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Update on immunotherapy for non-muscle invasive transitional cell carcinoma of the bladder

Patients with high-risk non-muscle invasive bladder cancer (NMIBC) that have failed Bacillus Calmette-Guérin (BCG) treatment are a difficult group to treat, and many may not be suitable for the preferred treatment option of radical cystectomy. Bladder-preserving treatments for BCG-unresponsive high-risk...

Small renal masses – diagnosis and management

Renal cancer is the eighth most common cancer in the UK and accounts for about 3% of all new cancer diagnoses [1]. The incidence rates are steadily rising, with the highest rates being in older men and women. This rise...

A guide to percutaneous nephrolithotomy

Percutaneous nephrolithotomy (PCNL) is now the gold standard approach to treating large renal stones. Since its development in the 1970s, it has undergone a series of refinements that could only have been possible with the symbiosis of both radiological and...

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,...

Optimisation of childhood spina bifida management – a prospective trial

Routh et al. describe a prospective trial which aims to determine the optimal urological management for children with spina bifida. The primary aim of neuropathic bladder management is to provide the patient with the best long-term quality of life with...

Worldwide flexible ureteroscopy practice uncovered

While guidelines recommend flexible ureteroscopy (fURS) for treating renal stones <1.5cm, considerable differences exist among urologists in the technique, use, and indications of fURS. In 2014, the Endourology Society set out to explore the differences in the fURS technique and...

Stepwise voltage ramping causes less renal haematomas than fixed maximal voltage ESWL

Extracorporeal shock wave lithotripsy (ESWL) remains the recommended first line treatment for stones <2cm in the renal pelvis and upper or mid-pole calyces (Türk C, Knoll T, Petrik A, et al. European Association of Urology Guidelines on Urolithiasis. 2014). There...

Is AS in SRM more convincing than in prostate cancer?

This article reviews active surveillance (AS) in the management of small renal masses (SRM), the role of renal tumour biopsy (RTB), patient selection, tumour growth kinetics, and outcomes. SRMs which are defined as masses ≤4 cm in diameter and enhance...

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...

Long-term consequences of posterior urethral valves

These two papers give a very good summary of the long-term effects of posterior urethral valves (PUV) into adulthood and are worth a read. Pereira et al. It is well known that the consequences of posterior urethral valves extend well...

Demanding cases or nightmares in uro-oncology? Jan/Feb 2022

When less is more: percutaneous biopsy and tumour seeding in papillary renal cell carcinoma Renal cell carcinoma (RCC) accounted for 2.2% of new cancer diagnoses worldwide in 2018 with over 400,000 new cases and 175,098 deaths [1]. The majority of...

Modern management of small renal masses

With the advent of widespread cross-sectional imaging there has been a surge in incidental detection of small renal masses (SRMs) and renal cell carcinoma (RCC) is now the seventh most common cancer in the UK. Whilst surgical excision for larger...