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Dietary citrate substitution in urolithiasis patients

Stone formation is dependent on supersaturation of urinary salts and urinary crystal retention. Urinary promoters (protein aggregates, cell debris) and inhibitors (citrate, magnesium, urinary macromolecules such as glycosaminoglycans and proteins) are involved in the process of stone formation [1]. Hypocitraturia...

The transition from surgeon to manager during the COVID-19 response

Writing this article on the first Sunday in May, when in any other year, I would be wearing my bowler hat in Hyde Park for the annual Cavalry Memorial Parade, a time ‘pre-COVID’ does seem a very distant memory. Having...

Nocturnal enuresis in children

Introduction Nocturnal enuresis is the complaint of bedwetting. The 2010 National Institute for Health & Care Excellence (NICE) guidelines define bedwetting as the “involuntary wetting during sleep without any inherent suggestion of frequency of bedwetting or pathophysiology” [1]. Bedwetting is...

Management of recurrent cystitis

Acute uncomplicated infective cystitis is most commonly seen in healthy women with a frequency of around 0.5-0.7 episodes per woman per year [1]. Around 10% of women report having had an episode of urinary tract infection (UTI) each year and...

Overview of partial nephrectomy techniques: influence of technology

Traditionally, radical nephrectomy was the preferred operation for kidney cancer, while partial nephrectomy was reserved for specific circumstances and essential indications such as a tumour in a solitary kidney, bilateral kidney tumours, or severe chronic kidney disease (CKD). Given the...

Intravesical GAG replacement therapies for bladder pain syndrome / interstitial cystitis – an update

The barrier function of the glycosaminoglycan (GAG) layer of the urothelium was identified by Parsons in 1975, and intravesical therapies to treat chronic inflammatory conditions of the bladder were developed soon after. However, the active role of the urothelium in...

The Mitrofanoff procedure: a continent revolution

Prior to 1980, surgeons had been struggling to provide a catheterisable, continent channel as an alternative to the native urethra, primarily for paediatric patients with congenital neuropathic bladder. In 1980, Professor Paul Mitrofanoff described the continent supravesical antireflux appendicovesicostomy [1]...

What is the role of evidence-based medicine in urology?

The concept of ‘evidence-based medicine’ (EBM) was first developed in the early 1990s and was described as “the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients” by the recently...

The role of PET-CT imaging in prostate cancer

Prostate cancer (PCa) is the second most common cancer in the UK, with 43,000 cases in 2017-18 [1,2]. Accurate primary staging and the detection of suspected recurrence following treatment is vital for directing management and predicting prognosis. This has conventionally...

Peyronie’s disease: a review and update

Peyronie’s disease (PD) describes an acquired disease of the penis, which is characterised by a number of signs and symptoms. These include penile pain, curvature, palpable plaques, wasting or narrowing of the penile shaft, a hinge deformity and potentially catastrophic...