Features
The surgical trainer – are we still evolving?
“We need a system and we will surely have it – which will produce not only surgeons, but surgeons of the highest type” William Halsted MD William Halsted, a famous American surgeon, is widely credited with developing the first formal...
Prostate artery embolisation
Introduction Benign prostatic hyperplasia (BPH), a common condition associated with ageing, affects 50% of those between the ages of 50 and 60 years, and as many as 90% of those older than 80 years. BPH is characterised by unregulated, benign...
Pelvic floor imaging – a brief synopsis
Background Pelvic floor imaging is an important part of both gastrointestinal and functional urology / urogynaecological departments. Symptoms such as obstructive defecation, incontinence and sphincter complex disorders have a significant impact on patient lifestyle and physical / mental well-being [1,2]....
Comedy and continence – don’t make me laugh
I’m a pelvic physiotherapist and, in a fit of temper, I wrote a comedy show about pelvic floors after having yet another woman say to me: “I’ve been leaking since my baby was born.” “How old is your baby?” “He’s...
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)...
Bladder cancer: where are we with intravesical therapies?
In the United Kingdom, almost 10,500 new cases of bladder cancer were identified in 2013, with over 5000 deaths in 2012 [1]. Seventy percent of new cases will be non-muscle invasive bladder cancer (NMIBC) at diagnosis and therefore will be...
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 It was Benjamin Franklin in the 18th Century who originally made the link between success and the proper...
Use of Clavien-Dindo classification in urology part 2 – upper tract
A classification system of surgical complications was proposed by Clavien in 1992 [1] and further modified by Dindo in 2004 [2]. Clavien-Dindo classification has since then been validated through many retrospective case series as well as in comparative studies to...
Why bother? Metabolic screening for stone formers
Introduction Despite the considerable increase in the incidence of stone disease in the UK and elsewhere in recent years, urologists have engaged with preventative strategies to only a limited degree. With mounting evidence of the strong correlation between obesity and...
Consensus statements on PSA testing in asymptomatic men in the UK
In January 2016, the UK National Screening Committee once again recommended against a systematic population screening programme for prostate cancer due to the, as yet, insufficient evidence that the benefits of screening would outweigh the harm to the population as...
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,...
