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A ‘survival guide’ to an ST3 year in urology

Following success in national selection, it soon dawns on the successful candidate that entry into higher surgical training (HST) requires more than a little clinical knowledge. The role requires administrative and organisational skills not hitherto called upon. This additional skill...

Developing a risk calculator to predict cancer in patients with haematuria: The IDENTIFY Study

Patients with haematuria require investigations to rule out urinary tract cancer. We know that the most common cancer found during these investigations is bladder cancer, whereas upper tract cancers such as renal cell carcinoma and upper urinary tract urothelial cancer...

Hypospadias – detecting your complications

All hypospadias surgeons will encounter complications. They are estimated to occur in around 10% of distal hypospadias repairs and more than 50% for proximal forms. Some controversy exists regarding the length of follow-up needed to detect them. Some series have...

Lichen sclerosus and isolated bulbar urethral stricture disease

The incidence of urethral stricture in men with lichen sclerosus (LS) has been reported to be between 4.8% and 14%. LS limited to the glans and urethral meatus can be treated with acceptable outcomes; however, more extensive urethral disease requires...

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...

The bulbocavernosus reflex

Despite its first discovery predating the early-1940s, clinical application of the bulbocavernosus reflex (BCR) has been limited to date. The BCR traditionally involves contraction of the bulbo- and ischiocavernosus pelvic floor muscles, often referred to as the ‘bulbocavernosus muscle’, in...

Inguinal vs. scrotal orchidopexy

Undescended testes occur in 1-3% of newborns; the prevalence is even higher in premature babies. Traditionally the surgical approach has been inguinal orchidopexy, involving two incisions – inguinal and scrotal. In 1989, Bianchi and Squire proposed single scrotal incision orchidopexy...

To clamp or not to clamp – outcomes of the CLOCK trial for robotic partial nephrectomy

The benefits of partial over radical nephrectomy are well established. The CLOCK trial (CLamp vs. Off Clamp the Kidney during robotic partial nephrectomy) was designed as a multicentre, randomised controlled trial to generate evidence on the role of the off-clamp...

COVID-19: the impact on urology so far

“How very little can be done under the spirit of fear.” Florence Nightingale Since 31 December 2019 when a cluster of pneumonia cases with an unknown cause were first referred to the WHO Country Office in China, there has been...

An inconvenient truth: reflections on the NHS

“What gets us into trouble is not what we don’t know. It’s what we know for sure that just ain’t so.” The above is a quote attributed to Mark Twain from the 2006 documentary, An Inconvenient Truth, which follows Al...

Long-term complications of bulking agents in the treatment of SUI

Incontinence poses a substantial economic burden on the UK’s NHS, estimated at £536 million in 1999/2000, equivalent to approximately 1.1% of the total NHS spend, for both men and women. Over two decades later, this cost is expected to have...

Is renal pelvis reduction during dismembered pyeloplasty necessary?

The development of laparoscopic pyeloplasty has progressively led to a reduction in the amount of perioperative renal pelvic excision as a large excision leads to a longer anastomosis with associated increased risks (leak, operative time). This prospective study of 40...