pro-inflammatory pathways and immune suppression in the tumour microenvironment. Moreover, TMZ treatment induced considerable PTMs in TNFAIP6, promoting resistance to the drug, which was confirmed by functional assays showing increased cell viability and migration in TNFAIP6-overexpressing cells.
Conclusions: TNFAIP6 is a key biomarker of poor prognosis in smoking-related cancers. Interestingly, silencing TNFAIP6 both inhibits TMZ’s anticancer effects and underscores its potential role in immune regulation, highlighting the paradoxical value of TNFAIP6 in developing novel therapeutic strategies, including combination therapies.
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Background: Bladder spasm is a common complication after transurethral laser prostatectomy. Herein, we aimed to assess the effect of transcutaneous electrical acupoint stimulation (TEAS) at the Sanyinjiao point on relieving bladder spasm after transurethral laser prostatectomy.
Methods: The medical data of patients undergoing transurethral laser prostatectomy were retrospectively collected from May 2021 to May 2024. Patients were divided into treatment (with TEAS at the Sanyinjiao point) and control (without TEAS at the Sanyinjiao point) groups. Basic characteristics, postoperative spasticity, prostate function, bladder function, urinary function and adverse events were compared between the groups.
Results: A total of 150 patients were enrolled and classified according to whether they were treated with TEAS at the Sanyinjiao point: 67 cases in the treatment group and 83 cases in the control group. After a 5-day treatment, postoperative spasticity was mitigated in the treatment group compared with the control group, as evidenced by decreases in postoperative bladder spasm duration, frequency of spasm, visual analogue scale score and use of drotaverine hydrochloride (p < 0.05). After a 1-month treatment, prostate, bladder and urinary function showed considerable improvement in the treatment group compared with the control group, as evidenced by a decrease in International Prostate Symptom Scale score, Patient Perception Of Bladder Condition score, Overactive Bladder Symptom Score, residual urine volume, urinary incontinence and uroschesis and an increase in maximum urine flow rate (p < 0.05). No considerable difference in the incidence of adverse events was observed between groups (p = 0.174).
Conclusions: TEAS at the Sanyinjiao point effectively relieves bladder spasm after transurethral laser prostatectomy, with a reasonable degree of safety.
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Objective: This study aimed to investigate the efficacy of electroacupuncture (EA) combined with supervised pelvic floor muscle training (PFMT) in improving post-radical prostatectomy urinary incontinence (PRPUI).
Methods: The clinical data and treatment methods of patients with PRPUI admitted to the Third Affiliated Hospital of Zhejiang Chinese Medicine University from January 2023 to December 2023 were retrospectively collected, and they were divided into the PFMT group and PFMT + EA group according to the postoperative treatment methods. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) and Incontinence Quality of Life Questionnaire (I-QOL) of patients before treatment (T0), 6 weeks of treatment (T1) and 12 weeks of treatment (T2) were collected and compared. Pelvic floor electromyography assessment values (maximum systolic electromyography (EMG) value, mean EMG value during isometric contraction and mean EMG value during endurance contraction) in patients at T0 and T2 were collected and compared.
Results: A total of 226 patients with PRPUI were included in the study: PFMT group (n = 112) and PFMT + EA group (n = 114). The results from repeated measures Analysis of Variance (ANOVA) indicated a significant interaction between time and group for ICIQ-UI-SF and I-QOL (p < 0.001), as well as a significant main effect for time and group (p < 0.001). The ICIQ-UI-SF in the PFMT + EA group was lower than that in the PFMT group at T1 and T2, but the I-QOL was higher in the PFMT + EA group than in the PFMT group, and there was a significant difference between the two groups (p < 0.001). At the T2 time point, the maximum systolic EMG value, mean isometric contraction EMG value and mean endurance contraction EMG value in the PFMT + EA group were significantly higher than those in the PFMT group (p < 0.05).
Conclusions: EA combined with supervised PFMT can be used as an effective non-surgical treatment for the treatment of PRPUI.
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Objective: This study explored infection risk factors within one month post-kidney transplantation (KT) and developed a clinical prediction model.
Methods: We retrospectively analyzed clinical data from KT patients treated at our hospital (January 2015–December 2024). Patients were categorized into infection or control groups based on 1-month postoperative infection status. Infection incidence and risk factors were analyzed, and a multivariate logistic regression model was developed. The receiver operating characteristic (ROC) curves and a nomogram were generated. Patients were randomly split 7:3 into training and validation sets to assess model performance.
Results: A total of 410 patients were included in this study, of whom 131 had postoperative infection, with an incidence rate of 31.95%. Multivariate logistic regression analysis showed that history of smoking (odds ratio (OR) = 2.96, 95% confidence interval (CI) (1.20–7.27)), drainage tube indwelling time (OR = 1.41, 95% CI (1.17–1.71)), catheter indwelling time (OR = 1.66, 95% CI (1.36–2.03)) and albumin (ALB) (OR = 0.78, 95% CI (0.71–0.86)) and haemoglobin (HGB) (OR = 0.70, 95% CI (0.59–0.83)) levels were independent risk factors for early infection after KT (p < 0.05). The area under the ROC curve of the training set was 0.954 (95% CI (0.925–0.982)), the specificity was 0.855 and the sensitivity was 0.896. In the validation set, the area under the ROC curve was 0.914 (95% CI (0.861–0.967)), the specificity was 0.832 and the sensitivity was 0.903. The Hosmer–Lemeshow goodness-of-fit test of the model showed that the training set χ2 = 6.962 (p = 1.000) and the validation set χ2 = 8.813 (p = 0.450). Multivariate risk factors were used to construct a nomogram model, and the calibration curve was consistent with the ideal curve, suggesting that the model had good stability. The clinical decision curve showed that it had good clinical value.
Conclusions: History of smoking, drainage tube indwelling time, catheter indwelling time and ALB and HGB levels are the risk factors of infection after KT. The model based on these factors can effectively predict the occurrence of infection after KT.
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Objective: To investigate the effect of postural nursing on the postoperative Face, Legs, Activity, Cry, Consolability (FLACC) scores and incision recovery of children undergoing high hernia sac ligation, which is an effective method for the treatment of inguinal hernia in children.
Methods: Clinical data were collected from paediatric patients who underwent laparoscopic high hernia sac ligation during the observation period in our hospital. According to different postoperative nursing methods, the children were divided into an observation group (postoperative position nursing) and a control group (postoperative routine nursing). The FLACC scores of the two groups of paediatric patients were obtained at 4, 12 and 24 h postoperatively. Data on the recovery time of relevant functions and surgical incision healing status for the two groups of paediatric patients were collected during the postoperative care period.
Results: A total of 207 paediatric patients’ clinical data were collected and divided into an observation group (n = 103) and a control group (n = 104). The results of repeated measures analysis of variance (ANOVA) indicated a significant interaction effect between measurement time and group on the FLACC scores (p < 0.001). Further simple effect analysis revealed no statistically significant difference in FLACC scores between the two groups at time T0 (p > 0.05). However, at time points T1 and T2, the FLACC scores in the observation group were significantly lower than those in the control group (p < 0.001). The postoperative recovery indexes of the observation group were better than those of the control group (p < 0.001), and the total incidence of postoperative surgical incision complications was lower than that of the control group (p < 0.05).
Conclusions: Positional care has a significant effect on postoperative pain and incision recovery in children undergoing hernia sac ligation.
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Objective: This study aims to investigate the effects of vitamin D3 supplementation on androgen levels and semen parameters in infertile men.
Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, Web of Science, Cochrane Library, Scopus and Embase, to identify studies investigating the effects of vitamin D3 supplementation on androgen levels and semen parameters in infertile males. Data pertaining to changes in testosterone, sex hormone-binding globulin (SHBG), total sperm count and percentage of motile sperm before and after intervention were extracted and analysed.
Results: Six studies, involving 945 subjects, were included in the quantitative analysis. With regard to testosterone levels, vitamin D3 supplementation was found to increase testosterone, although this change was not statistically significant (standard mean difference (SMD) = 0.07, 95% confidence interval (CI): –0.11, 0.25). Similarly, an increase in SHBG levels was observed after vitamin D3 supplementation, but the change was not statistically significant (SMD = 0.42, 95% CI: –0.38, 1.22). By contrast, an increase in total sperm count was observed (SMD = 1.04, 95% CI: 0.11, 2.19). Additionally, vitamin D3 supplementation significantly increased the percentage of motile sperm (SMD = 0.82, 95% CI: 0.00, 1.64).
Conclusions: In infertile men, vitamin D3 supplementation does not significantly affect androgen levels. Nevertheless, it may contribute to improvements in total sperm count and the percentage of motile sperm, potentially enhancing reproductive function.
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Background: Nutcracker syndrome is a rare clinical condition characterised by the compression of the left renal vein (LRV). This syndrome results in venous hypertension and a variety of symptoms, including haematuria and abdominal pain. We reported an unusual case of combined nutcracker syndrome caused by the compression of both branches of a circumaortic LRV, an anatomical variant.
Methods: An 18-year-old female presented with chronic abdominal pain and intermittent haematuria. Laboratory tests and imaging studies including contrast-enhanced computed tomography (CT) of the abdomen and pelvis were performed to investigate the cause. A comprehensive literature review of similar cases was conducted using PubMed.
Results: CT showed circumaortic LRV with the anterior branch compressed between the superior mesenteric artery and the aorta, and the posterior branch compressed between the aorta and the spine. This finding confirmed the diagnosis of combined nutcracker syndrome. The patient opted for conservative management, which improved her symptoms. Literature review identified only five other cases of combined nutcracker syndrome owing to circumaortic LRV.
Conclusions: Combined nutcracker syndrome is primarily diagnosed through imaging and should be considered in patients with chronic abdominal pain and haematuria, especially when anatomic variants such as circumaortic LRV are present. CT allows accurate visualisation of venous compression and the anatomic structures involved.
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