PDE5I in LUTS – how do they work – no proof yet

Phosphodiesterase type 5 (PDE5) inhibitors used in erectile dysfunction (ED) have been shown to improve lower urinary tract symptoms (LUTS) as well. The mechanism is not well understood. One of the hypotheses for benign prostatic hyperplasia (BPH) – LUTS is...

Button vesicostomy

Poor bladder emptying often requires clean intermittent catheterisation (CIC). In significant numbers of children CIC is not possible for a variety of reasons and an alternative is needed. This paper reviews a single centre’s usage of the vesicostomy button over...

Comparative effectiveness of radical prostatectomy and radiotherapy in prostate cancer

Despite prostate cancer being one of the most commonly diagnosed cancers worldwide, there remains a need for high-quality evidence regarding the optimal treatment choice. In this large population-based cohort study, using the PCBaSe Sweden dataset, Sooriakumaran and colleagues identified patients...

Intermittent vs. continuous hormonal therapy for metastatic prostate cancer

Continuous androgen deprivation therapy (cADT) is the standard management for metastatic prostate cancer (mPCa). Intermittent androgen deprivation therapy (iADT) is sought to have better quality of life (QoL) and adverse events profile during off-treatment period. This multicentre European randomised study...

Antibiotics and flexible cystoscopy

This study is from Memorial Sloan-Kettering Hospital in New York, USA. Thousands of flexible cystoscopies are performed every day worldwide. Do they need antibiotic cover? Flexible cystoscopy may cause urinary tract infection (UTI) in less than 10% of cases. Asymptomatic...

The EP2 receptor – a novel target for prostate cancer?

This basic science paper sets out to evaluate the effects that celecoxib, a selective cyclo-oxygenase-2 (COX-2) inhibitor, have on prostate cancer cell lines and evaluated the mechanisms behind these effects. COX-2 induces the production of prostaglandins, which promote cell proliferation...

New therapy for overactive bladder

Overactive bladder (OAB) is a complex symptom that can adversely affect quality of life. So far pharmacotherapy has focused on anti-cholinergic drugs. Recently, beta-adrenoreceptors have been identified as having an effect on the detrusor muscle and urothelium. Beta-3 is the...

Does more equal less in the management of acute renal colic?

Radiographs of kidneys, ureter and bladder (KUB) have long been used in the follow-up of patients with ureteral stones to reassess stone position and surgical planning. Emergence of computed tomography (CT) as the gold standard for the diagnosis of ureteral...

Reducing the burden of NMIBC: outpatient laser management in morbid patients

With non-muscle invasive bladder cancer (NMIBC) posing a significant burden on urological departments, alternative ways of safely and effectively managing these patients with a minimally invasive approach is desirable. As rates of recurrence are high but progression rates low, and...

Comparative effectiveness of nephron sparing surgery vs ablation

Nephron sparing surgery (NSS) and minimally invasive modality of thermal ablation have attracted great attention as an alternative surgical treatment to radical nephrectomy (RN) for renal tumours <4cm. High quality evidence comparing disease specific survival (DSS) is lacking. This issue...

Comparison of PCNL under spinal versus general anaesthesia

There are several advantages of performing percutaneous nephrolithotomy (PCNL) under spinal anaesthesia including lower cost, reduced adverse effects and less tracheal tube displacement. Another advantage is that the patient remains awake throughout making positioning easier and reducing the risk of...

Is the safety wire during ureteroscopy mandatory?

Traditional principles of ureteroscopic training involve the almost religious passage of a safety guide wire (SGW) into the ureter prior to ureteroscopy (URS). The authors compare the clinical outcomes of URS for ureteral stones in two university hospitals with opposite...