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The future of bladder-sparing therapy is bright

Trimodal therapy (TMT), combining optimal transurethral resection of bladder tumour (TURBT) and concurrent chemoradiotherapy, has garnered significant attention for managing muscle-invasive bladder cancer (MIBC). This approach offers the potential for bladder preservation while delivering oncological outcomes comparable to radical cystectomy....

Lifestyle interventions for UI in women

Lifestyle interventions for urinary incontinence (UI) are supported by all major guidelines. The National Institute for Health and Care Excellence (NICE) guideline (CG171) from September 2013 (updated November 2015) [1] recommends lifestyle advice including dietary modifications such as caffeine reduction,...

The Mitrofanoff procedure: a continent revolution

Prior to 1980, surgeons had been struggling to provide a catheterisable, continent channel as an alternative to the native urethra, primarily for paediatric patients with congenital neuropathic bladder. In 1980, Professor Paul Mitrofanoff described the continent supravesical antireflux appendicovesicostomy [1]...

Comedy and continence – don’t make me laugh

I’m a pelvic physiotherapist and, in a fit of temper, I wrote a comedy show about pelvic floors after having yet another woman say to me: “I’ve been leaking since my baby was born.” “How old is your baby?” “He’s...

EAU Annual Congress 2024

By Arun Sharma, Urologist, West Herts NHS Teaching, Trust Watford, UK. The 2024 Annual EAU meeting was held at the Expo Porte de Versailles in Paris, the 'city of lights'. The opening ceremony was full of razzmatazz and included breath-taking...

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...

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...

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...

The role of conservative renal colic treatment

Acute renal colic is a common emergency condition, which can arise from a variety of underlying conditions that affect the urinary tract, but it is usually associated with the passage of ureteral stones. Before considering expectant management or active intervention,...

The surgical management of female stress urinary incontinence in a post-mesh era

Trends in surgical management of women with stress urinary incontinence (SUI) have changed in recent times, mainly due to the ‘High Vigilance Pause’ placed on the use of mesh for SUI (and prolapse) surgery in July 2018 following an independent...

Quality Improvement – how to get involved?

The General Medical Council (GMC) requires all trainee doctors to carry out Quality Improvement (QI) as part of our annual appraisal process [1]. Exactly what QI projects are and how to get involved is less widely understood. Traditionally surgical trainees...

An overview of daytime wetting in children

It is estimated that daytime wetting affects one in seventy-five children over the age of five years [1]. Daytime wetting is commoner in younger children (1 in 7 aged 4.5 years, 1 in 20 aged 9.5 years) [1]. Many younger...