Onabotulinum toxin A (BTX) not helpful for chronic scrotal pain

It is refreshing to read a report on negative outcomes as it reinforces the honesty that is often lacking with the well-known publication bias in medical publications. It is also not common to come across surgical randomised controlled trials (RCTs)...

Prostatic artery embolisation versus sham

Randomised trials with use of sham is uncommon in the surgical literature, which makes this paper more interesting. Many different treatments are available for treating lower urinary tract symptoms / benign prostatic hyperplasia (LUTS / BPH). Prostatic artery embolisation (PAE)...

Chronic retention – all you need to know

Chronic retention – all you need to know Chronic urinary retention is a common presentation in elderly and frail patients. Two types should be recognised - low pressure chronic retention (LPCR) and high pressure chronic retention (HPCR). Acute-on-chronic retention occurs...

Prostatic urethral lift for obstructive median lobes: 12-month results of the MedLift study

As the various new BPH therapies try and mark out their role in the management of the condition, this is an interesting and useful addition to the literature. Patients were clinically screened for an obstructive median lobe on cystoscopy, which...

Urinary tract infections and antibiotics – the debate goes on

A large number of hospital patients and primary care patients suffer from recurrent urinary tract infection (UTI) and urosepsis. Some of these patients end up in intensive care units with multi-organ failure. New draft guidance from the National Institute for...

Beware of the ambiguous testicular lump

In busy day-to-day practice, we are often faced with puzzling situations. A useful mnemonic is 4-T: torsion, trauma, tumour and tuberculosis (infections). This case review in the BMJ is about a 34-year-old man presenting to A&E with left testicular pain...

Convective radiofrequency water vapour thermal therapy for BPH

There are a number of new treatments for benign prostatic hyperplasia (BPH) on the market. This paper reports retrospective data for 129 patients treated with convective radiofrequency water vapour thermal therapy (Rezum) by a single surgeon. There is variable length...

Should we let sleeping children lie?

Alarm therapy (AT) is a first line-treatment for nocturnal enuresis (NE) conditioning the child to wake in response to an auditory stimulus when wetting begins. It is currently unclear whether waking children and guiding them to urinate when the alarm...

Bladder debris on ultrasound as a predictor for positive urine culture

One of the common ultrasound findings in children who undergo renal tract evaluation is ‘debris in the bladder’. The aetiology of bladder debris is varied and the likelihood that urinary debris represents positive urine culture is debatable. The authors of...

Dual therapy for OAB in children

Overactive bladder (OAB) is a disorder frequently encountered by the paediatric urologist. Morin et al. report the results of the first known study on the efficacy of mirabegron (a β3 adrenoceptor agonist) as add-on therapy in paediatric patients with refractory...

Non-antibiotic options for recurrent UTI

Recurrent urinary tract infection (UTI) imposes a heavy burden on health services. By definition recurrent UTI is two infections in six months or three in one year. The annual incidence of single UTI is 30 per 1000 women. The Scottish...

Urologists beware!

This article recounts the story of a Californian urologist who was shot dead two decades later by a patient who was diagnosed with stricture of the urethra. The patient underwent surgery for urethral stricture in 1992 by a team (ironically,...