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Ejaculatory dysfunction: a review of current practice and guidelines
Introduction The ejaculatory process is paramount to procreation in nature. It is a complex orchestration of physiology that results in emission of the ejaculate into the posterior urethra followed by ejection of those fluids from the urethra and orgasm. 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,...
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...
Long-term oncologic outcomes of salvage cryoablation for rrPC
Of patients undergoing radiotherapy (RT) for prostate cancer (PC), at least 15-20% will experience recurrence. Although salvage prostatectomy achieves durable oncological outcomes at 10 years, it is associated with significantly high morbidity. Thus, the majority of men with radio-recurrent prostate...
Who should be taking care of the adolescent with testicular torsion?
From time to time (as paediatric surgeons), we receive referrals from regional hospitals to explore the testis in older boys. Given the time-critical nature of the condition, patients should benefit from assessment and surgery performed locally (when possible). Inter-hospital transfer...
Tamsulosin and spontaneous passage of ureteral stones in children
This was a retrospective analysis of data for five years from four institutions comparing stone passage rates in children with ureteric stones ≤10mm, aged 2-18, treated with tamsulosin vs. analgesia alone. The study identified 449 children, of whom 334 were...
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),...
New concepts, emerging technologies and potential therapeutics in testicular torsion
This review article is worthy of reading in its entirety. It addresses current concepts in the management of one of the few paediatric urological emergencies. For every 100,000 males <25 years, 4.5 will have testicular torsion per year. Given that...
Selective denervation of the bladder
The treatment of refractory overactive bladder is currently limited to neuromodulation (sacral nerve stimulation or percutaneous tibial nerve stimulation) or botulinum toxin injections. Although all these options are valuable, they have their own limitations and may not be suitable for...
