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A guide to percutaneous nephrolithotomy
Percutaneous nephrolithotomy (PCNL) is now the gold standard approach to treating large renal stones. Since its development in the 1970s, it has undergone a series of refinements that could only have been possible with the symbiosis of both radiological and...Post-orgasmic illness syndrome
Introduction Disorders of ejaculation are a rare and poorly understood subsection of male sexual dysfunction. A paucity of evidence has hindered advances in definitions, epidemiology, pathophysiology and management. The licensing of a specific medication for premature ejaculation signalled the research...Managing sustainability
Planetary health needs to be addressed at a societal level for any meaningful impact to occur. As the global director of sustainability for a law firm, Marion Palmer provides an overview of the responsibilities of corporate organisations for both a...
Androgen insensitivity in patients with proximal hypospadias
A number of surgeons use preoperative androgen stimulation for a period of time prior to hypospadias surgery. The aim is to increase glans circumference, penile length and improve prepucial vascularisation pre-surgery. Data confirming the results of these aims is scarce....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...
Active surveillance for intermediate-risk prostate cancer
In this review, Klotz and Dall’Era summarise available data from the Toronto, UCSF, ERSPC, PASS and Royal Marsden active surveillance cohorts, looking specifically at outcomes of patients classed as intermediate risk. Cancer specific survival in men managed initially with active...
Cystolithotripsy using the holmium laser: evolving uses for the laser lithotrite
This small prospective study examined 20 patients who were undergoing laser cystolithotripsy for bladder stones. Laser lithotripsy was performed using either a 365 or 550µm holmium:YAG laser fibre with a power setting of 1.0J and a frequency of 10Hz. Stone...Management of calyceal diverticular stones using ultramini PCNL
Calyceal diverticulae are congenital smooth-walled, non-secretory urothelium-lined cavities within the renal parenchyma that communicate with calyceal fornix through a diverticular neck. They were first described by Rayer in Traitements des maladies des reins [1]. Calculi occur in approximately 9.5% to...
Bladder perforation after augmentation cystoplasty
Delayed bladder perforation is well recognised after augmentation cystoplasty (5-13% of patients) and adult urologists need to be aware of this and identify the best treatment at the time. Mortality rates and re-perforation rates can be up to 25% and...
How successful is the transition to adult urology care in spina bifida?
These authors from Indianapolis, USA, aimed to assess rates and predictors of successful transition into adult care of spina bifida patients. They did this by a retrospective review of 77 patients discharged from a multidisciplinary paediatric clinic at a mean...
Uncovering the fate of small residual fragments
The concept of ‘stone free’ remains an enigma. To some urologists this refers to complete removal of all visible fragments, to others its removal of all ‘clinically significant’ fragments (generally regarded as fragments >2mm), and to some it is absence...
