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Who should be taking care of the adolescent with testicular torsion?

From time to time (as paediatric surgeons), we receive referrals from regional hospitals to explore the testis in older boys. Given the time-critical nature of the condition, patients should benefit from assessment and surgery performed locally (when possible). Inter-hospital transfer...

Is TRUS and biopsy obsolete as a diagnostic test for prostate cancer: refining the perineal biopsy technique?

Whilst there has been a dramatic shift in how patients are investigated for potential prostate cancer, transrectal ultrasound (TRUS) and biopsy remains the most commonly used technique for tissue sampling. In this single centre, retrospective analysis, 634 men, over a...

Model to predict malignancy among Bosniak III cysts

This retrospective study over a 15-year period is to identify independent predictors of malignancy in Bosniak III (BIII) renal lesions and to build a prediction model based on identifiable clinical variables. These cysts, characterised by contrast-enhanced computed tomography (CECT), have...

Does more equal less in the management of acute renal colic?

Radiographs of kidneys, ureter and bladder (KUB) have long been used in the follow-up of patients with ureteral stones to reassess stone position and surgical planning. Emergence of computed tomography (CT) as the gold standard for the diagnosis of ureteral...

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...

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...

Is robotic pyeloplasty in the under-ones as good as open repair?

Pelviureteric junction obstruction (PUJO) is a common cause of paediatric hydronephrosis. Indications for intervention include reduced renal function (<40%), symptoms (urinary tract infection or pain) and increasing dilatation. Although the Anderson-Hynes open pyeloplasty (OP) has long been the gold standard...

Biopsy should be considered for older boys (>10 years) undergoing orchidopexy for intra-abdominal testes

Cryptorchidism is associated with a 3 to 10-fold increase in malignancy and the age at which it is undertaken matters; the risk of testicular cancer is doubled in patients undergoing orchidopexy at 13 years of age compared to that treated...

Outcomes of sarcomatoid differentiation in urothelial carcinoma

Sarcomatoid differentiation is a rare variant of urothelial carcinoma (UC) seen in 0.6% of cases. Its response to neo-adjuvant chemotherapy (NAC) has not been well reported. The authors have done a retrospective analysis of patients undergoing cystectomy between 1995 and...

Effect of DUA on surgical outcomes of HoLEP

Lower urinary tract symptoms (LUTS) become increasingly common in men as they age, with over 70–90% of men aged over 80 experiencing these issues. Detrusor underactivity (DUA) is characterised by a weakened bladder contraction, leading to prolonged or incomplete bladder...

Treatment options for renal cell carcinoma

In this issue of European Urology, experts review advancements and challenges in treating renal cell carcinoma (RCC), emphasising the complexity of managing a disease with an expanding array of therapeutic options. Despite significant progress, critical questions remain about treatment sequencing,...

Surgical video – part 1: intraoperative video recording and storage

The use of digital technology has progressed in leaps and bounds and nowhere is this more apparent than in medicine and surgery. Footage of live surgery is now easily accessed on the internet or displayed at conferences. Thus, the 21st...