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The microbial syndicate: dysbiosis and origins of recurrent UTIs

Traditional dogma held that urine was sterile. However, recent molecular studies have revealed an underground microbial community, known as the urinary microbiome or ‘urobiome’ [1]. Far from being harmful, this community of microorganisms helps modulate immune responses, regulate inflammation, and...

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...

An introduction to research governance

Research is the process of acquiring new generalisable knowledge and should be fully integrated into healthcare work. There is a growing drive to encourage and further develop evidence-based practice in medicine so that staff and patients benefit from improved healthcare...

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...

Burnout: an increasing problem in urology

“What we mean, man,” said Chuck forcefully, “is this: how can we care for patients if nobody cares for us?” – Samuel Shem, The House of God, 1978. Samuel Shem’s (Steven Bergman, MD) satirical novel The House of God, has...

Prostate cancer survivorship: a new path for uro-oncology

Over two million people in England have a diagnosis of cancer [1]. Of this figure, over 250,000 have been diagnosed with prostate cancer [2]. However, during the next decade, a rapid increase in the number of new cancer diagnoses, as...

Update on immunotherapy for non-muscle invasive transitional cell carcinoma of the bladder

Patients with high-risk non-muscle invasive bladder cancer (NMIBC) that have failed Bacillus Calmette-Guérin (BCG) treatment are a difficult group to treat, and many may not be suitable for the preferred treatment option of radical cystectomy. Bladder-preserving treatments for BCG-unresponsive high-risk...

Prostatic fruit

In this series of articles, I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). The topic for this month’s article was stimulated by two recent occurrences. The...

ICS updates on continence care: making sense of detrusor underactivity and the underactive bladder

Countless epidemiological studies have established the frequent occurrence of lower urinary tract symptoms (LUTS) and the significant burden these symptoms incur. For the most part of the past three decades, there has been an overwhelming focus on detrusor overactivity (DO)...