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All you need to know about percutaneous nephrolithotomy: supine versus prone and mini versus traditional

Introduction Since the first percutaneous nephrolithotomy (PCNL), the technique has undergone many innovations, including modifications in positioning, miniaturisation of instruments and combination with retrograde intra-renal surgery (see Table 1 for an outline of the history of the technique). Controversy has...

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...

Moving hospitals as a consultant urological surgeon: what are the challenges?

Despite over 100 unfilled consultant urological surgeon posts in the UK, the reasons why an established surgeon should wish to move hospitals can still be viewed with suspicion. Why is this the case, when in many other careers, both within...

Are standard repeat biopsies during active surveillance for prostate cancer still necessary?

Active surveillance (AS) has emerged as a key strategy for managing low-risk prostate cancer (PCa), offering an alternative to immediate treatment. Initially, AS relied on prostate specific antigen (PSA) testing, digital rectal examinations (DRE), and systematic biopsies. Early studies using...

The Mitrofanoff procedure: a continent revolution

Prior to 1980, surgeons had been struggling to provide a catheterisable, continent channel as an alternative to the native urethra, primarily for paediatric patients with congenital neuropathic bladder. In 1980, Professor Paul Mitrofanoff described the continent supravesical antireflux appendicovesicostomy [1]...

Innovations in flexible ureteroscopy for renal calculi: a comprehensive review

This article has been verified for CPD. Click the button below to answer a few short questions and download a form to be included in your CPD folder. Flexible ureteroscopy (f-URS) has become a core modality in the treatment of...

A guide to percutaneous nephrolithotomy

Percutaneous nephrolithotomy (PCNL) is now the gold standard approach to treating large renal stones. Since its development in the 1970s, it has undergone a series of refinements that could only have been possible with the symbiosis of both radiological and...

Focal therapies in prostate cancer

The standard of care in the management of prostate cancer has, to date, always been to treat the whole gland. This has ranged from surveillance, surgical excision / prostatectomy or external beam radiotherapy / whole gland brachytherapy. With the evolution...

Klinefelter’s syndrome

Klinefelter’s syndrome (KF) is the most frequent sex chromosome abnormality with an estimated prevalence of 1 in 500 to 1 in 700 newborn males and 1 in 10 in men with azoospermia. While the majority of cases are an XXY...

Sexual dysfunction following prostate cancer treatment

Prostate cancer is common with over 52,300 new cases diagnosed annually in the UK; this is expected to rise by 15% between 2023-2025 and 2038-2040 [1]. Radical prostatectomy continues to be the most common form of radical treatment for men...

Surgical risk prediction

Patients presenting for urological surgery range from the young and fit to the elderly with multiple, and often significant, coexistent diseases. This latter cohort can present a significant challenge in the perioperative period, sometimes irrespective of the type of surgery....

Demanding cases or nightmares in endourology? Sep/Oct 2016

In this issue the authors will present once in a career cases that can truly haunt a urologist. “Mistakes are like bad loves, the more you learn from them, the more you wish they’d never happened. “ Gregory David Roberts*...