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Disconnect between clinical trials and real-world oncology patients

Clinical trials are essential to advancing cancer treatment, providing the evidence needed to approve new therapies and improve patient outcomes. However, the strict eligibility criteria used – especially in prostate cancer trials – often exclude real-world patients. These criteria prioritise...

Uncovering the fate of small residual fragments

The concept of ‘stone free’ remains an enigma. To some urologists this refers to complete removal of all visible fragments, to others its removal of all ‘clinically significant’ fragments (generally regarded as fragments >2mm), and to some it is absence...

Do stones still kill?

This paper is a retrospective analysis of deaths ascribed to stone disease in England and Wales over a 15-year period. The data was obtained from the Office of National Statistics, based on mortality derived from death certificates. One thousand, nine...

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...

Percutaneous ultrasound guided endoscopic lavage of perinephric abscess – different, but not necessarily better

Perinephric abscess is an uncommon but serious form of urosepsis. It develops as a consequence of the extension of an infection outside of the parenchyma of the kidney in acute pyelonephritis, or more rarely from haematogeneous spread of an infection...

Results of HoLEP in patients with prostate cancer and LUTS

Holmium laser enucleation of the prostate (HoLEP) is recommended for the management of benign prostatic obstruction. With similar functional outcomes and less morbidity compared to transurethral resection of the prostate (TURP), it has become a useful tool in the armament...

Comparison of PCNL under spinal versus general anaesthesia

There are several advantages of performing percutaneous nephrolithotomy (PCNL) under spinal anaesthesia including lower cost, reduced adverse effects and less tracheal tube displacement. Another advantage is that the patient remains awake throughout making positioning easier and reducing the risk of...

Is the safety wire during ureteroscopy mandatory?

Traditional principles of ureteroscopic training involve the almost religious passage of a safety guide wire (SGW) into the ureter prior to ureteroscopy (URS). The authors compare the clinical outcomes of URS for ureteral stones in two university hospitals with opposite...

Managing staghorn calculi – a return to the dark ages of stone surgery with the aid of the robot

Khurshid Ghani and colleagues present a novel, yet all too familiar, approach to the management of patients with staghorn calculi, in the form of anatrophic nephrolithotomy - however with the aid of a robot. The aim of this study is...

Prilocaine irrigation for pain relief after TURP

Transurethral resection of the prostate (TURP) is one of the commonest procedures undertaken by urologists. There are well known complications following the procedure which commonly include haematuria but also TUR syndrome, failure to pass urine and infections, amongst others. The...