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Prostate artery embolisation

Introduction Benign prostatic hyperplasia (BPH), a common condition associated with ageing, affects 50% of those between the ages of 50 and 60 years, and as many as 90% of those older than 80 years. BPH is characterised by unregulated, benign...

Fournier’s gangrene

Introduction Fournier’s gangrene (FG) is a rare but fulminant form of infective necrotising fasciitis affecting the perineum and external genitalia, which can rapidly progress along fascial planes. It most commonly affects men, but can occur in women and children, with...

Inpatient care of patients with established spinal cord injury - what a general urologist needs to know

Introduction Spinal cord injury (SCI) is a devastating, life-changing condition, which is currently irreversible. Depending on the level of the spinal cord affected (and whether the lesion is complete or incomplete), patients may subsequently develop reduced voluntary motor function, sensory...

A sigma six approach to improving nephrostomy and antegrade stent services at a district general hospital – an audit project

As hospitals merge into larger trusts there becomes a centralisation of some services. Interventional radiology (IR) has been one of those services. Our district general hospital runs bi-weekly lR lists following service centralisation. Urology and IR most commonly liaise on...

The importance of active investigation and follow-up in bladder injury

Bladder injury (BI) is uncommon, and patients are typically managed by large multidisciplinary teams, dealing concomitantly with other injuries or diagnoses. BI can be categorised by cause (traumatic vs. iatrogenic) or anatomical location (intraperitoneal vs. extraperitoneal), requiring differing approaches to...

Management of recurrent cystitis

Acute uncomplicated infective cystitis is most commonly seen in healthy women with a frequency of around 0.5-0.7 episodes per woman per year [1]. Around 10% of women report having had an episode of urinary tract infection (UTI) each year and...

Patient decision aids in the management of stress urinary incontinence

Urinary incontinence is a common condition faced by up to 20-50% of women, which impairs quality of life and poses a significant socioeconomic burden to both the individual women involved and more widely to the NHS [1]. The overall cost...

What are the long-term outcomes of TOT and TVT procedures?

This is a systematic review between 2000 and 2016 evaluating the efficacy and safety of midurethral sling (MUS) procedures in women. Studies were included if the follow-up data was five years or more. Objective cure rates showed no significant difference...

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...

Retroperitoneal sepsis

Case 1 An 80-year-old woman presented with history of recurrent and recent cystitis, low grade pyrexia, abdominal and back pain, and pain on movement of the left hip which was observed to be flexed and externally rotated. What is the...

The role of continuous prophylactic antibiotics following JJ stent insertion

Urinary tract infections (UTI) and stent-related symptoms (SRS) are frequently recognised complications of ureteric stent placement. Antibiotic administration at induction prior to ureteric stent insertion is recommended by the European Association of Urology (EAU). Commencing prophylactic antibiotics for the ‘entire...

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...