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Indication to pelvic lymph nodes dissection for prostate cancer

This paper explored the role of multiparametric MRI (mpMRI) in predicting the likelihood of lymph node invasion in patients with a risk of <5% according to the Briganti nomogram. Three hundred and ten patients who underwent a preoperative mpMRI and...

Erectile Dysfunction Part I: pathophysiology and risk factors

Introduction Erectile dysfunction (ED) is defined as the inability to achieve and maintain a penile erection, which is adequate for satisfactory sexual intercourse. The Massachusetts Male Ageing Study (MMAS) reported the results of a regional survey of men aged 40–69...

Preoperative use of testosterone prior to distal hypospadias repair

Preoperative hormonal stimulation has been utilised for >50 years in hypospadias surgery. Surgeons utilise testosterone (T) to increase penile size and glans width to try and improve clinical outcomes. However, a paucity of reliable data supporting its use has limited...

Rectal swab testing before prostate biopsy

This study explored the real terms value of rectal swab testing and targeted antibiotic prophylaxis in patients undergoing transrectal ultrasound prostate biopsy in view of increasing bacterial resistance to fluoroquinolones (17.6% in North America, 40% in Hong Kong). The authors...

Stuttering (recurrent ischaemic) priapism

Stuttering (recurrent ischaemic) priapism (SP) is a rare urological condition. Affected men will often experience almost daily prolonged and painful sleep related erections (SRE). Interestingly, these men report normal erections during the day and whilst awake. These episodes are usually...

Male infertility

Definitions Infertility is the inability of a sexually active, non-contracepting couple to achieve spontaneous pregnancy in one year [1]. About 15% of couples do not achieve pregnancy within one year and seek medical treatment for infertility. Semen parameters are standardised...

Conservative management of pelviureteric junction

Background Pelviureteric junction obstruction (PUJO) is defined as a functionally significant impairment of urine flow from the renal pelvis into the proximal ureter. For more than a century, surgery was considered the first-choice approach to management. However, the widespread use...

A guided guide to the guide wire

The use of guide wires has become a core skill utilised by urologists, especially within the field of endourology. The authors take us through the development of the guide wire and their current use in urology. The history The first...

Male urethrograms

An ascending urethrogram is the best initial radiographic technique to image a male patient’s urethra and is indicated for strictures, fistulae, trauma and urethral obstruction [1]. It is quick and straightforward to perform and is performed using an 8Fr Foley...

Outcomes of VUR in children with non-neurogenic dysfunction treated with Deflux

The 2010 American Urological Association (AUA) guidelines on primary vesicoureteral reflux (VUR) state that children with VUR and lower urinary tract dysfunction are less likely to have the VUR resolve spontaneously than those with primary VUR alone (31% vs. 61%)....

Prilocaine irrigation for pain relief after TURP

Transurethral resection of the prostate (TURP) is one of the commonest procedures undertaken by urologists. There are well known complications following the procedure which commonly include haematuria but also TUR syndrome, failure to pass urine and infections, amongst others. The...

When can antibiotic prophylaxis be stopped for VUR in children?

Continuous antibiotic prophylaxis (CAP) is the mainstay of treatment and reduces the risk of febrile urinary tract infections (fUTI) in children with VUR. Thus far, there are no clear management guidelines as to whether and when CAP may be safely...