Synthetic mid-urethral slings for stress incontinence in neurogenic LUTD

Neurogenic lower urinary tract dysfunction (NLUTD) is heterogeneous because of the multiplicity of underlying causes and mechanisms. In women with NLUTD, stress urinary incontinence may be due to intrinsic sphincter deficiency caused by the neurological disease itself or from sphincter...

Botox® instillation into the bladder

Patients with refractory overactive bladder (OAB) may be offered OnabotulinumtoxinA (Botox®) as one of the third-line options. Given the invasive nature of requiring cystoscopy, injections via a needle and local anaesthesia, it would be simpler, more convenient and more accessible...

Can continence and volitional voiding be achieved in bladder exstrophy?

Bladder exstrophy is a challenge to the paediatric urologist; here in the UK, repairs are now undertaken at two centres in order to concentrate experience. The ultimate aim is to achieve urinary continence and volitional voiding. In this study, John...

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...

Should maximal urethral closure pressure be performed before mid-urethral sling surgery for stress incontinence?

Maximum urethral closure pressure (MUCP) is a means of trying to provide an objective assessment of urethral integrity. In some centres it is used as a tool to help predict outcomes after mid-urethral sling (MUS) placement. The authors propose that...

Laparoscopic ureteral ligation (clipping)

Ectopic ureters in the presence of an upper moiety duplex kidney, or non functioning upper moieties, are traditionally treated with a heminephrectomy (open or laparoscopic). This carries significant risks, especially loss of the remaining lower moiety. These authors describe a...

Penile clamp device – a new indication?

This study originates from New Zealand and looks at men affected by post-prostatectomy incontinence (PPI). These patients are difficult to manage with the options of further surgery, indwelling catheters or pads. The aim of this questionnaire study (IIQ 7) was...

RARP – novel uroflow stop test

More and more centres are doing robotic assisted radical prostatectomy (RARP) surgery for cancer of the prostate .This study from Montreal, Canada describes a simple and novel test to predict recovery of urinary continence after RARP. The uroflow stop test...

Patient-reported outcomes after prostate cancer treatment

This study used the survivorship (LIVESTRONG) care plan tool to identify patient-reported toxicities that occurred following treatment for prostate cancer. All patients had undergone treatments, which were considered to have similar oncological endpoints. The tool asked patients questions with regard...

Long-term consequences of posterior urethral valves

These two papers give a very good summary of the long-term effects of posterior urethral valves (PUV) into adulthood and are worth a read. Pereira et al. It is well known that the consequences of posterior urethral valves extend well...