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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...

Thermal ablative techniques for small renal masses

The incidence of renal cell carcinoma has increased over the past decade which can be partly attributed to the increased use of imaging modalities [1,2]. Nephron sparing procedures for the management of small renal tumours have gained popularity which include...

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...

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...

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...

Predictive factors for conservative treatment failure in paediatric blunt renal trauma

Blunt renal trauma is managed conservatively in children in the vast majority of cases. Grade IV renal injury is also generally managed non-operatively although occasionally intervention is needed for a urinoma that fails to settle. These authors retrospectively looked at...

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...

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...

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...

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...

Antimuscarinics and behaviour in patients with spinal dysraphism

Since the 1980s patients with spinal dysraphism have had aggressive bladder management with clean intermittent catheterisation and anticholinergic therapy from early on in life. This strategy aims at improving lower and therefore upper urinary tract function thus decreasing the risk...