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LUTS update

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...

(Not very) clean intermittent self catheterisation

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...

In conversation with Mary Garthwaite

We were delighted to chat with Mary Garthwaite, former Consultant Urological Surgeon and Chair of The Urology Foundation, the UK’s only charity representing all urological cancers and conditions. Can you tell us a little bit about what led you into...

Bladder carcinoma MRI

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...

Infections and inflammation: Part 2

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...

Laparoscopic transposition of renal lower pole crossing vessels

The vascular hitch procedure for pelvi-ureteric junction obstruction (PUJO) was initially described by Hellstroem in1951 and has become popular again since the introduction of laparoscopy. There is still much controversy as to its efficiency. The authors of this paper analyse...

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...

Clinical trials 1

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?...

Ejaculatory dysfunction – too swift, too slow and the no-show

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...

Complications of CISC

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...

Urolithiasis – metabolic considerations

Case 1 A 32-year-old female patient is diagnosed with a ureteric calculus for the first-time. What type of metabolic evaluation investigations should be performed? When should stone analysis be repeated? What are the most common metabolic abnormalities associated with calcium...

Partial segmental thrombosis of the corpus cavernosum

Epidemiology Partial segmental thrombosis of the corpus cavernosum (PSTCC) is a rare condition and usually presents in young men. Approximately 56 cases have been reported in 34 publications since 1976, when the first two cases were described [1,2]. The mean...