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Cystoplasty

Case 1 A 48-year-old female, having previously had an augmentation ileocystoplasty 10 years ago, has been referred with right loin pain by the emergency department. A venous blood gas is performed shortly after triage with the following values: What is...

Bladder cancer

Case 1 A 78-year-old female presents with a week history of painless haematuria. She’s a smoker and used to work in the textiles industry. She underwent a flexible cystoscopy. What does this image show? What are the two-week wait National...

Do stones still kill?

This paper is a retrospective analysis of deaths ascribed to stone disease in England and Wales over a 15-year period. The data was obtained from the Office of National Statistics, based on mortality derived from death certificates. One thousand, nine...

A guide for the assessment and management of post-obstructive diuresis

Acute urinary retention is a common condition encountered in the emergency situation and is initially managed by urethral catheterisation. This is often performed by nursing staff or junior doctors. Post-obstructive diuresis (POD) is a specific entity which may occur post...

New techniques in UTI diagnosis

Urinary tract infection (UTI) is a common reason for seeking medical care in both primary and secondary settings. Half of women will have at least one episode of cystitis in their lifetime, and a third of them will have experienced...

Demanding cases or nightmares in endourology? May/June 2017

In the sixth article in this series the authors describe endourology nightmares involving ileal conduits and calculi. Case 1 A 69-year-old man who had a cystectomy and ileal conduit for muscle invasive bladder cancer, presented with an acute kidney injury...

Relax and take note of this!

Children with neurogenic bladders are at risk of renal compromise through high detrusor pressures. Management aims to provide continence and preserve the upper tracts by increasing capacity and compliance though early clean intermittent catheterisation and anticholinergics. Intradetrusor botulinum toxin has...

LUTS update

Case study A 70-year-old, generally fit and well male attends your outpatient clinic. He has experienced a gradual deterioration in his voiding over the last few months. Specifically, he reports hesitancy, poor flow and nocturia. He denies visible haematuria. His...

Ureterocystostomy – novel surgery for the paediatric obstructed megaureter

Megaureter is a relatively common congenital urinary tract anomaly; obstructed non-refluxing megaureter is one variant. Initial management is conservative, with operative intervention reserved for symptomatic cases (recurrent pyelonephritis, pain, increasing dilatation or worsening renal function). Surgical options include cutaneous ureterostomy,...

PFMT in males

Pelvic floor muscle training (PFMT) has been described since ancient times in Rome but Kegel popularised it to improve sexual and urinary health after childbirth. In the paediatric population, there is a paradigm shift towards biofeedback-based PFMT for lower urinary...

Urethral pain syndrome – is there a light at the end of the tunnel?

Urethral pain syndrome (UPS) is defined in the 2014 EAU Guidelines as the occurrence of chronic or recurrent episodic pain perceived in the urethra, in the absence of proven infection or other obvious local pathology. UPS is often associated with...

Prenatal spina bifida repair – does it have urological benefits in the longer term?

At present, I have one patient under my care who underwent prenatal closure of his spina bifida defect. Only with time, will we be able to determine whether this intervention has been of benefit for him from a urological standpoint....