Deep Dives
Articles that either helped my imposter syndrome or confirmed it was justified all along.
Emergency HoLEP for Refractory Haematuria: Stop Washing, Start Enucleating
A single-centre series of 24 emergency HoLEPs performed on inpatients whose prostatic bleeding wouldn't settle. Median gland enucleated was 156g, three quarters passed a trial without catheter on day one, and nobody needed a second procedure.
Rice-Grain Robots for Uric Acid Stones: Cool Tech, Long Road
A Waterloo-led team has built centimetre-long soft magnetic robots that carry urease to a uric acid stone and dissolve it from millimetres away. In vitro only, but a genuinely novel approach worth understanding.
A Smaller Scope, Fewer Pads: The MILES Trial on MiLEP vs Standard EEP
Preliminary data from a randomised trial show minimally invasive laser enucleation using a 22 Ch resectoscope cuts early stress urinary incontinence from 29% to 6% compared with a standard 26 Ch scope - with identical functional outcomes.
The Urine Test That Might Finally Spare Men the Surveillance Biopsy
MPS2-AS outperformed mpMRI for detecting grade group upgrading in active surveillance for low-risk prostate cancer, with a 99% negative predictive value for high-grade disease and the potential to avoid 64% of repeat biopsies.
Zamenix and Robotic RIRS: A New Technology Worth Understanding
Roen Surgical's AI-assisted kidney stone surgery robot has moved from a government innovation study to commercialisation in Korea, with early clinical experience now being shared across major centres. Here's what it actually does and what we don't know.
Suction URS: The CVAC System and Why Residual Fragments Matter
The ASPIRE trial showed a 73% reduction in healthcare events at two years with suction ureteroscopy. Here is what the evidence actually says, and what it doesn't.
When the Data Don't Fit the Dogma: Five Trials That Changed How We Think
ProtecT, PIVOT, CARMENA, SWOG 8710, POUT. Five trials that made urologists uncomfortable. Here is what they actually changed, and what they didn't.
Finasteride 1mg and New-Onset ED: The 3-Year Signal We Couldn't See Before
A propensity-matched cohort of over 10,000 young men links finasteride 1mg to new-onset erectile dysfunction at three years. The longest follow-up signal we've seen for this question.
Do You Actually Need That Foley After URS?
A 2025 EULIS-YAU RCT tested routine Foley placement after flexible ureteroscopy and JJ stent insertion. The short answer: not really.
Histotripsy for Kidney Tumours: No Scalpel, No Needle, No Heat
HistoSonics has submitted the Edison Histotripsy System to the FDA for kidney tumour destruction. Here is what the technology actually does, what the evidence says, and what we don't know yet.
Low Testosterone at Prostate Cancer Diagnosis: Not the Free Pass We Thought
Two 2025 studies suggest low testosterone at diagnosis independently predicts worse survival in prostate cancer. The effect sizes are hard to ignore.
A Multimodal Approach to Peyronie's
A new perspective article in IJIR proposes the first fully specified multimodal protocol for Peyronie's disease. The rationale is genuinely interesting. The evidence is still early.
Second-Wave BPH Devices: Useful Signal, Thin Evidence
Optilume, Zenflow, Butterfly, ProVee, Urocross, FloStent - a new wave of LIST and FIT devices is arriving with compelling narratives. Here is how to read them before the hype sets in.
CIRFs Are Dead: Stop Using That Term on the Ward Round
The AUA 2026 Surgical Stone Guidelines have quietly retired one of the most commonly used phrases in post-op urology. Here is what changed, why it matters, and what to say instead.
Beyond Hydration: What the PUSH Trial Tells Us About Stone Recurrence in 2026
The PUSH trial increased urine volume in stone formers and still failed to reduce stone recurrence. Here is what that means for the way we counsel patients.
The Quiet Eye: What Elite Performers Know About Focus That Most Surgeons Don't
There is a measurable moment of stillness between locking onto your target and initiating movement. Elite performers have more of it. Here is what that means for surgical training.
Inside the UroRef App
A walkthrough of what UroRef contains - procedures, emergency decision trees, drug doses, calculators, clinic frameworks and BAUS patient leaflets, with a core reference library available offline.
Why I Built UroRef
UroRef was not built by someone pretending medicine is simple. It was built by someone who remembers very clearly what it feels like when your brain goes blank at exactly the wrong moment.