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Upper tract urothelial carcinoma following cystectomy
Metachronous upper tract urothelial cancer (UTUC) is encountered in about 5% of patients after radical cystectomy (RC) with a median time to diagnosis of 24-36 months after RC, and most are asymptomatic and detected by surveillance protocols. In this multivariate...An inconvenient truth: reflections on the NHS
“What gets us into trouble is not what we don’t know. It’s what we know for sure that just ain’t so.” The above is a quote attributed to Mark Twain from the 2006 documentary, An Inconvenient Truth, which follows Al...
Performance of non-invasive tests in diagnosing BOO in men with LUTS
A large proportion of urology involves the treatment of bladder outflow obstruction (BOO) in men. Yet BOO in men is very difficult to accurately quantify with the only regular non-invasive test being uroflowmetry. Pressure flow urodynamics may be considered the...
Efficacy of flexible ureteroscopy and laser lithotripsy for lower pole renal calculi
The management of lower pole renal stones (LPS) is often difficult. Extracorporeal shock wave lithotripsy (ESWL), flexible ureterorenoscopy (fURS) and percutaneous nephrolithotomy (PCNL) are all potential options with potential benefits and disadvantages. In order to assess the success of fURS...
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...
Is routine renal tumour biopsy associated with lower rates of benign histology following nephrectomy for small renal masses?
There has been a considerable increase in the detection of small renal masses (SRM). Approximately 20% of these turn out to be benign lesions on final histopathological analysis. Therefore upfront surgery can be overtreatment in such a group of patients....
Prostate cancer mortality among elderly men after discontinuing organised screening
This study presents ground-breaking insights into discontinuing prostate cancer (PCa) screening in previously screened elderly men, aiming to mitigate the risk of overdiagnosis and overtreatment in the face of other-cause mortality. Examining men aged 70–74 who had undergone prostate specific...Read all about it May/Jun 2017
It can be awkward when a patient asks you about a report in their favourite tabloid detailing an amazing research breakthrough or a ‘cutting-edge’ new treatment / test and you don’t know what they are talking about! So this section...The COVID-19 ‘frontlines’: a foundation doctor’s perspective
Staring through the fragmented stained glass of the Virgin Mary and her assorted angels, I reflected on the strangeness of the workplace I now found myself in and the irony of a workforce now working together more enthusiastically than ever...
Nocturia: the debate goes on
This study is from Ghent, Belgium. Nocturia is one of the most bothersome lower urinary tract symptoms affecting both men and women. Key factors to consider in evaluating are nocturnal polyuria (NP) and reduced bladder capacity. NP with low osmolality...Testing radical prostatectomy in men with prostate cancer and oligometastases to the bone: a randomised controlled feasibility study
Prostate cancer is the commonest cancer and the second most frequent cause of cancer death in Western men [1]. The recent STAMPEDE data suggests a median survival of just 42.1 months in the control arm of metastatic men [2]. Current...
