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Inpatient care of patients with established spinal cord injury - what a general urologist needs to know

Introduction Spinal cord injury (SCI) is a devastating, life-changing condition, which is currently irreversible. Depending on the level of the spinal cord affected (and whether the lesion is complete or incomplete), patients may subsequently develop reduced voluntary motor function, sensory...

Ambulatory local anaesthetic implantation of percutaneous sacral nerve stimulators

Background The current treatment paradigm for detrusor overactivity (DO) and dysfunctional voiding (DV) includes conservative measures, pharmacotherapy, intravesical onabotulinum toxin A (Botox®), sacral nerve modulation (SNM / SNS) and urinary diversion as a last resort [1]. Incidence of DO is...

MRI screening for prostate cancer: a step towards a ‘prostagram’

The UK National Screening Committee has been calling for further research into alternative screening tests for prostate cancer. The committee decided against prostate cancer screening using prostate specific antigen (PSA) testing on the basis that “PSA is still a poor...

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...

The Nurse Practitioner in Urology

This book is designed to meet the needs of nurse practitioners, advanced practice nurses and physician assistants working in urology in the US where Advanced Practice Certification, although not mandatory, is highly sought after by employers and service users alike....

MSKCC prostate cancer screening guidelines – is it the way forward?

The Memorial Sloan Kettering Cancer Center (MSKCC) developed prostate cancer screening recommendations first in 2011 as a response to three limitations of previous screening guidelines: insufficient evidence base, failure to link screening with treatment, and lack of risk stratification. To...

Importance of PSA variation – an analysis of PLCO trial data

This study looks specifically at the group of patients in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial (PLCO), to investigate variations in prostate specific antigen (PSA) level. They have specifically included only patients who...

Urology MDTs: what members think

This study aimed to examine the functionality of urology cancer multidisciplinary team meetings (MDTs). Evidence has suggested that urology MDTs are not as well structured as other surgical disciplines. MDT members were asked their views on if there were any...

Can antibiotics reduce ‘unnecessary’ prostate biopsies?

With numerous factors capable of influencing prostate specific antigen (PSA) levels and therefore the likelihood of biopsy, this multi-centred randomised controlled trial (RCT) was designed to see if two weeks of ciprofloxacin compared to placebo would significantly reduce PSA levels...

A new haemostatic agent in tubeless PCNL

Tubeless percutaneous nephrolithotomy (PCNL) is increasingly being used in carefully selected patients to reduce hospital stay and analgesia requirements, especially in those with little bleeding who become stone free or have insignificant residual fragments (usually <4mm). Various agents have been...

Selective denervation of the bladder

The treatment of refractory overactive bladder is currently limited to neuromodulation (sacral nerve stimulation or percutaneous tibial nerve stimulation) or botulinum toxin injections. Although all these options are valuable, they have their own limitations and may not be suitable for...

Sexuality and erectile function in young men with spina bifida

As our patients with spina bifida (SB) continue to live longer into adulthood we recognise that many of these men experience challenges with sexual health, related to their underlying neurological function. Few studies on male sexual health in this population...