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Surgical treatment of LUTS secondary to BPH
For the vast majority of patients an initial trial of medical therapy for the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is indicated [1]. In a substantial minority of cases however, a surgical intervention...Ejaculatory dysfunction – too swift, too slow and the no-show
Timing is everything.’ Although an expression most frequently linked to comedy, timing also seems just as critical in the business of sexual climax. Indeed, many men worry about ejaculating. Too soon is embarrassing. Too slow is frustrating. And not ejaculating...
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...
CRP to predict the need for surgical intervention in acute renal colic
A previous paper has suggested that C-reactive protein (CRP) is a useful serum marker for determining the likelihood of a patient with renal colic requiring surgical intervention, the cut-off level being >28mg/l (specificity 88.9%, sensitivity 75.8%). This prospective observational study...
Lichen sclerosus and isolated bulbar urethral stricture disease
The incidence of urethral stricture in men with lichen sclerosus (LS) has been reported to be between 4.8% and 14%. LS limited to the glans and urethral meatus can be treated with acceptable outcomes; however, more extensive urethral disease requires...
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...
Redo orchidopexy
Cryptorchidism, or the undescended testis, is perhaps the most common genital anomaly in males. Historical success rates are approximately 90% depending on the preoperative location and technique used. Iatrogenic cryptorchidism can also occur in up to 2% of cases following...
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...
A phase II dose-ranging study of mirabegron in patients with OAB
This was a multinational, multicentre, randomised, double–blind, double-dummy, parallel group placebo- and active- controlled phase II study. The study enrolled 1108 men and women aged 18 and over. The criteria were: patients must have had overactive blader (OAB) symptoms for...
Supranormal function on MAG-3 – what is its significance and how to predict?
Differential renal function (DRF) on MAG-3 scans is typically used in patients with pelvic ureteric junction obstruction (PUJ obstruction). Supranormal DRF is when the kidney with PUJO has higher DRF than the normal contralateral kidney. The authors in this study...
