Features
Benign prostatic hyperplasia: what are the benefits and harms of various surgical management options?
Benign prostatic hyperplasia (BPH) is characterised by stromal and epithelial prostatic cell hyperplasia. The enlarged prostate may be associated with voiding and storage lower urinary tract symptoms (LUTS). These have been predominantly attributed to bladder outlet obstruction (BOO), assumed to...
Patient decision aids in the management of stress urinary incontinence
Urinary incontinence is a common condition faced by up to 20-50% of women, which impairs quality of life and poses a significant socioeconomic burden to both the individual women involved and more widely to the NHS [1]. The overall cost...
Ketamine uropathy – an update
The first two case series that documented the association between urinary tract damage and recreational ketamine use were published 12 years ago [1,2]. Since then ketamine has maintained a controversial profile as an essential medication of expanding utility but with...
Mechanisms and prevention of catheterisation associated urethral injury (CAUI)
Urethral catheterisation is a common procedure performed by health professionals across different grades and specialties in a variety of clinical settings. An estimated 15-25% of hospitalised patients have a urinary catheter inserted during their inpatient stay and up to 13%...
The conservative assessment and treatment of mixed urinary and anal incontinence in women: a multidisciplinary approach
Mixed urinary incontinence Urinary incontinence (UI) is considered to be a highly prevalent condition; however, depending upon the definitions used, actual reported prevalence rates can vary significantly. The International Consultation on Incontinence (ICI) review [1], reported unadjusted prevalence estimates for...
What exactly is Hinman Syndrome?
Who was Hinman and what is Hinman Syndrome? Frank Hinman Junior (1915–2011) first described ‘Hinman syndrome’ in the 1970s – a condition also known as a ‘non-neurogenic neurogenic bladder’. He was a renowned American urologist, educator and skilful artist and...
Artificial penile pearls: what every Urologist should know!
Penile implants are inert objects placed beneath the skin of the penis through an incision. These are variously referred to as Yakuza beads, pearls, ball bearings, speed bumps, penile marbles, inserts, etc. The term ‘penile implant’ described here should not...
Mesh in urological surgery in the UK – background, reviews and current status
All UK urologists, unless they have been on a 10-year silent retreat, are by now aware of the controversy surrounding surgical use of mesh in general and urological / urogynaecological use of mesh for the surgical treatment of stress urinary...
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...
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 –...
