Objective:To evaluate the feasibility of pelvic floor muscle reconstruction for women with vaginal laxity accompanied by stress urinary incontinence (SUI).Methods:A prospective cohort clinical study was conducted to collect clinical data from patients with vaginal laxity and SUI admitted to the Urogenital Reconstructive and Gender-affirming Department at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and the Department of Urology, Third Medical Center, Chinese PLA General Hospital, from January 2019 to September 2022. Patients underwent surgical treatment for pelvic floor muscle reconstruction. The cough provocation test and the patient global impression of improvement (PGI-I) scale were utilized as objective and subjective indicators of treatment effecacy, respectively. The urinary incontinence quality of life scale (I-QOL) and the pelvic organ prolapse and urinary incontinence sexual function questionnaire 12(PISQ-12) were used to evaluate the changes in quality of life and sexual funtion. The changes in pelvic floor anatomical structure were evaluated by pelvic floor ultrasound. Data analysis was performed using SPSS version 23.0. The I-QOL and PISQ-12 scores, posterior vesicourethral angle, urethral rotation angle, and bladder neck motion before and after surgery were analyzed using paired t-test, with P<0.05 was considered statistically significant. Results:A total of 36 female patients were included, with an average age of 41.7 years (ranged 24-51 years) and an average body mass index of 23.8 kg/m 2. The average operation time was 76.2 minutes, and the average blood loss was 84.5 milliliters. After 12-27 months of postoperative follow-up, the objective and subjective cure rates were 86.1% (31/36) and 88.9% (32/36), respectively. The sexual function and quality of life of the patients were significantly improved compared with the preoperative results, and postoperative pelvic floor ultrasound results showed significant improvement. The I-QOL and PISQ-12 scores 12 months after surgery were statistically significant compared with those before surgery ( P<0.01). Postoperative pelvic floor ultrasonography revealed statistically significant differences in posterior vesicourethral angle, urethral rotation angle, and bladder neck motion during maximum Valsalva maneuver compared to preoperative data ( P<0.01). Conclusion:Pelvic floor muscle reconstruction is a safe and effective surgical method for patients with vaginal laxity combined with SUI. This procedure can significantly improve sexual quality of life and alleviates SUI symptoms, restores anatomical structure in the female pelvic floor, and enhances overall quality of life.

Objective:To evaluate the feasibility of pelvic floor muscle reconstruction for women with vaginal laxity accompanied by stress urinary incontinence (SUI).Methods:A prospective cohort clinical study was conducted to collect clinical data from patients with vaginal laxity and SUI admitted to the Urogenital Reconstructive and Gender-affirming Department at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and the Department of Urology, Third Medical Center, Chinese PLA General Hospital, from January 2019 to September 2022. Patients underwent surgical treatment for pelvic floor muscle reconstruction. The cough provocation test and the patient global impression of improvement (PGI-I) scale were utilized as objective and subjective indicators of treatment effecacy, respectively. The urinary incontinence quality of life scale (I-QOL) and the pelvic organ prolapse and urinary incontinence sexual function questionnaire 12(PISQ-12) were used to evaluate the changes in quality of life and sexual funtion. The changes in pelvic floor anatomical structure were evaluated by pelvic floor ultrasound. Data analysis was performed using SPSS version 23.0. The I-QOL and PISQ-12 scores, posterior vesicourethral angle, urethral rotation angle, and bladder neck motion before and after surgery were analyzed using paired t-test, with P<0.05 was considered statistically significant. Results:A total of 36 female patients were included, with an average age of 41.7 years (ranged 24-51 years) and an average body mass index of 23.8 kg/m 2. The average operation time was 76.2 minutes, and the average blood loss was 84.5 milliliters. After 12-27 months of postoperative follow-up, the objective and subjective cure rates were 86.1% (31/36) and 88.9% (32/36), respectively. The sexual function and quality of life of the patients were significantly improved compared with the preoperative results, and postoperative pelvic floor ultrasound results showed significant improvement. The I-QOL and PISQ-12 scores 12 months after surgery were statistically significant compared with those before surgery ( P<0.01). Postoperative pelvic floor ultrasonography revealed statistically significant differences in posterior vesicourethral angle, urethral rotation angle, and bladder neck motion during maximum Valsalva maneuver compared to preoperative data ( P<0.01). Conclusion:Pelvic floor muscle reconstruction is a safe and effective surgical method for patients with vaginal laxity combined with SUI. This procedure can significantly improve sexual quality of life and alleviates SUI symptoms, restores anatomical structure in the female pelvic floor, and enhances overall quality of life.

Objective:To investigate the applicable effect of anatomical retroperitoneoscopic adrenalectomy in treating patients with adrenal tumors.Methods:A total of 112 patients with adrenal tumors admitted to the Department of urology of The Third Medical Center of Chinese PLA General Hospital from January 2016 to January 2021 were selected as research subjects，and they were divided into control group and study group according to the double-blind method，with 56 cases in each group. The patients in the control group were treated with laparoscopic transabdominal adrenalectomy，while the patients in the study group were treated with anatomical retroperitoneoscopic adrenalectomy. The clinical indicators of the two surgical methods were compared. Before and six hours after surgery，the serum levels of inflammatory factors including interleukin-6（IL-6），interleukin-1β（IL-1β），and hypersensitive C-reactive protein（hs-CRP）were detected by enzyme-linked immunosorbent assay（ELISA），and the electrolytes such as Na +，K +，and bicarbonate（HCO 3-）were detected by the America-made Medica electrolyte analyzer. The prognosis and incidence of complications in the two groups were observed. Results:Compared with the control group，the time spent in operation，the time spent for drainage tube placement and gastrointestinal function recovery，and hospital stay were all shorter in the study group（ P < 0.05 or P < 0.01）. After surgery，the serum levels of IL-6，IL-1β，and hs-CRP in the study group were significantly lower than those in the control group，and the levels of Na + and HCO 3- in the study group were also lower than those in the control group，while the K + level was higher than that in the control group，all with statistically significant differences（ P < 0.05 or P < 0.01）. The incidence of complications in the study group［3.57%（2/56）］was significantly lower than that in the control group［（14.29%（8/56）］，with statistically significant difference（ P < 0.05）. No recurrence or metastasis occurred in the two groups during the six-month follow-up after surgery. Conclusion:Anatomical retroperitoneoscopic adrenalectomy can better reduce the surgery trauma to patients with adrenal tumors，lessen the impact on the internal environment of patients，effectively promote the postoperative rehabilitation process，and has higher safety.

Objective:To investigate the applicable effect of anatomical retroperitoneoscopic adrenalectomy in treating patients with adrenal tumors.Methods:A total of 112 patients with adrenal tumors admitted to the Department of urology of The Third Medical Center of Chinese PLA General Hospital from January 2016 to January 2021 were selected as research subjects，and they were divided into control group and study group according to the double-blind method，with 56 cases in each group. The patients in the control group were treated with laparoscopic transabdominal adrenalectomy，while the patients in the study group were treated with anatomical retroperitoneoscopic adrenalectomy. The clinical indicators of the two surgical methods were compared. Before and six hours after surgery，the serum levels of inflammatory factors including interleukin-6（IL-6），interleukin-1β（IL-1β），and hypersensitive C-reactive protein（hs-CRP）were detected by enzyme-linked immunosorbent assay（ELISA），and the electrolytes such as Na +，K +，and bicarbonate（HCO 3-）were detected by the America-made Medica electrolyte analyzer. The prognosis and incidence of complications in the two groups were observed. Results:Compared with the control group，the time spent in operation，the time spent for drainage tube placement and gastrointestinal function recovery，and hospital stay were all shorter in the study group（ P < 0.05 or P < 0.01）. After surgery，the serum levels of IL-6，IL-1β，and hs-CRP in the study group were significantly lower than those in the control group，and the levels of Na + and HCO 3- in the study group were also lower than those in the control group，while the K + level was higher than that in the control group，all with statistically significant differences（ P < 0.05 or P < 0.01）. The incidence of complications in the study group［3.57%（2/56）］was significantly lower than that in the control group［（14.29%（8/56）］，with statistically significant difference（ P < 0.05）. No recurrence or metastasis occurred in the two groups during the six-month follow-up after surgery. Conclusion:Anatomical retroperitoneoscopic adrenalectomy can better reduce the surgery trauma to patients with adrenal tumors，lessen the impact on the internal environment of patients，effectively promote the postoperative rehabilitation process，and has higher safety.

ObjectiveTo summarize the initial experience of transumbilical laparoendoscopic single-site surgery of urology.MethodsFrom February 2010 to March 2011,21 patients underwent laparoendoscopic single-site surgery using transumbilical single-site and common surgical instruments of laparoendoscopic.Nine patients underwent single-site laparoscopic ureterolithotomy,5 underwent transumbilical single-site laparoscopic ureteral stricture resection and anastomosis,5 underwent transumbilical single-site laparoscopic renalcyst unroofing and 2 had a nephrectomy.All of the cases were definitely diagnosed.A single umbilical incision of 1.5 cm to 2.5 cm was made for Triport.The procedures were performed according to the methods used in classical laparoscope methods using general instruments.ResultsAll the operations were successfully completed without conversion to open surgery.The mean operative time of ureterolithotomy was 143 (120-230) min,the mean operative time of ureteral stricture resection and anastomosis was 157 (120 -180) min,the mean operative time of unroofing of renal cysts was 110 (95 -132) min,and the operative time of the nephrectomy was from 95 to 120 min.The intestinal tract function recovered within 1 -2 d,the drainage tube was removed within 2 -3 d and the postoperative hospitalization duration was 4 -7 d.The symptoms were reduced or disappeared and no major intraoperative or postoperative complications occurred within 4 - 6 months.Conclusions Transumbilical laparoendoscopic single-site surgery represents a safe and feasible operation for urologic patients.With more clinical practice,laparoendoscopic single-site surgery could be generally applied.