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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...Lifestyle interventions for UI in women
Lifestyle interventions for urinary incontinence (UI) are supported by all major guidelines. The National Institute for Health and Care Excellence (NICE) guideline (CG171) from September 2013 (updated November 2015) [1] recommends lifestyle advice including dietary modifications such as caffeine reduction,...The life of a urology trainee in Singapore
Despite the political and cultural differences between the United Kingdom and Singapore, the quality and nature of the medical training systems remain uniquely similar. It will come as no surprise to those of you who have either worked in Singapore...
Call for standardised reporting of adverse events
This article will be of immense benefit to all of us involved in mortality and morbidity meetings and Clinical Governance, especially registrars and junior members of the team. The authors present data from the UK, USA and Europe. In prostate...
