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Relax and take note of this!

Children with neurogenic bladders are at risk of renal compromise through high detrusor pressures. Management aims to provide continence and preserve the upper tracts by increasing capacity and compliance though early clean intermittent catheterisation and anticholinergics. Intradetrusor botulinum toxin has...

Transurethral enucleation is superior to resection for the management of LUTS secondary to BPH

This meta-analysis (Level 1b evidence) examined the efficacy and safety of two primary transurethral therapies used in the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), enucleation (HoLEP – holmium laser enucleation of prostate, ThuLEP,...

BCG after TURBT – does timing matter?

Intravesical bacille Calmette–Guerin (BCG) therapy continues to be widely used for patients with intermediate / high-risk non-muscle invasive bladder cancer (NMIBC). In this article, the researchers identified the lack of sufficient evidence with regards to timing of BCG after transurethral...

Is Retzius-sparing prostatectomy the way forward?

Urinary incontinence is a common complication of conventional robot-assisted radical prostatectomy (RARP). Retzius-sparing RARP is performed through the pouch of Douglas to avoid destroying the pelvic fascia and the prostate’s anatomical structures. It has shown early favourable results in terms...

Prostate biopsies without antibiotic cover – are we there yet?

Transperineal (TP) prostate biopsies are widely replacing the traditional transrectal route due to definite evidence of reduced infective complications. TP biopsies are usually performed with a single dose of antibiotic pre-procedure in most centres. In this article the authors attempt...

Pain relief after removal of non-obstructive renal calculi

Non-obstructing stones are often not considered to be the source of pain, and probably most are not. This is because flank pain associated with a stone is typically caused by a stone that obstructs urinary flow, which increases intraluminal pressure...

Long term outcomes of primary ureterovesicostomy for the primary obstructive megaureter

Primary obstructive megaureter is dilatation of the ureter secondary to narrowing at the vesicoureteric junction (VUJ). Many (80%) require no intervention, however, a select number do for worsening hydroureteronephrosis, decreasing renal function, prolonged drainage time, recurrent urinary tract infections or...

The future of bladder-sparing therapy is bright

Trimodal therapy (TMT), combining optimal transurethral resection of bladder tumour (TURBT) and concurrent chemoradiotherapy, has garnered significant attention for managing muscle-invasive bladder cancer (MIBC). This approach offers the potential for bladder preservation while delivering oncological outcomes comparable to radical cystectomy....

Clinical trials 1

Clinical Trials 2 is available here. Case 1 1. What are the levels of clinical evidence based on the 2009 definitions from the ‘Oxford CEBM’? 2. What is the null hypothesis? 3. What are type 1 and type 2 errors?...

Initial impressions of urology in the UK from overseas trainees

Readers of Urology News will be familiar with descriptions of overseas visits by UK-based urological trainees, but it is sometimes beneficial to reflect on the experience of international medical graduates (IMGs) who elect to come to work and train in...

An algorithm for the management of haemorrhagic cystitis

Haemorrhagic cystitis (HC) can be one of the most difficult conditions to treat in urological practice. It is characterised by intractable bleeding from the bladder and may be acute or chronic. The most frequently reported causal factors are radiotherapy (RT)...

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...