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Predictive factors for conservative treatment failure in paediatric blunt renal trauma
Blunt renal trauma is managed conservatively in children in the vast majority of cases. Grade IV renal injury is also generally managed non-operatively although occasionally intervention is needed for a urinoma that fails to settle. These authors retrospectively looked at...
Medical expulsive therapy for paediatric urolithiasis
Children who have kidney stones are likely to have recurrences. Many initial stones are treated conservatively allowing for spontaneous passage of small stones if possible. Doxazocin or tamsulosin are known to dilate the ureter and allow spontaneous passage of stones...
Urinary NGAL, KIM-1 and L-FABP concentrations in antenatal hydronephrosis
he elusive search for being able to diagnose pelvi-ureteric junction obstruction (PUJO) continues and this group of researchers investigated the possible clinical application of urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary kidney injury molecule-1 (uKIM-1) and urinary liver-type fatty acid-binding proteins...
RCC recurrence rates post laparascopic partial nephrectomy
In recent years laparascopic partial nephrectomy (LPN) has emerged as an oncologically safe alternative to its radical nephrectomy counterpart. There is however a lack of consensus amongst the urology community regarding surveillance after LPN for patients with stage I tumours....
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...
Local tumour bed recurrence following partial nephrectomy
In this interesting retrospective study, the authors looked at the incidence of local tumour bed recurrence after partial nephrectomy (PN), the factors associated with that, and the management. A total of 2,271 patients’ charts were reviewed who underwent partial nephrectomies...
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...
COVID-19 and acute kidney injury
Newspapers and online media are full of the effects of the coronavirus on airways and olfactory functions and the importance of respiratory physicians (pulmonologists in the USA), ventilators and intensive care teams. However, as per the Intensive Care National Audit...
