Features
ICS updates on continence care: making sense of detrusor underactivity and the underactive bladder
Countless epidemiological studies have established the frequent occurrence of lower urinary tract symptoms (LUTS) and the significant burden these symptoms incur. For the most part of the past three decades, there has been an overwhelming focus on detrusor overactivity (DO)...
A time management guide for urologists
Good time management is thought to not only reduce stress, but to improve personal efficiency, service delivery, clinical effectiveness and patient care. It was Benjamin Franklin in the 18th Century who originally made the link between success and the proper...
Urethral diverticulum: a review of the literature and local experience
Urethral diverticula are an uncommon finding on imaging. They are focal outpouchings of the urethra into the periurethral / urethrovaginal space, occurring more frequently in females (up to 6% of women) [1]. These diverticula are becoming more prevalent in clinical...
The scent of Ethiopia: a personal story – part 1
Background The year was 2004; I had just moved to the UK as a young house officer and finished my observership programme at Great Ormond Street Hospital in London. I was inspired by greats like Patrick Duffy and Phillip Ransley,...
ICS updates on continence care: what’s hot in physiotherapy after 80 years?
Origins of pelvic floor physiotherapy Physiotherapy, and in particular pelvic floor muscle training (PFMT) is nowadays first-line management for pelvic floor dysfunction (PFD). PFMT is originally attributed to Dr Arthur Kegel, hence the term Kegel exercises. Indeed, he was the...
Management of recurrent cystitis
Acute uncomplicated infective cystitis is most commonly seen in healthy women with a frequency of around 0.5-0.7 episodes per woman per year [1]. Around 10% of women report having had an episode of urinary tract infection (UTI) each year and...
The emerging role of physician associates in urology
The physician associate (PA) is a new role in the NHS which has expanded across medical and surgical specialties to include urology. In the USA, it has long been an established field of practice where physician assistants work autonomously within...
Physiotherapy first for pelvic floor dysfunction
Physiotherapy should be included in first-line management options for pelvic organ prolapse and urinary incontinence in women [1,2]. Additionally, referral to physiotherapy is widely practised for the management of urinary incontinence in men, faecal incontinence, defecation disorders and various pelvic...
An algorithm for the management of haemorrhagic cystitis
Haemorrhagic cystitis (HC) can be one of the most difficult conditions to treat in urological practice. It is characterised by intractable bleeding from the bladder and may be acute or chronic. The most frequently reported causal factors are radiotherapy (RT)...
Urinary incontinence in women – part 2: management
In the second part of our comprehensive overview of urinary incontinence (UI) the authors explore the plethora of treatment options for this complex condition. (Part 1 available here). Conservative management Initial treatment of incontinence should be conservative. Caffeine reduction and...
Reflections on 20 years as an Army Reserve doctor: live a life less ordinary
It seems a very short time ago that my predecessor recruited me into my regiment as a surgical senior house officer during a varicose vein operation in a cottage hospital in Stroud, informing me that I would be only the...
Urinary incontinence in women – part 1: terminology and diagnosis
Introduction Urinary incontinence (UI) is the involuntary and often embarrassing leakage of urine. It is a condition that is both under-reported and under-diagnosed, and when reported it is, unfortunately, often not assessed and managed adequately. Incontinence of urine is encountered...
