BMC Urology最新文献

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.

Objective: This randomized controlled trial evaluated the clinical efficacy of super-lubricous Foley catheters in reducing urethral complications during indwelling catheterization. Focusing on addressing friction-induced injuries, the study assessed four outcomes: 1) urethral adverse reactions; 2) urethral trauma and inflammatory responses; 3) patient comfort; and 4) post-removal voiding symptoms.

Methods: A total of 114 patients from a tertiary hospital (December 2023-June 2024) were randomly allocated into two arms: 57 individuals in the experimental arm were treated with super-lubricous Foley catheters, whereas the same number in the control arm received conventional catheters. Primary outcomes included bladder irritation and urethral pain. Secondary outcomes encompassed urethral injury (red blood cells and epithelial cells), inflammation (white blood cells), comfort metrics (activity restriction, sleep disturbance, anxiety), and voiding parameters (dysuria, urinary hesitation, incomplete bladder emptying and lower abdominal pain).

Results: The baseline data revealed no statistically meaningful differences between the two groups. (all P > 0.05). The experimental group demonstrated significantly lower overall rates of bladder irritation (31.6% vs. 50.9%, P < 0.05) and urethral pain during catheterization (14.0% vs. 31.6%, P < 0.05). Notably, urinary epithelial cells (median 6 vs. 13.5/HP) and leukocytes (31 vs. 81/μL) were reduced in the experimental group (P < 0.05). Activity restriction rates decreased significantly (42.1% vs. 68.4%, P < 0.05), and first void volume improved (200 vs. 150 mL, P < 0.05). There were no meaningful differences between groups in the occurrence of the four urination-related symptoms-including dysuria, urinary hesitation, incomplete bladder emptying, and lower abdominal pain (all P > 0.05).

Conclusion: Super-lubricous Foley catheters effectively mitigate bladder irritation, urethral trauma, and inflammation while enhancing patient mobility. However, they show limited efficacy in alleviating post-removal voiding dysfunction. These findings support the clinical adoption of super-lubricous Foley catheters for reducing catheterization-related complications.

Trial registration: This study was a randomized controlled trial registered at Chinese Clinical Trial Registry (ChiCTR2300078483, https://www.chictr.org.cn/ ) on 11 December 2023.

Background: This study aimed to identify predictive factors for the formation of steinstrasse following extracorporeal shock wave lithotripsy (SWL) in patients with medium-sized (10-20 mm) renal pelvic stones.

Methods: This retrospective cohort study, data of 718 patients who underwent SWL for urinary tract stones were analyzed and single, unilateral, radio-opaque renal pelvic stones were included in the study. Patient age, sex, stone side, shape (round/non-round), size, surface area (SA), and presence of hydronephrosis were recorded. Patients were divided into two groups depending on the presence of steinstrasse: Group 1 (with steinstrasse) and Group 2 (without). Demographic, clinical, and radiological parameters were compared between the groups.

Results: The mean age of the patients was 50.8 ± 11.2 years. The average number of SWL sessions was 2 (range 1-4). Group 1 included 12 patients (23.1%), while Group 2 comprised 40 patients (76.9%). The mean SA in Group 1 was significantly higher than in Group 2 (145.43 vs. 111.69 mm²; p = 0.044). Round stones were more frequently observed in Group 1, whereas non-round stones predominated in Group 2 (83.3% vs. 62.5%, respectively; p = 0.008). The overall SWL success rate was determined as 76.9%. Logistic regression analysis revealed that round stones increased the risk of steinstrasse by 8.333 times (OR = 8.333, 95% CI = 1.604-43.288, p = 0.012).

Conclusions: SA was higher in patients who developed steinstrasse. Since the likelihood of steinstrasse formation is elevated in medium-sized round renal pelvic stones, pre-stenting may be appropriate.