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Practical surgical management of chronic testicular pain

Chronic testicular pain (CTP) is defined as constant or intermittent, unilateral or bilateral testicular pain of more than three months’ duration, which significantly interferes with the daily activities of the patient prompting medical advice [1-4]. This condition is commonly seen...

Burnout in surgery

When I was pregnant with my first child, I went to a talk on how to achieve work-life balance and avoid burnout. It was given by a highly respected Australian surgeon and I was eager to hear the secrets that...

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...

Ipsilateral ureteroureterostomy: does function of the obstructed moiety matter?

Upper pole nephrectomy has been the traditional surgical management of children with poorly functioning upper pole moieties in duplex renal collecting systems having ureteral ectopia and ureterocele. However, ablative surgery confers a risk of functional loss to the remnant moiety...

Prostate cancer

Case 1 What is prostate specific antigen (PSA) and what is its function? According to the ERSPC Trial (at 13 years), what was the number needed to screen and diagnosed to prevent one prostate cancer death and what was the...

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...

A greener urology

Healthcare in England is responsible for 4-5% of the country’s carbon footprint which is defined as the amount of greenhouse gasses, primarily carbon dioxide, released into the atmosphere by a particular activity. The six greenhouse gasses which vary in their...

Intravesical GAG replacement therapies for bladder pain syndrome / interstitial cystitis – an update

The barrier function of the glycosaminoglycan (GAG) layer of the urothelium was identified by Parsons in 1975, and intravesical therapies to treat chronic inflammatory conditions of the bladder were developed soon after. However, the active role of the urothelium in...

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....

Endoscopic management of upper tract urothelial carcinoma

Upper tract urothelial carcinoma (UTUC) is a rare disease accounting for 5-10% of all urothelial carcinomas and has an annual incidence in Western countries of 1-2 per 100,000 [1,2]. It occurs more commonly in the pelvicalyceal system as opposed to...

Botulinum toxin – from the sausage poison to urology

Botulinum toxin is the first biological toxin to be licensed for use in treating human disease and since its first therapeutic use in the early 1980s for strabismus has become widely used in the fields of ophthalmology, cosmetic surgery, migraine...

Who was Zoon?

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). Eponyms are frowned upon in modern medical teaching but, as a medical historian,...