ObjectiveTo discuss the differences in the effectiveness and security for T1 renal tumors by radiofrequency ablation (RFA) and cryoablation (CA).MethodsWe systematically searched the Cochrane Library, PubMed, Embase, CNKI databases, and Science databases, and the date was from the above database establishment to August 2021. Controlled trials on RFA and CA for T1 renal tumors were included. The meta-analysis was conducted with the Review Manager 5.4 software.ResultsA total of ten studies with 2,367 patients were included in the analysis. There were no significant differences in complications (odds ratio [OR], 1.23; 95% CI, 0.80 to 1.90; p=0.35), primary technique efficacy rate (OR, 1.01; 95% CI, 0.33 to 3.14; p=0.98), changes in serum creatinine (weighted mean difference [WMD], 0.53; 95% CI, -0.50 to 1.57; p=0.31), or 5-year survival rate (hazard ratio [HR], 1.11; 95% CI, 0.41 to 3.00; p=0.84) among patients undergoing RFA and CA. However, compared with patients who underwent RFA, patients who underwent CA had a lower Local recurrence (OR: 2.25; 95% CI: 1.38 to 3.67; p = 0.001).ConclusionThe analysis demonstrated that in the treatment of T1 renal tumors, CA may be associated with lower local recurrence rates. However, no differences were observed in terms of primary technique efficacy rate, 5-year survival rate, changes in serum creatinine, and complication rate between groups.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO/], identifier PROSPERO (CRD42021295160).

Objectives To build a nomogram prediction model, assess its predictive ability, and perform a survival decision analysis on patients with muscle‐invasive bladder cancer (MIBC) to study risk factors affecting overall survival (OS). Methods A retrospective analysis was performed on the clinical information of 262 patients with MIBC who underwent radical cystectomy (RC) at the Urology Department of the Second Affiliated Hospital of Kunming Medical University between July 2015 and August 2021. The final model variables that were included were chosen using single‐factor stepwise Cox regression, optimal subset regression, and LASSO regression + cross‐validation with the minimum AIC value. The next step was to do a multivariate Cox regression analysis. The establishment of a nomogram model by fitting and the screening out of independent risk factors impacting the survival of patients with MIBC having radical resection. Receiver Activity Characteristic curves, C‐index, and a calibration plot evaluated the prediction accuracy, validity, and clinical benefit of the model. The 1‐, 3‐, and 5‐year survival rates were then computed for each risk factor using a Kaplan–Meier survival analysis. Results 262 eligible patients in total were enrolled. With a median follow‐up of 32 months, the follow‐up period ranged from 2 to 83 months. 171 cases (65.27%) survived while 91 cases (34.73%) perished. Age (HR = 1.06 [1.04; 1.08], p = 0.001), preoperative hydronephrosis (HR = 0.69 [0.46, 1.05], p = 0.087), T stage (HR = 2.06 [1.09, 3.93], p = 0.027), lymphovascular invasion (LVI, HR = 1.73 [1.12, 2.67], p = 0.013), prognostic nutritional index (PNI, HR = 1.70 [1.09, 2.63], p = 0.018), and neutrophil‐to‐lymphocyte ratio (NLR, HR = 0.52 [0.29, 0.93)], p = 0.026) were independent risk factor for the survival of bladder cancer patients. Create a nomogram based on the aforementioned findings, and then draw the 1‐year, 3‐year, and 5‐year OS receiver operating characteristic curves by the nomogram. The AUC values were 0.811 (95% CI [0.752, 0.869]), 0.814 (95% CI [0.755, 0.873]), and 0.787 (95% CI [0.708, 0.865]), respectively, and the calibration plot matched the predicted value well. The 1‐year, 3‐year, and 5‐year decision curve analyses were higher than the ALL line and None line at threshold values of >5%, 5%–70%, and 20%–70% indicating that the model has good clinical applicability. The calibration plot for the Bootstrap 1000‐time resampled validation model was similar to the actual value. Patients with preoperative combination hydronephrosis, higher T‐stage, combined LVI, low PNI, and high NLR had worse survival, according to Kaplan–Meier survival analysis for each variable. Conclusions This study might conclude that PNI and NLR were separate risk factors that affect a patient's OS after RC for MIBC. The prognosis of bladder cancer may be predicted by PNI and NLR, but additional confirmation in randomized controlled trials is required.

Background: Lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) are common in middle-aged and elderly men. The current drugs for treating this disease include α1-adrenoceptor antagonists (ABs), muscarinic receptor antagonists (MRAs), phosphodiesterase five inhibitors (PDE5-Is), and β3-adrenoceptor agonists (B3As). However, direct comparative studies analyzing different therapies are limited; therefore, we conducted a network meta-analysis (NMA) to evaluate the efficacy of different drug regimens for treating BPH/LUTS.Methods: The PubMed, EMbase, Web of Science, and Cochrane Library databases were searched to collect randomized controlled trials (RCTs) of different drug treatments for BPH/LUTS from January 2000 to April 2021. The NMA was performed using R 4.1 software.Results: Fifty-five RCTs were included among a total of 1639 trials. ① ABs + PDE5-Is, ABs + B3As, ABs + MRAs, ABs, and PDE5-IS were superior to the placebo in improving the total International Prostate Symptom Score (IPSS), IPSS-Voiding, and IPSS-storage. ② For increasing the maximum flow rate (Qmax), ABs + PDE5-Is, ABs + MRAs, and ABs were more effective than the placebo. ③ Regarding reducing post-void residual urine (PVR), none of the six treatment plans had significant effects.Conclusion: Combination therapy showed greater efficacy than monotherapy, and ABs + PDE5-Is was the most successful treatment for improving the overall IPSS score. ABs are a primary therapeutic measure to increase Qmax, and ABs + PDE5-I may be a more suitable choice for enhancing Qmax. The combination of MRA and AB+ MRA may lead to an increase in PVR.Systematic Review Registration: [website], identifier [registration number].

Background: This review aims to compare the efficacies of fluorescence cystoscopy, narrow-band imaging, and white-light cystoscopy in the treatment and diagnosis of bladder cancer. Methods: We searched PubMed, EMbase, Web of Science, and Cochrane Library from January 1990 to April 2022. A total of 26 randomized controlled studies and 22 prospective single-arm studies were selected. Most patients had non-muscle-invasive bladder cancer. The study protocol has been registered at PROSPERO. Results: In the pairwise meta-analysis, 5-aminolevulinic acid reduced the short- and long-term recurrence rates of bladder cancer compared with white light cystoscopy; however, no statistical difference was observed in intermediate-term recurrence rates(RR=0.79, 95%CI: 0.57, 1.09). Hexaminolevulinic acid and narrow-band imaging reduced short-, intermediate-, and long-term recurrence rates. The sensitivity of 5-aminolevulinic acid, hexaminolevulinic acid, narrow-band imaging and white light cystoscopy for bladder cancer were 0.89 (95% CI: 0.81–0.94), 0.96 (95% CI: 0.92–0.98), 0.96 (95% CI: 0.92–0.98), and 0.75 (95% CI: 0.70–0.79), respectively; however, only narrow-band imaging had the same specificity as white light cystoscopy(0.74 vs. 0.74). Compared with white light cystoscopy, 5-aminolevulinic acid improved the detection rate of carcinoma in situ and Ta stage bladder cancer but had no advantage in T1 stage tumors(OR=2.39, 95%CI:0.79, 7.19). Hexaminolevulinic acid and narrow-band imaging improved the detection rates of all non-muscular-invasive bladder cancers. In the network meta-analysis, there was no significant difference in either recurrence or detection rates between 5-aminolevulinic acid, hexaminolevulinic acid, and narrow-band imaging. Conclusion: Fluorescence cystoscopy and narrow-band imaging are advantageous for treating and diagnosing patients with non-muscle-invasive bladder cancer.