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Urinary NGAL, KIM-1 and L-FABP concentrations in antenatal hydronephrosis

he elusive search for being able to diagnose pelvi-ureteric junction obstruction (PUJO) continues and this group of researchers investigated the possible clinical application of urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary kidney injury molecule-1 (uKIM-1) and urinary liver-type fatty acid-binding proteins...

Near-infrared fluorescence in robotic surgery

This is a systematic review and critical analysis of the current evidence on the applications of near-infrared fluorescence (NIRF) in robotic urologic surgery. It uses indocyanine green (ICG), a sterile water-soluble dye which has been tested in various fields. In...

CRP to predict the need for surgical intervention in acute renal colic

A previous paper has suggested that C-reactive protein (CRP) is a useful serum marker for determining the likelihood of a patient with renal colic requiring surgical intervention, the cut-off level being >28mg/l (specificity 88.9%, sensitivity 75.8%). This prospective observational study...

Lower pole vessels in children with PUJO: laparoscopic vascular hitch or dismembered pyeloplasty?

A crossing vessel accompanying pelvi-ureteric junction obstruction (PUJO) occurs in 25-50% of cases. The Hellstrom vascular hitch procedure was first described in 1951 and has regained popularity since 2003 in the era of laparoscopic surgery as it negates the need...

Supranormal function on MAG-3 – what is its significance and how to predict?

Differential renal function (DRF) on MAG-3 scans is typically used in patients with pelvic ureteric junction obstruction (PUJ obstruction). Supranormal DRF is when the kidney with PUJO has higher DRF than the normal contralateral kidney. The authors in this study...

Is outpatient robotic surgery feasible in children?

Minimally invasive surgery has helped to achieve shorter hospitalisations, reduce postoperative pain and analgesia requirements and provides better cosmetic results. Robotic urological outpatient surgery has been examined in recent times in the adult population; here Neheman et al. look at...

Imaging and radiology

Case 1 What radiological test is this and what does it show? What is the typical radio-nucleotide used for this study, what is its half-life and how is it excreted? Approximately how long does this study take to perform? What...

Technology – Part 2

Case 1 Name the machine shown in the picture and describe how it works. What is the standard frequency of ultrasound waves in this machine? What frequency of ultrasound waves are utilised in an abdominal and scrotal ultrasound? Case 2...

The doctor as the patient: receiving bad news

This article, written by a GP working in the NHS, gives a unique insight into the experience of being a urology patient and some thoughtful advice on ‘breaking bad news’. Day 1 Alarm bells ring. It’s spotting an email from...

Radiological investigation of haematuria in 2016

This paper summarises the current evidence for and use of various imaging modalities for investigating haematuria. The following investigations are reviewed: Intravenous urogram (IVU) – the number of centres still using IVU is decreasing. IVU is cheaper and has less...

Cryotherapy for small renal masses: better than surveillance?

With the rapid rise in incidental small renal mass detection, some of which have malignant potential, comes the need to either survey or treat these masses safely and with minimal morbidity. This large series of 147 patients with 171 masses,...

Malignant upper urinary tract obstruction: emergency presentations and long-term outcomes

Malignant upper urinary tract obstruction (MUUTO) is a frequent emergency urological referral, often necessitating kidney drainage to preserve renal function. However, many patients have advanced cancer with limited life expectancy, raising questions about intervention benefits. While percutaneous nephrostomy (PCN) or...