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Medical Protection: Expertise, advocacy, and support when it matters most

The world’s leading medical defence organisation providing long-term protection against the potentially ruinous costs of litigation, as well as the other professional challenges that healthcare professionals might face during the course of their career. As a doctor your work is...

Is it time for a kidney stress test?

In healthcare, what we measure shapes how we predict outcomes and intervene. For kidney health, traditional tools like estimated glomerular filtration rate (eGFR) provide only a partial picture. Relying solely on eGFR is like judging heart health with a resting...

Comparison of CHOKAI, STONE and STONE PLUS scores

The prevalence of urinary stones is steadily increasing due to changing dietary habits and living conditions, leading to a significant number of emergency department (ED) visits, primarily for severe pain. While managing pain is crucial, accurate diagnosis remains essential. Non-enhanced...

ESWL and URS for treatment of paediatric urolithiasis

Tejwani et al. have undertaken a comparative effectiveness study to characterise differences in procedure frequency, postoperative re-admissions and emergency room (ER) visits, and repeat treatment rates for children (≤18 years) with urolithiasis who underwent initial intervention with extracorporeal shock wave...

Cystoplasty

Case 1 A 48-year-old female, having previously had an augmentation ileocystoplasty 10 years ago, has been referred with right loin pain by the emergency department. A venous blood gas is performed shortly after triage with the following values: What is...

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...

Phase two trial of SAbR for primary RCC

A study focused on stereotactic ablative radiotherapy (SAbR) as a treatment for primary renal cell carcinoma (RCC) has yielded significant findings. The primary objective of the study was successfully met, demonstrating a 94% local control rate at one year among...

Management dilemma for very high-risk non–muscle-invasive bladder cancer

The European Association of Urology (EAU) guidelines recommend upfront radical cystectomy (RC) for very high-risk (VHR) non-muscle-invasive bladder cancer (NMIBC). However, real-world adoption is limited, as most patients are reluctant to undergo immediate bladder removal. The EAU 2021 risk model...

Five-year outcomes following negative MRI or biopsy in the RAPID diagnostic pathway

The Rapid Assessment for Prostate Imaging and Diagnosis (RAPID) pathway was introduced in UK urology centres to streamline prostate cancer diagnosis using an MRI-directed approach. Men with elevated PSA undergo upfront multiparametric MRI (mpMRI), and biopsy is reserved for those...

Penile cancer: a practical approach

Penile cancer is rare and accounts for less than 1% of all new cancer cases in males in the UK, with around 640 new cases diagnosed every year [1]. In England and Wales, the annual incidence is between 1.2 and...

Urinary incontinence in women – part 1: terminology and diagnosis

Introduction Urinary incontinence (UI) is the involuntary and often embarrassing leakage of urine. It is a condition that is both under-reported and under-diagnosed, and when reported it is, unfortunately, often not assessed and managed adequately. Incontinence of urine is encountered...

ICS updates on continence care: making sense of detrusor underactivity and the underactive bladder

Countless epidemiological studies have established the frequent occurrence of lower urinary tract symptoms (LUTS) and the significant burden these symptoms incur. For the most part of the past three decades, there has been an overwhelming focus on detrusor overactivity (DO)...