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Background: Non–muscle-invasive bladder cancer (NMIBC) accounts for the majority of bladder cancers. Its follow-up entails high costs and significant impact on quality of life. Cystoscopy is the standard method, although uncertainties remain regarding the optimal frequency and duration. The aim was to review the available evidence on surveillance schedules and their impact on recurrence and progression.
Methods: A systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and MetaAnalyses). Searches in PubMed, Web of Science and Scopus included clinical and observational studies published between 2004 and 2024. After applying inclusion criteria and assessment with QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies), 8 articles were selected out of a total of 3679.
Results: The studies included a total of 30,600 patients. With regard to the first cystoscopy, performing it within 3–4 months after transurethral resection of the bladder showed better outcomes, whereas excessively early or delayed procedures increased the risk of recurrence and progression. In low-risk patients, some studies support discontinuing surveillance after 5 years without recurrence, while others recommend prolonging it in patients with risk factors such as smoking or multiple tumours. In high-risk patients, across the different surveillance schedules analysed, no differences were found in terms of mortality or progression. No conclusive studies were identified for the intermediate-risk group.
Conclusions: The first cystoscopy should be performed within 3–4 months after the initial surgery. Although risk-stratified recommendations exist, current evidence is limited and sometimes contradictory. Prospective and long-term studies are required to define optimal surveillance schedules, with the aim of optimising resources and reducing the burden on patients.
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Background: Penile curvature correction surgeries for Peyronie’s disease require a learning curve to acquire confidence and precision in optimally performing the procedures for the patient. Given that these interventions are not frequent in daily practice, surgical simulation with hyperrealistic models can be a tool for correctly and safely acquiring technical skills.
Materials and Methods: We developed hyperrealistic models with different curvature degrees that allow the complete simulation of Peyronie’s disease correction surgeries. These models were evaluated and validated by specialist clinicians and residents in training using a specific questionnaire for this measurement.
Results: The penile models have different curvature degrees and are anatomically accurate, mimicking corpora cavernosa, urethra, Buck’s fascia, neurovascular structures and skin layer. They were designed with different degrees of consistency and hardness to simulate any of the surgical techniques used to correct penile curvatures. In an initial simulation, the overall model accuracy was 3.8 (standard deviation (SD) 1.1) out of 6, improving to 4.8 (SD 0.9) out of 6 in the second simulation performed after the models had been developed and the materials improved. The model was recommended by participants for training in penile curvature correction procedures, with a score of 4.5 (SD 1.3) out of 6.
Conclusions: Hyperrealistic penile curvature models developed using additive printing may be an alternative for acquiring experience in performing penile curvature correction procedures and improving the outcomes and safety in real patient surgeries.
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Objective: This study aims to compare efficacy and safety between photoselective vaporization of the prostate (PVP) with GreenLight laser and Holmium laser enucleation of the prostate (HoLEP).
Materials and Methods: A total of 220 patients who underwent endoscopic disobstruction surgery of the prostate were included; Of which, 110 had PVP and 110 had HoLEP (prospective cohort). Preoperative, intraoperative and postoperative variables were recorded, including hospital stay, catheterisation duration, adverse effects, transfusion rate, maximum urinary flow (Qmax) at 12 months, reduction of prostate-specific antigen (PSA) at 6 months, urgency, urinary continence and urethral stricture. Statistical analysis was performed with Fisher’s exact, Student’s t and Mann–Whitney U tests, with a significance level of p < 0.05.
Results: Both groups presented comparable preoperative characteristics. No significant differences were observed in the days of admission, days of catheterisation, adverse effects, transfusion rate or readmission rate. However, the HoLEP group showed a significantly higher Qmax (31.31 mL/s vs. 24.48 mL/s, p = 0.014) and a greater reduction in PSA (94.54% vs. 47.11%, p = 0.008). Urgency was lower in the HoLEP group (0.9% vs. 11.8%, p = 0.001), and the rate of urinary continence was identical in both groups (99.09%). Urethral stricture was higher in the HoLEP group (4.5% vs. 0.9%, p = 0.219), although the difference was not statistically significant (p > 0.05).
Conclusions: Overall, PVP and HoLEP present a low morbidity rate and present similar long-term urinary continence rates. Moreover, HoLEP offers a greater improvement in urinary flow and a greater reduction in PSA but leads to a higher rate of urethral stricture than PVP.
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Background: Gleason score (GS) 7 prostate cancer (PCa) encompasses biologically heterogeneous subgroups with differing prognoses. This study aimed to assess long-term oncologic outcomes and develop a predictive nomogram for patients with GS 7 PCa treated with definitive radiotherapy (RT) with or without androgen deprivation therapy (ADT).
Methods: We retrospectively analysed the data of 372 patients with GS 7 PCa treated with RT between 2010 and 2020. Kaplan– Meier analysis was used to estimate freedom from biochemical failure (FFBF) and prostate cancer-specific survival (PCSS). Prognostic factors were identified using Cox regression models. A nomogram was constructed to predict individualised risks of FFBF and PCSS. Model performance was evaluated using time-dependent area under the curve (AUC), calibration plots and decision curve analysis.
Results: At a median follow-up of 102.6 months, the 8-year FFBF and PCSS rates were 88.2% and 96.3%, respectively. Patients with GS 4+3 had significantly poorer outcomes than those with GS 3+4 (FFBF: 84.3% vs. 91.1%, p = 0.010; PCSS: 92.1% vs. 98.5%, p = 0.002). Multivariable analysis revealed that young age (hazard ratio (HR): 0.95, p = 0.002), prostate specific antigen (PSA) >10 ng/mL (HR: 2.95, p = 0.010), GS 4+3 (HR: 2.67, p = 0.002) and absence of ADT (HR: 5.77, p < 0.001) were independently associated with an increased risk of biochemical failure. The final nomogram incorporating age, PSA, GS pattern, T stage, risk group, RT field, simultaneous integrated boost (SIB) use and ADT status showed excellent predictive performance, with 8-year time-dependent AUCs of 0.773 for FFBF and 0.914 for PCSS. Threshold scores > 0.5 for FFBF and > 1.06 for PCSS were associated with an increased event risk.
Conclusions: GS 4+3 emerged as the strongest predictor of poor outcomes, alongside elevated PSA, absence of ADT and young age. The proposed nomogram provides accurate individualised risk stratification and may assist in tailoring treatment intensity and follow-up in patients with GS 7 PCa undergoing definitive RT. External validation is warranted.
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Background: Bladder cancer is a prevalent urological malignancy, highlighting the need for prognostic biomarkers to optimise and individualise treatment strategies. This study aimed to assess the prognostic value of preoperative inflammatory and nutritional markers in patients with non-metastatic muscle-invasive bladder cancer (MIBC) treated with neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC), focusing on pathological response and survival.
Methods: This retrospective observational study included 133 patients with non-metastatic MIBC treated with NAC and RC between July 2011 and December 2024. Preoperative inflammatory and nutritional indices, including neutrophil/lymphocyte ratio (NLR), total lymphocyte count (TLC), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), systemic immune inflammation index (SII) and nutritional prognostic index (NPI), were analysed and correlated with pathological response (complete, partial, or no response/progression).
Results: Hematologic indices were associated with pathological response. Specifically, TLC (p <0.001), NLR (p = 0.002) and PLR (p = 0.006) were reduced in patients with cRP. Conversely, patients with elevated LMR values had a high percentage of complete pathological response (cPR) (p = 0.008). Elevated SII and low NPI were associated with poor pathological response (p <0.05) and survival. Patients with SII values below 535,000 showed higher mean survival compared with those with SII ≥ 535,000 (p <0.001), and patients with NPI ≥ 47 had a higher median survival compared with those with NPI <47 (p = 0.002).
Conclusions: Inflammatory and nutritional factors are key determinants in the response to NAC treatment in MIBC. Their use could optimise patient stratification and create new therapeutic opportunities.
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Background: To evaluate temporal trends in public interest regarding surgical treatments for benign prostatic hyperplasia (BPH) in the United States using Google Trends (GT) data from 2010–2025.
Methods: Relative search volume (RSV) data for Holmium Laser Enucleation of the Prostate (HoLEP), Rezūm®, UroLift, Aquablation, and Prostatic Arterial Embolization (PAE) were extracted from GT between January 2010 and August 2025. Annual mean RSV values were analyzed using descriptive statistics, linear regression, and Pearson correlation. Statistical significance was defined as p < 0.05.
Results: HoLEP demonstrated a robust and statistically significant upward trajectory throughout the study period (R2 = 0.762; β = 0.873; p < 0.001), reflecting sustained growth in public interest. Rezūm® similarly exhibited a strong and consistent increasing trend (R2 = 0.799; β = 0.894; p < 0.001), indicating a notable expansion in online engagement over time. Aquablation showed a moderate but significant rise in search activity (R2 = 0.549; β = 0.741; p < 0.001), although its overall magnitude of interest remained comparatively lower than other modalities. UroLift demonstrated a significant temporal association (R2 = 0.637; β = 0.798; p = 0.001), despite fluctuations in interest during later years of the study. PAE demonstrated a strong but non-significant upward trend (R2 = 0.788; β = 0.888; p = 0.051), suggesting a more variable pattern of public attention. Correlation analyses further revealed strong inter-modality relationships, particularly between HoLEP and Aquablation (r = 0.948) and between HoLEP and PAE (r = 0.916).
Conclusions: Rezūm® and Aquablation have experienced rapid growth in recent years, while HoLEP has consistently maintained its importance. UroLift and PAE have exhibited more variable trends. Digital trend analysis is a valuable tool for understanding evolving patient preferences and informing clinical and policy decisions.
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Objective: To evaluate the impact of cognitive behavioural therapy combined with tadalafil on the recovery of urinary and sexual function in patients with functional erectile dysfunction (ED) and moderate to severe lower urinary tract symptoms (LUTS).
Methods: This was a retrospective cohort study that involving a total of 236 patients. Patients were divided into two groups: the Tadalafil Group (n = 121) was given an oral dose of 5 mg of tadalafil daily for 12 weeks; the Combination Group (n = 115) received the same tadalafil treatment in addition to an additional 12-week course of cognitive behavioural therapy. Biochemical markers, urodynamic parameters, urinary function, sexual function, psychological state, and quality of life were compared between the two groups before and after treatment.
Results: Following treatment, the Combination Group demonstrated significantly greater improvements in interleukin-6 levels, cortisol levels, urodynamic parameters, sexual function markers, anxiety and depression scores, and quality of life compared with the Tadalafil Group (all p < 0.05).
Conclusions: For patients with functional ED complicated by moderate to severe LUTS, the combination of cognitive behavioural therapy and tadalafil is a promising integrated treatment strategy that can more effectively improve their urinary function, sexual function, psychological state, and quality of life.
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Background: Gut microbiota (GM) has been increasingly implicated in cancer development through immune modulation, metabolic regulation, and systemic inflammatory pathways. Although observational studies have suggested a potential link between GM dysbiosis and bladder cancer (BC), these findings remain susceptible to confounding and reverse causation. To our knowledge, few studies have applied a Mendelian randomisation (MR) framework to systematically evaluate the gut-bladder axis from a genetic perspective.
Methods: We performed a two-sample MR analysis to examine associations between genetically predicted GM composition and BC risk. Genetic instruments for 119 GM taxa were obtained from the MiBioGen consortium. Summary-level genetic association data for BC were derived from the UK Biobank. The inverse variance weighted (IVW) method was used as the primary analytical approach, complemented by Mendelian randomisation–Egger regression (MR-Egger) and weighted median methods. Sensitivity analyses were conducted to assess heterogeneity and horizontal pleiotropy. Instrumental variants were further mapped to host genes to perform exploratory functional annotation and pathway enrichment analyses.
Results: In the primary IVW analysis, five GM taxa demonstrated nominal associations with BC risk. Higher genetically predicted abundance of Oscillibacter (OR = 0.706, 95% CI: 0.564–0.883) and Oscillospira (OR = 0.668, 95% CI: 0.490–0.910) was associated with lower risk, whereas Lachnospiraceae (FCS020 group) was associated with increased risk (OR = 1.406, 95% CI: 1.070–1.847). However, none of the associations remained statistically significant after Bonferroni correction for multiple testing. Sensitivity analyses revealed no evidence of significant heterogeneity or directional pleiotropy, and estimates were broadly consistent across MR methods.
Conclusions: In this MR study, we identified nominal associations between genetically predicted GM composition and BC risk. As none of the findings remained statistically significant after correction for multiple testing, these results should be interpreted with caution. Further replication in independent cohorts and mechanistic investigations into the role of candidate taxa are warranted to clarify the potential involvement of the gut-bladder axis in bladder carcinogenesis.
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Background: Percutaneous nephrolithotomy (PCNL) is the primary surgical modality for managing renal calculi, yet the nonnegligible incidence of postoperative infectious complications significantly compromises patient prognosis.
Objective: To develop a pre-operative predictive model based on nutritional and inflammatory biomarkers to quantify the risk of infectious complications following PCNL. Methods: From January 2022 to December 2024, 529 consecutive PCNL patients met the inclusion criteria. Pre-operative baseline characteristics, nutritional biomarkers (Prealbumin (PA), Hemoglobin (Hb), Prognostic Nutritional Index (PNI)), and inflammatory biomarkers (C-Reactive Protein (CRP), Procalcitonin (PCT), White Blood Cell Count (WBC), Neutrophil-toLymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Immune-Inflammation Index (SII)) were collected. The main outcome was the occurrence of any infectious complication within 30 days. Univariable analysis screened candidate predictors; multivariable logistic regression integrated key biomarkers into a risk-prediction model. Receiver Operating Characteristic (ROC) curves were used to evaluate discrimination, providing the Area Under the Curve (AUC) and optimal cut-off values.
Results: Among 529 patients who undergoing PCNL, 54 (10.21%) developed postoperative infectious complications. Multivariate logistic regression analysis identified four independent predictors: PNI (Odds Ratio (OR) = 0.386, p < 0.001), PLR (OR = 3.362, p = 0.009), NLR (OR = 2.446, p = 0.017), and SII (OR = 3.300, p < 0.001). The combined prediction model integrating these biomarkers demonstrated superior discriminative ability (AUC = 0.871, 95% Confidence Interval (CI): 0.839-0.898), significantly outperforming individual biomarkers (all p < 0.001).
Conclusions: A pre-operative model integrating nutritional and inflammatory biomarkers may accurately stratifies patients at high risk for infectious complications after PCNL, enabling early risk assessment and targeted intervention to improve outcomes.
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Objective: To compare the effectiveness and safety of retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) in the treatment of diabetic patients with infected ureteral obstruction.
Methods: From February 2022 to February 2024, 202 diabetic patients with infected ureteral obstruction were included. Data were obtained retrospectively and the outcomes including complications, period for return to serum creatinine nadir, white blood cell (WBC) count and blood urea nitrogen were measured. Logistic regression was used to explore risk factors for postoperative complications.
Results: A total of 202 patients (PCN group: 102 patients; RUS group: 100 patients) were included in the final analysis. The incidence of complications of Clavien–Dindo Grade ≥ II was significantly higher in the PCN group (34.3%) than in the RUS group (11.0%, p < 0.001). The RUS group showed better renal function preservation rate (87.0% vs. 73.5%, p = 0.016) and lower recurrent urinary tract infection rate (11.0% vs. 21.6%, p = 0.042). After adjusting for potential confounding factors, the RUS group had a significantly lower risk of postoperative complications compared with the PCN group. In addition, the duration of diabetes mellitus, the amplitude of postoperative blood glucose fluctuation, and the duration of insulin use were independent risk factors for postoperative complications (p < 0.05).
Conclusions: RUS appears to be superior to PCN in reducing postoperative complications, preserving renal function, and lowering infection recurrence in diabetic patients with infected ureteral obstruction.
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Background: Lipid-poor adrenal adenomas (LPAs) and pheochromocytomas (PCCs) are similar tumours, but misdiagnosed LPAs may lead to health risks such as hypertensive crisis due to improper treatment. The aim of this study was to develop an efficient method for classifying LPAs and PCCs on the basis of different CT scans that minimises the number of radiation doses.
Methods: The patients included in this study were randomly divided into training and validation groups (the ratio was 7:3). The datasets, including 2-(plain and venous enhanced CT scans) or 3-phase CT data, were separately used to construct XGBoost, Gradient Boosted Decision Tree (GBDT), AdaBoost, random forest and decision-tree models. Receiver operator characteristic (ROC) curves were used to evaluate the models, and the DeLong test was used to determine significant differences.
Results: The models constructed were XGBoost, GBDT, AdaBoost, random forest and decision tree and their efficacies Area Under the Curves (AUCs) in the 2-phase CT group were 0.91, 0.89, 0.85, 0.78, and 0.71, respectively, while those in the 3-phase CT group were 0.92, 0.91, 0.89, 0.81, and 0.78, respectively. The optimal model in both the 2-and 3-phase groups was XGBoost; this model exhibited similar performance in both groups. The DeLong test also confirmed some difference in XGBoost between the two groups.
Conclusions: Our XGBoost-based model constructed using 2-phase CT data is similar to that constructed using 3-phase CT data; both of them exhibited good performance in the classification of LPAs and PCCs.
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Objective: To develop and internally validate a heart rate variability (HRV)-based predictive model for estimating the risk of postoperative urinary retention (POUR) in patients with benign prostatic hyperplasia (BPH).
Methods: We retrospectively reviewed clinical data from 237 patients with confirmed BPH who received surgical treatment. Among them, 36 patients (15.2%) developed POUR. Variables showing statistical significance (p < 0.05) in univariate analysis were subsequently entered into a multivariate logistic regression to determine factors independently associated with POUR. Based on the corresponding regression coefficients, a graphical risk prediction tool (nomogram) was constructed. The predictive capability of the model was evaluated through receiver operating characteristic (ROC) analysis, calibration assessment, and decision curve analysis (DCA), and its robustness was further tested using bootstrap-based internal validation.
Results: Multivariate analysis identified age, prostate volume, standard deviation of normal-to-normal intervals (SDNN), and root mean square of successive differences (RMSSD) as independent predictors of POUR. The HRV-based nomogram exhibited strong discriminative performance, achieving an area under the ROC curve (AUC) of 0.894 (95% CI: 0.833–0.956), with sensitivity and specificity of 0.861 and 0.806, respectively. Internal validation showed a comparable AUC of 0.884, indicating good model stability. The calibration curve indicated close alignment between predicted and actual outcomes (χ2 = 11.801) and a Brier score of 0.075, confirming precise calibration. DCA demonstrated that the model provided a favourable net clinical benefit over a broad range of probability thresholds.
Conclusions: The HRV-based nomogram established in this study accurately predicts POUR in patients with BPH. By integrating autonomic function indicators with clinical parameters, the model demonstrates strong predictive power and clinical utility, offering an effective tool for early identification and individualised management of patients.
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Background: To investigate the relationship between serum adiponectin, components of metabolic syndrome, and susceptibility to prostate cancer (PCa), and to construct a predictive nomogram model.
Methods: A retrospective, 1:1 individual-matched case–control study was conducted. A total of 152 patients diagnosed with PCa at our hospital between January 2018 and May 2025 were enrolled as the PCa group, and 152 age-matched healthy males were selected as the control group. Serum adiponectin levels, metabolic syndrome components, and general demographic data were compared between the two groups. A nomogram prediction model was constructed based on conditional logistic regression analysis.
Results: Multivariate conditional logistic regression analysis showed glycated haemoglobin (OR = 6.360), waist-to-hip ratio (OR = 2.394), waist circumference (OR = 1.457), and triglycerides (OR = 3.777) as independent risk factors for PCa susceptibility (all p < 0.05), whereas high-density lipoprotein (OR = 0.341) and adiponectin (OR = 0.513) were identified as independent protective factors (all p < 0.05). The nomogram model constructed based on these six indicators predicted PCa susceptibility with an area under the curve (AUC) of 0.869 (95% CI: 0.843–0.894). Bootstrap validation indicated good model fit, and decision curve analysis suggested a clinical net benefit of the model.
Conclusions: Serum adiponectin and components of metabolic syndrome are closely associated with PCa susceptibility. The nomogram model constructed using these indicators demonstrated good predictive performance in this study cohort.
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Objective: To evaluate the safety and feasibility of the enhanced MicroHand S surgical robot system in urological minimally invasive cancer surgeries, in alignment with the IDEAL-D Framework Stage 2a.
Methods: Procedures were performed by an experienced urologist from the Affiliated Hospital of Qingdao University using the MicroHand S surgical robot system. Patients requiring radical cystectomy, partial nephrectomy, or radical prostatectomy were enrolled. The primary endpoint was the rate of unplanned conversion from robot-assisted surgery to conventional laparoscopic or open surgery. An independent Clinical Expert Committee reviewed the study to adjudicate the occurrence of adverse events (AEs) and serious adverse events (SAEs). All patients were followed for 1 year postoperatively.
Results: These procedures included 12 radical cystectomies, 8 radical prostatectomies, and 3 partial nephrectomies. All procedures were completed successfully without the need for conversion to conventional laparoscopic or open surgery. No robotic devices or surgical instruments related AEs were recorded during the procedure. All patients had a postoperative Clavien–Dindo classification of grade Ⅰ before discharge (100%). No patients returned to the operating room within 24 hours of surgery. At 1- year follow-up none patient presented a tumor recurrence.
Conclusions: The MicroHand S system is safe and feasible for complex urological MICS, supporting further clinical trial recruitment.
Clinical Trial Registration: The study was registered at Clinicaltrials.gov (https://trialsearch.who.int/Trial2.aspx?TrialID=NCT 05462392), registration number: NCT05462392.
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Background: Intravesical Bacillus Calmette-Guérin (BCG) therapy is the standard adjuvant treatment for non–muscle-invasive bladder cancer (NMIBC), particularly in patients with carcinoma in situ, following transurethral tumor resection. Despite its proven oncological benefits, BCG therapy may be associated with a wide range of local and systemic adverse events. This study aimed to evaluate the clinical significance of BCG-related complications across the full severity spectrum and to assess their impact on treatment continuation using the Clavien–Dindo classification system.
Methods: This retrospective study included 694 patients with bladder cancer who received intravesical BCG therapy between 2004 and 2024. Ethical approval was obtained prior to data collection. Patient demographics, comorbidities, tumor characteristics, and treatment details were recorded. Freeze-dried BCG (12.5 mg) was administered intravesically according to induction and maintenance protocols. Adverse events occurring during therapy were systematically classified using the Clavien–Dindo system. The primary outcome was the occurrence of any BCG-related complication. The median follow-up duration was 34 months.
Results: The study cohort comprised 580 men (83.6%) and 114 women (16.4%), with a mean age of 65.1 ± 7.5. Maintenance BCG therapy was administered to 295 patients (42.5%). A total of 122 patients (17.6%) experienced BCG-related complications, the majority of which were low-grade (Clavien–Dindo grade ≤2). Severe complications were rare. In multivariate logistic regression analysis, increasing age (odds ratio [OR]: 1.055; 95% confidence interval [CI]: 1.033–1.078; p < 0.001) and high tumor grade (OR: 2.473; 95% CI: 1.379–4.436; p = 0.002) were identified as independent predictors of complications.
Conclusions: Intravesical BCG therapy is generally safe and well tolerated. However, advanced age and high tumor grade are associated with an increased risk of treatment-related adverse events. These findings highlight the importance of careful patient selection, close monitoring, and individualized management strategies, particularly in elderly patients undergoing BCG therapy.
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Background: Accurate prognostic tools for cystitis remain limited. This study aimed to develop and validate a nomogram-based prediction model and explore the prognostic value of serum amyloid A (SAA), advanced oxidation protein products (AOPP) and endothelial nitric oxide synthase (eNOS).
Methods: A total of 234 patients diagnosed with cystitis from March 2022 to December 2024 were assigned to a training cohort (n = 164) and a validation cohort (n = 70) in a 7:3 ratio. In the training cohort, independent prognostic risk factors were identified through univariate and subsequent multivariate logistic regression. These factors were then incorporated into a prognostic nomogram. The model’s performance was assessed using receiver operating characteristic (ROC) curve analysis, calibration plots and decision curve analysis (DCA). An internal validation was subsequently performed using an independent validation set.
Results: In the training cohort, 52 patients (31.71%) experienced a poor prognosis, compared with 22 patients (31.4%) in the validation cohort. No significant differences were observed in baseline characteristics or the incidence of poor prognosis between the two cohorts (p > 0.05). Multivariate analysis identified the following independent risk factors for a poor prognosis: elevated SAA levels, increased AOPP levels, decreased eNOS levels, comorbid diabetes mellitus, age of 60 years or older and a disease duration exceeding 3 months (all p < 0.05). The nomogram demonstrated favourable discriminatory ability, with an area under the ROC curve of 0.838 (95% confidence interval (CI): 0.757–0.919) in the training set and 0.735 (95% CI: 0.588–0.902) in the validation set.
Conclusions: The nomogram incorporating SAA, AOPP, eNOS and clinical factors demonstrates promising prognostic performance for patients with cystitis, serving as a potential tool for the early identification of high-risk individuals and supporting optimised treatment strategies.
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Background: Accurate risk stratification is crucial for managing men with suspected clinically localized prostate cancer, particularly those with total prostate-specific antigen (tPSA) in the diagnostic grey zone (4–10 ng/mL). This study aimed to develop and validate a predictive model integrating multi-dimensional indicators to distinguish clinically insignificant prostate cancer from significant disease.
Methods: This retrospective cohort study analysed 242 patients with suspected clinically localized prostate cancer who underwent biopsy from January 2020–December 2021. Patients were stratified into low-risk (n = 118) and high-risk (n = 124) groups based on biopsy pathology. Key biomarkers including free prostate-specific antigen (fPSA)/tPSA ratio, Prostate Health Index (PHI), and Prostate Cancer Antigen 3 (PCA3) score were measured before biopsy. Multiparametric magnetic resonance imaging (mp-MRI) parameters were also assessed.
Results: The high-risk group had significantly lower percentage of free to total prostate‑specific antigen (%fPSA) and prostate volume, but higher PHI, PCA3 scores, and positive Prostate Imaging-Reporting and Data System (PI-RADS) findings (all p < 0.05). Multivariate analysis identified %fPSA, PHI, PCA3 score, prostate volume, PI-RADS score ≥ 4, and index lesion diameter as independent predictors. A nomogram incorporating these factors demonstrated excellent discrimination, with an area under the curve (AUC) of 0.885 in the development cohort, remaining robust upon 10-fold cross-validation (AUC = 0.871). Temporal validation in an independent cohort (n = 80) yielded an AUC of 0.863.
Conclusions: The developed nomogram, integrating initial fPSA/tPSA screening, PHI risk quantification, PCA3 molecular confirmation, and magnetic resonance imaging (MRI) features, provides an effective tool for personalized risk stratification, with direct comparative analyses confirming its advantage over single-modality approaches.
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Objective: To investigate the effects of refined nursing on postoperative recovery, inflammatory cytokine levels, and quality of life in patients undergoing radical prostatectomy for prostate cancer (PCa).
Methods: A total of 116 patients who underwent radical prostatectomy in the Department of Urology of our hospital from October 2021 to October 2025 were retrospectively included. According to the different nursing methods documented in the medical records, patients were divided into a control group (n = 56, routine nursing) and a study group (n = 60, refined nursing). Postoperative recovery indices, urinary function, serum IL-6, TNF-α, and IL-10 levels, the incidence of postoperative complications, and quality of life scores (physical, psychological, and social functions) were compared between the two groups.
Results: The study group exhibited significantly shorter times to first postoperative exhaust, drainage tube removal, and hospital stay compared to the control group (p < 0.05), whilst the time to first defecation showed no significant difference (p > 0.05). The International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF) scores of patients in the study group were significantly lower than those in the control group(p < 0.05). On postoperative day 1, serum IL-6, IL-10, and TNF-α levels were comparable between groups. By day 5, the study group demonstrated lower IL-6 and TNF-α and higher IL-10 levels compared with the control group (p < 0.05). The incidences of nausea, vomiting, abdominal distension, and urinary tract infection (UTI) were significantly lower in the study group (p < 0.05), while the incidence of fever showed no significant difference (p > 0.05). Following the nursing care, the Expanded Prostate Cancer Index Composite (EPIC) scores increased in both groups, with the scores of the study group showing significantly higher scores than the control group (p < 0.05).
Conclusions: Refined nursing may facilitate improved postoperative recovery in patients undergoing radical prostatectomy for PCa, potentially benefiting urinary function, mitigating inflammatory responses and postoperative complications, and enhancing short-term quality of life.
Case Report
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Background: Pelvic floor dysfunction (PFD) encompasses the set of clinical alterations characterised by a loss of muscular control or an incoordination in the activity of the muscles that make up this region. In the female population, the prevalence of urinary incontinence (UI) is between 24% and 45%, making it the most common PFD. Stress urinary incontinence (SUI) occurs when there is an increase in intra- abdominal pressure, such as when coughing, sneezing or lifting heavy objects, causing involuntary urine leakage. It is common for elite gymnasts to experience an increase in intra-abdominal pressure, exacerbating the onset of SUI.
Case description: 25-year-old patient who started practising rhythmic gymnastics at the age of 9. In the anamnesis, the patient reported that for about 8 years she had been experiencing SUI during training and competitions. The patient refers that factors such as fatigue or stressful situations influence her presentation.
Objective: The main objective of this clinical case is the improvement of UI symptomatology during sports practice, through the use of the proprioceptive trunk.
Intervention: The physiotherapy intervention was carried out over six weeks with a frequency of three sessions per week and was structured under an active, guided treatment approach. The sessions lasted approximately 30 minutes. In the first phase of the intervention the aim was to improve the patient’s proprioception and pelvic floor activation; in the second phase, the aim was to strengthen the core musculature and the scapulohumeral region, while ensuring the maintenance of proper body posture; finally, the final phase consisted of the application of the intervention to functionality within the sporting context.
Conclusions: In this patient with SUI, an improvement has been observed in the symptomatology that she presented at the beginning of the intervention, achieving significant advances both at an objective level, with the self-reported questionnaires and the voiding diary, and at a subjective level in her sensations when practising sport.
