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Visual-estimation (cognitive), image-fusion (software) and in-bore targeted prostate biopsy: is there an optimal approach?
The diagnostic superiority of multiparametric magnetic resonance imaging (mpMRI) prior to targeted and systematic prostate biopsy over systematic transrectal ultrasound-guided (TRUS) biopsy alone in the detection of clinically significant prostate cancer (csPCa) has been proven by multiple level 1 studies...Use of Clavien-Dindo classification in urology part 2 – upper tract
A classification system of surgical complications was proposed by Clavien in 1992 [1] and further modified by Dindo in 2004 [2]. Clavien-Dindo classification has since then been validated through many retrospective case series as well as in comparative studies to...A practical guide to success in National Selection
Gidon Ellis and Jonathan Makanjuola were both selected at National Selection in 2012 for Urological Higher Surgical Training. Both were ranked first in their respective interview rounds that year. It is no mean feat. Having read their article – their...
Transfer to tertiary paediatric hospitals for patients with testicular torsion
Although this articles comes from a tertiary centre in Columbus, USA, there are similarities with the current controversies in the UK. The authors carried out a five-year retrospective review looking at the surgical transfer of 125 patients (mean age 13.4,...
Who should be taking care of the adolescent with testicular torsion?
From time to time (as paediatric surgeons), we receive referrals from regional hospitals to explore the testis in older boys. Given the time-critical nature of the condition, patients should benefit from assessment and surgery performed locally (when possible). Inter-hospital transfer...
Is TRUS and biopsy obsolete as a diagnostic test for prostate cancer: refining the perineal biopsy technique?
Whilst there has been a dramatic shift in how patients are investigated for potential prostate cancer, transrectal ultrasound (TRUS) and biopsy remains the most commonly used technique for tissue sampling. In this single centre, retrospective analysis, 634 men, over a...
Model to predict malignancy among Bosniak III cysts
This retrospective study over a 15-year period is to identify independent predictors of malignancy in Bosniak III (BIII) renal lesions and to build a prediction model based on identifiable clinical variables. These cysts, characterised by contrast-enhanced computed tomography (CECT), have...
Does more equal less in the management of acute renal colic?
Radiographs of kidneys, ureter and bladder (KUB) have long been used in the follow-up of patients with ureteral stones to reassess stone position and surgical planning. Emergence of computed tomography (CT) as the gold standard for the diagnosis of ureteral...
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...
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...
Is robotic pyeloplasty in the under-ones as good as open repair?
Pelviureteric junction obstruction (PUJO) is a common cause of paediatric hydronephrosis. Indications for intervention include reduced renal function (<40%), symptoms (urinary tract infection or pain) and increasing dilatation. Although the Anderson-Hynes open pyeloplasty (OP) has long been the gold standard...
