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Conservative management of pelviureteric junction
Background Pelviureteric junction obstruction (PUJO) is defined as a functionally significant impairment of urine flow from the renal pelvis into the proximal ureter. For more than a century, surgery was considered the first-choice approach to management. However, the widespread use...Neuromodulation for lower urinary tract dysfunction – an ICS update
Non-invasive and invasive electro-stimulation techniques have been extensively studied in the treatment of lower urinary tract and bowel dysfunction, including overactive bladder syndrome (OAB), non-obstructive chronic urinary retention, faecal incontinence and chronic pelvic pain. Currently, the most common indication for...Urinary incontinence in women – part 2: management
In the second part of our comprehensive overview of urinary incontinence (UI) the authors explore the plethora of treatment options for this complex condition. (Part 1 available here). Conservative management Initial treatment of incontinence should be conservative. Caffeine reduction and...Cutting-edge or over-hyped? Evaluating the role of robotic surgery in the management of renal cell carcinoma
The quest for a minimally-invasive approach to major abdominal surgery finds its roots at the start of the previous century, when Georg Kelling first described the technique of ‘ceolioscopy’ to inspect intraabdominal organs in 1901 [1]. Since those early days,...An algorithm for the management of haemorrhagic cystitis
Haemorrhagic cystitis (HC) can be one of the most difficult conditions to treat in urological practice. It is characterised by intractable bleeding from the bladder and may be acute or chronic. The most frequently reported causal factors are radiotherapy (RT)...The value of Urolink: an OOPE experience
I was fortunate enough to be able to take some time out of my training after ST5 to pursue an Out Of Programme Experience (OOPE) year. During the Urolink meeting at the British Association of Urological Surgeons (BAUS) 2017 conference...Physiotherapy first for pelvic floor dysfunction
Physiotherapy should be included in first-line management options for pelvic organ prolapse and urinary incontinence in women [1,2]. Additionally, referral to physiotherapy is widely practised for the management of urinary incontinence in men, faecal incontinence, defecation disorders and various pelvic...
Urinary NGAL, KIM-1 and L-FABP concentrations in antenatal hydronephrosis
he elusive search for being able to diagnose pelvi-ureteric junction obstruction (PUJO) continues and this group of researchers investigated the possible clinical application of urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary kidney injury molecule-1 (uKIM-1) and urinary liver-type fatty acid-binding proteins...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...The Mitrofanoff procedure: a continent revolution
Prior to 1980, surgeons had been struggling to provide a catheterisable, continent channel as an alternative to the native urethra, primarily for paediatric patients with congenital neuropathic bladder. In 1980, Professor Paul Mitrofanoff described the continent supravesical antireflux appendicovesicostomy [1]...
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...
