ObjectiveTo assess the efficacy of OnabotulinumtoxinA (BTXA) injections in men with drug-refractory non-neurogenic overactive bladder (NNOAB). Patients and MethodsA total of 43 men received BTXA injections for NNOAB from 2004 to 2012. Patient Global Impression of Improvement (PGI-I) score was obtained. For men with wet NNOAB, change in number of pads per day was also assessed. ResultsForty-three men with a mean age of 69 (range 37-85) received at least one injection. Of the 43 men, 20 (47%) had prior prostate surgery: 11 had radical prostatectomy (RP) and nine had transurethral resection of prostate (TURP). Overall, average PGI-I score was 2.7. Comparing PGI-I score in men who had prior prostate surgery with men who have not: 2.6 AE 0.5 vs 2.8 AE 0.5 respectively (average AE 95% CI), P = 0.6. Comparing PGI-I score in men who had previous TURP with men who had previous RP: PGI-I score: 3.3 AE 0.8 vs 2.0 AE 0.5 respectively, P < 0.05. Men who had RP experienced a reduction in pad use (from 3.5 AE 1.7 to 1.6 AE 0.9 pads/day, P < 0.05) while this was not the case amongst men who had TURP (from 1.7 AE 1.5 to 1.4 AE 1.5 pads/day, P = 0.4). ConclusionOverall, BTXA injection in men with drug-refractory NNOAB does provide a symptomatic benefit. Amongst men who have had prior prostate surgery, men who have had RP experience a greater benefit than men who have had TURP, both in regards to PGI-I score and pad use.

The AdVance sling provides mid-term improvement in men with PPI. However, men with radiotherapy or DO have significantly poorer outcomes with mid-term results indicating a return to baseline degree of incontinence. Caution should be taken when considering the AdVance sling in these men. Pre-op urodynamics in men with radiotherapy and/or overactive bladder may be important when considering men for AdVance sling. Neurourol. Urodynam. 36:1147-1150, 2017. © 2016 Wiley Periodicals, Inc.

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Objective: Endoscopic upper urinary tract instrumentation is a common urological procedure; often associated with prior ureteric stenting and postoperative urosepsis. This study aimed to explore the clinical utility of preoperative urine and intraoperative urine and ureteric stent cultures in the management of urosepsis post upper urinary tract instrumentation. Methods: Prospective study involving pre-stented patients whose upper urinary tract was instrumented at a single centre between 2017 and 2018. Five cultures were collected per patient. Patients were tracked for development of postoperative urosepsis. Results: The study included 227 patients, with a 5.7% postoperative urosepsis rate. Risk of urosepsis was significantly associated with female gender, steroid use and having a colonized preoperative urine culture, intraoperative bladder urine or stent-end culture, or kidney urine culture. Patients with a colonized intraoperative bladder urine were 11 times more likely to develop urosepsis and were colonized with the same organism isolated from urosepsis cultures for 50% of cases. Conclusions: To our knowledge this is the largest cohort study which analyses five different urinary tract cultures and the relationship with postoperative urosepsis. A positive intraoperative bladder urine culture is an independent predictor of postoperative urosepsis development and causative organism, which could guide antibiotic management for these patients. Level of Evidence 3-b

Predicting urinary tract calculi composition by DECT plays an important role in identifying patients who may be managed with dissolution therapy. Identification of uric acid stone composition altered management in 15 of 303 (5.0%) patients, and was successful in 12, thereby avoiding surgery and its attendant risks.