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Long-term risks of augmenting the bladder in spina bifida patients

Bladder augmentation is utilised to treat children with neuropathic bladders secondary to spina bifida that results in hostile urodynamics, renal deterioration and / or urinary incontinence. Whilst it is associated with an improved quality of life and low mortality, it...

Trade-offs between risks and benefits of localised prostate cancer treatments – the COMPARE study

We know little about the trade-offs men make when considering the oncological and functional outcomes of individual treatment options for localised prostate cancer, and decisions are often influenced by physician opinion. The likely compromised functional results are viewed as a...

Prostatic artery embolisation versus sham

Randomised trials with use of sham is uncommon in the surgical literature, which makes this paper more interesting. Many different treatments are available for treating lower urinary tract symptoms / benign prostatic hyperplasia (LUTS / BPH). Prostatic artery embolisation (PAE)...

Beware of the ambiguous testicular lump

In busy day-to-day practice, we are often faced with puzzling situations. A useful mnemonic is 4-T: torsion, trauma, tumour and tuberculosis (infections). This case review in the BMJ is about a 34-year-old man presenting to A&E with left testicular pain...

Repeat transurethral resection in non-muscle invasive bladder cancer

The authors felt this is a big problem because there is no standardised practice on re-resection following initial transurethral resection of bladder tumour (TURBT). Getting detrusor muscle in the first specimen is thought to be important. However muscle is not...

Morbidity and mortality after surgery for LUTS

The market for bladder outflow obstruction surgery is currently wide open with new technologies such as Urolift® emerging. One of the key selling points of new technologies is the comparative safety and efficacy compared to traditional techniques such as transurethral...

How successful is the transition to adult urology care in spina bifida?

These authors from Indianapolis, USA, aimed to assess rates and predictors of successful transition into adult care of spina bifida patients. They did this by a retrospective review of 77 patients discharged from a multidisciplinary paediatric clinic at a mean...

Uncovering the fate of small residual fragments

The concept of ‘stone free’ remains an enigma. To some urologists this refers to complete removal of all visible fragments, to others its removal of all ‘clinically significant’ fragments (generally regarded as fragments >2mm), and to some it is absence...

Performance status may alter outcomes in those treated with abiraterone

The drug therapies available for those with metastatic castrate-resistant prostate cancer have increased over the past few years. Abiraterone, a CYP17 inhibitor, has been proven effective in phase three trials, however those with poor performance status were largely under-represented in...

Impact of adjuvant radiation therapy on urinary continence recovery after radical prostatectomy

The functional side-effects of both radical prostatectomy and radiotherapy for prostate cancer are well known. The aim of this study was to evaluate if there was a significant worsening in recovery of urinary continence in those undergoing radical prostatectomy followed...

Prevention of urethral stricture recurrence

Urethral stricture recurrence after urethral reconstruction is one of the most challenging problems in urology. With the increase in endoscopic surgery over the last three decades the incidence of urethral strictures has increased, with iatrogenic manipulation the leading aetiology in...

Button vesicostomy

Poor bladder emptying often requires clean intermittent catheterisation (CIC). In significant numbers of children CIC is not possible for a variety of reasons and an alternative is needed. This paper reviews a single centre’s usage of the vesicostomy button over...