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Can continence and volitional voiding be achieved in bladder exstrophy?

Bladder exstrophy is a challenge to the paediatric urologist; here in the UK, repairs are now undertaken at two centres in order to concentrate experience. The ultimate aim is to achieve urinary continence and volitional voiding. In this study, John...

The doctor as the patient: receiving bad news

This article, written by a GP working in the NHS, gives a unique insight into the experience of being a urology patient and some thoughtful advice on ‘breaking bad news’. Day 1 Alarm bells ring. It’s spotting an email from...

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...

Surgical video – part 2: Tips on how to edit and create a finished surgical video for teaching or publication

A well-made and informative video can be one of the most valuable promotional tools for a department of urology. Having to resort to an external commercial source to produce a video can be prohibitively expensive. With the extensive computing power...

PDE5I in LUTS – how do they work – no proof yet

Phosphodiesterase type 5 (PDE5) inhibitors used in erectile dysfunction (ED) have been shown to improve lower urinary tract symptoms (LUTS) as well. The mechanism is not well understood. One of the hypotheses for benign prostatic hyperplasia (BPH) – LUTS is...

Imaging and radiology

Case 1 What radiological test is this and what does it show? What is the typical radio-nucleotide used for this study, what is its half-life and how is it excreted? Approximately how long does this study take to perform? What...

Can the latest patient decision aid help OAB patients?

OAB Answers is a patient decision aid co-authored by several European urologists and gynaecologists, and two patient advocates, to help patients understand and manage their overactive bladder (OAB). It is a 36-page document split into several clear sections, aiming to...

Nocturia – the Cinderella of lower urinary tract symptoms

Nocturia is defined as waking during the night (at least once) to urinate. The important part of the definition relates to the necessity of sleep to precede the episode (although whether sleep must follow the episode is less clear). The...

Post radical nephrectomy presenting with skull metastasis

We present the case of an 83-year-old female who underwent right radical nephrectomy for renal cell carcinoma (RCC). Despite negative surgical margins, the patient presented with a skull metastasis six years post radical nephrectomy. This case highlights the importance of...

Imaging and surveillance in sporadic renal angiomyolipoma: how and when to monitor effectively

Renal angiomyolipoma (AML) are benign tumours, accounting for approximately 2–3% of all renal neoplasms [1]. Seventy percent of renal AMLs are sporadic, and 20–30% are associated with genetic aetiology. They are composed of smooth muscle, blood vessels, and adipose tissue....

The Lister Royal College of Surgeons of England / BAUS Accredited Robotic Urological Fellowship Programme

Robotic fellowship training in the UK – overview Robotic surgery has increased in popularity since its introduction in 2003. Its validation in a growing number of operative procedures has increased its acceptance nationwide and its usage is becoming widespread. Initial...

Giggle incontinence – not a laughing matter!

For many decades, the condition of giggle incontinence (enuresis risoria, giggle micturition) has remained a rare and poorly understood condition. Patients (90% female) present in their teens, with the history revealing an issue for many years. It is debilitating and...