Objective: The objectives of this study, was to analyze epidemiological diagnosis, therapeutic option and evolutionary aspects. Materials and methods: This is a retrospective study regarding clinical data of nine peni...Objective: The objectives of this study, was to analyze epidemiological diagnosis, therapeutic option and evolutionary aspects. Materials and methods: This is a retrospective study regarding clinical data of nine penile fracture patients who have been admitted in the department of urology (university hospital, Brazzaville) from January 2006 to December 2018. The study parameters were: epidemiological, diagnosis, operative details, outcomes after treatment, and sexual disorders. Results: The mean age was 46.3 ± 14 years, ranged from 25 to 73 years. The etiology of penile fracture was coitus in 5 cases, masturbation in 3 cases and rolling of the penis on the bed in one case. 8 patients were managed surgically. The complications noticed in the postoperative period and during the follow-up visits were penile curvature in 2 cases, and erectyl dysfunction in 2 cases. Conclusion: The diagnosis of penile fracture remains clinic. Immediate surgical management is necessary for good functional result.展开更多
Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can ...Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can be overlooked or confused with other pathologies. Treatment remains controversial. The aim of this work is to study the epidemiological, clinical and therapeutic data of urethral mucosal prolapse in young girls in our department. Materials and methods: Retrospective and descriptive study on urethral mucosal prolapse in little girls identified from the hospitalization records of the Sino-Guinean Friendship Hospital in Conakry. The study period was 5 years. Patients were selected randomly. Outcome assessment focused on the occurrence of recurrences and urinary incontinence. The mean follow-up duration was 24 months. The parameters studied were: Age, clinical and histological findings, therapeutic data and patient outcomes. Results: The incidence of urethral mucosal prolapse in girls in the urology department was 2.2 cases/year. The mean age of the patients was 6.7 years (with extremes of 5 months and 10 years). The age group of 7 to 10 years was the most represented, observed in 63.63% of patients. The most frequent reason for consultation was vulvar bleeding in 7 patients, or 63.63%. Malpighian hyperplasia with a congested chorion was the most observed histological type, in 4 patients. Surgical treatment consisting of complete excision of the prolapsed part had given excellent results. Conclusion: Urethral prolapse is a rare pathology, observed mainly in young black girls. Its diagnosis is based mainly on clinical examination. Surgical treatment gives satisfactory results, both clinically and aesthetically.展开更多
Objective:This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.Methods:In this prospective,multicenter clinical trial,we exa...Objective:This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.Methods:In this prospective,multicenter clinical trial,we examined the effectiveness of the SHURUI single-port robotic surgical system in urological interventions.The first 50 patients from four centers in China underwent single-port surgeries including partial nephrectomy,radical prostatectomy,partial adrenalectomy,and pyeloureteroplasty,exclusively by the SHURUI single-port robotic surgical system.The study's primary endpoints focused on the success of surgeries,defined as no deviations from planned procedures,no need for more than one port,and no re-operations within 24 h after surgery.Secondary endpoints encompassed a range of surgical metrics,functional outcomes,and patient demographic data.Clinical assessments were conducted before surgery,before discharge,and 1 month after discharge.Results:The surgical procedures were executed successfully without requiring intraoperative conversions or transfusions.Both estimated blood loss and operation durations were maintained within satisfactory limits.For each type of surgery,the mean console times and estimated blood loss were 179.8(standard deviation[SD]39.4)min and 125.6(SD 126.0)mL for radical prostatectomy,126.7(SD 47.8)min and 39.2(SD 54.4)mL for partial nephrectomy,112.6(SD 37.4)min and 20.0(SD 13.2)mL for partial adrenalectomy,and 148.0(SD 18.2)min and 18.0(SD 17.9)mL for pyeloureteroplasty,respectively.Across the cohort,17 patients experienced a total of 25 adverse events,while 10 postoperative complications,all rated as Clavien-Dindo grade I,were encountered by eight patients.All patients had shown recovery or improvement from these events before the end of this trial.Conclusion:The SHURUI single-port robotic surgical system demonstrated feasibility and safety in the performance of major urological surgeries.These initial findings highlight the system's potential,though further research and longer follow-up are required to assess long-term outcomes.展开更多
Purpose: To study the epidemiology and treatment modalities of urolithiasis at Urology Department of University Hospital of Cotonou. Materials and Methods: It was a retrospective and descriptive study over a 10 years ...Purpose: To study the epidemiology and treatment modalities of urolithiasis at Urology Department of University Hospital of Cotonou. Materials and Methods: It was a retrospective and descriptive study over a 10 years period ranging from January 1st, 2004 to December 31st, 2013. One hundred and two patients who were hospitalized for symptomatic urolithiasis at the Urology Department of University Hospital of Cotonou were enrolled. Results: Hospital incidence of urolithiasis was 3.7%. Patients mean age was 39.6 years (extremes: 10 years to 73 years). Male to female ratio was 2.2. The main reason for consultation was renal colic for 81 patients (79.4%). Average duration of symptoms at presentation was 5 months (range: 1 day to 10 years). A total of 173 stones were identified with an average size of 12 mm (range: 1 mm to 95 mm). Calyceal stones were seen in 32.9% of cases, renal pelvis stones in 21.4% of cases, ureteral stones in 34.1% and bladder stones in 11.5% of cases. Open surgery was the main treatment for stones that could not be managed medically. 50.8% of patients underwent surgery with extraction of 116 stones. This represented 67.1% of all stones. 9 patients (8.8%) had expelled their stone during urination. The postoperative course was uneventful in 77.5% of cases. Conclusion: Modern treatment options for urolithiasis remain rudimentary in our health facilities. Open surgery is still the main stay of treatment in our countries with limited resources.展开更多
Introduction: Transurethral Resection of the Prostate (TURP) is a multi-invasive technique in the management of Benign Prostatic Hyperplasia. It constitutes a reference in developed countries;however in sub-Saharan Af...Introduction: Transurethral Resection of the Prostate (TURP) is a multi-invasive technique in the management of Benign Prostatic Hyperplasia. It constitutes a reference in developed countries;however in sub-Saharan Africa, it is prostatic adenomectomy which is mostly used. The aim was to analyze the results of the TURP carried out at the General National Reference University Hospital in N’Djamena (Chad). Patients and Methods: This is a retro-prospective study which extended over a period of 2 years, from June 2014 to May 2016. The records of all patients who had undergone TURP during this period were listed and analyzed. We did frequencies and average calculations. Results: 59 patients’ results that were treated with TURP were collected. TURP represented 33.4% of all interventions performed for prostate pathologies. The average age of our patients was 66 ± 8.06 years (50 to 92). Urinary retention was the main reason for consultation (45.7%;n = 27) followed by dysuria (27.1%;n = 16). TURP was associated with another procedure in 28.8% (n = 17). The average duration of hospitalization of our patients was 4.15 days with extremes of 2 to 9 days. Perioperative complications represented 13.6% of cases, early complications represented 15.3% of cases and late complications represented 6.8% of cases. The postoperative voiding status with an average follow-up of 6 months was judged to be good in 72.8% of cases (n = 43). Conclusion: TURP occupies an important place in the management of prostate pathologies with precise indications. It offers many advantages. It must be popularized in our countries;this will make it possible to limit morbidity and mortality rates and slow down medical evacuations abroad.展开更多
Objective:We aimed to study the effect of flexible ureteroscopy(FURS)for renal stones using a flexible and navigable suction ureteral access sheath(FANS)on intraoperative radiation dose and time.Methods:This was a mul...Objective:We aimed to study the effect of flexible ureteroscopy(FURS)for renal stones using a flexible and navigable suction ureteral access sheath(FANS)on intraoperative radiation dose and time.Methods:This was a multicenter study of adults who underwent FURS with FANS.The correlation analysis was done to identify factors affecting radiation dose and time measured by the C-arm fluoroscopy intraoperatively.Results:We analyzed 110 patients,with a median age of 50 years.Of them,72%were pre-stented prior to the procedure.The median stone volume was 1503 mm3 and the median operative time was 39 min.The median radiation dose was 7.4 mSv and median radiation time was 0.6 min.Totally,91%of patients achieved stone-free status(Grade A or B)on the non-contrast CT scan within 30 days postoperatively.There were no cases of postoperative sepsis.Body mass index,stone volume,and total operation time were associated with a higher radiation dose.Procedures performed under general anesthesia had a lower radiation dose and time than those performed under spinal anesthesia.Disposable scopes were associated with higher radiation time than reusable scopes but not dose.A low-power holmium laser had longer radiation time than other laser sources,but only the thulium fiber laser was associated with a significantly lower radiation dose.Conclusion:Our study is the first to highlight the multitude of factors affecting radiation exposure in FURS with FANS.Although not a direct measure of surgeons'actual exposure,it has important implications for the As Low As Reasonably Achievable principle which is commonly used to minimize radiation exposure to patients and operating room staff.展开更多
Introduction:With the aging population,more females will suffer from pelvic organ prolapse.Both urologists and gynecologists perform sacrocolpopexy,but there is no comparative study analyzing differences in provision ...Introduction:With the aging population,more females will suffer from pelvic organ prolapse.Both urologists and gynecologists perform sacrocolpopexy,but there is no comparative study analyzing differences in provision of care,outcomes,or patient population.We aimed to elucidate potential differences in demographics,outcomes,and minimally invasive surgery utilization for SCP performed by urology and gynecology.Methods:In our retrospective analysis,sacrocolpopexies were identified using the American College of Surgeons National Surgical Quality Improvement Project database from 2006–2020.Pearson’s chi-square test was performed to test trends in the utilization of MIS in five-year blocks.Frailty was calculated using the NSQIP modified frailty index and the revised surgical Risk Analysis Index.Univariate analysis was performed using Student’s t-test and Pearson’s chi-square to compare operative parameters,frailty,demographics,and outcomes.Results:We identified 8944 sacrocolpopexies.Gynecology performed 81%of cases while urology performed the remaining 19%(p<0.001).Between the specialties,there were no significant differences in outcomes,minor or major complications,or 30-day reoperations/hospital readmissions/mortality.However,urologists tended to care for patients who were older(65 vs.61 years,p<0.001)and frailer by both frailty indices(p<0.001).Conclusion:Case distributions have remained stable,with gynecologists four-fold more sacrocolpopexies,in keeping with the larger number of practicing gynecologists vs.urologists.There was no difference in 30-day outcomes between both specialties.However,urologists operated on older,more frail patients.展开更多
Objective To assess the effect of upper urinary tract(UUT)urolithiasis on urology services in a region with a high prevalence of the condition,and analyze the trends in endourological procedures for treating UUT uroli...Objective To assess the effect of upper urinary tract(UUT)urolithiasis on urology services in a region with a high prevalence of the condition,and analyze the trends in endourological procedures for treating UUT urolithiasis and the cost of treatments in 11 hospitals over the last 6 years.Methods Using the hospital surgery statistics database,data were gathered from the urology departments of 11 hospitals in Saudi Arabia.The analysis focused on the trends,distribution,and annual cost of endourological procedures for UUT urolithiasis from January 2017 to December 2022.Results Out of the total surgery performed(54711),over half(31039,57%)were related to UUT urolithiasis.Extracorporeal shock wave lithotripsy(ESWL)was the most performed procedure among stone-related procedures,accounting for 38%of all procedures.Double-J stent insertion,flexible ureteroscopy(URS),semi-rigid URS,percutaneous nephrolithotomy,and pyelo-and uretero-lithotomy accounted for 25%,19%,14%,3.8%,and 0.35%,respectively.Notably,the number of stone-related UUT procedures in 2022 increased by 35%(from 4671 to 6283)compared to 2017.In the year 2022 compared to 2017,there was a statistically significant increase in the rate of all stone-related UUT procedures(p<0.001),except for ESWL and pyelo-and uretero-lithotomy.The rates of ESWL procedures reduced from 21%in 2017 to 13%in 2022(p<0.001).Overall,the total cost of treatments has been estimated to be about 192.1 million SAR from 2017 to 2022 with an increase by 107%(47.7 million SAR in 2022 vs.23.0 million SAR in 2017).Conclusion Our research findings suggest that urolithiasis poses a significant burden,accounting for over half of all urological surgery performed at the participating centers.Furthermore,there has been a 35%rise in stone-related UUT procedures over the past 6 years.Percutaneous nephrolithotomy,flexible URS,and semi-rigid URS have experienced significant increase in usage.Furthermore,in 2022 the cost of urolithiasis treatments has been more than doubled compared to 2017.展开更多
Objective This study aimed to investigate the level of knowledge among urologists of usage of fluoroscopy during percutaneous nephrolithotomy.MethodsWe conducted an anonymous internet-based survey addressed to the EAU...Objective This study aimed to investigate the level of knowledge among urologists of usage of fluoroscopy during percutaneous nephrolithotomy.MethodsWe conducted an anonymous internet-based survey addressed to the EAU Section of Uro-Technology and the International Alliance of Urolithiasis members with particular interest in the stone treatment at all levels of expertise.The final version of the questionnaire included 31 questions,evaluated the level of knowledge on X-ray utilization and exposure,and identified correlations between geographic areas,levels of seniority,surgical volumes,and awareness on radiation protection.ResultsIn total,586 respondents were included.Knowledge of fluoroscopy settings appeared low,particularly among trainees(up to 87.5%were uninformed,p=0.008).Precautions to reduce exposure appeared poorly followed as up to 25.4%of respondents used regularly continuous fluoroscopy,and up to 20.5%used regularly high-frequency setting and this trend was more obvious among senior specialists(6.2%of trainees used high-frequency settings vs.21.3%of consultants,p<0.05).Additionally,only 24.9%of respondents would provide X-ray protection to patients too.ConclusionAlthough high and routinary utilization of X-rays,the level of awareness and adhesion to“as low as reasonably achievable”principles among endourologists seems suboptimal in 65.0%of all respondents.Highest volume surgeons,inevitably at higher risk,do not seem to adopt more precautions.More efforts should be addressed to improve these results,reducing the risk related to excessive radiation exposure for both surgical staff and patients in order to minimize health related issues.展开更多
Introduction: About 10 to 15% of couples in the world and 20 to 30% in Cameroon consult for infertility problems. Infertility is of male origin in 40% of cases. Our objective was to evaluate the epidemiological and cl...Introduction: About 10 to 15% of couples in the world and 20 to 30% in Cameroon consult for infertility problems. Infertility is of male origin in 40% of cases. Our objective was to evaluate the epidemiological and clinical aspects of male infertility in our setting. Methods: This was a cross-sectional and descriptive study, with retrospective data collection from the files of patients received for male infertility, over 5 years and 6 months (from January 1<sup>st</sup>, 2016 to April 30<sup>th</sup>, 2021) at the Urology Department of the Yaounde Central Hospital. Phone calls were made to patients with incomplete records for completion following a verbal consent. Data reported on data collection forms were entered into a data entry form designed on CSPro software version 7.2. The database was later exported for descriptive statistics using the IBM SPSS software version 23. Qualitative variables were summarized in frequencies and percentages while quantitative variables were summarized in means with their standard deviations for normally distributed data, or medians and interquartile ranges otherwise. Results: Out of 110 patients whose records were analyzed, the median age was 37.0 years, with an interquartile range of 8.3, with 55.5% in the age group 30 to 39 years. Of these 95 (86.4%) were married, 58 (52.7%) were from the West region, 76 (69.1%) were employed. Past history was dominated by mumps 40 (36.4%), varicocele surgery 25 (22.7%), alcoholism 87 (79.1%) and smoking 15 (13.6%). A disorder of spermatogenesis was found in all our patients: 37 (33.6%) azoospermia, 27 (24.6%) asthenospermia and 26 (23.7%) oligospermia patients. Paraclinical evidence of chlamydia and gonococcal infections were found respectively in 38 (34.5%) and 14 (12.7%) patients, varicocele and testicular dystrophy respectively in 95 (86.4%) and 38 (34.5%) patients. Infertility was primary in 67 (60.9%) patients. Conclusion: Most patients with infertility were in their thirties, had risky social habits and comorbidities. An early start of health promotion activities, comorbidities prevention and early detection of spermogram abnormalities would make it possible to reduce the frequency of male infertility.展开更多
Background:Artificial intelligence(AI)-assisted threedimensional(3D)surgical platforms,integrated with augmented reality,have the potential to improve intraoperative anatomical recognition and provide surgeons with an...Background:Artificial intelligence(AI)-assisted threedimensional(3D)surgical platforms,integrated with augmented reality,have the potential to improve intraoperative anatomical recognition and provide surgeons with an immersive,dynamic operating environment during urooncological procedures.This review aims to examine the current applications of AI in robotic uro-oncology,with a particular focus on its role in facilitating intraoperative navigation during complex surgeries.Methods:A systematic literature search was performed across PubMed,the National Library of Medicine,MEDLINE,the Cochrane Central Register of Controlled Trials(CENTRAL),ClinicalTrials.gov,and Google Scholar to identify relevant studies published up to July 2025.The search strategy incorporated a predefined set of keywords,including AI,machine learning,radical prostatectomy(RP),robotic-assisted radical prostatectomy(RARP),robotassisted partial nephrectomy(RAPN),and robot-assisted radical cystectomy(RARC).Only clinical trials,full-text peer-reviewed publications,and original research articles were included.Studies were eligible for inclusion if they evaluated or described applications of AI in RARP,RAPN,or RARC.Results:Technological advancements have substantially transformed the field of uro-oncologic surgery.In particular,AI and AI-assisted intraoperative navigation in RARP demonstrate considerable potential to objectively assess surgical performance and predict clinical outcomes.In RAPN,the adoption of preoperative,interactive 3D virtualmodels for surgical planning has influenced surgical decisions,thus,enhanced precision in resection planning correlates with superior nephron-sparing outcomes and optimized selective clamping.AI applications in RARC,techniques such as augmented reality(AR)can overlay critical information on the surgical field,by facilitating navigation through complex anatomical planes and enhancing identification of critical structures.Conclusion:AI appears to enhance robotic uro-oncologic procedures by increasing operative precision and supporting individualised surgical treatment strategies.展开更多
Background:Urologic cancers typically metastasize to common organs,while spread to sites such as the heart,hand,cranial bones,penis,or tonsil is exceedingly rare.The clinical relevance and prognostic impact of these u...Background:Urologic cancers typically metastasize to common organs,while spread to sites such as the heart,hand,cranial bones,penis,or tonsil is exceedingly rare.The clinical relevance and prognostic impact of these unusual metastases remain unclear.This case series highlights six exceptional cases,providing unique insights to support awareness and management.Case Description:We retrospectively analyzed six cases of patients diagnosed with urologic cancers who developed metastases at uncommon sites.Each case was evaluated based on clinical presentation,imaging findings,histopathological confirmation,treatment course,and outcomes.Relevant literature was reviewed to contextualize findings.Among the six cases,metastatic involvement was identified in atypical locations including the right atrium(testicular cancer),hand(bladder cancer),perineum and penis(sarcomatoid bladder cancer),cranial bones(prostate cancer),penis(rectal cancer),and tonsillar region(renal pelvis rhabdomyosarcoma).Timely imaging and histopathological confirmation guided personalized treatment strategies,primarily involving surgical interventions.Despite aggressive treatments,the prognosis remained poor in most cases,reflecting the aggressive nature of these metastases.Conclusion:Rare metastases from urologic malignancies,although uncommon,have significant implications on patient management.Early detection through advanced imaging and aggressive multimodal interventions are pivotal for improving outcomes.Awareness of such atypical metastatic patterns is essential for clinicians managing urologic cancers.展开更多
Objectives:Postmenopausal women with stress urinary incontinence(SUI)exhibit low androgen expression.This study aimed to evaluate the efficacy and safety of vaginal androgen combined with pelvic floor muscle training(...Objectives:Postmenopausal women with stress urinary incontinence(SUI)exhibit low androgen expression.This study aimed to evaluate the efficacy and safety of vaginal androgen combined with pelvic floor muscle training(PFMT)in the treatment of SUI in postmenopausal women.Methods:Postmenopausal women with SUI were recruited from Hainan West Central Hospital between January 2024 and March 2025.Participants were randomly assigned in a double-blind manner to receive either vaginal androgen cream combined with PFMT(treatment group)or a visually identical placebo cream(without androgens)combined with PFMT(control group).The vaginal cream was applied to the vaginal wall at a dose of 0.5 g per application,twice weekly for a total of 10 applications,while PFMT was conducted for 8 weeks.The clinical efficacy and safety were compared between the two groups.Results:A total of 61 patients were finally enrolled,with 31 in the treatment group and 30 in the control group.At both 3-month and 6-month follow-ups,the treatment group demonstrated significantly lower values in daily pad usage(p<0.05),24-h pad test scores(p<0.05),and ICIQ-UI SF scores(p<0.05)compared to the control group.The improvement rate of urinary incontinence was significantly higher in the treatment group(p<0.05).Compared to baseline,the treatment group showed statistically significant reductions in all three outcome measures(all p<0.05).No severe adverse events were reported in either group during the treatment period.Conclusions:Androgen therapy combined with PFMT significantly improved the urinary incontinence remission rate in postmenopausal women with SUI,with no severe adverse effects observed.These findings suggest that androgen therapy may represent a novel therapeutic approach for SUI management in postmenopausal women.展开更多
Background:Clear cell sarcoma of the kidney(CCSK)is a rare and highly aggressive pediatric renal malignancy with a marked propensity for metastatic spread.Cases of CCSK associated with inferior vena cava(IVC)tumor thr...Background:Clear cell sarcoma of the kidney(CCSK)is a rare and highly aggressive pediatric renal malignancy with a marked propensity for metastatic spread.Cases of CCSK associated with inferior vena cava(IVC)tumor thrombus(IVCTT)are exceptionally uncommon in the literature.We report a case of CCSK with IVCTT in a 15-month-old male infant.Case Description:We reported a case admitted in May 2020 for a 3-day history of fever and hematuria.Abdominal CT revealed an unevenly enhanced mass and low-density shadows within the IVC.The diagnosis of CCSK was confirmed via needle biopsy.The patient received 4 cycles of adjuvant chemotherapy.The initial surgery lasted 10 h with 600 mL blood loss,and primary closure was achieved.Postoperative management included 6 cycles of radiotherapy and 5 cycles of chemotherapy.In March 2022,CT detected IVCTT recurrence,requiring surgical intervention involving thrombus removal and partial IVC resection.This procedure lasted 8 h with 300 mL blood loss,followed by 5 additional chemotherapy cycles.The patient showed no sign of IVC obstruction,including varicose veins or lower limb edema,and maintained renal function throughout follow-up.However,Intracranial metastases were detected 15 months postoperatively.After the family opted against additional treatment,the patient succumbed to the disease.Conclusions:The management of CCSK associated with IVCTT should include consideration of IVC thrombectomy.In case of recurrent IVCTT with preserved collateral circulation,combined thrombus excision and partial IVC resection may be warranted.展开更多
Objective:Current research highlights periodontal disease as a systemic inflammatory condition that may influence extra-oral diseases such as prostatic diseases,which prompted us to explore the potential association.T...Objective:Current research highlights periodontal disease as a systemic inflammatory condition that may influence extra-oral diseases such as prostatic diseases,which prompted us to explore the potential association.To evaluate whether periodontal disease is associated with an increased risk of prostatic disease,including prostate cancer,benign prostatic hyperplasia(BPH),and prostatitis.Methods:A systematic search of observational studies concerning the relationship between periodontal disease and prostatic disease was performed in online databases PubMed,Embase,Web of Science,Scopus,CENTRAL,CNKI,and WanFang.Searches were conducted from database inception to 31 July 2025.Pooled hazard ratio(HR)or odds ratio(OR)with 95%confidence intervals(CIs)were synthesized.Subgroup analysis was used to detect the origin of heterogeneity,sensitivity analysis was employed to evaluate the robustness of the results,and publication bias analyses were also performed.R software was used to perform statistical analyses.Results:Sixteen studies that met the preset criteria were included in this study.In the pooled analysis,periodontal disease was associated with increased risk of prostate cancer(HR=1.23,95%CI:1.16-1.29,p<0.001)or BPH(OR=1.55,95%CI:1.41-1.70,p<0.001).Sensitivity analysis confirmed the robustness of the results.No obvious publication biaswas found in the meta-analysis.Only one cohort study reported that chronic periodontitis increases the risk of prostatitis(HR=2.521,95%CI:1.685-4.005,p<0.001).The effect of periodontal treatment on prostatic disease is still unclear.Conclusions:The systematic review and meta-analysis identified an observational association between periodontal disease and increased risks of prostate cancer and BPH.Because all included studies were observational,these results indicate association rather than causation,and further prospective and mechanistic studies are required to clarify temporality and causality.展开更多
Background:The Da Vinci Single-Port Robotic System(Da Vinci-SP),introduced by Intuitive(CA,USA)in 2018 in the USA and in 2024 in Europe,integrates advanced features like a flexible camera and articulating instruments....Background:The Da Vinci Single-Port Robotic System(Da Vinci-SP),introduced by Intuitive(CA,USA)in 2018 in the USA and in 2024 in Europe,integrates advanced features like a flexible camera and articulating instruments.It has garnered significant interest in urology.Our report presents the first described European series of Radical Prostatectomies using the Da Vinci SP at the leading Italian center,Istituto Nazionale Tumori di Napoli,IRCCS“G.Pascale”Foundation,detailing the technical differences and challenges faced by experienced multiport robotic surgeons.Methods:Sixteen patients have been enrolled and underwent Single-Port(SP)Robot-Assisted Radical Prostatectomy(SP-RARP).Baseline characteristics of the patients were collected.We provided a step-by-step description of the surgical technique.Oncological outcomes have been evaluated and compared with magnetic resonance imaging(MRI)and biopsy results.Intraoperative,perioperative,and postoperative complications,surgical outcomes,functional outcomes,and technical issues of the new system were also documented.Results:All surgeries were successfully performed without the need for conversion.An extraperitoneal approach was used for all patients.Median Console time was 110 min.No complications were reported.The estimated median blood loss was 175 cc.Discharge from the hospital was on the first post-operative day for all patients.Bladder catheter removal was on day 7 without the need for cystography.Conclusions:We presented the first European case series of SP-RARP,reporting our experience and confirming the procedure’s feasibility for a highly experienced robotic surgeon.Experience with an extraperitoneal approach using the multiport(MP)platform,combined with well-conducted training for the SP system,may facilitate the transition to SP surgery.Further procedures and studies are needed to evaluate the oncological and functional outcomes.展开更多
Multiple sclerosis is a severe autoimmune disorder that is mainly mediated by pathogenic cluster of CD4^(+)T cell subsets.Despite advancements in the management of multiple sclerosis,there is a critical need for more ...Multiple sclerosis is a severe autoimmune disorder that is mainly mediated by pathogenic cluster of CD4^(+)T cell subsets.Despite advancements in the management of multiple sclerosis,there is a critical need for more effective and safer treatments.In the present study,we administered Lycium barbarum glycopeptide to a mouse model of experimental autoimmune encephalomyelitis-an animal model of multiple sclerosis-and evaluated its effects on pathogenic CD4^(+)T cell activation both in vivo and in vitro.Lycium barbarum glycopeptide significantly mitigated the clinical severity of experimental autoimmune encephalomyelitis,as demonstrated by reduced demyelination and neuroinflammation.Moreover,Lycium barbarum glycopeptide treatment decreased the infiltration of peripheral leukocytes into the central nervous system and suppressed pro-inflammatory cytokine expression.Lycium barbarum glycopeptide also modulated pathogenic CD4^(+)T cell activation by inhibiting T helper 1/T helper 17 cell differentiation while promoting regulatory T cell expansion.Notably,no side effects were observed,suggesting the long-term safety and tolerability of Lycium barbarum glycopeptide.Furthermore,RNA sequencing data indicated that Lycium barbarum glycopeptide inhibits activator protein-1,an essential regulator of T cell activation and differentiation.This finding was supported by the reversal of T helper/T helper 17 cell response suppression upon AP-1 blockade.Collectively,these results highlight the potential of Lycium barbarum glycopeptide as an innovative therapeutic agent for CD4^(+)T cell-associated autoimmune or inflammatory diseases,such as multiple sclerosis.展开更多
Mastitis is one of the most significant diseases affecting the development of the dairy industry and has traditionally been associated with pathogenic infections.However,emerging evidence highlights that ruminal micro...Mastitis is one of the most significant diseases affecting the development of the dairy industry and has traditionally been associated with pathogenic infections.However,emerging evidence highlights that ruminal microbial homeostasis also plays a crucial role in the pathogenesis of mastitis.Specifically,cows with mastitis exhibit reduced alpha diversity and altered microbial composition in the rumen.Inducing ruminal dysbiosis through a high-concentrate diet has been shown to trigger mastitis in cows,and transplantation of ruminal microbiota from mastitis-affected cows to recipient mice can induce mastitis in mice.Mechanistically,ruminal dysbiosis increases gastrointestinal inflammation and compromises the integrity of the gastrointestinal barrier,thereby facilitating the translocation of harmful bacterial components,metabolites,and pathobionts into the bloodstream.This disruption impairs blood-milk barrier function,leading to systemic inflammation and the development of mastitis.In this review,we summarize recent advances in understanding how ruminal dysbiosis induces mastitis and explore potential prevention and control strategies targeting the modulation of ruminal microbiota.展开更多
Objectives: To study the epidemiological, diagnostic and prognostic aspects of bladder tumours in Segou Hospital. Patients and Methods: We conducted a descriptive cross-sectional study of bladder tumours over the peri...Objectives: To study the epidemiological, diagnostic and prognostic aspects of bladder tumours in Segou Hospital. Patients and Methods: We conducted a descriptive cross-sectional study of bladder tumours over the period from 1 April 2012 to 1 April 2017, in the urology department of the Nianankoro Fomba Hospital in Segou. The first three years were used for patient recruitment, and the last two years for follow-up of the patients in the series. Results: Over a period of three years, we collected 165 cases of bladder tumours hospitalised out of 1308 hospitalisations from 7007 consultations, i.e. 12.6% of hospitalisations and 2.3% of consultations. The sex ratio was 1.2 in favour of men. A history of treated bilharzia was reported in 78.8% of cases and untreated bilharzia in 9.1% of cases. Haematuria was the most common reason for consultation. The majority of our patients were at stage T4 and T3 at the time of diagnosis, i.e. 53.3% and 44.3% respectively. Most patients consulted within 13 to 24 months after the first sign, i.e. 44.8%. Conclusion: The prognosis is still clouded by the delay in management. All the patients diagnosed had a bladder tumour infiltrating the muscle.展开更多
Glassy polymers are widely used in biomedical applications in a solvent environment,yet their long-term performance is governed by the competing effects of physical aging and solvent-induced plasticization.Here,we dev...Glassy polymers are widely used in biomedical applications in a solvent environment,yet their long-term performance is governed by the competing effects of physical aging and solvent-induced plasticization.Here,we develop a constitutive model that explicitly couples the solvent concentration,structural relaxation,and mechanical response.This framework is built on a multiplicative decomposition of deformation and an Eyring-type flow rule,with structural evolution described by an effective temperature.A generalized shift factor is introduced to quantify how the solvent concentration and effective temperature jointly affect the relaxation time,thereby integrating physical aging and plasticization.The model is subsequently applied to methacrylate(MA)-based copolymer networks immersed in phosphate-buffered saline for up to nine months.Simulations accurately capture key experimental features,including the strong softening of highly swellable networks,the partial recovery due to aging,and the mitigating role of hydrophobic crosslinking in reducing solvent uptake.While the current single-mode description cannot reproduce the full relaxation spectrum,it establishes an efficient framework for predicting the long-term mechanical performance under coupled environmental and mechanical loading.This study provides a constitutive description of solvent-swollen glassy polymers,offering mechanistic insight into the interplay between plasticization and aging.Beyond biomedical MA networks,this framework establishes a foundation for predicting the long-term performance of polymer glasses under coupled aqueous environmental and mechanical loading.展开更多
文摘Objective: The objectives of this study, was to analyze epidemiological diagnosis, therapeutic option and evolutionary aspects. Materials and methods: This is a retrospective study regarding clinical data of nine penile fracture patients who have been admitted in the department of urology (university hospital, Brazzaville) from January 2006 to December 2018. The study parameters were: epidemiological, diagnosis, operative details, outcomes after treatment, and sexual disorders. Results: The mean age was 46.3 ± 14 years, ranged from 25 to 73 years. The etiology of penile fracture was coitus in 5 cases, masturbation in 3 cases and rolling of the penis on the bed in one case. 8 patients were managed surgically. The complications noticed in the postoperative period and during the follow-up visits were penile curvature in 2 cases, and erectyl dysfunction in 2 cases. Conclusion: The diagnosis of penile fracture remains clinic. Immediate surgical management is necessary for good functional result.
文摘Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can be overlooked or confused with other pathologies. Treatment remains controversial. The aim of this work is to study the epidemiological, clinical and therapeutic data of urethral mucosal prolapse in young girls in our department. Materials and methods: Retrospective and descriptive study on urethral mucosal prolapse in little girls identified from the hospitalization records of the Sino-Guinean Friendship Hospital in Conakry. The study period was 5 years. Patients were selected randomly. Outcome assessment focused on the occurrence of recurrences and urinary incontinence. The mean follow-up duration was 24 months. The parameters studied were: Age, clinical and histological findings, therapeutic data and patient outcomes. Results: The incidence of urethral mucosal prolapse in girls in the urology department was 2.2 cases/year. The mean age of the patients was 6.7 years (with extremes of 5 months and 10 years). The age group of 7 to 10 years was the most represented, observed in 63.63% of patients. The most frequent reason for consultation was vulvar bleeding in 7 patients, or 63.63%. Malpighian hyperplasia with a congested chorion was the most observed histological type, in 4 patients. Surgical treatment consisting of complete excision of the prolapsed part had given excellent results. Conclusion: Urethral prolapse is a rare pathology, observed mainly in young black girls. Its diagnosis is based mainly on clinical examination. Surgical treatment gives satisfactory results, both clinically and aesthetically.
基金funded by the National Key Research and Development Program of China(Grant No.2022YFB4700904 to Wang L)the Shanghai Shenkang Hospital Development Center's project for the Promotion of Clinical Skills and Clinical Innovation Three-Year Action Plan(Project No.SHDC2022CRT006 to Wang L and SHDC2022CRS010B to Tang S).
文摘Objective:This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.Methods:In this prospective,multicenter clinical trial,we examined the effectiveness of the SHURUI single-port robotic surgical system in urological interventions.The first 50 patients from four centers in China underwent single-port surgeries including partial nephrectomy,radical prostatectomy,partial adrenalectomy,and pyeloureteroplasty,exclusively by the SHURUI single-port robotic surgical system.The study's primary endpoints focused on the success of surgeries,defined as no deviations from planned procedures,no need for more than one port,and no re-operations within 24 h after surgery.Secondary endpoints encompassed a range of surgical metrics,functional outcomes,and patient demographic data.Clinical assessments were conducted before surgery,before discharge,and 1 month after discharge.Results:The surgical procedures were executed successfully without requiring intraoperative conversions or transfusions.Both estimated blood loss and operation durations were maintained within satisfactory limits.For each type of surgery,the mean console times and estimated blood loss were 179.8(standard deviation[SD]39.4)min and 125.6(SD 126.0)mL for radical prostatectomy,126.7(SD 47.8)min and 39.2(SD 54.4)mL for partial nephrectomy,112.6(SD 37.4)min and 20.0(SD 13.2)mL for partial adrenalectomy,and 148.0(SD 18.2)min and 18.0(SD 17.9)mL for pyeloureteroplasty,respectively.Across the cohort,17 patients experienced a total of 25 adverse events,while 10 postoperative complications,all rated as Clavien-Dindo grade I,were encountered by eight patients.All patients had shown recovery or improvement from these events before the end of this trial.Conclusion:The SHURUI single-port robotic surgical system demonstrated feasibility and safety in the performance of major urological surgeries.These initial findings highlight the system's potential,though further research and longer follow-up are required to assess long-term outcomes.
文摘Purpose: To study the epidemiology and treatment modalities of urolithiasis at Urology Department of University Hospital of Cotonou. Materials and Methods: It was a retrospective and descriptive study over a 10 years period ranging from January 1st, 2004 to December 31st, 2013. One hundred and two patients who were hospitalized for symptomatic urolithiasis at the Urology Department of University Hospital of Cotonou were enrolled. Results: Hospital incidence of urolithiasis was 3.7%. Patients mean age was 39.6 years (extremes: 10 years to 73 years). Male to female ratio was 2.2. The main reason for consultation was renal colic for 81 patients (79.4%). Average duration of symptoms at presentation was 5 months (range: 1 day to 10 years). A total of 173 stones were identified with an average size of 12 mm (range: 1 mm to 95 mm). Calyceal stones were seen in 32.9% of cases, renal pelvis stones in 21.4% of cases, ureteral stones in 34.1% and bladder stones in 11.5% of cases. Open surgery was the main treatment for stones that could not be managed medically. 50.8% of patients underwent surgery with extraction of 116 stones. This represented 67.1% of all stones. 9 patients (8.8%) had expelled their stone during urination. The postoperative course was uneventful in 77.5% of cases. Conclusion: Modern treatment options for urolithiasis remain rudimentary in our health facilities. Open surgery is still the main stay of treatment in our countries with limited resources.
文摘Introduction: Transurethral Resection of the Prostate (TURP) is a multi-invasive technique in the management of Benign Prostatic Hyperplasia. It constitutes a reference in developed countries;however in sub-Saharan Africa, it is prostatic adenomectomy which is mostly used. The aim was to analyze the results of the TURP carried out at the General National Reference University Hospital in N’Djamena (Chad). Patients and Methods: This is a retro-prospective study which extended over a period of 2 years, from June 2014 to May 2016. The records of all patients who had undergone TURP during this period were listed and analyzed. We did frequencies and average calculations. Results: 59 patients’ results that were treated with TURP were collected. TURP represented 33.4% of all interventions performed for prostate pathologies. The average age of our patients was 66 ± 8.06 years (50 to 92). Urinary retention was the main reason for consultation (45.7%;n = 27) followed by dysuria (27.1%;n = 16). TURP was associated with another procedure in 28.8% (n = 17). The average duration of hospitalization of our patients was 4.15 days with extremes of 2 to 9 days. Perioperative complications represented 13.6% of cases, early complications represented 15.3% of cases and late complications represented 6.8% of cases. The postoperative voiding status with an average follow-up of 6 months was judged to be good in 72.8% of cases (n = 43). Conclusion: TURP occupies an important place in the management of prostate pathologies with precise indications. It offers many advantages. It must be popularized in our countries;this will make it possible to limit morbidity and mortality rates and slow down medical evacuations abroad.
文摘Objective:We aimed to study the effect of flexible ureteroscopy(FURS)for renal stones using a flexible and navigable suction ureteral access sheath(FANS)on intraoperative radiation dose and time.Methods:This was a multicenter study of adults who underwent FURS with FANS.The correlation analysis was done to identify factors affecting radiation dose and time measured by the C-arm fluoroscopy intraoperatively.Results:We analyzed 110 patients,with a median age of 50 years.Of them,72%were pre-stented prior to the procedure.The median stone volume was 1503 mm3 and the median operative time was 39 min.The median radiation dose was 7.4 mSv and median radiation time was 0.6 min.Totally,91%of patients achieved stone-free status(Grade A or B)on the non-contrast CT scan within 30 days postoperatively.There were no cases of postoperative sepsis.Body mass index,stone volume,and total operation time were associated with a higher radiation dose.Procedures performed under general anesthesia had a lower radiation dose and time than those performed under spinal anesthesia.Disposable scopes were associated with higher radiation time than reusable scopes but not dose.A low-power holmium laser had longer radiation time than other laser sources,but only the thulium fiber laser was associated with a significantly lower radiation dose.Conclusion:Our study is the first to highlight the multitude of factors affecting radiation exposure in FURS with FANS.Although not a direct measure of surgeons'actual exposure,it has important implications for the As Low As Reasonably Achievable principle which is commonly used to minimize radiation exposure to patients and operating room staff.
文摘Introduction:With the aging population,more females will suffer from pelvic organ prolapse.Both urologists and gynecologists perform sacrocolpopexy,but there is no comparative study analyzing differences in provision of care,outcomes,or patient population.We aimed to elucidate potential differences in demographics,outcomes,and minimally invasive surgery utilization for SCP performed by urology and gynecology.Methods:In our retrospective analysis,sacrocolpopexies were identified using the American College of Surgeons National Surgical Quality Improvement Project database from 2006–2020.Pearson’s chi-square test was performed to test trends in the utilization of MIS in five-year blocks.Frailty was calculated using the NSQIP modified frailty index and the revised surgical Risk Analysis Index.Univariate analysis was performed using Student’s t-test and Pearson’s chi-square to compare operative parameters,frailty,demographics,and outcomes.Results:We identified 8944 sacrocolpopexies.Gynecology performed 81%of cases while urology performed the remaining 19%(p<0.001).Between the specialties,there were no significant differences in outcomes,minor or major complications,or 30-day reoperations/hospital readmissions/mortality.However,urologists tended to care for patients who were older(65 vs.61 years,p<0.001)and frailer by both frailty indices(p<0.001).Conclusion:Case distributions have remained stable,with gynecologists four-fold more sacrocolpopexies,in keeping with the larger number of practicing gynecologists vs.urologists.There was no difference in 30-day outcomes between both specialties.However,urologists operated on older,more frail patients.
文摘Objective To assess the effect of upper urinary tract(UUT)urolithiasis on urology services in a region with a high prevalence of the condition,and analyze the trends in endourological procedures for treating UUT urolithiasis and the cost of treatments in 11 hospitals over the last 6 years.Methods Using the hospital surgery statistics database,data were gathered from the urology departments of 11 hospitals in Saudi Arabia.The analysis focused on the trends,distribution,and annual cost of endourological procedures for UUT urolithiasis from January 2017 to December 2022.Results Out of the total surgery performed(54711),over half(31039,57%)were related to UUT urolithiasis.Extracorporeal shock wave lithotripsy(ESWL)was the most performed procedure among stone-related procedures,accounting for 38%of all procedures.Double-J stent insertion,flexible ureteroscopy(URS),semi-rigid URS,percutaneous nephrolithotomy,and pyelo-and uretero-lithotomy accounted for 25%,19%,14%,3.8%,and 0.35%,respectively.Notably,the number of stone-related UUT procedures in 2022 increased by 35%(from 4671 to 6283)compared to 2017.In the year 2022 compared to 2017,there was a statistically significant increase in the rate of all stone-related UUT procedures(p<0.001),except for ESWL and pyelo-and uretero-lithotomy.The rates of ESWL procedures reduced from 21%in 2017 to 13%in 2022(p<0.001).Overall,the total cost of treatments has been estimated to be about 192.1 million SAR from 2017 to 2022 with an increase by 107%(47.7 million SAR in 2022 vs.23.0 million SAR in 2017).Conclusion Our research findings suggest that urolithiasis poses a significant burden,accounting for over half of all urological surgery performed at the participating centers.Furthermore,there has been a 35%rise in stone-related UUT procedures over the past 6 years.Percutaneous nephrolithotomy,flexible URS,and semi-rigid URS have experienced significant increase in usage.Furthermore,in 2022 the cost of urolithiasis treatments has been more than doubled compared to 2017.
文摘Objective This study aimed to investigate the level of knowledge among urologists of usage of fluoroscopy during percutaneous nephrolithotomy.MethodsWe conducted an anonymous internet-based survey addressed to the EAU Section of Uro-Technology and the International Alliance of Urolithiasis members with particular interest in the stone treatment at all levels of expertise.The final version of the questionnaire included 31 questions,evaluated the level of knowledge on X-ray utilization and exposure,and identified correlations between geographic areas,levels of seniority,surgical volumes,and awareness on radiation protection.ResultsIn total,586 respondents were included.Knowledge of fluoroscopy settings appeared low,particularly among trainees(up to 87.5%were uninformed,p=0.008).Precautions to reduce exposure appeared poorly followed as up to 25.4%of respondents used regularly continuous fluoroscopy,and up to 20.5%used regularly high-frequency setting and this trend was more obvious among senior specialists(6.2%of trainees used high-frequency settings vs.21.3%of consultants,p<0.05).Additionally,only 24.9%of respondents would provide X-ray protection to patients too.ConclusionAlthough high and routinary utilization of X-rays,the level of awareness and adhesion to“as low as reasonably achievable”principles among endourologists seems suboptimal in 65.0%of all respondents.Highest volume surgeons,inevitably at higher risk,do not seem to adopt more precautions.More efforts should be addressed to improve these results,reducing the risk related to excessive radiation exposure for both surgical staff and patients in order to minimize health related issues.
文摘Introduction: About 10 to 15% of couples in the world and 20 to 30% in Cameroon consult for infertility problems. Infertility is of male origin in 40% of cases. Our objective was to evaluate the epidemiological and clinical aspects of male infertility in our setting. Methods: This was a cross-sectional and descriptive study, with retrospective data collection from the files of patients received for male infertility, over 5 years and 6 months (from January 1<sup>st</sup>, 2016 to April 30<sup>th</sup>, 2021) at the Urology Department of the Yaounde Central Hospital. Phone calls were made to patients with incomplete records for completion following a verbal consent. Data reported on data collection forms were entered into a data entry form designed on CSPro software version 7.2. The database was later exported for descriptive statistics using the IBM SPSS software version 23. Qualitative variables were summarized in frequencies and percentages while quantitative variables were summarized in means with their standard deviations for normally distributed data, or medians and interquartile ranges otherwise. Results: Out of 110 patients whose records were analyzed, the median age was 37.0 years, with an interquartile range of 8.3, with 55.5% in the age group 30 to 39 years. Of these 95 (86.4%) were married, 58 (52.7%) were from the West region, 76 (69.1%) were employed. Past history was dominated by mumps 40 (36.4%), varicocele surgery 25 (22.7%), alcoholism 87 (79.1%) and smoking 15 (13.6%). A disorder of spermatogenesis was found in all our patients: 37 (33.6%) azoospermia, 27 (24.6%) asthenospermia and 26 (23.7%) oligospermia patients. Paraclinical evidence of chlamydia and gonococcal infections were found respectively in 38 (34.5%) and 14 (12.7%) patients, varicocele and testicular dystrophy respectively in 95 (86.4%) and 38 (34.5%) patients. Infertility was primary in 67 (60.9%) patients. Conclusion: Most patients with infertility were in their thirties, had risky social habits and comorbidities. An early start of health promotion activities, comorbidities prevention and early detection of spermogram abnormalities would make it possible to reduce the frequency of male infertility.
文摘Background:Artificial intelligence(AI)-assisted threedimensional(3D)surgical platforms,integrated with augmented reality,have the potential to improve intraoperative anatomical recognition and provide surgeons with an immersive,dynamic operating environment during urooncological procedures.This review aims to examine the current applications of AI in robotic uro-oncology,with a particular focus on its role in facilitating intraoperative navigation during complex surgeries.Methods:A systematic literature search was performed across PubMed,the National Library of Medicine,MEDLINE,the Cochrane Central Register of Controlled Trials(CENTRAL),ClinicalTrials.gov,and Google Scholar to identify relevant studies published up to July 2025.The search strategy incorporated a predefined set of keywords,including AI,machine learning,radical prostatectomy(RP),robotic-assisted radical prostatectomy(RARP),robotassisted partial nephrectomy(RAPN),and robot-assisted radical cystectomy(RARC).Only clinical trials,full-text peer-reviewed publications,and original research articles were included.Studies were eligible for inclusion if they evaluated or described applications of AI in RARP,RAPN,or RARC.Results:Technological advancements have substantially transformed the field of uro-oncologic surgery.In particular,AI and AI-assisted intraoperative navigation in RARP demonstrate considerable potential to objectively assess surgical performance and predict clinical outcomes.In RAPN,the adoption of preoperative,interactive 3D virtualmodels for surgical planning has influenced surgical decisions,thus,enhanced precision in resection planning correlates with superior nephron-sparing outcomes and optimized selective clamping.AI applications in RARC,techniques such as augmented reality(AR)can overlay critical information on the surgical field,by facilitating navigation through complex anatomical planes and enhancing identification of critical structures.Conclusion:AI appears to enhance robotic uro-oncologic procedures by increasing operative precision and supporting individualised surgical treatment strategies.
文摘Background:Urologic cancers typically metastasize to common organs,while spread to sites such as the heart,hand,cranial bones,penis,or tonsil is exceedingly rare.The clinical relevance and prognostic impact of these unusual metastases remain unclear.This case series highlights six exceptional cases,providing unique insights to support awareness and management.Case Description:We retrospectively analyzed six cases of patients diagnosed with urologic cancers who developed metastases at uncommon sites.Each case was evaluated based on clinical presentation,imaging findings,histopathological confirmation,treatment course,and outcomes.Relevant literature was reviewed to contextualize findings.Among the six cases,metastatic involvement was identified in atypical locations including the right atrium(testicular cancer),hand(bladder cancer),perineum and penis(sarcomatoid bladder cancer),cranial bones(prostate cancer),penis(rectal cancer),and tonsillar region(renal pelvis rhabdomyosarcoma).Timely imaging and histopathological confirmation guided personalized treatment strategies,primarily involving surgical interventions.Despite aggressive treatments,the prognosis remained poor in most cases,reflecting the aggressive nature of these metastases.Conclusion:Rare metastases from urologic malignancies,although uncommon,have significant implications on patient management.Early detection through advanced imaging and aggressive multimodal interventions are pivotal for improving outcomes.Awareness of such atypical metastatic patterns is essential for clinicians managing urologic cancers.
基金supported by Joint Program on Health Science&Technology Innovation of Hainan Province(WSJK2024QN093)Discipline Leader Development Program for Outstanding Talents of Hainan West Central Hospital.
文摘Objectives:Postmenopausal women with stress urinary incontinence(SUI)exhibit low androgen expression.This study aimed to evaluate the efficacy and safety of vaginal androgen combined with pelvic floor muscle training(PFMT)in the treatment of SUI in postmenopausal women.Methods:Postmenopausal women with SUI were recruited from Hainan West Central Hospital between January 2024 and March 2025.Participants were randomly assigned in a double-blind manner to receive either vaginal androgen cream combined with PFMT(treatment group)or a visually identical placebo cream(without androgens)combined with PFMT(control group).The vaginal cream was applied to the vaginal wall at a dose of 0.5 g per application,twice weekly for a total of 10 applications,while PFMT was conducted for 8 weeks.The clinical efficacy and safety were compared between the two groups.Results:A total of 61 patients were finally enrolled,with 31 in the treatment group and 30 in the control group.At both 3-month and 6-month follow-ups,the treatment group demonstrated significantly lower values in daily pad usage(p<0.05),24-h pad test scores(p<0.05),and ICIQ-UI SF scores(p<0.05)compared to the control group.The improvement rate of urinary incontinence was significantly higher in the treatment group(p<0.05).Compared to baseline,the treatment group showed statistically significant reductions in all three outcome measures(all p<0.05).No severe adverse events were reported in either group during the treatment period.Conclusions:Androgen therapy combined with PFMT significantly improved the urinary incontinence remission rate in postmenopausal women with SUI,with no severe adverse effects observed.These findings suggest that androgen therapy may represent a novel therapeutic approach for SUI management in postmenopausal women.
基金Research Project of Hunan Health Commission in 2023(D202304058618)Innovation Project of Hunan Science and Technology Department(2018SK504)National Nature Science Foundation of China(No.82203414).
文摘Background:Clear cell sarcoma of the kidney(CCSK)is a rare and highly aggressive pediatric renal malignancy with a marked propensity for metastatic spread.Cases of CCSK associated with inferior vena cava(IVC)tumor thrombus(IVCTT)are exceptionally uncommon in the literature.We report a case of CCSK with IVCTT in a 15-month-old male infant.Case Description:We reported a case admitted in May 2020 for a 3-day history of fever and hematuria.Abdominal CT revealed an unevenly enhanced mass and low-density shadows within the IVC.The diagnosis of CCSK was confirmed via needle biopsy.The patient received 4 cycles of adjuvant chemotherapy.The initial surgery lasted 10 h with 600 mL blood loss,and primary closure was achieved.Postoperative management included 6 cycles of radiotherapy and 5 cycles of chemotherapy.In March 2022,CT detected IVCTT recurrence,requiring surgical intervention involving thrombus removal and partial IVC resection.This procedure lasted 8 h with 300 mL blood loss,followed by 5 additional chemotherapy cycles.The patient showed no sign of IVC obstruction,including varicose veins or lower limb edema,and maintained renal function throughout follow-up.However,Intracranial metastases were detected 15 months postoperatively.After the family opted against additional treatment,the patient succumbed to the disease.Conclusions:The management of CCSK associated with IVCTT should include consideration of IVC thrombectomy.In case of recurrent IVCTT with preserved collateral circulation,combined thrombus excision and partial IVC resection may be warranted.
文摘Objective:Current research highlights periodontal disease as a systemic inflammatory condition that may influence extra-oral diseases such as prostatic diseases,which prompted us to explore the potential association.To evaluate whether periodontal disease is associated with an increased risk of prostatic disease,including prostate cancer,benign prostatic hyperplasia(BPH),and prostatitis.Methods:A systematic search of observational studies concerning the relationship between periodontal disease and prostatic disease was performed in online databases PubMed,Embase,Web of Science,Scopus,CENTRAL,CNKI,and WanFang.Searches were conducted from database inception to 31 July 2025.Pooled hazard ratio(HR)or odds ratio(OR)with 95%confidence intervals(CIs)were synthesized.Subgroup analysis was used to detect the origin of heterogeneity,sensitivity analysis was employed to evaluate the robustness of the results,and publication bias analyses were also performed.R software was used to perform statistical analyses.Results:Sixteen studies that met the preset criteria were included in this study.In the pooled analysis,periodontal disease was associated with increased risk of prostate cancer(HR=1.23,95%CI:1.16-1.29,p<0.001)or BPH(OR=1.55,95%CI:1.41-1.70,p<0.001).Sensitivity analysis confirmed the robustness of the results.No obvious publication biaswas found in the meta-analysis.Only one cohort study reported that chronic periodontitis increases the risk of prostatitis(HR=2.521,95%CI:1.685-4.005,p<0.001).The effect of periodontal treatment on prostatic disease is still unclear.Conclusions:The systematic review and meta-analysis identified an observational association between periodontal disease and increased risks of prostate cancer and BPH.Because all included studies were observational,these results indicate association rather than causation,and further prospective and mechanistic studies are required to clarify temporality and causality.
文摘Background:The Da Vinci Single-Port Robotic System(Da Vinci-SP),introduced by Intuitive(CA,USA)in 2018 in the USA and in 2024 in Europe,integrates advanced features like a flexible camera and articulating instruments.It has garnered significant interest in urology.Our report presents the first described European series of Radical Prostatectomies using the Da Vinci SP at the leading Italian center,Istituto Nazionale Tumori di Napoli,IRCCS“G.Pascale”Foundation,detailing the technical differences and challenges faced by experienced multiport robotic surgeons.Methods:Sixteen patients have been enrolled and underwent Single-Port(SP)Robot-Assisted Radical Prostatectomy(SP-RARP).Baseline characteristics of the patients were collected.We provided a step-by-step description of the surgical technique.Oncological outcomes have been evaluated and compared with magnetic resonance imaging(MRI)and biopsy results.Intraoperative,perioperative,and postoperative complications,surgical outcomes,functional outcomes,and technical issues of the new system were also documented.Results:All surgeries were successfully performed without the need for conversion.An extraperitoneal approach was used for all patients.Median Console time was 110 min.No complications were reported.The estimated median blood loss was 175 cc.Discharge from the hospital was on the first post-operative day for all patients.Bladder catheter removal was on day 7 without the need for cystography.Conclusions:We presented the first European case series of SP-RARP,reporting our experience and confirming the procedure’s feasibility for a highly experienced robotic surgeon.Experience with an extraperitoneal approach using the multiport(MP)platform,combined with well-conducted training for the SP system,may facilitate the transition to SP surgery.Further procedures and studies are needed to evaluate the oncological and functional outcomes.
基金supported by the National Natural Science Foundational of China,Nos.U24A20692(to CJZ),82371355(to CJZ),and 82101414(to MH)National NaturalScience Foundational of China for Excellent Young Scholars,No.82022019(to CJZ)+5 种基金Sichuan Special Fund for Distinguished Young Scholars,No.24NSFJQ0052(to CJZ)The Innovationand Entrepreneurial Team of Sichuan Tianfu Emei Program,No.CZ2024018(to CJZ)Funding for Distinguished Young Scholars of Sichuan Provincial People’sHospital,No.30420230005Funding for Distinguished Young Scholars of University of Electronic Science and Technology of China,No.A1098531023601381(toCJZ)Sichuan Science and Technology Support Project,No.2023YFS0212(to BH)Project of Sichuan Provincial Health Commission,No.19PJ265(to LD).
文摘Multiple sclerosis is a severe autoimmune disorder that is mainly mediated by pathogenic cluster of CD4^(+)T cell subsets.Despite advancements in the management of multiple sclerosis,there is a critical need for more effective and safer treatments.In the present study,we administered Lycium barbarum glycopeptide to a mouse model of experimental autoimmune encephalomyelitis-an animal model of multiple sclerosis-and evaluated its effects on pathogenic CD4^(+)T cell activation both in vivo and in vitro.Lycium barbarum glycopeptide significantly mitigated the clinical severity of experimental autoimmune encephalomyelitis,as demonstrated by reduced demyelination and neuroinflammation.Moreover,Lycium barbarum glycopeptide treatment decreased the infiltration of peripheral leukocytes into the central nervous system and suppressed pro-inflammatory cytokine expression.Lycium barbarum glycopeptide also modulated pathogenic CD4^(+)T cell activation by inhibiting T helper 1/T helper 17 cell differentiation while promoting regulatory T cell expansion.Notably,no side effects were observed,suggesting the long-term safety and tolerability of Lycium barbarum glycopeptide.Furthermore,RNA sequencing data indicated that Lycium barbarum glycopeptide inhibits activator protein-1,an essential regulator of T cell activation and differentiation.This finding was supported by the reversal of T helper/T helper 17 cell response suppression upon AP-1 blockade.Collectively,these results highlight the potential of Lycium barbarum glycopeptide as an innovative therapeutic agent for CD4^(+)T cell-associated autoimmune or inflammatory diseases,such as multiple sclerosis.
基金supported by the National Key R&D Program of China(2023YFD1801100)China National Postdoctoral Program for Innovative Talents(BX20230140)China Postdoctoral Science Foundation(2023M741348)。
文摘Mastitis is one of the most significant diseases affecting the development of the dairy industry and has traditionally been associated with pathogenic infections.However,emerging evidence highlights that ruminal microbial homeostasis also plays a crucial role in the pathogenesis of mastitis.Specifically,cows with mastitis exhibit reduced alpha diversity and altered microbial composition in the rumen.Inducing ruminal dysbiosis through a high-concentrate diet has been shown to trigger mastitis in cows,and transplantation of ruminal microbiota from mastitis-affected cows to recipient mice can induce mastitis in mice.Mechanistically,ruminal dysbiosis increases gastrointestinal inflammation and compromises the integrity of the gastrointestinal barrier,thereby facilitating the translocation of harmful bacterial components,metabolites,and pathobionts into the bloodstream.This disruption impairs blood-milk barrier function,leading to systemic inflammation and the development of mastitis.In this review,we summarize recent advances in understanding how ruminal dysbiosis induces mastitis and explore potential prevention and control strategies targeting the modulation of ruminal microbiota.
文摘Objectives: To study the epidemiological, diagnostic and prognostic aspects of bladder tumours in Segou Hospital. Patients and Methods: We conducted a descriptive cross-sectional study of bladder tumours over the period from 1 April 2012 to 1 April 2017, in the urology department of the Nianankoro Fomba Hospital in Segou. The first three years were used for patient recruitment, and the last two years for follow-up of the patients in the series. Results: Over a period of three years, we collected 165 cases of bladder tumours hospitalised out of 1308 hospitalisations from 7007 consultations, i.e. 12.6% of hospitalisations and 2.3% of consultations. The sex ratio was 1.2 in favour of men. A history of treated bilharzia was reported in 78.8% of cases and untreated bilharzia in 9.1% of cases. Haematuria was the most common reason for consultation. The majority of our patients were at stage T4 and T3 at the time of diagnosis, i.e. 53.3% and 44.3% respectively. Most patients consulted within 13 to 24 months after the first sign, i.e. 44.8%. Conclusion: The prognosis is still clouded by the delay in management. All the patients diagnosed had a bladder tumour infiltrating the muscle.
基金the funding support from the Smart Medicine and Engineering Interdisciplinary Innovation Project of Ningbo University(No.ZHYG003)。
文摘Glassy polymers are widely used in biomedical applications in a solvent environment,yet their long-term performance is governed by the competing effects of physical aging and solvent-induced plasticization.Here,we develop a constitutive model that explicitly couples the solvent concentration,structural relaxation,and mechanical response.This framework is built on a multiplicative decomposition of deformation and an Eyring-type flow rule,with structural evolution described by an effective temperature.A generalized shift factor is introduced to quantify how the solvent concentration and effective temperature jointly affect the relaxation time,thereby integrating physical aging and plasticization.The model is subsequently applied to methacrylate(MA)-based copolymer networks immersed in phosphate-buffered saline for up to nine months.Simulations accurately capture key experimental features,including the strong softening of highly swellable networks,the partial recovery due to aging,and the mitigating role of hydrophobic crosslinking in reducing solvent uptake.While the current single-mode description cannot reproduce the full relaxation spectrum,it establishes an efficient framework for predicting the long-term mechanical performance under coupled environmental and mechanical loading.This study provides a constitutive description of solvent-swollen glassy polymers,offering mechanistic insight into the interplay between plasticization and aging.Beyond biomedical MA networks,this framework establishes a foundation for predicting the long-term performance of polymer glasses under coupled aqueous environmental and mechanical loading.
