1.Total 3D laparoscopic ileal ureters replacement for bilateral ureters combined with bladder augmentation in the management of post-radiotherapy bilateral ureteral strictures and contracted bladder
Wanwei HUANG ; Xianshen SHA ; Yibao ZHANG ; Guohao WU ; Feng LUO ; Zhihui CHEN ; Dongming YE ; Xue-song LI ; Caiyong LAI
Journal of Peking University(Health Sciences) 2025;57(4):789-795
Objective:To retrospectively evaluate the clinical efficacy and safety of total 3D laparo-scopic ileal ureters replacement for bilateral ureters combined with bladder augmentation in patients with post-radiotherapy long-segment bilateral ureteral strictures and contracted bladder.Methods:Clinical data of two patients(aged 72 and 54 years)with radiation-induced long-segment bilateral ureteral stric-tures and reduced bladder capacity,treated at the Sixth Affiliated Hospital of Jinan University from Octo-ber 2023 to June 2024,were analyzed.Both presented with bilateral flank pain,recurrent chills/fever,urinary frequency,and urgency.Preoperative ureteral stricture lengths were measured as follows:left 10.4 cm and right 8.7 cm in the first case;left 10.6 cm and right 11.7 cm in the second case.Bladder capacity assessed by nephrostomy-assisted antegrade urography was 90 mL and 130 mL respectively.Both underwent single-position,one-stage totally 3D laparoscopic bilateral ileal ureteral replacement and blad-der augmentation based on membrane anatomy principles,with regular postoperative follow-up.Results:Procedures were completed by the same experienced urologist.Operative times were 420 min and 355 min,with intraoperative blood loss of 50 mL(no transfusion required).Postoperative bowel function re-sumed at the end of 4.5 and 3 days.No major perioperative complications occurred.Ureteral stents were removed at 2 months postoperatively,with imaging showing improved hydronephrosis,unobstructed ure-teral drainage,symmetrical bladder morphology,and smooth walls.Postoperative bladder capacities were 230 mL and 250 mL.Follow-up durations were 10 and 8 months.Both patients experienced significant relief of flank pain and lower urinary tract symptoms.No complications(enteric fistula,urinary fistula,or metabolic acidosis)were observed.At the final follow-up,one patient had mildly elevated serum cre-atinine,while the other showed reduced levels compared with preoperative values;both remained stable.Conclusion:Membrane anatomy-based dissection facilitates safe mobilization of fibrotic ureters with mini-mal bleeding and collateral damage.Total intracorporeal 3D laparoscopic ileal ureters replacement for bi-lateral ureters combined with bladder augmentation effectively addresses long-segment ureteral obstruction and improves bladder capacity.This approach is technically safe and feasible,though further validation with larger clinical cohorts is warranted.
2.Total 3D laparoscopic ileal ureters replacement for bilateral ureters combined with bladder augmentation in the management of post-radiotherapy bilateral ureteral strictures and contracted bladder
Wanwei HUANG ; Xianshen SHA ; Yibao ZHANG ; Guohao WU ; Feng LUO ; Zhihui CHEN ; Dongming YE ; Xue-song LI ; Caiyong LAI
Journal of Peking University(Health Sciences) 2025;57(4):789-795
Objective:To retrospectively evaluate the clinical efficacy and safety of total 3D laparo-scopic ileal ureters replacement for bilateral ureters combined with bladder augmentation in patients with post-radiotherapy long-segment bilateral ureteral strictures and contracted bladder.Methods:Clinical data of two patients(aged 72 and 54 years)with radiation-induced long-segment bilateral ureteral stric-tures and reduced bladder capacity,treated at the Sixth Affiliated Hospital of Jinan University from Octo-ber 2023 to June 2024,were analyzed.Both presented with bilateral flank pain,recurrent chills/fever,urinary frequency,and urgency.Preoperative ureteral stricture lengths were measured as follows:left 10.4 cm and right 8.7 cm in the first case;left 10.6 cm and right 11.7 cm in the second case.Bladder capacity assessed by nephrostomy-assisted antegrade urography was 90 mL and 130 mL respectively.Both underwent single-position,one-stage totally 3D laparoscopic bilateral ileal ureteral replacement and blad-der augmentation based on membrane anatomy principles,with regular postoperative follow-up.Results:Procedures were completed by the same experienced urologist.Operative times were 420 min and 355 min,with intraoperative blood loss of 50 mL(no transfusion required).Postoperative bowel function re-sumed at the end of 4.5 and 3 days.No major perioperative complications occurred.Ureteral stents were removed at 2 months postoperatively,with imaging showing improved hydronephrosis,unobstructed ure-teral drainage,symmetrical bladder morphology,and smooth walls.Postoperative bladder capacities were 230 mL and 250 mL.Follow-up durations were 10 and 8 months.Both patients experienced significant relief of flank pain and lower urinary tract symptoms.No complications(enteric fistula,urinary fistula,or metabolic acidosis)were observed.At the final follow-up,one patient had mildly elevated serum cre-atinine,while the other showed reduced levels compared with preoperative values;both remained stable.Conclusion:Membrane anatomy-based dissection facilitates safe mobilization of fibrotic ureters with mini-mal bleeding and collateral damage.Total intracorporeal 3D laparoscopic ileal ureters replacement for bi-lateral ureters combined with bladder augmentation effectively addresses long-segment ureteral obstruction and improves bladder capacity.This approach is technically safe and feasible,though further validation with larger clinical cohorts is warranted.
3.Dynamics Changes of Long Non-Coding RNA in the Testis and Epididymis During Male Mouse Aging
Hongle HE ; Rui SUN ; Jinhong GUAN ; Ruoyang CHEN ; Yun XIE ; Chengqiang MO ; Xianshen SHA ; Yanping HUANG
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(5):806-815
[Objective]To investigate the dynamic expression profiles and potential regulatory mechanisms of long non-coding RNAs(lncRNAs)in male reproductive system aging.[Methods]A naturally aging C57BL/6 mouse model was used and 4 mice were selected each at 3,15,and 21 months of age.RNA was extracted from seven regions of the male reproductive tract(testis,efferent duct,initial segment of epididymis,caput epididymis,corpus epididymis,cauda epididymis,and vas deferens),followed by RNA sequencing and bioinformatics analysis.[Results]Region-specific dynamic expression profiles of lncRNAs were constructed in the testis,epididymis(efferent duct,initial segment,caput,corpus,and cauda),and vas deferens of male mice.Combined with gene functional enrichment analysis,the functional associations of lncRNAs were elucidated in reproductive system aging.The differentially expressed lncRNAs in the aging testis were primarily involved in hormone biosynthesis and extracellular matrix organization,while those in the initial segment of the epididymis were closely related to cell recognition and epithelial cell migration.A comprehensive lncRNA expression atlas associated with male reproductive aging was established.[Conclusion]LncRNAs may participate in male reproductive aging through the regulation of the reproductive microenvironment,which provides key molecular targets and a research foundation for understanding age-related fertility decline.
4.A case report of renal foreign-body
Xianshen SHA ; Zheng CHEN ; Zhichao LIN ; Zexiong GUO ; Yumin ZHUO
Chinese Journal of Urology 2024;45(9):709-710
Renal foreign-body is rare in clinical practice. This article reports a case of 12-year-old male patient who presented with intermittent right lumbar stabbing pain for one year. Physical and laboratory examinations showed no significant abnormalities. Enhanced CT and three-dimensional angiography indicated a metal object in the anterior superior pole of the right kidney. The patient had a history of consuming vermicelli frequently over the past year. Considering the medical history and clinical examinations, it was hypothesized that a foreign body had penetrated the duodenum and lodged into the kidney. A foreign body extraction was performed via 3D laparoscopy, confirming the object to be a 25 mm long metallic needle. The patient was discharged on the third postoperative day. Follow-up at six months showed the patient to be in good condition.

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