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Shared decision-making – minimising the mismatch

In Western countries, we are spoilt for choice in almost every aspect of our lives, but does that reflect also in healthcare? While we have taken some big strides towards shared decision-making with our patients, the age-old physician dominance remains...

Pain relief after removal of non-obstructive renal calculi

Non-obstructing stones are often not considered to be the source of pain, and probably most are not. This is because flank pain associated with a stone is typically caused by a stone that obstructs urinary flow, which increases intraluminal pressure...

Artificial intelligence

Artificial intelligence concerns me. Generally, people still tend to be concerned that their livelihoods will be replaced by an all powerful, all knowing artificial intelligence (AI) system. This at a time when the world’s largest technology companies (Amazon, Google, Apple),...

Comparing intravesical chemohyperthermia with Mitomycin C versus BCG in treating bladder cancer

In the advent of the recent Bacillus Calmette–Guérin (BCG) crisis, the importance of alternative adjuvant treatments for intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC) has been highlighted. Chemohyperthermia (CHT) has emerged as an option, however there remains a lack of...

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...

Robotic assisted perineal prostatectomy: descriptive technique of the inaugural case in the UK

Robotic surgery has taken full flight in the USA since its start in 2000 [1] and is replacing procedures where open surgical techniques were solely employed. While this technology is met with criticism over the costs, the superiority of robotic...

Metabolic syndrome and prostate cancer recurrence in a veterans’ cohort

This study explored the relationship between metabolic syndrome and localised prostate cancer recurrence in patients who had received active treatment (external beam radiation therapy – EBRT, radical retropubic prostatectomy – RRP, or brachytherapy). The definition of metabolic syndrome adopted was...

Establishing a new TPPBx service during the COVID-19 pandemic

COVID-19 had a major impact on our hospital services from early in the pandemic, with almost three times as many patients being ventilated compared to the normal ITU capacity at the beginning of April. During the build-up to this point,...

Pyonephrosis: is the kidney always doomed?

Pyonephrosis (Greek pyon ‘pus’ + nephros ‘kidney’) is defined in Campbell-Walsh Urology [1] as an infected hydro-nephrosis associated with suppurative destruction of the renal parenchyma which results in total or near total loss of renal function. The true incidence of...

Men with a susceptibility to prostate cancer: implications of ethnicity in PCa risk-prediction and diagnosis

The diagnostic and therapeutic landscapes of prostate cancer (PCa) have advanced at great pace in the past decade. However, disparities in access to care, clinical outcomes and representation in therapeutic, interventional and genomic studies continue to exist between Afro-Caribbean (AC)...

Infections and inflammation: Part 3

See also Part 1 and Part 2 Case 1 You review a man in the Emergency Department with scrotal pain and sepsis. His clinical examination findings are shown. What does this image show? Who was this condition named after? What...

An update on antibiotic prophylaxis in TRUS-guided prostate biopsy

Since its inception in the 1980s, transrectal ultrasound (TRUS)-guided prostate biopsy has remained the standard tool for the histological diagnosis of prostate cancer. There are several advantages to this technique which have led to the widespread use of TRUS in...