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Female and functional

Case 1 A 65-year-old woman presents with an 18-month history of “recurrent urinary tract infections” (rUTI). She is otherwise fit and well with no underlying medical problems and no lower urinary tract symptoms. What is the definition of a UTI...

Medical statistics for urologists: part 2 – probability and hypothesis testing

Following on from Part 1 of this series (Part 3 available here), this article aims to build on other analytical techniques commonly used within medical research, focusing on simple examples. Probability and testing Before exploring hypothesis testing, it is vital...

Management of RHC in prostate cancer with selective embolisation and hyperbaric oxygen therapy

Prostate cancer is one of the most prevalent malignancies affecting men worldwide. Radiotherapy is a common treatment modality for localised and locally advanced prostate cancer. While radiotherapy can be effective, it may lead to complications such as radiation-induced haemorrhagic cystitis...

The surgical management of female stress urinary incontinence in a post-mesh era

Trends in surgical management of women with stress urinary incontinence (SUI) have changed in recent times, mainly due to the ‘High Vigilance Pause’ placed on the use of mesh for SUI (and prolapse) surgery in July 2018 following an independent...

TIP hypospadias repair

This paper by one of the current international leaders in hypospadias surgery looks at the outcome of over 1800 consecutive hypospadias repairs using the tubularised incised plate (TIP) repair, beginning from the first original operation through to sequential modifications over...

Fournier’s gangrene

Introduction Fournier’s gangrene (FG) is a rare but fulminant form of infective necrotising fasciitis affecting the perineum and external genitalia, which can rapidly progress along fascial planes. It most commonly affects men, but can occur in women and children, with...

The importance of second-look transurethral resection for superficial bladder cancer

This was a prospective study of 100 consecutive patients with a newly diagnosed superficial bladder tumour who underwent a second look transurethral resection of bladder tumour (TURBT) two to six weeks post initial resection. This essentially included pTa multiple and...

Nephrocalcinosis

Case 1 What does this x-ray of the kidney, ureter and bladder (KUB) show? What are the likely causes? What is the pathology behind medullary sponge kidneys (MSK)? What is the risk of urolithiasis with MSK? How are such patients...

Infections and inflammation: Part 3

See also Part 1 and Part 2 Case 1 You review a man in the Emergency Department with scrotal pain and sepsis. His clinical examination findings are shown. What does this image show? Who was this condition named after? What...

Nuptial night tragedy

Case 1 A fit and well 50-year-old gentleman presents to the emergency department with pain and swelling of his penis that started a few hours after he had a shower earlier in the day. On examination, the appearance is as...

Dietary citrate substitution in urolithiasis patients

Stone formation is dependent on supersaturation of urinary salts and urinary crystal retention. Urinary promoters (protein aggregates, cell debris) and inhibitors (citrate, magnesium, urinary macromolecules such as glycosaminoglycans and proteins) are involved in the process of stone formation [1]. Hypocitraturia...

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...