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Getting it Right First Time in urology: the implementation phase

The Getting it Right First Time (GIRFT) programme is the largest and most comprehensive initiative to improve the quality and efficiency of individual clinical services that the NHS has ever instigated. The programme falls under the auspices of NHS Improvement...

The expanding indications for ureteroscopy – ad maiora!

The management of urolithiasis is becoming a Herculean task for healthcare providers worldwide. The incidence of stone disease is rising, with predicted lifetime risk of 12% in males and 6% in females [1]. This rise relates to both improving imaging...

Artificial penile pearls: what every Urologist should know!

Penile implants are inert objects placed beneath the skin of the penis through an incision. These are variously referred to as Yakuza beads, pearls, ball bearings, speed bumps, penile marbles, inserts, etc. The term ‘penile implant’ described here should not...

Benign prostatic hyperplasia: what are the benefits and harms of various surgical management options?

Benign prostatic hyperplasia (BPH) is characterised by stromal and epithelial prostatic cell hyperplasia. The enlarged prostate may be associated with voiding and storage lower urinary tract symptoms (LUTS). These have been predominantly attributed to bladder outlet obstruction (BOO), assumed to...

Delivering a laparoscopic urology workshop in West Africa: our initial experience in Senegal

Despite universal adoption and significant technological innovation since its inception around 30 years ago, access to laparoscopic surgery remains lacking in Sub-Saharan Africa (SSA). Whilst some progress has been made in recent years to bridge the gap with the developed...

Supporting return to clinical practice

There are many reasons for a clinician to take time away from clinical practice. These include parental leave, research, a period of ill health, a career break, or the opportunity to spend time pursuing other interests. At any one time,...

Use of MRI in the evaluation of prostate cancer: part 2

Diffusion weighted imaging and contrast enhanced imaging Introduction Magnetic resonance imaging (MRI) is widely used in localisation, staging and post-treatment follow-up of prostate cancer. In the previous issue, we discussed the usefulness of MRI in depicting prostate anatomy and pairing...

Conservative management of pelviureteric junction

Background Pelviureteric junction obstruction (PUJO) is defined as a functionally significant impairment of urine flow from the renal pelvis into the proximal ureter. For more than a century, surgery was considered the first-choice approach to management. However, the widespread use...

The impact of menopause on bladder symptoms

The menopause is a natural process of ageing when the ovaries completely stop producing reproductive hormones (oestrogen and other sex steroids), and there are no monthly periods for 12 consecutive months. It normally occurs between the ages of 45-55 years...

Using change theories can help nurses implement better care in prostate cancer

Nurses can help support change in prostate cancer care by understanding change management and models and provide leadership in improving prostate cancer care. An important part of being able to lead change is to understand change theories such as the...

Management of calyceal diverticular stones using ultramini PCNL

Calyceal diverticulae are congenital smooth-walled, non-secretory urothelium-lined cavities within the renal parenchyma that communicate with calyceal fornix through a diverticular neck. They were first described by Rayer in Traitements des maladies des reins [1]. Calculi occur in approximately 9.5% to...

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)...