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Onco-fertility: a review

Subfertility or infertility is a major problem affecting men diagnosed with testicular cancer (TC) either due to the disease itself [1], or as a result of management [2]. TC is the most prevalent cancer affecting men of reproductive age [3]....

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...

Use of Clavien-Dindo classification in urology part 1 – pelvic surgery

There is no widely accepted system to classify postoperative complications. It is necessary to compare the outcome and complications while validating a new surgical procedure or one of the surgical approaches of a particular condition. Several parameters have long been...

An inconvenient truth: reflections on the NHS

“What gets us into trouble is not what we don’t know. It’s what we know for sure that just ain’t so.” The above is a quote attributed to Mark Twain from the 2006 documentary, An Inconvenient Truth, which follows Al...

Ureteral clipping in children – longer term outcomes of a novel treatment

In this article, Lopes et al. report longer term outcomes of laparoscopic clipping of ureters of non-functioning kidneys or non-functioning renal moieties in duplex kidneys associated with ectopic ureter or obstructive ureteroceles. In 2014, their group published a promising preliminary...

Efficacy of flexible ureteroscopy and laser lithotripsy for lower pole renal calculi

The management of lower pole renal stones (LPS) is often difficult. Extracorporeal shock wave lithotripsy (ESWL), flexible ureterorenoscopy (fURS) and percutaneous nephrolithotomy (PCNL) are all potential options with potential benefits and disadvantages. In order to assess the success of fURS...

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....

Onabotulinum toxin A (BTX) not helpful for chronic scrotal pain

It is refreshing to read a report on negative outcomes as it reinforces the honesty that is often lacking with the well-known publication bias in medical publications. It is also not common to come across surgical randomised controlled trials (RCTs)...

A tale of two cities – hypospadias outcomes

As urologists, it is important to know our results. In terms of hypospadias surgery, which is commonly undertaken after the age of one year in the UK, long-term follow-up is required to fully acquire this knowledge. Long-term urinary outcomes and...

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...

Prostate cancer mortality among elderly men after discontinuing organised screening

This study presents ground-breaking insights into discontinuing prostate cancer (PCa) screening in previously screened elderly men, aiming to mitigate the risk of overdiagnosis and overtreatment in the face of other-cause mortality. Examining men aged 70–74 who had undergone prostate specific...