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Does stable or decreasing hydronephrosis on ultrasound lead to stable or improved function on diuretic renography?

Antenatal hydronephrosis is noted in approximately 1% of all pregnancies. Persistent renal obstruction may lead to progressive loss of renal function. Renal ultrasound (USS) is the preferred modality for diagnosis and monitoring of paediatric hydronephrosis as it is non-invasive, non-ionising,...

Redo orchidopexy

Cryptorchidism, or the undescended testis, is perhaps the most common genital anomaly in males. Historical success rates are approximately 90% depending on the preoperative location and technique used. Iatrogenic cryptorchidism can also occur in up to 2% of cases following...

Local tumour bed recurrence following partial nephrectomy

In this interesting retrospective study, the authors looked at the incidence of local tumour bed recurrence after partial nephrectomy (PN), the factors associated with that, and the management. A total of 2,271 patients’ charts were reviewed who underwent partial nephrectomies...

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...

LARP – three instrument techniques to reduce costs

The cost of laparoscopic radical prostatectomy (LARP) is high because of both the initial installation cost and, more importantly, high running costs. The main reason for the latter is the limited number of usage of the instruments; generally, each instrument...

Percutaneous ultrasound guided endoscopic lavage of perinephric abscess – different, but not necessarily better

Perinephric abscess is an uncommon but serious form of urosepsis. It develops as a consequence of the extension of an infection outside of the parenchyma of the kidney in acute pyelonephritis, or more rarely from haematogeneous spread of an infection...

Comparison of PCNL under spinal versus general anaesthesia

There are several advantages of performing percutaneous nephrolithotomy (PCNL) under spinal anaesthesia including lower cost, reduced adverse effects and less tracheal tube displacement. Another advantage is that the patient remains awake throughout making positioning easier and reducing the risk of...

Has laparoscopic radical prostatectomy had its day?

Over recent years there has been a massive uptake in robotic surgery particularly for robot-assisted prostatectomy. The drive for this has been patient and physician led with little in the way of prospective randomised trials showing benefits over established operative...

Lower pole vessels in children with PUJO: laparoscopic vascular hitch or dismembered pyeloplasty?

A crossing vessel accompanying pelvi-ureteric junction obstruction (PUJO) occurs in 25-50% of cases. The Hellstrom vascular hitch procedure was first described in 1951 and has regained popularity since 2003 in the era of laparoscopic surgery as it negates the need...

How often are instruments changed in RALP & RAPN?

This study investigates how often the robotic instruments are exchanged during robotic-assisted laparoscopic prostatectomy (RALP) and robot-assisted partial nephrectomy (RAPN). They presently come with a life span of 10 uses but whether all instruments are used fully on 10 different...

Hypospadias – how long should follow-up be?

The optimal duration of follow-up following childhood hypospadias repair (to detect complications) is ill-defined. Several surgeons recommend it to include assessment during puberty. Some may worry that ‘rapid penile growth’, ‘erectile forces’ and ‘sexual activity’ could potentially stress previously successful...

The workplace environment and doctors’ health

It is well established that doctors have higher levels of stress, depression and suicide than the general population [1] and most other professional groups. In addition they have high levels of ‘burnout’. Research indicates that although burnout is correlated with...