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Radiological investigation of haematuria in 2016

This paper summarises the current evidence for and use of various imaging modalities for investigating haematuria. The following investigations are reviewed: Intravenous urogram (IVU) – the number of centres still using IVU is decreasing. IVU is cheaper and has less...

MSKCC prostate cancer screening guidelines – is it the way forward?

The Memorial Sloan Kettering Cancer Center (MSKCC) developed prostate cancer screening recommendations first in 2011 as a response to three limitations of previous screening guidelines: insufficient evidence base, failure to link screening with treatment, and lack of risk stratification. To...

HIV-related stone disease – a potential new paradigm?

This paper discusses the management of patients with stone disease and HIV. The chronic nature of HIV infection is due in large part to the effectiveness of anti-retroviral therapies (ART). However, the role of protease inhibitors has been widely discussed...

Role of emergency ureteroscopy in the management of ureteric stones

Emergency ureteroscopy for all acute stone patients is not widespread in the UK but this is not the case elsewhere. In Auckland, New Zealand, it is commonly carried out in the emergency setting to reduce pressure on elective lists and...

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),...

Fluoroquinolone resistant rectal colonisation predicts risk of infectious complications after TRPB

Transrectal prostate biopsy (TRPB) has been associated with increased risk of infection between 3.6-5% and sepsis rates of 0.3-3.1% mainly due to fluoroquinolone resistance (FQR). At present, FQ antibiotic prophylaxis is utilised commonly across North America and Europe but due...

Antimuscarinics and behaviour in patients with spinal dysraphism

Since the 1980s patients with spinal dysraphism have had aggressive bladder management with clean intermittent catheterisation and anticholinergic therapy from early on in life. This strategy aims at improving lower and therefore upper urinary tract function thus decreasing the risk...

Prenatal spina bifida repair – does it have urological benefits in the longer term?

At present, I have one patient under my care who underwent prenatal closure of his spina bifida defect. Only with time, will we be able to determine whether this intervention has been of benefit for him from a urological standpoint....

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...