Bladder cancer (BC) is one of the most common malignancies of the urinary system, and chemoresistance remains a major obstacle limiting the clinical efficacy of cisplatin-based chemotherapy. Elucidating the mechanisms underlying cisplatin resistance may facilitate the identification of potential therapeutic targets and ultimately improve patient outcomes. In this study, we found that Y-box binding protein 1 (YBX1) was upregulated in bladder cancer tissues with poor chemotherapeutic response as well as in cisplatin-resistant bladder cancer cell lines, where it promoted tumor cell proliferation and invasion. Functional assays demonstrated that depletion of YBX1 significantly enhanced cisplatin sensitivity in both in vitro and in vivo. Mechanistically, elevated YBX1 expression was associated with reduced ferroptosis sensitivity in cisplatin-resistant cells. Although YBX1 induced autophagy and was accompanied by a reduction in glutathione peroxidase 4 (GPX4) protein levels, the overall enhancement of intracellular antioxidant capacity in resistant cells may partially offset the increased susceptibility to ferroptosis caused by GPX4 degradation. Furthermore, we identified the transcription factor ELK1 as an upstream regulator that transcriptionally upregulates YBX1, while YBX1 may contribute to the cisplatin-resistant phenotype through activation of the p62-NRF2-associated antioxidant pathway. Collectively, these findings highlight a critical role of YBX1 in cisplatin resistance and suggest that targeting YBX1 may represent a promising strategy for overcoming cisplatin-based chemoresistance in bladder cancer.

To assess whether preoperative non-contrast CT-derived adiposity quantity and attenuation are independently associated with recurrence-free survival (RFS) after surgery for localized clear cell renal cell carcinoma (ccRCC). We performed a single-center retrospective cohort study of adults with pathologically confirmed ccRCC who underwent upfront partial or radical nephrectomy and had preoperative non-contrast abdominal CT within 30 days. A single mid-L3 axial slice was segmented for subcutaneous (SAT) and visceral adipose tissue (VAT) using predefined thresholds (SAT−190 to −30 HU; VAT−150 to−50 HU). Adiposity indices were normalized by height squared (SATI, VATI), and mean SAT/VAT attenuation (HU) was recorded. RFS was defined as time from surgery to first documented local/regional recurrence or distant metastasis. Multi-variable Cox models were adjusted for age, sex, chronic disease history, tumor diameter, surgery type, and WHO/ISUP grade; continuous predictors were standardized (per 1-SD). Incremental prognostic performance beyond the clinicopathologic base model was assessed using Harrell’s C-index. Among 598 patients, 151 (25.3

ObjectivesTo evaluate real-world effectiveness and safety of adjuvant disitamab vedotin plus PD-1 blockade (ADC+ICI) versus gemcitabine/cisplatin (GC) in high-risk upper tract urothelial carcinoma after radical nephroureterectomy.Patients and methodsThis single-center, two-stage observational study enrolled 421 patients with study-defined high-risk upper tract urothelial carcinoma. Cohort A evaluated adjuvant GC versus surgery alone using propensity score matching. Cohort B compared adjuvant GC with ADC+ICI using overlap weighting, with ECOG performance status and three-level HER2 IHC category included in covariate adjustment. Overall survival (OS), conventional disease-free survival (DFS), non-intravesical progression-free survival (PFS), intravesical recurrence-free survival (IVRFS), safety, and exploratory HER2-stratified outcomes were assessed.ResultsIn Cohort A, adjuvant GC was associated with improved OS after matching. In Cohort B, 48 patients received GC and 53 received ADC+ICI. After overlap weighting, baseline covariates were well balanced. ADC+ICI was not associated with a significant OS improvement versus GC (HR 0.47, 95% CI 0.12–1.89; P = 0.287; FDR-adjusted P = 0.403). Directionally favorable associations were observed for conventional DFS (HR 0.32, 95% CI 0.11–0.96; nominal P = 0.043; FDR-adjusted P = 0.172), non-intravesical PFS (HR 0.32, 95% CI 0.09–1.18; P = 0.086), and IVRFS (HR 0.21, 95% CI 0.04–1.09; P = 0.063). HER2 IHC 2+/3+ tumors showed exploratory favorable DFS/PFS signals. Grade ≥3 treatment-related adverse events were similar between groups.ConclusionsAdjuvant ADC+ICI showed comparable short-term OS and directionally favorable DFS/PFS trends versus GC, with a distinct toxicity profile. These findings are hypothesis-generating and require prospective validation.

INTRODUCTION:A randomized controlled trial was conducted to compare the clinical efficacy of lateral transperitoneal adrenalectomy (LTA) versus posterior retroperitoneoscopic adrenalectomy (PRA) and to explore suitable surgical approaches for different patients. METHODS:This prospective study enrolled 184 adrenal tumor patients treated at our hospital from May 2023 to October 2025. Patients were randomly assigned to the LTA group or PRA group using minimization. Subgroup analyses were performed based on tumor diameter, location, and pathological type to investigate suitable surgical approaches for tumors with different characteristics. The impact of surgeon qualifications on outcomes was examined to indirectly assess the differences in learning curves. Primary outcomes included operative time, laparoscopic operation time, and blood loss. Secondary outcomes included trocar establishment time, number of trocars, transfusion rates, intraoperative complication rates, conversion rates, analgesic requirement grade on postoperative day 1, postoperative antibiotic use, postoperative recovery time of gastrointestinal function, postoperative drainage time, short-term postoperative complication rates, postoperative length of stay, and total hospitalization cost. RESULTS:The LTA and the PRA groups each comprised 92 patients. No significant differences were observed between LTA and PRA for primary outcomes. PRA demonstrated superiority over LTA in the number of trocars (p = 0.006), intraoperative complication rates (p = 0.047), analgesic requirement grade on postoperative day 1 (p = 0.042), postoperative recovery time of gastrointestinal function (p < 0.001), and postoperative drainage time (p < 0.001). When tumor diameter >3 cm, LTA demonstrated superiority in blood loss (p = 0.007) and intraoperative complication rates (p = 0.032). Subgroup analysis showed that LTA had a significantly higher complication rate than PRA (p = 0.027) when treating right adrenal tumors. Surgeon qualifications significantly influenced operative time (p < 0.001), laparoscopic operation time (p = 0.006), and blood loss (p = 0.002) of PRA, but had no apparent effect on perioperative indicators of LTA. CONCLUSION:Both LTA and PRA are safe surgical methods for treating adrenal tumors, but PRA has advantages, especially for right adrenal tumors, where it can significantly reduce the incidence of complications, but it requires a greater technical challenge for the surgeon. For adrenal tumors with a diameter greater than 3 cm, LTA can be considered. Clinicians should comprehensively consider their technical proficiency, patient characteristics, and tumor features when choosing the appropriate surgical method.

Intravesical recurrence (IVR) after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) is frequent, but postoperative recurrence risk is heterogeneous. We developed and multicohort-validated an interpretable postoperative model for IVR risk stratification after RNU. We included 813 patients with pathologically confirmed UTUC treated with RNU across four predefined cohorts: retrospective development (n = 400), retrospective external validation (n = 173), internal prospective validation (n = 166), and external prospective validation (n = 74). Missing data were handled using cohort-specific multiple imputation. A Cox model integrating clinicopathological factors and neutrophil-to-lymphocyte ratio (NLR) was developed and locked in the development cohort, then transported unchanged to validation cohorts. Bootstrap confidence intervals, competing-risk analyses, benchmark comparisons, and sensitivity analyses were performed. The locked Cox + NLR model retained tumor location, ureteroscopic manipulation, hydronephrosis, pathological stage, surgical margin status, lymphovascular/perineural invasion, history of bladder cancer, and NLR. Harrell’s C-indices were 0.709, 0.746, 0.868, and 0.811 across the four cohorts. At the primary 12-month horizon, AUCs were 0.739, 0.771, 0.953, and 0.791, respectively. Low-risk and high-risk groups remained separated under the competing-risk framework. More complex survival machine-learning models did not show a consistent transportability advantage. The 24-month estimates and surveillance simulation were considered exploratory because prospective follow-up was limited. This interpretable postoperative Cox + NLR model showed favorable multicohort performance for IVR risk stratification after RNU. It may support postoperative risk assessment, but prospective implementation studies are needed before surveillance schedules are changed.

Objective:Disitamab vedotin (RC48) is a HER2-targeted antibody-drug conjugate (ADC) that can induce immunogenic cell death and enhance antitumor immunity. Preclinical data suggest synergistic activity with PD-1 inhibitors, but its benefit in upper tract urothelial carcinoma (UTUC) remains unclear. This study evaluated the efficacy and safety of RC48, as monotherapy or combined with PD-1 blockade, in advanced UTUC. Methods:We conducted a multicenter retrospective study of patients with locally advanced or metastatic UTUC treated with RC48 ± PD-1 inhibitors. Baseline features and adverse events (AEs) were summarized descriptively. Objective response rate (ORR) and disease control rate (DCR) were calculated with exact 95% confidence intervals. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan-Meier and compared with the log-rank test. Multivariable Cox models included covariates significant in univariable analyses. Results:A total of 41 patients were analyzed (9 monotherapy, 32 combination). Median follow-up was 16.5 months. The 12-month OS rate was 92.3%, and the 24-month OS rate was 63.2%; median OS was not reached. Median PFS was 12.6 months, with 6- and 12-month PFS rates of 78.0% and 56.4%, respectively. In an exploratory subgroup analysis, the 12-month PFS rate was 68.9% for first-line treatment versus 36.5% for later lines (p = 0.031). Among 22 patients with measurable lesions, ORR was 40.9% (9/22) and DCR was 81.8% (18/22). In the overall cohort of 41 patients, grade ≥3 AEs occurred in 18.8% (6/32) of patients in the combination group, including one grade 4 Stevens-Johnson syndrome. Conclusion:RC48, used alone or in combination with PD-1 inhibitors, showed preliminary antitumor activity with manageable toxicity in patients with locally advanced or metastatic UTUC in this multicenter real-world cohort.

Objective To compare the outcomes of patients undergoing Retroperitoneal laparoscopic Radical nephrectomy (RLRN) and Transperitoneal laparoscopic Radical nephrectomy (TLRN). Methods A total of 120 patients with localized renal cell carcinoma were randomized into either RLRN or TLRN group. Mainly by comparing the patient perioperative related data, surgical specimen integrity, pathological results and tumor results. Results Each group comprised 60 patients. The two group were equivalent in terms of perioperative and pathological outcomes. The mean integrity score was significantly lower in the RLRN group than TLRN group. With a median follow-up of 36.4 months after the operation, Kaplan–Meier survival analysis showed no significant difference between RLRN and TLRN in overall survival (89.8% vs. 88.5%; P = 0.898), recurrence-free survival (77.9% vs. 87.7%; P = 0.180), and cancer-specific survival (91.4% vs. 98.3%; P = 0.153). In clinical T2 subgroup, the recurrence rate and recurrence-free survival in the RLRN group was significantly worse than that in the TLRN group (43.2% vs. 76.7%, P = 0.046). Univariate and multivariate COX regression analysis showed that RLRN (HR: 3.35; 95%CI: 1.12–10.03; P = 0.030), male (HR: 4.01; 95%CI: 1.07–14.99; P = 0.039) and tumor size (HR: 1.23; 95%CI: 1.01–1.51; P = 0.042) were independent risk factor for recurrence-free survival. Conclusions Our study showed that although RLRN versus TLRN had roughly similar efficacy, TLRN outperformed RLRN in terms of surgical specimen integrity. TLRN was also significantly better than RLRN in controlling tumor recurrence for clinical T2 and above cases. Trial registration Chinese Clinical Trial Registry ( https://www.chictr.org.cn/showproj.html?proj=24400 ), identifier: ChiCTR1800014431, date: 13/01/2018.

长段输尿管狭窄的重建是泌尿外科临床上的一个挑战. 近年来,机器人手术因创伤小、出血少、恢复快、操作精准等优势越来越多地应用于肾盂皮瓣、膀胱皮瓣输尿管成形术,口腔黏膜皮片输尿管成形术,肠管代输尿管术及自体肾移植术等输尿管修复重建手术,日益成为长段输尿管狭窄重建的优选技术.

The primary objective of the current study is to undertake a comparative analysis of the effectiveness and safety of minimally-invasive partial nephrectomy (MIPN; including laparoscopic and robotic approaches) and open partial nephrectomy (OPN) for the treatment of highly complex renal tumors (defined as PADUA or RENAL score ≥ 10). A comprehensive search was conducted in four electronic databases (PubMed, Web of Science, Embase, and Cochrane Library) to identify relevant studies published in the English language up to April 2023. The current study employed Review Manager 5.4 and encompassed controlled trials of both MIPN and OPN for the treatment of highly complex renal tumors. This study comprised a total of eight comparative trials involving 1161 patients. MIPN demonstrated a significant reduction in length of hospital stay (weighted mean difference [WMD] − 2.08 days, 95

Systemic therapy for muscle-invasive bladder cancer (BC) remains dominated by cisplatin-based chemotherapy. However, resistance to cisplatin therapy greatly limits long-term survival. Resistance to cisplatin-based chemotherapy still needs to be addressed. In this study, we established three cisplatin-resistant BC cell lines by multiple cisplatin pulse treatments. Interestingly, after exposure to cisplatin, all cisplatin-resistant cell lines showed lower reactive oxygen species (ROS) levels than the corresponding parental cell lines. Using proteomic analysis, we identified 35 proteins that were upregulated in cisplatin-resistant BC cells. By knocking down eleven of these genes, we found that after CAB39 knockdown, BC cisplatin-resistant cells were more sensitive to cisplatin. Overexpression of CAB39 had the opposite effect. Then, the knockdown of six genes downstream of CAB39 revealed that CAB39 promoted cisplatin resistance in BC through LKB1. Moreover, a key cause of cisplatin-induced cell death is damage to mitochondria and increased ROS levels. In our study, cisplatin-resistant cells exhibited higher autophagic flux and healthier mitochondrial status after cisplatin exposure. We demonstrated that the CAB39-LKB1-AMPK-LC3 pathway plays a critical role in enhancing autophagy to maintain the health of mitochondria and reduce ROS levels. In addition, the autophagy inhibitor chloroquine (CQ) can significantly enhance the killing effect of cisplatin on BC cells. Compared with gemcitabine plus cisplatin (GC), GC plus CQ significantly reduced tumor burden in vivo. In conclusion, our study shows that CAB39 counteracts the killing of cisplatin by enhancing the autophagy of BC cells to damaged mitochondria and other organelles to alleviate the damage of cells caused by harmful substances such as ROS.

Abstract Background Surgical management of long ureteral stenosis is challenging. We describethe different modalities used in our center to treat long ureteral stenosis and report ourlong-term results. Methods This is a 17-year retrospective study to evaluate the efficacy of ureteroplasty with different surgical procedures in 12 patients with long ureteral stenosis. This study has passed ethical approval. Data were collected between May 2005 and September 2021. The mean age was 41 years. Recurrent stenosis was treated with long-term ureteral stent placement. The main observation index was the success rate of surgery. The secondary index was the rate of surgical complications and recurrent stenosis. The mean is used to describe parametric continuity variables, and the median and quartile range (IQR) are used to describe nonparametric continuity variables. Results Twelve patients were included. There were iatrogenic injuries in nine patients (75%), bilateral polyps in one (8.3%), ureteral occupation in one (8.3%), and unknown origins in one (8.3%). Ileal replacement was performed in three (25%) patients, lingual mucosa grafts in four(33.3%) patients, and boari bladder flaps in five (41.7%) patients. One of the surgeries was performed laparoscopically. The median follow-up was 49 months (range 8-204), and three patients (25%) had major postoperative complications. One patient’s treatment failed, requiring special reintervention, and two patients (16.7%) underwent ureteral stent placement. We accept the limitations of this small retrospective single-surgeon series, where the surgeon had a certain surgical selection preference. Conclusion Iatrogenic injury is the most common cause of long ureteral stenosis.There are many surgical methods for ureteral reconstruction, and the boari bladder flap is a preferred method for repairing long ureteral stenosis due to fewer postoperative complications and a low treatment failure rate.

Angiogenesis plays a vital role in the development of bladder cancer (BC). The Y-box-binding protein 1 (YB-1) is a well-known oncoprotein which is closely related to angiogenesis of tumors, but the relationship and mechanism of YB-1 and angiogenesis in BC remain unclear. Based on 56 clinical BC specimens, this study found that high expression of YB-1 samples demonstrated a higher expression of vascular endothelial growth factor A (VEGFA) than those of YB-1 low expression. Subsequently, the expression of YB-1 and miR-29b-3p was regulated in the BC cell lines where we noted that YB-1 promoted VEGFA expression by downregulating the expression of miR- 29b-3p. The ability of BC cells to induce angiogenesis decreased after YB-1 was knocked down. Moreover, the in vivo study further confirmed that YB-1 promotes angiogenesis in BC. Our findings enhance the understanding of how YB-1 promotes angiogenesis in BC and provide evidence for YB-1 as a therapeutic target of BC. Moreover, this may provide new inspiration for miRNAs replacement therapies.

内脏反位(situs inversus totalis ,SIT )是一种罕见的先天性畸形 ,具有常染色体隐形遗传倾向,发病率约1/104 [1-3 ] ,包括全内脏反位和部分内脏反位.全内脏反位患者 ,因脏器解剖位置与正常人完全相反 ,呈镜像改变 ,故又称"镜面人"[4 ] .部分内脏反位较全内脏反位少见[5 ] ,而合并恶性肿瘤更为少见.2018年5月兰州大学第二医院泌尿外科收治1例部分内脏反位合并右侧肾癌患者 ,现报道如下.

: This paper presents an extremely rare case of testicular metastasis arising from renal pelvis carcinoma. The testicle is a rare site of clinically detectable tumor metastasis, originating rarely from upper tract urothelial carcinoma (UTUC). There are only two cases concerning UTUC metastasis to the testis available in the literature. In this report, we presented a patient who developed serial testicle, lung, liver and retroperitoneal lymph node metastasis from primary urothelial carcinoma of the renal pelvis within one year after surgery and chemotherapy. In conclusion, for patients with a history of UTUC who present with testicular symptoms, clinicians should be highly alert for the possibility of malignant involvement at this site.

Xue-wu Wu * Yang Zhang* Yu-feng Li Ye Li Xiang-xiang Zhang Wei Wang Jun-hai Ma Pei-long Wang Zhi-chun Dong Wei Shi Jun-qiang Tian 1Department of Urology, The Second Hospital of Lanzhou University, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou 730000, People’s Republic of China; 2Department of Ultrasound in Medicine, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai Institute of Ultrasound in Medicine, Shanghai 200233, People’s Republic of China

Objective To investigate the effect of the endoscopic surveillance system in irrigating fluid absorption and bleeding during transurethral resection of the prostate. Methods In vitro trials, we simulated the fluid absorption and bleeding in the operation by using self-developed endoscopic surveillance system from January 2013 to June 2013. Continuous irrigation of 5% mannitol solution, we extracted 5 times irrigating fluid (each time 100 ml and a total of 500 ml) in the process of irrigation and recorded absorption measurements of every time extraction rinses. At the same time, we dripped human whole blood 5 times(each time 5 ml and a total of 25 ml) in the process of irrigation and recorded the bleeding measurements. The above process was repeated three times to detect the accuracy and consistency of the endoscopic surveillance system. In clinical trials, 50 cases of BPH were monitored in surgery and the biochemical index, hemodynamics, irrigating fluid absorption and bleeding were compared from October 2016 to April 2017.The included criteria contained as follow: the age of patients should be more than 50 years. The transabdominal ultrasound showed that the volume of prostate should be more than 60 ml. The maximal uroflowmetry should be less than 15ml/s. The IPSS scores should be more than 8. Based on the operative time, two groups (<60 min and ≥60 min) were classified. Results We developed the endoscopic surveillance system which is original in the world. In vitro trials, the average irrigating fluid were (100.60±2.07) ml, (201.00±3.39) ml, (302.00±4.67) ml, (403.60±4.39) ml and (502.40±7.57) ml; and the average bleeding were (5.06±0.11) ml, (10.10±0.16) ml, (15.04±0.15) ml, (20.06±0.11)ml and (25.10±0.16) ml. No significant difference was observed in all groups (P>0.05). In clinical trials, we compared some preoperative and postoperative indexes. The average blood oxygen saturation were (94.46±2.49)% and (92.39±2.77)%(P 0.05). The MAP were (90.32±9.75)mmHg and (91.07±8.96)mmHg(P>0.05). The average serum potassium ion concentration were (4.13±0.53)mmol/L and (4.09±0.37)mmol/L(P>0.05). The average irrigating fluid absorption of the group less than 60 minutes and the group equal or more than 60 minutes were (401.83±279.23)ml and (885.25±367.68)ml(P<0.01). The average blood loss were (64.10±47.47)ml and (158.40±65.22)ml(P<0.01). The preoperative and postoperative hemodynamic, blood biochemical and hematology showed difference in our trials. Irrigating fluid absorption and blood loss were positively associated with operation time. Conclusions The endoscopic surveillance system was safety and accuracy. It can offer real-time monitoring data and alarm mechanism for the surgeons that possibly improve operation safety. Key words: Endoscopic surveillance system; Irrigating fluid absorption; Bleeding; Transurethral resection of the prostate

目的:利用红外光谱(IR)联合X射线粉末衍射(XRD)技术定性分析三聚氰胺相关泌尿系结石化学组分及物相构成.方法:选取6份2008年4月～2011年3月在我院诊治的三聚氰胺致婴幼儿泌尿系结石患儿的结石标本,分别编号为S1～S6.采用IR自动分析仪联合X射线衍射仪对其成分进行定性分析,依据国际衍射数据中心卡片库检索分析结石标本的衍射图谱是否与已知的化合物的衍射图谱相匹配.结果:三聚氰胺致婴幼儿泌尿系结石大体形态各异.IR分析显示6份结石标本中的S1～S5主要由尿酸盐组成,其中S1的主要成分是无水尿酸;S2的主要成分为一水尿酸钠;S3、S4和S5的主要成分是二水尿酸和尿酸铵.但是S6的主要成分是六水磷酸镁铵、尿酸铵和碳酸磷灰石.没有已知的化合物的衍射图谱可以同S1～S5的衍射图谱相匹配,S6晶体组成符合六水磷酸镁铵的衍射图谱.结论:尿酸和尿酸铵是三聚氰胺相关泌尿系结石的主要成分;三聚氰胺导致的泌尿系结石的晶体物相组成是无定形的,暂时还无法明确其准确的物相结构.

Many studies have reported various results regarding the relationship of Y-box binding protein 1 (YB-1) and E-cadherin with many cancers, including bladder carcinoma (BC). However, there is still an incomplete understanding about the role of YB-1 and E-cadherin in BC prognosis. This study aimed to evaluate the value of YB-1 and E-cadherin in BC. In this study, the expression of YB-1 and E-cadherin was examined using immunohistochemical staining in a study cohort including 117 BC patients. The results showed that there were significant correlations of YB-1 and E-cadherin with clinical T stage, pathologic T stage, and lymph node metastasis (LNM) in BC patients. Univariate analysis showed that the patients with high YB-1 expression levels (HR = 2.732; P = 0.001), low E-cadherin expression levels (HR = 2.899; P = 0.003), high clinical T stage (HR = 3.905; P < 0.001), high pathologic stage (HR = 4.199; P < 0.001), or LNM (HR = 5.267; P < 0.001) had a significantly higher risk of worse overall survival (OS). In the multivariate analysis, YB-1 (HR = 2.031; P = 0.022) and LNM (HR = 3.546; P < 0.001) predicted worse OS. Therefore, YB-1 and E-cadherin expression is associated with BC incidence; tumor stage, grade and metastasis; and survival and may be reliable prognostic markers for patients undergoing radical cystectomy for BC.

OBJECTIVE:To investigate the clinical characteristics of urolithiasis, retrospectively, in children who ingested melamine-poisoned formula as infants, and report a 5-year follow-up analysis. MATERIALS AND METHODS:Clinical data on 207 patients (mean ± standard deviation, 13.6 ± 8.0 months) with melamine-induced urolithiasis were retrospectively analyzed. Patients were subdivided into 2 groups according to treatment. A 5-year follow-up study was conducted with 95.7% (198 of 207) of the children. Ultrasonography, renal function evaluation, and urinalysis were analyzed. RESULTS:A total of 149 (72.0%) patients accepted conservative treatment. Fifty-eight (28.0%) patients accepted surgical intervention after conservative treatment proved ineffective. Of the 48 patients in whom retrograde ureteral catheterization was performed, 33 discharged the stone successfully, 4 had residual stones, 2 were switched to percutaneous nephrolithotripsy, and 9 underwent ureteroscopic lithotripsy. Six patients underwent extracorporeal shock wave lithotripsy, and other 4 patients underwent ureteral lithectomy. The age of onset, clinical presentations, size and location of stones, renal function, and mean time of hospitalization in patients with surgical intervention were significantly different from those of patients who accepted conservative treatment only (P < .001). The main component of the 12 melamine-contained stone samples was urate. The results of 5-year follow-up (mean ± standard deviation, 72.7 ± 4.1 months) study in 198 children did not show any significant difference of stone residue, renal function, and urinalysis between 2 groups. CONCLUSION:If the stones were treated appropriately in patients with melamine-induced urolithiasis, there is no medium-term risk for stone formation. Still, a longer time follow-up study is required to determine if there is any long-term poisonous effect on these patients.