Journal Reviews archive for January 2017
Uncovering the fate of small residual fragments
The concept of ‘stone free’ remains an enigma. To some urologists this refers to complete removal of all visible fragments, to others its removal of all ‘clinically significant’ fragments (generally regarded as fragments >2mm), and to some it is absence...
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...
Optimisation of childhood spina bifida management – a prospective trial
Routh et al. describe a prospective trial which aims to determine the optimal urological management for children with spina bifida. The primary aim of neuropathic bladder management is to provide the patient with the best long-term quality of life with...
Urology patient assessment – importance of holistic approach – new paradigm
Mild cognitive impairment (MCI) seems to affect 30% of the general population above 65 and its presence has a wide range of significance. This is a prospective single centre study to look at MCI in adult urological patients above 18...
Understanding gender differences in nephrolithiasis
Rates of nephrolithiasis are higher in males than females. The cause for this remains unclear, however animal models have demonstrated an association between sex steroid hormone levels and lithogenesis. This relationship in humans is less well established. This study from...
Factors associated with post ureteroscopy urosepsis
The authors investigate which factors were most likely to increase the risk of postoperative urosepsis within 28 days of ureteroscopy (URS) and laser stone fragmentation by analysing the 34 of 562 patients who developed this complication. Stone size, same session...
Should maximal urethral closure pressure be performed before mid-urethral sling surgery for stress incontinence?
Maximum urethral closure pressure (MUCP) is a means of trying to provide an objective assessment of urethral integrity. In some centres it is used as a tool to help predict outcomes after mid-urethral sling (MUS) placement. The authors propose that...
Outcome analysis of paediatric pyeloplasty
This prospective study from India included 744 patients of whom 112 had renal function less than or equal to 20% at the time of diagnosis. Thirty percent underwent a nephrostomy initially. Ten with no function had a nephrectomy. Of the...
Male genital mysteries
Every now and then urologists are asked to give an opinion on genital lesions and rashes. This article from University College Hospital London is certainly worth a read. Most conditions are benign but some are precancerous leading to penile cancer...