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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...

NICE backs laser for BPH

Benign prostatic hyperplasia affects 60% of men aged 60 or over. The medical technology division of the National Institute for Health & Care Excellence (NICE) has supported the GreenLight XPS laser system as a surgical tool. The specific indications are:...

Getting it Right First Time in urology: the implementation phase

The Getting it Right First Time (GIRFT) programme is the largest and most comprehensive initiative to improve the quality and efficiency of individual clinical services that the NHS has ever instigated. The programme falls under the auspices of NHS Improvement...

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,...

Robotic assisted perineal prostatectomy: descriptive technique of the inaugural case in the UK

Robotic surgery has taken full flight in the USA since its start in 2000 [1] and is replacing procedures where open surgical techniques were solely employed. While this technology is met with criticism over the costs, the superiority of robotic...

Missed Meyer-Weigert duplex ureter during emergency ureteric stenting for ureteric stones

The Meyer-Weigert rule is a fundamental anatomical principle in urology that describes the typical orientation of ureteral orifices in duplex kidneys. In a duplex system, the upper pole ureter usually inserts inferomedially, while the lower pole ureter inserts superolaterally. This...

Clean catch urine from babies – the ‘quick wee method’

Urinary tract infections (UTIs) are common in children and babies and can lead to urosepsis, renal scarring and chronic kidney disease. As per American Academy of Pediatrics guidelines, urine samples are a must in febrile / unwell infants even if...

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...

Biomarkers in prostate cancer detection

Prostate cancer (PCa) is the second most common cancer in men with an estimated prevalence of 1.1 million worldwide in 2012. This heterogeneous disease resulted in approximately 307,000 deaths, making it the fifth leading cause of cancer-related death in men...

Update on immunotherapy for non-muscle invasive transitional cell carcinoma of the bladder

Patients with high-risk non-muscle invasive bladder cancer (NMIBC) that have failed Bacillus Calmette-Guérin (BCG) treatment are a difficult group to treat, and many may not be suitable for the preferred treatment option of radical cystectomy. Bladder-preserving treatments for BCG-unresponsive high-risk...

Challenging Cases in Urological Surgery: Cases With Expert Commentary (Challenging Concepts)

The authors’ intention with this book is to provide a consensus on a number of common, challenging and controversial topics in urology, which are examined from a multidisciplinary approach with insights from expert opinion and current evidence. Challenging Cases in...

Urinary tract stones

Case 1 What does this plain X-ray of kidneys, ureters and bladder (KUB) show? What, according to the 2009 The National Institute for Health and Care Excellence (NICE) guidelines, is the most appropriate first-line treatment? What factors do the NICE...