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The assessment and medical treatment of LUTS secondary to BPH

The term benign prostatic hyperplasia (BPH) describes prostate enlargement due to non-cancerous processes. Several aetiological mechanisms are involved, including hormonal and vascular alterations; abnormal regulation of apoptosis; and prostatic inflammation, which may stimulate cellular proliferation. With ageing, prostate enlargement can...

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...

Oncological Imaging: Urology

Imaging updates on renal tumours, urothelial tumours, prostate, adrenal and retroperitoneal tumours are all covered in this text. Whilst aspects relating to prostate imaging are probably covered better elsewhere, what remains is a decent account nicely contained within a single...

Psychosocial distress in parents of children with DSD

Disorders of sex development (DSD) are a rare set of medical conditions with prevalence rates ranging between 1:00 to 1:5000 births. Secondary atypical genitalia is seen in a subset. Psychosocial aspects have until recently been understudied. We know that some...

Preparing for the FRCS (Urol) viva

Ping! You look down to your phone and you have just received an email saying, “Congratulations, you have now successfully completed The Joint Committee on Intercollegiate Examinations section 1 of the Fellowship of the Royal College of Surgeons (Urol) exam.”...

The NICE Guideline on Urinary Incontinence: the management of urinary incontinence in women

Background Urinary incontinence (UI) is a common symptom that can affect women of all ages. It is difficult to estimate the prevalence of UI since it is often under-reported, although the Norwegian EPINCONT study looking at women over 20 reported...

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...

What are the long-term outcomes of TOT and TVT procedures?

This is a systematic review between 2000 and 2016 evaluating the efficacy and safety of midurethral sling (MUS) procedures in women. Studies were included if the follow-up data was five years or more. Objective cure rates showed no significant difference...

Men with a susceptibility to prostate cancer: implications of family history in PCa risk-prediction

Incorporation of family history (FH) status into prostate cancer (PCa) risk stratification has the potential to underpin many aspects of PCa care. This group of men presents a unique challenge in early cancer detection, particularly given that most men without...

Technology – Part 1

Case 1 What is this and what material is it made from? What property of the catheter does the size refer to? What is the relationship between French size and diameter? What is a biofilm? How can you reduce catheter...

Urinary tract stones

Case 1 What does this plain X-ray of kidneys, ureters and bladder (KUB) show? What, according to the 2009 The National Institute for Health and Care Excellence (NICE) guidelines, is the most appropriate first-line treatment? What factors do the NICE...

Consent

See Part 2 on this topic here Case 1 A 15-year-old boy attends with his father to have a circumcision on a day case list. He had been seen previously by a colleague and noted to have a tight phimosis...