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Active surveillance for small renal masses in younger patients
Active surveillance (AS) is discussed as an option for renal masses <2cm in patients with significant competing risks for mortality. This multicentre data from the US seeks to fill an important gap in current guidelines for provision of this option...Pyonephrosis: is the kidney always doomed?
Pyonephrosis (Greek pyon ‘pus’ + nephros ‘kidney’) is defined in Campbell-Walsh Urology [1] as an infected hydro-nephrosis associated with suppurative destruction of the renal parenchyma which results in total or near total loss of renal function. The true incidence of...
Efficacy of flexible ureteroscopy and laser lithotripsy for lower pole renal calculi
The management of lower pole renal stones (LPS) is often difficult. Extracorporeal shock wave lithotripsy (ESWL), flexible ureterorenoscopy (fURS) and percutaneous nephrolithotomy (PCNL) are all potential options with potential benefits and disadvantages. In order to assess the success of fURS...
Thiazide diuretic prophylaxis for kidney stones and the risk of diabetes mellitus
Thiazide diuretics have been used to reduce calcium nephrolithiasis recurrence as it is tolerated well, inexpensive and reduces calcium excretion in urine. It has been linked with increased risk of diabetes mellitus (DM) in the presence of hypertension (ALLHAT study),...
Cryotherapy for small renal masses: better than surveillance?
With the rapid rise in incidental small renal mass detection, some of which have malignant potential, comes the need to either survey or treat these masses safely and with minimal morbidity. This large series of 147 patients with 171 masses,...
Assessing resolution of isolated hydronephrosis – is APPD superior to the SFU system?
Antenatal scanning detects urinary tract dilatation in 1-5% of pregnancies. Isolated hydronephrosis (i.e., that not due to secondary dilatation e.g. bladder dysfunction) is known to resolve or improve in most; some patients may, however, require intervention through deterioration of obstruction...
To clamp or not to clamp – outcomes of the CLOCK trial for robotic partial nephrectomy
The benefits of partial over radical nephrectomy are well established. The CLOCK trial (CLamp vs. Off Clamp the Kidney during robotic partial nephrectomy) was designed as a multicentre, randomised controlled trial to generate evidence on the role of the off-clamp...
