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Erectile dysfunction part II: treatment

Introduction The identification of specific risk factors associated with erectile dysfunction (ED) allows patients with mild or moderate ED to undergo a series of lifestyle changes, which may provide enough improvement in the erectile function to avoid pharmacotherapies. Cessation of...

Developing a core outcome set for male fertility trials

Advances in fertility treatment since in vitro fertilisation was pioneered by Edwards and Steptoe, cumulating in the birth of Louise Brown in 1978, have been nothing short of remarkable [1]. Since then, a myriad of treatments has been developed for...

Transfer to tertiary paediatric hospitals for patients with testicular torsion

Although this articles comes from a tertiary centre in Columbus, USA, there are similarities with the current controversies in the UK. The authors carried out a five-year retrospective review looking at the surgical transfer of 125 patients (mean age 13.4,...

Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer

Abiraterone acetate, the prodrug of abiraterone, blocks endogenous androgen synthesis by inhibiting cytochrome p-450c17, a critical enzyme in androgen biosynthesis. Its active D4A metabolite also has anti-tumour effects through possibly multiple mechanisms. 3-5% of men diagnosed with prostate cancer in...

Who should be taking care of the adolescent with testicular torsion?

From time to time (as paediatric surgeons), we receive referrals from regional hospitals to explore the testis in older boys. Given the time-critical nature of the condition, patients should benefit from assessment and surgery performed locally (when possible). Inter-hospital transfer...

Radiological investigation of haematuria in 2016

This paper summarises the current evidence for and use of various imaging modalities for investigating haematuria. The following investigations are reviewed: Intravenous urogram (IVU) – the number of centres still using IVU is decreasing. IVU is cheaper and has less...

Prostatic urethral lift provides good alternative to TURP for men with LUTS

Lower urinary tract symptoms (LUTS) due to prostatic enlargement resulting in bladder outflow obstruction are common. Transurethral resection of the prostate (TURP) remains the gold standard in operative management, however it is not without its risks. In this multicentre European...

Role of emergency ureteroscopy in the management of ureteric stones

Emergency ureteroscopy for all acute stone patients is not widespread in the UK but this is not the case elsewhere. In Auckland, New Zealand, it is commonly carried out in the emergency setting to reduce pressure on elective lists and...

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...

Model to predict malignancy among Bosniak III cysts

This retrospective study over a 15-year period is to identify independent predictors of malignancy in Bosniak III (BIII) renal lesions and to build a prediction model based on identifiable clinical variables. These cysts, characterised by contrast-enhanced computed tomography (CECT), have...

Does more equal less in the management of acute renal colic?

Radiographs of kidneys, ureter and bladder (KUB) have long been used in the follow-up of patients with ureteral stones to reassess stone position and surgical planning. Emergence of computed tomography (CT) as the gold standard for the diagnosis of ureteral...

Can antibiotics reduce ‘unnecessary’ prostate biopsies?

With numerous factors capable of influencing prostate specific antigen (PSA) levels and therefore the likelihood of biopsy, this multi-centred randomised controlled trial (RCT) was designed to see if two weeks of ciprofloxacin compared to placebo would significantly reduce PSA levels...