Introduction Half of all patients with testicular germ cell tumours (GCTs) present with metastases to retroperitoneal lymph nodes or visceral organs. Inguinal metastases (I/M) are very rare. We aimed to evaluate the relative frequency and clinical features of I/M and to look for predisposing factors. Methods A cohort of 740 GCT patients treated between 2010-2022 was analyzed. The frequency of I/M and their clinical features were statistically compared among the subgroups. Results Eight patients had I/M, with a median age of 55 years, all of whom had primary seminoma, six had previous groin surgery. The relative frequency of I/M is 1.1% and 8.3% in the GCT patient cohort and the metastasized seminoma subgroup, respectively. All patients were cured, six underwent surgery and additional chemotherapy, and two received cisplatin-based chemotherapy alone. Discussion Inguinal metastases occur in approximately 1% of GCT patients. Prior groin surgery, bulky retroperitoneal metastases and possibly histology of seminoma represent risk factors for I/M. The presence of I/M does not adversely affect prognosis, and all cases can be cured with standard therapeutic measures. Lymph node excision may be required to establish the diagnosis. In patients with risk factors, follow-up examinations should include the groins.

Introduction This study aims to investigate the relationship between surgical difficulty and postoperative complications in kidney transplantation, as well as to develop a preoperative prediction model for assessing surgical difficulty. Methods This is a prospective cohort included 122 kidney transplant adult recipients. The subjective score for operative difficulty, ranging from 1 to 3 points, served as the quantitative measure of surgical difficulty. Analysis of Variance (ANOVA) and Chi-square tests were employed to investigate the differences in postoperative complications. Additionally, Pearson and Spearman correlation analyses were conducted to assess the relationship between preoperative data and surgical difficulty scores, while multiple linear regression analysis was utilized to develop a prediction model. Results With the increase of surgical difficulty, the incidence and severity of postoperative complications of kidney transplant recipients increased significantly (1 vs 2, P=0.009; 1 vs 3, P=0.004; 2 vs 3, P=0.004). The incidence of delayed graft function (DGF) and graft loss was relatively high(1 vs 2, P<0.001; 1 vs 3, P<0.001; 2 vs 3, P=0.131). The source of donor kidney, number of arteries after donor kidney trimming, end resistance index of in vitro perfusion, vascular anastomosis mode of recipient, BMI, and calcification of the vessels to be anastomosed were influencing factors of surgical difficulty. The results of linear regression analysis showed that the difficulty of surgery =0.30 (donated by relatives) +0.48× the number of arteries +0.58× end resistance index of isolated perfusion +0.24× the mode of arterial anastomosis+0.02×BMI+0.17 (calcification of the vessel). Conclusion Higher levels of difficulty in kidney transplantation are associated with increased incidence and severity of postoperative complications, as well as prolonged recovery times. Concurrently, we developed a predictive model to quantify the difficulty of kidney transplantation and validated its accuracy.

Introduction SUI is a common pelvic floor dysfunction in middle-aged and elderly women, which has a serious negative impact on the patient's quality of Life (QoL), pelvic floor muscle training (PFMT) and electrical stimulation (ES), as common non-surgical treatment modalities, have been widely used in the management of SUI. However, there is controversy about the effectiveness of the combined application of these two interventions. For this reason, this study evaluated the efficacy of PFMT combined with ES in the treatment of SUI by Meta-analysis. To systematically evaluate the efficacy of PFMT combined with ES in improving urinary incontinence symptoms, increasing pelvic floor muscle strength, enhancing QoL, and improving clinical symptoms, with the aim of providing more adequate evidence to support clinical treatment. Methods A literature search was conducted in PubMed, Embase, Web of Science, and Cochrane Library databases from database construction to October 2024 to include RCTs and case-control studies evaluating PFMT combined with ES for the treatment of SUI. The Cochrane Risk Assessment Tool and NOS were used to assess the quality of the included literature, and effect sizes were calculated by random-effects model and fixed-effects model, and the main outcome indicators included incontinence symptoms, pelvic floor muscle strength, QoL and clinical symptoms. Results Eight studies were ultimately included, with a total sample size of 885 cases. Meta-analysis showed that PFMT combined with ES was significantly better than the control group on all outcome measures. The combined effect size for improvement in urinary incontinence symptoms was OR = 1.42 (95% CI: 1.10, 1.85, P < 0.05), that for pelvic floor muscle strength was OR = 1.55 (95% CI: 1.20, 2.05, P < 0.01), that for QoL improvement was OR = 4.29 (95% CI: 3.68, 4.99, P < 0.0001), and the combined effect size for clinical symptom improvement was OR = 1.35 (95% CI: 1.05, 1.70, P < 0.05). Heterogeneity between studies was low (I² values were less than 40%), indicating a high degree of consistency in the effect of the combination treatment. Conclusion PFMT combined with ES showed significant benefits in improving incontinence symptoms, enhancing pelvic floor muscle strength, boosting QoL and improving clinical symptoms. Future studies should further standardize the intervention parameters and extend the follow-up period to fully assess the long-term effects of the combined treatment.

To evaluate the feasibility and safety of using the novel flexible vacuum-assisted ureteral access sheath (FV-UAS) in flexible ureteroscopy (F-URS) treatment of impacted non-distal ureteral stones.

Fournier's gangrene (FG) is a life-threatening necrotizing infection of the perineal, genital, or perianal regions, often requiring extensive surgical intervention and prolonged recovery. Despite advances in acute management, the long-term impact of FG on patients' self-esteem and quality of life remains underexplored.

To assess the prognostic value of the preoperative serum ferritin-to-transferrin ratio (FTR) in renal cell carcinoma (RCC). Methods：We retrospectively reviewed data from 226 patients who underwent surgery for non-metastatic RCC at our institution between January 1, 2012, and June 30, 2021. Time-dependent receiver operating characteristic (timeROC) analysis identified the optimal FTR cut-off, dividing patients into high and low FTR groups. Propensity score matching (PSM) adjusted for baseline differences. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using the Kaplan-Meier method and Cox regression, with a nomogram validating the results.

Purpose Subfertility is a well-known aftermath of treatment of testicular germ cell tumours (GCTs). Growing evidence suggests reduced semen quality also before therapy. The present study aimed to evaluate pre-orchiectomy semen parameters in GCT patients and to compare the results with controls. Methods GCT patients providing semen for cryopreservation before orchiectomy during 2012 - 2023 were retrospectively enrolled (TT cohort). Controls consisted of healthy volunteers for sperm donation (HD), and of patients with other malignancies (OM). The following parameters were recorded in each participant: ejaculate volume (EV; ml), total sperm count in ejaculate (TSC), and proportion of progressive motility (PM) (%). Descriptive statistical methods were used to compare the 3 populations with each other. Results A total of 664 subjects were included, thereof 163 TT, 289 HD, and 212 OM. Median ejaculate volume was 3.0 ml, 3.5 ml, and 3.4 ml; median TSC was 56.9 x106, 207 x106, and 152 x106; median PM was 40%, 40.2%, and 43% in TT, HD, and OM, respectively. TSC, EV and several secondary parameters of semen quality observed in TT were significantly worse than those in the two control cohorts. HD and OM were within normal limits with regard to TSC and PM and were different in only a few secondary parameters. Conclusion This study confirmed significantly lower pre-orchiectomy semen quality in GCT patients in comparison to healthy males and to patients with other malignancies. Subfertility is an intrinsic feature of GCT preceding treatment that needs to be considered by care-givers.

Auto-expandable ureteral stents can be an alternative to percutaneous nephrostomy (PCN) in refractory ureteral stenosis. Our aim was to analyse results and complications of ureteral stents in our centre.

This research investigates the influence of the medical personnel shortage on the treatment of urolithiasis by comparing the complication rates in patients with urinary stones who undergo ureterorenoscopy with laser lithotripsy before and after the emergence of this unprecedented situation.

To determine the impact of diabetes and antidiabetic medications on referral and pathological outcomes in uro-oncology cases. We report preliminary results from a single center study.

Ureteral access sheaths (UAS) are widely used in the endoscopic treatment of urolithiasis. In modern medicine, radiation exposure from diagnostics and therapy is increasing; however, the impact of UAS on procedure duration, fluoroscopy time, and radiation exposure is still uncertain.

This study aims to evaluate the impact of preoperative ureteral stenting on post-operative outcomes, especially the incidence of urinoma, in patients with complex renal tumours undergoing nephron-sparing surgery (NSS).

To examine the value of tumor size, weight, and density in predicting pathological tumor stage in patients with suspected bladder cancer (BCa), minimize interobserver variability of estimated tumor size, and thus provide a more objective instrument to describe the extent of local tumor growth.

The impact of surgical therapy in selected patients with limited metastatic/recurrence burden have not yet been well studied. We investigated the outcome of surgical resection for patients with local recurrence only or oligometastatic UC of the bladder.

This study aimed to compare spinal and general anesthesia methods in endoscopic management of proximal ureteral stones with a particular emphasis on total anesthesia time.

Early radical cystectomy (eRC) can be performed for high or very high risk non-muscle-invasive bladder cancer (NMIBC). Whether immediate eRC is beneficial is still unclear. The objective of this study was to compare outcomes between immediate eRC, delayed eRC and radical cystectomy (RC) at diagnosis of muscle-invasive bladder cancer (MIBC).

A comprehensive understanding of the renal vascular anatomy variations is paramount to a successful kidney transplant. This reduces vascular injury risks and minimizes ischemia duration, optimizing surgical outcomes. The current study aims to assess the accuracy of renal computed tomography angiography (CTA) findings of live renal donors by comparing them with intraoperative findings.

Adjuvant pembrolizumab versus placebo significantly improved disease-free survival (DFS) in renal cell carcinoma (RCC) patients at high risk (HR) of recurrence following nephrectomy in KEYNOTE-564 trial (NCT03142334). The objective of this study was to evaluate efficacy and safety of adjuvant pembrolizumab in a real-world setting.

The aim of the study was to analyze contemporary treatment trends in bladder stone management in Germany over a 15-year period.

The aim of the study was to explore the application value of three-dimensional (3D) model in partial nephrectomy across varying RENAL scores.