Transfer to tertiary paediatric hospitals for patients with testicular torsion

Although this articles comes from a tertiary centre in Columbus, USA, there are similarities with the current controversies in the UK. The authors carried out a five-year retrospective review looking at the surgical transfer of 125 patients (mean age 13.4,...

Bedside teaching

All of us are involved in the teaching and training of under or postgraduate medical students and nurses. This article gives a patient’s perspective and thoughts on being an ‘interesting’ patient within a ward or clinic setting. Important points to...

Emergency department revisits for patients with ureteral stones

The authors aimed to identify clinical predictors for emergency department (ED) revisits in patients diagnosed with ureteral stones. Patients presenting between 2010 and 2013 were included. Those who were admitted at the initial presentation were excluded. CT scans were reviewed...

Who should be taking care of the adolescent with testicular torsion?

From time to time (as paediatric surgeons), we receive referrals from regional hospitals to explore the testis in older boys. Given the time-critical nature of the condition, patients should benefit from assessment and surgery performed locally (when possible). Inter-hospital transfer...

Predictive factors for conservative treatment failure in paediatric blunt renal trauma

Blunt renal trauma is managed conservatively in children in the vast majority of cases. Grade IV renal injury is also generally managed non-operatively although occasionally intervention is needed for a urinoma that fails to settle. These authors retrospectively looked at...

Urology patient assessment – importance of holistic approach – new paradigm

Mild cognitive impairment (MCI) seems to affect 30% of the general population above 65 and its presence has a wide range of significance. This is a prospective single centre study to look at MCI in adult urological patients above 18...

Sepsis and antibiotics: the debate goes on

Sepsis statistics are staggering around the world. The UK Sepsis Trust estimates that there are around 150,000 cases of sepsis in the UK every year and it kills 44,000 patients per year. There are many different definitions and criteria; in...

Non-urologist non-physician assessment of scrotal pain using the TWIST score

Testicular torsion is a urological emergency that requires prompt diagnosis and intervention. Some providers are becoming increasingly dependent on ultrasound (US) to make the diagnosis. This NIH clinical trial evaluated the use of the TWIST (Testicular Workup for Ischaemia and...

Junior doctors’ strike: is there light at the end of the tunnel?

Most urology departments will be affected one way or another by the ongoing industrial action by our junior colleagues. This article gives an interview between the BMJ team and Jeremy Hunt, UK Secretary of State for Health. We may or...

Role of emergency ureteroscopy in the management of ureteric stones

Emergency ureteroscopy for all acute stone patients is not widespread in the UK but this is not the case elsewhere. In Auckland, New Zealand, it is commonly carried out in the emergency setting to reduce pressure on elective lists and...

The impact of seat belts and airbags on renal injuries and nephrectomy rate

Motor vehicle collisions (MVC) account for 3.6 million emergency department attendances and 34,000 deaths annually. The combination of lap / shoulder seat belts and airbag deployment reduces mortality by more than 80%. MCVs are responsible for 48-66% of all renal...

New concepts, emerging technologies and potential therapeutics in testicular torsion

This review article is worthy of reading in its entirety. It addresses current concepts in the management of one of the few paediatric urological emergencies. For every 100,000 males <25 years, 4.5 will have testicular torsion per year. Given that...

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