Urinary dysfunction is a common complication in elderly stroke patients, primarily manifesting as urinary incontinence, dysuria, and urinary retention. It can lead to complications such as urinary tract infections, renal impairment, and bladder stones, induce psychological problems including anxiety and depression, and increase economic burden. Currently, there remains a gap in management guidelines for urinary dysfunction in this population in China. Developing evidence-based guidelines that meet international standards is of great significance for standardizing clinical practice and improving prognosis.Formulated collaboratively by multidisciplinary experts, this guideline adheres to internationally recognized clinical practice guideline development processes, based on the GRADE system and RIGHT reporting standards, while integrating clinical realities. It systematically covers five core domains: classification, assessment, treatment, complications, and follow-up of our country. The guideline aims to provide a standardized diagnostic and therapeutic framework for medical institutions at all levels, optimize the full-cycle management of urinary dysfunction in elderly stroke patients, enhance their quality of life, and reduce the risk of complications.

This article reviews the major academic highlights of the 2025 European Association of Urology (EAU) Congress, focusing on innovations in perioperative management, the restructuring of benign prostatic hyperplasia (BPH) treatment pathways, and the application of precision biomarkers in urological oncology. The congress demostrated a systemic transition of urology from being 'surgery-centered’ to 'continuum of care-centered’, with digital health and telemonitoring, minimally invasive interventions, and liquid biopsy technologies as key driving forces. This review summarizes the academic findings, clinical implications, and policy insights from EAU Congress, aiming to provide valuable references for the advancement of urology in China.

Flexible ureteroscopy is one of the primary methods for treating upper urinary tract stones. In recent years, with the widespread adoption of disposable ureteroscopes and the introduction of new technologies such as tip-bendable and suction sheaths, the indications for ureteroscopy have expanded. Complications have significantly reduced, and the stone-free rate has noticeably improved. With the continuous development of artificial intelligence and robot-assisted technology, in the future, f-URS is expected to further change the treatment strategies for urinary tract stones.

Bladder cancer (BC) is one of the most common genitourinary tumors in China, traditionally diagnosed and monitored through cystoscopy and tissue biopsy, which are considered as the gold standard. However, the invasive nature and high cost of cystoscopy often lead to poor patient compliance, limiting its utility in routine screening. Circulating tumor cells (CTCs), a promising liquid biopsy approach, offer the advantages of being non-invasive, convenient, and cost-effective, with broad applications in early cancer diagnosis, prognostic evaluation, and personalized treatment. Compared to other liquid biopsy methods, CTCs preserve intact cellular information, which holds potential clinical value for predicting prognosis and therapeutic efficacy in patients with bladder urothelial carcinoma. This review systematically summarizes the enrichment and detection techniques of CTCs, explores their clinical applications in the diagnosis and treatment of bladder cancer, and discusses the future prospects and challenges of CTC technology in light of recent research advances.

To independently design a lithotomy position pelvic fixation device for use in patients undergoing transperineal prostate biopsy under local anesthesia, aiming to improve patient cooperation during the lithotomy position surgery and provide an effective tool to reduce adverse reactions associated with prostate biopsies under local anesthesia.

Using convenience sampling, 120 patients undergoing transperineal prostate biopsy under local anesthesia at our hospital's Urology center from July to September 2024 were selected as research subjects. They were divided into control and observation groups of 60 cases each based on their admission order. The control group was positioned in the lithotomy position with leg strap fixation, while the observation group used the independently designed lithotomy position pelvic fixation device. Comparisons were made between the two groups regarding positional changes, biopsy surgery time, incidence of gross hematuria postoperatively, and surgeon satisfaction.

The operation time in the observation group [(9.45±1.31) min] was significantly shorter than that in the control group [(13.37±1.49) min]. Patients using the lithotomy position pelvic fixation device show fewer positional changes during the transperineal prostate biopsy compared to the control group. The incidence of gross hematuria was lower in the observation group compared to the control group. Surgeon satisfaction was higher in the observation group compared to the control group, with all differences being statistically significant (P<0.05).

The application of the lithotomy position pelvic fixation device effectively reduces positional changes caused by fear and pain in patients undergoing transperineal prostate biopsy under local anesthesia, thereby significantly shortening the surgical time. This device demonstrates significant advantages in improving patient cooperation, reducing adverse reactions,and enhancing surgeon satisfaction, making it worthy of further promotion and application in clinical practice.

To explore the feasibility of segmenting benign bulk specimens in vivo and then removing them from a minimally invasive incision without extending the incision during retroperitoneoscopic surgery for upper urinary tract diseases in Urology.

Patients with adrenal benign lesions, non-functional kidney (not caused by tumor or tuberculosis) and renal hamartoma requiring laparoscopic resection of the lesions were selected from January 2023 to December 2024, and a total of 15 patients were included in the study. The dorsal incision was selected as the sample extraction channel. After the dorsal skin incision, Hasson technique was used to establish the retroperitoneal cavity and place the cannula. The adrenal, renal hamartoma and nonfunctional renal lesions were removed according to the routine surgical procedures. In the process of specimen extraction, the specimen is first placed into the "minimally invasive surgery special excision tissue extraction device" (referred to as the bag), and the specimen is processed in sections in the bag. Different extraction strategies were adopted according to the texture of the specimens without extending the incision. The extraction time of specimens was compared and analyzed.

In all cases, specimens were successfully extracted through laparoscopic minimally invasive incision without extending the incision. The success rate of specimen removal through minimally invasive incisions is 100%. Ranked by the time of specimen removal, they were renal hamartoma [9.52 (8.35-10.69) min], adrenal medullary lipoma [9.78 (8.92-10.91) min], adrenal adenoma [15.12 (12.15-17.52) min], multiple nodular hyperplasia of the adrenal gland [15.27 (14.95-15.59) min], and non-functional kidney [23.31 (21.87-24.57) min]. The postoperative follow-up period was 9 to 12 months. No incision bleeding, infection or incisional hernia occurred in all cases. The extraction time of the specimen is related to the volume of the specimen on the one hand, and the texture of the specimen on the other hand. The extraction time of adrenal medullary lipoma and renal hamartoma was the shortest, and the extraction time of adrenal adenoma and adrenal nodular hyperplasia was the middle. The extraction time of non-functioning kidney specimens is the longest.

Benign bulk specimens of the upper urinary tract can be successfully removed through a minimally invasive laparoscopic incision without the need to extend the incision after in vivo segmentation. This method is convenient and feasible and worthy of clinical promotion.

To explore the risk factors and time distribution of pelvic lymph node metastasis after neoadjuvant chemotherapy in different subtypes of prostate cancer.

162 prostate cancer patients who received neoadjuvant chemotherapy in our hospital from January 2017 to January 2020 were selected as the research subjects. According to the cancer gene atlas (TCGA) classifier, they were divided into four molecular subtypes: ERG, ETV1, ETV4, and FLI1, to explore the relationship between molecular typing and clinical characteristics, and analyze the time distribution pattern of pelvic lymph node metastasis after neoadjuvant chemotherapy for prostate cancer with different molecular subtypes. According to whether pelvic lymph node metastasis occurred during the follow-up period, patients were divided into a metastatic group (n=65) and a non metastatic group (n=97). The influencing factors of pelvic lymph node metastasis in patients were analyzed through univariate and multivariate logistic analysis, and a nomogram prediction model was constructed and validated.

The differences in Gleason score, PSA, T stage, N stage, tumor grade, and pelvic lymph node metastasis among patients with different subtypes were statistically significant (P<0.05). Gleason score, PSA, tumor grade, and FLI1 type are independent risk factors for pelvic lymph node metastasis in prostate cancer patients after neoadjuvant chemotherapy (P<0.05). Using independent influencing factors to construct a nomogram prediction model, the model has good discrimination and accuracy. The risk time of total pelvic lymph node metastasis of prostate cancer after neoadjuvant chemotherapy showed a bimodal distribution, and the peak of metastasis was in the 12th month and 30th month after neoadjuvant chemotherapy respectively.

Molecular typing is a influencing factor for pelvic lymph node metastasis in prostate cancer after neoadjuvant chemotherapy, and there is a certain regularity in the time of pelvic lymph node metastasis in different molecular subtypes of prostate cancer after neoadjuvant chemotherapy.

To explore the effects on clinical application of intelligent wireless endoscope in ultra-mini percutaneous nephrolithotomy.

The clinical data of 48 patients with upper urinary tract calculi who underwent ultra-mini percutaneous nephrolithotomy in Tongling People’s Hospital from June 2022 to December 2023 were retrospectively analyzed. According to the type of endoscopy used during the operation, patients were divided into observation group (intelligent wireless endoscopy group) and the control group (traditional high-definition endoscope group). There were 22 cases in the observation group and 26 cases in the control group. The connecting time of endoscopy, operation time, intraoperative blood loss, postoperative hospital stay, surgical complications, stone clearance rate and operator comfort score were compared between the two groups.

All 48 operations were successfully completed without severe bleeding or interventional embolization. The preparation time of laparoscopic connection in the observation group was significantly shorter than the control group [(178.32±13.15)s vs (300.73±17.46)s, P<0.001]. There was no significant difference in operation time, intraoperative blood loss, postoperative hospital stay, surgical complications and stone clearance rate between the two groups (P>0.05). The operation comfort score of the observation group was significantly higher than that of the control group [(3.95±0.49) vs (2.85±0.37), P<0.001].

The application of intelligent wireless endoscopy combined with ultra-fine nephroscope in percutaneous nephrolithotomy shortens the preparation time of surgical instrument connection, improves operator comfort.

To investigate the safety and efficacy of laparoscopic radiofrequency ablation of the sympathetic nerve in the adventitia of the renal artery for refractory hypertension.

Five patients with refractory hypertension in the Second Affiliated Hospital of Soochow University from 2021 to 2024, laparoscopic radiofrequency ablation of renal artery adventitial sympathetic nerve was performed after operator evaluation: laparoscopic retroperitoneal approach, radiofrequency ablation catheter after freeing renal artery, annular ablation along the renal artery wall, radiofrequency lasting for about 10 seconds each time. Postoperative regular follow-up, pay close attention to the complication rate and blood pressure changes.

The age of 5 patients was 18-75 years, of which 4 males and 1 female were diagnosed essential hypertension after perfecting the relevant examination. One patient underwent laparoscopic unilateral adrenal tumor resection combined with sympathetic radiofrequency ablation of the renal artery; the remaining four patients underwent laparoscopic bilateral sympathetic radiofrequency ablation of the renal artery. All 5 patients successfully completed the operation and the follow-up ranged from 1 month to 2 years, and the postoperative pathology of patient with unilateral adrenal tumor resection indicated nonfunctional adenoma. All five patients showed significant improvement in postoperative blood pressure without significant complications.

Laparoscopic sympathetic radiofrequency ablation of renal arteries provides a new exploration for the treatment of refractory hypertension.

To compare the safety and effectiveness of modified direct trocar insertion and Hasson open technique in retroperitoneal laparoscopic surgery to establish a retroperitoneal space.

The data of 205 cases of retroperitoneal laparoscopy performed by the same surgeon from January 2019 to December 2021 were retrospectively analyzed, and the patients were divided into two groups, of which modified direct trocar insertion was performed in 107 patients to establish a retroperitoneal space (group A), and Hasson open technique was performed in 98 patients (group B). The general situation, average insertion time, trocar leakage, insertion related complications, application of analgesic, VAS score, incision infection, and postoperative hospitalization days of two groups were compared.

The retroperitoneal laparoscopic entry time in group A (6.6±1.8 min) was shorter than that in group B (9.7±1.5 min), P<0.001. Trocar leakage was less in Group A compared to Group B (P=0.030). Insertion related complications in group A were fewer than in group B (P=0.039). Both groups had no major bleeding caused by insertion, no serious complications such as kidney, large blood vessels, intestinal injury, or gas embolism.

The modified direct trocar insertion is a fast, safe and effective method for establishing a retroperitoneal space, it is worth promoting in retroperitoneal laparoscopic surgery.

To explore the diagnosis and treatment strategies for ureteral injury after pernicious placenta previa (PPP) with placental implantation, with a focus on analyzing the role and limitations of preoperative retrograde ureteral catheterization, as well as the clinical value of multidisciplinary collaboration.

A retrospective analysis was conducted on the clinical data of a patient with PPP combined with placental implantation who was admitted to the Third Affiliated Hospital of Sun Yat-sen University in May 2024. The incidence of ureteral injury during surgery was compared between patients with preplaced ureteral catheters and those without catheters, and the prevention methods of urinary tract injury during surgery and the standardized operation process of postoperative ureteroscopy were summarized.

Although preoperative catheterization reduces the risk of injury in PPP patients, intraoperative bleeding still leads to ureteral injury caused by accidental ligation. The patient underwent ureteral reimplantation 3 months after surgery and recovered well.

Ureteral injury after dangerous placenta previa surgery is a serious complication. Preoperative placement of ureteral catheter, careful operation during surgery, and timely postoperative management are key factors in reducing ureteral injury. For complex cases, multidisciplinary collaboration and the selection of individualized surgical plans are particularly important.

To explore methods for fertility preservation in prepubertal boys with severe β-thalassemia (β-TM), Ewing's sarcoma, and neuroblastoma.

To preserve fertility, 48 cases of boys (46 with severe β-TM, 1 with Ewing sarcoma, and 1 with neuroblastoma) who underwent right partial orchiectomy (removing 20-30% of the volume) in the pediatric surgery department of the Sixth Affiliated Hospital of Sun Yat-sen University from October 2023 to April 2024. The excised testicular tissue was preserved using slow programmable cryopreservation. Two parallel experiments of testicular tissue freezing in prepubertal crab-eating macaques were conducted to verify the changes in the number of spermatogonia stem cells in resuscitated frozen testicular tissue and fresh testicular tissue.

The average age of 48 patients was (9.63±3.00) years, and BMI was 15.29 (14.37, 16.41) kg/m². All 48 patients successfully completed the surgery with a hospital stay of 2 (2, 3) days, intraoperative blood loss 2 (2, 5) ml,and operation time 70.0 (50.0, 99.5) min. Among them, 3 children had cryptorchidism and underwent orchiopexy during the surgery. One child developed postoperative scrotal hematoma, which improved after antibiotic treatment. Slow programmable cryopreservation was successfully used to preserve testicular tissue for all 48 boys, and the freezing process was uneventful. Compared with fresh testicular tissue, there was no significant change in the number of spermatogonia stem cells in the resuscitated frozen testicular tissue of two prepubertal crab-eating macaques.

For prepubertal boys with severe β-TM, Ewing sarcoma, and neuroblastoma who are candidates for hematopoietic stem cell transplantation (HSCT), partial orchiectomy is performed on one side and the testicular tissue of the child is preserved, leaving hope for them to have offspring in adulthood.

To investigate the nursing experience of postoperative complications such as rectal fistula, peritoneal infection, urethral anastomotic fistula, intermuscular venous thrombosis of both legs, separation of skin and mucosa after radical prostatectomy with robot-assisted laparoscopy.

The clinical data of a patient with multiple complications after radical robot-assisted laparoscopic prostatectomy were retrospectively analyzed. The patient was diagnosed with prostate cancer on August 18, 2023, and underwent robot-assisted laparoscopic radical prostatectomy on September 27, 2023. Rectal fistula occurred on the 3rd day after surgery, complicated with abdominal infection, urethral anastomotic fistula on the 6th day after surgery, followed by intramuscular venous thrombosis of both legs (acute stage) and separation of the skin and mucosa of the stoma. Nursing points include close observation of patients' abdominal drainage, body temperature and other changes, alert to complications, active thrombolysis and lower limb deep vein thrombosis care, timely assessment of patients' nutritional status, and formulation of individualized nutrition programs, standardized stoma care throughout the whole process, personalized psychological care, in order to ensure patients' physical and mental health.

The patient recovered and was discharged 37 days after surgery. Three months after surgery, a follow-up examination showed that the venous thrombosis in both lower limbs was organized, the stoma function was good, and the albumin level was 38.6g/L.

Radical prostatectomy is traumatic, complicated and prone to complications. For patients with multiple complications and complicated conditions, medical care should closely observe the changes of the condition, adhere to multidisciplinary diagnosis and treatment, integrate the advantages of multiple disciplines, and formulate an individualized treatment plan, so as to maximize the long-term benefits of patients.

This study aimed to investigate risk factors for urinary infection in patients with negative preoperative urine culture after percutaneous nephrolithotomy (PCNL) and to develop a predictive model to assist clinicians in preoperative assessment of infection risk.

278 patients with negative preoperative urine cultures who underwent PCNL in our hospital from January 2020 to December 2023 were included. Clinical data, including age, sex, body mass index (BMI), diabetes, hypertension, stone characteristics, hydronephrosis, and intraoperative parameters were collected. Multivariate logistic regression analysis was performed to identify independent risk factors for postoperative urinary infection. A predictive model was subsequently constructed based on these factors.

The incidence of postoperative urinary infection was 11.9% (33/278). Univariate analysis revealed that female sex, larger stone burden, hydronephrosis, and positive urine white blood cells (WBCs) were significantly associated with postoperative urinary infection (P<0.05). Multivariate analysis identified stone burden≥500 m² (OR=3.07, P=0.035), hydronephrosis (OR=1.34, P=0.034), and positive urine WBCs (OR=31.50, P<0.001) as independent risk factors for postoperative urinary infection. The predictive model demonstrated excellent discriminatory performance, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.89.

Patients with negative preoperative urine culture remain at risk of postoperative infection following PCNL, particularly those with larger stone burden, hydronephrosis, or positive urine WBCs. The predictive model provides clinicians with a practical tool for preoperative infection risk stratification.

A laparoscopic novel dual-channel smoke evacuation device was designed, and its smoke exhaust effect was verified.

In the in vitro transparent laparoscopic simulation box, the chicken fat was grasped by ultrasonic knife and bipolar electrocoagulation forceps, and the novel dual-channel smoke evacuation device installed group (study group) and the traditional smoke extraction device installed group (control group) were compared. The smoke particle count in the simulated box was measured. The laparoscopic lens was used to observe the experimental operation at different distance, and the number of times the lens contaminated during 100 operations was recorded.

In the smoke evacuated experiment, the number of particles measured in the study group about 0.3 μm particles [(1 329 247 ± 159 800) vs (24 123 431 ± 9 366 698), P=0.006], 0.5 μm particles [(339 856 ± 96 857) vs (3 037 262 ± 1 038 992), P<0.001], and 1.0 μm particles [(60 542 ± 38 500) vs (779 007 ± 96 318), P<0.001], 2.5 μm particles [(4 938 ± 1 938)vs (89 846 ± 20 408), P<0.001], 5.0 μm particles [(1 365 ± 414) vs (42 649 ± 8 489), P<0.001], 10.0 μm particles [(36 ± 17) vs (2 797 ± 1 094), P<0.001] were significantly lower than those in the control group. In the experiment of lens anti-pollution effect, the number of contaminated operations observed by the study group at middle distance (5 cm) (13/100 vs 27/100 times, P=0.013) and the number of contaminated operations observed by the lens at close distance (3 cm) (18/100 vs 40/100 times, P<0.001) were significantly fewer than those in the control group.

The novel dual-channel smoke evacuation device can effectively evacuate smoke and maintain a clear surgical field of view during laparoscopic surgery.

Nutcracker Syndrome (NCS) is a condition characterized by a variety of symptoms caused by the compression of the left renal vein by the angle between the abdominal aorta and the superior mesenteric artery or the spine. The clinical manifestations of NCS are diverse and lack specificity. Although advancements in the diagnosis and treatment of NCS, controversies remain regarding its diagnostic criteria, treatment approaches, and surgical indications. This article reviews recent progress in the diagnosis and treatment of NCS, highlights the role of advances in surgical techniques in providing more treatment options for patients, and serves as a reference for clinicians.

Percutaneous nephrolithotomy plays an important role in the treatment of upper urinary tract calculi. With the continuous development of technology, more and more scholars begin to pay attention to the influencing factors of renal function deterioration after percutaneous nephrolithotomy, including preoperative influencing factors: urinary tract infection, hypertension, diabetes, proteinuria, serum creatinine, etc; intraoperative influencing factors: channel size, number of channels, surgical time, intraoperative hypotension, etc; postoperative influencing factors: bleeding, etc. This review synthesizes current evidence on perioperative determinants of renal function deterioration after PCNL, aiming to provide guidance for clinical prevention and management of this complication.

The reported incidence of pleural effusion after percutaneous nephrolithotomy (PCNL) ranges from 2% to 16%, primarily attributed to pleural injury, extravasation of irrigation fluid, or absorption syndrome. Identified risk factors include renal pelvic pressure >40 cm H₂O during surgery, prolonged irrigation time, complex stones (multiple or large), supracostal access (particularly via the 11th or 12th intercostal space), medially or cranially located puncture sites, and a narrow costovertebral angle. Preventive strategies include maintaining low irrigation pressure (100-200 mmHg, equivalent to 136-270 cmH₂O), ensuring unobstructed outflow, selecting safer subcostal access routes (e.g., lateral to the scapular line, below the 10th rib), puncturing at end-expiration, intraoperative ultrasound guidance, and preoperative CT-based anatomical assessment. For treatment, conservative observation is appropriate for small effusions, moderate effusions may be managed by thoracentesis, and large or symptomatic effusions require closed thoracic drainage, with adjunctive human albumin administration if necessary to promote absorption.

Prostate cancer (PCa) is a malignant tumor with high incidence and mortality rates worldwide. Its insidious early symptoms make early screening and diagnosis crucial. This review systematically elaborates on the common methods and latest research advances in early screening for PCa. Traditional methods such as digital rectal examination (DRE) and prostate-specific antigen (PSA) testing, while widely used clinically, have limitations including high operator dependence and insufficient specificity, potentially leading to missed diagnoses or overdiagnosis. In recent years, significant progress has been made in imaging techniques. Multiparametric magnetic resonance imaging (mpMRI) has become a cornerstone for evaluating suspicious lesions and guiding targeted biopsies. Derived technologies of transrectal ultrasound (TRUS), such as superb microvascular imaging (SMI), contrast-enhanced ultrasound (CEUS), and elastography, have significantly improved diagnostic efficacy through multimodal fusion. Positron emission tomography/computed tomography (PET/CT), particularly prostate-specific membrane antigen (PSMA)-targeted PET/CT, shows great potential in precise staging and detection of metastatic lesions. Meanwhile, emerging biomarkers such as the prostate health index (PHI), 4Kscore, urinary non-coding RNAs (e.g., PCA3), and circulating tumor DNA (ctDNA) from liquid biopsies provide new avenues for non-invasive and precise risk stratification and personalized diagnosis and treatment. Furthermore, risk prediction models based on molecular characteristics and radiomics are advancing PCa management towards personalized medicine.

This article reports a case of primary muscle-invasive urothelial carcinoma of the bladder diagnosed in a male patient 9 years after allogeneic kidney transplantation. The patient presented with a one-week history of painless gross hematuria. Computed tomography (CT) and magnetic resonance (MR) imaging revealed a space-occupying lesion at the bladder base and right wall. Pathological examination following transurethral resection of the bladder tumor (TURBT) indicated high-grade invasive urothelial carcinoma. Given the patient's long-term immunosuppressive therapy, multiple comorbidities (particularly severe cardiac dysfunction), and inability to tolerate radical cystectomy or standard chemotherapy, monotherapy with the antibody-drug conjugate (ADC) disitamab vedotin (RC48) was initiated. A multidisciplinary consultation organized by the Guangdong Urological Association concluded that the patient was not a surgical candidate and was unsuitable for combined immunotherapy. It was recommended to switch the immunosuppressive regimen to sirolimus, which has potential antitumor effects, and to perform genetic testing to guide further targeted therapy. After communication with the patient and family, treatment with disitamab vedotin was continued. After the 11th cycle, a second cystoscopy with pathological biopsy of the original tumor site and margins showed no residual carcinoma, indicating a pathological complete response. The treatment was well-tolerated with alopecia as the only notable adverse event. This case suggests that disitamab vedotin monotherapy is a promising and effective option for renal transplant recipients with muscle-invasive bladder cancer who are ineligible for standard treatments due to poor general condition.