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Ejaculatory dysfunction: a review of current practice and guidelines

Introduction The ejaculatory process is paramount to procreation in nature. It is a complex orchestration of physiology that results in emission of the ejaculate into the posterior urethra followed by ejection of those fluids from the urethra and orgasm. The...

Peyronie’s disease: a review and update

Peyronie’s disease (PD) describes an acquired disease of the penis, which is characterised by a number of signs and symptoms. These include penile pain, curvature, palpable plaques, wasting or narrowing of the penile shaft, a hinge deformity and potentially catastrophic...

Priapism

Priapism is defined as an abnormally persistent erection lasting greater than four hours, not associated with sexual desire [1]. Although relatively uncommon with an incidence of 1.5 per 100,000 [2], priapism has a risk of complications which can have a...

Male urethrograms

An ascending urethrogram is the best initial radiographic technique to image a male patient’s urethra and is indicated for strictures, fistulae, trauma and urethral obstruction [1]. It is quick and straightforward to perform and is performed using an 8Fr Foley...

Adrenal incidentalomas: what next?

An incidentaloma refers to an adrenal lesion >1cm discovered incidentally during radiologic examination. Identifying a malignant and / or functioning lesion is critical for management. However, as the majority of lesions are benign, the challenge is the identification of malignant...

Ejaculatory dysfunction – too swift, too slow and the no-show

Timing is everything.’ Although an expression most frequently linked to comedy, timing also seems just as critical in the business of sexual climax. Indeed, many men worry about ejaculating. Too soon is embarrassing. Too slow is frustrating. And not ejaculating...

Comparing intravesical chemohyperthermia with Mitomycin C versus BCG in treating bladder cancer

In the advent of the recent Bacillus Calmette–Guérin (BCG) crisis, the importance of alternative adjuvant treatments for intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC) has been highlighted. Chemohyperthermia (CHT) has emerged as an option, however there remains a lack of...

Percutaneous ultrasound guided endoscopic lavage of perinephric abscess – different, but not necessarily better

Perinephric abscess is an uncommon but serious form of urosepsis. It develops as a consequence of the extension of an infection outside of the parenchyma of the kidney in acute pyelonephritis, or more rarely from haematogeneous spread of an infection...

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...

Inguinal vs. scrotal orchidopexy

Undescended testes occur in 1-3% of newborns; the prevalence is even higher in premature babies. Traditionally the surgical approach has been inguinal orchidopexy, involving two incisions – inguinal and scrotal. In 1989, Bianchi and Squire proposed single scrotal incision orchidopexy...

The management of renal calculi – Pt 1

Renal calculi can be managed according to four treatment options: conservative management, extracorporeal shockwave lithotripsy (ESWL), flexible ureterorenoscopy (FURS) and percutaneous nephrolithotomy (PCNL). This is the first in a two-part series in Urology News (Part 2 available here) that will...

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]...