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Dr Glaucomflecken: Stayin’ Alive

Peter Cackett spoke to ophthalmologist and social media sensation Dr Glaucomflecken about his early days in comedy, the role satire can play in impacting medical governance, and where he might take his brand of medical comedy next. It was towards...

LUTS update

Case study A 70-year-old, generally fit and well male attends your outpatient clinic. He has experienced a gradual deterioration in his voiding over the last few months. Specifically, he reports hesitancy, poor flow and nocturia. He denies visible haematuria. His...

A review of the diagnosis and management of urethral caruncles

Introduction The innocuous urethral caruncle is the most common benign urethral lesion in females. It can pose a significant challenge to urologists due to the plethora of differentials and poor evidence surrounding management. In 1926, Ferrier eloquently described the macroscopic...

Urologic complications of radiotherapy

Case 1 1. What machine is seen in the picture? 2. What is the standard dose schedule for radiotherapy for prostate cancer? 3. What are the complications of radiotherapy? Case 2 1. How does haemorrhagic cystitis develop? 2. What are...

Physiotherapy first for pelvic floor dysfunction

Physiotherapy should be included in first-line management options for pelvic organ prolapse and urinary incontinence in women [1,2]. Additionally, referral to physiotherapy is widely practised for the management of urinary incontinence in men, faecal incontinence, defecation disorders and various pelvic...

Benign prostatic hyperplasia: what are the benefits and harms of various surgical management options?

Benign prostatic hyperplasia (BPH) is characterised by stromal and epithelial prostatic cell hyperplasia. The enlarged prostate may be associated with voiding and storage lower urinary tract symptoms (LUTS). These have been predominantly attributed to bladder outlet obstruction (BOO), assumed to...

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...

Outcomes of VUR in children with non-neurogenic dysfunction treated with Deflux

The 2010 American Urological Association (AUA) guidelines on primary vesicoureteral reflux (VUR) state that children with VUR and lower urinary tract dysfunction are less likely to have the VUR resolve spontaneously than those with primary VUR alone (31% vs. 61%)....

The GMS hypospadias score

Hypospadias surgery has been carried out for decades. Descriptive parameters for hypospadias severity are variable and difficult to reproduce. The severity of abnormalities lies along a continuous spectrum. The paediatric urological fraternity is attempting to develop more reliable comparators for...

COVID-19: cancer and corticosteroids

Under the prevailing COVID-19 crisis, this article is well worth reading. The current World Health Organization (WHO) guidance is not to start steroids in cancer cases, but there is no clear evidence of risks with steroids in cancer patients having...

Refining management of non-visible haematuria

The optimal evaluation of non-visible haematuria (NVH) continues to be debated, with competing interests of avoidance underdiagnosis and the harms of over-testing. Current National Institute for Health & Care Excellent (NICE) guidance recommends referral for patients ≥60 years with NVH....

The urinary microbiome in IC/BPS: more complicated than we imagined

The concluding statement of this short review states, “the study of the urinary microbiome and its impact on urological disease, including IC/BPS, is in its infancy.” A lot has been said on this subject in recent years, but this, in...