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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...

Consent: your obligations in the modern, post-Montgomery era

There has been so much recent discussion and so much emphasis placed on the fundamental right that we all have to determine what is or is not done to us, the right to self-determination, that it would be either a...

Use of Clavien-Dindo classification in urology part 2 – upper tract

A classification system of surgical complications was proposed by Clavien in 1992 [1] and further modified by Dindo in 2004 [2]. Clavien-Dindo classification has since then been validated through many retrospective case series as well as in comparative studies to...

Read all about it Sep/Oct 2018

For this article we are ditching the usual format and looking instead at some the standout posters and papers from the recent BAUS meeting that have the potential to inform, change and influence your practice in the near future. Whilst...

Upper Tract Developmental Abnormalities

Case 1 1. What is the abnormality and how common is it? 2. What is the embryological origin? 3. With what other conditions can this be associated? Case 2 1. What is the diagnosis and how common is it? 2....

Management of urological issues following genital gender affirmation surgery for individuals assigned female at birth

Gender incongruence arises when there is a mismatch between an individual’s gender identity and their sex assigned at birth. Genital gender affirmation surgery (GAS) is the final step of transition for transgender and non-binary individuals who experience gender incongruence. This...

Ipsilateral ureteroureterostomy: does function of the obstructed moiety matter?

Upper pole nephrectomy has been the traditional surgical management of children with poorly functioning upper pole moieties in duplex renal collecting systems having ureteral ectopia and ureterocele. However, ablative surgery confers a risk of functional loss to the remnant moiety...

An update on lower pole stone management for 2015

Introduction Urolithiasis is an increasing healthcare problem, with an estimated lifetime prevalence of up to 15% [1]. The number of interventions undertaken for stone disease has increased dramatically over recent years, particularly with respect to ureteroscopy and percutaneous nephrolithotomy (PCNL)...

Pain relief after removal of non-obstructive renal calculi

Non-obstructing stones are often not considered to be the source of pain, and probably most are not. This is because flank pain associated with a stone is typically caused by a stone that obstructs urinary flow, which increases intraluminal pressure...

All you need to know about percutaneous nephrolithotomy: supine versus prone and mini versus traditional

Introduction Since the first percutaneous nephrolithotomy (PCNL), the technique has undergone many innovations, including modifications in positioning, miniaturisation of instruments and combination with retrograde intra-renal surgery (see Table 1 for an outline of the history of the technique). Controversy has...

Pyonephrosis: is the kidney always doomed?

Pyonephrosis (Greek pyon ‘pus’ + nephros ‘kidney’) is defined in Campbell-Walsh Urology [1] as an infected hydro-nephrosis associated with suppurative destruction of the renal parenchyma which results in total or near total loss of renal function. The true incidence of...

Functional and reconstructive urology

Case 1 A 45-year-old female presents with a one-year history of urinary leakage, especially worse on coughing. She is otherwise well, with no co-morbidities. What is the International Continence Society (ICS) definition of stress urinary incontinence (SUI)? What are the...