Background and Purpose: Percutaneous nephrolithotomy (PCNL) using a small tract is controversial, and its indication is considered limited. In our center, however, we have performed Chinese minimally invasive PCNL regularly for managing upper-tract calculi. We report our experience. Patients and Methods: Our technique is not just about using smaller instruments and tracts. Our overall approach is different from the standard PCNL. We preferred a middle caliceal puncture via the 11th rib space and also relied mainly on a strong irrigant current for stone fragment removal. We reviewed and analyzed the prospectively collected database on patients who underwent minimally invasive (MPCNL) from 2001 to 2005. Results: A total of 4760 MPCNL procedures were performed in 3610 kidneys. There were 1240 staghorn stones and 85 ureteral stones. There were 14 transplanted kidneys and 27 cases of horseshoe kidneys. The average operative time was 78 minutes. The stone-free rate at postoperative day 2 was 89%. The major complication rate was 0.86%. Conclusion: Our experience with the Chinese MPCNL shows that it is safe and effective for managing all kinds of upper-tract calculi.

Previous studies have reported an inconsistent relationship between overactive bladder (OAB) and the consumption of tea, coffee, and caffeine. Our study aims to determine these associations in a large and nationally representative adult sample. This cross-sectional study included 15,379 participants from the 2005-2018 US National Health and Nutrition Examination Survey (NHANES) database. The outcome was the risk of wet OAB that was diagnosed when the OAB symptom score was ≥3 with urgent urinary incontinence and excluded other diseases affecting diagnosis. The exposures were the consumption of tea, coffee, and caffeine. Weighted logistic regression models were established to explore these associations by calculating odds ratios (OR) and 95% confidence intervals (CI), as did restricted cubic splines (RCS) used to analyze the nonlinear associations. Of all the participants (n = 15,379), 2207 had wet OAB. Mean [SE] consumption of tea, total coffee, caffeinated coffee, decaffeinated coffee, and caffeine was 233.6 [15.7] g/day, 364.3 [15.5] g/day, 301.6 [14.9] g/day, 62.7 [7.9] g/day, 175.5 [6.6] mg/day in participants with wet OAB, respectively. In the fully adjusted model, compared to those without tea consumption, the high consumption of tea (>481 g/day) was associated with an increased risk of wet OAB (OR: 1.29; 95%CI: 1.01-1.64). Low decaffeinated coffee (0.001-177.6 g/day) had a negative association with the risk (OR: 0.66; 95%CI: 0.49-0.90). In the RCS analysis, tea consumption showed a positive linear association with the risk of wet OAB, and decaffeinated coffee showed a nonlinear relationship with the risk and had a turning point of 78 g/day in the U-shaped curve between 0 and 285 g/day. Besides, total coffee, caffeinated coffee, and caffeine consumption had no significant association with the risk. Interestingly, in the high tea consumption, participants with high total coffee consumption [>527.35 g/day, OR and 95%CI: 2.14(1.16-3.94)] and low caffeine consumption [0.1-74.0 mg/day, OR and 95%CI: 1.50(1.03-2.17)] were positively associated with the risk of wet OAB. High tea consumption was associated with the increased risk of wet OAB, especially intake together with high total coffee and low caffeine consumption, but no significant association with the single consumption of total coffee and caffeine. Low decaffeinated coffee was associated with a decreased risk of wet OAB. It is necessary to control tea intake when managing the liquid intake of wet OAB patients.

Objectives: To determine whether relationship exists between overactive bladder (OAB) and sleep patterns through the cross-sectional study. Patients and methods: Patients from the National Health and Nutrition Examination Survey (NHANES) 2007–2014 were included in this study. Data were extracted through questionnaires, including demographics, dietary and health-related behaviors, body measurements and disease information. Three sleep factors were included to aggregate overall sleep scores, ranging from 0 to 3. A sleep score of 0 to 1, 2 or 3 was expressed as a bad, intermediate or healthy sleep pattern, respectively. The Overactive Bladder Symptom Score (OABSS) scale was applied to quantify the severity of OAB for each participant. Weighted logistic regression models were used to investigate the associations between sleep and OAB. Results: A total of 16,978 participants were enrolled in this study. The relationship between OAB and sleep patterns was statistically significant. After fully adjusting for confounding factors, the OAB risk of patients with intermediate and poor sleep patterns obviously increased by 26% and 38%, respectively, and mild (OR = 1.21, 95% CI [1.03,1.42]), moderate (OR = 1.45, 95% CI [1.27,1.66]) and severe (OR = 1.57, 95% CI [1.18,2.09]) OAB were significantly associated with sleep pattern grouping. The prevalence of OAB is significantly higher in patients with bad sleep patterns, and vice versa. Conclusion: This study indicated that there is a positive relationship between OAB and worse sleep-related issues.

Background: Kidney stone disease is a common surgical disease and a significant public health issue, which may be influenced by environmental factors such as domestic water hardness and its related minerals. Previous studies have shown inconsistent and controversial results regarding the impact of domestic water hardness on kidney stone formation. Methods: This prospective cohort study analyzed data from 288 041 participants in the UK Biobank with no prior history of kidney stones from 2006 to 2024. The exposures were domestic water hardness, calcium concentration, calcium carbonate concentration, and magnesium concentration. The main outcomes were the disease status and onset time of kidney stone diseases. The confounding factors of model adjustment included age, sex, ethnicity, economic level, education level, Townsend Deprivation Index, Index of Multiple Deprivation, assessment center, body mass index, drug history influencing the metabolism of calcium and magnesium, and water intake based on the directed acyclic graph of causal hypothesis. The association between domestic water hardness and kidney stones was assessed using the Cox regression models, sensitivity analyses, subgroup and interactive analyses. Results: During the follow-up period, 3298 participants (1.14%) developed kidney stones. In all participants, the mean concentration of calcium, calcium carbonate, and magnesium was 52.61, 135.01, and 4.66 mg/L, respectively. In Cox regression models, higher magnesium levels (Q4, > 5 mg/L) in natural water use can reduce the risk of kidney stones [HR and 95% CI: 0.88 (0.80–0.97) in model 3], but no significant correlation was found in domestic water hardness, calcium concentration, and calcium carbonate concentration in the overall models. Four sensitivity analyses further supported the overall results in the overall models. In subgroup analysis, hard water and calcium concentration in domestic water can increase the 18%–34% incidence risk of kidney stones in participants over 60 years old and female participants; high magnesium concentration (>5 mg/L) in domestic water can decrease the 10%–28% risk of kidney stones in males, participants ≤ 45 years old, and participants without renal failure. Magnesium interacted with other minerals, and its protective effects were more significant in hard water (HR: 0.73, 95% CI: 0.61–0.87), a high concentration of CaCO₃ (HR: 0.62, 95% CI: 0.50–0.78), and calcium (HR: 0.48, 95% CI: 0.33–0.71) in domestic water. Conclusion: Our findings suggested that magnesium levels in water can decrease kidney stone risk, but in the overall population, domestic water hardness, calcium concentration, and calcium carbonate concentration have no significant impact on the formation of kidney stones. Interestingly, hard water and its calcium concentration can promote the formation risk of kidney stones in participants > 60 years old and females, while high magnesium concentration in domestic water can reduce the risk in males, ≤ 45 years old, and those without renal failure. The protective effects of magnesium interacted with other minerals and were more obvious in the population intake of hard water and high concentrations of CaCO₃ and calcium. This study contributes to the complex understanding of environmental factors in kidney stone etiology and suggests a need for focusing on mineral-specific effects in different populations and interaction with other minerals, which hope to provide some evidence of water’s role in public health and clinical management of kidney stones.