Surgical site infections (SSIs) are a complication in any surgical field and they are responsible for 38% of surgery‑related patient deaths. Identifying appropriate prophylaxis and solutions to combat SSIs is of global interest. Several studies and reports on SSI raise awareness of this costly complication, both in terms of physical and mental suffering, and as a monetary burden. Knowing the risk factors and implementing strategies to reduce SSI risk represent an adequate approach to reduce SSI incidence. General risk factors of SSI are applicable in the obstetrics and gynecology field, alongside its specific characteristics, including immunological changes occurring during pregnancy, as well as disturbances of vaginal microbiota. The risk of SSI is determined by patient factors but also by preoperative, intraoperative and postoperative care. ‘Bundle’ prevention strategies have been smartly adopted and their efficiency has been demonstrated in colorectal surgery, cesarean deliveries and gynecological oncology surgeries. ‘Bundle’ measures may vary among studies, but they remain important prevention methods, which contribute to decreasing SSIs, which is a favorable outcome, and thus, are increasingly used as a routine practice. Therefore, healthcare personnel should aim for the early identification of risk factors to minimize the risk of SSI. All evidence‑based methods for preventing and treating SSIs in all surgical fields should be considered to be integral components in order for the best care to be provided to patients.

Xanthogranulomatous pyelonephritis (XGP) represents a rare and severe pathology secondary to chronic urinary obstruction and recurrent infections. Commonly, this condition leads to loss of kidney function, and frequently, surgical approach is the only optional treatment. Proteus mirabilis and Escherichia coli are the most frequent pathogens associated with XGP. The actual changes in the pathogen’s characteristics increased the risk of newly acquired infections once considered opportunistic. Stenotrophomonas malthophilia is one of those agents more related to immunocompromised patients, presenting an increased incidence and modified antibiotic resistance profile in the modern era. This case report presents a healthy female patient with an underlying renal stone pathology diagnosed with XGP related to S. maltophilia urinary infection. After a complete biological and imagistic evaluation, the case was treated as pyonephrosis. Empirical antibiotic administration and a surgical approach were considered. A total nephrectomy was performed, but the patient’s condition did not improve. The patient’s status improved when specific antibiotics were administered based on the bacterial identification and antibiotic susceptibility pattern of drained perinephric fluid. Levofloxacin and Vancomycin were considered the optimal combination in this case. The histopathological examination revealed XGP secondary to chronic renal stone. The present study describes the first case of XGP related to an aerobic Gram-negative pathogen such as S. maltophilia, once considered opportunistic, in an apparently healthy female adult.

Percutaneous renal surgery, although much less invasive than other procedures, is subject to several complications, which can occur at any time during the course of treatment, starting from the performance of the minimal nephrostomy procedure. We present an extremely rare vascular complication of percutaneous nephrostomy represented by arteriovenous fistula that occurred in a 24-year-old patient known to have right ureteropelvic junction obstruction operated with the absence of double-J catheter permeability and grade II-III hydronephrosis for which minimal percutaneous nephrostomy was urgently fitted. The arteriovenous fistula was resolved by supraselective artery embolization.

Background: The benefit of adding hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreductive surgery (CRS) in ovarian cancer with peritoneal metastasis remains debated outside selected indications. We performed a systematic review and meta-analysis to quantify survival, perioperative morbidity, and completeness of cytoreduction using study-level data. Methods: PubMed/MEDLINE, Embase, and Web of Science were searched. Eligible English-language studies included ovarian cancer patients undergoing CRS plus HIPEC and reported at least one of the following: overall survival (OS), progression-free survival (PFS), Grade III–IV complications, or CC-0 rate. Random-effects meta-analyses were conducted using inverse-variance pooling. For HR outcomes, DerSimonian–Laird τ² with Hartung–Knapp confidence intervals was applied. Proportions were pooled using logit transformation (PLOGIT) with random-effects models. Results: Twelve studies (n = 567) were included. Only two studies provided extractable HRs for OS and PFS (n = 217). CRS plus HIPEC was associated with improved OS (HR 0.68, 95% CI 0.52–0.90, p = 0.0023; I² = 0%; prediction interval 0.14–3.34) and improved PFS (HR 0.70, 95% CI 0.31–1.57, p = 0.0007; I² = 0%; prediction interval 0.18–2.66). Across 12 studies (n = 563), the pooled Grade III–IV complication rate was 0.18 (95% CI 0.14–0.22; I² = 16.3%; prediction interval 0.12–0.26). In 10 studies (n = 385), the pooled CC-0 rate was 0.87 (95% CI 0.79–0.92; I² = 46.7%; prediction interval 0.66–0.96). Conclusions: CRS plus HIPEC shows a favorable signal for OS and PFS in the limited HR-eligible evidence and appears feasible, with a pooled severe complication rate of ~18% and high CC-0 rates. Current data support HIPEC primarily as a targeted intensification strategy in carefully selected patients, while broader adoption requires additional randomized, context-specific evidence.

Background: Colorectal cancer (CRC) prognosis, particularly in liver metastasis (CRLM), is influenced by histopathological and molecular factors. Methods: A narrative analysis of the specialized literature was conducted using databases such as PubMed, MEDLINE, Scopus, and Embase. The review focused on original articles published between 2005 and 2025. Results: Lymph node involvement is a critical prognostic factor, with lymph node-positive CRC correlating with increased risk of liver metastasis and significantly reduced survival rates. Poorly differentiated tumors (G3) exhibit a higher likelihood of metastasis, including liver involvement, and are associated with worse clinical outcomes. Vascular emboli and perineural invasion are indicative of hematogenous spread and higher metastatic potential, leading to poorer survival outcomes. Genetic mutations, such as KRAS, NRAS, and BRAF, are associated with therapy resistance, complicating treatment and highlighting the importance of personalized approaches. MSI-H and HER2 amplification further affect treatment response, with MSI-H tumors showing a favorable response to immunotherapy, while HER2-positive CRCs may benefit from targeted therapies. Tumor budding, high levels of which predict poor survival, is another key histopathological feature associated with aggressive metastatic behavior. Systemic inflammatory markers, such as the Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and C-Reactive Protein-to-Albumin Ratio (CAR), offer prognostic insights into CRLM patient survival. Conclusions: Histopathological features, molecular alterations, and immune microenvironment factors significantly impact the prognosis of CRC with liver metastasis. The integration of molecular profiling, immunotherapy, and targeted therapies offers promise for improving treatment outcomes. Personalized treatment strategies, incorporating these factors, are essential for overcoming therapy resistance and improving survival in CRLM patients.

Background and Clinical Significance: Sodium–glucose cotransporter-2 (SGLT2) inhibitors cause persistent glucosuria, which has been hypothesized to facilitate urinary tract infection (UTI) when urinary stasis or anatomic variants coexist; causality, however, remains unproven and almost certainly multifactorial. Case Presentation: A 72-year-old man treated with dapagliflozin 10 mg/day for 4 months presented with 3 days of dysuria and nocturia, without fever or systemic signs. One month before SGLT2 inhibitor initiation, urological work-up had been unremarkable: prostate ~50 cm³, post-void residual (PVR) 0 mL, and a negative midstream culture. At presentation we obtained a midstream clean-catch specimen before antibiotics. Dipstick showed glucose 2+ (~100 mg/dL, as expected with SGLT2 inhibition), leukocyte esterase 3+ and nitrites negative; microscopy revealed 45 leukocytes/high-power field with pronounced bacteriuria. Quantitative culture grew Morganella morganii at 1 × 10⁵ CFU/mL in pure culture. Antimicrobial susceptibility (VITEK^® 2 Compact, EUCAST v14.0, 2024) demonstrated resistance to ampicillin, amoxicillin–clavulanate, ampicillin–sulbactam, ceftriaxone, ceftazidime, gentamicin and trimethoprim–sulfamethoxazole, with susceptibility (S) retained only to piperacillin–tazobactam, levofloxacin/norfloxacin, cefepime and carbapenems (ertapenem, meropenem). Imaging revealed a right duplicated ureter with distal fusion (single bladder insertion, no dilatation or obstruction) and benign prostatic hyperplasia with PVR ~100 mL; renal function was preserved, two blood culture sets (pre-antibiotic) were negative, and repeat urine culture on day 7 was sterile. Management/outcome: The episode was classified as a localized (cystitis-range) UTI per European Association of Urology (EAU) criteria (no fever, flank pain or bacteremia). Meropenem 1 g intravenously every 8 h (3 g/day) was given for 10 days after urology/infectious-disease review. Dapagliflozin was held at presentation and not restarted during the 3-month follow-up period; reintroduction was planned only after full urological reassessment with cardiology input. Transurethral resection of the prostate (TUR-P) was performed 18 days after completing antibiotics (28 days after presentation) for bladder outlet obstruction refractory to tamsulosin 0.4 mg daily, with complete resolution of symptoms, normalization of inflammatory markers and PVR 0 mL. No recurrence occurred during 3 months of follow-up after TUR-P. Conclusions: This single case illustrates a temporal association—not proven causation—between SGLT2-related glucosuria, incomplete emptying and a non-obstructive duplicated ureter that likely created a permissive milieu for opportunistic Morganella UTI. The narrative is hypothesis-generating; urinary stasis was the dominant modifiable factor. Culture-guided therapy, individualized decisions on SGLT2 continuation, and definitive correction of outlet obstruction are the practical takeaways.