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,...

Solifenacin for children and adolescents with overactive bladders

Solifenacin (VESIcare®) is the second-line anti-muscarinic medication of choice for my patients with overactive bladder (oxybutynin being my initial choice). However, currently, it remains unlicensed for use in children. Newgreen et al. have evaluated the long-term safety and efficacy of...

What are the long-term outcomes of TOT and TVT procedures?

This is a systematic review between 2000 and 2016 evaluating the efficacy and safety of midurethral sling (MUS) procedures in women. Studies were included if the follow-up data was five years or more. Objective cure rates showed no significant difference...

Performance of non-invasive tests in diagnosing BOO in men with LUTS

A large proportion of urology involves the treatment of bladder outflow obstruction (BOO) in men. Yet BOO in men is very difficult to accurately quantify with the only regular non-invasive test being uroflowmetry. Pressure flow urodynamics may be considered the...

The role of acupuncture in managing overactive bladder

Overactive bladder (OAB) affects 17% of American men and women and represents a burden in terms of both quality of life and finances. Alternative therapies may be sought for this condition as there is a high drop-out rate with regards...

Mindfulness-based stress reduction as a novel treatment for IC/PBS

Interstitial cystitis / painful bladder syndrome (IC / PBS) is not fully understood and is associated with significant morbidity. The objective of this study was to provide initial data to evaluate mindfulness-based stress reduction (MBSR) as a treatment for IC...