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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...

PREDICT Prostate – individualised, evidence-based estimates of survival and treatment benefit

Earlier this year ‘PREDICT Prostate’ was launched online alongside a high-profile publication in PLOS Medicine. The prognostic model and decision-aid has been designed to inform treatment decision-making among men newly diagnosed with non-metastatic prostate cancer. David Thurtle and Vincent Gnanapragasam...

Medical statistics for urologists: part 3 – diagnostic testing

Following on from the first two parts of this series (see Part 1 here, and Part 2 here), this final article aims to demonstrate how the theory of statistics applies to medical diagnostics. Probability in diagnostic testing Diagnostic tests refer...

Giggle incontinence – not a laughing matter!

For many decades, the condition of giggle incontinence (enuresis risoria, giggle micturition) has remained a rare and poorly understood condition. Patients (90% female) present in their teens, with the history revealing an issue for many years. It is debilitating and...

Urology around the world: Myanmar

In this article the author, a urologist from Myanmar, discusses the presentation, diagnosis and management of a condition common in his country. Urethral orifice stones Urolithiasis is one of the most common urological conditions, usually involving the kidneys, ureters and...

The assessment and medical treatment of LUTS secondary to BPH

The term benign prostatic hyperplasia (BPH) describes prostate enlargement due to non-cancerous processes. Several aetiological mechanisms are involved, including hormonal and vascular alterations; abnormal regulation of apoptosis; and prostatic inflammation, which may stimulate cellular proliferation. With ageing, prostate enlargement can...

Ejaculatory dysfunction and the treatment of LUTS

For years ejaculatory dysfunction in men following medical or surgical treatment of lower urinary tract symptoms (LUTS) was thought to be a result of disruption of the bladder neck mechanism and the subsequent retrograde flow of semen. Men commenced on...

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...