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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...

Preparing for the FRCS (Urol) viva

Ping! You look down to your phone and you have just received an email saying, “Congratulations, you have now successfully completed The Joint Committee on Intercollegiate Examinations section 1 of the Fellowship of the Royal College of Surgeons (Urol) exam.”...

Essentials of Robotic Surgery

Essentials of Robotic Surgery is an ambitious attempt to educate the readership on the history and current applications of robotic surgery in today’s operating theatre. Aimed at primary care providers and other health care specialists, it provides an overview on...

Urinary tuberculosis and the busy urologist!

This article is a very good read for any busy urologist. When in medical school, we were taught that tuberculosis (TB) was rare in the UK and other developed countries. We have come full circle; now there are increasing cases...

The life of a urology trainee in Singapore

Despite the political and cultural differences between the United Kingdom and Singapore, the quality and nature of the medical training systems remain uniquely similar. It will come as no surprise to those of you who have either worked in Singapore...

Urological trauma – part 1

Part 2 of this topic is available here. Case 1 A 45-year-old male presented with acute onset abdominal pain following a fall whilst out drinking. A CT cystogram was arranged as he developed haematuria and acute renal impairment. 1. What...

Is outpatient robotic surgery feasible in children?

Minimally invasive surgery has helped to achieve shorter hospitalisations, reduce postoperative pain and analgesia requirements and provides better cosmetic results. Robotic urological outpatient surgery has been examined in recent times in the adult population; here Neheman et al. look at...

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...

Laparoscopic transposition of renal lower pole crossing vessels

The vascular hitch procedure for pelvi-ureteric junction obstruction (PUJO) was initially described by Hellstroem in1951 and has become popular again since the introduction of laparoscopy. There is still much controversy as to its efficiency. The authors of this paper analyse...

Prenatal spina bifida repair – does it have urological benefits in the longer term?

At present, I have one patient under my care who underwent prenatal closure of his spina bifida defect. Only with time, will we be able to determine whether this intervention has been of benefit for him from a urological standpoint....

Upper tract abnormalities

Case 1 Figure 1. A 26-year-old female presents to A&E with loin pain. What do the CT images in Figures 1 (left, centre and right) show? What is the prevalence of the congenital anomaly in the general population, and is...

Assessing resolution of isolated hydronephrosis – is APPD superior to the SFU system?

Antenatal scanning detects urinary tract dilatation in 1-5% of pregnancies. Isolated hydronephrosis (i.e., that not due to secondary dilatation e.g. bladder dysfunction) is known to resolve or improve in most; some patients may, however, require intervention through deterioration of obstruction...