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AML – a rare variant

With the increasing number of CT and ultrasound scans performed in hospital practice more and more incidental angiomyolipomas (AML) are being picked up, some of which are asymptomatic and may not bother patients at all. This study comes from the...

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...

Robot-assisted ureterocalicostomy

Ureterocalicostomy was first introduced by Neuwirt (1947) and further described by Jameson et al. (1957) as an alternative procedure for repair of pelviureteric junction (PUJ) obstruction associated with an intrarenal pelvis. Performing ureterocalicostomy for PUJ repair has been suggested in...

Scrotal antegrade sclerotherapy for the adolescent varicocele

The incidence of varicocele in adolescent males is around 15%. Treatment indications include symptoms (pain) and evidence of a smaller testis. Numerous surgical techniques are described but there is a lack of randomised controlled trials (RCT), specifically in adolescents. This...

Preoperative testosterone for hypospadias

Hypospadias affects around 1 in 400 boys. Glans width (GW) of <14mm has been shown to be an independent risk factor for urethroplasty complications following hypospadias repair. Testosterone (T) administration in prepubertal males increases both penile length and circumference. Its...

Effects of orchidopexy upon testicular temperature

The undescended testis (cryptorchidism) is the most common correctable disorder in paediatric urology (1-4.6% of newborns). An important role of the scrotum is to keep the temperature of the testes 2-40C below core body temperature. Here, Shiraishi et al. from...

A tale of two cities – hypospadias outcomes

As urologists, it is important to know our results. In terms of hypospadias surgery, which is commonly undertaken after the age of one year in the UK, long-term follow-up is required to fully acquire this knowledge. Long-term urinary outcomes and...

Selective denervation of the bladder

The treatment of refractory overactive bladder is currently limited to neuromodulation (sacral nerve stimulation or percutaneous tibial nerve stimulation) or botulinum toxin injections. Although all these options are valuable, they have their own limitations and may not be suitable for...

Should we let sleeping children lie?

Alarm therapy (AT) is a first line-treatment for nocturnal enuresis (NE) conditioning the child to wake in response to an auditory stimulus when wetting begins. It is currently unclear whether waking children and guiding them to urinate when the alarm...

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...

PFMT in males

Pelvic floor muscle training (PFMT) has been described since ancient times in Rome but Kegel popularised it to improve sexual and urinary health after childbirth. In the paediatric population, there is a paradigm shift towards biofeedback-based PFMT for lower urinary...

Increasing PSA after negative prostate biopsy - solving the clinical puzzle

There are standard guidelines for first transrectal ultrasonography (TRUS) guided biopsy in a patient presenting with elevated prostate-specific antigen (PSA) or suspicious digital rectal examination (DRE) findings. Patients are generally warned before a TRUS biopsy in respect of a false...