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Rethinking stone-free rates and surgical outcomes in endourology

Retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) are two key minimally invasive treatments for kidney stones in both adults and children. The success of these procedures is primarily measured by two factors: (1) the absence of complications and (2)...

Predicting resolution of the primary obstructed megaureter

Primary obstructive mega ureter (POM) is the congenital dilatation of the ureter in the absence of other structural urinary tract anomalies and comprises 10–20% of prenatal hydronephrosis cases. It is often detected during workup for prenatal hydronephrosis and confirmed using...

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...

Demanding cases or nightmares in endourology? Jan/Feb 2017

In the fifth article in this series the authors describe some of the most complex cases they have encountered. Case 1 A 45-year-old woman was admitted under the care of the medical team with shortness of breath, renal failure and...

The management of renal calculi – Pt 1

Renal calculi can be managed according to four treatment options: conservative management, extracorporeal shockwave lithotripsy (ESWL), flexible ureterorenoscopy (FURS) and percutaneous nephrolithotomy (PCNL). This is the first in a two-part series in Urology News (Part 2 available here) that will...

Small renal masses – diagnosis and management

Renal cancer is the eighth most common cancer in the UK and accounts for about 3% of all new cancer diagnoses [1]. The incidence rates are steadily rising, with the highest rates being in older men and women. This rise...

Endoscopic management of upper tract urothelial carcinoma

Upper tract urothelial carcinoma (UTUC) is a rare disease accounting for 5-10% of all urothelial carcinomas and has an annual incidence in Western countries of 1-2 per 100,000 [1,2]. It occurs more commonly in the pelvicalyceal system as opposed to...

Józef Dietl – more than one crisis

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). To urologists, the name Dietl is linked with the eponym of Dietl’s crisis,...

The role of embolisation in urology

Case 1 An 86–year–old male presented with visible haematuria and suprapubic pain. He had a history of diabetes, heart failure, benign prostatic hypertrophy, aortic valve replacement, deep vein thrombosis (DVT) and atrial fibrillation (AF) and was anticoagulated on a non-VKA...

Assessment of the incidental adrenal lesion

Introduction The adrenal glands are seen on CT or MRI surrounded by fat in the peri-renal space. The right adrenal gland lies medial to the right lobe of the liver, lateral to the right crus of the diaphragm and superior...

Understanding Stauffer’s syndrome

Who was Stauffer and what is Stauffer’s syndrome? Maurice Stauffer (1915-1994) was a gastroenterologist at the Mayo Clinic in Rochester, United States, and in 1961 first characterised the non-metastatic, paraneoplastic effects of renal cell carcinoma (RCC) on liver size and...

Challenges of upper tract urothelial carcinoma

Upper tract uroepithelial carcinoma (UTUC) is a fairly common disease which traditionally had poorer outcomes compared to bladder cancer. This is due to various factors leading to delayed diagnosis and problems in risk stratification. Continuing efforts have focused on early...