Journal Reviews
Increased use of active surveillance for men with intermediate risk prostate cancer
The optimal management of men with intermediate risk prostate cancer remains unclear and continues to be debated. The authors interrogate the US National Cancer Database for 176,122 men diagnosed with intermediate risk prostate cancer between 2010 and 2016. Of these...
The importance of assessing frailty in patients prior to radical prostatectomy
This large-scale retrospective study evaluated the short-term postoperative outcomes in patients with localised prostate cancer treated with radical prostatectomy (RP). Both body mass index (BMI) and Charlson comorbidity Index (CCI) are well established indicators of adverse outcomes post major surgery,...
Cardiac failure and medical therapy for LUTS / BPH
Alpha blockers (AB), 5-alpha reductase inhibitors (5-ARI) and combination therapy are widely prescribed for lower urinary tract symptoms (LUTS) considered consequent to prostatic enlargement and are the mainstay of first-line therapy. This retrospective interrogation of a large population-based dataset of...
Male LUTS: where do we stand?
Patients’ preferences and expectations depend on cultural, geographical, economic and national factors. Data from different countries should be interpreted with caution when applied to the individual patient. Patients rarely seek help for benign prostatic obstruction (BPO) unless urinary retention occurs,...
‘Born in the USA’ – neonatal circumcision
In 2006, the British Association of Paediatric Urologists (BAPU) published a statement paper on the management of foreskin conditions (www.baps.org.uk/resources/management-foreskin-conditions). Non-therapeutic circumcisions (those to comply with religious or cultural practices) are not uniformly available on the NHS. Circumcisions for medical...
Urinary frequency and COVID-19: is there a missing link?
The current COVID pandemic has been a worldwide challenge for over a year. It can affect an individual in various ways. According to the World Health Organization, the classical signs are dry cough, fever and shortness of breath. In addition,...
Assessing resolution of isolated hydronephrosis – is APPD superior to the SFU system?
Antenatal scanning detects urinary tract dilatation in 1-5% of pregnancies. Isolated hydronephrosis (i.e., that not due to secondary dilatation e.g. bladder dysfunction) is known to resolve or improve in most; some patients may, however, require intervention through deterioration of obstruction...
Urinary diversion and infections
This article will be of interest to colleagues undertaking reconstructive surgery. Urinary diversions have been performed for decades. Common indications are muscle-invasive bladder cancer, neurological disorders, inflammatory conditions and congenital malformation. The diversions could be continent or non-continent. Complications due...
Vitamin D and LUTS
Lower urinary tract symptoms (LUTS) and vitamin D deficiency have been thought to be connected, but the association has been inconsistent. Vitamin D receptors have been identified in the bladder, prostate and pelvic floor muscles, and it has been linked...
Risk stratified approach to early intervention for renal colic
Existing guidance on this topic is based on older and smaller studies, and there remains variation in practice. This review of database outcomes of 1168 out of 3081 (38%) patients who underwent early intervention after presentation to nine Canadian emergency...
Testicular masses – can the testis be spared?
The standard practice for testicular masses confirmed on ultrasound has been to offer an inguinal orchidectomy, on the presumption that the mass represents testicular cancer. The growing use of scrotal ultrasound for various indications has led to an increase in...
Hypospadias – detecting your complications
All hypospadias surgeons will encounter complications. They are estimated to occur in around 10% of distal hypospadias repairs and more than 50% for proximal forms. Some controversy exists regarding the length of follow-up needed to detect them. Some series have...
