Stephen R. Keoghane

Trends in urological stone disease

Study Type – Therapy (case series)

Blood transfusion, embolisation and nephrectomy after percutaneous nephrolithotomy (PCNL)

Percutaneous treatment for renal stone disease is associated with a risk of significant morbidity. Our large UK series provides contemporary data on the risk of vascular complications and admission to the Intensive Care Unit (ICU) after PCNL. When compared with recent international databases, these data support the current evidence that better outcomes can be achieved in centres performing large numbers of procedures. These data add to the debate for the centralisation of specialist stone surgery.

Twelfth rib syndrome: a forgotten cause of flank pain.

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The natural history of untreated renal tract calculi

Evidence exists from cohort studies from the 1970s and 80s to guide us away from simply observing large kidney stones. In 1976, in a benchmark observational paper, Blandy and Singh [1] assessed the outcome of untreated staghorn calculi in 60 patients compared with 125 treated cases. In the group managed conservatively, a 10-year mortality of 28% was described compared with 7.2% for the treated group. Subsequently, 27% of the untreated group developed a life-threatening pyonephrosis and stones recurred in 17% of the treated patients. The following year, Rous and Turner [2] also described mortality rates as high as 30% in 30 patients with staghorn calculi managed without surgical intervention.

Radiation exposure to a pregnant urological surgeon – what is safe?

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