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The emerging role of physician associates in urology
The physician associate (PA) is a new role in the NHS which has expanded across medical and surgical specialties to include urology. In the USA, it has long been an established field of practice where physician assistants work autonomously within...Demanding cases or nightmares in endourology? Nov/Dec 2017
Case 1 A 78-year-old male was transferred from a referring hospital. He had a cystectomy and ileal conduit performed 15 years previously and had recently been admitted with a clinical diagnosis of an infected obstructed kidney. The referring hospital had...
Performance of non-invasive tests in diagnosing BOO in men with LUTS
A large proportion of urology involves the treatment of bladder outflow obstruction (BOO) in men. Yet BOO in men is very difficult to accurately quantify with the only regular non-invasive test being uroflowmetry. Pressure flow urodynamics may be considered the...
Long-term oncologic outcomes of salvage cryoablation for rrPC
Of patients undergoing radiotherapy (RT) for prostate cancer (PC), at least 15-20% will experience recurrence. Although salvage prostatectomy achieves durable oncological outcomes at 10 years, it is associated with significantly high morbidity. Thus, the majority of men with radio-recurrent prostate...
PFMT in males
Pelvic floor muscle training (PFMT) has been described since ancient times in Rome but Kegel popularised it to improve sexual and urinary health after childbirth. In the paediatric population, there is a paradigm shift towards biofeedback-based PFMT for lower urinary...
Tamsulosin and spontaneous passage of ureteral stones in children
This was a retrospective analysis of data for five years from four institutions comparing stone passage rates in children with ureteric stones ≤10mm, aged 2-18, treated with tamsulosin vs. analgesia alone. The study identified 449 children, of whom 334 were...
Thiazide diuretic prophylaxis for kidney stones and the risk of diabetes mellitus
Thiazide diuretics have been used to reduce calcium nephrolithiasis recurrence as it is tolerated well, inexpensive and reduces calcium excretion in urine. It has been linked with increased risk of diabetes mellitus (DM) in the presence of hypertension (ALLHAT study),...
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...
Keep it simple: a proposal for a new definition of uncomplicated and complicated UTIs
Urinary tract infections (UTIs) are one of the most common bacterial infections in both community and healthcare settings, leading to frequent antibiotic use. They range widely in severity, from mild cases like cystitis to severe, potentially life-threatening conditions such as...
How can we reduce morbidity after RARC with intracorporeal neobladder?
Robot-assisted radical cystectomy (RARC) is a complex procedure with high postoperative morbidity, especially when combined with neobladder reconstruction, which has a higher complication rate compared to other urinary diversions. To minimise these complications, it is crucial to understand their nature...
