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Sepsis syndrome in urology

There are approximately 100,000 cases of sepsis per year in the UK, of which 37,000 result in death (this is more than prostate cancer, breast cancer, HIV / AIDS and road traffic accidents combined). Urosepsis is defined as sepsis caused...

Visual-estimation (cognitive), image-fusion (software) and in-bore targeted prostate biopsy: is there an optimal approach?

The diagnostic superiority of multiparametric magnetic resonance imaging (mpMRI) prior to targeted and systematic prostate biopsy over systematic transrectal ultrasound-guided (TRUS) biopsy alone in the detection of clinically significant prostate cancer (csPCa) has been proven by multiple level 1 studies...

Standard versus expanded cultures to diagnose UTIs in women

Clinicians are well aware of the limitations of the so-called Kass criteria applied to standard urine culture (SUC) techniques as well as the limitations of empiric antibiotic prescribing for symptoms that are known to overlap with chronic conditions such as...

Prostate cancer detection rate of MRI-TRUS fusion vs. systematic biopsy

With the advent of one-stop prostate cancer diagnostic clinics, the findings of this study are of interest to readers who may be considering introducing the technique of magnetic resonance imaging transrectal ultrasound (MRI-TRUS) fusion biopsies to their practice. A retrospective...

Renal calculi: the role of imaging in pregnancy

Nephrolithiasis is the most common cause of non-obstetric abdominal pain in pregnancy. Accurate diagnosis is imperative as stone related complications can lead to pre-eclampsia, urosepsis, and premature labour [1,2]. In the general population, non-contrast cross sectional imaging is recommended by...

Evaluation of the learning curve for learning MRI-US fusion prostate biopsies

With the advent of one-stop prostate cancer diagnostic clinics, the findings of this study are of interest to readers who may be implementing MRI-US transrectal or transperineal fusion biopsies to their clinical practice. This prospective cohort study evaluated 779 consecutive...

The role of an enhanced recovery protocol in patients undergoing robotic radical cystectomy

Enhanced recovery after surgery (ERAS) protocols are patient pathways designed to reduce surgical stress and accelerate postoperative recovery. Uptake of such protocols in colorectal surgery in particular has been high, however ERAS protocols developed or utilised in urological surgery have...

Quality Improvement – how to get involved?

The General Medical Council (GMC) requires all trainee doctors to carry out Quality Improvement (QI) as part of our annual appraisal process [1]. Exactly what QI projects are and how to get involved is less widely understood. Traditionally surgical trainees...

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...

Metabolic screening and stone-prevention in urolithiasis patients

The incidence and prevalence of kidney stones is increasing [1,2]. Significant recurrence rates are noted with 14% of patients experiencing a further episode at one year, 35% at five years, and 52% at 10 years [3]. Over 10% of stone...

Urine leak post partial nephrectomy: a case for lower tract before upper tract

Partial nephrectomy has become the standard of care in the management of small renal masses. It is a vital tool in maximising nephron preservation and oncological control for patients. It has been shown to produce equivalent oncological outcomes to radical...

Imaging and surveillance in sporadic renal angiomyolipoma: how and when to monitor effectively

Renal angiomyolipoma (AML) are benign tumours, accounting for approximately 2–3% of all renal neoplasms [1]. Seventy percent of renal AMLs are sporadic, and 20–30% are associated with genetic aetiology. They are composed of smooth muscle, blood vessels, and adipose tissue....