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Risk stratified approach to early intervention for renal colic

Existing guidance on this topic is based on older and smaller studies, and there remains variation in practice. This review of database outcomes of 1168 out of 3081 (38%) patients who underwent early intervention after presentation to nine Canadian emergency...

Beware of the ambiguous testicular lump

In busy day-to-day practice, we are often faced with puzzling situations. A useful mnemonic is 4-T: torsion, trauma, tumour and tuberculosis (infections). This case review in the BMJ is about a 34-year-old man presenting to A&E with left testicular pain...

Low dose PDE5I in IC

This is a randomised, double-blind, placebo-controlled trial to evaluate the efficacy of daily low-dose sildenafil (25mg) for the treatment of non-ulcer interstitial cystitis (IC) in women. Forty-eight women with clinical diagnosis of IC, from three centres, were equally randomised to...

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...

Managing staghorn calculi – a return to the dark ages of stone surgery with the aid of the robot

Khurshid Ghani and colleagues present a novel, yet all too familiar, approach to the management of patients with staghorn calculi, in the form of anatrophic nephrolithotomy - however with the aid of a robot. The aim of this study is...

Laparoscopic transposition of renal lower pole crossing vessels

The vascular hitch procedure for pelvi-ureteric junction obstruction (PUJO) was initially described by Hellstroem in1951 and has become popular again since the introduction of laparoscopy. There is still much controversy as to its efficiency. The authors of this paper analyse...