The benefits of sodium‐glucose transport protein 2 inhibitor (SGLT2i) use on severe urolithiasis requiring surgery remains unclear. All patients with incident T2D in Taiwan National Health Institution databases (2016–2021) and TriNetX datasets (2014–2023) were retrospectively analyzed. The study analyzed a propensity score‐matched pairs with T2D treated with SGLT2i or dipeptidyl peptidase 4 inhibitors (DPP4i). The primary outcome was the incidence of urolithiasis and urolithiasis requiring surgery during the study period. Urolithiasis diagnoses were identified using International Classification of Diseases diagnostic codes and categorized into upper and lower urinary tract stones. Cases of urolithiasis requiring surgery were determined by the presence of both diagnostic codes and surgical procedure codes within the same outpatient visit or hospitalization. Conditional and time‐dependent Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During the study period, 5700 participants were diagnosed with urolithiasis, 1297 participants were urolithiasis requiring surgery in Taiwan NHIRD cohort 8438 participants with urolithiasis as well as 289 participants with urolithiasis requiring surgery were in the TriNetX cohort. Adjusted HRs of urolithiasis and urolithiasis requiring surgery were 0.82‐fold (95% CI, 0.77–0.87), 0.72‐fold (95% CI, 0.63–0.82) in Taiwan NHIRD, 0.84 (95% CI, 0.78–0.90), and 0.62 (95% CI, 0.44–0.88) in TriNetX cohort respectively. Similar protective associations with SGLT2i use against urolithiasis were observed across subgroups in both datasets from Taiwan NHIRD and TriNetX. In conclusion, SGLT2i might protect against kidney stones and severe cases requiring surgery in T2D patients.

Background/Objectives: Colorectal cancer (CRC) with bladder involvement represents a distinct subgroup of locally advanced disease frequently accompanied by urinary tract-related manifestations (UTRMs). However, the clinical relevance of prediagnostic UTRMs in this high-risk population remains unclear. This study investigated the association between UTRMs and oncologic outcomes in patients with bladder-involved CRC. Methods: We conducted a population-based retrospective cohort study using the National Health Insurance Research Database and Catastrophic Illnesses Database (2000–2020). A total of 2608 patients with CRC involving the bladder were included. Patients with prediagnostic UTRMs, including urinary frequency, urgency, dysuria, hematuria, and urinary tract infections, were identified using diagnostic codes recorded within 6 months before CRC diagnosis. Inverse probability of treatment weighting was applied to balance baseline characteristics. Patients were followed from CRC diagnosis until disease recurrence, death, or end of the study period. Weighted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Patients with UTRMs had a significantly higher risk of disease recurrence than those without UTRMs (adjusted HR 1.57). Patients with UTRMs requiring antibiotic treatment exhibited an even greater recurrence risk (adjusted HR 4.17), although this finding should be interpreted cautiously because of the limited sample size. Associations between UTRMs and recurrence were generally consistent across subgroup analyses. In contrast, UTRMs were not significantly associated with CRC-specific mortality. Conclusions: Prediagnostic UTRMs were associated with an increased risk of recurrence in patients with CRC involving the bladder. These readily obtainable preoperative clinical manifestations may provide supplementary information for postoperative surveillance in this high-risk population. Further studies are warranted to validate these findings.