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Rare and Complex Urology

Diseases that are rare or of low prevalence pose challenges to provision of high-quality care because of limited available knowledge and sparse good-quality evidence regarding uncommon presentations, mechanisms of disease, and optimal treatments. Approximately 80% of rare diseases are of...

Basic Urological Sciences

The scientific foundation of any discipline is, as the name suggests, basic to the understanding of pathophysiology, mechanisms, physiologic and pharmacologic interactions, and technology. It arms the clinician with the ability to challenge dogma and keep pace with recent advances...

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 impact of menopause on bladder symptoms

The menopause is a natural process of ageing when the ovaries completely stop producing reproductive hormones (oestrogen and other sex steroids), and there are no monthly periods for 12 consecutive months. It normally occurs between the ages of 45-55 years...

Missed Meyer-Weigert duplex ureter during emergency ureteric stenting for ureteric stones

The Meyer-Weigert rule is a fundamental anatomical principle in urology that describes the typical orientation of ureteral orifices in duplex kidneys. In a duplex system, the upper pole ureter usually inserts inferomedially, while the lower pole ureter inserts superolaterally. This...

Time for tea

Kidney stone disease can be related to genetic, biochemical, and dietary factors. Much has been said about the link between tea and coffee consumption and risks of urinary stone formation. This is a systematic review using the PRISM statement with...

The cost of bladder cancer: what can be done?

The rising cost of cancer care is a growing concern for health systems. A 2020 study estimated Europe’s annual cancer-related expenditure at €199 billion, with €109 billion attributed to healthcare costs. Bladder cancer (BC), in particular, imposes a significant financial...

Cardiac failure and medical therapy for LUTS / BPH

Alpha blockers (AB), 5-alpha reductase inhibitors (5-ARI) and combination therapy are widely prescribed for lower urinary tract symptoms (LUTS) considered consequent to prostatic enlargement and are the mainstay of first-line therapy. This retrospective interrogation of a large population-based dataset of...

Long-term risks of augmenting the bladder in spina bifida patients

Bladder augmentation is utilised to treat children with neuropathic bladders secondary to spina bifida that results in hostile urodynamics, renal deterioration and / or urinary incontinence. Whilst it is associated with an improved quality of life and low mortality, it...

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...

Management of lower urinary tract foreign bodies

Of all the urological emergencies presenting to the emergency department, perhaps one of the most technically challenging cases is the patient with a foreign body in the genitourinary (GU) tract. A wide variety of GU foreign bodies have been reported...

The role of transperineal template biopsies in the diagnosis of prostate cancer

The case In 2002, Mr A, a 64-year-old software engineer, was referred by his GP for further investigation of a raised prostate specific antigen (PSA) of 6.2. His prostate felt benign. He underwent transrectal ultrasound guided (TRUS) prostate biopsies. This...