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Urolithiasis – metabolic considerations

Case 1 A 32-year-old female patient is diagnosed with a ureteric calculus for the first-time. What type of metabolic evaluation investigations should be performed? When should stone analysis be repeated? What are the most common metabolic abnormalities associated with calcium...

Should it be a mandatory requirement for medical students to receive the COVID-19 vaccine to attend clinical attachments?

The vast majority of medical students have positive attitudes towards the COVID-19 vaccine for themselves and patients, however, what about the small inevitable minority who resist it? Should they be prevented from attending clinical attachments in the NHS? It is...

Urological Men’s Health – A guide for Urologists and Primary Care Physicians

Urologists, perhaps more than any other group of clinicians, can quite reasonably lay claim to be the champions for men’s health. But are we particularly well placed to deliver? This text is aimed at primary care physicians and those urologists...

Reliability of grading of VUR and other findings on VCUG

The gold standard for diagnosing VUR is still the voiding cycstogram (VCUG). These authors looked at the inter observer variability of grading of vesicoureteral reflux (VUR) using a VCUG and highlight the implications for treatment and prognosis as a results....

Comparison of the microbiological milieu of CIC patients

Children performing clean intermittent catheterisation (CIC) have a higher risk of bacteriuria. This occasionally can lead to full urinary tract infection (UTI) which can influence long-term renal function. Hydrophilic catheters are said to be less traumatic to the urothelium and...

Intermittent self-catheterisation

Intermittent self-catheterisation (ISC) is used in everyday practice for bladder dysfunction. This study from Southampton, UK presents a Cochrane review of different catheter designs, user satisfaction and incidence of urinary tract infection (UTI), etc. The following factors were looked at:...

MRU for diagnosis of paediatric ureteral stricture

Hydronephrosis is diagnosed antenatally in approximately 1-5% of all pregnancies. A rare cause is ureteral stricture, found in 4% of these cases. This study reports a series of 28 strictures diagnosed over a 10-year period by magnetic resonance urography (MRU)...

Refluxing ureteral reimplantation

Obstructed megaureters may be managed with temporising stents, cutaneous ureterostomies, or in older children with ureteral reimplantation (usually if the child is over one year of age). Cutaneous ureterostomies have risks of stomal stenosis, infection and leakage problems over nappies...

Antibiotics and flexible cystoscopy

This study is from Memorial Sloan-Kettering Hospital in New York, USA. Thousands of flexible cystoscopies are performed every day worldwide. Do they need antibiotic cover? Flexible cystoscopy may cause urinary tract infection (UTI) in less than 10% of cases. Asymptomatic...

Urinary tract infections and antibiotics – the debate goes on

A large number of hospital patients and primary care patients suffer from recurrent urinary tract infection (UTI) and urosepsis. Some of these patients end up in intensive care units with multi-organ failure. New draft guidance from the National Institute for...

New ultrasound imaging technique reliably spots prostate cancer, initial patient trial reveals

A groundbreaking new imaging approach developed by researchers at Heriot-Watt University has shown ‘extremely encouraging’ results in early-stage clinical trials on prostate cancer at the Western General Hospital in Edinburgh, Scotland. The ongoing clinical trial demonstrated an initial 94% sensitivity...

Retropubic versus transobturator mid-urethral slings for stress incontinence

Mid-urethral slings are commonly used in the surgical management of stress urinary incontinence. This multicentre, randomised trial aimed to compare the safety and efficacy of the retropubic tension-free vaginal tape (TVT) with the transobturator tension-free vaginal tape (TVT-O) in a...