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Management of lower urinary tract foreign bodies

Of all the urological emergencies presenting to the emergency department, perhaps one of the most technically challenging cases is the patient with a foreign body in the genitourinary (GU) tract. A wide variety of GU foreign bodies have been reported...

Klinefelter’s syndrome

Klinefelter’s syndrome (KF) is the most frequent sex chromosome abnormality with an estimated prevalence of 1 in 500 to 1 in 700 newborn males and 1 in 10 in men with azoospermia. While the majority of cases are an XXY...

Recent advances in the management of castration resistant prostate cancer

Castrate resistant prostate cancer (CRPC) is defined by disease progression despite androgen-deprivation therapy lowering testosterone to castrate levels. It may present as a rise in serum levels of prostate specific antigen (PSA), progression of pre-existing disease, or the appearance of...

A guide for the assessment and management of post-obstructive diuresis

Acute urinary retention is a common condition encountered in the emergency situation and is initially managed by urethral catheterisation. This is often performed by nursing staff or junior doctors. Post-obstructive diuresis (POD) is a specific entity which may occur post...

‘One team’: our experience teaching catheter care and difficult urethral catheterisation to NHS Nightingale Hospital London volunteer staff members

The NHS Nightingale Hospital London was launched in response to the COVID-19 pandemic. In mid-March 2020, the predicted scale of the pandemic was uncertain and there was concern that COVID-19 might overwhelm existing intensive care unit (ICU) capacity within weeks....

Management of RHC in prostate cancer with selective embolisation and hyperbaric oxygen therapy

Prostate cancer is one of the most prevalent malignancies affecting men worldwide. Radiotherapy is a common treatment modality for localised and locally advanced prostate cancer. While radiotherapy can be effective, it may lead to complications such as radiation-induced haemorrhagic cystitis...

The microbial syndicate: dysbiosis and origins of recurrent UTIs

Traditional dogma held that urine was sterile. However, recent molecular studies have revealed an underground microbial community, known as the urinary microbiome or ‘urobiome’ [1]. Far from being harmful, this community of microorganisms helps modulate immune responses, regulate inflammation, and...

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...

The doctor as the patient: receiving bad news

This article, written by a GP working in the NHS, gives a unique insight into the experience of being a urology patient and some thoughtful advice on ‘breaking bad news’. Day 1 Alarm bells ring. It’s spotting an email from...

Pelvic floor imaging – a brief synopsis

Background Pelvic floor imaging is an important part of both gastrointestinal and functional urology / urogynaecological departments. Symptoms such as obstructive defecation, incontinence and sphincter complex disorders have a significant impact on patient lifestyle and physical / mental well-being [1,2]....

Imaging of varicoceles

A varicocele is a collection of dilated, tortuous spermatic veins of the pampiniform venous plexus. It is seen in 10-15% of the general population and is associated with both primary and secondary infertility. A varicocele is the most common cause...

Frailty in urology – part 1

Part 2 of this topic can be found here Statement of the problem Clinical frailty carries an increased risk of poor health outcomes. The pathological process resulting in frailty is often overlooked and elucidating its aetiology and natural history are...