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Demanding cases or nightmares in endourology? Sep/Oct 2015

One of the most interesting aspects of attending international meetings is the rare but invaluable, honest presentation of complex cases. We aim to present the readers with some complex and challenging ongoing cases in endourology. Case 1 A general practitioner...

Neuromodulation for lower urinary tract dysfunction – an ICS update

Non-invasive and invasive electro-stimulation techniques have been extensively studied in the treatment of lower urinary tract and bowel dysfunction, including overactive bladder syndrome (OAB), non-obstructive chronic urinary retention, faecal incontinence and chronic pelvic pain. Currently, the most common indication for...

Lasers in benign prostatic hyperplasia

Clinical benign prostatic hyperplasia (BPH) impacts on the quality of life of many men. It is intimately related to ageing, but exact calculations of its prevalence remain difficult since an accurate clinical definition still eludes us. Histological BPH has been...

HIV / AIDS – implications for the urologist

“It’s no fun to have HIV even though it’s viewed as a chronic, controllable disease. It means being wedded to the health system.” - Philip Berger, Associate Professor in the Department of Family and Community Medicine, Toronto, Canada; and leading...

Pacemakers in the upper urinary tract

This is an interesting study from Italy. The mechanism by which urine is transported from the kidney to the bladder via the upper urinary tract (UUT) remains poorly understood and elusive. For many years, pyeloureteric rhythmicity is thought to arise...

Infections and inflammation: Part 1

See also Part 2 and Part 3. Case 1 A 59-year-old man presented with right loin pain. His GP arranged for him to have an intravenous urogram (IVU) and subsequent CT urogram performed. What is the likely diagnosis? What are...

Do stones still kill?

This paper is a retrospective analysis of deaths ascribed to stone disease in England and Wales over a 15-year period. The data was obtained from the Office of National Statistics, based on mortality derived from death certificates. One thousand, nine...

Loop-tail stents in reducing stent related symptoms – the search continues

Insertion of double J (DJ) stents is one of the most commonly performed procedures in urology. One of its major drawbacks is stent related symptoms (SRS) which has generated a lot of research in drugs, stent design and materials. One...

Pain relief after removal of non-obstructive renal calculi

Non-obstructing stones are often not considered to be the source of pain, and probably most are not. This is because flank pain associated with a stone is typically caused by a stone that obstructs urinary flow, which increases intraluminal pressure...

An algorithm for the management of haemorrhagic cystitis

Haemorrhagic cystitis (HC) can be one of the most difficult conditions to treat in urological practice. It is characterised by intractable bleeding from the bladder and may be acute or chronic. The most frequently reported causal factors are radiotherapy (RT)...

Non-urothelial bladder malignancies

Case 1 An 80-year-old gentleman presented with a history of visible haematuria and recurrent urinary tract infections (UTIs). He has been performing intermittent self catheterisation (ISC) for detrusor underactivity for over 20 years. A flexible cystoscopy showed these appearances of...

Outcomes of VUR in children with non-neurogenic dysfunction treated with Deflux

The 2010 American Urological Association (AUA) guidelines on primary vesicoureteral reflux (VUR) state that children with VUR and lower urinary tract dysfunction are less likely to have the VUR resolve spontaneously than those with primary VUR alone (31% vs. 61%)....