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What is the role of evidence-based medicine in urology?
The concept of ‘evidence-based medicine’ (EBM) was first developed in the early 1990s and was described as “the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients” by the recently...Ambulatory local anaesthetic implantation of percutaneous sacral nerve stimulators
Background The current treatment paradigm for detrusor overactivity (DO) and dysfunctional voiding (DV) includes conservative measures, pharmacotherapy, intravesical onabotulinum toxin A (Botox®), sacral nerve modulation (SNM / SNS) and urinary diversion as a last resort [1]. Incidence of DO is...The burning issue of urinary tract infections
Urinary tract infections (UTIs) occur when bacteria colonise and proliferate in the urinary tract. These are characterised by specific clinical symptoms (dysuria, suprapubic tenderness, urgency and urinary frequency) which commonly occur alongside the finding of bacteriuria. UTIs are common –...
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...Metabolic screening and stone-prevention in urolithiasis patients
The incidence and prevalence of kidney stones is increasing [1,2]. Significant recurrence rates are noted with 14% of patients experiencing a further episode at one year, 35% at five years, and 52% at 10 years [3]. Over 10% of stone...The role of embolisation in urology
Case 1 An 86–year–old male presented with visible haematuria and suprapubic pain. He had a history of diabetes, heart failure, benign prostatic hypertrophy, aortic valve replacement, deep vein thrombosis (DVT) and atrial fibrillation (AF) and was anticoagulated on a non-VKA...The AUA Residents’ Bowl: with the help of BSoT (13-16 May 2022 • New Orleans, USA)
After successfully sitting both parts of the FRCS(Urol) examination in 2021 and still basking in the knowledge that I would never have to sit another examination again, it’s fair to say there was a certain amount of consternation when I...Transplant urology at Guy’s Hospital: making the most of a year out before specialty training
It was gutting to miss out on urology at national selection on my first attempt. The ST3 application has become increasingly competitive and this means more appointable trainees find themselves looking to plan B. The options available can be daunting...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...
Why defining and managing DUST matters in endourology
In endourology, defining ‘DUST’ and optimising its management is vital for improving stone-free rates (SFR) and reducing complications. Residual fragments, even those ≤4mm, can act as a nidus for infection, obstruction, and recurrence. Studies have shown that 30% of patients...Bladder cancer: where are we with intravesical therapies?
In the United Kingdom, almost 10,500 new cases of bladder cancer were identified in 2013, with over 5000 deaths in 2012 [1]. Seventy percent of new cases will be non-muscle invasive bladder cancer (NMIBC) at diagnosis and therefore will be...
