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Stereotactic body radiotherapy for oligometastatic disease secondary to urological cancer

The concept of oligometastatic disease is controversial. The traditional model of cancer, which most of us learnt at medical school, is of a disease which starts confined to an organ, for example the prostate, where it can be cured with...

Cystitis Unmasked

Cystitis is often viewed as a heartsink diagnosis, and sometimes one of exclusion. The aetiology is multifactorial and misunderstood. Treatment has been based on dogma, and poor clinical and scientific evidence. The truth is, that despite the significant morbidity caused...

Can transcutaneous peroneal nerve stimulation treat OAB?

The peroneal nerve follows sacral, pudendal, and tibial nerves as a target for overactive bladder (OAB) treatment. This multicentre prospective randomised RCT compared a transcutaneous electrical neuromodulation system (eTNM) at-home treatment once daily for 30 minutes to solifenacin 5mg once...

PIRADS-3 lesions and clinically significant prostate cancer – what are we missing?

The use of pre-biopsy MRI has definitely enhanced our decision making in managing patients with suspected prostate cancer (PCa). There is still uncertainty around the outcomes for patients with PIRADS-3 lesions, with a small but definite risk of missing clinically...

Evidence-based treatment of MCDK: a systematic review

The authors of this systematic review have not only aimed to establish the incidence of hypertension associated with a multicystic dysplastic kidney (MCDK) but have also tried to determine the malignancy risk associated with an MCDK and assess the rate...

Characteristics of testicular tumours in prepubertal children

It is well known that testicular tumours in children occur in one of two peaks. Firstly, in the first four years of life where a third to half of these tumours are benign and secondly during puberty where there is...

ESWL and URS for treatment of paediatric urolithiasis

Tejwani et al. have undertaken a comparative effectiveness study to characterise differences in procedure frequency, postoperative re-admissions and emergency room (ER) visits, and repeat treatment rates for children (≤18 years) with urolithiasis who underwent initial intervention with extracorporeal shock wave...

Worldwide flexible ureteroscopy practice uncovered

While guidelines recommend flexible ureteroscopy (fURS) for treating renal stones <1.5cm, considerable differences exist among urologists in the technique, use, and indications of fURS. In 2014, the Endourology Society set out to explore the differences in the fURS technique and...

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...

BCG maintenance therapy not superior to induction alone

With the ongoing shortage of BCG remaining an issue for urologists in the UK and further afield, this topical paper presented the results of the CUETO study evaluating the outcome of a modified three-year BCG maintenance regimen versus induction therapy...

Adjuvant radiotherapy versus wait-and-see after radical prostatectomy

Optimum treatment modalities in prostate cancer continue to evolve, with debates at each stage of the evolution process, from focal therapy to radical treatment. In this randomised study, Wiegel et al. investigated the role of adjuvant radiotherapy following open radical...

Comparative effectiveness of nephron sparing surgery vs ablation

Nephron sparing surgery (NSS) and minimally invasive modality of thermal ablation have attracted great attention as an alternative surgical treatment to radical nephrectomy (RN) for renal tumours <4cm. High quality evidence comparing disease specific survival (DSS) is lacking. This issue...