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Ten years of experience with intravesical and intrasphincteric botulinum toxin A in children
This is one of the longest follow-up studies of botulinum toxin A usage in children with bladder dysfunction in the paediatric literature. Fifty-three children had Botox® (Allergan) injected for a variety of reasons (spina bifida – 18, acquired cord injury...
Laparoscopic transposition of renal lower pole crossing vessels
The vascular hitch procedure for pelvi-ureteric junction obstruction (PUJO) was initially described by Hellstroem in1951 and has become popular again since the introduction of laparoscopy. There is still much controversy as to its efficiency. The authors of this paper analyse...
BCG maintenance therapy not superior to induction alone
With the ongoing shortage of BCG remaining an issue for urologists in the UK and further afield, this topical paper presented the results of the CUETO study evaluating the outcome of a modified three-year BCG maintenance regimen versus induction therapy...
Impact of case volume on outcomes of ureteroscopy for ureteral stones
With the ever-increasing focus on patient safety, centralisation of services for major procedures is becoming more common. Using data from the Clinical Research Office of the Endourological Society (CROES) Ureteroscopy Global Study database, a prospective observational multicentre study created to...
CRP to predict the need for surgical intervention in acute renal colic
A previous paper has suggested that C-reactive protein (CRP) is a useful serum marker for determining the likelihood of a patient with renal colic requiring surgical intervention, the cut-off level being >28mg/l (specificity 88.9%, sensitivity 75.8%). This prospective observational study...
Can continence and volitional voiding be achieved in bladder exstrophy?
Bladder exstrophy is a challenge to the paediatric urologist; here in the UK, repairs are now undertaken at two centres in order to concentrate experience. The ultimate aim is to achieve urinary continence and volitional voiding. In this study, John...
Multiparametric MRI with targeted-only biopsy – a new standard?
In this issue of European Urology, Kasivisvanathan et al. present a meta-analysis of two randomised trials comparing prebiopsy MRI with targeted biopsy (TBx) alone versus standard transrectal ultrasound-guided biopsy (TRUS-Bx) in biopsy-naïve men at risk of prostate cancer. Their findings...Clinical trials 1
Clinical Trials 2 is available here. Case 1 1. What are the levels of clinical evidence based on the 2009 definitions from the ‘Oxford CEBM’? 2. What is the null hypothesis? 3. What are type 1 and type 2 errors?...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...
Lichen sclerosus and isolated bulbar urethral stricture disease
The incidence of urethral stricture in men with lichen sclerosus (LS) has been reported to be between 4.8% and 14%. LS limited to the glans and urethral meatus can be treated with acceptable outcomes; however, more extensive urethral disease requires...
Low dose PDE5I in IC
This is a randomised, double-blind, placebo-controlled trial to evaluate the efficacy of daily low-dose sildenafil (25mg) for the treatment of non-ulcer interstitial cystitis (IC) in women. Forty-eight women with clinical diagnosis of IC, from three centres, were equally randomised to...
