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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...

Local tumour bed recurrence following partial nephrectomy

In this interesting retrospective study, the authors looked at the incidence of local tumour bed recurrence after partial nephrectomy (PN), the factors associated with that, and the management. A total of 2,271 patients’ charts were reviewed who underwent partial nephrectomies...

Managing staghorn calculi – a return to the dark ages of stone surgery with the aid of the robot

Khurshid Ghani and colleagues present a novel, yet all too familiar, approach to the management of patients with staghorn calculi, in the form of anatrophic nephrolithotomy - however with the aid of a robot. The aim of this study is...

Supranormal function on MAG-3 – what is its significance and how to predict?

Differential renal function (DRF) on MAG-3 scans is typically used in patients with pelvic ureteric junction obstruction (PUJ obstruction). Supranormal DRF is when the kidney with PUJO has higher DRF than the normal contralateral kidney. The authors in this study...

Coronaviruses and kidney injury

This is a topical review of the effects of coronaviruses on the kidney and includes a description of the mechanisms of kidney damage by SARS, MERS and COVID-19. The authors quote two previous reports which estimate the incidence of acute...

Chronic retention – all you need to know

Chronic retention – all you need to know Chronic urinary retention is a common presentation in elderly and frail patients. Two types should be recognised - low pressure chronic retention (LPCR) and high pressure chronic retention (HPCR). Acute-on-chronic retention occurs...

Infections and inflammation: Part 3

See also Part 1 and Part 2 Case 1 You review a man in the Emergency Department with scrotal pain and sepsis. His clinical examination findings are shown. What does this image show? Who was this condition named after? What...

Laparoscopic ureteral ligation (clipping)

Ectopic ureters in the presence of an upper moiety duplex kidney, or non functioning upper moieties, are traditionally treated with a heminephrectomy (open or laparoscopic). This carries significant risks, especially loss of the remaining lower moiety. These authors describe a...

MRI scans and cardiac devices

There is an increasing use of MRI in many urological disorders e.g. prostate cancer and renal cancer. Many patients with cardiac pacemakers or implantable cardioverter defibrillators (ICD) are denied access to MRI scans due to safety concerns. MRI is given...

Model to predict malignancy among Bosniak III cysts

This retrospective study over a 15-year period is to identify independent predictors of malignancy in Bosniak III (BIII) renal lesions and to build a prediction model based on identifiable clinical variables. These cysts, characterised by contrast-enhanced computed tomography (CECT), have...

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...

Post radical nephrectomy presenting with skull metastasis

We present the case of an 83-year-old female who underwent right radical nephrectomy for renal cell carcinoma (RCC). Despite negative surgical margins, the patient presented with a skull metastasis six years post radical nephrectomy. This case highlights the importance of...