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The Lester Eshleman Urology Workshop (Tanzania): a trainee’s perspective

For many trainees a period abroad is increasingly an essential supplement to higher surgical training in the UK. However, for many, because of family responsibilities or financial imperatives, this is not always a viable option. There are however alternatives. Here...

The how, why and when of bladder washouts: a guide

Bladder washouts are a treatment usually employed by the urology team, more often in an inpatient setting, and commonly indicated for haematuria with clot retention and catheter bypassing [1,2]. Bladder washout is a cornerstone of treatment in urology wards, yet...

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,...

The role of an enhanced recovery protocol in patients undergoing robotic radical cystectomy

Enhanced recovery after surgery (ERAS) protocols are patient pathways designed to reduce surgical stress and accelerate postoperative recovery. Uptake of such protocols in colorectal surgery in particular has been high, however ERAS protocols developed or utilised in urological surgery have...

Prevention of urethral stricture recurrence

Urethral stricture recurrence after urethral reconstruction is one of the most challenging problems in urology. With the increase in endoscopic surgery over the last three decades the incidence of urethral strictures has increased, with iatrogenic manipulation the leading aetiology in...

BCG strain differences have an impact on clinical outcome in bladder cancer immunotherapy

Bacillus Calmette-Guérin (BCG) has been part of the treatment algorithm for non-muscle invasive bladder cancer (NMIBC) for a number of years. In this single centre, prospective, randomised trial, two of the most commonly available strains, BCG Connaught and BCG Tice,...

Upper Tract Developmental Abnormalities

Case 1 1. What is the abnormality and how common is it? 2. What is the embryological origin? 3. With what other conditions can this be associated? Case 2 1. What is the diagnosis and how common is it? 2....

Is laparoscopic urological training in Sub-Saharan Africa a goal worth pursuing? Observations from my experience with IVUmed in Senegal

Laparoscopic surgery has developed at an unimaginable pace over the last three decades. The first laparoscopic cholecystectomy was performed by Dr Phillip Mouret in France in 1987, with the first series of 63 cases published in 1989 [1]. However, its...

Metabolic stone disease for urology trainees

Urolithiasis continues to be a heavy burden on the worldwide medical infrastructure with an estimated 106 million cases recorded internationally in 2021 [1]. Whilst incidence rates have started to decline across Europe and high-income North America, there are emerging hotspots...

ICS updates in continence care: the role of the nurse continence specialist in continence services

The nurse who specialises in continence care is recognised as a key member of interdisciplinary teams seeking to deliver high quality integrated continence services. The recently published international service specifications for continence care [1] supports the use of specialist continence...

What is the role of evidence-based medicine in urology?

The concept of ‘evidence-based medicine’ (EBM) was first developed in the early 1990s and was described as “the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients” by the recently...

Benign prostatic hyperplasia: what are the benefits and harms of various surgical management options?

Benign prostatic hyperplasia (BPH) is characterised by stromal and epithelial prostatic cell hyperplasia. The enlarged prostate may be associated with voiding and storage lower urinary tract symptoms (LUTS). These have been predominantly attributed to bladder outlet obstruction (BOO), assumed to...