BACKGROUND Pelvic fractures are often associated with significant morbidity, including injuries to the urinary tract. Understanding the incidence and risk factors for urinary tract injury in these patients is crucial for prompt diagnosis and management. This meta-analysis aims to synthesize existing evidence to determine the overall incidence and identify specific risk factors associated with urinary tract injuries in patients with pelvic fractures. AIM To determine the incidence and risk factors for urinary tract injuries in patients with pelvic fractures. METHODS A systematic search of PubMed, EMBASE, Scopus, and the Cochrane Library was conducted without date restrictions. Studies examining the incidence and risk factors of urinary tract injuries in patients with pelvic fractures were included. Data extracted included demographics, injury mechanism, pelvic fracture type, urinary tract injury incidence, mortality, and discharge disposition. Review Manager 5.4 was used for data analysis. RESULTS Ten studies comprising 22700 patients were included. The pooled incidence of urinary tract injury associated with pelvic fracture was 6.88% (95%CI: 6.20%-7.55%). Vehicle, motorcycle, and pedestrian accidents were identified as risk factors for urinary tract injury, with relative risks (RR) of 1.08 (95%CI: 1.06-1.11), 1.89 (95%CI: 1.78-2.00), and 1.53 (95%CI: 1.20-1.95), respectively. Pubic fracture and pelvic ring disruption were significantly associated with urinary tract injury [odds ratio (OR) 1.94, 95%CI: 1.09-3.44 and OR 5.53, 95%CI: 4.67-6.54, respectively)]. Patients without urinary tract injury were more likely to be discharged home (RR 0.79, 95%CI: 0.67-0.92). Mortality was higher in patients with urinary tract injury (OR 1.92, 95%CI: 1.77-2.09). CONCLUSION Urinary tract injury occurs in nearly 7% of patients with pelvic fractures. Motorcycle accidents, pubic fractures, and pelvic ring disruptions are significant risk factors. Urinary tract injury following pelvic fracture is associated with increased mortality.

Introduction: Urachal carcinomas are uncommon malignant neoplasms comprising only 0.01% of all adult cancers. Most patients were aged from 58 to 64 years at diagnosis with 60 years being the median. It usually metastasizes to the lungs (22%), bones (22%), and liver (16%). Presentation: We report a case of a 71-year-old female patient who initially presented with two large liver masses and a small nodule on the anterior side of the bladder. The symptoms were nonspecific with abdominal discomfort. The final diagnosis of urachal adenocarcinoma was finalized with a biopsy of the bladder mass. The patient initially received six doses of FOLFOX6 without improvement and then Gem-Carbo, showing improvement after six doses. Finally, the patient received two doses of FOLFIRI-B with no response and kept deteriorating and died after 19 months of treatment. Discussion: About 90% of patients are symptomatic and hematuria is the most typical presenting symptom at diagnosis. The low incidence and the histopathologic similarities to adenocarcinoma from various sources pose a difficulty in recognizing the tumor. Our study presents the only case of a urachal carcinoma first manifesting with abdominal mass resulting from liver metastasis with no prior symptoms of urological origins. Also, our study presents the first attempt of using FLOFIRI-B to treat metastatic UraC. Conclusion: This case highlights the necessity for clinicopathological correlation to make the correct diagnosis and the challenges in the treatment which urges the need for further research to identify more effective treatment strategies for this rare cancer.

Background: The effectiveness of arthroscopic ankle surgery for chronic ankle conditions, including pain intensity, functionality, and success rates, remains uncertain. Methods: PubMed, Scopus, and Web of Science databases were searched until October 2023. Mean differences (MDs) were calculated for pain reduction and functional improvements, and arthroscopy success rates were determined using a random-effects model. Results: In total, 47 studies were included, encompassing 2,653 patients. Arthroscopic surgery resulted in a significant decrease in pain intensity for osteochondral lesions (MD = −4.49, P = .002) and ankle osteoarthritis (MD = −2.88, P = .034). Functional improvements were observed with notable success rates: 92.5% (soft tissue impingement), 87.5% (ankle synovitis), 73.2% (osteochondral lesions), 71.53% (bony impingement), and 54.7% (ankle osteoarthritis). Conclusion: Arthroscopic ankle surgery proves effective, particularly for osteochondral lesions and impingement conditions, offering good outcomes in terms of pain reduction and functionality. However, the limited quality of available evidence calls for cautious interpretation of these results. Level of Evidence: Meta-analysis of studies with level of evidence III and IV