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Kidney stones in pregnancy

Case 1 A 28-year-old female, 19 weeks pregnant, presents with severe left loin pain. There is no past medical history of note. Blood tests show a white cell count of 14.1x109/L and creatinine of 56umol/L. An ultrasound scan (USS) reports...

Post CCT fellowship in genitourethral reconstruction at St George’s Hospital: an experience unique to the UK

I first developed an interest in genitourethral reconstruction, particularly urethroplasty, at the beginning of my urology training. Working in Bristol and Weston Super Mare for David Dickerson inspired me to develop this further. Mr Dickerson performs one of the largest...

Management of lower urinary tract foreign bodies

Of all the urological emergencies presenting to the emergency department, perhaps one of the most technically challenging cases is the patient with a foreign body in the genitourinary (GU) tract. A wide variety of GU foreign bodies have been reported...

The bulbocavernosus reflex

Despite its first discovery predating the early-1940s, clinical application of the bulbocavernosus reflex (BCR) has been limited to date. The BCR traditionally involves contraction of the bulbo- and ischiocavernosus pelvic floor muscles, often referred to as the ‘bulbocavernosus muscle’, in...

Erectile dysfunction part II: treatment

Introduction The identification of specific risk factors associated with erectile dysfunction (ED) allows patients with mild or moderate ED to undergo a series of lifestyle changes, which may provide enough improvement in the erectile function to avoid pharmacotherapies. Cessation of...

Feeling like a fraud — imposter syndrome: what it is and what to do about it

Have you ever been plagued by feelings of incompetence despite evidence to the contrary, then this article is for you. Dr Dunay Schmulian provides insight into imposter syndrome and what to do about it. Excerpt 1 Consultant:That was excellent, and...

The emerging role of physician associates in urology

The physician associate (PA) is a new role in the NHS which has expanded across medical and surgical specialties to include urology. In the USA, it has long been an established field of practice where physician assistants work autonomously within...

The how, why and when of bladder washouts: a guide

Bladder washouts are a treatment usually employed by the urology team, more often in an inpatient setting, and commonly indicated for haematuria with clot retention and catheter bypassing [1,2]. Bladder washout is a cornerstone of treatment in urology wards, yet...

Urethroplasty: a review of indications, techniques and outcomes

Urethral stricture is the most common cause of lower urinary tract obstruction in men aged between 20 and 40, carrying an estimated overall prevalence of 0.5% in the UK [1] and results in around 17,000 hospital admissions annually [2]. Endoscopic...

Prostate artery embolisation

Introduction Benign prostatic hyperplasia (BPH), a common condition associated with ageing, affects 50% of those between the ages of 50 and 60 years, and as many as 90% of those older than 80 years. BPH is characterised by unregulated, benign...

Immunotherapy in renal cancer

Renal cell carcinoma (RCC) is the sixth most common solid organ cancer in the UK. In 2018, there were 403,262 people diagnosed worldwide with the disease (2.2% of all cancer cases), and it accounted for 175,098 deaths in total (1.8%...

What exactly is Hinman Syndrome?

Who was Hinman and what is Hinman Syndrome? Frank Hinman Junior (1915–2011) first described ‘Hinman syndrome’ in the 1970s – a condition also known as a ‘non-neurogenic neurogenic bladder’. He was a renowned American urologist, educator and skilful artist and...