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Antibiotics and HoLEP

Holmium laser enucleation of the prostate (HoLEP) is an increasingly done size-independent surgical treatment for benign prostatic hypertrophy. There is currently a lack of data on perioperative antibiotic prescribing patterns for HoLEP and thus, no consensus on optimal practices. This...

Preoperative risk stratification of high-risk prostate cancer patients

High-risk prostate cancer (HRPCa) is associated with a significant risk of recurrence after radical treatment. While several classification systems exist, the D’Amico criteria – based on clinical T stage ≥T2c, prostate specific antigen (PSA) ≥20 ng/mL, or Gleason score (GS)...

The future of bladder preservation for muscle-invasive bladder cancer

Localised muscle-invasive bladder cancer (MIBC) has historically been treated with radical cystectomy (RC), but bladder preservation therapy (BPT) has emerged as a credible and increasingly refined alternative. Early work by Herr in the 1980s demonstrated that radical transurethral resection of...

Call for standardised reporting of adverse events

This article will be of immense benefit to all of us involved in mortality and morbidity meetings and Clinical Governance, especially registrars and junior members of the team. The authors present data from the UK, USA and Europe. In prostate...

Imaging and Intervention in Urinary Tract Infections and Urosepsis

Urinary tract infections (UTIs) are highly prevalent in the community and account for approximately 40% of hospital-acquired infections. Yet, they are often underestimated and under-diagnosed: as one chapter of this book is entitled, nothing is simple about acute pyelonephritis. This...

Refining management of non-visible haematuria

The optimal evaluation of non-visible haematuria (NVH) continues to be debated, with competing interests of avoidance underdiagnosis and the harms of over-testing. Current National Institute for Health & Care Excellent (NICE) guidance recommends referral for patients ≥60 years with NVH....

PDE5I in LUTS – how do they work – no proof yet

Phosphodiesterase type 5 (PDE5) inhibitors used in erectile dysfunction (ED) have been shown to improve lower urinary tract symptoms (LUTS) as well. The mechanism is not well understood. One of the hypotheses for benign prostatic hyperplasia (BPH) – LUTS is...

Why defining and managing DUST matters in endourology

In endourology, defining ‘DUST’ and optimising its management is vital for improving stone-free rates (SFR) and reducing complications. Residual fragments, even those ≤4mm, can act as a nidus for infection, obstruction, and recurrence. Studies have shown that 30% of patients...