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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...

An overview of non-surgical treatment options for Peyronie’s disease

Peyronie’s disease (PD) is a therapeutic challenge despite the availability of several non-surgical and surgical options. Very few of these options are supported by good quality evidence according to the current American and European guidelines [1-3]. The period of plaque...

The microbial syndicate: dysbiosis and origins of recurrent UTIs

Traditional dogma held that urine was sterile. However, recent molecular studies have revealed an underground microbial community, known as the urinary microbiome or ‘urobiome’ [1]. Far from being harmful, this community of microorganisms helps modulate immune responses, regulate inflammation, and...

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...

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...

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...

The process of medical innovation – evolving trends and future perspectives

In 2018 the United Kingdom Government spending on healthcare totalled almost £166 billion. Of this approximately 65% was attributed to providing curative or rehabilitation therapy, with health-related long-term care and provision of goods accounting for 25%. The remaining was accredited...