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The role of continuous prophylactic antibiotics following JJ stent insertion
Urinary tract infections (UTI) and stent-related symptoms (SRS) are frequently recognised complications of ureteric stent placement. Antibiotic administration at induction prior to ureteric stent insertion is recommended by the European Association of Urology (EAU). Commencing prophylactic antibiotics for the ‘entire...
Can PET/CT help in selecting treatment for patients with muscle-invasive bladder cancer more appropriately?
Radical cystectomy is one of the most drastic procedures that urological patients have to undergo with a five-year mortality of around 50% in those with organ-confined disease at presentation. Traditional imaging is with contrast-enhanced computed tomography (CT) but lymphadenectomy often...History of prostate biopsy – part 2
For Part 1 of this topic is available here. The major limitations of the transrectal ultrasound (TRUS) guided prostate biopsy (PBx) protocols are the risk of profound sepsis and the risk of persistently significant false negative rates, related to the...
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...
Intravesical cytosine arabinoside + Mitomycin C for bladder cancer – is it beneficial?
Mitomycin C (MMC) is often used as an intravesical therapy for low / intermediate risk non-muscle invasive bladder cancer. This randomised controlled trial (RCT) was designed to assess the safety and efficacy of MMC + cytosine arabinoside (Ara-C). Ara-C was...
To clamp or not to clamp – outcomes of the CLOCK trial for robotic partial nephrectomy
The benefits of partial over radical nephrectomy are well established. The CLOCK trial (CLamp vs. Off Clamp the Kidney during robotic partial nephrectomy) was designed as a multicentre, randomised controlled trial to generate evidence on the role of the off-clamp...
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...
Curing pure CIS with radical surgery: lessons learned
As carcinoma in situ (CIS) theoretically has no ability to invade or metastasise, performing radical cystectomy for CIS-only disease should be curative. In this single centre review over 37 years, 1964 patients undergoing cystectomy were analysed with 52 undergoing surgery...
Can antibiotics reduce ‘unnecessary’ prostate biopsies?
With numerous factors capable of influencing prostate specific antigen (PSA) levels and therefore the likelihood of biopsy, this multi-centred randomised controlled trial (RCT) was designed to see if two weeks of ciprofloxacin compared to placebo would significantly reduce PSA levels...
Surgical and pathological outcome of partial nephrectomy: robotic versus laparoscopic approach
Nephron sparing surgery has become the standard surgical treatment for small renal masses (<4cm). Laparoscopic partial nephrectomy (LPN) is shown to be superior to the open approach (OPN) in peri and postoperative morbidity; however, it requires advanced skills and has...
Cryotherapy for small renal masses: better than surveillance?
With the rapid rise in incidental small renal mass detection, some of which have malignant potential, comes the need to either survey or treat these masses safely and with minimal morbidity. This large series of 147 patients with 171 masses,...
