The traditional dogma of "sterile urine" has long dominated clinical practice, expanded quantitative urine culture (EQUC) and metagenomic sequencing have revealed the presence of a complex and functionally active microbiome within the urinary tract. Imbalances in the urine microbiome are significantly associated with various diseases. Urine microbiome transplantation (UMT) represents a breakthrough innovation that restores urine microbiome balance in patients by transplanting bacteria from healthy donors, offering a precision interventional strategy for urinary tract diseases. As a therapeutic modality, UMT demonstrates promising safety and considerable therapeutic potential. However, its widespread clinical application warrants careful consideration and necessitates large-scale clinical trials to accelerate the accumulation of evidence-based medical data. Based on existing UMT case data, this consensus document synthesizes and summarizes current knowledge, preliminarily proposing the clinical application standards of urine microbiome transplantation in partial female urological diseases. Its aim is to provide reference for the design of future clinical trials.

The overactive bladder (OAB) is one of the top 10 chronic diseases in the world, with a high prevalence rate in China. Through a long-term management, OAB can be prevented and cured. However, the health literacy level of residents in China is only 27.78%. It is essential to strengthen the urinary health education in the community to improve the prevention and treatment efficiency of OAB. At present, there are challenges in the prevention and treatment of OAB at the community, such as incomplete professional skills of medical staff, insufficient self-management ability of patients, imperfect urological health education, and inadequate supporting policies. The healthy education of OAB needs to be improved in several aspects, such as improving professional training of primary medical staff, innovating educational modes, promoting network construction, and increasing funding investment. Finally, the efficiency of OAB diagnosis and treatment will be improved and the medical burden will be reduced.

Over more than a decade of development and integration into urology, laparoscopic single-site surgery (LESS) has demonstrated its unique advantages, showcasing significant potential within this field. The transvesical approach enjoys extensive utilization in the field of urological surgery as well, which is a highly effective surgical method. The advent of robotic-assisted techniques has further advanced the capabilities of single-port laparoscopy. This article provides a comprehensive overview of the application of transvesical LESS (T-LESS) in urology, drawing upon our department's operational experience and existing literature on the subject.

Cryoablation, as a minimally invasive treatment, is widely used in bladder cancer. However, postoperative recurrence remains relatively high, and reliable biomarkers for predicting recurrence risk are still lacking. This study aims to explore the correlation between laboratory indicators and recurrence risk after cryoablation of bladder cancer.

This study is a post-hoc analysis based on a cohort of bladder cancer patients from a multicenter, prospective, randomized controlled trial (ChiCTR registration number: ChiCTR-INR-17013060). All patients underwent laboratory testing on postoperative day 7 and at 4-6 weeks. Recurrence was assessed over a 3-year follow-up period using ultrasound and cystoscopy. Univariate and multivariate Logistic regression analyses were conducted between the recurrence and non-recurrence groups. Patients were grouped according to prothrombin time (PT) using the optimal cutoff value, and the relationship between different groups and clinicopathological characteristics was evaluated.

A total of 72 patients were included, with 11 experiencing recurrence during follow-up. Univariate Logistic regression analysis showed that age (OR=1.082, 95%CI: 1.008-1.173, P=0.039), tumor number (OR=2.851, 95%CI: 1.295-6.773, P=0.011), and PT on postoperative day 7 (OR=0.423, 95%CI: 0.164-0.889, P=0.043) were significantly associated with recurrence. Multivariate analysis identified shortened PT on postoperative day 7 as an independent risk factor of recurrence (OR=0.222, 95%CI: 0.053-0.602, P=0.013). When patients were stratified by a PT cutoff value of 12.1 seconds, patients in the low PT group had a higher proportion of low-grade tumors (P=0.028), higher platelet levels (P=0.014), and shorter activated partial thromboplastin time (P<0.001).

Shortened PT on postoperative day 7 is an independent risk factor of recurrence after bladder cancer cryoablation.

To explore the effect of total laparoscopic ileum augmentation cystoplasty in the treatment of contracted ketamine-related cystitis evaluated by imaging and urodynamics.

A total of 13 patients with contracted ketamine-related cystitis were included in this study. The age was 20-66 years. Duration of ketamine abuse ranged from 0.3 to 10.0 years. The patients were required to abstain from ketamine prior to treatment, and their symptoms were repeated or even worsened due to poor response to initial conservative treatment. Patients with severe bladder contracture (bladder volume <50 mL) and low compliance of bladder (<20 mL/cmH₂O) underwent total laparoscopic ileum augmentation cystoplasty.

After operations, the VAS score [(5.69±1.93)vs (9.62±2.66) ], the number of daytime urinations [(5.00±1.58) vs (14.15±3.05)], nocturnal urinations [(3.85±1.52) vs (6.69±1.84)], bladder capacity [(241.92±29.41) vs (39.62±8.60) mL], maximum urine flow rate [(15.85±1.68) vs (11.39±2.43) mL/s], bladder compliance[(33.92±7.81) vs (23.15±7.82) mL/cmH₂O], and maximum detrusor pressure during the filling phase [(21.77±3.14) vs (30.31±6.81) cmH₂O] were significantly improved (all P<0.001). All patients experienced effective relief of bladder pain after operations, and 5 out of 10 patients with elevated creatinine levels before the operation had their creatinine levels return to normal after the operation.

Total laparoscopic ileum augmentation cystoplasty can effectively improve the lower urinary tract symptoms and urinary bladder storage function caused by contracted ketamine related cystitis, and further protect renal function.

To compare the effect of super fine disposable digital flexible ureteroscope and ordinary disposable digital flexible ureteroscope in the treatment of upper urinary tract stones with diameter <1.5 cm.

From October 2024 to January 2025, 70 patients with diameter <1.5 cm upper urinary tract calculi in our hospital were randomly divided into two groups, 35 patients in 6.3 F sheathless group were treated with 6.3 F HugeMed disposable electronic ureteroscopic laser lithotripsy. In the 7.5 F sheathed group, 35 cases were treated with 7.5 F common disposable electronic ureteroscope laser lithotripsy. The stone free rate, the success rate of the first stage operation, the operation time and the postoperative hospital stay were compared between the two groups.

The operation time of 6.3 F sheathless group was shorter than that of 7.5 F sheathed group, with significant difference (P=0.011). The success rate of the first stage operation was 100% in the 6.3 F sheathless group and 91.43% in the 7.5 F sheathed group, with no significant difference (P>0.05). There were no significant differences in stone free rate, laser working time, hemoglobin decline on the first day after surgery, creatinine increase, postoperative hospitalization days and postoperative complications between the two groups (P>0.05).

It is safe and effective to treat upper urinary tract stones with diameter <1.5 cm by super fine disposable electronic ureteroscope.

To explore the clinical characteristics of ICU treatment requirements and shock occurrence in patients with urosepsis after upper urinary tract stone surgery, identify high-risk factors, and provide evidence for early assessment and precise intervention.

Clinical data of 36 cases who developed urosepsis after PCNL for upper urinary tract stone from January 2020 to June 2023 were retrospectively collected. Demographic characteristics, laboratory and imaging parameters, treatment processes, and outcomes were compared between ICU group (n=7) and non-ICU group (n=29), shock group (n=23) and non-shock group (n=13), as well as non-ICU shock subgroup (n=17) and non-shock subgroup (n=12).

Compared with the non-ICU group, the ICU group had higher preoperative neutrophil count [(6.03±2.39) vs (4.12±1.99)×10⁹/L, P=0.035] and percentage[(70.73%±13.44%) vs (59.12%±12.81%), P=0.042], higher preoperative serum creatinine [177.29 (17.01, 337.57) vs 86.72 (38.71, 134.74) μmol/L, P=0.008], lower postoperative hemoglobin [(91.29±19.52) vs (108.00±16.87) g/L,P=0.030], and lower systolic blood pressure [(95.43±17.94) vs (110.55±16.58) mmHg, P=0.042]. The shock group had significantly higher stone CT values than the non-shock group [(1 170.55±265.55) vs (905.69±302.91) Hu, P=0.010], and a higher proportion of high-density stones (CT value >1 000 Hu)(73.91% vs 30.77%, P=0.012). Hemodynamically, the shock group had lower systolic blood pressure [(100.35±15.99) vs (120.46±12.69) mmHg, P<0.001], higher shock index [(1.25±0.19) vs (0.84±0.10), P<0.001], and higher quick sequential organ failure assessment (qSOFA) score [(2.52±0.51) vs (2.15±0.38), P=0.030]. In the non-ICU group, shock patients had lower preoperative neutrophil count [(3.45±1.31) vs (5.07±2.42)×10⁹/L, P=0.027] and percentage [(54.41%±9.52%) vs (65.78%±14.26%), P=0.016] than non-shock patients.

Abnormal neutrophil count and ratio, renal dysfunction, decreased hemoglobin, and circulatory instability are important indicators for assessing ICU treatment requirements. High stone density, hemodynamic abnormalities, and elevated qSOFA score contribute to early identification of shock risk.

The success of retrograde intrarenal surgery (RIRS) largely depends on the successful placement of a ureteral access sheath (UAS). This study aimed to develop and validate a Logistic regression-based predictive model to assess the risk of UAS insertion failure during primary RIRS, providing a preoperative reference for surgical decision-making.

The data of patients undergoing primary RIRS at the Urology Department of Huadu District People’s Hospital, Guangzhou, from January 2023 to September 2024 were retrospectively analyzed. Patients were divided into success (396 cases, 83.19%) and failure (80 cases, 16.81%) groups based on UAS placement outcomes. Independent risk factors for UAS failure were identified using univariate and multivariate Logistic regression, and a dynamic online nomogram model was constructed. Model performance was evaluated via receiver operating characteristic (ROC) curve analysis, calibration curve, and decision curve analysis (DCA), with internal validation using the Bootstrap method.

Male gender (OR=4.793, P<0.001), younger age (OR=0.963, P=0.004), higher BMI (OR=1.129, P=0.011), absence of ipsilateral ureteral surgical history (OR=0.071, P=0.010), and smaller maximum stone diameter on the operative side (OR=0.890, P<0.001) were identified as independent risk factors for UAS failure. The model demonstrated strong discrimination (AUC=0.811, 95%CI: 0.764-0.859) and calibration (Hosmer-Lemeshow test: χ²=2.871, P=0.942). DCA confirmed its clinical utility, and Bootstrap validation yielded an AUC of 0.804 (95%CI: 0.758-0.850).

Age, gender, BMI, ipsilateral ureteral surgical history, and stone size are associated with UAS failure during primary RIRS. The predictive model constructed based on these factors demonstrates good discrimination, calibration, and net clinical benefit. It can serve as a valuable reference for preoperative surgical plan selection.

To explore the relationship between sodium-glucose cotransporter 2 (SGLT-2) inhibitors and severe urinary tract infections (UTIs) in patients with type 2 diabetes following endoscopic urological surgery.

Retrospective analysis of clinical data from 3 patients with type 2 diabetes who suffered severe infections after endoscopic urological surgery while on long-term SGLT-2 inhibitors, and literature review for a summary analysis of cases with severe urinary tract infections following SGLT-2 inhibitor use.

Two patients underwent transurethral prostate enucleation, and one underwent transurethral ureteroscopy with lithotripsy. All three patients were readmitted within 1-2 months post-surgery due to severe UTIs. One patient required unilateral orchiectomy due to a scrotal abscess from a retrograde genital infection, another patient developed methicillin-resistant Staphylococcus aureus infection, and the third patient had a Candida infection. Nineteen cases of severe UTIs associated with SGLT-2 inhibitors were reported in 18 articles, with six occurring after endoscopic urological surgery, the remaining 13 were hospitalized due to various UTI symptoms, and one patient died due to severe infection.

SGLT-2 inhibitors may increase urinary glucose levels in patients with type 2 diabetes, thereby raising the risk of UTIs following endoscopic urological surgery. It is recommended that type 2 diabetes patients scheduled for endoscopic urological surgery avoid SGLT-2 inhibitors perioperatively to prevent severe UTIs.

To evaluate the effect of the 6-o'clock posterior urethral flap transection technique in transurethral plasmakinetic enucleation of prostate.

The clinical data of patients who underwent transurethral plasmakinetic enucleation of prostate in our hospital from January 2022 to December 2023 were retrospectively analyzed. The patients were divided into two groups according to whether the 6-o'clock posterior urethral flap transection technique was used or not. There were 100 cases in the conventional technique group and 106 cases in the 6-o'clock posterior urethral flap transection technique group, the intraoperative and postoperative outcomes were compared between the two groups.

All cases completed the operation successfully. There was no statistical difference in the baseline data and functional prognosis indicators one month and three months postoperatively between the two groups (P>0.05). However, the 6-o'clock posterior urethral flap transection technique required less operation time than the conventional technique (P<0.001).

The 6-o'clock posterior urethral flap transection technique can reduce the difficulty of surgery, shorten the operation time.

To evaluate the efficacy of the inverted "J" flap helical suture tunnel technique for neomeatus formation and U-shaped stent tube drainage in the treatment of severe hypospadias.

A retrospective analysis was conducted on 25 patients with severe hypospadias who underwent staged hypospadias repair in our hospital from April 2019 to December 2023. All patients first underwent correction of penile curvature (first stage). Six months later, a second-stage tubularized preputial flap urethroplasty was performed. The neomeatus was created using the inverted "J" flap helical suture tunnel technique, and a U-shaped stent tube was used for urinary diversion.

Among the 25 patients, urethrocutaneous fistula occurred in 6 cases (24%). The urethral meatus was located at the tip of the glans in all cases, and the penile appearance was satisfactory.

The second-stage urethroplasty using the inverted "J" flap helical suture tunnel technique for neomeatus formation combined with U-shaped stent tube drainage results in a glanular meatus, is simple to perform, has a low incidence of urethral stricture, and provides satisfactory penile appearance.

To compare the efficacy and safety between robotic-assisted radical prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP) for low or intermediate-risk prostate cancer (PCa).

The data of 70 patients with low or intermediate-risk PCa including 35 patients who received RARP (RARP group) and another 35 patients who received LRP (LRP group) from October 2019 to January 2024 in Urology Department of Shenzhen Second People's Hospital were retrospectively analyzed. Propensity score matching (PSM) was conducted. According to D'Amico risk grouping, all patients were classified as low or intermediate-risk PCa. Both surgical procedures were performed via a transabdominal approach. There were no significant differences between the two groups in the preoperative clinical data including age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, prostate volume, prostate specific antigen (PSA) level, biopsy Gleason score, clinical stage and D'Amico risk grouping (P>0.05). All patients were followed up for at least 12 months. The intraoperative, postoperative parameters and functional recovery of the two groups were compared.

Compared with the LRP group, the RARP group had longer operation time (P<0.05) but less intraoperative blood loss (P<0.05). The continence recovery in the RARP group was significantly higher than that in the LRP group at 1, 2 months after operation (P<0.05). The sexual function recovery of the RARP group was significantly higher than that of the LRP group at 6, 9 and 12 months after operation (P<0.05). All patients recovered continence at 12 months after operation. None of the patients had biochemical recurrence during the follow-up period.

Compared with laparoscopic surgery, robotic surgery can reduce the risk of bleeding in radical prostatectomy for low or intermediate-risk PCa. At the same time, robotic surgery has more advantages in early postoperative continence and sexual function recovery.

To explore the role of colony-stimulating factor-1(CSF-1) and 1,25(OH)₂D₃ in macrophage proliferation and polarization and their impact on the formation of calcium oxalate kidney stones.

Fifteen 8-week-old male CSF-1-deficient C57 mice were randomly divided into three groups: a control group, a CSF-1 induction group, and a 1,25(OH)₂D₃+CSF-1 intervention group. Bone marrow macrophages from each group of mice were cultured. Optical microscopy, flow cytometry, and quantitative real-time polymerase chain reaction were used to detect the number of macrophages and the expression levels of CD206 and CSF-1 receptor mRNA in each group.

The CSF-1 group significantly increased the number of macrophages and the expression of the M2 marker CD206. Although the combined treatment with 1,25(OH)₂D₃ and CSF-1 had a synergistic effect, it was less effective than the CSF-1 induction group.

1,25(OH)₂D₃ and CSF-1 play significant roles in regulating macrophage proliferation and polarization towards the M2 type, and there is an interrelationship between them, which provides a new research direction for the immunomodulation of calcium oxalate kidney stones.

Prostate cancer remains one of the most prevalent malignant tumors in males, with persistently high incidence and mortality rates. In recent years, immunotherapy has emerged as a novel therapeutic approach, demonstrating remarkable efficacy in treating various malignancies and gaining widespread application in prostate cancer. However, it still faces numerous challenges. This review summarizes the primary immunotherapeutic strategies and combination approaches for prostate cancer. Current research emphasizes the necessity to further elucidate the mechanisms of the prostate cancer tumor microenvironment, identify more effective biomarkers, optimize combination regimens, and implement personalized treatment to enhance the safety and efficacy of immunotherapy.

Radical prostatectomy remains the first-line recommended treatment for prostate cancer. Post-prostatectomy urinary incontinence stands as one of the primary complications of this procedure, with multiple contributing factors identified. In response to these risk elements, various modified radical prostatectomy techniques have been utilized in clinical practice. Urethral reconstruction technique is one of them. This article reviews advancements in urethral reconstruction techniques during laparoscopic radical prostatectomy, evaluates their efficacy in restoring postoperative urinary continence, and aims to provide clinicians with surgical alternatives for optimized clinical decision-making.

To report a case of low-grade leiomyosarcoma of the bladder, summarize the clinical diagnosis and treatment process and review relevant literature, then discuss the diagnosis and treatment of bladder leiomyosarcoma to improve the understanding of this disease.

A 35-year-old male patient with low- grade leiomyosarcoma of bladder admitted to Third Affiliated Hospital of Southern Medical University was analyzed retrospectively. He presented with " urinary frequency, urgency, and dysuria for more than one week". The imaging examinations and cystoscopic tumor biopsy were performed, and the pathological diagnosis was low-gradeleiomyosarcoma of the bladder.

After comprehensive consideration, the patient underwent partial cystectomy. Postoperative pathology confirmed low-grade leiomyosarcoma of the bladder. Immunohistochemistry showed that SMA(+), Desmin(+), IMP3 was strongly positive, and the incision margin was negative. The patient was discharged without urine leakage. After two-year follow-up, the patient showed no tumor recurrence.

Leiomyosarcoma of the bladder is a rare malignant tumor with highly invasive and poor prognosis generally. The primary treatment is surgery. Radical resection is the main treatment for high-grade leiomyosarcoma of the bladder, followed by radiotherapy and chemotherapy. Partial cystectomy is feasible for low-grade and small tumors. During surgery, it is crucial to obtain a negative surgical margin of at least 2-3 cm around the tumor.

To report a case of cecovesical fistula, summarize its clinical features and review the literature.

The clinical data of a 67-year-old female patient with cecovesical fistula in the Department of Urology of our hospital in August 2024 were retrospectively analyzed. Relevant literature was consulted to analyze and summarize this type of disease.

The patient presented with fecal-like material during urination and had a history of ascariasis, including expulsion of worms via the urethra. Robot-assisted laparoscopic partial bladder and partial cecal resection were conducted using the Da Vinci system. Postoperative pathology revealed chronic inflammation of the mucosa in the cecovesical fistula tissue.

Cecovesical fistula is a relatively rare clinical condition that often requires a comprehensive evaluation combining patient symptoms, signs, and relevant imaging data for diagnosis. Surgical intervention is usually necessary for treatment.

This paper reports a case of advanced penile cancer. The patient was a 44-year-old male who was admitted to our hospital due to "penile ulceration for 3 months and urinary leakage for over 1 month." Physical examination revealed significant swelling at the distal end of the penis, with the foreskin being non - retractable and exudate from the ulcerated foreskin opening. A mass about 4 cm×3 cm in size, with a firm texture and poor mobility, was visible in the right inguinal region. Enlarged lymph nodes were palpable in both inguinal regions. Imaging examinations suggested penile cancer with multiple lymph node metastases in the bilateral inguinal regions and beside the external iliac artery. After multidisciplinary consultation by Guangdong Urological Association, the expert group recommended completing a comprehensive assessment of the whole body, followed by neoadjuvant therapy and immunotherapy. Then, a total penectomy should be performed, along with inguinal and pelvic lymph node dissection either simultaneously or in stages. The necessity for adjuvant therapy or radiotherapy would be assessed based on the postoperative situation. The patient was informed of the recommendations. After full communication and obtaining informed consent, a partial penectomy was carried out. The postoperative pathology showed non-HPV-related squamous cell carcinoma, poorly differentiated (sarcomatoid squamous cell carcinoma). Following four cycles of adjuvant chemotherapy, the lymph node metastases were significantly relieved. Subsequently, bilateral inguinal lymph node dissection was performed. Regular follow-up examinations after the operation showed no signs of local recurrence or lymph node recurrence and metastasis. This case indicated that for advanced penile cancer, a comprehensive treatment model combining surgical treatment with chemotherapy, immunotherapy, etc., is the key to significantly improving the therapeutic effect.