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PSM increases risk of recurrence after PN for high-risk renal tumours

Positive surgical margins (PSM) for solid organ malignancies are associated with adverse oncological outcomes. However, for RCC the prognostic significance of PSM after partial nephrectomies (PN) remains a matter of debate. As PN is more increasingly being used to excise...

Surgical Techniques for Kidney Cancer

The principle advantage to this book over other more augmented texts is its conciseness. As a result, the editors are compelled to deliver a more focused approach to the management of kidney cancer. Although the title purports to consider ‘surgical’...

Use of Clavien-Dindo classification in urology part 2 – upper tract

A classification system of surgical complications was proposed by Clavien in 1992 [1] and further modified by Dindo in 2004 [2]. Clavien-Dindo classification has since then been validated through many retrospective case series as well as in comparative studies to...

The origins of urinary stone disease

This is a descriptive paper of micro CT scans of tubular mineralisation in 12 nephrectomy specimens. The authors noted that: in the small number of specimens examined, mineralisation started in the outer medulla and appeared to proceed distally along the...

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...

Ipsilateral ureteroureterostomy: does function of the obstructed moiety matter?

Upper pole nephrectomy has been the traditional surgical management of children with poorly functioning upper pole moieties in duplex renal collecting systems having ureteral ectopia and ureterocele. However, ablative surgery confers a risk of functional loss to the remnant moiety...

How often are instruments changed in RALP & RAPN?

This study investigates how often the robotic instruments are exchanged during robotic-assisted laparoscopic prostatectomy (RALP) and robot-assisted partial nephrectomy (RAPN). They presently come with a life span of 10 uses but whether all instruments are used fully on 10 different...

RN or PN for small RCCs – the debate continues

This is a retrospective study to evaluate kidney function and overall survival (OS) in patients who underwent partial nephrectomy (PN) and radical nephrectomy (RN) for RCCs <4cm. They looked at 2110 patients who underwent RN/PN for T1a renal cell carcinomas...

Modern management of small renal masses

With the advent of widespread cross-sectional imaging there has been a surge in incidental detection of small renal masses (SRMs) and renal cell carcinoma (RCC) is now the seventh most common cancer in the UK. Whilst surgical excision for larger...

Demanding cases or nightmares in endourology? Sep/Oct 2016

In this issue the authors will present once in a career cases that can truly haunt a urologist. “Mistakes are like bad loves, the more you learn from them, the more you wish they’d never happened. “ Gregory David Roberts*...

Is outpatient robotic surgery feasible in children?

Minimally invasive surgery has helped to achieve shorter hospitalisations, reduce postoperative pain and analgesia requirements and provides better cosmetic results. Robotic urological outpatient surgery has been examined in recent times in the adult population; here Neheman et al. look at...

Sir Henry Morris and the first nephrolithotomy

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). In the last history article we were treated to the story behind the...