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Challenges of catheter associated urinary tract infection: is prevention better than cure?
Catheterisation is a common medical procedure in which a catheter (a hollow flexible tube) is inserted into the bladder in order to facilitate the drainage of urine. Catheters are usually passed into the bladder via the urethra, either to be...Testicular cancer: management of stage I seminoma
Introduction Testicular cancer is the most frequently occurring solid tumour in men between the ages of 15 and 34 years [1]. About 60% of cases are seminomas and approximately 70-80% of them have, at presentation, clinical stage I disease. This...
Solifenacin for children and adolescents with overactive bladders
Solifenacin (VESIcare®) is the second-line anti-muscarinic medication of choice for my patients with overactive bladder (oxybutynin being my initial choice). However, currently, it remains unlicensed for use in children. Newgreen et al. have evaluated the long-term safety and efficacy of...
Solifenacin and mirabegron are safe and effective in combination
Antimuscarinic agents remain the mainstay of medical management of bladder overactivity. Limited somewhat by their tolerability, the new agent mirabegron, a β3-adrenoreceptor agonist, has been approved as an alternative. There is little known however about the possible synergistic effects of...
Comparative effectiveness of radical prostatectomy and radiotherapy in prostate cancer
Despite prostate cancer being one of the most commonly diagnosed cancers worldwide, there remains a need for high-quality evidence regarding the optimal treatment choice. In this large population-based cohort study, using the PCBaSe Sweden dataset, Sooriakumaran and colleagues identified patients...Prostate cancer management 1 – non-metastatic disease
You are referred a 68-year-old gentleman to the rapid access prostate clinic with a serum prostate specific antigen (PSA) of 12ug/L. He is otherwise fit and well with mild voiding lower urinary tract symptoms (LUTS). He undergoes a multi parametric...Prostate cancer management 2 – metastatic disease
A 72-year-old gentleman is referred to you in the two-week wait clinic with a prostate specific antigen (PSA) of 22ug/L. He is otherwise fit and well and does not take any regular medication. His multi-parametric magnetic resonance imaging (mpMRI) shows...So you want to go on a fellowship – part II: the research year
This article is the second in a three-part series which follows directly on from the first part which concentrated on the rationale for going on a fellowship, as well as some of the administrative hurdles you might face in planning...Things I wish I knew before starting on-call as an CST in urology
When I started my first core surgical trainee (CST) job in urology, I had no prior exposure or experience. Quickly I realised the significant step up and responsibility involved. Covering multiple sites overnight is something that requires organisation and awareness...Management of recurrent cystitis
Acute uncomplicated infective cystitis is most commonly seen in healthy women with a frequency of around 0.5-0.7 episodes per woman per year [1]. Around 10% of women report having had an episode of urinary tract infection (UTI) each year and...
Are urodynamics still useful?
Two major UK randomised controlled trials, UPSTREAM and FUTURE, compared comprehensive clinical assessment (CCA) alone with CCA plus urodynamics (UDS), incorporating filling cystometry and pressure–flow studies. Both trials involved patients in whom diagnostic uncertainty suggested a potential role for UDS...
