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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...

Robot-assisted ureterocalicostomy

Ureterocalicostomy was first introduced by Neuwirt (1947) and further described by Jameson et al. (1957) as an alternative procedure for repair of pelviureteric junction (PUJ) obstruction associated with an intrarenal pelvis. Performing ureterocalicostomy for PUJ repair has been suggested in...

Urological trauma – part 2

Part 1 of this topic is available here. Case 1 A 29-year-old male was attacked and kicked in his left flank. He presented to the emergency department with left flank pain and frank haematuria. He remained haemodynamically stable. 1. What...

Urachal anomalies in children: surgical or conservative treatment?

Urachal anomalies are rare with an incidence of 1:5000-8000 live births. There is still some controversy as to whether to treat them expectantly or surgically with published reports describing malignant changes in adulthood. These authors describe their retrospective series of...

Is renal pelvis reduction during dismembered pyeloplasty necessary?

The development of laparoscopic pyeloplasty has progressively led to a reduction in the amount of perioperative renal pelvic excision as a large excision leads to a longer anastomosis with associated increased risks (leak, operative time). This prospective study of 40...

PUJO: Hellstrom principle revisited

This paper describes the result of four out of twenty-three cases (two males, two females) of pelvi-ureteric junction obstruction - PUJO - (mean age 18.25 years, range 16-20), mean follow-up two years (range six months – three years) that were...

Demanding cases or nightmares in uro-oncology? May/Jun 2021

It’s not in the bag until it’s out of the abdomen: abdominal wall recurrence after ruptured retrieval bag during robot-assisted partial nephrectomy We present a case of failure of a specimen retrieval bag during a robot-assisted partial nephrectomy resulting in...

Overview of partial nephrectomy techniques: influence of technology

Traditionally, radical nephrectomy was the preferred operation for kidney cancer, while partial nephrectomy was reserved for specific circumstances and essential indications such as a tumour in a solitary kidney, bilateral kidney tumours, or severe chronic kidney disease (CKD). Given the...

Clinical visit for PCNL experience: Agra, India

In September 2015, I travelled to India for a two-week clinical visit with Professor Madhu Sudan Agrawal at the Global Rainbow Hospital, Agra. Having completed my training I wanted to further develop my skills with PCNL, particularly with regards to...

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...

Management of calyceal diverticular stones using ultramini PCNL

Calyceal diverticulae are congenital smooth-walled, non-secretory urothelium-lined cavities within the renal parenchyma that communicate with calyceal fornix through a diverticular neck. They were first described by Rayer in Traitements des maladies des reins [1]. Calculi occur in approximately 9.5% to...

Use of Clavien-Dindo classification in urology part 1 – pelvic surgery

There is no widely accepted system to classify postoperative complications. It is necessary to compare the outcome and complications while validating a new surgical procedure or one of the surgical approaches of a particular condition. Several parameters have long been...