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Surgical risk prediction

Patients presenting for urological surgery range from the young and fit to the elderly with multiple, and often significant, coexistent diseases. This latter cohort can present a significant challenge in the perioperative period, sometimes irrespective of the type of surgery....

The surgical trainer – are we still evolving?

“We need a system and we will surely have it – which will produce not only surgeons, but surgeons of the highest type” William Halsted MD William Halsted, a famous American surgeon, is widely credited with developing the first formal...

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...

Fournier’s gangrene

Introduction Fournier’s gangrene (FG) is a rare but fulminant form of infective necrotising fasciitis affecting the perineum and external genitalia, which can rapidly progress along fascial planes. It most commonly affects men, but can occur in women and children, with...

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...

SUSPEND suspended MET

This review is on the recent groundbreaking evidence on medical expulsive therapy (MET). MET using alpha adrenergic blockers (like tamsulosin) are in regular clinical practice. Even though it is an off label prescription, it is well accepted and practised world...

Repeat transurethral resection in non-muscle invasive bladder cancer

The authors felt this is a big problem because there is no standardised practice on re-resection following initial transurethral resection of bladder tumour (TURBT). Getting detrusor muscle in the first specimen is thought to be important. However muscle is not...

The risk of tumour recurrence in patients undergoing renal transplantation for end-stage renal disease

End stage renal disease (ESRD) patients in need of a kidney transplant who have a previous history of urological cancer should undergo a cancer-free waiting period before receiving a kidney transplant. Currently the recommended waiting time is based on the...

Near-infrared fluorescence in robotic surgery

This is a systematic review and critical analysis of the current evidence on the applications of near-infrared fluorescence (NIRF) in robotic urologic surgery. It uses indocyanine green (ICG), a sterile water-soluble dye which has been tested in various fields. In...

Reviewing the evidence for TNS in neurogenic lower urinary tract dysfunction

Tibial nerve stimulation (TNS) is a recognised minimally invasive treatment option for bladder overactivity and non-neurogenic lower urinary tract dysfunction. In this systematic review, the role TNS can play in the management of neurogenic lower urinary tract dysfunction is evaluated...

Bladder debris on ultrasound as a predictor for positive urine culture

One of the common ultrasound findings in children who undergo renal tract evaluation is ‘debris in the bladder’. The aetiology of bladder debris is varied and the likelihood that urinary debris represents positive urine culture is debatable. The authors of...

Predictive factors for conservative treatment failure in paediatric blunt renal trauma

Blunt renal trauma is managed conservatively in children in the vast majority of cases. Grade IV renal injury is also generally managed non-operatively although occasionally intervention is needed for a urinoma that fails to settle. These authors retrospectively looked at...