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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...

Male infertility

Definitions Infertility is the inability of a sexually active, non-contracepting couple to achieve spontaneous pregnancy in one year [1]. About 15% of couples do not achieve pregnancy within one year and seek medical treatment for infertility. Semen parameters are standardised...

Urinary incontinence in women – part 1: terminology and diagnosis

Introduction Urinary incontinence (UI) is the involuntary and often embarrassing leakage of urine. It is a condition that is both under-reported and under-diagnosed, and when reported it is, unfortunately, often not assessed and managed adequately. Incontinence of urine is encountered...

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...

Recent developments in bladder cancer

There have been some exciting developments in bladder cancer over the last few years. Immunotherapy has prolonged survival in a proportion of patients with metastatic disease, with sustained efficacy in some. Advances in genetic analysis and molecular subtyping make personalised...

History of prostate biopsy – part 2

For Part 1 of this topic is available here. The major limitations of the transrectal ultrasound (TRUS) guided prostate biopsy (PBx) protocols are the risk of profound sepsis and the risk of persistently significant false negative rates, related to the...

Nurse practitioner TRUS biopsy: training and preparation

As prostate cancer rates increase, many urology departments rely on multi-professional teams to diagnose and manage patients with prostate cancer. The aim of this article is to highlight the skills, training and preparation required for nurse practitioners to undertake trans-rectal...

The NICE Guideline on Urinary Incontinence: the management of urinary incontinence in women

Background Urinary incontinence (UI) is a common symptom that can affect women of all ages. It is difficult to estimate the prevalence of UI since it is often under-reported, although the Norwegian EPINCONT study looking at women over 20 reported...

Lasers in benign prostatic hyperplasia

Clinical benign prostatic hyperplasia (BPH) impacts on the quality of life of many men. It is intimately related to ageing, but exact calculations of its prevalence remain difficult since an accurate clinical definition still eludes us. Histological BPH has been...

Priapism

Priapism is defined as an abnormally persistent erection lasting greater than four hours, not associated with sexual desire [1]. Although relatively uncommon with an incidence of 1.5 per 100,000 [2], priapism has a risk of complications which can have a...

Men with a susceptibility to prostate cancer: implications of ethnicity in PCa risk-prediction and diagnosis

The diagnostic and therapeutic landscapes of prostate cancer (PCa) have advanced at great pace in the past decade. However, disparities in access to care, clinical outcomes and representation in therapeutic, interventional and genomic studies continue to exist between Afro-Caribbean (AC)...

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...