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Functional and reconstructive urology

Case 1 A 45-year-old female presents with a one-year history of urinary leakage, especially worse on coughing. She is otherwise well, with no co-morbidities. What is the International Continence Society (ICS) definition of stress urinary incontinence (SUI)? What are the...

Benign upper tract abnormalities

Case 1 A 28-year-old lady has been referred to your clinic with right loin pain. She has no significant past medical history but mentions that she and her partner have been trying to get pregnant. She has an US renal...

MSKCC prostate cancer screening guidelines – is it the way forward?

The Memorial Sloan Kettering Cancer Center (MSKCC) developed prostate cancer screening recommendations first in 2011 as a response to three limitations of previous screening guidelines: insufficient evidence base, failure to link screening with treatment, and lack of risk stratification. To...

Increasing PSA after negative prostate biopsy - solving the clinical puzzle

There are standard guidelines for first transrectal ultrasonography (TRUS) guided biopsy in a patient presenting with elevated prostate-specific antigen (PSA) or suspicious digital rectal examination (DRE) findings. Patients are generally warned before a TRUS biopsy in respect of a false...

Intravesical instillation of chemotherapy before radical surgery for upper UTUC

Upper urinary tract urothelial carcinoma (UTUC) is a rare but increasingly prevalent form of urothelial cancer, accounting for 5–10% of cases, with an annual incidence of two to three cases per 100,000 individuals in Western Europe. Radical nephroureterectomy (RNU) with...

The conservative assessment and treatment of mixed urinary and anal incontinence in women: a multidisciplinary approach

Mixed urinary incontinence Urinary incontinence (UI) is considered to be a highly prevalent condition; however, depending upon the definitions used, actual reported prevalence rates can vary significantly. The International Consultation on Incontinence (ICI) review [1], reported unadjusted prevalence estimates for...

Electrical injury – all you need to know

The modern operating theatre presents a highly complex and busy environment with a huge variety of machines, devices and gadgets. This article from France will be of interest to urologists, nurses, anaesthetists and theatre managers alike. We all use electrical...

Clean catch urine from babies – the ‘quick wee method’

Urinary tract infections (UTIs) are common in children and babies and can lead to urosepsis, renal scarring and chronic kidney disease. As per American Academy of Pediatrics guidelines, urine samples are a must in febrile / unwell infants even if...

Renal stones: an American perspective

This study is from Dallas, USA and appears on the front cover of the BMJ. About 1 in 11 people will have a kidney stone at some point in their lifetime. There is a linear increase in stone prevalence in...

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...

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%)....

Is surgical antibiotic prophylaxis necessary for paediatric orchiopexy?

With the rise of resistant organisms to most commonly used antibiotics, there is a plea for judicious use of antibiotics, especially for clean surgical procedures. Potential adverse events associated with antibiotic use include allergic reaction (including anaphylaxis), clostridium difficile infection,...