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Urological trauma – part 2

Part 1 of this topic is available here. Case 1 A 29-year-old male was attacked and kicked in his left flank. He presented to the emergency department with left flank pain and frank haematuria. He remained haemodynamically stable. 1. What...

Lower pole vessels in children with PUJO: laparoscopic vascular hitch or dismembered pyeloplasty?

A crossing vessel accompanying pelvi-ureteric junction obstruction (PUJO) occurs in 25-50% of cases. The Hellstrom vascular hitch procedure was first described in 1951 and has regained popularity since 2003 in the era of laparoscopic surgery as it negates the need...

Retroperitoneal fibrosis

Introduction Retroperitoneal fibrosis (RPF) is a condition that occurs when extensive fibrosis develops in the retroperitoneum, usually centred over the anterior aspect of the fourth and fifth lumbar vertebrae. The fibrotic tissue typically surrounds the infrarenal aorta, inferior vena cava...

Challenges of upper tract urothelial carcinoma

Upper tract uroepithelial carcinoma (UTUC) is a fairly common disease which traditionally had poorer outcomes compared to bladder cancer. This is due to various factors leading to delayed diagnosis and problems in risk stratification. Continuing efforts have focused on early...

Stenting prior to URS or ESWL – does it increase ED visits and opiate prescriptions?

Ureteral stents are used to bypass obstructive stones, to dilate the ureter in order to facilitate ureteroscopy (URS), and to maintain patency / low intrarenal pressure following stone surgery. However, there can be morbidity (pain / voiding symptoms). Tasian et...

A negative ureteroscopy for stone disease: is it acceptable and is it avoidable?

Urinary tract stone disease and the consequent demand for endoscopic intervention in the upper urinary tract is an increasing phenomenon [1]. Although ureteroscopy is generally considered to be associated with low morbidity [2], risks do exist. Recognised complications include urothelial...

Bladder carcinoma MRI

Bladder malignancy is one of the commonest malignancies of the renal tract, accounting for approximately 6% of male malignancy and 2% of female malignancy. The incidence increases with patient age with 70% of patients being over the age of 65...

Kidney stones in pregnancy

Case 1 A 28-year-old female, 19 weeks pregnant, presents with severe left loin pain. There is no past medical history of note. Blood tests show a white cell count of 14.1x109/L and creatinine of 56umol/L. An ultrasound scan (USS) reports...

Flexible cystoscopy

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 article I told you about Jonathan Goddard, a C17th doctor...

Demanding cases or nightmares in endourology? May/June 2017

In the sixth article in this series the authors describe endourology nightmares involving ileal conduits and calculi. Case 1 A 69-year-old man who had a cystectomy and ileal conduit for muscle invasive bladder cancer, presented with an acute kidney injury...

David Newman

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 article I said I would write on a Scottish theme...

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...