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Bladder cancer diagnosis and follow up: A new proven urinary biomarker to support the post COVID-19 recovery phase

Since lockdown began most urologists have been following the advice of BAUS Oncology, to minimise the risk of exposure of patients and staff to potential COVID-19 infection: the result is an increasing backlog of patients requiring tests to determine if...

Ureterocystostomy – novel surgery for the paediatric obstructed megaureter

Megaureter is a relatively common congenital urinary tract anomaly; obstructed non-refluxing megaureter is one variant. Initial management is conservative, with operative intervention reserved for symptomatic cases (recurrent pyelonephritis, pain, increasing dilatation or worsening renal function). Surgical options include cutaneous ureterostomy,...

Risk factors for CKD following treatment for RCC

This paper concerns the prevention of chronic kidney disease (CKD) following treatment for renal cell carcinoma (RCC). Over the last 10 years, partial nephrectomy has played an increasing role in the management of RCC, especially T1a disease. It has been...

Thiazide diuretic prophylaxis for kidney stones and the risk of diabetes mellitus

Thiazide diuretics have been used to reduce calcium nephrolithiasis recurrence as it is tolerated well, inexpensive and reduces calcium excretion in urine. It has been linked with increased risk of diabetes mellitus (DM) in the presence of hypertension (ALLHAT study),...

Surgical and pathological outcome of partial nephrectomy: robotic versus laparoscopic approach

Nephron sparing surgery has become the standard surgical treatment for small renal masses (<4cm). Laparoscopic partial nephrectomy (LPN) is shown to be superior to the open approach (OPN) in peri and postoperative morbidity; however, it requires advanced skills and has...

Open radical prostatectomy vs. robotic prostatectomy: early oncological outcome

There is currently a trend towards robot-assisted laparoscopic radical prostatectomy (RALP) as opposed to open radical prostatectomy (ORP) despite ongoing debates about oncological outcomes in patients treated for prostate cancer (PCa). Several papers have compared both surgical approaches but available...

Assessing resolution of isolated hydronephrosis – is APPD superior to the SFU system?

Antenatal scanning detects urinary tract dilatation in 1-5% of pregnancies. Isolated hydronephrosis (i.e., that not due to secondary dilatation e.g. bladder dysfunction) is known to resolve or improve in most; some patients may, however, require intervention through deterioration of obstruction...

Fluoxetine for refractory night wetting in children – is it safe and effective?

Around 1-2% of teenagers above the age of 15 years and 2-6% of adults continue to wet the bed. Standard treatment often includes bladder advice, alarm therapy, desmopressin and anticholinergics. Tricyclic antidepressants (imipramine) can also be utilised. Unfortunately, most have...

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)...

Consent

See Part 2 on this topic here Case 1 A 15-year-old boy attends with his father to have a circumcision on a day case list. He had been seen previously by a colleague and noted to have a tight phimosis...

An update on robotic surgery in urology

The early adoption of new technology has long been a trademark of urological surgeons. Like the introduction of the cystoscope, lasers and flexible endoscopy, the field of urology has witnessed a revolutionary transformation with the advent of robotic surgery. Robotic-assisted...

The doctor as the patient: receiving bad news

This article, written by a GP working in the NHS, gives a unique insight into the experience of being a urology patient and some thoughtful advice on ‘breaking bad news’. Day 1 Alarm bells ring. It’s spotting an email from...