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Oncological benefits of extended pelvic lymph node dissection

Touijer and colleagues present extended follow-up results from a large randomised trial comparing limited pelvic lymph node dissection (l-PLND) and extended PLND (e-PLND) in prostate cancer patients undergoing radical prostatectomy. The study aimed to assess whether e-PLND, which includes external...

Accuracy of cognitive vs software-guided MRI-targeted biopsy

The FUTURE randomised trial showed no difference in prostate cancer (PCa) detection between cognitive, in-bore and software guided MRI-targeted biopsy (TBx) techniques, a finding supported by meta-analyses and reflected in European Association of Urology (EAU) guidelines. However, whether any TBx...

Interpretation of Urodynamic Studies

It does not matter if you are the kind of person who gets excited by books on urodynamics or someone who just wants to learn a new skill, you need to get your hands on this book as it blows...

Bladder perforation after augmentation cystoplasty

Delayed bladder perforation is well recognised after augmentation cystoplasty (5-13% of patients) and adult urologists need to be aware of this and identify the best treatment at the time. Mortality rates and re-perforation rates can be up to 25% and...

How successful is the transition to adult urology care in spina bifida?

These authors from Indianapolis, USA, aimed to assess rates and predictors of successful transition into adult care of spina bifida patients. They did this by a retrospective review of 77 patients discharged from a multidisciplinary paediatric clinic at a mean...

Uncovering the fate of small residual fragments

The concept of ‘stone free’ remains an enigma. To some urologists this refers to complete removal of all visible fragments, to others its removal of all ‘clinically significant’ fragments (generally regarded as fragments >2mm), and to some it is absence...

TIP hypospadias repair

This paper by one of the current international leaders in hypospadias surgery looks at the outcome of over 1800 consecutive hypospadias repairs using the tubularised incised plate (TIP) repair, beginning from the first original operation through to sequential modifications over...

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...

What is the role of evidence-based medicine in urology?

The concept of ‘evidence-based medicine’ (EBM) was first developed in the early 1990s and was described as “the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients” by the recently...

A review of the diagnosis and management of urethral caruncles

Introduction The innocuous urethral caruncle is the most common benign urethral lesion in females. It can pose a significant challenge to urologists due to the plethora of differentials and poor evidence surrounding management. In 1926, Ferrier eloquently described the macroscopic...

Bladder cancer

Case 1 A 78-year-old female presents with a week history of painless haematuria. She’s a smoker and used to work in the textiles industry. She underwent a flexible cystoscopy. What does this image show? What are the two-week wait National...