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Predictive factors for conservative treatment failure in paediatric blunt renal trauma

Blunt renal trauma is managed conservatively in children in the vast majority of cases. Grade IV renal injury is also generally managed non-operatively although occasionally intervention is needed for a urinoma that fails to settle. These authors retrospectively looked at...

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...

Radiation in paediatric urology – PURSE study

Urological operative procedures often use fluoroscopy for diagnosis and treatment of stone disease and structural anomalies. Paediatric tissues are sensitive to the effects of ionising radiation. Paediatric radiation safety has gained concerns due to the possible long-term effects such as...

ASAP: is a repeat biopsy necessary?

This study examined the validity of current US and European guidelines on the management of patients diagnosed with atypical small acinar proliferation (ASAP). Current guidance states that these patients should undergo repeat biopsy within three to six months due to...

Impact of prostatic apex in continence after RARP

This article investigates the impact of prostatic apical shape from preoperative magnetic resonance imaging (MRI) on early recovery of urinary continence after robot-assisted radical prostatectomy (RARP). It is a retrospective study of 1011 patients at a tertiary centre. Patients were...

Active surveillance for small renal masses in younger patients

Active surveillance (AS) is discussed as an option for renal masses <2cm in patients with significant competing risks for mortality. This multicentre data from the US seeks to fill an important gap in current guidelines for provision of this option...

Cortical stimulation for voiding dysfunction in multiple sclerosis

Voiding dysfunction (VD) increases morbidity in patients with multiple sclerosis (MS), and may be associated with urinary tract infections, stones and renal failure. Catheterisation is required when impaired hand function precludes self-catheterisation, which is associated with further morbidity. In this...

Improving on the Rotterdam Prostate Cancer Risk Calculator

Following the PROMIS trial [1], many cancer centres in the UK are now offering pre-biopsy multiparametric MRI (mpMRI) for men suitable for radical treatment. The European Association of Urology for Prostate Cancer (PCa) guidelines recommend individual risk stratification before the...

Urethral pathology

Case 1 A 43-year-old lady presents with urinary incontinence and vaginal pain associated with intercourse. An initial CT scan is performed. Case courtesy of Radswiki, Radiopaedia.org, rID: 12056. Case courtesy of Radswiki, Radiopaedia.org, rID: 12056 What is the clinical diagnosis...

A time management guide for urologists

Good time management is thought to not only reduce stress, but to improve personal efficiency, service delivery, clinical effectiveness and patient care. It was Benjamin Franklin in the 18th Century who originally made the link between success and the proper...

Upper urinary tract urothelial cell carcinoma

Case 1 A 64-year-old man presents to the haematuria clinic with visible haematuria, on a background of a 40 pack-year smoking history and family history of bowel cancer in his sister at the age of 48. A CT was performed...

Focal therapy for prostate cancer – ready for prime time?

The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...