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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...

A new treatment for genitourinary syndrome of menopause

Genitourinary syndrome of menopause (GSM) [1] is defined as a collection of symptoms and signs mainly associated with the progressive decrease in oestrogen levels. The lack of hormones, usually produced by the ovaries in fertile age, may lead to genital symptoms...

Update on urodynamic equipment performance

This article is from the steering committee of the International Continence Society (ICS) and it gives a comprehensive account of what is required from modern urodynamic machines. It will be of interest to purchasers, designers and clinical users (doctors and...

Ureteric injury rates during robot assisted radical prostatectomy

Jhaveri et al. and colleagues have produced a timely report on the incidence of ureteric injuries during robot assisted radical prostatectomy. They reviewed the complications of 6442 consecutive patients treated with robot assisted prostatectomy at the same institution by one...

Optimisation of childhood spina bifida management – a prospective trial

Routh et al. describe a prospective trial which aims to determine the optimal urological management for children with spina bifida. The primary aim of neuropathic bladder management is to provide the patient with the best long-term quality of life with...

Has laparoscopic radical prostatectomy had its day?

Over recent years there has been a massive uptake in robotic surgery particularly for robot-assisted prostatectomy. The drive for this has been patient and physician led with little in the way of prospective randomised trials showing benefits over established operative...

Testosterone supplementation after prostatectomy – journey from bad to good

The role of androgens in the pathogenesis of prostate cancer is quite complex and is not entirely clear yet. Despite several reports suggesting testosterone use is safe in patients diagnosed with prostate cancer, many clinicians are still reluctant to use...

Predicting resolution of the primary obstructed megaureter

Primary obstructive mega ureter (POM) is the congenital dilatation of the ureter in the absence of other structural urinary tract anomalies and comprises 10–20% of prenatal hydronephrosis cases. It is often detected during workup for prenatal hydronephrosis and confirmed using...

I wasn’t expecting that! A series of unexpected radiology findings

Case 1 A 76-year-old diabetic man with a long-term catheter presents to the Emergency Department with rigors and non-specific abdominal pain. He has an elevated white cell count (WCC) and C-reactive protein (CRP). An abdominal and pelvic CT scan was...

Delivering a laparoscopic urology workshop in West Africa: our initial experience in Senegal

Despite universal adoption and significant technological innovation since its inception around 30 years ago, access to laparoscopic surgery remains lacking in Sub-Saharan Africa (SSA). Whilst some progress has been made in recent years to bridge the gap with the developed...

Practical surgical management of chronic testicular pain

Chronic testicular pain (CTP) is defined as constant or intermittent, unilateral or bilateral testicular pain of more than three months’ duration, which significantly interferes with the daily activities of the patient prompting medical advice [1-4]. This condition is commonly seen...

Prostatic artery embolisation – an option for select BPO patients

Few proponents of prostatic artery embolisation (PAE) regard it as a potential standard in future for benign prostatic obstruction (BPO) / benign prostatic hyperplasia (BPH) treatment. Present guidelines from the National Institute for Health & Care Excellence (NICE) and the...