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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,...
Lower pole vessels in children with PUJO: laparoscopic vascular hitch or dismembered pyeloplasty?
A crossing vessel accompanying pelvi-ureteric junction obstruction (PUJO) occurs in 25-50% of cases. The Hellstrom vascular hitch procedure was first described in 1951 and has regained popularity since 2003 in the era of laparoscopic surgery as it negates the need...
Hypospadias – detecting your complications
All hypospadias surgeons will encounter complications. They are estimated to occur in around 10% of distal hypospadias repairs and more than 50% for proximal forms. Some controversy exists regarding the length of follow-up needed to detect them. Some series have...Conservative management of pelviureteric junction
Background Pelviureteric junction obstruction (PUJO) is defined as a functionally significant impairment of urine flow from the renal pelvis into the proximal ureter. For more than a century, surgery was considered the first-choice approach to management. However, the widespread use...
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...Neuromodulation for lower urinary tract dysfunction – an ICS update
Non-invasive and invasive electro-stimulation techniques have been extensively studied in the treatment of lower urinary tract and bowel dysfunction, including overactive bladder syndrome (OAB), non-obstructive chronic urinary retention, faecal incontinence and chronic pelvic pain. Currently, the most common indication for...Urinary incontinence in women – part 2: management
In the second part of our comprehensive overview of urinary incontinence (UI) the authors explore the plethora of treatment options for this complex condition. (Part 1 available here). Conservative management Initial treatment of incontinence should be conservative. Caffeine reduction and...An algorithm for the management of haemorrhagic cystitis
Haemorrhagic cystitis (HC) can be one of the most difficult conditions to treat in urological practice. It is characterised by intractable bleeding from the bladder and may be acute or chronic. The most frequently reported causal factors are radiotherapy (RT)...
Outcome analysis of paediatric pyeloplasty
This prospective study from India included 744 patients of whom 112 had renal function less than or equal to 20% at the time of diagnosis. Thirty percent underwent a nephrostomy initially. Ten with no function had a nephrectomy. Of the...
Laparoscopic ureteral ligation (clipping)
Ectopic ureters in the presence of an upper moiety duplex kidney, or non functioning upper moieties, are traditionally treated with a heminephrectomy (open or laparoscopic). This carries significant risks, especially loss of the remaining lower moiety. These authors describe a...
Adolescents and adults in paediatric urology clinics
This elegant descriptive paper retrospectively reviewed cases seen in a paediatric urology clinic with respect to age, diagnosis and presentations in a major Brazilian city. Of 521 patients, 404 were <12 years old, 103 were between 12-18 and 14 were...
