Features
Urodynamics in review: stress urinary incontinence in women produced by the Urodynamics Committee of the ICS
Urodynamic studies (UDS) are the best tools to objectively assess the lower urinary tract dysfunction (LUTD) of various aetiologies [1]. According to the general understanding and consensus of the medical community UDS should be performed only when they will change...
Optimising weight loss advice in obese women with urinary incontinence: a review
Background The National Institute for Health & Care Excellence (NICE) guidance specifies that women with a body mass index (BMI) of over 30, combined with urinary incontinence or overactive bladder, should be advised to lose weight [1]. A BMI over...
The burning issue of urinary tract infections
Urinary tract infections (UTIs) occur when bacteria colonise and proliferate in the urinary tract. These are characterised by specific clinical symptoms (dysuria, suprapubic tenderness, urgency and urinary frequency) which commonly occur alongside the finding of bacteriuria. UTIs are common –...
The medical management of LUTS/BPH – an update
For many years it has been recognised by both medical professionals and the general public that the development of lower urinary tract symptoms (LUTS) is highly prevalent and is predominantly age-dependent. Medical professionals understand that in men this is often,...
Neuromodulation for lower urinary tract dysfunction – an ICS update
Non-invasive and invasive electro-stimulation techniques have been extensively studied in the treatment of lower urinary tract and bowel dysfunction, including overactive bladder syndrome (OAB), non-obstructive chronic urinary retention, faecal incontinence and chronic pelvic pain. Currently, the most common indication for...
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...
Catheters and incontinence after radical prostatectomy: Preparing (but not scaring) men
Every year about 6000 men in the UK undergo radical prostatectomy (RP) for treatment of prostate cancer [1]. Despite surgical advances, RP continues to be associated with significant side-effects including urinary incontinence (UI) [2]. Immediately following removal of the urinary...
Lifestyle interventions for UI in women
Lifestyle interventions for urinary incontinence (UI) are supported by all major guidelines. The National Institute for Health and Care Excellence (NICE) guideline (CG171) from September 2013 (updated November 2015) [1] recommends lifestyle advice including dietary modifications such as caffeine reduction,...
The Mitrofanoff procedure: a continent revolution
Prior to 1980, surgeons had been struggling to provide a catheterisable, continent channel as an alternative to the native urethra, primarily for paediatric patients with congenital neuropathic bladder. In 1980, Professor Paul Mitrofanoff described the continent supravesical antireflux appendicovesicostomy [1]...
Simulation-based training of procedural skills: application and integration of educational theories
Educational theories: how familiar are we with these theories and their application in our training? As a Simulation Fellow I have been involved in teaching specific procedural skills and running full immersion simulation sessions. This experience has exposed me to...
Challenges of catheter associated urinary tract infection: is prevention better than cure?
Catheterisation is a common medical procedure in which a catheter (a hollow flexible tube) is inserted into the bladder in order to facilitate the drainage of urine. Catheters are usually passed into the bladder via the urethra, either to be...
Prolapse surgery with mesh: where do we stand in 2017? An ICS update
Background Surgery for pelvic organ prolapse (POP) is common among women. The lifetime risk of undergoing at least one surgical procedure for POP is up to 20% [1]. This kind of surgery will be increasingly important due to an ageing...