BMC Urology最新文献

Background: This study aimed to systematically compare the most recent guidelines from the European Association of Urology (EAU, 2025), American Urological Association (AUA, 2024), and National Comprehensive Cancer Network (NCCN, 2025) for the management of non-muscle invasive bladder cancer (NMIBC). The primary objective was to assess the degree of concordance and identify sources of divergence across 32 predefined clinical decision domains.

Materials and methods: This guideline concordance study was conducted according to PRISMA 2020 recommendations, evaluating full-text versions of the latest EAU, AUA, and NCCN guidelines. Thirty-two clinical domains encompassing the diagnostic, therapeutic, and follow-up aspects of NMIBC management were pre-defined based on literature review and expert consensus. Two independent reviewers classified each domain for each guideline as full concordance, partial concordance, or discordance, with discrepancies resolved by a third reviewer. Inter-guideline agreement was quantified using Cohen's and Fleiss' kappa coefficients.

Results: Among the 32 domains analyzed, full concordance was identified in 19 domains (59.4%), partial concordance in 12 domains (37.5%), and discordance in 1 domain (3.1%). Inter-guideline reliability was high, with Cohen's kappa values ranging from 0.83 to 0.94 across pairs and an overall Fleiss' kappa of 0.74, indicating substantial agreement among the three guidelines. Clinically meaningful differences were mainly related to risk-stratification criteria, the management of BCG-unresponsive disease, the selective use of urinary biomarkers, and the endorsement of conservative strategies for recurrent low-grade tumors.

Conclusion: Current international guidelines for NMIBC are highly consistent across the majority of clinical decision domains, providing a strong framework for evidence-based care. Residual differences reflect evolving evidence, regulatory environments, and the pace of integration of new diagnostics and therapeutics. Continued harmonization efforts and regular guideline updates are necessary to further optimize global NMIBC management.

Background: For infected wounds, including clostridial myonecrosis, necrotizing soft tissue infections, and Fournier's gangrene, hyperbaric oxygen therapy (HBOT) is advised; however, tension pneumothorax and gas emboli may occur during the process. Other instances of relative contraindications include illnesses like asthma and chronic obstructive lung disease. We can use radio frequency and strong pulsed light in our research without having to worry about these kinds of issues and could have a significant impact on improving treatment outcomes.

Objective: To assess how well intensely pulsed light and radiofrequency work for treating the aftereffects of post-Fournier's gangrene.

Patients and method: Intense pulsed light and radiofrequency sessions were used to treat sixteen male patients with isolated penile or scrotal post-Fournier's gangrene raw areas.

Results: Twelve patients (75%) had an excellent satisfaction rate, and four (25%) rated it as good. No fair or poor results were documented.

Conclusion: We are unable to make significant conclusions because of the small number of patients; however, since E-light is a simple, effective, and affordable treatment with good outcomes and no side effects, we advise more research on its application in the treatment of post-Fournier's gangrene isolated raw areas of the scrotum and penis.

Introduction: Overactive bladder (OAB) is a common urological condition affecting millions of people worldwide, significantly reducing their quality of life. Patient compliance and active participation in disease management are critical to achieving successful outcomes. This study aims to understand the potential role of AI-assisted chatbots in educating patients with OAB and their impact on health literacy.

Methods: We compared responses from four AI chatbots (ChatGPT, DeepSeek, Claude, and Gemini) to 16 standardized questions from the AUA Overactive Bladder Patient Guide. Two board-certified urologists independently evaluated responses using Ensuring Quality Information for Patients (EQIP) tool and Google E-E-A-T principles.

Results: Inter-rater reliability was excellent (ICC = 0.97 for EQIP, κ = 0.89 for E-E-A-T). A significant difference was found between chatbots in terms of readability scores (Gunning Fox Index p = 0.008, Flesch-Kincaid Grade Level p < 0.001), with all responses requiring education levels above the recommended 6th-8th grade. However, significant differences emerged in information quality (EQIP, p < 0.001; E-E-A-T, p < 0.001). Gemini demonstrated superior performance in both EQIP (60.2 ± 6.92) and E-E-A-T scores (13.5) compared to all other chatbots.

Conclusion: AI chatbots show potential for patient education but produce content with readability levels too complex for general audiences. Significant quality variations exist between models. These findings emphasize the need for collaboration between healthcare professionals and AI developers to create more accessible, reliable health information systems.