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Preventive pharmacological therapy for kidney stones

Kidney stones are common, painful and are a chronic disease with a high lifetime risk of recurrence. Without treatment 35-50% of patients experience a second stone within five years of their first experience. Thiazide diuretics, alkali citrate treatment and allopurinol...

Stepwise voltage ramping causes less renal haematomas than fixed maximal voltage ESWL

Extracorporeal shock wave lithotripsy (ESWL) remains the recommended first line treatment for stones <2cm in the renal pelvis and upper or mid-pole calyces (Türk C, Knoll T, Petrik A, et al. European Association of Urology Guidelines on Urolithiasis. 2014). There...

Comparing NSAIDs with antibiotics in the treatment of uncomplicated UTIs in women

Uncomplicated urinary tract infections (UTIs) are a common presentation in primary care, however there is increasing concern regarding antibiotic use and resistant organisms. In this double-blind randomised German study, the authors seek to establish if ibuprofen 400mg three times a...

Prostate cancer management 1 – non-metastatic disease

You are referred a 68-year-old gentleman to the rapid access prostate clinic with a serum prostate specific antigen (PSA) of 12ug/L. He is otherwise fit and well with mild voiding lower urinary tract symptoms (LUTS). He undergoes a multi parametric...

Predicting resolution of the primary obstructed megaureter

Primary obstructive mega ureter (POM) is the congenital dilatation of the ureter in the absence of other structural urinary tract anomalies and comprises 10–20% of prenatal hydronephrosis cases. It is often detected during workup for prenatal hydronephrosis and confirmed using...

JCST, GMC, HEE and SACs: how this alphabet soup translates into a seven-year urology training programme

As many trainees will know, and I count myself among them, there are a plethora of organisations involved in our training. Most of us will be familiar with our deaneries, the haven we return to once a month for our...

The assessment and medical treatment of LUTS secondary to BPH

The term benign prostatic hyperplasia (BPH) describes prostate enlargement due to non-cancerous processes. Several aetiological mechanisms are involved, including hormonal and vascular alterations; abnormal regulation of apoptosis; and prostatic inflammation, which may stimulate cellular proliferation. With ageing, prostate enlargement can...

Upper Tract Developmental Abnormalities

Case 1 1. What is the abnormality and how common is it? 2. What is the embryological origin? 3. With what other conditions can this be associated? Case 2 1. What is the diagnosis and how common is it? 2....

Genital gender affirmation surgery for transgender men

Genital gender affirmation surgery (GAS) is the final step in the transition journey for transgender men. Genital GAS involves a combination of procedures to surgically align physical characteristics with one’s gender identity. These needs change between each individual depending on...

Mechanisms and prevention of catheterisation associated urethral injury (CAUI)

Urethral catheterisation is a common procedure performed by health professionals across different grades and specialties in a variety of clinical settings. An estimated 15-25% of hospitalised patients have a urinary catheter inserted during their inpatient stay and up to 13%...

Getting it Right First Time in urology: the implementation phase

The Getting it Right First Time (GIRFT) programme is the largest and most comprehensive initiative to improve the quality and efficiency of individual clinical services that the NHS has ever instigated. The programme falls under the auspices of NHS Improvement...

Men with a susceptibility to prostate cancer: implications of family history in PCa risk-prediction

Incorporation of family history (FH) status into prostate cancer (PCa) risk stratification has the potential to underpin many aspects of PCa care. This group of men presents a unique challenge in early cancer detection, particularly given that most men without...