Case study A 70-year-old, generally fit and well male attends your outpatient clinic. He has experienced a gradual deterioration in his voiding over the last few months. Specifically, he reports hesitancy, poor flow and nocturia. He denies visible haematuria. His...
“What gets us into trouble is not what we don’t know. It’s what we know for sure that just ain’t so.” The above is a quote attributed to Mark Twain from the 2006 documentary, An Inconvenient Truth, which follows Al...
In a small room near the operating theatre of the London Hospital sometime in the 1880’s, a surgeon slips off his outdoor frock coat. From his pocket he pulls a silver curved catheter, spits on it and nonchalantly passes it...
Patients with haematuria require investigations to rule out urinary tract cancer. We know that the most common cancer found during these investigations is bladder cancer, whereas upper tract cancers such as renal cell carcinoma and upper urinary tract urothelial cancer...
The incidence of urethral stricture in men with lichen sclerosus (LS) has been reported to be between 4.8% and 14%. LS limited to the glans and urethral meatus can be treated with acceptable outcomes; however, more extensive urethral disease requires...
Nephrostomies are a valuable uroradiological intervention which enables drainage of the obstructed kidney, amongst other indications. Complications associated with nephrostomies following placement are not uncommon, with re-presentation to the emergency department or surgical emergency unit. In this review we will...
This book is designed to meet the needs of nurse practitioners, advanced practice nurses and physician assistants working in urology in the US where Advanced Practice Certification, although not mandatory, is highly sought after by employers and service users alike....
Bladder malignancy is one of the commonest malignancies of the renal tract, accounting for approximately 6% of male malignancy and 2% of female malignancy. The incidence increases with patient age with 70% of patients being over the age of 65...
Timing is everything.’ Although an expression most frequently linked to comedy, timing also seems just as critical in the business of sexual climax. Indeed, many men worry about ejaculating. Too soon is embarrassing. Too slow is frustrating. And not ejaculating...
See also Part 1 and Part 3. Case 1 A 43-year-old lady presented to the urologist with a history of pain during bladder filling and associated frequency / urgency. She underwent standard microbiological and radiological investigations that are normal. She...
Clinical Trials 2 is available here. Case 1 1. What are the levels of clinical evidence based on the 2009 definitions from the ‘Oxford CEBM’? 2. What is the null hypothesis? 3. What are type 1 and type 2 errors?...
Introduction Clean intermittent self catheterisation (CISC) was first introduced and popularised by Lapides in 1972. Since then its utilisation has become widespread and it is now commonly used throughout the world as the preferred means of facilitating complete and effective...