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Results of HoLEP in patients with prostate cancer and LUTS

Holmium laser enucleation of the prostate (HoLEP) is recommended for the management of benign prostatic obstruction. With similar functional outcomes and less morbidity compared to transurethral resection of the prostate (TURP), it has become a useful tool in the armament...

Ketamine uropathy – an update

The first two case series that documented the association between urinary tract damage and recreational ketamine use were published 12 years ago [1,2]. Since then ketamine has maintained a controversial profile as an essential medication of expanding utility but with...

Percutaneous ultrasound guided endoscopic lavage of perinephric abscess – different, but not necessarily better

Perinephric abscess is an uncommon but serious form of urosepsis. It develops as a consequence of the extension of an infection outside of the parenchyma of the kidney in acute pyelonephritis, or more rarely from haematogeneous spread of an infection...

Pacemakers in the upper urinary tract

This is an interesting study from Italy. The mechanism by which urine is transported from the kidney to the bladder via the upper urinary tract (UUT) remains poorly understood and elusive. For many years, pyeloureteric rhythmicity is thought to arise...

Trials offering cytoreductive surgery for men with de novo synchronous metastatic prostate cancer

Life expectancy in men diagnosed with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) has risen to a median of 4.8 years with upfront systemic agents (such as docetaxel) in addition to standard androgen deprivation therapy (ADT) [1-3]. Within this...

Hail the Portfolio Pathway!

In the United Kingdom, the pursuit of a surgical career traditionally follows a conventional pathway, primarily through the completion of specialty programmes accredited by the Royal College of Surgeons or the Intercollegiate Surgical Curriculum Programme (ISCP). However, for doctors with...

Prostate artery embolisation

Introduction Benign prostatic hyperplasia (BPH), a common condition associated with ageing, affects 50% of those between the ages of 50 and 60 years, and as many as 90% of those older than 80 years. BPH is characterised by unregulated, benign...

What is the role of evidence-based medicine in urology?

The concept of ‘evidence-based medicine’ (EBM) was first developed in the early 1990s and was described as “the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients” by the recently...

A negative ureteroscopy for stone disease: is it acceptable and is it avoidable?

Urinary tract stone disease and the consequent demand for endoscopic intervention in the upper urinary tract is an increasing phenomenon [1]. Although ureteroscopy is generally considered to be associated with low morbidity [2], risks do exist. Recognised complications include urothelial...

Metastatic spinal cord compression – a review

Introduction Metastatic spinal cord compression (MSCC) is an oncological emergency that, unless diagnosed early and treated appropriately, can lead to significant morbidity and mortality, including paralysis and bladder and bowel dysfunction. MSCC can be defined as spinal cord or cauda...

Mindfulness-based stress reduction as a novel treatment for IC/PBS

Interstitial cystitis / painful bladder syndrome (IC / PBS) is not fully understood and is associated with significant morbidity. The objective of this study was to provide initial data to evaluate mindfulness-based stress reduction (MBSR) as a treatment for IC...

Imaging and surveillance in sporadic renal angiomyolipoma: how and when to monitor effectively

Renal angiomyolipoma (AML) are benign tumours, accounting for approximately 2–3% of all renal neoplasms [1]. Seventy percent of renal AMLs are sporadic, and 20–30% are associated with genetic aetiology. They are composed of smooth muscle, blood vessels, and adipose tissue....