Single-port robotic adrenalectomy offers advantages over conventional laparoscopic surgery in terms of reduced postoperative pain and superior cosmetic outcomes, however, there is currently no unified standard for surgical protocols or patient selection criteria either domestically or internationally. This consensus was based on a review of 108 Chinese and English publications and a standardized questionnaire survey involving 45 senior urology experts from 40 tertiary hospitals across China. It provides systematic recommendations covering preoperative evaluation, surgical approaches, equipment and instruments, key procedural steps, complication management, and surgeon training. The consensus recommends that a maximum tumor diameter of <5 cm as the primary indication. Tumor size, location, and patient obesity are important factors affecting the difficulty of single-port surgery, and the transperitoneal approach is preferable for relatively large or inferiorly located tumors. Key operative points for the single-port robotic adrenalectomy are specified. A graded management strategy is proposed for complications, including hemorrhage, visceral injury, incisional hernia, and adrenal insufficiency. This consensus aims to standardize clinical workflows, reduce complication risks, and lay a foundation for the broader adoption of this technique and for future high-quality clinical research.

Urethral catheterization is one of the most fundamental routine clinical procedures. Males are more prone to difficult catheterization due to the anatomical characteristics of the urethra. Blind manipulation may cause iatrogenic urethral injury and long-term urethral stricture, yet unified domestic standards are currently absent in China. Based on the GRADE evidence grading system, combined with domestic and international evidence-based medical data and the actual clinical practice in China, the consensus on the management of difficult male urethral catheterization has been formulated. This consensus clarifies the standardized definition and three-tier clinical grading criteria for difficult male urethral catheterization, and systematically sorts out risk factors including benign prostatic hyperplasia, urethral stricture, pelvic trauma and iatrogenic manipulation. It standardizes preoperative assessment and tiered procedural workflows, and recommends a stepwise management algorithm consisting of conventional catheterization, coude catheterization, guidewire-assisted catheterization, endoscopic-guided catheterization, and suprapubic puncture cystostomy. Strategies for the prevention and treatment of complications such as hemorrhage, false passage, infection and secondary urethral stricture are elaborated in detail, and tiered training for medical staff, procedural quality control and consultation protocols are also proposed. The consensus emphasizes that non-urological practitioners shall promptly refer patients to specialized urologists when encountering high-risk scenarios such as catheter resistance or hematuria, to avoid repeated forceful catheterization. This consensus provides unified, actionable guidance for medical staff at all levels of medical institutions to manage difficult male urethral catheterization, standardizes clinical workflows, and lowers the risk of urethral injury caused by inappropriate catheterization operations.

Upper tract urothelial carcinoma (UTUC) is a relatively uncommon but highly aggressive malignancy of the urothelial tract. Radical nephroureterectomy has traditionally been regarded as the standard treatment. However, this procedure inevitably results in loss of functional renal units and is associated with an increased risk of chronic kidney disease and related complications. With continuous advances in imaging modalities, endoscopic technologies, and risk stratification systems, kidney-sparing treatment has gradually evolved from a "passive alternative" into an evidence-based therapeutic strategy for selected patient populations. In recent years, beyond conventional kidney-sparing approaches such as endoscopic ablation and segmental resection, novel multimodal strategies integrating perioperative systemic therapy-particularly antibody-drug conjugates combined with immunotherapy-with local treatment have emerged. These approaches offer new possibilities for achieving oncologic control while preserving renal function in selected patients with high-risk UTUC. This review summarizes current domestic and international evidence on kidney-sparing management of UTUC, with a focus on risk stratification, major technical approaches, recent advances, and existing limitations.

Prostate cancer (PCa) is the second most common malignancy in elderly men. Data indicate that approximately 90% of patients develop bone metastases in the advanced stage, significantly impairing quality of life and life expectancy. The biological characteristics of PCa bone metastases are closely associated with abnormal bone remodelling and pathological bone changes. Current clinical approaches for advanced PCa primarily include androgen deprivation therapy (ADT) combined with novel endocrine therapies, radiotherapy and chemotherapy, and novel radionuclide therapies. Among these, radionuclide therapy delivers radionuclides precisely to systemic tumour sites via drug delivery vehicles, offering advantages such as targeted treatment and initiating a new era in managing advanced PCa with bone metastases. ⁸⁹Sr and ¹⁵³Sm alleviate pain associated with PCa bone metastases, while ²²³Ra has demonstrated potential survival benefits in multiple combination therapy studies. The combined application of novel radiopharmaceuticals such as ¹⁷⁷Lu-PSMA and ²²⁵Ac has reshaped the therapeutic landscape for patients with advanced PCa. This article summarises recent advances in radionuclide therapy for patients with advanced PCa and bone metastases, providing systematic insights and novel perspectives for clinical practice.

With advances in refined imaging assessment and robot-assisted minimally invasive techniques, partial nephrectomy (PN) has been increasingly applied in patients with T₂ renal cell carcinoma (RCC). This study aimed to compare the mid- to long-term outcomes of PN and radical nephrectomy (RN) in patients with T₂ RCC, and to evaluate the safety and feasibility of PN in this setting.

The clinical data of 246 patients with T₂ RCC who underwent surgical treatment at our center between January 2017 and December 2025 were retrospectively analyzed, including 61 patients in the PN group and 185 in the RN group. The primary endpoints were disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS). To reduce bias caused by baseline differences between groups, an average treatment effect on the treated (ATT) weighting method based on propensity scores was applied.

Among the 61 patients in the PN group, 2 experienced recurrence or metastasis, and no deaths were observed. In the RN group, 20 of 185 patients developed recurrence or metastasis, and 14 patients died, of whom 12 died from RCC. After ATT weighting, no statistically significant differences were observed between the two groups in DFS (P=0.116), OS (P=0.147), or CSS (P=0.088). The percentage decline in postoperative estimated glomerular filtration rate (eGFR) was significantly lower in the PN group than in the RN group (P<0.001).

Under careful patient selection and appropriate surgical practice, partial nephrectomy can achieve oncologic outcomes comparable to radical nephrectomy in patients with T₂ RCC, and may therefore be considered a reasonable surgical option in selected patients.

To compare the safety and clinical outcomes of off-clamp robot-assisted partial nephrectomy (Off-clamp RAPN) versus on-clamp robot-assisted partial nephrectomy (On-clamp RAPN) in the treatment of cT₁ renal cell carcinoma (RCC).

The clinical data of 122 patients with cT₁ RCC who underwent RAPN at the First Affiliated Hospital of Harbin Medical University from April 2021 to September 2024 were retrospectively analyzed. Among these, 66 patients underwent Off-clamp RAPN and 56 underwent On-clamp RAPN. There were no statistically significant differences between the two groups in terms of age, gender, body mass index (BMI), maximum tumor diameter, R.E.N.A.L. score, preoperative serum creatinine (Scr), preoperative estimated glomerular filtration rate (eGFR), and other baseline characteristics (P>0.05). The clinical outcomes compared between the two groups included operation time, postoperative renal function indicators, intraoperative blood loss, postoperative recovery, and complications.

All 122 surgeries were successfully completed, with no conversions to open surgery, radical nephrectomy, renal artery clamping, or positive surgical margin. The operation time for the Off-clamp group was [122.50 (100.75, 150.00) min], compared to [140.00 (115.00, 162.75) min] for the On-clamp group, which was statistically significant (P=0.034). There were no significant differences in intraoperative blood loss, postoperative hospital stay, and postoperative hemoglobin drop between the two groups (P>0.05). The Off-clamp group demonstrated a lower incidence of postoperative acute kidney injury (7.58% vs 25.00%), a lower three-day Scr rise rate [8.38% (3.10%, 17.54%) vs 21.42% (12.80%, 34.67%)], a lower three-day eGFR decline rate [2.76% (1.04%, 5.75%) vs 6.88% (4.11%, 11.40%)], a lower three-month Scr rise rate [6.72% (5.62%, 8.22%) vs 8.79% (6.69%, 12.82%)], and a lower three-month eGFR decline rate [2.23% (1.83%, 3.15%) vs 2.92% (2.26%, 4.65%)] compared to the On-clamp group, all of which were statistically significant (P<0.05). The "trifecta" achievement rates were 80.30% and 60.71% for the Off-clamp and On-clamp groups, respectively (P=0.029).

Off-clamp RAPN is a safe, feasible, and effective alternative to On-clamp RAPN for the treatment of cT₁ RCC when applied to appropriately selected patients. It offers superior renal function preservation, shorter operative time, and higher trifecta achievement rates, while maintaining comparable oncological outcomes and complication rates. However, long-term efficacy and renal functional changes require further investigation.

To compare the efficacy of transurethral thulium laser enucleation of the prostate (ThuLEP) with transurethral resection of the prostate (TURP), and to develop a nomogram-based prediction model for urethral stricture occurrence based on the outcomes of these two procedures.

The clinical data of 174 patients with benign prostatic hyperplasia were retrospectively analyzed. The observation group (n=95) underwent ThuLEP, while the control group (n=79) underwent TURP. Perioperative indicators, including operation time, indwelling catheterization duration, hospital stay, and hospitalization cost were collected. At six months postoperatively, the international prostate symptom score (IPSS), quality of life (QOL), and incidence of urethral stricture were assessed. Logistic regression analysis was performed to identify risk factors for urethral stricture, and a predictive nomogram model was established. The model's performance was evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and clinical decision curve.

Both groups successfully completed their respective surgeries and were discharged without complications. Compared with the TURP group, the ThuLEP group demonstrated less hospitalization cost, shorter hospital stay, and shorter operation time. No significant difference was observed in indwelling catheterization duration between the two groups. Additionally, there was no significant difference in the incidence of postoperative urethral stricture between the ThuLEP and TURP groups. Preoperative IPSS, prostate size, operation time, and catheter placement duration were identified as independent risk factors for urethral stricture, and a nomogram-based prediction model was developed accordingly.

ThuLEP demonstrates superior efficacy compared to TURP, with less medical cost and shorter operation time. Furthermore, a predictive model incorporating preoperative IPSS, prostate size, operation time, and catheter placement duration can effectively estimate the probability of postoperative urethral stricture.

This study aims to investigate the multiparametric MRI (mpMRI) manifestations of cystitis glandularis (CG), with the goal of improving the diagnostic accuracy of CG.

Patients with pathologically confirmed CG who underwent pelvic MRI between November 2011 and September 2023 were retrospectively reviewed. The mpMRI characteristics of CG were evaluated, and the apparent diffusion coefficient (ADC) values were measured to assess the diffusion restriction within the lesions.

40 patients aged (49.4±14.4) years, including 35 male and 5 females with CG were analyzed. Lesions were predominantly located in the trigone and/or bladder neck (90.0%). On T2-weighted imaging (T2WI), 32 lesions (80.0%) exhibited characteristic "floating water weeds sign" (a layered structure) and/or "bubble-like sign." Based on MRI morphology, CG was classified into four types, with nodular thickening type being the most common (60.0%). The majority of lesions (92.5%) exhibited marked enhancement, with 24 patients (60.0%) showing linear contrast enhancement on the lesion surface. Most lesions (90.0%) showed no or mild diffusion restriction with a mean ADC value of (1.67 ± 0.38) ×10^-3 mm²/s.

CG demonstrates several characteristic mpMRI features, particularly on T2WI, dynamic contrast-enhanced (DCE) imaging, and diffusion-weighted imaging (DWI), which are valuable for differential diagnosis.

To investigate the relationship between basal metabolic indexes and the degree of intravesical prostatic protrusion (IPP) in patients undergoing benign prostatic hyperplasia (BPH) surgery.

Clinical data of 649 BPH patients who underwent surgical treatment at the Department of Urology, the Seventh Affiliated Hospital of Sun Yat-sen University between May 2018 and December 2024 were retrospectively collected. IPP was measured via transabdominal ultrasound. Correlation analysis and generalized linear modeling were employed to examine the associations between IPP and various metabolic indicators, including body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). An age-stratified analysis was also performed.

In the overall population, BMI (r=-0.182, P<0.001), fasting blood glucose (r=-0.118, P<0.01), and TG (r=-0.128, P=0.012) were negatively correlated with IPP, while HDL-C was positively correlated (r=0.118, P= 0.021). Age-stratified analysis revealed a significant negative correlation between BMI and IPP in the groups of 61-70 (r=-0.209) and 71-80 (r=-0.226) years (both P<0.05). A significant negative correlation between TG and IPP was observed in patients over 80 years (r=-0.399, P=0.012). Fasting blood glucose in the group of 61-70 years was significantly negatively correlated with IPP (r=-0.143, P=0.032). Generalized linear modeling confirmed that BMI (β=-0.040, P=0.001) was an independent predictor of IPP, whereas no other metabolic indicators showed independent association.

In BPH patients undergoing surgery, BMI, fasting blood glucose, and TG were negatively correlated with IPP, whereas HDL-C was positively correlated. BMI was an independent predictor of IPP, with age-specific negative associations. Enhanced monitoring of IPP may be warranted in patients aged 61-80 years with low BMI and those over 80 years with decreased TG levels.

To evaluate the safety and clinical efficacy of photoselective vaporesection of the prostate treatment in high-risk elderly patients with benign prostatic hyperplasia (BPH) who are on oral anticoagulant therapy during the perioperative period.

A total of 116 elderly patients clinically diagnosed with benign prostatic hyperplasia who were admitted to Huaibei People's Hospital from September 2021 to September 2024 were included. They were divided into the oral anticoagulant group (OA group, n=45) and the non-anticoagulant group (non-OA group, n=71) based on whether they took oral anticoagulant drugs before the operation. The operation time, pre- and postoperative haemoglobin changes, bladder irrigation time and indwelling catheter time, postoperative hospital stay, IPSS, QOL, Q_max, PVR and postoperative complications at 1, 3 and 6 months before and after operation were observed in the two groups.

The incidence of postoperative complications in the two groups was 17.8% (OA group) and 12.7% (non-OA group), respectively, with no significant difference between the two groups (P>0.05). The operation time in the OA group [(68.8±9.5) min] was longer than that in the non-OA group [(59.2±5.5) min], which was a significant difference (P<0.001). The duration of continuous postoperative bladder irrigation in the OA group [(24.8±2.2) h] was longer than that of the non-OA group [(24.2±2.6) h], with no significant difference (P>0.05). The postoperative catheter retention time in the OA group [(4.7±0.8) d] was longer than that in the non-OA group [(4.5±0.5) d], and the difference was statistically significant (P=0.043). The decrease in haemoglobin in the OA group and the non-OA group after the surgery was (9.8±3.4) g/L and (9.3±2.7)g/L respectively, and the difference between the two groups was not statistically significant (P>0.05). The length of postoperative hospital stay in the OA group [(5.5±0.7) d] was longer than that in the non-OA group [(5.3±0.5) d], and the difference was not statistically significant (P>0.05). The patients in the two groups at 1, 3, and 6 months after the surgery had a significant improvement in the IPSS, QOL, Q_max, and PVR compared with that of preoperative period and the difference was statistically significant (P<0.05), the differences in IPSS, QOL, Q_max and PVR between the two groups were not statistically significant (P>0.05).

Photoselective vaporesection of the prostate may be an effective and safe way for the treatment of perioperative maintenance of oral anticoagulants in elderly patients with high-risk prostatic hyperplasia.

To summarize the surgical procedure and key technical points of retroperitoneal laparoscopic partial nephrectomy.

The surgical videos of patients who underwent retroperitoneal laparoscopic partial nephrectomy in our hospital were retrospectively analyzed, the operative workflow was summarized, and the surgical techniques were refined.

A standardized ten-step method for retroperitoneal laparoscopic partial nephrectomy was established, comprising: patient positioning, trocar placement, retroperitoneal space establishment, perirenal fat dissection, Gerota’s fascia opening, renal artery identification and isolation, tumor localization, renal artery clamping, tumor resection, and wound suturing.

Retroperitoneal laparoscopic partial nephrectomy has become an important approach for the treatment of renal tumors. Its surgical workflow and key technical points can be effectively summarized by the "ten-step method". Proficiency in these techniques is essential for urologists.

Benign prostatic hyperplasia (BPH) and cardiovascular diseases (CVD) are common in middle-aged and elderly men, and the prevalence of these diseases increases significantly with the increase of age. BPH is usually characterized by lower urinary tract symptoms, and most patients showed a significant improvement in LUTS after receiving active surgical intervention. However, postoperative follow-up showed that patients with BPH combined with CVD risk factors had poor improvement in LUTS after surgery. This article discusses the role of each risk factor, including hypertension, diabetes, obesity and hyperlipidemia, in the development and progression of BPH, and further explores the current research status of LUTS in BPH patients with co-existing CVD risk factors, with the aim of providing certain reference for the prevention and treatment of LUTS in BPH patients with CVD through targeted intervention measures.

Erectile dysfunction and urinary incontinence remain common complications following robot-assisted radical prostatectomy (RARP) in patients suffer from prostate cancer. Preservation of the neurovascular bundles (NVBs) is a critical surgical step for promoting functional recovery, with techniques continuously refined through advances in prostatic anatomy research and robotic platforms. However, the relative merits of cold versus thermal dissection of the neurovascular bundles remain controversial, and pertinent evidence-based investigations have advanced considerably in recent years. This review comprehensively examines cold and thermal techniques in NVBs preservation during nerve-sparing RARP and their impact on postoperative functional outcomes, aiming to provide evidence-based references for clinical decision-making.

Adrenal tumors are highly heterogeneous endocrine disorders with markedly varied prognoses across clinical subtypes, underscoring the critical need for precise diagnosis and treatment. Artificial intelligence (AI) is increasingly employed in this field to improve diagnostic accuracy, refine prognostic assessment, and advance personalized medicine. This review systematically summarizes recent advancements in AI for the precise diagnosis, treatment planning, and prognosis prediction of adrenal tumors, while examining its strengths and limitations. AI has significantly enhanced precision in managing adrenal tumors. It achieves an area under the curve (AUC) of 94.5% for subtype classification, 93.7% for predicting intraoperative hemodynamic risk, and 91.7% sensitivity for tumor metastasis, and 95.5% specificity for prognosis assessment. Additionally, AI effectively supports surgical decision-making and personalized medication recommendations. However, current applications face several challenges, including high heterogeneity in single-center data, insufficient algorithm interpretability, and inadequate integration of multimodal and multi-omics data. Future efforts should focus on establishing standardized multicenter databases, developing explainable AI techniques, enhancing multidimensional data integration, and conducting large-scale clinical validation. These measures are essential to accelerate the clinical translation of AI and to propel the field toward more precise and individualized patient management.

Interstitial cystitis (IC) is also known as bladder pain syndrome (BPS), which is a chronic condition characterized by bladder or pelvic pain, urinary frequency, and urgency, typically without evidence of infection. Its pathogenesis is complex and remains unclear. Current clinical treatments primarily involve behavioral interventions, medications, and minimally invasive surgeries, but long-term efficacy remains limited. In recent years, platelet-rich plasma (PRP), a regenerative medicine therapy, has demonstrated significant efficacy through submucosal bladder injections or intravesical instillation. PRP promotes urothelial healing, alleviates bladder neuropathic pain, and exerts antibacterial effects, offering a safe and effective treatment option for IC patients unresponsive to conventional therapies. Multiple hospitals have now adopted PRP in clinical practice. This article elaborates on the key components, preparation methods, the mechanisms of PRP action, and the current status of PRP therapy for IC.

Percutaneous nephrolithotomy (PCNL) is the main treatment for large renal calculi (>2 cm), and puncture localization is the key to surgical success. This article reviews the research progress of puncture localization techniques in PCNL to provide strategies for improving PCNL surgical skills.

A systematic literature search was conducted across databases including PubMed, Web of Science, and CNKI. The principles, advantages, limitations, and clinical utility of both conventional (fluoroscopy, ultrasound, CT-guidance) and emerging (augmented reality, electromagnetic tracking, robotic assistance, three-dimensional visualization) localization techniques were analyzed.

Novel imaging-guided techniques, such as robot-assisted, augmented reality, CT-ultrasound fusion, and electromagnetic tracking, have shown significant advantages in improving localization accuracy, reducing surgical difficulty, shortening the learning curve, and decreasing radiation exposure.

Key future directions include stereoscopic imaging, radiation dose reduction, image quality optimization, and multimodal image fusion. The integration of artificial intelligence with medical imaging technologies holds promise for further shortening the learning curve and reducing procedural complexity, which is crucial for the broader adoption of PCNL.

This article reports a case of metastatic recurrent adrenal pheochromocytoma in a young man presenting with recurrent chest tightness and chest pain. In 2019, a right adrenal mass was detected, and laparoscopic resection of the right adrenal tumor was performed. Pathology confirmed pheochromocytoma, with a Ki-67 index of 1%-2% and positive SDH-B expression. In 2022, recurrence at the operative site with peritoneal, greater omental, and lymph node metastases was identified, and the patient underwent debulking surgery followed by cyclophosphamide, vincristine, and dacarbazine (CVD) chemotherapy. In 2025, recurrent disease at the operative site and multiple peritoneal metastases were detected again. A second debulking surgery was performed, and tumor tissue was obtained for patient-derived organoid culture. Drug sensitivity testing showed that sunitinib markedly inhibited adenosine triphosphate (ATP) activity and epinephrine secretion in the organoids. After multidisciplinary consultation on difficult cases in Guangdong Urological Association, oral targeted therapy with sunitinib at 37.5 mg/day was initiated. At the latest follow-up, the patient remained in good general condition, without chest tightness, palpitations, or other discomfort. This case suggests that the management of metastatic recurrent pheochromocytoma should not rely solely on conventionally low-risk pathological features, but should incorporate recurrence pattern, metastatic evidence, and the longitudinal disease course to assess malignant potential. In this case, MDT discussion integrated input from Urology, Radiology, Pathology, Medical Oncology, and other specialties. This collaborative approach helped establish an individualized strategy involving surgical debulking, systemic treatment selection, and long-term follow-up, thereby highlighting the important clinical value of MDT-based decision-making in complex cases.