Background:To describe the urodynamic features of early (≤6 months) male urinary incontinence after transurethral resection of the prostate (TURP) and robot-assisted radical prostatectomy (RARP) as two separate cohorts, and to evaluate the clinical significance of detrusor overactivity (DO) within each group, thereby providing descriptive evidence to support tailored diagnosis and treatment strategies. Methods:A retrospective analysis was conducted using data from patients diagnosed with early (≤6 months) urinary incontinence (UI) after TURP or RARP. Urodynamic parameters, including maximum cystometric capacity (MCC), first desire to void (FD), strong desire to void (SD), bladder compliance (BC), abdominal leak point pressure (ALPP), and the presence of detrusor overactivity (DO), were analyzed within each cohort.Subgroup analyses based on DO status were performed separately for each group. The severity of UI was assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF). Results:A total of 51 patients in the TURP+UI group and 38 patients in the RARP+UI group were included. The TURP+UI group showed significantly higher MCC [260 (207-301) vs 217 (154.50-274.50) mL, P=0.02] and FD (152.78 ± 57.52 vs 123.95 ± 65.65 mL, P=0.03), and lower ICI-Q-SF scores [10 (6-16) vs 19 (17-20), P<0.00] compared to the RARP+UI group. DO was observed in 27.45% of TURP+UI patients and 39.47% of RARP+UI patients. In both groups, patients with DO exhibited significantly lower MCC, FD, SD, and BC values(P<0.00). In the RARP+UI group, patients with DO also had significantly lower ALPP values [0 (0-44) vs 58 (43-91) cmH2O, P<0.001]. Partial correlation analysis revealed that ICI-Q-SF scores were negatively associated with MCC (r=-0.34, p=0.02) and SD (r=[-0.34, p=0.02) in the TURP+UI group, and with ALPP (r=-0.60, p<0.00) in the RARP +UI group. Conclusion:This study describes the urodynamic characteristics of patients with early (≤6 months) UI following TURP and those with UI after RARP as two separate cohorts. In both groups, the presence of DO was associated with reduced MCC and BC, suggesting that DO is a clinically relevant factor affecting storage-phase function regardless of surgical type. The distinct urodynamic profiles observed between the two cohorts likely reflect differences in underlying pathology and surgical mechanisms. Due to the absence of preoperative urodynamic data, these findings should be interpreted as descriptive phenotypic characterizations rather than comparative evidence.

BackgroundThis study aimed to investigate whether the presence or the absence of detrusor overactivity (DO) in patients with urodynamic-confirmed benign prostatic obstruction (BPO) leads to alterations in urodynamic parameters.MethodsThis study is a retrospective analysis of patients with urodynamic-confirmed BPO [Bladder Outlet Obstruction Index (BOOI) >40]. Patients with a clinical diagnosis of benign prostatic hyperplasia (BPH) or benign prostatic enlargement (BPE) were initially screened, but only those with BOOI > 40 were included. Based on the presence or absence of DO during urodynamics, patients were categorized into two groups: BPO with DO and BPO without DO. Subsequently, the BPO with DO group was further stratified according to DO subtype into BPO with terminal DO (TDO) and BPO with phasic DO (PDO). Differences in the urodynamic parameters and the DO-related indices among these groups were then evaluated. In addition, correlations between the DO-related indicators and the urodynamic parameters within each DO subtype were further examined.ResultsThere were 75 patients assigned to the BPO with DO group and 71 to the BPO without DO group. There was a statistically significant difference in the maximum cystometric capacity (MCC) and bladder compliance (BC) between the BPO with DO group and the BPO without DO group: 259.05 ± 44.54 vs. 273.13 ± 36.69 (p = 0.04) and 158.71 ± 83.86 vs. 210.95 ± 82.58 (p < 0.001), respectively. The BPO with PDO group comprised 38 patients, while the BPO with TDO cohort included 37 patients. There exists a statistically significant difference between MCC and BC: 291.50 (248.75–301.75) vs. 250.00 (210.00–296.00) (p = 0.02) and 184.00 (150.50–286.75) vs. 103.00 (85.00–141.50) (p < 0.001), respectively. Univariate regression analysis revealed a statistically significant negative correlation between the maximum contraction amplitude of DO and BC exclusively within the BPO with TDO cohort (rs = −0.34, p = 0.03). Multivariable analysis confirmed this independent correlation (β = −0.33, 95%CI = −0.59 to −0.07, p < 0.05). Age was identified as an independent risk factor for DO (OR = 1.19, p < 0.001) and first desire to void (FD) as an independent protective factor (OR = 0.98, p < 0.001).ConclusionThis preliminary study indicates that DO is associated with storage-phase urodynamic alterations in BPO patients, with no notable association with the voiding phase parameters. Multivariable analysis identified age as an independent risk factor for DO and FD as an independent protective factor. TDO is associated with more pronounced storage-phase changes than PDO. In the TDO subgroup, the correlation between BC and DO contraction amplitude was independent of age. However, several other comparisons remain unadjusted; therefore, these findings are exploratory. Future prospective studies with larger samples and age-adjusted designs are needed.

This study was designed to quantitatively analyze time-related parameters in uroflowmetry curve patterns in patients with benign prostatic hyperplasia and bladder outlet obstruction, and to investigate their potential clinical implications. A total of 63 patients were included in this retrospective, single-center study. The benign prostatic hyperplasia (BPH) with benign prostatic obstruction(BPO) group consisted of 37 patients, while the nromal group included 26 individuals. Urodynamic study traces and clinical data were analyzed based on inclusion and exclusion criteria. Time-related parameters, including: Time to Qmax (T1), The time from Qmax to the end of uroflow (T2), and Uroflow time (T3 = T1 + T2), as well as corresponding ratios, were quantified and compared between the two groups. Significant differences were observed in several time-related parameters between the BPH with BPO group and the normal group. There following parameters demonstrated statistically significant differences: T1 [5 (3.25, 7) s vs. 8.5 (6, 11.5) s, p = 0.00], T2 [23 (15, 34.5) s vs. 10 (6.75, 13.25) s, p = 0.00], T3 [30 (20, 40.5) s vs. 19 (14.75, 23.25) s, p = 0.00], T1/T2 [0.20 (0.13, 0.30) vs. 0.89 (0.65, 1.12), p = 0.00], T1/T3 [0.18 ± 0.10 vs. 0.47 ± 0.10, p = 0.00], T2/T3 [0.82 ± 0.10 vs. 0.54 ± 0.09, p = 0.00].The BPH with BOO group exhibited a shorter time to Qmax onset but significantly prolonged overall voiding duration, a pattern that was consistent with the distinctive “comet tail-like” morphology frequently observed in their uroflowmetry curves. Furthermore, several time-related parameters were identified as potential independent risk factors for bladder outlet obstruction index (BOOI). The time-related parameters in uroflowmetry curve patterns in BPH patients with BPO show distinct characteristics compared to the normal group. These findings suggest that such parameters may serve as valuable diagnostic indicators for bladder outlet obstruction, though further studies with larger sample sizes are needed for confirmation.

Catheter displacement during urodynamic studies remains a common challenge, potentially introducing artifacts, compromising test accuracy, and decreasing patient comfort. Despite the clinical significance of stable catheter fixation, evidence-based recommendations for optimal fixation techniques are lacking. This study seeks to address this gap by comparing the effectiveness and patient comfort associated with three commonly used catheter fixation methods during urodynamic study. We retrospectively collected data from non-randomized patients who underwent urodynamic studies (UDS) at West China Hospital of Sichuan University between April and June 2023. Patients were selected based on predefined inclusion and exclusion criteria and assigned to one of three catheter fixation methods. The effectiveness of the following fixation techniques was evaluated: waterproof tape fixation (Group 1: catheter secured to the skin with adhesive tape), (2) patient-manual fixation (Group 2: patient holds the catheter manually throughout the procedure), and (3) silk thread fixation (Group 3: catheter secured with silk suture tied and fixed externally). A total of 168 patients were enrolled in the study, with 56 patients in each group. The median ages for Groups 1, 2, and 3 were 66 (47.25, 76), 67 (61,71), and 66 (48, 76.75) years, respectively. There were no statistically significant differences among the three groups in terms of maximum cystometric capacity (MCC), bladder compliance (BC), maximum flow rate (Qmax), detrusor pressure at Qmax (Pdet.Qmax), bladder contractility index (BCI), or bladder outlet obstruction index (BOOI) (P > 0.05). The overall incidence of catheter displacement was 35.71

Considering that the circulating proteome represents a primary source of candidate biomarkers and therapeutic targets, we conducted a large-scale Mendelian randomization (MR) study to identify plasma proteins potentially involved in the pathogenesis and treatment of common urological cancers (UCs), including bladder cancer (BC), prostate cancer (PC), renal cell carcinoma (RCC), and testicular cancer (TC). Cis-protein quantitative trait loci (cis-pQTLs) were derived from two large-scale genome-wide association studies (GWASs) of plasma proteomes. GWAS for UCs were obtained from FinnGen and pan-UKBB meta-analysis, FinnGen and UK Biobank. Colocalization analysis and summary data-based MR (SMR) were performed to evaluate the robustness of the associations. Further evaluations involved Bulk RNA-seq differential expression and single cell-type expression analysis, protein–protein interaction, and druggability evaluation. For BC, we identified four protein markers: one associated with increased risk (PSCA) and three with decreased risk (GSTM1, GSTM3, GSTM4), which are mainly expressed in pericyte, urothelial, and NK cells in bladder tumors. Regarding PC, we found 15 protein markers: seven linked to increased risk (AGER, ALAD, CHMP2B, PEX14, ZG16B, PPP1R14A, SERPINA3) and eight to decreased risk (BTN2A1, CEACAM21, DNAJB9, MSMB, PYGL, HLA-E, SOD2, TOR1AIP1), enriched in epithelial cells, monocytes/macrophages in prostate tumors. The strongest evidence from MR and colocalization analyses supported GSTM4 (BC), SOD2 and CHMP2B (PC) as causal markers. Notably, seven identified proteins have been previously targeted by drugs for other cancers and immune disorders, indicating their potential therapeutic relevance in UCs. This study highlights several proteins with predictive value for BC and PC risk and supports their utility in biomarker discovery and drug development.

Objective: To assess efficacy and safety of mirabegron 25 mg/day and 50 mg/day for overactive bladder in Chinese participants. Methods: Participants of >= 18 years with overactive bladder symptoms lasting for >= 12 weeks, a mean of >= 8 micturitions per 24 h, and a mean of at least one episode of Grade 3 or 4 urgency or urge incontinence per 24 h based on the Patient Perception of Intensity of Urgency Scale over a 3-day micturition diary period were randomized 2:1 to open-label treatment with oral mirabegron 50 mg or 25 mg once daily for 12 weeks (15 sites in China, January 2021-March 2022). A dose escalation from 25 mg/day to 50 mg/day was permitted at weeks 4 and 8 according to the investigators' discretion. The primary efficacy endpoint was the change from baseline to Week 12 in the mean number of micturitions per 24 h in those randomized to mirabegron 50 mg/day. Secondary efficacy endpoints were the change in mean number of micturitions at weeks 4 and 8 in the mirabegron 50 mg/day group and weeks 4, 8, and 12 in the mirabegron 25 mg/day group, change from baseline to weeks 4, 8, and 12 in Grade 3 or 4 urgency episodes on the Patient Perception of Intensity of Urgency Scale, episodes of daytime incontinence, nighttime incontinence, and urgency incontinence, and Overactive Bladder Symptom Score for mirabegron 50 mg/day and 25 mg/day groups. Results: Statistically significant reduction (p<0.001) from baseline to Week 12 was observed in mean micturitions per 24 h for participants randomized to mirabegron 50 mg/day: mean +/- standard error: 11.71 +/- 0.43 at baseline, 7.80 +/- 0.24 at Week 12; adjusted mean change: -3.73 (95% confidence interval -4.30 to -3.16). Both doses showed statistically significant improvement in secondary efficacy endpoints at weeks 4, 8, and 12 versus baseline. Safety was consistent with mirabegron's known safety profile. Conclusion: The results support a mirabegron dosage of 50 mg/day for the treatment of OAB in China. (c) 2025 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).

OBJECTIVE:To investigate the efficacy and safety of intravesical DMSO instillation for the treatment of interstitial cystitis/bladder pain syndrome. METHOD:The following databases were searched for relevant studies: PubMed, EMBASE, MEDLINE, Cochrane Library, and Web of Science (updated August 10, 2024). All studies on intravesical DMSO met the inclusion criteria and were evaluated using various quality assessment methods based on the type of study. Data were then analyzed using Review Manager 5.4 (Cochrane Collaboration software). The primary outcomes and indicators included the Interstitial Cystitis Symptom Index, the Interstitial Cystitis Problem Index, and Pain Scores. The secondary outcomes were bladder diary metrics and Pelvic Pain and Urgency/Frequency Symptom Scale (PUF). RESULTS:This systematic review and meta-analysis included 5 randomized controlled trials and 9 single-arm or cohort studies, involving 554 patients. The combined statistics indicated an average pretreatment Interstitial Cystitis Symptom Index score was 14.27, an average Interstitial Cystitis Problem Index Score was 12.72, and an average Pain Score was 7.06. Compared to pretreatment values, the results indicated that the Interstitial Cystitis Symptom Index score decreased by 5.59 (95% CI: -6.68 to -4.50, p < 0.00001), the Interstitial Cystitis Problem Index score decreased by 5.14 (95% CI: -6.45 to -3.83, p < 0.00001), and the Pain Score decreased by 3.27 (95% CI: -3.95 to -2.60, p < 0.00001). Additionally, the overall incidence rate of adverse events in patients was 37.6%. Although 37% of cases had adverse events, the majority were considered mild and acceptable. CONCLUSION:Evidence-based statistical analysis of the literature on intravesical DMSO treatment for interstitial cystitis/bladder pain syndrome indicates that this therapy is both effective and safe. Therefore, intravesical DMSO instillation can be considered a standard treatment method for interstitial cystitis/bladder pain syndrome.

This study aimed to investigate common complications during the chronic phase of spinal cord injury (SCI) and to assess bladder management methods and their associated complications in patients with neurogenic lower urinary tract dysfunction (NLUTD). A retrospective analysis was performed using clinical data from chronic-phase SCI patients across multiple centers in China. The study population included individuals diagnosed with SCI and admitted between January 1, 2017, and December 31, 2022. Chi-square tests were used to evaluate differences in the distribution of complications, disease duration, bladder management methods, and urinary complications. Univariate and multivariate analyses were conducted to identify risk factors for urinary complications. A total of 849 SCI patients from 28 provinces in China were included, showing significant demographic and clinical differences between traumatic SCI (TSCI) and non-traumatic SCI (NTSCI). Urinary tract infection (59.95%) and bowel-related complications, such as constipation (62.17%), were the most frequently reported complications. Additionally, the incidences of osteoporosis (38.50%), neuropathic pain (29.99%), bowel incontinence (12.06%), and hydronephrosis (11.91%) were also high. NLUTD was present in 90.58% of SCI patients. Among these, intermittent catheterization was associated with significantly lower rates of urological complications compared to indwelling catheterization (p = 0.025). Multivariate analysis identified bladder management method as a significant risk factor for urinary complications, with indwelling catheterization associated with a higher risk of urinary stones (p < 0.001) compared to intermittent catheterization. The high prevalence of bowel- and urological-related complications among Chinese SCI patients highlights the need for increased societal attention. In terms of bladder management, intermittent catheterization may provide greater benefits compared to indwelling catheterization. Further research and education are necessary to promote intermittent catheterization as a standardized bladder management approach for SCI patients.

Background:Urodynamic study (UDS) is essential for assessing lower urinary tract function, but quality control methods remain limited. Statistical process control (SPC), a tool originally developed in manufacturing, has shown promise in healthcare for improving quality and reducing variability. Objective:This study explored the application of SPC to analyze the typical value ranges (TVR) of urodynamic measurements. Methods:A total of 84 urodynamic traces that met all inclusion criteria were included for analysis. We recorded the TVR for initial intravesical pressure (Pves), initial abdominal pressure (Pabd), and initial detrusor pressure (Pdet) from each enrolled UDS trace. These data were then compared with the standard TVR. In addition, we used the X-bar and S control charts of SPC for process performance analysis. Results:The study included 20 females and 64 males, with an average age of 58.02 ± 16.09 years. Of the participants, 32 were diagnosed with neurogenic bladder dysfunction, and 52 were diagnosed with non-neurogenic bladder dysfunction. The average TVR for initial Pves was 34.81 ± 10.78 cmH2O, Pabd 30.92 ± 11.14 cmH2O, and Pdet 4.20 ± 3.73 cmH2O. We further analyzed the data using scatter plots. In the X-bar control chart, the control limit (CL) was 22.48, the upper CL (UCL) was 32.04, and the lower CL (LCL) was 12.92. In the S control chart, the CL was 15.78, the UCL was 22.57, and the LCL was 8.9. Two cases exceeded the UCL in the X-bar control chart, and one case exceeded the UCL in the S control chart. Conclusion:The clinical value of SPC in the quality review of UDS has been confirmed in previous studies. In this study, we preliminarily verified the use of SPC for continuous variable data, such as the TVR of UDS parameters. The results of this study need to be further validated in a larger sample size, multi-center, and prospective study.

Cancer-associated fibroblasts (CAFs) in the tumor microenvironment (TME) interact with multiple immune cells, such as T cells, macrophages, neutrophils, and other immune cells, to display both antitumor or protumor effects. Despite enormous progress in immunotherapy, the CAF-associated resistance of immunotherapy is still urgent to be solved. In this review, we summarize the origins and heterogeneity of CAFs in the TME, including the subpopulations of CAFs and their biological function. Then we discuss the communications between CAFs and tumor-associated macrophages, T lymphocytes, tumor-associated neutrophils, and other immune cells. CAFs cannot only recruit immune cells in the TME, but also trigger polarization, proliferation, infiltration of immune cells, thereby promoting tumor progression. Inversely, some immune cells promote the recruitment, transdifferentiation, and proliferation of CAFs. We also focus on the current progress in therapeutic strategies targeting CAF-elimination, CAF-reprograming, downstream signaling blockade, and CAF-induced extracellular matrix barrier elimination to enhance the efficacy of immunotherapy and related clinical trials. Overall, we aim to provide the conceptions of CAF-immunocyte crosstalk in the TME and application of immunotherapy, paving the way for the development of precise and individualized strategies through clarifying the interaction between CAFs and immunocytes.

To evaluate the efficacy and safety of a non-invasive low-frequency tibial nerve stimulator (TNS-01) vs sham control in relieving the symptoms of overactive bladder (OAB) patients. Participants who were diagnosed with primary OAB or exhibited at least one OAB symptom. All participants underwent three 30-min intervention sessions weekly. The subjects were 1:1randomized (block randomization with a block size of 4) to either active treatment (TNS-01 group) or sham treatment (sham group). Based on the randomization, the subject will be given either an active or sham device system (systems will only differ in the Instructions for Use and electrode size/shape). During the 12-week study period, all participants underwent three 30-min intervention sessions weekly. The primary endpoint was the change in Overactive Bladder Symptom Score (OABSS) at week 12 from the baseline. Of the 109 recruited OAB patients. In the TNS-01 group, the OABSS change from baseline at week 12 was significantly higher than that in the sham group (2.83 ± 2.53 vs 1.62 ± 2.59, p = 0.02). The absolute and percent changes of average UUI episodes per day from baseline at week 8 in the TNS-01 group were significantly lower from those in the sham group (0.11 ± 1.33 vs 0.68 ± 2.14, p = 0.01; − 27.82

This study aims to evaluate detrusor after contraction (DAC) characteristics in females with pure urodynamic stress incontinence (USI). We examined the urodynamics database from our urodynamic study center. Urodynamic data from pure USI cases with and without DAC were compared. DAC was categorized based on morphological features, and urodynamic parameters in different subgroups were analyzed. A total of 61 female pure USI patients met all the study requirements. Among them, there were 27 cases of pure USI with DAC and 34 cases of pure USI without DAC. The incidence of pure USI with DAC in the overall female sample was 2.5

ABSTRACTAimThis study aimed to analyze the clinical efficacy and safety of autologous fascial pubovaginal sling (AFPVS) surgery in treating recurrent stress urinary incontinence (SUI) following the failure of mid‐urethral sling procedures.MethodsA retrospective analysis was conducted on the clinical data of SUI patients who underwent AFPVS at our hospital between 2008 June and 2024 June following the failure of mid‐urethral sling procedures. The analysis included basic information, surgical parameters, and postoperative complications. Additionally, telephone interviews using the International Consultation on Incontinence Questionnaire‐Short Form (ICI‐Q‐SF) and the Incontinence Quality of Life Questionnaire (I‐QOL) was conducted at 6‐month follow‐up.ResultsThirty‐four patients with the mean age of 54.8 ± 15.7 years old were reviewed, and the median disease duration was 3 (2–10) years. Of the 34 patients, 20 (58.8%) were cured, 8 (23.5%) showed improvement, resulting in an overall effectiveness rate of 82.3%. Three cases experienced bladder injury, which resolved after 2 weeks of catheterization, but no patients had urethral or vaginal injuries intraoperatively. Postoperative scores on the ICI‐Q‐SF significantly decreased (p < 0.001), and postoperative I‐QOL scores significantly increased (p < 0.001) compared to preoperative scores.ConclusionAFPVS is a safe and effective salvage procedure for recurrent SUI following the failure of mid‐urethral sling procedures.

Uterine corpus endometrial carcinoma (UCEC) poses a significant to women's health. Accurate prediction of prognosis plays a crucial role in facilitating clinical decision-making processes. Therefore, this study aimed to develop a robust prognostic model based on gene expression profile. Gene expression profile of 546 UCEC samples of The Cancer Genome Atlas were retrieved. A multi-step strategy was employed to develop and validate a prognostic model predicting all-cause mortality rates. Receiver operating characteristic curve and decision curve analysis were performed to assess the predictive accuracy and net benefit of the model. Besides, model-associated immunological features were explored. The UCEC Prognostic Model (TUPM) performed well in identifying patients at high mortality risk. Patients with risk scores above the upper quartile had significantly decreased overall survival compared to patients with risk scores below the lower quartile (HR = 12.56, CI95: 4.629-34.09, P = 6.76E-7), indicating a prominent discriminability. The model accurately predicted patient survival from 1 to 5-year (area under the curve [AUC](1-year) = 0.766, AUC(2-year) = 0.816, AUC(3-year) = 0.764, AUC(4-year) = 0.783, AUC(5-year) = 0.814) and provided excellent calibration. Meanwhile, The UCEC Prognostic Model encompassing transcriptome scores yielded a higher net clinical benefit than the baseline model that only included patient age and clinical stage. Furthermore, the prolonged survival in the low-risk group may be associated with increased infiltration of follicular T cells and regulatory T cells in the tumor microenvironment. We have developed a robust prognostic model for UCEC that may provide preliminary evidence for individualized management and treatment modality decision.

Hunner-type interstitial cystitis/bladder pain syndrome (HIC) is a debilitating condition defined by bladder pain and urinary urgency, yet its upstream drivers remain poorly understood. To identify upstream mechanisms that exacerbate urothelial injury, here we apply an integrative multi-omics framework combining metagenomic sequencing, targeted metabolomics of urine and serum, and single-cell RNA sequencing. This approach reveals a microbial signature enriched in Enterococcus avium and a marked alteration in bile acid metabolism, including increased taurochenodeoxycholic acid (TCDCA). Single-cell analysis indicates that these changes converge on Toll-like receptor 3 (TLR3) activation in urothelial cells. Further validations show that a microbiota–bile acid–TLR3 axis disrupts epithelial barrier integrity and triggers inflammatory responses in experimental models. Transplantation and metabolite administration confirm the causal role of E. avium and TCDCA, while TLR3 inhibition ameliorates injury. These findings uncover an upstream pathway linking gut-derived metabolites to bladder pathology and suggest opportunities for biomarker development and targeted therapies for HIC. Through integrated multi-omics and experimental validation, this study reveals that altered gut microbiota and bile acid metabolism activate TLR3 to induce urothelial injury in interstitial cystitis, identifying a pathway with therapeutic potential.

With increasing age, pelvic organ prolapse (POP), due to its high incidence, has become a common disease that seriously affects patients’ quality of life and places a heavy economic burden on families and society. Transvaginal mesh (TVM) is a minimally invasive and effective treatment for POP, although its use remains controversial due to the potential risk of meshrelated complications. The US Foods and Drugs Administration, along with authorities in England, Australia, New Zealand, and other countries, have banned the sale and distribution of commercial TVM kits designed for POP. The TVM procedure remains an option for POP treatment and still appeals to many surgeons and patients today in Asia and most European countries, which suggests that a considerable number of POP patients can benefit from its continued refinement. Here we introduce the Huaxi protocol of the TVM plant for the treatment of POP.

BACKGROUND:Stress urinary incontinence is common among women, and surgical interventions have significantly improved patients' symptoms. The long-term effectiveness of these surgeries is increasingly drawing attention, yet it remains sparsely documented in the literature. OBJECTIVE:To compare the long-term effectiveness and safety of retropubic tension-free vaginal tape (TVT-RP), tension-free vaginal tape-obturator (TVT-O), transobturator tape (TOT), single-incision sling (SIS), Burch colposuspension, and pubovaginal sling (PVS). METHODS:A comprehensive and systematic literature review was conducted in PubMed, EMBASE, MEDLINE, Cochrane Library, Medicine, and clinicaltrials.gov from inception to May 2023. Selected trials were evaluated for potential bias using the Cochrane tool. Treatment modalities were compared using network meta-analysis to assess objective success rate, subjective success rate, and complications as outcomes. RESULTS:A total of 37 studies involving 5720 patients were included. No significant statistical differences were found among the interventions regarding objective success rate. PVS had the highest surface under the cumulative ranking curve SUCRA value (93.1). For subjective success rate, TVT-RP, TVT-O, and PVS demonstrated superiority over SIS, with PVS having the highest SUCRA value (80.1). SIS had lower overall complication and pain rates compared to other methods, with statistical significance. There were no differences in reoperation rate, exposure rate, and urinary tract infection occurrence among the surgical approaches. CONCLUSIONS:In terms of long-term effectiveness and safety, TVT-RP and TVT-O appear to be the preferred options for patients opting for synthetic slings, while for patients seeking nonsynthetic slings, PVS may represent the optimal choice.

ImportanceInterstitial cystitis (IC) is a debilitating condition. Although viral infection is a potential etiological cause, few studies have detected the effect of antiviral treatment.ObjectiveTo determine the efficacy and safety of intravesical interferon instillation compared with hyaluronic acid in female patients with IC.Design, Setting, and ParticipantsThis double-masked, randomized phase 2/3 clinical trial with parallel group design was implemented from October 2022 to April 2023 and had a 6-month follow-up period. The study was conducted at a single center. Eligible participants were female patients aged 18 to 70 years with a diagnosis of IC for more than 6 months. The last visit took place in October 2023. Data were analyzed between October and November 2023.InterventionPatients were randomized 1:1 to receive either intravesical instillation of interferon or hyaluronic acid.Main Outcomes and MeasuresThe primary end point was change in visual analog scale pain score. Secondary end points included changes in voiding frequency, functional bladder capacity, symptom index, and global response assessment. Adverse events were closely monitored.ResultsAmong the 52 patients, the mean (SD) age was 50.0 (14.1) years and they were randomized to either the interferon group (26 [50%]) or hyaluronic acid (26 [50%]). The visual analog pain score showed the interferon group decreased more significantly than hyaluronic acid (−1.3; 95% CI, −2.3 to −0.3; P = .02) at month 6, with 20 patients (77%) exhibiting a 30% or higher reduction in pain compared with baseline. Secondary end points of voiding frequency, functional bladder capacity, and nocturia episodes showed no significant difference between 2 therapies. However, interferon showed a significantly higher reduction in the Interstitial Cystitis Symptom Index (−3.0; 95% CI, −5.3 to −0.7; P = .01) and the Problem Index (−2.5; 95% CI, −4.5 to −0.4; P = .02) at month 6, with 22 patients (85%) presenting as moderately or markedly improved. The frequencies of adverse events were similar between 2 groups. Only 1 patient discontinued hyaluronic acid because of poor effectiveness.Conclusions and RelevanceIn this randomized clinical trial, female patients with IC could benefit from intravesical interferon therapy, without serious adverse events. These results offered hope for antiviral approaches in IC, but larger-scale, multicenter trials and long-term follow-up should be considered.Trial RegistrationClinicalTrials.gov Identifier: NCT05912946

Objectives This study in order to provide better evidence for the selection of fixation methods for measurement catheters during clinical UDS . Methods We selected patients who had undergone urodynamic examinations at the XXX between April and June 2023. These patients were chosen based on the inclusion and exclusion criteria established for the study. We observed the effectiveness of three different fixation methods: 1.Waterproof Tape Fixation(group1) 2. Patient-Manual Fixation(group2) 3. Silk Thread Fixation(group3). Results There were 28 patients enrolled in each group, and the mean ages were: 62.82 ± 15.59, 66.14 ± 8.63, 63 ± 16.78 years, respectively. MCC, BC, Qmax, Pdet.Qmax, BCI and BOO in 3 different catheter fixation methods had no statistical difference (P > 0.05). The total incidence of catheter displacement in group1, group2 and group3 was 35.71%, 0, 14.29%, respectively. There was a statistically significant difference between the Comfort-B scale of Group 1 and Group 2, Group 2 and Group 3 (p < 0.000). Regarding the visual analogue scores, there was a statistically significant difference between Group 1 and Group 2, Group 2 and Group 3 (p < 0.000). Conclusions We conducted a preliminary verification and found that three different methods of catheter fixation during UDS had no significant impact on the test results. However, it is important to note that patient-manual fixation, as well as the other two fixation methods, may result in decreased comfort and increased pain for patients during the UDS process. Clinical trial registration: ChiCTR2300068280. 2023-5-15

Shen, Si-hong MMa,b; Chen, Jia-wei MMa,b; Liu, Meng-zhu MMa,b; Peng, Liao MDa,b; Chen, Yuan-zhuo MDa,b; Shen, Hong MDa,b; Luo, De-yi MD, PhDa,b Author Information