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Virtual reality: a novel approach to pain management during ESWL

Extracorporeal shock wave lithotripsy (ESWL) is a well-established treatment for kidney and ureteric stone disease, employing high-energy shock waves to fragment stones into smaller pieces for passage through the urinary tract. This article explores the application of virtual reality (VR)...

A guide to local anaesthetic transperineal prostate biopsy

In the UK, nearly 100,000 men undergo a prostate biopsy annually, a figure projected to double in the next decade [1]. In recent years, we have observed a paradigm shift in urological practice in numerous UK hospitals. The conventional transrectal,...

CROWN initiative – what is it about?

The editors of around 50 journals related to women’s health have joined forces to support the CROWN initiative (core outcomes in women’s health). The aim is to standardise the collection of outcomes for all trials in a specific dataset in...

Is AS in SRM more convincing than in prostate cancer?

This article reviews active surveillance (AS) in the management of small renal masses (SRM), the role of renal tumour biopsy (RTB), patient selection, tumour growth kinetics, and outcomes. SRMs which are defined as masses ≤4 cm in diameter and enhance...

Digital Anatomy

Anatomy has been a cornerstone of medical and surgical education for hundreds of years. As an adjunct to traditional dissection-based teaching and textbooks, this month’s digital review guides you through some internet based anatomy resources. 3D models Anatomy for urology,...

The role of conservative renal colic treatment

Acute renal colic is a common emergency condition, which can arise from a variety of underlying conditions that affect the urinary tract, but it is usually associated with the passage of ureteral stones. Before considering expectant management or active intervention,...

Does stable or decreasing hydronephrosis on ultrasound lead to stable or improved function on diuretic renography?

Antenatal hydronephrosis is noted in approximately 1% of all pregnancies. Persistent renal obstruction may lead to progressive loss of renal function. Renal ultrasound (USS) is the preferred modality for diagnosis and monitoring of paediatric hydronephrosis as it is non-invasive, non-ionising,...

Preventive pharmacological therapy for kidney stones

Kidney stones are common, painful and are a chronic disease with a high lifetime risk of recurrence. Without treatment 35-50% of patients experience a second stone within five years of their first experience. Thiazide diuretics, alkali citrate treatment and allopurinol...

Performance status may alter outcomes in those treated with abiraterone

The drug therapies available for those with metastatic castrate-resistant prostate cancer have increased over the past few years. Abiraterone, a CYP17 inhibitor, has been proven effective in phase three trials, however those with poor performance status were largely under-represented in...

Transurethral enucleation is superior to resection for the management of LUTS secondary to BPH

This meta-analysis (Level 1b evidence) examined the efficacy and safety of two primary transurethral therapies used in the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), enucleation (HoLEP – holmium laser enucleation of prostate, ThuLEP,...

Multiparametric MRI with targeted-only biopsy – a new standard?

In this issue of European Urology, Kasivisvanathan et al. present a meta-analysis of two randomised trials comparing prebiopsy MRI with targeted biopsy (TBx) alone versus standard transrectal ultrasound-guided biopsy (TRUS-Bx) in biopsy-naïve men at risk of prostate cancer. Their findings...

The role of embolisation in urology

Case 1 An 86–year–old male presented with visible haematuria and suprapubic pain. He had a history of diabetes, heart failure, benign prostatic hypertrophy, aortic valve replacement, deep vein thrombosis (DVT) and atrial fibrillation (AF) and was anticoagulated on a non-VKA...