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Nocturia – the Cinderella of lower urinary tract symptoms

Nocturia is defined as waking during the night (at least once) to urinate. The important part of the definition relates to the necessity of sleep to precede the episode (although whether sleep must follow the episode is less clear). The...

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...

AML – a rare variant

With the increasing number of CT and ultrasound scans performed in hospital practice more and more incidental angiomyolipomas (AML) are being picked up, some of which are asymptomatic and may not bother patients at all. This study comes from the...

Mesh in urological surgery in the UK – background, reviews and current status

All UK urologists, unless they have been on a 10-year silent retreat, are by now aware of the controversy surrounding surgical use of mesh in general and urological / urogynaecological use of mesh for the surgical treatment of stress urinary...

Lifestyle interventions for UI in women

Lifestyle interventions for urinary incontinence (UI) are supported by all major guidelines. The National Institute for Health and Care Excellence (NICE) guideline (CG171) from September 2013 (updated November 2015) [1] recommends lifestyle advice including dietary modifications such as caffeine reduction,...

ICS updates on continence care: what’s hot in physiotherapy after 80 years?

Origins of pelvic floor physiotherapy Physiotherapy, and in particular pelvic floor muscle training (PFMT) is nowadays first-line management for pelvic floor dysfunction (PFD). PFMT is originally attributed to Dr Arthur Kegel, hence the term Kegel exercises. Indeed, he was the...

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...

Is laparoscopic urological training in Sub-Saharan Africa a goal worth pursuing? Observations from my experience with IVUmed in Senegal

Laparoscopic surgery has developed at an unimaginable pace over the last three decades. The first laparoscopic cholecystectomy was performed by Dr Phillip Mouret in France in 1987, with the first series of 63 cases published in 1989 [1]. However, its...

Cutting-edge or over-hyped? Evaluating the role of robotic surgery in the management of renal cell carcinoma

The quest for a minimally-invasive approach to major abdominal surgery finds its roots at the start of the previous century, when Georg Kelling first described the technique of ‘ceolioscopy’ to inspect intraabdominal organs in 1901 [1]. Since those early days,...

What should we do with the incidentally detected renal cyst in a child?

The introduction of routine prenatal screening in the early 1980s resulted in paediatric urologists being confronted with the dilemma of what to do with antenatally-detected urinary tract dilatation, many of whom, we now know, do not require long-term surveillance or...

Rethinking stone-free rates and surgical outcomes in endourology

Retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) are two key minimally invasive treatments for kidney stones in both adults and children. The success of these procedures is primarily measured by two factors: (1) the absence of complications and (2)...

Study confirms UroShield™ device extremely effective as a bacteriostatic agent

UroShield™ is a breakthrough disposable ultrasound device developed to prevent catheter blockages and biofilm formation, resulting in a reduction in Urinary Tract Infections (UTI) and therefore reducing the need for antibiotics, improving patient outcomes and lowering healthcare costs.