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Use of Clavien-Dindo classification in urology part 2 – upper tract

A classification system of surgical complications was proposed by Clavien in 1992 [1] and further modified by Dindo in 2004 [2]. Clavien-Dindo classification has since then been validated through many retrospective case series as well as in comparative studies to...

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...

Catheters and incontinence after radical prostatectomy: Preparing (but not scaring) men

Every year about 6000 men in the UK undergo radical prostatectomy (RP) for treatment of prostate cancer [1]. Despite surgical advances, RP continues to be associated with significant side-effects including urinary incontinence (UI) [2]. Immediately following removal of the urinary...

Surgical video – part 1: intraoperative video recording and storage

The use of digital technology has progressed in leaps and bounds and nowhere is this more apparent than in medicine and surgery. Footage of live surgery is now easily accessed on the internet or displayed at conferences. Thus, the 21st...

A guide for the assessment and management of post-obstructive diuresis

Acute urinary retention is a common condition encountered in the emergency situation and is initially managed by urethral catheterisation. This is often performed by nursing staff or junior doctors. Post-obstructive diuresis (POD) is a specific entity which may occur post...

Getting it Right First Time in urology: the implementation phase

The Getting it Right First Time (GIRFT) programme is the largest and most comprehensive initiative to improve the quality and efficiency of individual clinical services that the NHS has ever instigated. The programme falls under the auspices of NHS Improvement...

Artificial penile pearls: what every Urologist should know!

Penile implants are inert objects placed beneath the skin of the penis through an incision. These are variously referred to as Yakuza beads, pearls, ball bearings, speed bumps, penile marbles, inserts, etc. The term ‘penile implant’ described here should not...

Benign prostatic hyperplasia: what are the benefits and harms of various surgical management options?

Benign prostatic hyperplasia (BPH) is characterised by stromal and epithelial prostatic cell hyperplasia. The enlarged prostate may be associated with voiding and storage lower urinary tract symptoms (LUTS). These have been predominantly attributed to bladder outlet obstruction (BOO), assumed to...

Post-prostatectomy incontinence

Urinary incontinence following prostate surgery (post-prostatectomy incontinence or PPI) is a significant complication that can have a profoundly negative impact on the quality of life of patients suffering with it. It may become a barrier to physical activity and social...

Moving hospitals as a consultant urological surgeon: what are the challenges?

Despite over 100 unfilled consultant urological surgeon posts in the UK, the reasons why an established surgeon should wish to move hospitals can still be viewed with suspicion. Why is this the case, when in many other careers, both within...

Use of MRI in the evaluation of prostate cancer: part 1

Introduction Prostate cancer remains the most commonly diagnosed cancer in males and the second leading cause of cancer related deaths in UK men, after lung cancer [1]. The incidence of prostate cancer in the UK has shown a rapid increase...