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Hypospadias – can urologists achieve the unachievable?

US News & World Report (USNWR) provide rankings on a wide range of topics (education, health, money, travel, cars and law firms). In terms of healthcare, they suggest that their rankings (based on metrics) are a tool that can help...

Preoperative risk stratification of high-risk prostate cancer patients

High-risk prostate cancer (HRPCa) is associated with a significant risk of recurrence after radical treatment. While several classification systems exist, the D’Amico criteria – based on clinical T stage ≥T2c, prostate specific antigen (PSA) ≥20 ng/mL, or Gleason score (GS)...

Why are urology consultants leaving full-time NHS practice?

The early retirement of experienced doctors in the UK poses a significant challenge to healthcare provision, particularly in urology, where workforce shortages are exacerbated by high attrition rates among both trainees and consultants. While career dynamics in high-income countries have...

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...

Urinary incontinence in women – part 2: management

In the second part of our comprehensive overview of urinary incontinence (UI) the authors explore the plethora of treatment options for this complex condition. (Part 1 available here). Conservative management Initial treatment of incontinence should be conservative. Caffeine reduction and...

Small renal masses – diagnosis and management

Renal cancer is the eighth most common cancer in the UK and accounts for about 3% of all new cancer diagnoses [1]. The incidence rates are steadily rising, with the highest rates being in older men and women. This rise...

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]....

Edward Canny Ryall: the lost urologist

In this series of articles I am going to show you some of the exhibits contained in the BAUS Virtual Museum of the History of Urology which is part of the BAUS website (www.baus.org.uk). In the last article we looked...

Urological trauma – part 1

Part 2 of this topic is available here. Case 1 A 45-year-old male presented with acute onset abdominal pain following a fall whilst out drinking. A CT cystogram was arranged as he developed haematuria and acute renal impairment. 1. What...

Urological Complications of Malignancy

Case 1 1. What does this sagittal magnetic resonance imaging (MRI) scan show? 2. Which cancers commonly cause this? 3. What is the acute management? Case 2 1. What is the diagnosis? 2. What local effects can this mass cause?...

Neurourology

Case 1 What are the urological indications for use of this medication? What is the mechanism of action when used in the bladder? What is the average duration of action? What are the contraindications to the use of this medication?...

Upper urinary tract urothelial cell carcinoma

Case 1 A 64-year-old man presents to the haematuria clinic with visible haematuria, on a background of a 40 pack-year smoking history and family history of bowel cancer in his sister at the age of 48. A CT was performed...