Purpose: To investigate the efficacy and safety of retrograde intrarenal surgery (RIRS) for the treatment of pediatric patients. Materials and Methods: A total of 45 patients with upper urinary stones treated using flexible ureteroscopy combined with holmium laser lithotripsy at our department between June 2015 and January 2017 were examined in this study. Results: The operative success rate of treatment using holmium laser lithotripsy via flexible ureteroscopy was 97.8% (44/45); one patient (1/45, 2.2%) was converted to laparoscopic pyelolithotomy, and the calculus was successfully removed. Lithotripsy via flexible ureteroscopy was successful during the first phase in 38 patients (38/45, 84.4%), and second or third phase lithotripsy was needed for six patients (6/45, 13.3%). Intraoperative ureteral fracture in the middle and lower sections occurred in one pediatric patient who was converted to laparoscopic pyelolithotomy and ureter bladder reimplantation. This patient was discharged after recovery at 2 weeks postoperative and showed no significant renal dysfunction over the 12-month follow-up period. Severe postoperative gross hematuria occurred in one patient, who improved after hemostasis and other symptomatic treatments. High fever occurred in two patients (body temperature >39 degrees C), who later improved. These pediatric patients were discharged after active anti-infection and other conservative treatments for 4 days. All of the included patients were followed up for 2-15 months, with an average follow-up period of 8 months. The total calculus clearance rate was 100% (45/45), with no recurrence of the calculus. Conclusion: In this study, most upper urinary stones in children and infants were treated successfully with holmium laser lithotripsy applied via flexible ureteroscopy.

The objective of this study was to assess the clinical effectiveness and safety of type A botulinum toxin in the treatment of refractory overactive bladder in adolescents. We conducted a retrospective analysis of 37 adolescent patients with refractory overactive bladder who were treated at the Urology Department of Hangzhou Third People’s Hospital between January 2018 and August 2023. These patients received intravesical injections of type A botulinum toxin at a concentration of 10 U/mL, with an average of 20 injection points. We recorded changes in urination diaries and urodynamic parameters both before and 1 month after treatment. After 1 month of treatment, significant improvements were observed in several parameters, when compared to the pretreatment values. These included daytime frequency of urination (11.13 ± 6.45), average single void volume (173.24 ± 36.48) mL, nighttime frequency of urination (2.43 ± 0.31), urgency episodes (3.12 ± 0.27), initial bladder capacity (149.82 ± 41.34) mL, and maximum bladder capacity (340.25 ± 57.12) mL (all P < .001). After the first treatment, 5 patients had mild hematuria, 4 patients had urinary tract infection, and 1 patient had urinary retention, which was relieved after catheterization. No serious complications or adverse reactions were observed in other patients. The follow-up period ranged from 6 to 18 months, and the duration of efficacy varied from 2 to 8 months. Eight patients who initially had treatment failure achieved symptom relief after reinjection. In adolescents with refractory overactive bladder who do not respond well to conventional drug therapy, type A botulinum toxin can be administered safely and effectively. It significantly improves lower urinary tract symptoms and enhances the quality of life for these patients.

To investigate the effect of sacral nerve root magnetic stimulation(SMS) on bladder urodynamics and M3 receptor expression in rats with neurogenic bladder. 30 adult female SD rats were randomly divided into Normal Group, Model Group, and Magnetic Stimulation Group, with 10 rats in each group. The Model Group and Magnetic Stimulation Group used the spinal cord transtion method to establish the neurogenic bladder animal model. After successful modeling, the Magnetic Stimulation Group received magnetic stimulation treatment once per day for 8 consutive weeks. After 8 weeks, bladder urodynamics were measured under anesthesia, rats were sacrificed, and bladder detrusor muscle tissue was collected for histological and ultrastructural observation, and M3 receptor expression levels were measured. The maximum bladder capacity and bladder compliance in the Magnetic Stimulation Group were higher than those in the Model Group (all P < 0. 05), and the leak point pressure was lower than that in the Model Group (P < 0. 05); there were no significant differences between the Magnetic Stimulation Group and the Normal Group in these three parameters (all P > 0. 05). H&E staining of bladder detrusor muscle tissue in the Magnetic Stimulation Group revealed minimal neutrophil infiltration. Moreover, the morphology and arrangement of the mucosal epithelial cells were closer to those observed in the Normal Group when compared with the Model Group. Under transmission electron microscopy, detrusor muscle cells had a smooth surface, slightly widened intercellular spaces, relatively uniform arrangement, and relatively intact mitochondrial structure. The expression level of M3 receptors in the bladder detrusor muscle tissue of the Magnetic Stimulation Group was significantly higher than that in the Normal Group and the Model Group (all P < 0. 05); there was no significant difference between the Model Group and the Normal Group (P > 0. 05). Sacral nerve root magnetic stimulation has a certain effect on improving bladder function in rats with neurogenic bladder, which may be related to the increased expression level of M3 receptors in the bladder detrusor muscle tissue.

To compare the efficacy and safety of ultrasound-guided transabdominal versus transurethral cystoscopic botulinum toxin type A (BoNT-A) injection for treat