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Clinical visit for PCNL experience: Agra, India

In September 2015, I travelled to India for a two-week clinical visit with Professor Madhu Sudan Agrawal at the Global Rainbow Hospital, Agra. Having completed my training I wanted to further develop my skills with PCNL, particularly with regards to...

Kidney stones in pregnancy

Urolithiasis related complications are estimated to affect between 1:200 and 1:2000 pregnancies [1,2]. With around 825,000 conceptions in England and Wales in 2021 [3], this represents an uncommon but not rare occurrence. What is normally a straightforward pathway for a...

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...

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...

Penile fracture

Traumatic rupture of the tunica albuginea with either one or both corpora cavernosa of the penis is known as penile fracture. This may be associated with corpus spongiosum or urethral injury. Incidence Penile fracture was reported for the first time...

Pyonephrosis: is the kidney always doomed?

Pyonephrosis (Greek pyon ‘pus’ + nephros ‘kidney’) is defined in Campbell-Walsh Urology [1] as an infected hydro-nephrosis associated with suppurative destruction of the renal parenchyma which results in total or near total loss of renal function. The true incidence of...

Kidney stones in pregnancy

Case 1 A 28-year-old female, 19 weeks pregnant, presents with severe left loin pain. There is no past medical history of note. Blood tests show a white cell count of 14.1x109/L and creatinine of 56umol/L. An ultrasound scan (USS) reports...

A negative ureteroscopy for stone disease: is it acceptable and is it avoidable?

Urinary tract stone disease and the consequent demand for endoscopic intervention in the upper urinary tract is an increasing phenomenon [1]. Although ureteroscopy is generally considered to be associated with low morbidity [2], risks do exist. Recognised complications include urothelial...

Focal therapy trials

Men with localised prostate cancer have traditionally required whole gland treatment involving radical prostatectomy or radical radiation treatment, independent of disease location and size. Increasing evidence supports the use of active treatment only in those men diagnosed with prostate cancer...

Suprapubic catheterisation – a core surgical trainee’s perspective

Suprapubic catheters (SPCs) are in widespread usage in medical practice and this review will focus on the pre-assessment, indications, methods and complications that are associated with the insertion of an SPC. Although suprapubic catheter insertions may be done electively or...

Introduction to prostate cryotherapy

Introduction Cryotherapy was first described by Dr James Arnott in 1850 where he used crushed ice and salt to get temperatures as low as -24oC, in the treatment of cervical and breast tumours [1]. The literature on prostatic cryotherapy dates...

Localised renal cancer

Case 1 A 56-year-old lady is referred to the urology clinic after the GP conducted an ultrasound abdomen for deranged liver function tests and found a renal lesion. She is otherwise fit and well. Figure 1. What is the sensitivity...