“SEER-UROLOGY”

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“It’s a gold mine!” said someone to me once about the Surveillance, Epidemiology, and End Results (SEER). Most of you are probably aware of the existence of this large observational population-based cohort of the National Cancer Institute in the United States. The quality of the SEER’s data collection and the immense pool of information on patient socio-demographics, morphology, therapeutic treatment and long-term follow-up for vital status (and more) are nothing short of extraordinary. Officially,…

Humour and the doctor-patient interaction: thoughts from a urological perspective

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The Urologist cursed with contempt at his finger in the air, discussing with me his practice of prostatic massage, “I’ve had to learn to use my left pointer, the right one developed osteoarthritis”. A moment of silence, then laughter! From medical school I observed the different ‘phenotype’ of consultant between the specialties and noted the way certain personality types appeared attracted to particular fields. Whilst plastic surgeons displayed a dichotomy of perfectionism and relaxed…

Anaesthesia for robotic-assisted laparoscopic radical prostatectomy

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Here’s my technique for anaesthetising patients for robotic-assisted laparoscopic radical prostatectomy and I’d be interested to hear any thoughts, comments and ideas. Pre-op. I try to fast the patients for as short a time as possible and also include pre-operative carbohydrate loading. This is in line with Enhanced Recovery After Surgery (ERAS) Guidelines for major bowel surgery and has been shown to reduce the negative nitrogen balance that occurs following major surgery. I use 200ml cartons…

The X-Factor, Reality TV, and Live Surgery Demonstration

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My first suggestion to my wife was that I enter Pop Idol with my modified, radiation-bashing rendition of American Pie (chorus "bye bye brachytherapy seeds"). She quickly retorted "DIVORCE! YOU CANT SING!" I begrudgingly agreed. Then Britain’s Got Talent came along and I saw an overweight Greek father and son duo, Stavros Flatley, prance around the stage bare-chested, dancing to some traditional Greek music and I thought “YES! There is hope!" I put on Riverdance, grabbed my then three-year-old…

Superstition

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In 1948 BF Skinner put a pigeon in a box.  Unlike most of Skinner’s birds, this one did not have to learn a behavior, such as pecking a lever, to receive an edible reward. Food was automatically dispensed at fixed time intervals without fail, the pigeon simply had to wait. The fascinating development from this experiment was that after some few hours in the box the bird was performing an elaborate routine of behaviors; turns, head movements, foot raises, all presumably in an effort to bring about…

What prophylactic steps should we take to prevent DVT/PE after RARP?

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Deep vein thromboses (DVT) and pulmonary embolism (PE) are rare, but potentially devastating, complications of major pelvic surgery. We have performed more than 1000 robot assisted radical prostatectomy (RARP) procedures in Central London (Lessons learned from 1000 RARP operations BJUI 2013;111(1):9-10.) and to date encountered just a couple of DVTs, as well as a single, non-fatal instance of PE. However, in the case of one of us (RK), a close relative passed away as a result of a PE 10 days…

The self-proclaimed King of the Urology twitter world

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Howard Stern proclaimed himself the King of all Media; I have proclaimed myself the King of the Urology twitter world.  There is no basis for my claim.  I certainly do not have the most followers nor do I have regal heritage. If you repeat things often enough they simply become true on the web - so I'm happy to be the king What is true is that I was the first academic urologist to take to the twitterverse in a persistent, snarky, timely, and - at times- academic manner. I coached the uro-twitterati…

Editorial: Is botulinum toxin not the solution to OAB after all?

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Dirk De Ridder Department of Urology, University Hospital Leuven, Belgium The article by Mohee et al. highlights a problem that is often neglected: the outomes we see in clinical trials do not predict the success of the therapy in real life. We know this from anticholinergics: the study results are good, but the performance in real life is much poorer. Only 20-40% will continue to take the medication. For botulinum toxin in OAB it is surprising to see that even in experienced hands only…

Ten stories of 2012, part II

Thanks for all the helpful input regarding my first blog post. Constructive criticism is always helpful, especially if I am to get better at this. If you haven't read it, part 1 is here. So, in no particular order, part 2 of 2: + Metastatic prostate cancer - it's getting complicated… 2012 was a year of hope for metastatic prostate cancer patients.  First, Enzalutamide (also known as MDV3100), in the context of a phase III RCT, was shown to prolong the survival of men with metastatic…

International Urology Journal Club on Twitter

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International Urology Journal Club on Twitter: The Beginnings of a New Application of Social Media in Urology CME The International Urology Journal Club on Twitter almost came about by accident, although the formation of such was an inevitability. Over the course of 2012, a number of research papers have been the subjects of discussion amongst urologists on Twitter. The standout paper as example for discussion in 2012 was the PIVOT study. This generated comments that were difficult to follow…
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