Bladder cancer is one of the most common malignant tumors of the urinary system， characterized by high recurrence rates and progression risks.Traditional urine-based diagnostic methods are limited in terms of sensitivity and specificity， whereas the introduction of artificial intelligence （AI） has significantly improved diagnostic accuracy.This article summarizes the combination of AI technology with various urine-based diagnostic techniques， including cytology，genetic sequencing， proteomics， metabolomics， microbiomics， DNA methylation， and flow cytometry， highlighting their potential applications in bladder cancer diagnosis.The challenges of clinical implementation are also discussed， providing valuable insights for further research and clinical practice.
Bladder-preserving therapy has become an important option for patients with muscle-invasive bladder cancer （MIBC） due to the increasing value on the quality of life.As a classical bladder-preserving treatment option， trimodality treatment （TMT） not only maintains a significantly better quality of life but also has comparable efficacy to surgery.TMT has been widely used in various applications.Through analyzing the application and toxicity of radiotherapy in different TMT treatments， this article found that reducing the dose of whole pelvic radiotherapy， increasing the dose for radiotherapy with localized tumors， decreasing the scope of radiotherapy and splitting the process of radiotherapy can reduce the radiotherapy toxicity and immunotherapy further increase the complete response （CR） rate and then improve survival.However， the optimal modes of radiotherapy and combinations of radiotherapy， chemotherapy， and immunotherapy are still unclear and need further discussion.
Immunohistochemistry is an important adjunct to the diagnosis， classification， and prediction of the efficacy of targeted therapy and immunotherapy in bladder cancer.This paper presents the commonly used immunohistochemical markers in pathological reports of bladder cancer.In the future， with the application of immunohistochemistry-based molecular subtypes of urothelial carcinoma and artificial intelligence technology，immunohistochemistry will further promote the development of precision diagnosis and treatment of bladder cancer.
To investigate the significance of en-bloc resection of bladder tumor（ERBT） in the pathological sub-staging of T1 stage bladder cancer.
Methods
Data of T1 stage bladder cancer （BC） patients who underwent ERBT or conventional transurethral resection of bladder tumor （cTURBT） done by a same surgeon from January 2017 to January 2019 were collected to make retrospective analysis.All patients were T1 stage， diagnosed as primary BC with no more than 3 tumors and no more than 3.5 cm in diameter.Tumor sections stained by hematoxylin-eosin （HE） were collected and the T1m/e sub-staging diagnosis was performed， and postoperative tumor recurrence was followed up.
Results
A total of 120 cases were enrolled， in which 52 cases treated with ERBT and 68 cases with cTURBT.There was no significant difference in gender， mean age， tumor size and number between the two groups.The average follow-up time for the ERBT group and cTURBT group was （22±11） months and （21±12）months， respectively.Kaplan-Meier survival curve found no significant difference in RFS between ERBT and cTURBT group （P＞0.05）， but the ERBT group had significant advantages in muscle layer detection rate and T1m/e sub-staging success rate （P＜0.05）.There was a statistically significant difference in RFS between T1m patients and T1e patients after comparing the T1m/e sub-staging of patients in the ERBT group（P=0.039）.
Conclusions
ERBT takes smore advantages in providing high quality pathological samples and improving sub-staging accuracy.T1m/e sub-staging system has certain advantages and application value in evaluating the prognosis of T1 stage bladder cancer.
To compare the clinical efficacy of en-bloc resection of bladder tumor（ERBT） with transurethral resection of bladder tumor （TURBT） in the comprehensive preservation of bladder treatment for high-risk non-muscle-invasive bladder cancer （NMIBC） patients.
Methods
A retrospective analysis was conducted on the data of 104 patients with high-risk NMIBC from November 2016 to September 2022 in the First Affiliated Hospital， Sun Yat-sen University.Among them，62 patients received ERBT and 42 patients received TURBT.The recurrence-free survival （RFS），recurrence rate， progression rate， and bladder preservation rate were compared between the two groups.
Results
There was no significant difference in demographic data between the two groups （P＞0.05）.The median recurrence-free survival was 30（20， 49） months in the ERBT group and 19（9， 49） months in the TURBT group.The recurrence rate was 16.1% in the ERBT group and 57.1% in the TURBT group.The progression rate was 4.8% in the ERBT group and 9.5% in the TURBT group.The bladder preservation rate was 96.8% in the ERBT group and 95.2% in the TURBT group.There were statistically significant differences in recurrence-free survival time and recurrence rate between the two groups（P＜0.05）.However， no significant difference was observed in progression rate between the groups（P＞0.05）.
Conclusion
Patients in the ERBT group had a lower recurrence rate and longer recurrencefree survival compared with those in the TURBT group.ERBT has more advantages than TURBT in bladder-preserving treatment of high-risk NMIBC patients.
To investigate the prognostic role of long non-coding RNA （LncRNA）in bladder urothelial carcinoma （BLCA） and to establish a prognostic assessment model of BLCA angiogenesis-associated LncRNA.
Methods
The RNA sequencing and clinical data of BLCA were downloaded from the TCGA database， and the latest list of human angiogenesis genes was obtained from the molecular characteristics database.The correlation coefficient between each LncRNA and each angiogenesis gene was calculated， and LncRNA significantly correlated with angiogenesis genes were obtained.Univariate and multivariate Cox regression analysis was performed for each LncRNA using R software， and the LncRNA associated with BLCA prognosis was screened by Kaplan-Meier method.Kaplan-Meier curves of survival time of relevant LncRNA and BLCA patients were drawn， and the risk score of each sample was calculated.According to the score， the samples were divided into high-risk group and low-risk group， and the differences in survival between the two groups were compared.The ROC curve was drawn to evaluate the predictive ability of the model， and Cox regression was used to analyze the correlation between the risk score and patients' clinical characteristics and survival.
Results
Initial screening identified 207 LncRNA associated with BLCA angiogenesis （correlation coefficient |R|＞0.4，P＜0.001）.Cox regression analysis was used to select 9 angiogenesis-related LncRNA that independently correlated with BLCA prognosis to establish a prognostic assessment model for BLCA.According to the model， patients were divided into high-risk and low-risk groups， and the survival of patients in the high-risk group was significantly shorter than that in the low-risk group （P＜0.05）.The area under the ROC curve of the model is 0.716， indicating that the model has good predictive efficiency.The risk score was positively correlated with age， tumor grade， pathological stage and T stage （P＜0.05） and was an independent prognostic predictor of BLCA.
Conclusion
The prognostic assessment model based on LncRNA associated with angiogenesis can provide accurate prognostic assessment for BLCA patients and help guide individualized treatment selection and prognostic assessment for BLCA patients.
To investigate the relationship between preoperative inflammatory indicators and the WHO/ISUP pathological grading of clear cell renal cell carcinoma， and to construct a predictive model.
Methods
The data of clear cell renal cell carcinoma patients who underwent surgical treatment in the Urology Department of the First Affiliated Hospital of Soochow University from January 2018 to December 2019 were analyzed retrospectively.According to the WHO/ISUP pathological grading system， 153 patients were divided into a low-grade group （grade I， II） and a high-grade group （grade III，IV）， and the differences in clinical and pathological parameters between the two groups were compared.Multivariate logistic analyses were used to identify independent risk factors for predicting pathological grading， and a nomogram predictive model was constructed and evaluated using a calibration curve.Lastly，the diagnostic efficacy of the model was tested using receiver operating characteristic （ROC） curves and decision curve analysis （DCA） was used to evaluate the net benefits of the model.
Results
There were significant differences between the low-grade and high-grade groups in tumor diameter， neutrophil-tolymphocyte ratio （NLR）， platelet-to-lymphocyte ratio （PLR）， lymphocyte-to-monocyte ratio （LMR）， and systemic immune inflammation index （SII） （P＜0.05）.Multivariate logistic analyses revealed that tumor diameter （OR=1.026， 95%CI： 1.003-1.050）， NLR （OR=3.725， 95%CI： 1.818-7.630）， and PLR （OR=1.021，95%CI： 1.008-1.035） were independent risk factors for predicting the pathological high grading of clear cell renal cell carcinoma （P＜0.05）.A predictive model was constructed using the multivariate logistic model and the calibration curve， which demonstrated good predictive accuracy （χ2=12.853， P=0.117）.The ROC curve results suggested that the predictive model had the highest area under the curve （AUC）value （0.809）， which was significantly higher than that of the single diagnostic parameters including tumor diameter， NLR， and PLR （P＜0.05）.The DCA presented higher clinical net benefits for the predictive model as compared to other indicators.
Conclusions
The tumor diameter， NLR， and PLR are related to the WHO/ISUP pathological grading of clear cell renal cell carcinoma， and the constructed predictive model has strong diagnostic efficacy.
To compare the dynamic-enhanced computed tomography （DCE-CT）features and clinical features between TFE3-rearranged renal cell carcinoma （TFE3 rRCC） and clear cell renal cell carcinoma （ccRCC）.
Methods
The DCE-CT features and clinical data of 45 adult patients with TFE3 rRCC and 135 adult patients with ccRCC confirmed by postoperative molecular pathology were retrospectively analyzed， and the differences between the two groups were compared.
Results
Of the TFE3 rRCC group， the average age was （32±11） years old.Among them， 20 cases （44.4%） were accompanied by gross hematuria， and 28 cases （62.2%） were female.The overall 5-year survival rate was 62.2%.In the ccRCC group， the average age was （60±13） years， 11 cases （8.1%） were accompanied by gross hematuria， of which only 46 cases （34.1%） were female， and the overall 5-year survival rate was 80%.There were significant difference between the two groups （P＜0.05）.In unenhanced CT scan， compared to ccRCC， tumor lesions in TFE3 rRCC exhibited higher CT values than normal renal parenchyma （P＜0.001），with 35.5% exhibiting intratumoral calcification， particularly circular calcification （P＜0.001）.In dynamic enhanced CT， TFE3 rRCC demonstrated moderately heterogeneous persistent enhancement throughout the renal parenchymal phase， peaking in the medullary phase and slowly declining in the excretory phase，exhibiting a "less in and slow out" pattern.In ccRCC， after enhancement， the lesion rapidly strengthens and reaches its peak in the cortical phase， while it rapidly declines until the delayed phase in the medullary phase， exhibiting typical "fast in and fast out" pattern.
Conclusion
The high density and intratumoral calcification on CT plain scan， along with the "less in and slow out" pattern in the dynamic enhancement phase of TFE3 rRCC， combined with the clinical features of young women with high incidence and frequent hematuria， aid in distinguishing it from ccRCC.
To compare perioperative outcomes of retroperitoneal single-port and multi-port laparoendoscopic partial nephrectomy for renal tumor.
Methods
The clinical data of patients with renal tumors who underwent retroperitoneal multi-port or single-port partial nephrectomy from July 2021 to March 2023 were retrospectively analyzed， including 22 patients in the multi-port group and 20 patients in the single-port group.The perioperative clinical indicators such as operation time， perioperative bleeding and postoperative diversion were compared between the two groups.
Results
There was no significant difference between the two groups in operation time， perioperative bleeding，warm ischemia time， time for tumor resection， time for suture wound， total drainage volume three days after operation，anal exsufflation time， hemoglobin decrease and serum creatinine increase.However， the total length of incision and postoperative pain score were less in the single-port group than multi-port group （P＜0.001）.The positive surgical margins were negative in both groups.The follow-up time of renal malignant tumors in single-site group and multi-site group was （18.9±5.0） months and （18.7±5.7） months， respectively， with no significant difference.No local recurrence or distant metastasis occurred during the follow-up period.
Conclusion
Retroperitoneal laparoscopic partial nephrectomy with multiple-port or single-port is safe，feasible and effective.But for patients， single-port is better than multi-port in pain and postoperative incision scar， which is easier for patients to accept.
To Analyze the clinical characteristics of patients with upper urinary tract stones combined with positive urine fungal cultures， summarize experiences and lessons learned in diagnosis and treatment， and offer guidance for clinical practice.
Methods
Clinical data from 94 patients with upper urinary tract stones combined with positive urine fungal cultures between September 2016 and September 2021 in the secondAffiliated Hospital of Guangzhou Medical University were collected retrospectively.We analyzed the clinical characteristics of these patients， the use of antimicrobial agents during the perioperative period， and the incidence of postoperative infections.
Results
The stone length was 19（10， 25） mm in the 94 patients， with 73 cases （77.7%） having multiple stones.At the time of presentation， 46 cases （48.9%） had indwelling catheters （ureteral stent， DJ stent， nephrostomy tube）， 40 cases （42.6%） had a history of stone surgery within 3 months， and 36 cases （38.8%） had received antibiotics within the same period.Additionally，19 cases （20.2%） had type 2 diabetes.The most common fungal species were Candida tropicalis （33/94，35.1%） and Candida albicans （30/94， 31.9%）.Among the patients， 80（85.1%） had isolated urinary fungal infections， while 14（14.9%） had concomitant urinary bacterial infections.All fungi were highly sensitive to amphotericin B and voriconazole with the sensitility rates being higher than those of fluconazole，flucytosine， and itraconazole （P＜0.05）.Antifungal drugs were used in 47 cases （50.0%） with a duration of 6（3， 9） days.Surgical intervention was performed in 84 cases （89.4%）， with postoperative fever （＞38°C）observed in 33 cases （39.3%）， systemic inflammatory response syndrome in 26 cases （31.0%）， and sepsis in 4 cases （4.8%）.Among patients with isolated urinary fungal infections， those who did not receive antifungal treatment preoperatively had a significantly higher postoperative fever rate （43.5%， 20/46） compared to those who did （11.8%， 2/17） （P＜0.05）.In patients with fungal and bacterial coinfections， the postoperative fever rate was significantly higher in those without preoperative antifungal treatment （83.3%， 10/12） compared to those without bacterial coinfections （43.5%， 20/46） （P＜0.05）.Of the 49 patients who underwent urine culture retesting 3 months post-discharge， the fungal positive rate was significantly higher in patients with postoperative fever （60.7%， 17/28） compared to those without （23.8%， 5/21） （P＜0.05）.
Conclusion
Patients with upper urinary tract calculi combined with positive urine fungal cultures often present with complex medical histories and a heightened risk of postoperative infections and complications.The predominant fungal species identified were Candida tropicalis and Candida albicans.Preoperative antifungal therapy was associated with a reduced postoperative fever rate.Therefore， there is a need for further standardization of perioperative management for this patient population to optimize clinical outcomes.
To compare the cost-effectiveness of flexible ureteroscopic lithotripsy（FURL） versus mini-percutaneous nephroscopic lithotripsy （mPCNL） for treating unilateral renal and upper ureteral stones with diameter ＜2.0 cm.
Methods
The data of 115 patients with unilateral kidney diameter ＜2.0 cm and upper ureteral calculi admitted in Jiangsu Province Hospital from March to November 2022 were collected， and the decision tree analysis model analyzing outcomes one month after surgery was constructed using Treeage Pro software to evaluate the clinical efficacy，safety and economy of the two lithotripsy procedures.The robustness of the results of this study was verified by one-way sensitivity analysis and probabilistic sensitivity analysis.
Results
The success rate of first lithotripsy in FURL group was significantly higher than that in mPCNL group，with a significant difference （P＜0.05）， and no significant difference in the occurrence of postoperative complications in the two groups （P＞0.05）.The basic analysis showed that the FURL cost and health utility were 29 080.9 and 0.90 quality adjusted life years （QALYs）， respectively， the cost and health utility of mPCNL group were 26 787.6 and 0.87 QALYs， respectively， the incremental costeffectiveness ratio （ICER） of mPCNL was 76 443.3/QALYs， which was lower than willingness to pay（WTP）， so FURL group was the dominant scheme.When the patient's willingness to pay is higher than 60 000 yuan， the FURL group has a higher probability of economy than the mPCNL group， and the sensitivity analysis results verify the robustness of the basic analysis results.
Conclusion
FURL treatment of renal and upper ureteral stones can effectively shorten the operation time and increase the stone clearance rate， which has no significant difference from mPCNL in terms of complications， and has significant cost-effect advantages， with good clinical value and health economic advantages.
To discuss the possibility， application value and mechanism of blood pressure regulation in the treatment of massive hemorrhage after percutaneous nephrolithotomy （PCNL）.
Methods
In patients with massive hemorrhage after PCNL， the blood pressure was regulated to 10%-20% below the normal basal blood pressure after conventional conservative treatment was ineffective，recording the changes of 24-hour urine volume， blood creatinine and hemoglobin of the patients postmanagement， comparing the color changes of urinary catheter and renal fistula drainage fluid before and after regulation.It is considered successful when the color of urine becomes lighter or the red and yellow stratification is observed.The blood pressure changes before and after successful regulation of hemostasis were compared.
Results
In this study， all the 10 cases were successful.Compared with the baseline blood pressure， the reduction of systolic blood pressure and diastolic blood pressure after adjustment was 15.6% and 14.4%， respectively.After 8-24 hours， the drainage fluid from the urinary catheter became significantly lighter and stratified， and no obvious gross hematuria after 48 hours， the nephrostomy tube was opened and the drainage fluid became basically clear， and there was no intermediate open surgery or renal artery embolization， and the patients recovered well.
Conclusions
Physiological hypotension regulation is safe and feasible， fully protecting nephron， avoiding reoperation or interventional treatment， saving hospitalization cost， and improving the success rate of surgery， especially suitable for hospitals lacking vascular interventional techniques.
To analyze the various factors affecting the efficacy of emergency ultrasound-guided extracorporeal shock wave lithotripsy （ESWL） in the treatment of ureteral calculi.
Methods
1 139 patients with emergency ureteral or pelevis calculi who underwent ultrasound-guided ESWL in the Third People's Hospital of Xindu District， Chengdu from May 2020 to April 2022 were selected.And 988 patients were successfully followed up， among them， 929 cases were ureteral calculi.Based on the success or failure of the ESWL， the patients were divided into two groups.Univariate and multivariate analyses were conducted to identify the factors influencing the efficacy of emergency ESWL.
Results
The total success rate of ESWL was 80.41（747/929）， and the one-time success rate of ESWL was 73.18%.Some of patients had mild gross hematuria， subcutaneous hemorrhage， renal colic and other complications， and the symptoms disappeared immediately after ESWL.Univariate analysis showed statistically significant differences in the size， location， CT value， and time from symptom onset to lithotripsis were associated with the efficacy of emergency ESWL （P＜0.05）， while multivariate analysis only showed statistically significant differences in CT value of calculi （P＜0.05）.
Conclusions
Emergency ESWL treatment is a safe and effective minimally invasive method.The CT value of calculi is important factor affecting the effect of lithotripsy.
To explore the value of prostate three-dimensional reconstruction imaging（P-3DRI） in preoperative education and treatment decision-making for patients with benign prostatic hyperplasia （BPH）.
Methods
The study subjects were BPH patients admitted to the Department of Urology， First Medical Centre of PLA General Hospital， from April 1， 2024， to July 31， 2024.Patients were divided into observation group and control group based on whether P-3DRI was used in preoperative patient education.The effectiveness of preoperative patient education was assessed through questionnaires，and the Cochran-Armitage trend test was used to compare the effectiveness of preoperative patient education between the two groups.
Results
A total of 149 BPH patients were included in the study，with 100 in the control group and 49 in the observation group.The observation group had higher prostate volume （P=0.001）， total PSA （P=0.002） and free-PSA （P=0.001） compared to the control group， with no significant differences in other baseline characteristics between the two groups.The observation group showed significant advantages over the control group in understanding the disease of BPH （Z=-6.8231，P＜0.001）， understanding the degree of prostate enlargement （Z=-7.4208， P＜0.001）， understanding the morphology of the enlarged prostate gland （Z=-.7652， P＜0.001）， understanding BPH surgery （Z=-6.358， P＜0.001）， satisfaction with the surgical plan for BPH （Z=-6.0487， P＜0.001）， and satisfaction with preoperative education （Z=-6.9476， P＜0.001）.Three patients refused surgical treatment after preoperative education， two of whom were in the observation group.
Conclusion
Utilizing P-3DRI in preoperative patient education facilitates patients' understanding of BPH and its related surgical information， thereby improving doctor-patient communication efficiency， and promoting informed medical decision-making.
To investigate the effect of prostate volume on efficacy and postoperative pathology of robot-assisted laparoscopic radical prostatectomy （RALRP）.
Methods
Data were collected from 44 patients who were diagnosed with prostate cancer and underwent RALRP in the Third Affiliated Hospital of Sun Yat-sen University from January 2022 to March 2024.Patients were divided into small prostate group （＜50 mL） and large prostate group （≥50 mL） according to the volume of the prostate gland，and were compared to the two groups in terms of operative time， intraoperative bleeding， postoperative Hb changes， hospitalization days， biopsy and postoperative Gleason score and variation tendency， surgical margins status， immediate postoperative urinary continence and other clinical parameters.
Results
The differences between the two groups in terms of operation time， peroperative bleeding， postoperative Hb changes，hospitalization days， and immediate postoperative urinary continence rate were not statistically significant（P＞0.05）， the positive rate of surgical margin and the upgraded rate of postoperative Gleason score in the small volume prostate group was higher than those in the large volume prostate group （P＜0.05）.
Conclusion
Small prostate is associated with poor pathology after RALRP and should be emphasized in clinical work.
The reconstruction of ureteral stricture disease presents a agreat challenge to urologist.With the advance of medical technology， the specific surgical techniques of ureteral reconstruction have been continuously enriched， providing alternative solutions for different conditions of ureteral stricture disease.However， the high reoperation rate of ureteral reconstruction not only affects the quality of life of patients after surgery， but also is not conducive to the construction of a harmonious doctor-patient relationship.This article reviews the research progress of reconstruction of ureteral stricture， current situation of reoperation and the risk factors of reoperation.In order to provide reference for the selection of clinical treatment options for patients with ureteral stenosis and clinical evaluation of the reoperation of ureteral reconstruction.
This article reports a case of complex pediatric adrenal cortical hyperplasia.The patient was a 5-year-old boy admitted for "cough， fever， and convulsions." Physical examination revealed typical Cushingoid signs： moon face， rough skin， facial hirsutism， and a high blood pressure of 149/99 mmHg.Laboratory tests indicated severe electrolyte disorders and significantly elevated cortisol levels.Imaging showed diffuse enlargement of both adrenal glands with a nodule on the left side.Through Multidisciplinary consultation on difficult cases in Guangdong Urological Association， pediatric experts ruled out primary aldosteronism， radiology experts confirmed the characteristics of adrenal hyperplasia with adenoma，and urological surgery experts emphasized the necessity of surgery， intraoperative arterial blood pressure monitoring， and postoperative cortisol replacement therapy.Based on the discussion， whole-exome sequencing was performed， revealing a 3.6 Mb copy number duplication in the 19p13.2-p13.11 region， involving key genes such as PRKACA， consistent with the molecular features of PPNAD4.After fully informing the patient's family about the discussion and obtaining informed consent， a transabdominal laparoscopic left adrenalectomy was performed.Postoperative pathology confirmed a cortical adenoma.Postoperatively， blood pressure was controlled with a reduced dosage of antihypertensive drugs， and cortisol levels returned to normal within two weeks.This case suggests that copy number variations in chromosome 19p lead to ACTH-independent Cushing's syndrome through the constitutive activation of the PRKACA gene.Pediatric adrenal surgery requires individualized selection of the surgical approach （prioritizing the more severely affected side）， and caution is needed to prevent postoperative adrenal crisis.Multimodal evaluation （genetic， imaging， and pathological） is of core value in the diagnosis and treatment of complex bilateral adrenal hyperplasia.
This article reports a case of pelvic recurrence after radical cystectomy for bladder cancer.The patient was admitted to the hospital due to "progressive increase of pelvic mass for 2 years after radical cystectomy for bladder cancer 9 years".PET-CT showed a cystic and solid mass on the right side of the pelvis after radical cystectomy， which was considered a malignant lesion， possibly from the intestinal substitute bladder or recurrence of bladder cancer.The lesion involved the right iliac vessels， the right obturator internus muscle， and the left ureteral stoma， accompanied by hydronephrosis of the left kidney and hydroureter of the left ureter.The local lesion was indistinguishable from the adjacent sigmoid colon and small intestine， and there was a presacral nodule with abnormally increased glucose metabolism， suggesting metastasis.After multidisciplinary consultation on difficult cases in Guangdong Urological Association， experts considered that the surgery was difficult and recommended taking a biopsy first to confirm the pathology and then give chemotherapy.The surgery would be re-evaluated based on the therapeutic effect.Subsequently， a biopsy of the pelvic mass was performed under ultrasound guidance， and the pathological result indicated metastatic urothelial carcinoma.The patient was treated with GC chemotherapy （gemcitabine 1 600 mg + lobaplatin 45 mg）.The patient underwent a follow-up CT scan after over a month of chemotherapy， which showed no significant changes in tumor size compared to previous imaging.Experts recommend continuing chemotherapy or participating in clinical drug trials.The patient is currently continuing chemotherapy， and the next treatment plan will be reassessed after monitoring the therapeutic effects.The prognosis of pelvic recurrence after bladder cancer surgery is poor， with severe tumor adhesion， high surgical difficulty and risk.Ultrasound-guided biopsy has advantages.Treatment should be individualized， providing radiotherapy， chemotherapy， surgery or combined treatment.
