Favorable testicular cancer mortality-to-incidence ratios (MIRs) are associated with health care disparities, including health care expenditures, but the trends of testicular MIR and health care disparity remain unclear. We evaluated changes in MIR as the difference between 2012 and 2018, termed delta MIR (δMIR). Health care expenditures and the human development index (HDI) were obtained from the World Health Organization and the Human Development Report Office of the United Nations Development Programme. The association between the variables was analyzed by Spearman’s rank correlation coefficient. A total of 54 countries were included in the criteria of data quality reports and missing data. By continent, the most favorable MIR was in Oceania (0.03) while it was 0.36 in Africa. In these areas, the incidence rates were positively correlated to health care expenditure, but the mortality rates showed a reversed correlation. The MIR ranged from 0.01 to 0.34 and the δMIR ranged from −0.05 to 0.34. The favorable MIRs are correlated to high health care expenditure and HDI (all p < 0.001). Interestingly, favorable δMIRs tend to be seen in countries with relatively low health care expenditure and HDI (all p < 0.001). In conclusion, favorable testicular cancer MIRs are associated with high HDI and health care expenditure, but the improvement in MIR between 2012 and 2018 (δMIR) is negatively correlated with HDI and health care expenditure.

Background: The incidence of upper tract urothelial carcinoma (UTUC) is uniquely high in kidney transplant (KT) recipients in Taiwan. The evidence of adjuvant chemotherapy (AC) in UTUC is contradictory. We have sought to determine whether AC is associated with potential benefits related to locally advanced UTUC after KT. Methods: We retrospectively analyzed 134 patients with locally advanced UTUC (at least stage T2) and patients who were administrated AC after unilateral or bilateral nephroureterectomy with bladder cuff excision. Of these 134 patients, 57 patients fulfilled our inclusion criteria. We used 23 KT and 34 non-KT locally advanced UTUC patients for comparison. Results: The mean follow-up time was 52.35 ± 34.56 and 64.71 ± 42.29 months for the KT and non-KT groups, respectively. The five-year disease-free survival (DFS) and overall survival (OS) rates were 45.7% vs. 70.2% and 62.8% vs. 77.6%, for the KT and non-KT groups. The Kaplan–Meier curve and the log rank test revealed significant differences in the DFS and OS rates between the two groups, p = 0.015 and 0.036. The influence of chemotherapy on graft kidney function was mild. Only three in the KT group and two in the non-KT group developed > grade 2 nephrotoxicity. Conclusions: Our study suggested that KT patients with locally advanced UTUC who had been administered AC after surgery presented worse OS and DFS than non-KT patients. KT patients tolerated the AC course well, and their nephrotoxicity levels were mild and acceptable.

A patient in his mid-40s with a history of gastric ulcer and gastro-oesophageal reflux disease presented with 6 months of left flank discomfort. He was diagnosed with stage III (cT3aN1M0) papillary renal cell carcinoma and received neoadjuvant therapy for 3 months. Follow-up imaging showed partial response with residual carcinoma and metastatic lymphadenopathies. The patient subsequently underwent laparoscopic radical nephrectomy with lymph node dissection. Postoperatively, he developed chylous ascites and subsequent persistent hiccups as unusual complications. Although chylous ascites improved gradually, the hiccups persisted despite non-pharmacological interventions and pharmacological treatments. Finally, the hiccups ceased following the removal of the J-P drain which ended up stimulating the phrenic nerve by the J-P drain at left renal fossa.

We present a case of a man in his late 70s with a history of peritonitis and vesical stones who developed severe complications after undergoing the transurethral resection of a bladder tumour (TURBT) followed by immediate mitomycin C (MMC) instillation. The patient experienced abdominal pain and haematuria and was subsequently diagnosed with pancytopenia and extraperitoneal bladder rupture. He later developed a urinary tract infection, leading to methicillin-resistant Staphylococcus aureus-related septic pulmonary embolism (SPE). Despite intensive care efforts, his condition deteriorated, culminating in discharge for impending death. Pancytopenia and SPE represent rare but severe complications associated with post-TURBT immediate intravesical MMC instillation. Clinicians must be vigilant for symptoms of bladder perforation and consider deferring to chemotherapy in such cases.

Cystitis cystica and glandularis is a rare pathological condition characterised by cystic and glandular proliferations of the bladder wall. This case report presents a unique instance of bladder outlet obstruction (BOO) caused by this condition at the bladder neck, emphasising clinical manifestations, surgical intervention and postoperative outcomes. A literature review further contextualises this diagnosis within urology.