Cardiac failure and medical therapy for LUTS / BPH

Alpha blockers (AB), 5-alpha reductase inhibitors (5-ARI) and combination therapy are widely prescribed for lower urinary tract symptoms (LUTS) considered consequent to prostatic enlargement and are the mainstay of first-line therapy. This retrospective interrogation of a large population-based dataset of...

Assessing resolution of isolated hydronephrosis – is APPD superior to the SFU system?

Antenatal scanning detects urinary tract dilatation in 1-5% of pregnancies. Isolated hydronephrosis (i.e., that not due to secondary dilatation e.g. bladder dysfunction) is known to resolve or improve in most; some patients may, however, require intervention through deterioration of obstruction...

Vitamin D and LUTS

Lower urinary tract symptoms (LUTS) and vitamin D deficiency have been thought to be connected, but the association has been inconsistent. Vitamin D receptors have been identified in the bladder, prostate and pelvic floor muscles, and it has been linked...

Delayed decompression of the infected obstructed kidney increases fatality

Well, we know this, I hear you all say. It is standard practice that the obstructed kidney with associated infection requires prompt decompression, and this is drilled into all UK trainees. It is surprising therefore that although we frequently deal...

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)...

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 origins of urinary stone disease

This is a descriptive paper of micro CT scans of tubular mineralisation in 12 nephrectomy specimens. The authors noted that: in the small number of specimens examined, mineralisation started in the outer medulla and appeared to proceed distally along the...

Reviewing the evidence for TNS in neurogenic lower urinary tract dysfunction

Tibial nerve stimulation (TNS) is a recognised minimally invasive treatment option for bladder overactivity and non-neurogenic lower urinary tract dysfunction. In this systematic review, the role TNS can play in the management of neurogenic lower urinary tract dysfunction is evaluated...

Intermittent self-catheterisation

Intermittent self-catheterisation (ISC) is used in everyday practice for bladder dysfunction. This study from Southampton, UK presents a Cochrane review of different catheter designs, user satisfaction and incidence of urinary tract infection (UTI), etc. The following factors were looked at:...

Outcomes of VUR in children with non-neurogenic dysfunction treated with Deflux

The 2010 American Urological Association (AUA) guidelines on primary vesicoureteral reflux (VUR) state that children with VUR and lower urinary tract dysfunction are less likely to have the VUR resolve spontaneously than those with primary VUR alone (31% vs. 61%)....

Prostate alpha-1 receptors: what is new?

This article from the west of Germany will be of interest to many of us who use alpha-blockers for bladder outflow symptoms. The classic model of understanding of alpha receptors has been challenged recently. Further models have been identified, including...