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Phase two trial of SAbR for primary RCC

A study focused on stereotactic ablative radiotherapy (SAbR) as a treatment for primary renal cell carcinoma (RCC) has yielded significant findings. The primary objective of the study was successfully met, demonstrating a 94% local control rate at one year among...

Management dilemma for very high-risk non–muscle-invasive bladder cancer

The European Association of Urology (EAU) guidelines recommend upfront radical cystectomy (RC) for very high-risk (VHR) non-muscle-invasive bladder cancer (NMIBC). However, real-world adoption is limited, as most patients are reluctant to undergo immediate bladder removal. The EAU 2021 risk model...

Guide to gaining approval for a clinical study

This article focuses on gaining approval for clinical research involving NHS patients, although the principles can be applied to other types of research. It can be quite a daunting process for the uninitiated applicant. Often it can be made less...

ESWL and URS for treatment of paediatric urolithiasis

Tejwani et al. have undertaken a comparative effectiveness study to characterise differences in procedure frequency, postoperative re-admissions and emergency room (ER) visits, and repeat treatment rates for children (≤18 years) with urolithiasis who underwent initial intervention with extracorporeal shock wave...

Do stones still kill?

This paper is a retrospective analysis of deaths ascribed to stone disease in England and Wales over a 15-year period. The data was obtained from the Office of National Statistics, based on mortality derived from death certificates. One thousand, nine...

The impact of seat belts and airbags on renal injuries and nephrectomy rate

Motor vehicle collisions (MVC) account for 3.6 million emergency department attendances and 34,000 deaths annually. The combination of lap / shoulder seat belts and airbag deployment reduces mortality by more than 80%. MCVs are responsible for 48-66% of all renal...

The current state of surgical practice for neonatal torsion

Perinatal testicular torsion may be subdivided into prenatal (73%) and postnatal (28%) up to 30 days post birth. Aetiology in the former is universally extra vaginal around the whole of the tunica vaginalis with testicular salvage rate of <5%. Postnatal...

Early complications following ambulatory hypospadias repair

Most hypospadias repairs are undertaken on a day case ambulatory basis. Roth et al. have studied clinically significant events occurring within 30 days of operation. Data was obtained from the Paediatric Health Information System (PHIS), an administrative database that contains...

Risk stratified approach to early intervention for renal colic

Existing guidance on this topic is based on older and smaller studies, and there remains variation in practice. This review of database outcomes of 1168 out of 3081 (38%) patients who underwent early intervention after presentation to nine Canadian emergency...

Is outpatient robotic surgery feasible in children?

Minimally invasive surgery has helped to achieve shorter hospitalisations, reduce postoperative pain and analgesia requirements and provides better cosmetic results. Robotic urological outpatient surgery has been examined in recent times in the adult population; here Neheman et al. look at...

Medical Protection: Expertise, advocacy, and support when it matters most

The world’s leading medical defence organisation providing long-term protection against the potentially ruinous costs of litigation, as well as the other professional challenges that healthcare professionals might face during the course of their career. As a doctor your work is...

Cystoplasty

Case 1 A 48-year-old female, having previously had an augmentation ileocystoplasty 10 years ago, has been referred with right loin pain by the emergency department. A venous blood gas is performed shortly after triage with the following values: What is...