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HIV-related stone disease – a potential new paradigm?
This paper discusses the management of patients with stone disease and HIV. The chronic nature of HIV infection is due in large part to the effectiveness of anti-retroviral therapies (ART). However, the role of protease inhibitors has been widely discussed...
Importance of PSA variation – an analysis of PLCO trial data
This study looks specifically at the group of patients in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial (PLCO), to investigate variations in prostate specific antigen (PSA) level. They have specifically included only patients who...
Role of emergency ureteroscopy in the management of ureteric stones
Emergency ureteroscopy for all acute stone patients is not widespread in the UK but this is not the case elsewhere. In Auckland, New Zealand, it is commonly carried out in the emergency setting to reduce pressure on elective lists and...
PFMT in males
Pelvic floor muscle training (PFMT) has been described since ancient times in Rome but Kegel popularised it to improve sexual and urinary health after childbirth. In the paediatric population, there is a paradigm shift towards biofeedback-based PFMT for lower urinary...
Tamsulosin and spontaneous passage of ureteral stones in children
This was a retrospective analysis of data for five years from four institutions comparing stone passage rates in children with ureteric stones ≤10mm, aged 2-18, treated with tamsulosin vs. analgesia alone. The study identified 449 children, of whom 334 were...
Cryotherapy in prostate cancer
This review of the literature aims to summarise what is known in regards to outcomes in patients undergoing cryotherapy in a number of settings: whole gland, salvage and targeted focal therapy. It highlights that more prostate cancers are being diagnosed...
Antimuscarinics and behaviour in patients with spinal dysraphism
Since the 1980s patients with spinal dysraphism have had aggressive bladder management with clean intermittent catheterisation and anticholinergic therapy from early on in life. This strategy aims at improving lower and therefore upper urinary tract function thus decreasing the risk...
A new haemostatic agent in tubeless PCNL
Tubeless percutaneous nephrolithotomy (PCNL) is increasingly being used in carefully selected patients to reduce hospital stay and analgesia requirements, especially in those with little bleeding who become stone free or have insignificant residual fragments (usually <4mm). Various agents have been...
Prenatal spina bifida repair – does it have urological benefits in the longer term?
At present, I have one patient under my care who underwent prenatal closure of his spina bifida defect. Only with time, will we be able to determine whether this intervention has been of benefit for him from a urological standpoint....
Assessing resolution of isolated hydronephrosis – is APPD superior to the SFU system?
Antenatal scanning detects urinary tract dilatation in 1-5% of pregnancies. Isolated hydronephrosis (i.e., that not due to secondary dilatation e.g. bladder dysfunction) is known to resolve or improve in most; some patients may, however, require intervention through deterioration of obstruction...
Fluoxetine for refractory night wetting in children – is it safe and effective?
Around 1-2% of teenagers above the age of 15 years and 2-6% of adults continue to wet the bed. Standard treatment often includes bladder advice, alarm therapy, desmopressin and anticholinergics. Tricyclic antidepressants (imipramine) can also be utilised. Unfortunately, most have...
