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Renal fossa recurrence after nephrectomy for renal cell carcinoma

This paper is an analysis of 36 years of radical nephrectomy for renal cell carcinoma in the Mayo Clinic (1970-2006). In particular, it contains an analysis of the risk of renal fossa recurrence after nephrectomy (partial nephrectomies are not included)...

Focal therapy for prostate cancer – ready for prime time?

The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...

Smith’s Textbook of Endourology, 2 Volume Set, 4th Edition

Since the founding fathers of endourology first published this textbook in 1996, the surgical vista has been changed unrecognisably by technological advances. Laparoscopic approaches have become commonplace for renal, ureteric, bladder and prostatic surgery, and robotic-assisted techniques have developed with...

Has laparoscopic radical prostatectomy had its day?

Over recent years there has been a massive uptake in robotic surgery particularly for robot-assisted prostatectomy. The drive for this has been patient and physician led with little in the way of prospective randomised trials showing benefits over established operative...

Modern management of small renal masses

With the advent of widespread cross-sectional imaging there has been a surge in incidental detection of small renal masses (SRMs) and renal cell carcinoma (RCC) is now the seventh most common cancer in the UK. Whilst surgical excision for larger...

Overview of partial nephrectomy techniques: influence of technology

Traditionally, radical nephrectomy was the preferred operation for kidney cancer, while partial nephrectomy was reserved for specific circumstances and essential indications such as a tumour in a solitary kidney, bilateral kidney tumours, or severe chronic kidney disease (CKD). Given the...

Frailty in urology – part 2

The first article in this series defined frailty and introduced the concept and importance of identifying patients living with frailty who undergo surgery, including those undergoing urological procedures. In the second part of this series we outline how to identify...

Recent developments in bladder cancer

There have been some exciting developments in bladder cancer over the last few years. Immunotherapy has prolonged survival in a proportion of patients with metastatic disease, with sustained efficacy in some. Advances in genetic analysis and molecular subtyping make personalised...

PREDICT Prostate – individualised, evidence-based estimates of survival and treatment benefit

Earlier this year ‘PREDICT Prostate’ was launched online alongside a high-profile publication in PLOS Medicine. The prognostic model and decision-aid has been designed to inform treatment decision-making among men newly diagnosed with non-metastatic prostate cancer. David Thurtle and Vincent Gnanapragasam...

BCG after TURBT – does timing matter?

Intravesical bacille Calmette–Guerin (BCG) therapy continues to be widely used for patients with intermediate / high-risk non-muscle invasive bladder cancer (NMIBC). In this article, the researchers identified the lack of sufficient evidence with regards to timing of BCG after transurethral...

Active surveillance for small renal masses in younger patients

Active surveillance (AS) is discussed as an option for renal masses <2cm in patients with significant competing risks for mortality. This multicentre data from the US seeks to fill an important gap in current guidelines for provision of this option...

Beware of the ambiguous testicular lump

In busy day-to-day practice, we are often faced with puzzling situations. A useful mnemonic is 4-T: torsion, trauma, tumour and tuberculosis (infections). This case review in the BMJ is about a 34-year-old man presenting to A&E with left testicular pain...