ESWL, fURS and PCNL for lower pole renal stones

Lower pole stones (LPSs) are common but less likely to pass spontaneously than other renal stones, often necessitating intervention. In 2015, a systematic review and meta-analysis comparing percutaneous nephrolithotomy (PCNL), flexible ureterorenoscopy (fURS), and extracorporeal shockwave lithotripsy (ESWL) was published....

Percutaneous nephrolithotomy: wisdom, dogma, paradigm and myths

A non-transpapillary technique appears to ease access to the kidney – the most critical step in percutaneous nephrolithotomy (PNL) – when compared to the classic transpapillary approach. Remarkably, the earliest descriptions of percutaneous access by Goodwin et al. in 1955...

Management dilemma for very high-risk non–muscle-invasive bladder cancer

The European Association of Urology (EAU) guidelines recommend upfront radical cystectomy (RC) for very high-risk (VHR) non-muscle-invasive bladder cancer (NMIBC). However, real-world adoption is limited, as most patients are reluctant to undergo immediate bladder removal. The EAU 2021 risk model...

Is antibiotic prophylaxis warranted in hypospadias repairs?

Hypospadias repair is a common paediatric urological procedure. Complication rates following hypospadias repair are variable (ranging from 5–10% for distal hypospadias repairs and as high as 32–70% for proximal repairs). Limiting surgical site infections by minimising infection through antibiotic prophylaxis...

Does coiling of the proximal end of the ureteral stent affect stent-related symptoms?

Ureteral stents, first described by Zimskind in 1967, have become a critical tool in modern urology. They are widely used in various endourological procedures to drain obstructed or infected renal units and as a safety measure before or after surgeries....

Disconnect between clinical trials and real-world oncology patients

Clinical trials are essential to advancing cancer treatment, providing the evidence needed to approve new therapies and improve patient outcomes. However, the strict eligibility criteria used – especially in prostate cancer trials – often exclude real-world patients. These criteria prioritise...

Preoperative risk stratification of high-risk prostate cancer patients

High-risk prostate cancer (HRPCa) is associated with a significant risk of recurrence after radical treatment. While several classification systems exist, the D’Amico criteria – based on clinical T stage ≥T2c, prostate specific antigen (PSA) ≥20 ng/mL, or Gleason score (GS)...

Malignant upper urinary tract obstruction: emergency presentations and long-term outcomes

Malignant upper urinary tract obstruction (MUUTO) is a frequent emergency urological referral, often necessitating kidney drainage to preserve renal function. However, many patients have advanced cancer with limited life expectancy, raising questions about intervention benefits. While percutaneous nephrostomy (PCN) or...

Association of prostate size with capsule thickness and glandular epithelial cell density

Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are two significant urologic diseases affecting ageing men. BPH is histologically evident in over half of men above 50, while PCa is a highly lethal cancer prevalent in men in the United...

Adjustable Transobturator Male System® as a novel treatment for men with stress urinary incontinence

Stress urinary incontinence (SUI) in men is a debilitating condition, often occurring after prostate cancer surgery, with an incidence ranging from 4% to 40%. Key predictors of SUI post-prostatectomy include age, body mass index (BMI), comorbidity index, lower urinary tract...

Oncological benefits of extended pelvic lymph node dissection

Touijer and colleagues present extended follow-up results from a large randomised trial comparing limited pelvic lymph node dissection (l-PLND) and extended PLND (e-PLND) in prostate cancer patients undergoing radical prostatectomy. The study aimed to assess whether e-PLND, which includes external...

Anti-VEGF and PD-1 combinations in renal cell carcinoma

Over the past decade, vascular endothelial growth factor (VEGF) tyrosine kinase inhibitors (TKIs) have been central to treating renal cell carcinoma (RCC), with oncologists refining dosing strategies to balance treatment efficacy with quality of life (QoL). Recently, the introduction of...