Introduction: Patients with bladder cancer have a high risk of venous thrombosis that represents a key challenge for physicians in the decision-making for initiating anticoagulation therapy. Non-muscle-invasive bladder cancer (NMIBC) represents more than 70% of all diagnosed bladder malignancies; therefore, we aimed to evaluate the relationship of the neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and risk of thrombosis by using the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) score as well as the risk of bleeding by using the IMPROVE Bleeding Risk Assessment Score in a study cohort. Material and Methods: This was a retrospective observational study involving 130 patients who met the inclusion criteria: age > 18 years, stage pTa-pT1 NMIBC. The exclusion criteria were age < 18 years; stage pT2 or higher; or a presentation of metastasis, inflammatory, liver or autoimmune diseases, or other systemic neoplasms. In order to evaluate the risk of thromboembolic events as well as those of bleeding, the IMPROVE scores were calculated for each patient. Subjects were categorized in a Low IMPROVE group (< 4 points) or a High IMPROVE group. By using uni- and multivariate regression models, we analyzed CBC-derived parameters which could be associated with a higher risk of venous thrombosis in subjects with low or high IMPROVE scores. Results: Patients with IMPROVE score greater than 4 were associated with higher NLR, LMR and lymphocyte values (p < 0.05). In a multivariate regression model, the IMPROVE score was significantly influenced by lymphocyte count (p = 0.007) as well as the NLR value (p < 0.0001). Conclusions: In our study population, subjects with NMIBC with low lymphocytes and NLR > 3 were at a higher risk of developing venous thromboembolic events, reflected by an IMPROVE score of greater than 4. The IMPROVE and IMPROVE Bleeding Risk Assessment Scores are easy to use, and, complemented with the CBC-derived lymphocyte to monocyte ratio as a prothrombotic marker, could aid in the decision of prophylactic anticoagulation therapy during admission.

Rationale: Concurrent pelvic organ prolapse (POP) and rectal prolapse is a rare condition that poses significant therapeutic challenges. A customized, multidisciplinary strategy is frequently required, particularly in complex cases with underlying functional deficits. Patient concerns: A 71-year-old woman presented with stage III POP and grade V rectal prolapse. Her history included no pregnancies or vaginal intercourse, and she previously underwent sacral tumor excision resulting in anal and urinary incontinence, requiring long-term catheterization. Diagnoses: Preoperative clinical examination and imaging (transabdominal and transvaginal ultrasound) confirmed the diagnosis of stage III POP and grade V rectal prolapse. Routine blood tests, vaginal bacteriological cultures, and Pap smear were unremarkable. Interventions: The patient underwent a multidisciplinary surgical procedure including hysterectomy, sacrocolpopexy, and rectopexy using a Pro-Grip™ self-fixating mesh. The mesh was placed to anchor the vaginal stump and provide rectal support simultaneously. Outcomes: The patient had an uneventful recovery, with drain removal on postoperative day 5 and discharge on day 7. Follow-up at 3 months, 6 months, and 1 year showed no recurrence of prolapse. The patient declined additional imaging at 1 year, considering herself fully recovered. Lessons: This case demonstrates that a self-fixating mesh can provide effective concurrent repair of POP and rectal prolapse in a single procedure. Short-term outcomes were favorable, but long-term follow-up remains essential to assess durability and potential complications.

It is estimated that erectile dysfunction (ED) affects more than 150 million people worldwide and this number is expected to double by the year 2025. Vascular component represents the most important etiological cause of erectile dysfunction. ED shares almost all risk factors, such as hypertension, diabetes mellitus, hyperlipidaemia and smoking, with arteriosclerosis. Moderate to severe ED is associated with a considerably increased risk for coronary heart disease (CHD). This review was conducted in May 2016, when the PubMed database was searched using the combination of the terms “erectile dysfunction” and “cardiovascular diseases”, “coronary artery diseases” and “risk factors”. In this review, we analyzed the published literature, regarding the predictive role of ED in CVD and the association of ED risk factors with CVD risk factors, aiming to draw particular attention on the role of sexual inquiry of all men to prevent or decrease major cardiovascular events. In conclusion, the early detection of ED can prevent major cardiovascular events with early management of cardiovascular risk and permits to include patients in a risk stratification group. Erectile function should be evaluated using questionnaires in all male patients to prevent and decrease the rates of major cardiovascular events.

Introduction: Bladder cancer (BC) ranks as the 10th most common cancer globally, predominantly affecting older adults. Non-muscle invasive BC (NMIBC) are known for high recurrence and progression rates despite standard treatments. Objective: This study assesses the efficacy of chemohyperthermia with epirubicin in Bacillus Calmette–Guérin (BCG)-naïve patients with either primary or recurrent NMIBC. Methods: We conducted a prospective pilot study on this cohort using the bladder wall thermochemotherapy – UniThermia platform, with a follow-up period of 24 months. Nine NMIBC patients (88.89% male; mean age: 70.22 ± 11.82 years) were prospectively enrolled. Inclusion criteria were NMIBC stage Ta–T1 with BCG-naïve status; patients with carcinoma in situ (CIS) were excluded. Results: Tumor staging revealed pTa in six patients and pT1 in three patients; tumor grading included G1 (11.11%) and G2 (88.89%). No CIS was detected. All patients received six weekly chemohyperthermia instillations. At the 24-month follow-up, four patients (44.4%) achieved a complete response with no recurrences; all remained alive with no disease progression. All recurrences were low-grade pTa. Conclusion: These findings suggest that chemohyperthermia with epirubicin may offer therapeutic advantages over intravesical BCG or conventional chemotherapy, especially for BCG-intolerant or refractory patients. Study limitations include the small sample size and limited follow-up duration. Further multicenter studies are warranted to validate these preliminary results. Overall, chemohyperthermia with epirubicin appears to be a promising alternative for the management of recurrent NMIBC when standard BCG treatment is ineffective or unavailable.

Introduction: Cystic congenital malformations of the seminal vesicle are unusual. More than half of them are associated with ipsilateral renal agenesis. This disease was first described by Zinner in 1914, and since then, more than 200 cases have been reported. Most of the patients with this congenital disease present few symptoms until the middle-age. Case presentation: A 61-year-old male was referred to the Urology Clinic with intermittent pain and sensibility in his lower left abdomen in the last 12 months accompanied by intermittent bowel obstruction. The digital rectal examination could not assess the prostate due to a rectal stenosis. On computed tomography and magnetic resonance imaging (MRI) a cystic tumor with close relations with the bladder wall and prostate, associated with left kidney agenesis was identified. The cystic tumor was surgically removed. The histopathological examination of the tumor revealed a multilocular seminal vesicle cyst, with a muscular wall. Conclusions: Seminal vesicle cysts combined with ipsilateral renal agenesis are rare urological anomalies. Imaging allows a comprehensive investigation of renal and seminal vesicle anomalies. MRI seems to better visualize cysts and differentiate them from ureteroceles, while the histopathological examination contributes to a correct diagnosis. A multidisciplinary team (urologists, radiologists, and morphologists) is necessary for the proper diagnosis of Zinner’s syndrome.