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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...

Stuttering (recurrent ischaemic) priapism

Stuttering (recurrent ischaemic) priapism (SP) is a rare urological condition. Affected men will often experience almost daily prolonged and painful sleep related erections (SRE). Interestingly, these men report normal erections during the day and whilst awake. These episodes are usually...

All you need to know about percutaneous nephrolithotomy: supine versus prone and mini versus traditional

Introduction Since the first percutaneous nephrolithotomy (PCNL), the technique has undergone many innovations, including modifications in positioning, miniaturisation of instruments and combination with retrograde intra-renal surgery (see Table 1 for an outline of the history of the technique). Controversy has...

Medical statistics for urologists: part 2 – probability and hypothesis testing

Following on from Part 1 of this series (Part 3 available here), this article aims to build on other analytical techniques commonly used within medical research, focusing on simple examples. Probability and testing Before exploring hypothesis testing, it is vital...

ICS updates in continence care: the role of the nurse continence specialist in continence services

The nurse who specialises in continence care is recognised as a key member of interdisciplinary teams seeking to deliver high quality integrated continence services. The recently published international service specifications for continence care [1] supports the use of specialist continence...

An update on erectile dysfunction guidelines and treatment options

Erectile dysfunction is defined as the persistent inability to attain and / or maintain an erection sufficient for sexual performance. Not only does this have a psychosocial impact, it also affects the quality of life of both the patients and...

Can we make LATE-presenting posterior urethral valves an EARLIER-treated condition?

What are posterior urethral valves? Posterior urethral valve (PUV) is the most common cause of congenital bladder outlet obstruction (BOO) and renal failure in male children. They were first described by the Italian anatomist Giovanni Battista Morgagni back in the...

The impact of menopause on bladder symptoms

The menopause is a natural process of ageing when the ovaries completely stop producing reproductive hormones (oestrogen and other sex steroids), and there are no monthly periods for 12 consecutive months. It normally occurs between the ages of 45-55 years...

Shared decision-making – minimising the mismatch

In Western countries, we are spoilt for choice in almost every aspect of our lives, but does that reflect also in healthcare? While we have taken some big strides towards shared decision-making with our patients, the age-old physician dominance remains...

Male infertility

Definitions Infertility is the inability of a sexually active, non-contracepting couple to achieve spontaneous pregnancy in one year [1]. About 15% of couples do not achieve pregnancy within one year and seek medical treatment for infertility. Semen parameters are standardised...

An update on antibiotic prophylaxis in TRUS-guided prostate biopsy

Since its inception in the 1980s, transrectal ultrasound (TRUS)-guided prostate biopsy has remained the standard tool for the histological diagnosis of prostate cancer. There are several advantages to this technique which have led to the widespread use of TRUS in...