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Upper pole access is safe and effective for paediatric percutaneous nephrolithotomy

Upper pole access for percutaneous nephrolithotomy (PCNL) provides a straight access tract to the ureter with easier placement of a guidewire, good exposure of the pelvis and upper ureter, and comfortable manipulations for the treatment of staghorn, large upper caliceal,...

Comparative effectiveness of nephron sparing surgery vs ablation

Nephron sparing surgery (NSS) and minimally invasive modality of thermal ablation have attracted great attention as an alternative surgical treatment to radical nephrectomy (RN) for renal tumours <4cm. High quality evidence comparing disease specific survival (DSS) is lacking. This issue...

Does stable or decreasing hydronephrosis on ultrasound lead to stable or improved function on diuretic renography?

Antenatal hydronephrosis is noted in approximately 1% of all pregnancies. Persistent renal obstruction may lead to progressive loss of renal function. Renal ultrasound (USS) is the preferred modality for diagnosis and monitoring of paediatric hydronephrosis as it is non-invasive, non-ionising,...

What should we do with the incidentally detected renal cyst in a child?

The introduction of routine prenatal screening in the early 1980s resulted in paediatric urologists being confronted with the dilemma of what to do with antenatally-detected urinary tract dilatation, many of whom, we now know, do not require long-term surveillance or...

Urinary frequency and COVID-19: is there a missing link?

The current COVID pandemic has been a worldwide challenge for over a year. It can affect an individual in various ways. According to the World Health Organization, the classical signs are dry cough, fever and shortness of breath. In addition,...

Rethinking stone-free rates and surgical outcomes in endourology

Retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) are two key minimally invasive treatments for kidney stones in both adults and children. The success of these procedures is primarily measured by two factors: (1) the absence of complications and (2)...

Predicting resolution of the primary obstructed megaureter

Primary obstructive mega ureter (POM) is the congenital dilatation of the ureter in the absence of other structural urinary tract anomalies and comprises 10–20% of prenatal hydronephrosis cases. It is often detected during workup for prenatal hydronephrosis and confirmed using...

Demanding cases or nightmares in endourology? Jan/Feb 2017

In the fifth article in this series the authors describe some of the most complex cases they have encountered. Case 1 A 45-year-old woman was admitted under the care of the medical team with shortness of breath, renal failure and...

The management of renal calculi – Pt 1

Renal calculi can be managed according to four treatment options: conservative management, extracorporeal shockwave lithotripsy (ESWL), flexible ureterorenoscopy (FURS) and percutaneous nephrolithotomy (PCNL). This is the first in a two-part series in Urology News (Part 2 available here) that will...

Can continence and volitional voiding be achieved in bladder exstrophy?

Bladder exstrophy is a challenge to the paediatric urologist; here in the UK, repairs are now undertaken at two centres in order to concentrate experience. The ultimate aim is to achieve urinary continence and volitional voiding. In this study, John...

Urinary tuberculosis and the busy urologist!

This article is a very good read for any busy urologist. When in medical school, we were taught that tuberculosis (TB) was rare in the UK and other developed countries. We have come full circle; now there are increasing cases...

Small renal masses – diagnosis and management

Renal cancer is the eighth most common cancer in the UK and accounts for about 3% of all new cancer diagnoses [1]. The incidence rates are steadily rising, with the highest rates being in older men and women. This rise...