Background and objectives: Type 2 diabetes mellitus (T2DM) is becoming increasingly prevalent worldwide and is associated with increased incidence of kidney cancer and bladder cancer (BC). However, studies have produced conflicting results. Therefore, we retrospectively evaluated the incidence of BC in T2DM patients using the Taiwan National Health Insurance Research Database (NHIRD). Materials and Methods: We included 31,932 patients with a diagnosis of T2DM in the study group and 63,864 age- and sex-matched patients without T2DM at a ratio of 1:2 in the control group. The primary outcome was the diagnosis of BC. Cox proportional hazards regression was used to evaluate the incidence and adjusted hazard ratio (aHR) of BC in the multivariate model. Results: After a 16-year follow-up, we found that 67 BC cases occurred in the study group and 152 BC events in the non-T2DM group without a significantly higher risk (aHR: 0.842, 95% confidence interval: 0.627–1.13). Conclusions: T2DM patients do not have a higher risk of BC.

Background and Objectives: This paper evaluates the efficacy and safety of ureteral access sheath (UAS) utilization in retrograde intrarenal surgery (RIRS). Materials and Methods: We searched PubMed, Embase, and the Cochrane Library up to 30 August 2023. The inclusion criteria comprised English-language original studies on RIRS with or without UAS in humans. The primary outcome was SFR, while the secondary outcomes included intraoperative and postoperative complications, the lengths of the operation and the hospitalization period, and the duration of the fluoroscopy. Subgroup analyses and a sensitivity analysis were performed. Publication bias was assessed using funnel plots and Egger’s regression tests. Dichotomous variables were analyzed using odds ratios (ORs) with 95% confidence intervals (CIs), while mean differences (MDs) were employed for continuous variables. Results: We included 22 studies in our analysis. These spanned 2001 to 2023, involving 12,993 patients and 13,293 procedures. No significant difference in SFR was observed between the UAS and non-UAS groups (OR = 0.90, 95% CI 0.63–1.30, p = 0.59). Intraoperative (OR = 1.13, 95% CI 0.75–1.69, p = 0.5) and postoperative complications (OR = 1.29, 95% CI 0.89–1.87, p = 0.18) did not significantly differ between the groups. UAS usage increased operation times (MD = 8.30, 95% CI 2.51–14.10, p = 0.005) and fluoroscopy times (MD = 5.73, 95% CI 4.55–6.90, p < 0.001). No publication bias was detected for any outcome. Conclusions: In RIRS, UAS usage did not significantly affect SFR, complications, or hospitalization time. However, it increased operation time and fluoroscopy time. Routine UAS usage is not supported, and decisions should be patient-specific. Further studies with larger sample sizes and standardized assessments are needed to refine UAS utilization in RIRS.

Background: Since the mass vaccination for COVID-19, several case reports indicated the risk of autoimmune disease flare-ups after the vaccination. Among them, COVID-19 vaccine-induced glomerular diseases have drawn attention worldwide. The cases demonstrating the association between the mRNA vaccine and IgA nephropathy (IgAN) exacerbation had been noticed. Mostly mentioned, the flare-ups usually occurred after the second dose. Methods: We present a Taiwanese female with IgAN who developed gross hematuria within only six hours after the first dose of the Moderna vaccine. Results: Six hours after the first dose of Moderna vaccine on 8 June 2021, the patient developed gross hematuria and significantly decreased urine output. All symptoms resolved spontaneously on the fifth day after the vaccination without any intervention. On the fourth day after the vaccination, the patient were able to back to her original condition. Conclusion: This was an intriguing case of IgAN flare-up following the first dose of mRNA-based COVID-19 vaccination.

Introduction: Benign prostatic enlargement (BPE) and lower urinary tract symptoms present challenges in aging men, often addressed through transurethral resection of the prostate (TURP). Despite technological advancements, bladder neck contracture (BNC) remains a concern. This study explores predictors, including comorbidities, influencing BNC after TURP. Methods: A retrospective cohort study at Changhua Christian Hospital analyzed 2041 BPE patients undergoing bipolar TURP. Preoperative urinary catheterization and resection speed were categorized. Patient data included demographics, comorbidities, operative details, and outcomes. Statistical analyses utilized χ2, Kruskal-Wallis tests, and Cox regression models. Results: Within 3 years, 306 (15%) patients developed BNC. Univariate Cox regression identified chronic heart failure (p = 0.033), chronic obstructive pulmonary disease (COPD; p = 0.002), preoperative urinary catheterization (p < 0.001), and low resection speed (p = 0.045) as significant BNC risk factors. Notably, COPD (p = 0.011) and preoperative urinary catheterization (p < 0.001) emerged as independent risk factors for BNC development in multivariate Cox regression analysis. Conclusions: Preoperative urinary catheterization and COPD were significant predictors of BNC post-TURP, while resection speed showed no significant influence. These findings offer clinicians insights for risk assessment, enhancing patient outcomes, and optimizing resources post-TURP.

Background and Objectives: The limited literature on the significance and risk factors of intraoperative anastomotic leakage (IAL) following Retzius-sparing robot-assisted radical prostatectomy (Rs-RARP) highlights the need for further investigation. This study aimed to assess the incidence of IAL, identify its associated risk factors, and evaluate its clinical implications. Materials and Methods: Patients with prostate adenocarcinoma who underwent Rs-RARP performed by a single surgeon between February 2015 and August 2023 were included in this study. Positive IAL was defined as the presence of anastomotic leakage identified through a water injection test performed immediately after vesicourethral anastomosis (VUA). Postoperative urinary continence was defined as the use of no pads or only a safety pad. Patients were categorized into two groups: those with positive IAL and those without. Immediate repair was performed in cases of positive IAL, and cystography was conducted approximately 10–14 days postoperatively. Chi-square test, Fisher’s exact test, Mann–Whitney U test, as well as univariable and multivariable logistic regression analyses, were used to evaluate the risk factors associated with IAL. Additionally, we analyzed the continence rate and the time to achieve continence following surgery. Results: A total of 230 patients underwent Rs-RARP for prostate adenocarcinoma performed by a single surgeon at our center during the aforementioned period. A water injection test was performed in all patients immediately after the VUA. IAL was observed in 32 patients (14%) during the water injection test. Postoperative cystography revealed very mild contrast medium leakage in only two patients (0.9%), with no impact on clinical recovery. No major IAL cases were identified on postoperative cystography. Patients with positive IAL required a significantly longer time to achieve continence compared to those without IAL (2.13 vs. 0.46 months, p = 0.008). Univariable analysis showed that a locally advanced T stage (>T2), longer console time, and absence of nerve-sparing were significantly associated with positive IAL. In multivariable analysis, a longer console time and a locally advanced T stage remained significant predictors of IAL. Conclusions: IAL detected by the water injection test was associated with the development of postoperative urinary incontinence and delayed recovery of continence. A tumor stage greater than T2 and longer console time were significant predictors of IAL. Further prospective randomized studies with larger sample sizes are required to validate our findings.

Diabetic Mellitus (DM) is a widespread chronic disease around the world, among which type 2 DM (T2DM) shared the majority. It caused multiple severe complications and consequently a high mortality rate. DM complications overwhelm jeopardize the patient’s quality of life. In response to the threats of such complications, some nutraceuticals were developed, including the highly praised bitter melon peptide (BMP). This study aims to apply the structural equation model in HBM. A theoretical model had been developed on the health belief model (HBM), and to test with the structural equation model (SEM) technique to examine the fitness of the theory and the data gathered in this research. A structural questionnaire was developed and used to collect 292 valid responses from DM patients. The SEM results indicated the fitness of the theory and the data were acceptable. Perceived susceptibility of DM complications and perceived benefits of nutraceutical were major predictors of intake behavior, and the association of perceived benefits and behavior was mediated by the patient’s self-efficacy on nutraceutical intake behavior.