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LARP – three instrument techniques to reduce costs

The cost of laparoscopic radical prostatectomy (LARP) is high because of both the initial installation cost and, more importantly, high running costs. The main reason for the latter is the limited number of usage of the instruments; generally, each instrument...

How often are instruments changed in RALP & RAPN?

This study investigates how often the robotic instruments are exchanged during robotic-assisted laparoscopic prostatectomy (RALP) and robot-assisted partial nephrectomy (RAPN). They presently come with a life span of 10 uses but whether all instruments are used fully on 10 different...

Percutaneous ultrasound guided endoscopic lavage of perinephric abscess – different, but not necessarily better

Perinephric abscess is an uncommon but serious form of urosepsis. It develops as a consequence of the extension of an infection outside of the parenchyma of the kidney in acute pyelonephritis, or more rarely from haematogeneous spread of an infection...

Redo orchidopexy

Cryptorchidism, or the undescended testis, is perhaps the most common genital anomaly in males. Historical success rates are approximately 90% depending on the preoperative location and technique used. Iatrogenic cryptorchidism can also occur in up to 2% of cases following...

Comparison of PCNL under spinal versus general anaesthesia

There are several advantages of performing percutaneous nephrolithotomy (PCNL) under spinal anaesthesia including lower cost, reduced adverse effects and less tracheal tube displacement. Another advantage is that the patient remains awake throughout making positioning easier and reducing the risk of...

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,...

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...

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,...

Long term outcomes of primary ureterovesicostomy for the primary obstructive megaureter

Primary obstructive megaureter is dilatation of the ureter secondary to narrowing at the vesicoureteric junction (VUJ). Many (80%) require no intervention, however, a select number do for worsening hydroureteronephrosis, decreasing renal function, prolonged drainage time, recurrent urinary tract infections or...