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Conservative management of pelviureteric junction

Background Pelviureteric junction obstruction (PUJO) is defined as a functionally significant impairment of urine flow from the renal pelvis into the proximal ureter. For more than a century, surgery was considered the first-choice approach to management. However, the widespread use...

Induction Switch

Changing medical jobs or working in multiple hospitals is often a frustrating experience. Switch wait times can be agonisingly long, and at least in my experience, hospital intranet telephone directories are frequently inaccurate and unhelpful in connecting to the relevant...

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...

HOLEP and detrusor underactivity

Lower urinary tract symptoms (LUTS) are common among adult males, significantly influence quality of life (QoL) and contribute to pressure on the NHS. LUTS are conventionally associated with benign prostatic obstruction (BPO), which is commonly observed during the histological progression...

The role of continuous prophylactic antibiotics following JJ stent insertion

Urinary tract infections (UTI) and stent-related symptoms (SRS) are frequently recognised complications of ureteric stent placement. Antibiotic administration at induction prior to ureteric stent insertion is recommended by the European Association of Urology (EAU). Commencing prophylactic antibiotics for the ‘entire...

Penile fracture

Traumatic rupture of the tunica albuginea with either one or both corpora cavernosa of the penis is known as penile fracture. This may be associated with corpus spongiosum or urethral injury. Incidence Penile fracture was reported for the first time...

Medical statistics for urologists: part 1

Part 2 of this article is available here, and Part 3 here Clinicians often consider statistics to be a dry and challenging subject. However, an understanding of the basics of statistic methods underpins the interpretation and use of current best...

PSA screening in limbo: how low should we go?

One may wonder how the management of prostate cancer could have evolved differently if it had followed a path similar to breast cancer. In breast cancer, early detection in the 1970s relied heavily on imaging because no reliable circulating biomarker...

An introduction to research governance

Research is the process of acquiring new generalisable knowledge and should be fully integrated into healthcare work. There is a growing drive to encourage and further develop evidence-based practice in medicine so that staff and patients benefit from improved healthcare...

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...

Pushing the boundaries of urological research with trainee-led collaboration in the BURST Research Collaborative

Background: the concept of trainee-led research Over the past five years a novel and exciting collaborative approach to delivering research has been developed in the UK. Trainee-led regional and national research networks have been introduced, with the greatest success seen...

Medical Protection: Expertise, advocacy, and support when it matters most

The world’s leading medical defence organisation providing long-term protection against the potentially ruinous costs of litigation, as well as the other professional challenges that healthcare professionals might face during the course of their career. As a doctor your work is...