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Has laparoscopic radical prostatectomy had its day?
Over recent years there has been a massive uptake in robotic surgery particularly for robot-assisted prostatectomy. The drive for this has been patient and physician led with little in the way of prospective randomised trials showing benefits over established operative...
What should we do with the incidentally detected renal cyst in a child?
The introduction of routine prenatal screening in the early 1980s resulted in paediatric urologists being confronted with the dilemma of what to do with antenatally-detected urinary tract dilatation, many of whom, we now know, do not require long-term surveillance or...
Testosterone supplementation after prostatectomy – journey from bad to good
The role of androgens in the pathogenesis of prostate cancer is quite complex and is not entirely clear yet. Despite several reports suggesting testosterone use is safe in patients diagnosed with prostate cancer, many clinicians are still reluctant to use...
Coronaviruses and kidney injury
This is a topical review of the effects of coronaviruses on the kidney and includes a description of the mechanisms of kidney damage by SARS, MERS and COVID-19. The authors quote two previous reports which estimate the incidence of acute...
Cardiac failure and medical therapy for LUTS / BPH
Alpha blockers (AB), 5-alpha reductase inhibitors (5-ARI) and combination therapy are widely prescribed for lower urinary tract symptoms (LUTS) considered consequent to prostatic enlargement and are the mainstay of first-line therapy. This retrospective interrogation of a large population-based dataset of...
Active surveillance for small renal masses in younger patients
Active surveillance (AS) is discussed as an option for renal masses <2cm in patients with significant competing risks for mortality. This multicentre data from the US seeks to fill an important gap in current guidelines for provision of this option...
Factors and time to conversion from prostate cancer active surveillance to treatment
Active surveillance is the standard of care for men with low-risk and selected men with favourable intermediate risk prostate cancer. The aim is to reduce the morbidity and mortality of overtreatment of non-clinically significant prostate cancer. A significant proportion progress...
Cortical stimulation for voiding dysfunction in multiple sclerosis
Voiding dysfunction (VD) increases morbidity in patients with multiple sclerosis (MS), and may be associated with urinary tract infections, stones and renal failure. Catheterisation is required when impaired hand function precludes self-catheterisation, which is associated with further morbidity. In this...
PIRADS-3 lesions and clinically significant prostate cancer – what are we missing?
The use of pre-biopsy MRI has definitely enhanced our decision making in managing patients with suspected prostate cancer (PCa). There is still uncertainty around the outcomes for patients with PIRADS-3 lesions, with a small but definite risk of missing clinically...
