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PUJO: Hellstrom principle revisited

This paper describes the result of four out of twenty-three cases (two males, two females) of pelvi-ureteric junction obstruction - PUJO - (mean age 18.25 years, range 16-20), mean follow-up two years (range six months – three years) that were...

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...

Does stable or decreasing hydronephrosis on ultrasound lead to stable or improved function on diuretic renography?

Antenatal hydronephrosis is noted in approximately 1% of all pregnancies. Persistent renal obstruction may lead to progressive loss of renal function. Renal ultrasound (USS) is the preferred modality for diagnosis and monitoring of paediatric hydronephrosis as it is non-invasive, non-ionising,...

Supranormal function on MAG-3 – what is its significance and how to predict?

Differential renal function (DRF) on MAG-3 scans is typically used in patients with pelvic ureteric junction obstruction (PUJ obstruction). Supranormal DRF is when the kidney with PUJO has higher DRF than the normal contralateral kidney. The authors in this study...

Can continence and volitional voiding be achieved in bladder exstrophy?

Bladder exstrophy is a challenge to the paediatric urologist; here in the UK, repairs are now undertaken at two centres in order to concentrate experience. The ultimate aim is to achieve urinary continence and volitional voiding. In this study, John...

Long-term risks of augmenting the bladder in spina bifida patients

Bladder augmentation is utilised to treat children with neuropathic bladders secondary to spina bifida that results in hostile urodynamics, renal deterioration and / or urinary incontinence. Whilst it is associated with an improved quality of life and low mortality, it...

Peak Medical – new additions to our catheter range

UltraSmooth Tapered Tip Meatal Dilator / UltraSmooth Aqua Tiemann Tip Catheter / UltraSmooth Aqua ISC Nelaton Catheter

The Mitrofanoff procedure: a continent revolution

Prior to 1980, surgeons had been struggling to provide a catheterisable, continent channel as an alternative to the native urethra, primarily for paediatric patients with congenital neuropathic bladder. In 1980, Professor Paul Mitrofanoff described the continent supravesical antireflux appendicovesicostomy [1]...

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,...

Complications of CISC

Introduction Clean intermittent self catheterisation (CISC) was first introduced and popularised by Lapides in 1972. Since then its utilisation has become widespread and it is now commonly used throughout the world as the preferred means of facilitating complete and effective...

Frailty in urology – part 2

The first article in this series defined frailty and introduced the concept and importance of identifying patients living with frailty who undergo surgery, including those undergoing urological procedures. In the second part of this series we outline how to identify...

Using cryopreserved prepubertal testis tissues – are we getting warmer?

The rising incidence of childhood cancer coupled with increasing survivorship means there is a growing population of childhood cancer survivors with unmet health needs. In the UK around 1 in 500 children and young people are survivors of childhood cancer....