Objectives To compare sequential intravesical gemcitabine and docetaxel (Gem/Doce) with repeat BCG‐based intravesical salvage after prior BCG failure in high‐risk non–muscle‐invasive bladder cancer (NMIBC). Methods PubMed/MEDLINE, Embase, Web of Science, and the Cochrane Library were searched from inception to 20 January 2026. Comparative studies enrolling adults with high‐risk NMIBC after prior BCG exposure or failure were eligible if they compared sequential Gem/Doce with repeat BCG‐based intravesical therapy. Prior BCG status was extracted according to the source‐study definitions. The primary outcome was landmark recurrence. Secondary or exploratory outcomes included recurrence‐related time‐to‐event endpoints, radical cystectomy, progression, cancer‐specific survival, and adverse events. When time‐point data were not tabulated, prespecified landmark estimates were digitized from published Kaplan–Meier curves. Risk of bias was assessed with ROBINS‐I and certainty of evidence with GRADE. Results Three retrospective comparative cohorts involving 605 patients met the inclusion criteria. Of these, 299 patients (49.4%) were enrolled in an FDA‐defined BCG‐unresponsive cohort, whereas 306 patients (50.6%) were BCG‐exposed patients with recurrent disease after initial/single induction BCG rather than FDA‐defined BCG‐unresponsive disease. There was no significant difference in recurrence at 12 months (risk ratio [RR] 0.90, 95% confidence interval [CI] 0.60–1.34; I 2 = 72%). At 24 months, Gem/Doce was associated with lower recurrence (RR 0.77, 95% CI 0.63–0.94; I 2 = 0%), which represented the clearest pooled signal. An exploratory pooled hazard ratio for recurrence‐related survival was not significant (HR 0.95, 95% CI 0.77–1.18; I 2 = 0%) and should be interpreted cautiously because endpoint definitions differed across studies. Limited landmark data suggested fewer cystectomies with Gem/Doce at 24 months (RR 0.29, 95% CI 0.15–0.58). In the largest inverse probability of treatment weighted cohort, progression‐free, cystectomy‐free, and cancer‐specific survival were directionally favorable to Gem/Doce. Comparative safety reporting was sparse, but available data suggested less dysuria with Gem/Doce. Conclusions In selected patients pursuing bladder preservation after prior BCG failure, Gem/Doce was associated with more durable recurrence control than repeat BCG‐based intravesical salvage, with a concurrent signal for improved bladder preservation. However, only three retrospective studies could be included and they were heterogeneous with respect to prior BCG exposure; evidence for deeper oncological benefit therefore remains preliminary.

BackgroundUreteral stones frequently lead to urinary tract obstruction, and medical expulsive therapy (MET) continues to serve as a mainstay of non-invasive management. Total flavonoids from Desmodium styracifolium (TFDS), a traditional Chinese herbal extract, have been suggested to promote stone passage, but real-world evidence is limited.MethodsWe performed a retrospective cohort study including 341 outpatients diagnosed with unilateral ureteral stones between January and December 2024. Patients receiving TFDS were classified as the study group (n = 194), while those not receiving TFDS served as controls (n = 147). We used 1:1 propensity score matching to ensure comparable baseline profiles, yielding 142 matched pairs. The primary outcomes were stone expulsion time and expulsion rate within 30 days. Subgroup analyses were performed according to stone size and location.ResultsAfter PSM, all baseline variables were well balanced between the two groups. Patients treated with TFDS experienced a shorter average duration to stone passage than controls (9.06 vs. 12.24 days, p = 0.003). Subgroup analyses showed that TFDS shortened expulsion time in both small (<5 mm) and larger (five to nine mm) stones, as well as across different ureteral locations, with the most marked benefit observed in upper ureteral stones. The overall stone expulsion rate was higher in the TFDS group than in controls (63.4% vs. 47.9%, p = 0.09), with significant improvement in stones 5–9 mm (p = 0.021) and in middle-to-lower ureteral stones (p = 0.011). No adverse drug reactions were reported.ConclusionAfter adjusting for baseline differences using PSM, TFDS significantly shortened stone expulsion time and improved expulsion rates, particularly for larger and distally located ureteral stones. TFDS appears to be a safe and effective adjunct to MET in the conservative management of ureteral stones.

The efficacy of Low-intensity extracorporeal shockwave therapy (Li-ESWT) for erectile dysfunction (ED) in patients undergoing radical prostatectomy (RP) remains poorly recognized. To address this, we conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the effectiveness of this intervention. From January 2000 to May 2025, five RCTs were selected, involving a total of 297 patients from PubMed, EMBASE, and the Cochrane Library to evaluate the efficacy of Li-ESWT for ED in patients undergoing RP. At the 8- and 12-week assessments following Li-ESWT, participants who underwent Li-ESWT demonstrated significantly greater improvements in IIEF scores compared with those in the control group (8-week: MD 2.80, P < 0.0001; 12-week: MD 2.10, P = 0.004). In contrast, no significant differences in IIEF scores were detected between the Li-ESWT and control groups at 24 weeks and beyond post-treatment. Li-ESWT significantly improves short-term erectile function in patients following RP. However, this therapeutic benefit was not sustained beyond 24 weeks. Accordingly, further research is warranted to investigate novel strategies and combination therapies aimed at preserving long-term erectile function after RP.

Fibromyalgia (FM), a chronic centralized pain syndrome, has been associated with lower urinary tract pain and lower urinary tract symptoms (LUTS) in women, but quantitative evidence remains limited. We searched PubMed/MEDLINE, Embase, Web of Science Core Collection, and CINAHL from January 1990 to December 2025 for observational studies. Fourteen studies involving 17,139 women were included. Random-effects meta-analysis showed increased odds of lower urinary tract pain (OR = 2.92, 95% CI: 1.41-6.06) and lower urinary tract symptoms (OR = 2.83, 95% CI: 1.98-4.03), but the certainty of evidence was very low. For lower urinary tract pain, the association was concentrated in studies using validated interstitial cystitis/painful bladder syndrome definitions; the clinician-based FM subgroup yielded a more conservative estimate (OR = 1.45, 95% CI: 1.15-1.83), whereas the larger self-reported estimate (OR = 5.84, 95% CI: 2.16-15.79) may have inflated the overall pooled estimate. The overall LUTS association appeared to be driven predominantly by urgency-related storage symptoms, including overactive bladder (OR = 2.65, 95% CI: 1.88-3.74) and urge urinary incontinence (OR = 2.95, 95% CI: 1.05-8.28); no significant association was found for stress urinary incontinence (OR = 1.00, 95% CI: 0.63-1.59). Heterogeneity was substantial for both primary outcomes (I 2 = 79.07% and 79.05%). Outlier exclusion reduced the lower urinary tract pain OR to 1.66, while LUTS heterogeneity remained substantial (I 2 = 73.50%). These findings are preliminary and hypothesis-generating and require confirmation in prospective studies with standardized outcome assessment.

BACKGROUND:We aimed to evaluate the efficacy, safety, and cost-effectiveness of suction-assisted retrograde intrarenal surgery (SA-RIRS) compared with conventional retrograde intrarenal surgery (RIRS) and to compare outcomes between suction catheters and suction sheaths in the management of upper urinary tract stones ≤30 mm. METHODS:A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. PubMed, Embase, Cochrane Library, and Web of Science were searched to September 2025. Eligible RCTs compared SA-RIRS (catheter or sheath) with conventional RIRS in adults. Primary outcomes were stone-free rate (SFR), total complications, and operative time; secondary outcomes included hospital stay, reoperation rate, stone retropulsion, basket use, and laser time. Risk of bias (RoB) was assessed using the Cochrane RoB 2.0, and evidence certainty was rated with the Grading of Recommendations, Assessment, Development, and Evaluation. RESULTS:Six RCTs involving 843 patients (SA-RIRS: 420; conventional RIRS: 423) were included. SA-RIRS significantly improved SFR (odds ratio [OR] = 4.00, 95% confidence interval [CI]: [2.92, 5.48], p < 0.001) and reduced total complications (OR = 0.40, 95% CI: [0.17, 0.97]), stone retropulsion (OR = 0.26, p = 0.03), and basket use (OR = 0.01, p < 0.001). Subgroup analysis demonstrated that both suction sheaths (OR = 4.46) and suction catheters (OR = 2.64) significantly improved SFR compared with conventional RIRS, with sheaths showing greater complication reduction (OR = 0.27 vs 0.77). No significant differences were observed in operative time, hospital stay, or reoperation rate. Evidence certainty was high for all outcomes. CONCLUSIONS:SA-RIRS provides superior stone clearance and safety compared with conventional RIRS. Although sheath-based systems offer the highest SFRs and complication reductions, suction catheters also significantly improve clearance and remain a cost-effective option for impacted ureteral stones. Findings support integrating SA-RIRS into routine endourological practice, with device selection guided by stone location and resource availability.Trial Registration PROSPERO:CRD420251149743.

The optimal treatment for 2–3 cm renal stones requires balancing efficacy with minimal invasiveness. While mini-percutaneous nephrolithotomy (mPCNL) is a standard approach, retrograde intrarenal surgery with a Flexible and Navigable Suction Sheath (FANS-RIRS) has emerged as a promising alternative. We conducted a meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of these two procedures. A systematic search of PubMed, Embase, Web of Science, and CENTRAL was conducted through August 2025 to identify RCTs comparing FANS-RIRS and mPCNL for 2–3 cm renal stones. Primary outcomes included stone-free rates (SFRs), perioperative variables, and safety profiles, including hemorrhagic and infectious complications. Evidence was synthesized using random-effects models, and certainty was assessed with the GRADE framework. Three high-quality RCTs enrolling 1020 patients were included. Final SFRs were comparable between FANS-RIRS and mPCNL (OR 0.80, 95

This systematic review and meta-analysis compares oncological outcomes, pathological quality, and safety profiles between en bloc (ERBT) and conventional transurethral resection (cTURBT) for non-muscle-invasive bladder cancer (NMIBC), incorporating the latest evidence from randomized trials and high-quality observational studies. We systematically searched PubMed, Embase, Cochrane Library, and Web of Science (up to December, 2024) for studies comparing ERBT and cTURBT outcomes. Methodological quality was assessed using standardized tools, with statistical analysis performed using RevMan 5.3. Our meta-analysis incorporated 35 studies involving 6,013 patients with NMIBC. The overall methodological quality was high with a low risk of bias in most included trials; however, moderate to substantial heterogeneity was observed for several outcomes, and potential publication bias was detected for certain safety endpoints. The pooled results demonstrated statistically significant advantages for ERBT in reducing tumor recurrence at 12 months (OR = 0.56, 95

To evaluate the technological evolution of Retrograde Intrarenal Surgery (RIRS) by comprehensively comparing real-world and randomized outcomes of suction-assisted (SA-fURS) and conventional (C-fURS) techniques against Mini-Percutaneous Nephrolithotomy (mPCNL) for 2–3 cm renal stones. A systematic search was performed in PubMed, Embase, Web of Science, Cochrane Library, and Scopus up to September 1, 2025. Randomized controlled trials (RCTs) and observational studies were included. Primary outcomes were immediate and final stone-free rates (SFR). Secondary outcomes included complications, operative time, and hospital stay. The certainty of evidence was assessed using the GRADE approach. Eighteen studies (4 RCTs, 14 non-RCTs) involving 3,832 patients were included. mPCNL provided higher immediate SFR (OR 0.41, low certainty). However, low-certainty evidence suggests the difference in final SFR between SA-fURS and mPCNL did not reach statistical significance (OR 0.77, P = 0.11), whereas C-fURS remained significantly inferior. RIRS demonstrated a superior safety profile with significantly lower risks of hemorrhage (OR 0.40, moderate certainty) and blood transfusion (OR 0.17, moderate certainty), and a shorter hospital stay (MD -2.26 days, very low certainty), despite longer operative times (MD 8.81 min, Very Low Certainty). While mPCNL provides superior immediate clearance, low-certainty evidence indicates no statistically significant difference in final stone-free rates between SA-fURS and mPCNL. Furthermore, SA-fURS demonstrates a favorable safety profile and faster recovery. Crucially, C-fURS remains significantly inferior in efficacy. These comprehensive findings validate recent randomized trials in a broader clinical context, establishing SA-fURS as a highly effective, minimally invasive alternative to mPCNL, whereas C-fURS should be considered a suboptimal choice for this stone burden.

BACKGROUND:Prostate cancer is a prevalent malignancy in males, with prostate MRI imaging as the primary diagnostic method. However, this method is subjective and can miss early-stage cancers, necessitating more efficient diagnostic techniques. METHOD:In this study, we introduced the PRAD-Hybrid CNN (Prostate Adenocarcinoma Hybrid Convolutional Neural Network, PRADHC) model, a novel amalgamation of EfficientNet and Residual Blocks, which was developed and validated on 1,528 MRI images from 64 patients. By strategically increasing the number of Convolutional Neural Network (CNN) layers in the EfficientNet architecture, our model improved the diagnostic accuracy inherent to the original EfficientNet. Additionally, the integration of Residual Networks (ResNet) successfully mitigated the gradient vanishing issue often encountered during the training of deeper models, thereby significantly enhancing training accuracy. This innovative model, thus, offers clinicians an efficacious tool for assisted diagnosis. RESULT:The PRADHC model, upon validation, achieved an accuracy of 99.34% and an AUC of 99.34%, a 4% improvement over the conventional EfficientNet. The baseline elementary CNN model achieved 95.72% accuracy and 96.74% AUC, which are still lower than the PRADHC model. DISCUSSION:The superior performance of PRADHC can be attributed to the synergistic integration of EfficientNet’s multi-scale feature extraction and residual learning, which facilitates deeper network optimization without degradation. Compared with single-architecture CNN models, the hybrid design enhances robustness to MRI appearance variability and improves discrimination between malignant and non-significant prostate tissue CONCLUSION:This study introduces a novel deep learning model specifically designed for automated prostate cancer diagnosis. This model aims to enhance diagnostic accuracy, especially in the early stages of the disease. Such advancements have the potential to enhance the diagnostic proficiency of both radiologists and urologists, enabling more informed treatment planning. However, it is imperative to acknowledge that false-positive lesion detections remain a limitation of AI-assisted diagnostic tools. Nevertheless, this system can serve as a valuable supplementary instrument for radiologists in their diagnostic endeavors.

STX16 has been studied in various cancers, where it is suggested to regulate tumor cell proliferation, migration, and invasion by affecting vesicle trafficking and signal transduction pathways. However, its specific role in clear cell renal cell carcinoma (ccRCC) remains unclear. This study aims to systematically investigate the expression patterns, clinical significance, prognostic value and functional role of STX16 in ccRCC. Bioinformatics analyses using TCGA, CTPAC, TIMER, and UALCAN databases evaluated STX16 expression, clinical correlations, prognosis, and immune infiltration. Functional enrichment, co-expression, and PPI analyses explored STX16-associated pathways. Single-cell sequencing elucidated tumor microenvironment heterogeneity. Laboratory validation included Western blot, immunohistochemistry, and functional assays with siRNA-mediated STX16 knockdown in ccRCC cell lines. STX16 was significantly upregulated at mRNA and protein levels in ccRCC tissues. High STX16 expression correlated with advanced tumor stages, poor overall survival (OS), and disease-specific survival (DSS). Multivariable Cox regression identified STX16 as an independent prognostic factor. STX16 influenced immune infiltration, particularly involving CD4 + T cells, macrophages, and neutrophils, and was associated with immune pathways. Single-cell sequencing revealed heterogeneous STX16 expression across tumor microenvironment cell types. STX16 knockdown inhibited proliferation, migration, and invasion of ccRCC cell lines. STX16 is upregulated in ccRCC and acts as an independent prognostic factor associated with poor outcomes. Its role in promoting tumor progression and modulating immune infiltration highlights STX16 as a potential biomarker and therapeutic target in ccRCC.

BACKGROUND AND OBJECTIVE:This meta-analysis compared the efficacy and safety of degarelix and GnRH agonists in prostate cancer treatment. METHODS:A comprehensive literature search was carried out using PubMed, Web of Science, Cochrane Library, and Scopus. RevMan 5.3 software was applied to conduct the meta-analysis. RESULTS:Degarelix resulted in a higher frequency of adverse events compared to GnRH agonists (59.7% vs 48.4%; RR: 1.07, 95%CI: 1.02-1.13, p < 0.001). However, these events did not translate into a higher rate of severe complications (10.8% vs 11.8%; RR: 0.89, 95%CI: 0.66-1.19, p = 0.43), treatment discontinuation (5.5% vs 5.5%; RR:1.00, 95%CI: 0.67-1.50, p = 0.99) or death (2.5% vs 3.9%; RR: 0.64, 95%CI: 0.34-1.19, p = 0.16). Degarelix triggered higher incidence of injection site reaction (45.3%vs 4.4%; RR: 19.17, 95%CI: 5.51-66.74, p < 0.00001), but contributed to lower rates of cardiovascular events (6.1% vs 7.8%; RR: 0.7, 95%CI: 0.51-0.96, p = 0.03), musculoskeletal events (12.7% vs 15.2%; RR: 0.79, 95%CI: 0.65-0.95, p = 0.01) and urinary adverse effects (AEs) (6.4% vs 14.1%; RR: 0.46, 95%CI: 0.33-0.63, p < 0.00001). Degarelix provided better relief of IPSS (MD -1.85, 95%CI: -2.97- -0.72, P = 0.001) and was linked to reduced prostate volume (MD -1.4, 95%CI: -4.83-2.02, P = 0.42). There was no significant difference in PSA progression at 12 months (13.3% vs 14%; RR: 0.88, 95%CI: 0.73-1.06, p = 0.17). However, degarelix achieved significantly higher castration rates at day 3 (96.5% vs 0%; RR: 356.05, 95%CI: 87.57-1447.68, p < 0.00001) and more sustained testosterone suppression at 12 months (96.1% vs 74.3%; RR: 1.3, 95%CI: 1.02-1.66, p = 0.03). CONCLUSIONS AND CLINICAL IMPLICATIONS:While degarelix is associated with higher overall AE rates, it provides significant benefits in terms of cardiovascular and musculoskeletal safety, rapid testosterone suppression, and lower urinary AEs.

OBJECTIVE:To assess the efficacy and safety of Sacral Neuromodulation (SNM) in conjunction with 3D printing and ultrasound localization for treating patients with neurogenic bladder and pelvic structural anomalies. METHODS:This prospective study involved 56 patients diagnosed with neurogenic bladder and pelvic anomalies. They were treated with SNM from January 2022 to December 2023. Patients were split into study and control groups based on the origins of their pelvic anomalies, with each group comprising 28 individuals. The study group underwent preoperative 3D printing and intraoperative ultrasound-assisted puncture, whereas the control group utilized intraoperative X-ray-assisted puncture. Metrics compared included the number of punctures, average puncture duration, intraoperative SNS tuning time, effective initial voltage, postoperative testing duration, phase two conversion rates, and the incidence of bleeding and infection. RESULTS:The study group experienced significantly fewer punctures compared to the control group (2.21 ± 0.92 vs 9.29 ± 4.37) (P < 0.01), had a shorter average puncture duration (5.71 ± 2.69 min vs. 28.60 ± 9.69 min) (P < 0.01), and required a lower effective initial voltage (0.87 ± 0.23v vs. 1.38 ± 0.52v) (P < 0.01). X-ray exposure was eliminated in the study group, in contrast to 11.51 ± 4.62 mAs in the control group(P < 0.01). The phase two implantation rates were 67.8 % for the study group and 57.1 % for the control group(P = 0.04). No surgery-related complications occurred in either group. CONCLUSION:Combining preoperative 3D printing with intraoperative ultrasound-assisted puncture significantly improves the accuracy of SNM placement, reduces surgery time, and eliminates X-ray exposure for both doctors and patients. This method is both safe and effective for patients with neurogenic bladder and pelvic anomalies.

Although pentatricopeptide repeat domain 1 (PTCD1) has been found to modulate mitochondrial metabolic and oxidative phosphorylation, its contribution in the growth of clear cell renal cell carcinoma (ccRCC) remains unknown. The Cancer Genome Atlas (TCGA) dataset was utilized to examine the transcriptional alterations, patient characteristics, clinical outcomes, as well as pathway activation of PTCD1. The Weighted Gene Co-expression Network Analysis (WGCNA) was performed to investigate potential genes that associated with PTCD1. The researchers estimated the relationship between PTCD1, tumor immunology, and epithelial mesenchymal transition (EMT). Researchers studied how PTCD1 affects the functional behavior of tumor cells in vitro. PTCD1 expression was greater in ccRCC samples than in normal samples, and expression increased gradually as the stage increased. In TCGA cohorts, higher PTCD1 expression was substantially associated with a poorer clinical stage, histological grading, T stage, N stage, M stage, and survival outcomes. The results of multivariate analysis showed that PTCD1 was an independent variable affecting the survival outcomes of ccRCC patients (p < 0.001). PTCD1 regulated ccRCC progression via various cancer mechanisms including PI3K-Akt signaling, focal adhesion, PD-L1 expression, and PD-1 checkpoints in cancer. WGCNA discovered a significant relationship between PTCD1 and IARS2, LRPPRC, MT-ND2, MT-CO1, MT-CO2, MT-CYB, MT-ATP6, and MT-ND4. Furthermore, PTCD1 expression levels was closely associated with immune infiltrating, immunological checkpoint, EMT, immunotherapy responsiveness, and anti-tumor medication sensitivities. Upregulation of PTCD1 in ccRCC cells resulted in considerably increased cellular invasion and migration. Mechanistically, the upregulation of PTCD1 increased the phosphorylation of AKT at Ser473 and GSK-3β at Ser9, as well as enhanced activation of Wnt/β-catenin pathway. Elevated expression of PTCD1 was associated with malignant biological behaviors and poor outcomes of ccRCC patients, and PTCD1 may accelerate tumor cells proliferation and invasion via the Akt/GSK3β/β-catenin pathway. Our findings indicated that PTCD1 had the potential to become a new target for predicting prognosis and targeted therapy.

OBJECTIVE:Suburethral mid-urethral sling (SMUS) is considered the gold standard for the treatment of female stress urinary incontinence (SUI). In recent years, the vaginal single-incision mini-sling (SIMS) has emerged as a new approach for treating SUI. However, the efficacy and safety of SIMS require further experimental validation. This study aimed to evaluate the efficacy and safety of the vaginal SIMS compared to SMUS in the treatment of female SUI. DATA SOURCES:This study incorporated studies published from January 2007 to May 2024, encompassing our complete literature search and selection timeline. Following the inclusion criteria for systematic reviews and meta-analyses, we performed a meta-analysis of all randomized controlled trials (RCTs) comparing the vaginal SIMS and SMUS. STUDY ELIGIBILITY CRITERIA:All published RCTs involving women with SUI receiving SIMS or SMUS were eligible for inclusion, with no exclusion criteria based on language, type of SIMS/SMUS devices, or publication status. STUDY APPRAISAL AND SYNTHESIS METHODS:Data were analyzed using Review Manager 5.3, with primary outcomes being patient-reported and objective cure rates. Secondary outcomes included operative time, length of hospital stay, postoperative day one pain scores, quality of life assessments, and certain safety-related surgical indicators. RESULTS:A total of 24 RCTs were included, comprising 3687 women, of whom 328 were lost to follow-up, with a mean follow-up duration of 13.42 months. SIMS showed a slight superiority over SMUS in terms of objective cure rates (risk ratio [RR]: 0.93; 95% CI [confidence interval], [0.85, 0.98]). Compared to SMUS, SIMS was significantly associated with reduced operative time (mean difference [MD]: -6.52; 95% CI, [-9.47, -3.57]), shorter hospital stays (MD: -0.23; 95% CI, [-0.42, -0.05]), lower pain scores on postoperative day one (MD: -2.28; 95% CI, [-3.21, -1.36]), lower incidence of organ injury (RR: 0.30; 95% CI, [0.13, 0.69]), less groin pain (RR: 0.24; 95% CI, [0.08, 0.73]) and less postoperative bleeding (MD: -24.27 ml; 95% CI, [-32.32, -16.23]). However, there were no statistically significant differences between SIMS and SMUS regarding patient-reported cure rates, quality of life, urinary difficulties, sling erosion, dyspareunia, reoperation, new-onset urgency incontinence, postoperative urinary tract infections, or other postoperative complications. CONCLUSIONS:SIMS is not inferior to SMUS in terms of patient-reported cure rates, objective cure rates, quality of life, and postoperative complications in treating female SUI. Additionally, SIMS demonstrates advantages over SMUS in terms of operative time, length of hospital stay, postoperative pain, incidence of organ injury, and amount of postoperative bleeding.

To systematically evaluate the effectiveness and safety of suction-assisted sheaths (SAS) compared to traditional access sheaths (TAS) in minimally invasive percutaneous nephrolithotomy (MPCNL) for renal calculi—addressing key limitations of MPCNL such as compromised irrigation outflow, intraoperative elevation of intrarenal pressure (IRP), and the associated risk of infectious complications. This PRISMA-compliant meta-analysis (PROSPERO-registered) included 10 randomized controlled trials (RCTs; n = 1,540) identified through comprehensive searches of PubMed, Embase, Web of Science, and the Cochrane Library from database inception to May 2025. Pooled outcomes were calculated using random- or fixed-effects models, with subgroup analyses based on lithotripsy modality (laser vs. non-laser) and stone type (staghorn vs. non-staghorn). Study quality was assessed using the Cochrane Risk of Bias Tool, and evidence certainty was graded via GRADE. Compared to TAS, the use of SAS was associated with a significantly higher immediate stone-free rate (SFR; OR 2.29, 95

AimDespite the presence of published evidence in recent decades suggesting an improvement in overactive bladder (OAB) with the utilization of parasacral transcutaneous electrical nerve stimulation (PTENS), there is currently a lack of consensus guidelines for therapy. We conducted a meta-analysis to assess the impact of PTENS on children with OAB.MethodsA search was carried out using EMBASE, PubMed, and the Cochrane Controlled Register of Trials to find eligible randomized controlled trials (RCTs) published up to 1 May 2023. From the literature review, eight RCTs (351 participants) comparing PTENS and other treatments (standard urotherapy/anticholinergics/biofeedback/placebo stimulation) were considered.ResultsThe overall complete response rate with PTENS was 1.90 times that of children undergoing other treatment (relative risk 1.90, 95% confidence interval 1.45–2.49). No significant differences were observed in the mean dysfunctional voiding score system (p = 0.26), mean maximum voided volume (p = 0.79), average voided volume (p = 0.94), voiding frequency (p = 0.31), or reduction in the number of children with incontinence episodes (p = 0.81). However, regarding the reduction of children with constipation, the PTENS group demonstrated a better effect compared with the control groups (p = 0.01).ConclusionsIn summary, PTENS has demonstrated better response rates and fewer side effects compared to conventional first-line treatments, such as standard urotherapy and antimuscarinic drugs. Clinicians should consider individual circumstances when treating children with OAB. However, it is important to note that the findings of this study are limited by the small sample size and imperfect outcomes. Further high-quality RCTs are needed to establish the most effective treatment protocol.

There is conflicting evidence regarding the association between platelet-lymphocyte ratio (PLR) and the prediction of outcomes in bladder cancer (BCa). Due to the rapidly increasing availability of data to explore this issue, this updated meta-analysis investigates how pretreatment PLR influences the outcomes of BCa. Literature was retrieved from Embase, Cochrane Library, Web of Science, and PubMed from 2015 to April 2025. The 95% confidence intervals (CIs) and pooled hazard ratio (HR) have been employed in the exploration of the link across BCa prediction and PLR. The 95% CIs and pooled odds ratios (ORs) examined the connection between PLR and clinicopathological features of BCa. Subgroup analysis and meta-regression were conducted to identify the main sources of heterogeneity. Sensitivity analysis was used to assess the robustness of the results. The Egger's test and "trim and fill" method have been used in evaluating publication bias. This study incorporated 20 studies comprising 5,594 participants. Elevated PLR was conspicuously linked to inferior overall survival (OS) (HR = 1.51, 95% CI 1.23-1.85, P < 0.001) and recurrence-free survival (RFS) (HR = 1.68, 95% CI 1.26-2.24, P < 0.001). A marginally significant association was observed between high PLR and progression-free survival (PFS) (HR = 1.61, 95% CI1.00-2.59, P = 0.052). No strong correlation between PLR and cancer-specific survival (CSS) (HR = 1.14, 95% CI 0.96-1.35, P = 0.138). Additionally, elevated PLR was significantly associated with tumor stage ≥ T2 (OR = 1.92, 95% CI 1.24-2.97, P = 0.003). The PLR can be regarded as an indicative predictor of the destitution of individuals suffering from BCa.

Background:This meta-analysis aimed to evaluate the efficacy of topical minoxidil-finasteride combination (MFX) versus minoxidil monotherapy (MNX) for male androgenetic alopecia (AGA). Methods:Following PRISMA 2020 guidelines, we systematically searched PubMed, Embase, and Cochrane Central Register of Controlled Trials from inception through May 2025. Methodological quality was assessed using Cochrane Risk of Bias 2.0 tool, with statistical analyses performed using RevMan 5.3 and evidence certainty evaluated through GRADEpro GDT. CRD420251054497. Results:This meta-analysis of seven RCTs (N = 396) demonstrated superior efficacy of topical minoxidil-finasteride combination (MFX) over monotherapy (MNX) for male androgenetic alopecia. Pooled analyses showed clinically meaningful improvements in hair density (MD = 9.22, p = 0.04), hair diameter (MD = 2.26, p = 0.005), and global photographic assessment (MD = 0.79, p < 0.00001), all exceeding minimal clinically important thresholds. The treatment effect followed a hierarchical pattern, with MFX showing strongest benefits for marked improvement (OR = 3.29, p = 0.015) and more variable results for moderate outcomes. While primary outcomes demonstrated robust effects with moderate certainty evidence, observed heterogeneity in some endpoints and sample size limitations suggest the need for standardized assessment methods and larger confirmatory studies to strengthen these conclusions. Conclusion:Topical minoxidil-finasteride combination therapy demonstrates superior efficacy over monotherapy for male AGA, supporting its clinical adoption. However, larger, standardized trials are needed to confirm long-term outcomes and optimize treatment protocols. Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/view/CRD420251054497, identifier CRD420251054497.

Introduction: Bladder urothelial carcinoma is highly heterogeneous and is prone to recurrence. There are many types of drugs for intravesical instillation, and there is an urgent need for reliable tumor models for individualized treatment strategies. Patient-derived organoids (PDOs) are efficient and accurate neotype tumor models that can compensate for the deficiencies of traditional tumor models. Methods: From September 2023 to February 2024, bladder cancer tissues were collected from surgical resections in the Department of Urology, Beijing Tiantan Hospital, Capital Medical University. We explored suitable culture systems and cultured primary tumor cells in Matrigel matrix gels. Hematoxylin and eosin (HE) staining and immunohistochemistry were performed for comparison with the original tumor tissue at the histological level for validation. Drug sensitivity tests were also conducted. Results: In this study, a culture system for PDOs was successfully established. HE staining and immunohistochemistry were used to morphologically verify the organ model. Drug sensitivity tests have clarified the value of PDOs as preclinical models of precision medicine. Conclusion: A bladder tumor PDO culture platform was initially established, which laid a foundation for the subsequent construction of the organoid bank, the study of bladder tumor progression mechanism, and research in precision medicine.