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Does empowering men on active surveillance for prostate cancer improve patient compliance and reduce conversion to treatment?
Active surveillance is a major treatment option for patients with favourable prognosis prostate cancer, such as those regarded as Cambridge Prognostic Group (CPG) 1 and 2 [1]. The rationale for this management strategy is the lack of survival benefit from...
HIV-related stone disease – a potential new paradigm?
This paper discusses the management of patients with stone disease and HIV. The chronic nature of HIV infection is due in large part to the effectiveness of anti-retroviral therapies (ART). However, the role of protease inhibitors has been widely discussed...
Risk factors for CKD following treatment for RCC
This paper concerns the prevention of chronic kidney disease (CKD) following treatment for renal cell carcinoma (RCC). Over the last 10 years, partial nephrectomy has played an increasing role in the management of RCC, especially T1a disease. It has been...
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...
Is TRUS and biopsy obsolete as a diagnostic test for prostate cancer: refining the perineal biopsy technique?
Whilst there has been a dramatic shift in how patients are investigated for potential prostate cancer, transrectal ultrasound (TRUS) and biopsy remains the most commonly used technique for tissue sampling. In this single centre, retrospective analysis, 634 men, over a...
Curing pure CIS with radical surgery: lessons learned
As carcinoma in situ (CIS) theoretically has no ability to invade or metastasise, performing radical cystectomy for CIS-only disease should be curative. In this single centre review over 37 years, 1964 patients undergoing cystectomy were analysed with 52 undergoing surgery...
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...
Surgical and pathological outcome of partial nephrectomy: robotic versus laparoscopic approach
Nephron sparing surgery has become the standard surgical treatment for small renal masses (<4cm). Laparoscopic partial nephrectomy (LPN) is shown to be superior to the open approach (OPN) in peri and postoperative morbidity; however, it requires advanced skills and has...
Cryotherapy for small renal masses: better than surveillance?
With the rapid rise in incidental small renal mass detection, some of which have malignant potential, comes the need to either survey or treat these masses safely and with minimal morbidity. This large series of 147 patients with 171 masses,...
To clamp or not to clamp – outcomes of the CLOCK trial for robotic partial nephrectomy
The benefits of partial over radical nephrectomy are well established. The CLOCK trial (CLamp vs. Off Clamp the Kidney during robotic partial nephrectomy) was designed as a multicentre, randomised controlled trial to generate evidence on the role of the off-clamp...
Intravesical cytosine arabinoside + Mitomycin C for bladder cancer – is it beneficial?
Mitomycin C (MMC) is often used as an intravesical therapy for low / intermediate risk non-muscle invasive bladder cancer. This randomised controlled trial (RCT) was designed to assess the safety and efficacy of MMC + cytosine arabinoside (Ara-C). Ara-C was...
