Features
Delivering a laparoscopic urology workshop in West Africa: our initial experience in Senegal
Despite universal adoption and significant technological innovation since its inception around 30 years ago, access to laparoscopic surgery remains lacking in Sub-Saharan Africa (SSA). Whilst some progress has been made in recent years to bridge the gap with the developed...
The Re-humanising Revolution: Breaking the conspiracy of silence
Over the last few years, the mental and emotional wellbeing of those who work in medicine has come under scrutiny. The author introduces a new resource. Working in healthcare has always been stressful but never more so than today. In...
A guided guide to the guide wire
The use of guide wires has become a core skill utilised by urologists, especially within the field of endourology. The authors take us through the development of the guide wire and their current use in urology. The history The first...
Pyonephrosis: is the kidney always doomed?
Pyonephrosis (Greek pyon ‘pus’ + nephros ‘kidney’) is defined in Campbell-Walsh Urology [1] as an infected hydro-nephrosis associated with suppurative destruction of the renal parenchyma which results in total or near total loss of renal function. The true incidence of...
Is laparoscopic urological training in Sub-Saharan Africa a goal worth pursuing? Observations from my experience with IVUmed in Senegal
Laparoscopic surgery has developed at an unimaginable pace over the last three decades. The first laparoscopic cholecystectomy was performed by Dr Phillip Mouret in France in 1987, with the first series of 63 cases published in 1989 [1]. However, its...
A guide to percutaneous nephrolithotomy
Percutaneous nephrolithotomy (PCNL) is now the gold standard approach to treating large renal stones. Since its development in the 1970s, it has undergone a series of refinements that could only have been possible with the symbiosis of both radiological and...
The expanding indications for ureteroscopy – ad maiora!
The management of urolithiasis is becoming a Herculean task for healthcare providers worldwide. The incidence of stone disease is rising, with predicted lifetime risk of 12% in males and 6% in females [1]. This rise relates to both improving imaging...
Getting it Right First Time in urology: the implementation phase
The Getting it Right First Time (GIRFT) programme is the largest and most comprehensive initiative to improve the quality and efficiency of individual clinical services that the NHS has ever instigated. The programme falls under the auspices of NHS Improvement...
A negative ureteroscopy for stone disease: is it acceptable and is it avoidable?
Urinary tract stone disease and the consequent demand for endoscopic intervention in the upper urinary tract is an increasing phenomenon [1]. Although ureteroscopy is generally considered to be associated with low morbidity [2], risks do exist. Recognised complications include urothelial...
Dietary citrate substitution in urolithiasis patients
Stone formation is dependent on supersaturation of urinary salts and urinary crystal retention. Urinary promoters (protein aggregates, cell debris) and inhibitors (citrate, magnesium, urinary macromolecules such as glycosaminoglycans and proteins) are involved in the process of stone formation [1]. Hypocitraturia...
The management of renal calculi – Pt 2
Renal calculi can be managed according to four treatment options: conservative management, extracorporeal shock wave lithotripsy (ESWL), flexible ureterorenoscopy (FURS) and percutaneous nephrolithotomy (PCNL). Having addressed conservative management and ESWL in the last edition of Urology News, the second article...
Training to be a urologist: how risky is it?
The NHS and urology face challenging times in trying to provide quality patient care efficiently and economically. Urology trainees are experiencing conflicting pressures with a new contract, a challenging on-call system and changing training requirements in an overstretched, centralised service...
