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Mesh in urological surgery in the UK – background, reviews and current status

All UK urologists, unless they have been on a 10-year silent retreat, are by now aware of the controversy surrounding surgical use of mesh in general and urological / urogynaecological use of mesh for the surgical treatment of stress urinary...

The PROMIS trial – time for multi-parametric MRI before a first prostate biopsy

Whilst the relatively random process of 12 core transrectal ultrasound guided (TRUS) prostate biopsy remains by far the most widely employed approach to prostate cancer diagnosis in the UK, its flaws as a standalone diagnostic strategy are increasingly apparent. TRUS-biopsy...

Consent: your obligations in the modern, post-Montgomery era

There has been so much recent discussion and so much emphasis placed on the fundamental right that we all have to determine what is or is not done to us, the right to self-determination, that it would be either a...

A time management guide for urologists

Good time management is thought to not only reduce stress, but to improve personal efficiency, service delivery, clinical effectiveness and patient care. It was Benjamin Franklin in the 18th Century who originally made the link between success and the proper...

The scent of Ethiopia: a personal story – part 1

Background The year was 2004; I had just moved to the UK as a young house officer and finished my observership programme at Great Ormond Street Hospital in London. I was inspired by greats like Patrick Duffy and Phillip Ransley,...

ICS updates on continence care: what’s hot in physiotherapy after 80 years?

Origins of pelvic floor physiotherapy Physiotherapy, and in particular pelvic floor muscle training (PFMT) is nowadays first-line management for pelvic floor dysfunction (PFD). PFMT is originally attributed to Dr Arthur Kegel, hence the term Kegel exercises. Indeed, he was the...

Training to be a urologist: how risky is it?

The NHS and urology face challenging times in trying to provide quality patient care efficiently and economically. Urology trainees are experiencing conflicting pressures with a new contract, a challenging on-call system and changing training requirements in an overstretched, centralised service...

Optimising weight loss advice in obese women with urinary incontinence: a review

Background The National Institute for Health & Care Excellence (NICE) guidance specifies that women with a body mass index (BMI) of over 30, combined with urinary incontinence or overactive bladder, should be advised to lose weight [1]. A BMI over...

Is laparoscopic urological training in Sub-Saharan Africa a goal worth pursuing? Observations from my experience with IVUmed in Senegal

Laparoscopic surgery has developed at an unimaginable pace over the last three decades. The first laparoscopic cholecystectomy was performed by Dr Phillip Mouret in France in 1987, with the first series of 63 cases published in 1989 [1]. However, its...