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The effect of COVID-19 on urology training

COVID-19 has affected all aspects of medicine. Urologists have been called upon to work in vastly different working environments including acute pan-surgical teams, intensive care and medical wards. The strategies put in place by hospital management teams vary significantly across...

Urolithiasis – metabolic considerations

Case 1 A 32-year-old female patient is diagnosed with a ureteric calculus for the first-time. What type of metabolic evaluation investigations should be performed? When should stone analysis be repeated? What are the most common metabolic abnormalities associated with calcium...

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...

Use of Clavien-Dindo classification in urology part 2 – upper tract

A classification system of surgical complications was proposed by Clavien in 1992 [1] and further modified by Dindo in 2004 [2]. Clavien-Dindo classification has since then been validated through many retrospective case series as well as in comparative studies to...

Marin Marais: Fiddling with bladder stones

In this series of articles, I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). I’ve known about Marin Marais’ musical composition describing his bladder stone operation for...

An update on lower pole stone management for 2015

Introduction Urolithiasis is an increasing healthcare problem, with an estimated lifetime prevalence of up to 15% [1]. The number of interventions undertaken for stone disease has increased dramatically over recent years, particularly with respect to ureteroscopy and percutaneous nephrolithotomy (PCNL)...

Challenges of catheter associated urinary tract infection: is prevention better than cure?

Catheterisation is a common medical procedure in which a catheter (a hollow flexible tube) is inserted into the bladder in order to facilitate the drainage of urine. Catheters are usually passed into the bladder via the urethra, either to be...

Ureterocystostomy – novel surgery for the paediatric obstructed megaureter

Megaureter is a relatively common congenital urinary tract anomaly; obstructed non-refluxing megaureter is one variant. Initial management is conservative, with operative intervention reserved for symptomatic cases (recurrent pyelonephritis, pain, increasing dilatation or worsening renal function). Surgical options include cutaneous ureterostomy,...

Long-term complications of bulking agents in the treatment of SUI

Incontinence poses a substantial economic burden on the UK’s NHS, estimated at £536 million in 1999/2000, equivalent to approximately 1.1% of the total NHS spend, for both men and women. Over two decades later, this cost is expected to have...

Can you boost your bladder with vitamin D?

Bladder overactivity is a common problem affecting the social functioning of children. Overactive bladder dry (OAB-dry) is a term (one not utilised by the International Children’s Continence Society) and refers to patients who are experiencing frequency, urgency and nocturia symptoms...

All biochemical recurrences are equal, but some are more equal than others

Despite significant technological advancements, radical prostatectomy (RP) and radiotherapy (RT) are not always effective in curing localised prostate cancer (PCa). Many patients experience a rise in prostate-specific antigen (PSA), known as biochemical recurrence (BCR), leading to considerable anxiety and a...

Keep it simple: a proposal for a new definition of uncomplicated and complicated UTIs

Urinary tract infections (UTIs) are one of the most common bacterial infections in both community and healthcare settings, leading to frequent antibiotic use. They range widely in severity, from mild cases like cystitis to severe, potentially life-threatening conditions such as...