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New – unique 20ml pre-filled syringe hyaluronate GAG replenisher

Solatumfarma’s new sodium hyaluronate GAG replenisher offers to improve treatment for patients with chronic cystitis.

To clamp or not to clamp – outcomes of the CLOCK trial for robotic partial nephrectomy

The benefits of partial over radical nephrectomy are well established. The CLOCK trial (CLamp vs. Off Clamp the Kidney during robotic partial nephrectomy) was designed as a multicentre, randomised controlled trial to generate evidence on the role of the off-clamp...

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...

Age does not impact risk for urethroplasty complications after TIP repair of hypospadias

This paper is evidence of an increasing trend (especially in the USA) to lower the age at which hypospadias repair is undertaken. The current generalised best accepted age to repair hypospadias is between 6-18 months, which was reduced in the...

Rare and Complex Urology

Diseases that are rare or of low prevalence pose challenges to provision of high-quality care because of limited available knowledge and sparse good-quality evidence regarding uncommon presentations, mechanisms of disease, and optimal treatments. Approximately 80% of rare diseases are of...

First and second-line treatments in metastatic renal cell carcinoma

Over the past two decades, the treatment landscape for metastatic renal cell carcinoma (mRCC) has evolved significantly, leading to a quadrupling of patient survival rates. Modern systemic treatments include combinations of anti-PD-1 antibodies with either anti-CTLA-4 antibodies or antiangiogenic tyrosine...

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...

The role of an enhanced recovery protocol in patients undergoing robotic radical cystectomy

Enhanced recovery after surgery (ERAS) protocols are patient pathways designed to reduce surgical stress and accelerate postoperative recovery. Uptake of such protocols in colorectal surgery in particular has been high, however ERAS protocols developed or utilised in urological surgery have...

Conservative management of pelviureteric junction

Background Pelviureteric junction obstruction (PUJO) is defined as a functionally significant impairment of urine flow from the renal pelvis into the proximal ureter. For more than a century, surgery was considered the first-choice approach to management. However, the widespread use...

ASAP: is a repeat biopsy necessary?

This study examined the validity of current US and European guidelines on the management of patients diagnosed with atypical small acinar proliferation (ASAP). Current guidance states that these patients should undergo repeat biopsy within three to six months due to...

Comparing NSAIDs with antibiotics in the treatment of uncomplicated UTIs in women

Uncomplicated urinary tract infections (UTIs) are a common presentation in primary care, however there is increasing concern regarding antibiotic use and resistant organisms. In this double-blind randomised German study, the authors seek to establish if ibuprofen 400mg three times a...

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...