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Urolithiasis – metabolic considerations

Case 1 A 32-year-old female patient is diagnosed with a ureteric calculus for the first-time. What type of metabolic evaluation investigations should be performed? When should stone analysis be repeated? What are the most common metabolic abnormalities associated with calcium...

Ambulatory local anaesthetic implantation of percutaneous sacral nerve stimulators

Background The current treatment paradigm for detrusor overactivity (DO) and dysfunctional voiding (DV) includes conservative measures, pharmacotherapy, intravesical onabotulinum toxin A (Botox®), sacral nerve modulation (SNM / SNS) and urinary diversion as a last resort [1]. Incidence of DO is...

Urolithiasis 1 – ureteric colic

- Click for Part 2 and Part 3 on this topic - Case scenario A 45-year-old male presents to Accident & Emergency with two days of intermittent, severe, left-sided loin to groin pain and multiple episodes of vomiting. He undergoes...

Long-term oncologic outcomes of salvage cryoablation for rrPC

Of patients undergoing radiotherapy (RT) for prostate cancer (PC), at least 15-20% will experience recurrence. Although salvage prostatectomy achieves durable oncological outcomes at 10 years, it is associated with significantly high morbidity. Thus, the majority of men with radio-recurrent prostate...

RN or PN for small RCCs – the debate continues

This is a retrospective study to evaluate kidney function and overall survival (OS) in patients who underwent partial nephrectomy (PN) and radical nephrectomy (RN) for RCCs <4cm. They looked at 2110 patients who underwent RN/PN for T1a renal cell carcinomas...

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...

Increasing PSA after negative prostate biopsy - solving the clinical puzzle

There are standard guidelines for first transrectal ultrasonography (TRUS) guided biopsy in a patient presenting with elevated prostate-specific antigen (PSA) or suspicious digital rectal examination (DRE) findings. Patients are generally warned before a TRUS biopsy in respect of a false...

Children with neuropsychiatric developmental disorders respond less well when treated for bladder bowel dysfunction

Bladder and bowel dysfunction (BBD) is a spectrum of lower urinary tract symptoms and voiding dysfunction accompanied by functional constipation and / or encopresis and may represent up to 47% of paediatric urology consultations. The BBD cycle pattern begins when...

Long-term complications of bulking agents in the treatment of SUI

Incontinence poses a substantial economic burden on the UK’s NHS, estimated at £536 million in 1999/2000, equivalent to approximately 1.1% of the total NHS spend, for both men and women. Over two decades later, this cost is expected to have...

Sexual dysfunction following prostate cancer treatment

Prostate cancer is common with over 52,300 new cases diagnosed annually in the UK; this is expected to rise by 15% between 2023-2025 and 2038-2040 [1]. Radical prostatectomy continues to be the most common form of radical treatment for men...

Nurse practitioner TRUS biopsy: training and preparation

As prostate cancer rates increase, many urology departments rely on multi-professional teams to diagnose and manage patients with prostate cancer. The aim of this article is to highlight the skills, training and preparation required for nurse practitioners to undertake trans-rectal...

Sarcomatoid renal cell carcinoma

Renal cell carcinoma (RCC) represents 2-3% of all cancers [1]. It is an adenocarcinoma making up 85% of all renal malignancies. Sarcomatoid transformation is a microscopically identified feature of RCC accounting for 5% of all RCCs [2]. Known as sarcomatoid...