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Transfer to tertiary paediatric hospitals for patients with testicular torsion
Although this articles comes from a tertiary centre in Columbus, USA, there are similarities with the current controversies in the UK. The authors carried out a five-year retrospective review looking at the surgical transfer of 125 patients (mean age 13.4,...
Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer
Abiraterone acetate, the prodrug of abiraterone, blocks endogenous androgen synthesis by inhibiting cytochrome p-450c17, a critical enzyme in androgen biosynthesis. Its active D4A metabolite also has anti-tumour effects through possibly multiple mechanisms. 3-5% of men diagnosed with prostate cancer in...
Non-urologist non-physician assessment of scrotal pain using the TWIST score
Testicular torsion is a urological emergency that requires prompt diagnosis and intervention. Some providers are becoming increasingly dependent on ultrasound (US) to make the diagnosis. This NIH clinical trial evaluated the use of the TWIST (Testicular Workup for Ischaemia and...
Outcomes of renal cancer surgery on renal function and mortality on those with and without CKD
In urology we are encountering an ageing and more comorbid population, including a group of patients with chronic kidney disease (CKD). In this retrospective study, a group from the Cleveland Clinic present the extended follow-up of patients with and without...
Ureteral clipping in children – longer term outcomes of a novel treatment
In this article, Lopes et al. report longer term outcomes of laparoscopic clipping of ureters of non-functioning kidneys or non-functioning renal moieties in duplex kidneys associated with ectopic ureter or obstructive ureteroceles. In 2014, their group published a promising preliminary...
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...
Tamsulosin and spontaneous passage of ureteral stones in children
This was a retrospective analysis of data for five years from four institutions comparing stone passage rates in children with ureteric stones ≤10mm, aged 2-18, treated with tamsulosin vs. analgesia alone. The study identified 449 children, of whom 334 were...
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...
Prostatic artery embolisation – an option for select BPO patients
Few proponents of prostatic artery embolisation (PAE) regard it as a potential standard in future for benign prostatic obstruction (BPO) / benign prostatic hyperplasia (BPH) treatment. Present guidelines from the National Institute for Health & Care Excellence (NICE) and the...
Curing pure CIS with radical surgery: lessons learned
As carcinoma in situ (CIS) theoretically has no ability to invade or metastasise, performing radical cystectomy for CIS-only disease should be curative. In this single centre review over 37 years, 1964 patients undergoing cystectomy were analysed with 52 undergoing surgery...
New concepts, emerging technologies and potential therapeutics in testicular torsion
This review article is worthy of reading in its entirety. It addresses current concepts in the management of one of the few paediatric urological emergencies. For every 100,000 males <25 years, 4.5 will have testicular torsion per year. Given that...
