Fluoxetine for refractory night wetting in children – is it safe and effective?

Around 1-2% of teenagers above the age of 15 years and 2-6% of adults continue to wet the bed. Standard treatment often includes bladder advice, alarm therapy, desmopressin and anticholinergics. Tricyclic antidepressants (imipramine) can also be utilised. Unfortunately, most have...

Robot-assisted ureterocalicostomy

Ureterocalicostomy was first introduced by Neuwirt (1947) and further described by Jameson et al. (1957) as an alternative procedure for repair of pelviureteric junction (PUJ) obstruction associated with an intrarenal pelvis. Performing ureterocalicostomy for PUJ repair has been suggested in...

Scrotal antegrade sclerotherapy for the adolescent varicocele

The incidence of varicocele in adolescent males is around 15%. Treatment indications include symptoms (pain) and evidence of a smaller testis. Numerous surgical techniques are described but there is a lack of randomised controlled trials (RCT), specifically in adolescents. This...

Stenting prior to URS or ESWL – does it increase ED visits and opiate prescriptions?

Ureteral stents are used to bypass obstructive stones, to dilate the ureter in order to facilitate ureteroscopy (URS), and to maintain patency / low intrarenal pressure following stone surgery. However, there can be morbidity (pain / voiding symptoms). Tasian et...

SWL for renal stones – a new index

Shockwave lithotripsy (SWL) treatment is a common, non-invasive urology procedure used for kidney stones nearly every day throughout the UK. In this study the team evaluated factors affecting treatment success of SWL treatment. The prospective data were collected from 2013...

Botox® instillation into the bladder

Patients with refractory overactive bladder (OAB) may be offered OnabotulinumtoxinA (Botox®) as one of the third-line options. Given the invasive nature of requiring cystoscopy, injections via a needle and local anaesthesia, it would be simpler, more convenient and more accessible...

Prodromal period of Fournier’s gangrene

Necrotising soft tissue infections of the genitalia (NSTIG), commonly known as Fournier’s gangrene, is a rare but important surgical emergency associated with significant morbidity and mortality. It is estimated that every six hours of delay in surgical debridement leads to...

Keep an eye on Viagra™

Many of the side-effects and contra-indications of sildenafil and other phosphodiesterase 5 (PDE 5) inhibitors for erectile dysfunction have become well known to doctors and pharmacists over the years. This study from the United States collected case reports of adverse...

Hypospadias – how long should follow-up be?

The optimal duration of follow-up following childhood hypospadias repair (to detect complications) is ill-defined. Several surgeons recommend it to include assessment during puberty. Some may worry that ‘rapid penile growth’, ‘erectile forces’ and ‘sexual activity’ could potentially stress previously successful...

Save the orchid

In many urological cancers there is currently more and more inclination for organ-preserving surgery but in patients with germ cell tumours (GCT), radical orchidectomy remains the gold standard. Can we somehow save the testes? This study aims to summarise published...

Outcomes of sarcomatoid differentiation in urothelial carcinoma

Sarcomatoid differentiation is a rare variant of urothelial carcinoma (UC) seen in 0.6% of cases. Its response to neo-adjuvant chemotherapy (NAC) has not been well reported. The authors have done a retrospective analysis of patients undergoing cystectomy between 1995 and...

PIRADS-3 lesions and clinically significant prostate cancer – what are we missing?

The use of pre-biopsy MRI has definitely enhanced our decision making in managing patients with suspected prostate cancer (PCa). There is still uncertainty around the outcomes for patients with PIRADS-3 lesions, with a small but definite risk of missing clinically...