AIM:To investigate the clinical efficacy of transurethral columnar balloon dilation of prostate (TUCBDP) in the treatment of small-volume benign prostatic hyperplasia (BPH) and provide the optimal treatment for the surgical treatment of small volume benign prostatic hyperplasia. METHODS:This retrospective study analyzed 106 patients with small-volume BPH who underwent surgical treatment at the Department of Urology, Xiangya Changde Hospital from December 2023 to January 2024. The patients were divided into two groups based on the type of surgery received: TUCBDP group (n = 53) and transurethral resection of prostate (TURP) group (n = 53), which serves as the control group. We observed and measured the primary outcome indexes of the two groups, including international prostate symptom score (IPSS), maximum urinary flow rate (Qmax), postvoid residual (PVR), and quality of life (QoL) score, as well as the secondary outcome indicators, such as operation time, hospital stay, indwelling catheter time, the frequency of night urination and daytime urination, and the total incidence of long-term and short-term complications. RESULTS:Preoperative IPSS, Qmax, PVR, and QoL scores showed no significant differences between the TUCBDP and TURP groups (p > 0.05). Postoperatively, the TUCBDP group showed superior results in terms of shortened operation time (-15.96 minutes, 95% confidence interval (CI) [-20.06, -11.86], p < 0.001), hospitalization time (-1.73 days, 95% confidence interval (CI) [-2.26, -1.20], p < 0.001), and indwelling catheter time (-1.17 days, 95% CI [-1.55, -0.79], p < 0.001), reduced night urination frequency (-0.71 times, 95% CI [-0.89, -0.53], p < 0.001) and daytime urination frequency (-1.80 times, 95% CI [-2.25, -1.35], p < 0.001). For patients receiving TUCBDP, improvements were also noted in IPSS (-2.27, 95% CI [-3.58, -0.96], p < 0.001), Qmax (4.50 mL/s, 95% CI [3.30, 5.70], p < 0.001), PVR (-6.89 mL, 95% CI [-9.48, -4.30], p < 0.001), and QoL (-0.87, 95% CI [-1.57, -0.17], p = 0.026). The TUCBDP group also had lower rates of near-term (15.09% vs. 35.85%, χ2 = 6.013, p = 0.014) and long-term complications (11.32% vs. 37.74%, χ2 = 9.988, p = 0.002). CONCLUSIONS:TUCBDP demonstrates significant clinical efficacy in the treatment of small-volume BPH, causing a low incidence of postoperative complications.

BACKGROUND:Hypoxia up-regulated 1 (HYOU1) was identified as a proto-oncogene and involved in tumorigenesis and progression in several cancer. Nonetheless, the biological function and mechanism of HYOU1 in bladder cancer (BCa) remian unclear.METHODS:The HYOU1 level in BCa tissues and cells was examined using RT-qPCR and western blot methods. The relationship between HYOU1 expression and clinicopathologic characteristics of BCa was analyzed. The biological role of HYOU1 on BCa cell proliferation, apoptosis, migration and invasion were analyzed via counting kit-8 (CCK-8), flow cytometry, wound healing and Transwell assays, respectively. The association between HYOU1 and the PI3K/AKT/Forkhead box O1 (FOXO1) signalling was assessed via western blot assay, meanwhile the the association of FOXO1 with HYOU1 was also investigated.RESULTS:HYOU1 was up-regulated in BCa tissues and cell lines, and the high level of HYOU1 was associated with bladder cancer histological grade and pathologic stage. Moreover, patients with high expression of HYOU1 showed poor overall survival from Kaplan-Meier Plotter. HYOU1 depletion impeded cell proliferation, migration and invasion, and induced cell apoptosis, while HYOU1 overexpression promoted cell proliferation, migration and invasion. Mechanically, our results showed that HYOU1 knockdown repressed PI3K/AKT/FOXO1 pathway and HYOU1 was negative regulated by FOXO1 in BCa. Significantly, we confirmed that the HYOU1/PI3K-AKT/FOXO1 negative feedback loop was involved in BCa cell proliferation, migration and invasion.CONCLUSION:These findings revealed that HYOU1 acted as a pro-oncogene on BCa progression, and it will be a possible target for BCa treatment.

Prostate cancer with refractory hyponatremia is rare. A patient was admitted with urinary retention, who developed weakness, apathy, and altered mental status during hospitalization, and was diagnosed with severe hyponatremia. After multidisciplinary consultations with departments such as endocrinology and neurology, the patient was diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). The patient received serum PSA test and prostate MRI examination, and was diagnosed with prostate cancer by prostate biopsy. Laparoscopic radical prostatectomy was successfully performed. Results: The patients took tolvaptan orally before operation to maintain normal serum sodium. One month after radical prostatectomy, the symptoms of fatigue and anorexia disappeared, and serum sodium returned to normal without tolvaptan taking and sodium supplementation. No tumor recurrence or hyponatremia relapse observed during the 6-month follow-up.

Objective:To explore the application of rapid rehabilitation surgery combined with self-made reflux ureteroscope lithotripsy in the treatment of ureteral calculi (>1.5 cm in diameter).Methods:From August 2018 to May 2020, 306 patients with>1.5 cm in diameter ureteral calculi were selected. Sixty-three cases in group A were treated with rapid rehabilitation surgery combined with self-made reflux ureteroscopic lithotripsy, 102 cases in group B were treated with rapid rehabilitation surgery combined with traditional ureteroscopic lithotripsy, and 141 cases in control group were treated by simple traditional ureteroscopic lithotripsy. The intraoperative and postoperative observation indexes (operation time, ureter injury during operation, bleeding during operation, incidence of postoperative fever, postoperative hematuria, time of first exhaust, length of stay, cost of hospitalization, incidence of deep vein thrombosis in both legs, incidence of stage II lithotripsy, stone removal rate in one month after operation, patient satisfaction), postoperative pain and anxiety were compared among the three groups.Results:Compared with the group B and the control group, group A experienced shorter operation time, lower the incidence of ureteral injury and stone escape rate II lithotripsy and in cidence of postoperative fever, and higher stone removal rate in one month after operation ( P<0.05). Compared with the control group, the observation group A and observation group B had significantly earlier first postoperative exhaust time, significantly shorter hospital stay time, significantly reduced hospital costs, significantly improved patient satisfaction, significantly reduced the incidence of deep vein thrombosis in both lower extremities. The scores of self-rating anxiety scale (SAS) and visual analogue scale (VAS) were significantly lower than those of the control group ( P<0.05). Additionally, there was no significant difference among three groups regarding intraoperative bleeding and postoperative hematuresis. Conclusions:For the patients with ureteral calculi (>1.5 cm in diameter), the accelerate rehabilitation surgery combined with self-made reflux ureteroscopic lithotripsy has advantages of reducing complications, shortening the length of stay, reducing medical costs, and improving the anxiety of patients, which thus led to speeding up the recovery of disease, indicating that it is worthy to be clinically popularized and applied.

Background: Primary renal leiomyosarcoma (LMS) is an exceedingly rare entity with a poor prognosis. We summarized the clinicopathological characteristics, treatment choice, and survival outcomes of LMS from the Surveillance, Epidemiology, and End Results (SEER) database.Methods: Renal LMS and kidney renal clear cell carcinoma (KIRC) data from 1998 to 2016 were collected from the SEER database. The continuous variables were analyzed using t-tests, while the categorical variables were analyzed using Pearson's chi-squared or Fisher's exact tests. Propensity score matching (PSM) was also performed. The cancer-specific survival (CSS) and overall survival (OS) curves were estimated using Kaplan-Meier analyses and compared by log-rank tests. The risk factors for CSS and OS were estimated using univariable and multivariable Cox proportional hazard regression models.Results: A total of 140 patients with renal LMS and 75,401 patients with KIRC were enrolled. These groups differed significantly in sex, race, tumor size, grade, SEER stage, surgery, radiation, and chemotherapy. Renal LMS exhibited poorer CSS and OS compared with KIRC before and after PSM. For renal LMS, the univariate Cox proportional hazard regression model indicated that larger tumor size, higher tumor grade, higher SEER stage, and chemotherapy were risk factors for CSS and OS, while surgery appeared to be a protective factor. However, only tumor grade, SEER stage, and receiving surgery remained independent prognostic factors in the multivariable Cox proportional hazard regression model. In addition, subgroup analyses indicated that surgery remained a protective factor for advanced renal LMS. However, there was no survival benefit for patients receiving chemotherapy.Conclusions: Primary renal LMS is an exceedingly rare entity with distinct clinicopathological features and a poor prognosis. A higher tumor grade and late stage may indicate a poor prognosis. Complete tumor resection remains to be the first treatment choice, while chemotherapy may be a palliative treatment for patients with advanced disease.

Objective:To analyze the clinical efficacy and safety of " less tube" microchannel percutaneous nephrolithotomy for upper urinary calculi.Methods:Eighty patients with upper urinary calculi who were hospitalized in our hospital from January 2018 to February 2019 were selected as group study subjects.Patients were divided into observation group and control group by random number table method, 40 cases in each group. The control group was treated with microchannel percutaneous nephrolithotomy.The observation group was treated with " non-tubular" microchannel percutaneous nephrolithotomy.The general data, surgical related indexes and complications were compared between the two groups, and the clinical efficacy was evaluated.Results:The intraoperative blood loss of the observation group was significantly lower than that of the control group, and the operation time, hospitalization time, anal exhaust time, first time of bed-out activity, and total treatment cost were significantly lower in the observation group than in the control group.Statistical significance( P<0.05), and there was no significant difference in the total effective rate between the two groups( P>0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group, and the difference was statistically significant( P<0.05). Conclusions:The " non-tubular" microchannel PCNL has a low incidence of postoperative urinary calculi, which avoids the discomfort caused by the tube and shortens the postoperative recovery time.It has certain clinical application value.

目的 探究3D打印技术辅助腹腔镜下肾脏部分切除术(Laparoscopic Partial Nephrectomy,LPN)的应用价值.方法 回顾性纳入自2019年1月～2020年1月收治的80例行LPN患者,随机分为观察组(40例)和对照组(40例).观察组术前采用3D打印技术模拟患肾三维成像行术前讨论及与患者术前谈话;对照组术前采用普通CT影像技术模拟患肾行术前讨论及与患者术前谈话.比较两组患者围手术期相关指标、认识度评分.结果 观察组患者围手术期相关指标均优于对照组,两组间比较差异有统计学意义(P<0.05);观察组患者对疾病的认识度评分高于对照组,两组间比较差异有统计学意义(P<0.05).结论 3D打印模拟三维成像技术相比普通CT影像技术能够更好的辅助LPN,提升患者对疾病的认识度、减少手术及肾动脉阻断时间、减少出血量、缩短术后肠道恢复时间及住院日、降低肾功能的损害,提升患者的治疗效果.