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ESWL and URS for treatment of paediatric urolithiasis

Tejwani et al. have undertaken a comparative effectiveness study to characterise differences in procedure frequency, postoperative re-admissions and emergency room (ER) visits, and repeat treatment rates for children (≤18 years) with urolithiasis who underwent initial intervention with extracorporeal shock wave...

Testicular masses – can the testis be spared?

The standard practice for testicular masses confirmed on ultrasound has been to offer an inguinal orchidectomy, on the presumption that the mass represents testicular cancer. The growing use of scrotal ultrasound for various indications has led to an increase in...

Has laparoscopic radical prostatectomy had its day?

Over recent years there has been a massive uptake in robotic surgery particularly for robot-assisted prostatectomy. The drive for this has been patient and physician led with little in the way of prospective randomised trials showing benefits over established operative...

Testicular cancer (Mar 2015)

Case 1 What does the ultrasound show? What further imaging does this patient require? Which tumour markers should be checked? What is the half-life of these markers? What does an elevation in these markers mean? Case 2 What is this...

Upper Tract Developmental Abnormalities

Case 1 1. What is the abnormality and how common is it? 2. What is the embryological origin? 3. With what other conditions can this be associated? Case 2 1. What is the diagnosis and how common is it? 2....

MPs urge government to end continence pad ‘rationing’ after trusts found limiting supplies

A group of MPs have called on the government to intervene over what they describe as the “rationing” of continence products across the NHS, warning that thousands of patients are being left without adequate support and may be costing the...

So you want to be a urologist?

Urology is a varied, innovative and friendly speciality and it is easy to see why so many people are attracted to it. The article below is designed to help all doctors wishing to apply for an ST3 post get the...

Ureterocystostomy – novel surgery for the paediatric obstructed megaureter

Megaureter is a relatively common congenital urinary tract anomaly; obstructed non-refluxing megaureter is one variant. Initial management is conservative, with operative intervention reserved for symptomatic cases (recurrent pyelonephritis, pain, increasing dilatation or worsening renal function). Surgical options include cutaneous ureterostomy,...

Transfer to tertiary paediatric hospitals for patients with testicular torsion

Although this articles comes from a tertiary centre in Columbus, USA, there are similarities with the current controversies in the UK. The authors carried out a five-year retrospective review looking at the surgical transfer of 125 patients (mean age 13.4,...

Performance of non-invasive tests in diagnosing BOO in men with LUTS

A large proportion of urology involves the treatment of bladder outflow obstruction (BOO) in men. Yet BOO in men is very difficult to accurately quantify with the only regular non-invasive test being uroflowmetry. Pressure flow urodynamics may be considered the...

Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer

Abiraterone acetate, the prodrug of abiraterone, blocks endogenous androgen synthesis by inhibiting cytochrome p-450c17, a critical enzyme in androgen biosynthesis. Its active D4A metabolite also has anti-tumour effects through possibly multiple mechanisms. 3-5% of men diagnosed with prostate cancer in...