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What is the role of evidence-based medicine in urology?

The concept of ‘evidence-based medicine’ (EBM) was first developed in the early 1990s and was described as “the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients” by the recently...

A guide for the assessment and management of post-obstructive diuresis

Acute urinary retention is a common condition encountered in the emergency situation and is initially managed by urethral catheterisation. This is often performed by nursing staff or junior doctors. Post-obstructive diuresis (POD) is a specific entity which may occur post...

Prostate cancer series: diagnostics 2

- Click here for Part 1 - A 68-year-old male was referred to the two-week wait prostatic clinic with a serum prostate specific antigen (PSA) of 17. He had no bothersome lower urinary tract symptoms, relevant past medical history or...

Thulium laser: the new kid ‘en bloc’

Transurethral resection of bladder tumour (TURBT) is considered the gold standard for management of bladder cancer. Residual rates of 15-53% at second TURB and upstaging rates of 4-29% with muscle invasion have been reported. The quality and result of the...

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...

Durability and complications of photoselective vaporisation of the prostate with GreenLightTM

Alternatives to the standard transurethral resection of the prostate (TURP) in the management of bladder outflow obstruction due to prostatic hypertrophy are becoming more common. In this retrospective case series, the outcomes of 117 patients undergoing GreenLightTM lithium triborate photoselective...

Chronic retention – all you need to know

Chronic retention – all you need to know Chronic urinary retention is a common presentation in elderly and frail patients. Two types should be recognised - low pressure chronic retention (LPCR) and high pressure chronic retention (HPCR). Acute-on-chronic retention occurs...

Trade-offs between risks and benefits of localised prostate cancer treatments – the COMPARE study

We know little about the trade-offs men make when considering the oncological and functional outcomes of individual treatment options for localised prostate cancer, and decisions are often influenced by physician opinion. The likely compromised functional results are viewed as a...

Hypospadias – detecting your complications

All hypospadias surgeons will encounter complications. They are estimated to occur in around 10% of distal hypospadias repairs and more than 50% for proximal forms. Some controversy exists regarding the length of follow-up needed to detect them. Some series have...

An Insider’s Perspective of Prostate Cancer – Understanding Effects, Management Options and Consequences

This deceptively small paperback punches way above its weight compared to some of the existing hefty tomes on prostate cancer. It is an admirable effort at delivering content pitched at both the lay reader as well as the medical graduate....

Renal stones: an American perspective

This study is from Dallas, USA and appears on the front cover of the BMJ. About 1 in 11 people will have a kidney stone at some point in their lifetime. There is a linear increase in stone prevalence in...

Rectal swab testing before prostate biopsy

This study explored the real terms value of rectal swab testing and targeted antibiotic prophylaxis in patients undergoing transrectal ultrasound prostate biopsy in view of increasing bacterial resistance to fluoroquinolones (17.6% in North America, 40% in Hong Kong). The authors...