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Demanding cases or nightmares in endourology? Nov/Dec 2017

Case 1 A 78-year-old male was transferred from a referring hospital. He had a cystectomy and ileal conduit performed 15 years previously and had recently been admitted with a clinical diagnosis of an infected obstructed kidney. The referring hospital had...

Intravesical glycosaminoglycan analogue instillations for recurrent cystitis

Introduction The symptoms of recurrent cystitis can be triggered by inflammatory or infective causes. Bladder pain syndrome (BPS) and bacterial recurrent lower urinary tract infection can both present with symptoms of recurrent cystitis and cause significant morbidity in affected individuals....

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...

A tale of two cities – hypospadias outcomes

As urologists, it is important to know our results. In terms of hypospadias surgery, which is commonly undertaken after the age of one year in the UK, long-term follow-up is required to fully acquire this knowledge. Long-term urinary outcomes and...

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...

The bulbocavernosus reflex

Despite its first discovery predating the early-1940s, clinical application of the bulbocavernosus reflex (BCR) has been limited to date. The BCR traditionally involves contraction of the bulbo- and ischiocavernosus pelvic floor muscles, often referred to as the ‘bulbocavernosus muscle’, in...

How do we tackle social injustice in urological cancer?

Socioeconomic status as an established determinant of health and associated injustices is well recognised. Confronting these injustices and creating a fairer healthcare system is an ongoing challenge for many governments. In Scotland, the devolved government has created the Scottish Index...

Consensus statements on PSA testing in asymptomatic men in the UK

In January 2016, the UK National Screening Committee once again recommended against a systematic population screening programme for prostate cancer due to the, as yet, insufficient evidence that the benefits of screening would outweigh the harm to the population as...

Renal calculi: the role of imaging in pregnancy

Nephrolithiasis is the most common cause of non-obstetric abdominal pain in pregnancy. Accurate diagnosis is imperative as stone related complications can lead to pre-eclampsia, urosepsis, and premature labour [1,2]. In the general population, non-contrast cross sectional imaging is recommended by...

The medical management of LUTS/BPH – an update

For many years it has been recognised by both medical professionals and the general public that the development of lower urinary tract symptoms (LUTS) is highly prevalent and is predominantly age-dependent. Medical professionals understand that in men this is often,...

Modern management of small renal masses

With the advent of widespread cross-sectional imaging there has been a surge in incidental detection of small renal masses (SRMs) and renal cell carcinoma (RCC) is now the seventh most common cancer in the UK. Whilst surgical excision for larger...

Increasing PSA after negative prostate biopsy - solving the clinical puzzle

There are standard guidelines for first transrectal ultrasonography (TRUS) guided biopsy in a patient presenting with elevated prostate-specific antigen (PSA) or suspicious digital rectal examination (DRE) findings. Patients are generally warned before a TRUS biopsy in respect of a false...