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The emerging role of physician associates in urology

The physician associate (PA) is a new role in the NHS which has expanded across medical and surgical specialties to include urology. In the USA, it has long been an established field of practice where physician assistants work autonomously within...

New techniques in UTI diagnosis

Urinary tract infection (UTI) is a common reason for seeking medical care in both primary and secondary settings. Half of women will have at least one episode of cystitis in their lifetime, and a third of them will have experienced...

What’s new in post prostatectomy incontinence?

With an ageing population, the number of men being diagnosed with prostate cancer each year is steadily rising. With more specific investigations, such as multiparametric magnetic resonance imaging (MpMRI) and transperineal biopsies, the number of cases diagnosed at an earlier...

An overview of daytime wetting in children

It is estimated that daytime wetting affects one in seventy-five children over the age of five years [1]. Daytime wetting is commoner in younger children (1 in 7 aged 4.5 years, 1 in 20 aged 9.5 years) [1]. Many younger...

Use of bone windows in urological CT

Introduction Unenhanced computed tomography of kidneys, ureter and bladder (CTKUB) is the recommended gold standard investigation in patients with acute renal colic. CT urography is now a commonly used technique in the investigation of haematuria, for surgical planning and for...

Ureterocystostomy – novel surgery for the paediatric obstructed megaureter

Megaureter is a relatively common congenital urinary tract anomaly; obstructed non-refluxing megaureter is one variant. Initial management is conservative, with operative intervention reserved for symptomatic cases (recurrent pyelonephritis, pain, increasing dilatation or worsening renal function). Surgical options include cutaneous ureterostomy,...

Is TRUS and biopsy obsolete as a diagnostic test for prostate cancer: refining the perineal biopsy technique?

Whilst there has been a dramatic shift in how patients are investigated for potential prostate cancer, transrectal ultrasound (TRUS) and biopsy remains the most commonly used technique for tissue sampling. In this single centre, retrospective analysis, 634 men, over a...

Prostatic artery embolisation – an option for select BPO patients

Few proponents of prostatic artery embolisation (PAE) regard it as a potential standard in future for benign prostatic obstruction (BPO) / benign prostatic hyperplasia (BPH) treatment. Present guidelines from the National Institute for Health & Care Excellence (NICE) and the...

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...

Can antibiotics reduce ‘unnecessary’ prostate biopsies?

With numerous factors capable of influencing prostate specific antigen (PSA) levels and therefore the likelihood of biopsy, this multi-centred randomised controlled trial (RCT) was designed to see if two weeks of ciprofloxacin compared to placebo would significantly reduce PSA levels...

Surgical and pathological outcome of partial nephrectomy: robotic versus laparoscopic approach

Nephron sparing surgery has become the standard surgical treatment for small renal masses (<4cm). Laparoscopic partial nephrectomy (LPN) is shown to be superior to the open approach (OPN) in peri and postoperative morbidity; however, it requires advanced skills and has...

Cryotherapy for small renal masses: better than surveillance?

With the rapid rise in incidental small renal mass detection, some of which have malignant potential, comes the need to either survey or treat these masses safely and with minimal morbidity. This large series of 147 patients with 171 masses,...