Prostate cancer is one of the most common malignant tumors in the male urogenital system, and its early and accurate diagnosis is crucial for clinical decision-making. Pathological imaging is the gold standard for diagnosing prostate cancer, and recent advancements in artificial intelligence (AI) technologies have significantly improved the analysis of pathological images. These innovative techniques permeate the entire process of prostate cancer pathological diagnosis, demonstrating broad application prospects. This paper systematically reviews the applications and performance of AI models in clinical tasks such as pathological image segmentation and risk stratification for prostate cancer, discusses the advantages and limitations of AI technologies, and looks ahead to future research directions.

Prostate cancer is one of the most common malignancies among males worldwide. Accurate assessment of lymph node status and optimization of surgical scope are essential for improving patient outcomes. Traditional imaging technologies lack the sensitivity for real-time guidance and micrometastasis detection. Near infrared (NIR) fluorescence imaging provides advantages such as non-invasiveness, high sensitivity, deep tissue penetration, and real-time visualization, which can significantly enhance the efficiency of lymphatic tissue imaging and pathological diagnosis in prostate cancer. While non-specific dyes like indocyanine green (ICG) are widely used, but lack tumor specificity. NIR probes targeting prostate-specific membrane antigen (PSMA) can accurately detect cancerous lymph nodes and micrometastases, supporting surgical navigation and personalized therapy. This emerging approach that integrates targeted strategies with NIR-II imaging not only ensures specificity but also overcomes the limitations of NIR-I in tissue penetration depth and signal-to-noise ratio. When combined with artificial intelligence (AI)-assisted pathological analysis, these advances may enhance the detection of small metastatic lesions and facilitate precision medicine in prostate cancer.

In recent years, the application of artificial intelligence (AI) in the medical field has made rapid progress. AI can assist doctors in making faster and more accurate decisions in diagnosis, treatment, and patient management through its powerful data processing and analysis capabilities. Urinary calculi is a common disease in urology, and the colic caused by them is one of the most common emergencies in clinical practice. Timely and accurate diagnosis and reasonable treatment plans are needed. This article elaborates on the imaging diagnosis, efficacy prediction, intraoperative assistance, patient management and monitoring, as well as the challenges faced by AI in urinary calculi.

Renal cell carcinoma (RCC), a prevalent urological malignancy globally, has seen significant shifts in its therapeutic strategies in recent years. With advancements in minimally invasive surgery, robotic-assisted systems have become crucial tools in partial nephrectomy for RCC. This review discusses the use of robotic technology in RCC partial nephrectomy, summarizing its advantages, practical techniques, clinical efficacy, challenges, and future perspectives.

Bladder cancer (BC) is a major global public health concern and a leading cause of cancer-related mortality. This study aimed to analyze global, regional, and national epidemiological trends of BC from 1990 to 2021 and to predict future trends through 2050.

Data from the Global Burden of Disease (GBD) 2021 study were used to evaluate BC incidence, mortality, and disability-adjusted life years (DALYs) between 1990 and 2021. Predictions through 2050 were conducted using statistical modeling, key risk factors and the burden of BC across regions with varying social-demographic index (SDI) levels were analyzed.

In 2021, there were 540 309.73 (95%UI: 494 720.89-582 579.44) new BC cases and 221 888.32 (95%UI: 200 567.17-242 326.46) deaths globally, resulting in 4 397 066.63 (95%UI: 4 063 656.74-4 813 655.42) DALYs. The highest incidence was observed in the Lebanese Republic, while Mali reported the highest mortality rate. Most cases and deaths occurred in high and high-middle SDI regions. Although the absolute numbers of incidence and deaths have increased over the past three decades, the age-standardized incidence rate (ASIR), mortality rate (ASMR), and DALYs rate (ASDR) have generally declined. Future predictions indicate continued global declines in ASIR, ASMR, and ASDR through 2050. Smoking and elevated fasting plasma glucose were identified as the primary risk factors.

The burden of bladder cancer varies significantly across regions and countries, highlighting the need for tailored prevention strategies. Reducing smoking and managing blood glucose levels help to lower BC incidence and mortality.

Using intelligent bladder management system to build urinary control standardized wards, standardize the management of patients, and improve the efficiency of patients' rehabilitation.

The Xiaoyu bladder management system platform was constructed and a departmental healthcare team system was created. The intelligent system was used to manage patients with lower urinary tract dysfunction from pre-hospitalization to perioperative period to discharge from September 2023 to June 2024 in our hospital. The results of patient compliance, patient satisfaction, patient quality of life, and physician satisfaction were analyzed.

A total of 172 patients registered the Xiaoyu bladder management system, of which 111 patients (64.53%) used the pre-hospitalization-perioperative-discharge system to record urination diaries. 69 patients (40.12%) used the system to record perioperative urination diary, free urine flow rate and residual urine volume in the bladder. 57 patients (33.14%) used the system to record urination diaries, complete rehabilitation training according to the system push content, and complete health education content learning and questionnaire surveys within 1 month after discharge. Compared to patients without the management system, there were statistically significant improvements in patient satisfaction and quality of life at 1-month post-discharge (P<0.05). Doctors' satisfaction score with the nursing team increased from (8.73±1.10) points to (9.80±0.42) points, the difference was not statistically significant (P>0.05).

The intelligent urinary control standardized ward and patient management system realizes the standardized management of urination data, improves the rehabilitation training effect of patients, greatly improves patient satisfaction, and enhances the tacit understanding between the medical team.

To explore the effectiveness of transurethral lithotomy of bladder calculus in high-risk anesthesia patients under local anesthesia (LA).

The clinical data of 30 bladder calculus patients underwent transurethral lithotomy using ureteroscope under LA in the Department of Urology, Nanjing Drum Tower Hospital from September 2021 to May 2024 were collected. The general clinical data (age, gender, ASA grade, stone number, stone size, comorbidity) and postoperative clinical data (surgical time, blood loss, postoperative hospital stay, postoperative complications) were analyzed. The surgical effects were evaluated by analysing the Visual Analogue Scale (VAS) scores at various stages of the procedure during local anesthesia, as well as the stone-free rate (SFR).

30 cases of primary transurethral lithotomy of bladder calculus under LA were completed, including 29 males and 1 female. The operation time was (69.00±24.73) minutes, the blood loss was (4.00±3.21) ml, and the postoperative hospital stay was (2.41±1.40) days. At each stage of procedure, the VAS was (1.73±0.64) for ureteroscopy, (3.43±0.77) for holmium laser/pneumatic ballistics lithotripsy, (2.33±0.84) for placement of sheath, (1.80±0.76) at 1 h after operation and (1.33±0.71) at 8 h after operation. The lithotripsy had the highest score of pain, and the placement of sheath followed. Postoperative complications included 5 cases of gross hematuria, 3 cases of nausea and vomiting, and 2 cases of fever. None serious complications like septic shock were observed. The SFR of patients was 93.33%(28/30).

After strict preoperative assessment and adequate preparation, transurethral lithotomy of bladder calculus can be attempted for patients with high-risk anesthesia.

To investigate the diagnostic value of an extracellular volume (ECV) model integrating intratumoral(I) and peritumoral (P) regions (ECV-IP) for prostate cancer (PCa), and to validate the mechanism by which peritumoral ECV (ECV-P) indirectly drives malignant progression via modulation of the intratumoral microenvironment.

A retrospective study was conducted on 117 patients with prostatic disease, 63 cases of benign prostatic hyperplasia (BPH), 54 cases of PCa, the age of patients was (69.67±8.64) years. Imaging parameters including intratumoral apparent diffusion coefficient (ADC-I), peritumoral apparent diffusion coefficient (ADC-P), intratumoral extracellular volume (ECV-I), ECV-P, ECV-IP were compared. Diagnostic performance was evaluated using binary logistic regression modeling, receiver operating characteristic (ROC) curves with DeLong's test, 5-fold cross-validation, and the underlying mechanism was assessed via bootstrap-mediated effect analysis (5 000 resamples).

The ECV-IP model achieved an AUC of 0.883 (95%CI: 0.800-0.941) for PCa diagnosis, with a sensitivity of 87.2% and a specificity of 83.0%. It demonstrated significantly superior diagnostic performance compared to single-region parameters (ECV-I: AUC=0.854, P=0.017; ADC-I: AUC=0.797, P=0.032), PSA (AUC=0.775, P=0.002), and the ADC-IP model (AUC=0.810, P<0.001). Cross-validation demonstrated robust performance: training set (AUC=0.865, accuracy=85.6%); test set (AUC=0.889, accuracy=70.6%). ECV-P was significantly lower in PCa than BPH [0.28 (0.17, 0.38) vs 0.36 (0.25, 0.49), P=0.045] and showed a positive correlation with intratumoral ADC-I (r=0.278, P=0.007). A 1-unit increase in ECV-P increased ADC-I by 256.945×10^-6mm²/s (P=0.027). A decrease of 100×10^-6 mm²/s in ADC-I increased malignant risk (β=-0.001, P<0.001).The indirect effect of ECV-P on PCa progression mediated by ADC-I was significant (β=-0.294, 95%CI: -0.626 to -0.049, P=0.048; proportion mediated: 59.2%). The direct effect of ECV-P on PCa was non-significant (P=0.366). This validates that ECV-P indirectly drives malignant progression of tumors by down-regulating the diffusion of water molecules.

The ECV-IP model, as a dual-region approach, significantly enhances PCa diagnostic accuracy over conventional single-region parameters and PSA.This study provides the first imaging-based validation of the "ECV-P leads to the malignant progression of PCa by influencing ADC-I" indirect regulatory mechanism, establishing ECV-IP as a novel non-invasive biomarker for targeting the prostate cancer tumor microenvironment.

To investigate whether the positive expression levels of androgen receptor (AR) were different between the internal spermatic veins vascular smooth muscle cells in patients with varicocele (VC) and that of normal internal spermatic veins vascular smooth muscle cells in the control group without VC, and whether there were differences of the serum testosterone (ST) level between VC groups and control group. To provide a theoretical basis for further exploring the pathogenesis and treatment of VC.

From December 2009 to January 2025, 58 left internal spermatic veins of patients with VC (grade Ⅱ group 28, grade Ⅲ group 30) and 26 normal left internal spermatic veins of males without VC, as well as the ST level of each study subject were collected. The AR positive ratio (APR) of the internal spermatic veins vascular smooth muscle cells was detected by immunohistochemistry.The level of ST was detected by chemiluminescent immunoassay. The APR and ST were compared and analyzed in three groups.

The APR of the internal spermatic veins vascular smooth muscle cells in VC groups (grade Ⅱ group, grade Ⅲ group) were significantly lower than that of the control group (P<0.05), the APR of the internal spermatic veins vascular smooth muscle cells in VC III group was significantly lower than that of VC II group (P<0.05). There was no significant difference of ST levels between three groups (P>0.05).

VC did not affect the ST level of the patients. The APR in internal spermatic veins vascular smooth muscle cells of patients with VC was significantly lower than that of controls without VC, and there was a significant negative correlation with the severity of VC.

Based on the genome-wide association study (GWAS) database, this study utilized R software to explore the causal association between type 2 diabetes mellitus (T2DM) and erectile dysfunction (ED).

Open genomic data for T2DM (ebi-a-GCST005047) and ED (ebi-a-GCST006956) were downloaded from the GWAS database. After selecting meaningful instrumental variables (IVs), two sample MR analysis was conducted to apply the "TwoSampleMR" package in R software by using inverse variance weighted (IVW), weighted median, MR-Egger regression and weighted mode method.

We selected 24 significant single nucleotide polymorphisms as IVs from the GWAS dataset of T2DM. The IVW results revealed the causal association between T2DM and ED (OR=1.208, 95%CI: 1.088-1.340, P<0.001). The weighted median method provides evidence of a causal association between T2DM and ED (OR=1.254, 95%CI: 1.092-1.441, P=0.001). MR-Egger regression showed that horizontal pleiotropy was unlikely to affect the outcome (P=0.973). The Cochran's Q-test did not show heterogeneity (P>0.05), and the funnel plot did not show asymmetry, further confirming the credibility of the study.

The results of MR analysis support that T2DM may have a causal association with the increased risk of ED.

To compare the application of two single-layer approaches in retroperitoneal laparoscopic adrenalectomy for adrenal tumors.

The data of patients with retroperitoneal laparoscopic adrenalectomy procedures performed in our hospital from June 2016 to June 2023 were retrospectively analyzed. Patients were divided into two groups based on the surgical procedure. Group A, which underwent complete resection of the adrenal gland; group B, which underwent partial resection with preservation of the adrenal gland. The patients were further classified into two subgroups based on the surgical approach: approach one, which involved the renal surface layer, and approach two, which was between the perirenal fat and the anterior layer of the renal fascia. Among them, group A had 64 cases in approach one and 56 cases in approach two. Group B had 47 cases in approach one and 42 cases in approach two. A comparison was made between the two groups regarding gender, age, BMI, tumor diameter, surgical time, hospital stay, intraoperative blood loss, time to first flatus (indicating postoperative gastrointestinal recovery), drainage volume, time to removal of drainage tube, and surgical complications.

All operations were successful. In group A, there were no statistically significant differences between approach one and approach two in gender, age, BMI, tumor diameter, length of hospital stay, intraoperative blood loss, time to drainage tube removal, incidence of complications (P>0.05). However, there were statistically significant differences in terms of surgical time, time to postoperative gastrointestinal recovery, drainage volume (P<0.05). In group B, there were no statistically significant differences in gender, age, BMI, tumor diameter, length of hospital stay, postoperative gastrointestinal function recovery time, postoperative drainage volume, incidence of complications between the two approaches (P>0.05); however, there were statistically significant differences in terms of surgical time and intraoperative blood loss between the two approaches (P<0.05).

In retroperitoneal laparoscopic adrenalectomy for complete resection of the adrenal gland, the approach one can reduce surgical time, time to postoperative gastrointestinal recovery, and drainage volume. In retroperitoneal laparoscopic adrenalectomy with partial resection and preservation of the adrenal gland, the approach two can reduce surgical time and blood loss.

To summarize the diagnosis and treatment of adrenal crisis after unilateral adrenal surgery.

The clinical data of 12 patients with adrenal crisis after adrenal surgery from January 2018 to June 2023 in our hospital were retrospectively analyzed.

Among the 12 patients, there were 1 case of adrenal hyperplasia, 2 cases of aldosteronomas, 1 case of adenoma with Cushing's syndrome, 7 cases of non-functional adenomas, 1 case of adrenal cyst with hemorrhage. All patients underwent laparoscopic unilateral adrenal surgery, with 11 cases of adrenal resection and 1 case of adrenal tumor resection. Adrenal crisis occurred within 48 hours after surgery in all patients. All patients were cured and discharged after treatment with glucocorticoid supplementation, fluid resuscitation and correction of electrolyte disturbances.

Adrenal crisis can occur after unilateral adrenalectomy regardless of tumor functionality, with the high-risk period being within 48 hours postoperatively. Early recognition and timely treatment lead to favorable prognosis.

To discuss the design and practical effect of the urology specialist nurse training system, and provide a reference for cultivating urology specialist nurses.

In order to improve the core competence of urology specialist nurses, the training content of urology specialist nurses is set up from six aspects: clinical practice, clinical thinking, nursing education, nursing research, nursing management and nursing humanities. Including 140 hours of theoretical teaching and 280 hours of clinical practice. After the training, the theory, clinical practice, and scientific research ability will be assessed. The core competence of specialist nurses is also used for self-evaluation to investigate the core competence of the trainees before, during and after the training.

After training, all trainees achieved a 100% pass rate in theoretical knowledge, clinical skills, and scientific research. After the training, the total score of nurses' core competence was (106.10±16.31) points. Compared with the pre-training, the core competence scores and total scores of all dimensions were improved (P<0.05).

The preliminarily constructed urology specialist nurse training system has a significant effect on improving the theory, clinical practice, scientific research ability and thinking ability of urology specialist nurses. In the future, combined with professional development and training experience, we will continue to improve the training of specialist nurses in urology.

To investigate the role and mechanisms of SOAT1 gene expression in the development and progression of prostate cancer.

The expression of the SOAT1 gene was analyzed based on TCGA datasets and validated in prostate cancer cell lines. The correlation between SOAT1 gene expression and patient prognosis in prostate cancer was assessed through gene expression, methylation levels, and survival analysis. A gene knockout cell line was established using CRISPR-Cas9 technology, and gene expression levels were verified by Western blot. Cell proliferation and migration abilities were analyzed using MTS, colony formation, and transwell assays. The role and molecular mechanisms of SOAT1 in prostate cancer cells were further investigated through quantitative real-time polymerase chain reaction, Western blot, high-resolution mass spectrometry, and cellular energy metabolism experiments.

SOAT1 expression was upregulated in prostate cancer tissues (P<0.05), and high SOAT1 expression was associated with decreased patient survival. SOAT1 expression was not regulated by the androgen receptor signaling pathway and was unrelated to the process of acquired castration resistance (P>0.05). Knockout of SOAT1 inhibited prostate cancer cell proliferation by reducing mitochondrial metabolism (approximately 45% decrease in oxygen consumption and 55% reduction in production of adenosine triphosphate), independent of the androgen metabolic pathway.

Targeted knockout of SOAT1 can inhibit prostate cancer cell proliferation, epithelial-mesenchymal transition (EMT), and tumor stemness by reducing mitochondrial metabolism, suggesting its potential as a therapeutic target.

Against the backdrop of China's escalating population aging, the incidence of prostate cancer is rising significantly, leading to an increasing disease burden. Prostate-specific antigen (PSA) screening is currently an effective method for improving early diagnosis rates and patient prognosis. However, there is a lack of large-scale, prospective studies in China to guide the development of screening strategies. This article analyzes the impact of population aging on healthcare economics, describes the current status and trends of the prostate cancer disease burden, and combines the latest evidence on PSA screening from both domestic and international sources to conduct an in-depth discussion on the necessity, and existing models of PSA screening in China. It also emphasizes that when developing screening strategies, the disease burden brought about by aging and health economic benefits must be fully considered. This article aims to provide a reference for the development of an individualized prostate cancer screening program that aligns with China's national conditions and considers cost-effectiveness, thereby helping to improve the overall diagnosis and treatment level of prostate cancer in China and improve patient survival and quality of life.

Calyceal diverticulum is a relatively rare congenital renal malformation with an incidence of 0.21%-0.45%, frequently accompanied by stone formation, which may cause pain, hematuria, or recurrent urinary tract infections. Treatment options include extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy (PCNL), flexible ureteroscopic lithotripsy (FURL), laparoscopic surgery, and traditional open surgery. With advances in minimally invasive techniques, PCNL and FURL have become the primary treatment modalities, though optimal surgical selection remains controversial. The advantages of PCNL including high stone clearance rates (87.5%-100%) and diverticular closure rates (76%-100%) through diverticular wall fulguration or neck incision, but carries risks of bleeding, renal parenchymal injury, and prolonged recovery. FURL demonstrates minimal trauma, rapid recovery, and reduced postoperative inflammatory response with high stone clearance rates, particularly suitable for stones <2 cm in the upper-middle calyces, though challenging for lower calyceal or narrow-necked diverticula. This article aims to review the progress in minimally invasive treatment of calyceal diverticulum stones.

Varicocele is the most common cause of male infertility, while varicocele with thrombosis is extremely rare. This article reports two cases of varicocele with thrombosis, one with thrombosis secondary to varicocele and the other with an uncertain temporal sequence, and explores the underlying mechanism based on these cases. For treatment, there is no evidence that conservative anticoagulation or surgical treatment is preferable, but surgical treatment is preferentially recommend.

This article reports the diagnosis and treatment process of a patient with bladder diverticulum carcinoma. The patient presented to a local hospital in May 2023 with recurrent gross hematuria. Imaging studies suggested a mass in the diverticulum of the right bladder wall, and cystoscopic biopsy pathology revealed high-grade non-invasive papillary urothelial carcinoma. The patient underwent open partial cystectomy. Postoperative pathology indicated muscle-invasive urothelial carcinoma, but no further treatment was received initially. Subsequently, the patient visited our hospital, repeated contrast-enhanced CT, MRI, and cystoscopy showed no definite evidence of residual tumor. However, based on literature review, perioperative data, and the possibility of extravesical extension not being ruled out, radical cystectomy was recommended. But the patient strongly desired bladder preservation and therefore received three cycles of immunotherapy with toripalimab. Follow-up examination in September of the same year revealed thickening and enhancement of the right bladder wall on routine imaging. A multidisciplinary consultation on difficult cases in Guangdong Urological Association was conducted, the experts suggested that based on the comprehensive examination results, residual tumor and lymph node metastasis could not be excluded. The diagnosis was high-grade bladder diverticulum carcinoma, which is highly malignant and may involve early invasion of the bladder wall layers. The case did not meet the recommended criteria for bladder-preserving therapy, and there were signs of progression even after immunotherapy. Therefore, it was recommended to perform a PET-CT scan and proceed with radical cystectomy as soon as possible. Subsequent treatment (including radiotherapy, chemotherapy, or immunotherapy) would depend on the postoperative pathology, and close follow-up was necessary. After careful consideration, the patient returned to the hospital and underwent robot-assisted laparoscopic radical cystectomy. Intraoperatively, a frozen pelvis was found on the right side, and frozen section pathology confirmed metastasis to the right pelvic lymph nodes and invasion of the pelvic wall. An ileal conduit urinary diversion was subsequently performed. Postoperative immunohistochemical pathology confirmed regional urothelial carcinoma in situ of the bladder, with metastasis to the pelvic lymph nodes and pelvic wall. This case suggests that postoperative recurrence in bladder diverticulum carcinoma may not be local and could involve distant metastasis. Bladder-preserving therapy should be reserved for selected, suitable patients with favorable profiles, and should not be pursued blindly.