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The surgical trainer – are we still evolving?

“We need a system and we will surely have it – which will produce not only surgeons, but surgeons of the highest type” William Halsted MD William Halsted, a famous American surgeon, is widely credited with developing the first formal...

Francisco Díaz (1527-1590), forefather of urology

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). We often talk about urology being the oldest surgical specialty and discuss the...

Sepsis syndrome in urology

There are approximately 100,000 cases of sepsis per year in the UK, of which 37,000 result in death (this is more than prostate cancer, breast cancer, HIV / AIDS and road traffic accidents combined). Urosepsis is defined as sepsis caused...

Clitoral reconstructive surgery after female genital cutting

Practised in Africa and other parts of the world, the WHO recently estimated that over 250 million females have been circumcised so far, and an additional three million are at risk of circumcision each year...

Update on immunotherapy for non-muscle invasive transitional cell carcinoma of the bladder

Patients with high-risk non-muscle invasive bladder cancer (NMIBC) that have failed Bacillus Calmette-Guérin (BCG) treatment are a difficult group to treat, and many may not be suitable for the preferred treatment option of radical cystectomy. Bladder-preserving treatments for BCG-unresponsive high-risk...

BCG after TURBT – does timing matter?

Intravesical bacille Calmette–Guerin (BCG) therapy continues to be widely used for patients with intermediate / high-risk non-muscle invasive bladder cancer (NMIBC). In this article, the researchers identified the lack of sufficient evidence with regards to timing of BCG after transurethral...

Percutaneous ultrasound guided endoscopic lavage of perinephric abscess – different, but not necessarily better

Perinephric abscess is an uncommon but serious form of urosepsis. It develops as a consequence of the extension of an infection outside of the parenchyma of the kidney in acute pyelonephritis, or more rarely from haematogeneous spread of an infection...

TPTNS: evaluation of a therapeutic option in the management of anticholinergic refractory overactive bladder

This is a prospective study evaluating the tolerability and efficacy of transcutaneous posterior tibial nerve stimulation (TPTNS) in patients with urodynamically proven overactive bladder (OAB), who have failed anticholinergic treatment. Forty-three patients were studied and followed up over a period...

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...

Long-term complications of bulking agents in the treatment of SUI

Incontinence poses a substantial economic burden on the UK’s NHS, estimated at £536 million in 1999/2000, equivalent to approximately 1.1% of the total NHS spend, for both men and women. Over two decades later, this cost is expected to have...

Systematic reviews and meta-analysis – a stepwise approach

As per Cochrane definition (2013), a systematic literature review (SR) attempts “to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question” [1]. A meta-analysis (MA) is a statistical assessment of...

Goddard’s Dropps: a Paradox of the C17th

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). In the last article I told you about the world of the London...