Delayed ileal neobladder fistula caused by bladder stones: a case report.

BACKGROUND: Ileal neobladder fistula is a rare complication after radical cystectomy, with an incidence of approximately 0.7%. At present, there are scattered reports of vesicoileal fistula, but there are no reports of ileal neobladder fistula (INF) caused by bladder stones. In this paper, a case of ileal neobladder fistula caused by chronic stimulation of bladder stones was successfully diagnosed and treated. CASE PRESENTATION: A 68-year-old man who had undergone radical cystectomy and an orthotopic ileal neobladder procedure 10 years prior presented with refractory diarrhoea and oliguria and was diagnosed with ileal neobladder fistula caused by chronic stimulation of bladder stones. We performed fistulectomy, cystotomy, partial ileectomy, and end-to-end ileal anastomosis, and the patient recovered and was discharged after the operation. CONCLUSION: Urinary calculi are delayed complications of orthotopic neobladder construction after total cystectomy. Bladder stones are a rare complication of ileal neovesical fistula, which can cause neovesical cutaneous fistula. It is difficult to diagnose through routine examination and easily misdiagnosed as acute gastroenteritis. Surgery is an effective treatment for INF and can achieve a good prognosis.

The efficacy of cytoreductive surgery for oligometastatic prostate cancer: a meta-analysis.

BACKGROUNDS: At present, the application of tumor reduction surgery in oligometastatic prostate cancer has aroused extensive discussion among urologists, but clinicians have not reached a consensus on this issue. The purpose of this study was to evaluate the effect of cytoreductive surgery for patients with oligometastatic prostate cancer by meta-analysis. METHODS: All relevant studies were systematically searched through The Cochrane Library, PubMed, Web of Science, EMBASE, and China Biomedical Literature Database (CBM) up to December 2019. All the previous clinical studies on the comparison of long-term efficacy between the cytoreductive surgery group and the endocrine therapy group were included in the search. The included studies were analyzed using Stata ver.14.0. The research has been registered on PROSPERO website with the registration number of crd42021224316. The relevant registration information can be obtained from the website: https://www.crd.york.ac.uk/prospero . RESULTS: The case presentation is as follows: ten studies were identified that met the conclusion criteria. The total number of samples was 804; 449 patients underwent cytoreductive surgery, and 355 patients underwent endocrine therapy, and we conducted a meta-analysis of studies to compare the prognosis of endocrine therapy and cytoreductive surgery for treating prostate cancer. After all the studies were analyzed, we found that between cytoreductive surgery and endocrine therapy, a significant difference existed in overall survival (HR = 0.635, 95% CI 0.443-0.908, P = 0.013), cancer-specific survival (HR = 0.407, 95% CI 0.243-0.681, P = 0.001), and progression-free survival (HR = 0.489, 95% CI 0.315-0.758, P = 0.001), while there were no significant difference in progresses to castration-resistant prostate cancer (HR = 0.859, 95% CI 0.475-1.554, P = 0.616). CONCLUSION: The cytoreductive surgery held advantages in overall survival, cancer-specific survival, and progression-free survival. Therefore, compared with endocrine therapy, cytoreductive surgery could be a more suitable approach in treating oligometastatic prostate cancer.

Differential expression of epithelial sodium channels in human RCC associated with the prognosis and tumor stage: Evidence from integrate analysis.

Background: Epithelial sodium channels are disputed in renal cell carcinoma, but its functions and effects on clinical outcomes are not well understood. Materials and Methods: IHC and PT-PCR were used to detect ENaCα, ß, γ, AVPR2, AQP2, and MR expression in the primary tumor and peritumoral tissues. GEPIA online tool was used to analyze the relationship between epithelial sodium channels and clinical-pathological characteristics. Tumor IMmune Estimation Resource online tool was used to investigate the immune profile relevant to epithelial sodium channels expression. Results: Quantitative RT-PCR analysis revealed that ENaCα, ß, γ, AQP2, and AVPR2 mRNA were decreased in the RCC, but there was no difference in MR mRNA expression between kidney and RCC (p=0.238). The IHC analyses showed that the intensely positive staining of ENaCα, ß, γ, AVPR2, and AQP in the renal tubular and the attenuated in the RCCs. MR displayed moderate staining in both RCC and normal tissue. With the promotion of staging, the expression of AQP2, AVPR2, and MR reduced gradually and predicted a better prognosis. Although ENaCα, ß, and γ were unable to associate with staging, we still observed a high expression of ENaCß and γ displayed a poorer prognosis of RCC. Conclusions: ENaCs shows an oncogene profile in RCC, drugs targeting epithelial sodium channel should be a possible therapeutic way to treat RCC. AVPR2 and MR exhibit an encouraging immunomodulatory function; patients with low expression of AVPR2 and MR may obtain more benefit from immunotherapy.