Journal Reviews
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...
Upper tract urothelial carcinoma following cystectomy
Metachronous upper tract urothelial cancer (UTUC) is encountered in about 5% of patients after radical cystectomy (RC) with a median time to diagnosis of 24-36 months after RC, and most are asymptomatic and detected by surveillance protocols. In this multivariate...
Is robotic pyeloplasty in the under-ones as good as open repair?
Pelviureteric junction obstruction (PUJO) is a common cause of paediatric hydronephrosis. Indications for intervention include reduced renal function (<40%), symptoms (urinary tract infection or pain) and increasing dilatation. Although the Anderson-Hynes open pyeloplasty (OP) has long been the gold standard...
Risk factors for BC after minimally invasive RNU
Bladder cancer (BC) after radical nephroureterectomy (RNU) has an approximate incidence of 20-50%. This contemporary multicentre study will inform the ongoing debate on risk factors for BC after minimally invasive RNU and how it may be prevented. Three hundred and...
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...
Delayed decompression of the infected obstructed kidney increases fatality
Well, we know this, I hear you all say. It is standard practice that the obstructed kidney with associated infection requires prompt decompression, and this is drilled into all UK trainees. It is surprising therefore that although we frequently deal...
Ipsilateral ureteroureterostomy: does function of the obstructed moiety matter?
Upper pole nephrectomy has been the traditional surgical management of children with poorly functioning upper pole moieties in duplex renal collecting systems having ureteral ectopia and ureterocele. However, ablative surgery confers a risk of functional loss to the remnant moiety...
Comparing treatment modalities for transplant kidney VUR in the paediatric population
The management of Transplant kidney vesicoureteral reflux in the paediatric population is a heavily debated issue and Deflux® injection to manage VUR is both widely described in the literature and commonly practised. In this paper, these authors have put forth...
Comparison of pathological stage in patients treated with and without neoadjuvant chemotherapy for high-risk UTUC
High-risk upper tract urothelial carcinoma (UTUC) has been associated with poor survival outcomes. The authors evaluated the role of neoadjuvant chemotherapy in high-risk cases prior to radical nephroureterectomy (RNU) in terms of pathological stage of the final surgical specimen. A...
Bladder debris on ultrasound as a predictor for positive urine culture
One of the common ultrasound findings in children who undergo renal tract evaluation is ‘debris in the bladder’. The aetiology of bladder debris is varied and the likelihood that urinary debris represents positive urine culture is debatable. The authors of...
Ureteral clipping in children – longer term outcomes of a novel treatment
In this article, Lopes et al. report longer term outcomes of laparoscopic clipping of ureters of non-functioning kidneys or non-functioning renal moieties in duplex kidneys associated with ectopic ureter or obstructive ureteroceles. In 2014, their group published a promising preliminary...
Ureterocystostomy – novel surgery for the paediatric obstructed megaureter
Megaureter is a relatively common congenital urinary tract anomaly; obstructed non-refluxing megaureter is one variant. Initial management is conservative, with operative intervention reserved for symptomatic cases (recurrent pyelonephritis, pain, increasing dilatation or worsening renal function). Surgical options include cutaneous ureterostomy,...
