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Prostate cancer management 1 – non-metastatic disease

You are referred a 68-year-old gentleman to the rapid access prostate clinic with a serum prostate specific antigen (PSA) of 12ug/L. He is otherwise fit and well with mild voiding lower urinary tract symptoms (LUTS). He undergoes a multi parametric...

Is routine renal tumour biopsy associated with lower rates of benign histology following nephrectomy for small renal masses?

There has been a considerable increase in the detection of small renal masses (SRM). Approximately 20% of these turn out to be benign lesions on final histopathological analysis. Therefore upfront surgery can be overtreatment in such a group of patients....

All you need to know about percutaneous nephrolithotomy: supine versus prone and mini versus traditional

Introduction Since the first percutaneous nephrolithotomy (PCNL), the technique has undergone many innovations, including modifications in positioning, miniaturisation of instruments and combination with retrograde intra-renal surgery (see Table 1 for an outline of the history of the technique). Controversy has...

Bladder urothelial neoplasms in children

Urothelial bladder neoplasms are rare in children, occurring in 0.1-0.4% of the population before the age of 20. There are no current paediatric guidelines to their management. This study retrospectively reviews the files of patients from three tertiary centres between...

What can you do NOW to help kidney stone patients?

Given that the pandemic has meant that cancer surgery and treatment has been postponed, what can be done for patients if their condition isn’t life-threatening?

Bridging the gap – a nurse-led UTI information and support service

Urinary tract infections (UTIs) are among the most frequently diagnosed bacterial infections in both primary and secondary care. While acute, uncomplicated cases may be managed effectively, recurrent and chronic UTIs often present a more complex challenge. For many people, these...

Urinary retention in women: what a general urologist should know

Urinary retention (UR) is classified by the International Continence Society (ICS) into acute (AUR) and chronic (CUR). AUR is defined as the “inability to pass any urine despite having a full bladder which is painfully distended and readily palpable or...

Prostate Cancer – Diagnosis and Clinical Management

This rather modest looking paperback actually punches well beyond its humble appearance. There are of course the predictable sub-sections appropriate to any prostate cancer text – but that said this relatively small-volume affair (compared to some of the Goliaths out...

What are the long-term outcomes of TOT and TVT procedures?

This is a systematic review between 2000 and 2016 evaluating the efficacy and safety of midurethral sling (MUS) procedures in women. Studies were included if the follow-up data was five years or more. Objective cure rates showed no significant difference...

Abiraterone acetate in men with castration-resistant prostate cancer

With emerging results from the Stampede and Latitude studies, abiraterone has taken the forefront in the management of metastatic prostate cancer while researchers try to identify the ideal timing for administration. It is a potent inhibitor of CYP17 which results...

Nomograms – is it hide and seek?

Everyday new decision-making aids are being developed due to various advances in software technology. This article from the UK makes very interesting reading. The word ‘nomogram’ is derived from the Greek word translated as ‘law line’ or ‘alignment chart’. The...

The survival impact of neoadjuvant hormonal therapy before radical prostatectomy

There is increasing evidence for the role of radical prostatectomy in select patients with T3-T4 prostate cancer (as part of multimodal therapy). This retrospective multicentre study explored the benefit of neoadjuvant hormonal therapy before radical prostatectomy specifically in patients with...