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Are urodynamics still useful?

Two major UK randomised controlled trials, UPSTREAM and FUTURE, compared comprehensive clinical assessment (CCA) alone with CCA plus urodynamics (UDS), incorporating filling cystometry and pressure–flow studies. Both trials involved patients in whom diagnostic uncertainty suggested a potential role for UDS...

Why defining and managing DUST matters in endourology

In endourology, defining ‘DUST’ and optimising its management is vital for improving stone-free rates (SFR) and reducing complications. Residual fragments, even those ≤4mm, can act as a nidus for infection, obstruction, and recurrence. Studies have shown that 30% of patients...

In conversation with Roger Kirby

We were delighted to catch up with Roger Kirby, new President of the RSM, about his illustrious career in urology. Can you tell us a little bit about what led you into the field of urology and what have been...

Demanding cases or nightmares in uro-oncology? May/Jun 2022

Delayed diagnosis of testicular cancer Testicular cancer is considered rare in the general population but is the most common cancer affecting males between 24 and 49 years. The diagnosis of testicular cancer depends on physical examination, ultrasound findings and tumour...

The emerging role of physician associates in urology

The physician associate (PA) is a new role in the NHS which has expanded across medical and surgical specialties to include urology. In the USA, it has long been an established field of practice where physician assistants work autonomously within...

Thermal ablative techniques for small renal masses

The incidence of renal cell carcinoma has increased over the past decade which can be partly attributed to the increased use of imaging modalities [1,2]. Nephron sparing procedures for the management of small renal tumours have gained popularity which include...

Neuromodulation for lower urinary tract dysfunction – an ICS update

Non-invasive and invasive electro-stimulation techniques have been extensively studied in the treatment of lower urinary tract and bowel dysfunction, including overactive bladder syndrome (OAB), non-obstructive chronic urinary retention, faecal incontinence and chronic pelvic pain. Currently, the most common indication for...

Urethral pathology

Case 1 A 43-year-old lady presents with urinary incontinence and vaginal pain associated with intercourse. An initial CT scan is performed. Case courtesy of Radswiki, Radiopaedia.org, rID: 12056. Case courtesy of Radswiki, Radiopaedia.org, rID: 12056 What is the clinical diagnosis...

Urologic complications of radiotherapy

Case 1 1. What machine is seen in the picture? 2. What is the standard dose schedule for radiotherapy for prostate cancer? 3. What are the complications of radiotherapy? Case 2 1. How does haemorrhagic cystitis develop? 2. What are...

Penile cancer

Case 1 A 67-year-old man presents with a worsening red patch over the past three months. It looks velvety in some areas. What is the most likely diagnosis? What are the risk factors? How do you classify this condition? How...

Stone Pass: Kidney Stones app

For this Digital Review I have focused on the Stone Pass: Kidney Stones app (Know Stone LLC) – a new information tool for patients with ureteric stones. I had recently seen a shared tweet originating from the app’s author Dr...

The postcode lottery costing men with prostate cancer years of life

Nearly a third of men miss out on lifesaving treatments for prostate cancer – raising to more than half in worst-hit areas Prostate cancer can be cured if found early, but 31% of men diagnosed with aggressive but curable prostate...