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A tale of two cities – hypospadias outcomes
As urologists, it is important to know our results. In terms of hypospadias surgery, which is commonly undertaken after the age of one year in the UK, long-term follow-up is required to fully acquire this knowledge. Long-term urinary outcomes and...
Is robotic pyeloplasty in the under-ones as good as open repair?
Pelviureteric junction obstruction (PUJO) is a common cause of paediatric hydronephrosis. Indications for intervention include reduced renal function (<40%), symptoms (urinary tract infection or pain) and increasing dilatation. Although the Anderson-Hynes open pyeloplasty (OP) has long been the gold standard...
Effects of orchidopexy upon testicular temperature
The undescended testis (cryptorchidism) is the most common correctable disorder in paediatric urology (1-4.6% of newborns). An important role of the scrotum is to keep the temperature of the testes 2-40C below core body temperature. Here, Shiraishi et al. from...
Biopsy should be considered for older boys (>10 years) undergoing orchidopexy for intra-abdominal testes
Cryptorchidism is associated with a 3 to 10-fold increase in malignancy and the age at which it is undertaken matters; the risk of testicular cancer is doubled in patients undergoing orchidopexy at 13 years of age compared to that treated...
Hypospadias – how long should follow-up be?
The optimal duration of follow-up following childhood hypospadias repair (to detect complications) is ill-defined. Several surgeons recommend it to include assessment during puberty. Some may worry that ‘rapid penile growth’, ‘erectile forces’ and ‘sexual activity’ could potentially stress previously successful...
Fluoxetine for refractory night wetting in children – is it safe and effective?
Around 1-2% of teenagers above the age of 15 years and 2-6% of adults continue to wet the bed. Standard treatment often includes bladder advice, alarm therapy, desmopressin and anticholinergics. Tricyclic antidepressants (imipramine) can also be utilised. Unfortunately, most have...
Robot-assisted ureterocalicostomy
Ureterocalicostomy was first introduced by Neuwirt (1947) and further described by Jameson et al. (1957) as an alternative procedure for repair of pelviureteric junction (PUJ) obstruction associated with an intrarenal pelvis. Performing ureterocalicostomy for PUJ repair has been suggested in...
Scrotal antegrade sclerotherapy for the adolescent varicocele
The incidence of varicocele in adolescent males is around 15%. Treatment indications include symptoms (pain) and evidence of a smaller testis. Numerous surgical techniques are described but there is a lack of randomised controlled trials (RCT), specifically in adolescents. This...
Preoperative use of testosterone prior to distal hypospadias repair
Preoperative hormonal stimulation has been utilised for >50 years in hypospadias surgery. Surgeons utilise testosterone (T) to increase penile size and glans width to try and improve clinical outcomes. However, a paucity of reliable data supporting its use has limited...
AML – a rare variant
With the increasing number of CT and ultrasound scans performed in hospital practice more and more incidental angiomyolipomas (AML) are being picked up, some of which are asymptomatic and may not bother patients at all. This study comes from the...
Phase two trial of SAbR for primary RCC
A study focused on stereotactic ablative radiotherapy (SAbR) as a treatment for primary renal cell carcinoma (RCC) has yielded significant findings. The primary objective of the study was successfully met, demonstrating a 94% local control rate at one year among...
