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Digital Twins: From NASA to the clinic
Clinical practice generates an enormous amount of patient data – histories, observations, blood results, imaging and molecular biomarkers. The problem is that these data streams rarely talk to each other. Instead, we use them in isolation, when what we actually...Prostate abscess
Prostate abscess (PA) is a relatively uncommon clinical condition which is often difficult to diagnose because clinical symptoms are non-specific. It may be associated with a significant fatality rate, estimated to be between 3% and 30%, which may reflect its...Prostate cancer management 1 – non-metastatic disease
You are referred a 68-year-old gentleman to the rapid access prostate clinic with a serum prostate specific antigen (PSA) of 12ug/L. He is otherwise fit and well with mild voiding lower urinary tract symptoms (LUTS). He undergoes a multi parametric...
Should maximal urethral closure pressure be performed before mid-urethral sling surgery for stress incontinence?
Maximum urethral closure pressure (MUCP) is a means of trying to provide an objective assessment of urethral integrity. In some centres it is used as a tool to help predict outcomes after mid-urethral sling (MUS) placement. The authors propose that...
Kidney stone basketing forces unmasked
Ureteral avulsion is the most dreaded situation for any urologist to be faced with. Although uncommon, with rates of ureteroscopy on the increase, the potential for this serious complication should also be recognised. To avoid such serious complications, smart devices...
Renal fossa recurrence after nephrectomy for renal cell carcinoma
This paper is an analysis of 36 years of radical nephrectomy for renal cell carcinoma in the Mayo Clinic (1970-2006). In particular, it contains an analysis of the risk of renal fossa recurrence after nephrectomy (partial nephrectomies are not included)...Things in a place they should not be!
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). I think we all have stories of objects inserted into the urethra and...
Curing pure CIS with radical surgery: lessons learned
As carcinoma in situ (CIS) theoretically has no ability to invade or metastasise, performing radical cystectomy for CIS-only disease should be curative. In this single centre review over 37 years, 1964 patients undergoing cystectomy were analysed with 52 undergoing surgery...Use of Clavien-Dindo classification in urology part 1 – pelvic surgery
There is no widely accepted system to classify postoperative complications. It is necessary to compare the outcome and complications while validating a new surgical procedure or one of the surgical approaches of a particular condition. Several parameters have long been...
Refluxing ureteral reimplantation
Obstructed megaureters may be managed with temporising stents, cutaneous ureterostomies, or in older children with ureteral reimplantation (usually if the child is over one year of age). Cutaneous ureterostomies have risks of stomal stenosis, infection and leakage problems over nappies...Focal therapy for prostate cancer – ready for prime time?
The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...
