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Transplant urology at Guy’s Hospital: making the most of a year out before specialty training

It was gutting to miss out on urology at national selection on my first attempt. The ST3 application has become increasingly competitive and this means more appointable trainees find themselves looking to plan B. The options available can be daunting...

Theatre utilisation in urology theatres at a UK tertiary referral centre

Introduction The efficient use of operating theatres is important to ensure optimum cost-benefit for the hospital and to clear waiting lists. The key elements in the efficient use of operating theatres are: effective management and good communication, trained staff, appropriate...

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...

The role of an enhanced recovery protocol in patients undergoing robotic radical cystectomy

Enhanced recovery after surgery (ERAS) protocols are patient pathways designed to reduce surgical stress and accelerate postoperative recovery. Uptake of such protocols in colorectal surgery in particular has been high, however ERAS protocols developed or utilised in urological surgery have...

Urological trauma – part 2

Part 1 of this topic is available here. Case 1 A 29-year-old male was attacked and kicked in his left flank. He presented to the emergency department with left flank pain and frank haematuria. He remained haemodynamically stable. 1. What...

Retroperitoneal fibrosis

Introduction Retroperitoneal fibrosis (RPF) is a condition that occurs when extensive fibrosis develops in the retroperitoneum, usually centred over the anterior aspect of the fourth and fifth lumbar vertebrae. The fibrotic tissue typically surrounds the infrarenal aorta, inferior vena cava...

BAUS Annual Scientific Meeting 2024

Day 1 Toni Huw Mihailidis and Mriganka Mani Sinha Another year and another brilliant meeting in which urologists from the UK and around the globe assembled for a highly entertaining event. Day one kicked off with a topical and ever-pervasive...

Emphysematous pyelonephritis: a review

Introduction Emphysematous pyelonephritis (EPN) is an acute, severe, necrotising, bacterial infection of the renal parenchyma and surrounding tissues, with gas in the renal parenchyma, collecting system or perinephric tissue. Although it is rare, it is potentially life threatening and early...

Ketamine uropathy – an update

The first two case series that documented the association between urinary tract damage and recreational ketamine use were published 12 years ago [1,2]. Since then ketamine has maintained a controversial profile as an essential medication of expanding utility but with...

Challenges of upper tract urothelial carcinoma

Upper tract uroepithelial carcinoma (UTUC) is a fairly common disease which traditionally had poorer outcomes compared to bladder cancer. This is due to various factors leading to delayed diagnosis and problems in risk stratification. Continuing efforts have focused on early...

Fluoxetine for refractory night wetting in children – is it safe and effective?

Around 1-2% of teenagers above the age of 15 years and 2-6% of adults continue to wet the bed. Standard treatment often includes bladder advice, alarm therapy, desmopressin and anticholinergics. Tricyclic antidepressants (imipramine) can also be utilised. Unfortunately, most have...

Frailty in urology – part 1

Part 2 of this topic can be found here Statement of the problem Clinical frailty carries an increased risk of poor health outcomes. The pathological process resulting in frailty is often overlooked and elucidating its aetiology and natural history are...