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Risk factors for BC after minimally invasive RNU

Bladder cancer (BC) after radical nephroureterectomy (RNU) has an approximate incidence of 20-50%. This contemporary multicentre study will inform the ongoing debate on risk factors for BC after minimally invasive RNU and how it may be prevented. Three hundred and...

Can transcutaneous peroneal nerve stimulation treat OAB?

The peroneal nerve follows sacral, pudendal, and tibial nerves as a target for overactive bladder (OAB) treatment. This multicentre prospective randomised RCT compared a transcutaneous electrical neuromodulation system (eTNM) at-home treatment once daily for 30 minutes to solifenacin 5mg once...

Non-urothelial bladder malignancies

Case 1 An 80-year-old gentleman presented with a history of visible haematuria and recurrent urinary tract infections (UTIs). He has been performing intermittent self catheterisation (ISC) for detrusor underactivity for over 20 years. A flexible cystoscopy showed these appearances of...

Clinical trials 1

Clinical Trials 2 is available here. Case 1 1. What are the levels of clinical evidence based on the 2009 definitions from the ‘Oxford CEBM’? 2. What is the null hypothesis? 3. What are type 1 and type 2 errors?...

The transition from surgeon to manager during the COVID-19 response

Writing this article on the first Sunday in May, when in any other year, I would be wearing my bowler hat in Hyde Park for the annual Cavalry Memorial Parade, a time ‘pre-COVID’ does seem a very distant memory. Having...

Dogs and humans share a bladder cancer biomarker: a new discovery that opens doors for early detection and treatment

A new scientific study has identified a new molecular biomarker that could help doctors detect aggressive early-stage bladder cancer, such as high-grade non-muscle invasive bladder cancer (NMIBC), in both dogs and humans. This discovery advances our knowledge of how aggressive...

An introduction to research governance

Research is the process of acquiring new generalisable knowledge and should be fully integrated into healthcare work. There is a growing drive to encourage and further develop evidence-based practice in medicine so that staff and patients benefit from improved healthcare...

History of prostate biopsy – part 1

Part 2 of this topic is available here. Prostate biopsy (PBx) to exclude cancer has been part of clinical practice since the beginning of the 20th Century. PBx techniques have evolved over time to optimally address some of the unique...

Intravesical glycosaminoglycan analogue instillations for recurrent cystitis

Introduction The symptoms of recurrent cystitis can be triggered by inflammatory or infective causes. Bladder pain syndrome (BPS) and bacterial recurrent lower urinary tract infection can both present with symptoms of recurrent cystitis and cause significant morbidity in affected individuals....

Surgical treatment of LUTS secondary to BPH

For the vast majority of patients an initial trial of medical therapy for the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is indicated [1]. In a substantial minority of cases however, a surgical intervention...

Can antibiotics reduce ‘unnecessary’ prostate biopsies?

With numerous factors capable of influencing prostate specific antigen (PSA) levels and therefore the likelihood of biopsy, this multi-centred randomised controlled trial (RCT) was designed to see if two weeks of ciprofloxacin compared to placebo would significantly reduce PSA levels...

Inguinal vs. scrotal orchidopexy

Undescended testes occur in 1-3% of newborns; the prevalence is even higher in premature babies. Traditionally the surgical approach has been inguinal orchidopexy, involving two incisions – inguinal and scrotal. In 1989, Bianchi and Squire proposed single scrotal incision orchidopexy...