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Neuromodulation for lower urinary tract dysfunction – an ICS update

Non-invasive and invasive electro-stimulation techniques have been extensively studied in the treatment of lower urinary tract and bowel dysfunction, including overactive bladder syndrome (OAB), non-obstructive chronic urinary retention, faecal incontinence and chronic pelvic pain. Currently, the most common indication for...

Klinefelter’s syndrome

Klinefelter’s syndrome (KF) is the most frequent sex chromosome abnormality with an estimated prevalence of 1 in 500 to 1 in 700 newborn males and 1 in 10 in men with azoospermia. While the majority of cases are an XXY...

Obesity and Urologic cancers: A student’s perspective on risk, systems and surgical implications

During my clinical placements, I began to notice that some patients did not fit neatly into the scenarios we learned about in lectures. One patient in particular had a raised PSA and several comorbidities, including obesity. What stood out was...

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,...

Prolapse surgery with mesh: where do we stand in 2017? An ICS update

Background Surgery for pelvic organ prolapse (POP) is common among women. The lifetime risk of undergoing at least one surgical procedure for POP is up to 20% [1]. This kind of surgery will be increasingly important due to an ageing...

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...

The multidisciplinary team meeting: London calling!

The multidisciplinary team meeting, or MDT, is the foundation of cancer management in the UK. The MDT consists of a group of experts in different fields of medicine and surgery coming together at regular intervals to discuss the diagnosis and...

A review of the diagnosis and management of urethral caruncles

Introduction The innocuous urethral caruncle is the most common benign urethral lesion in females. It can pose a significant challenge to urologists due to the plethora of differentials and poor evidence surrounding management. In 1926, Ferrier eloquently described the macroscopic...

Ambulatory local anaesthetic implantation of percutaneous sacral nerve stimulators

Background The current treatment paradigm for detrusor overactivity (DO) and dysfunctional voiding (DV) includes conservative measures, pharmacotherapy, intravesical onabotulinum toxin A (Botox®), sacral nerve modulation (SNM / SNS) and urinary diversion as a last resort [1]. Incidence of DO is...

Advanced renal tumours

Case 1 A 67-year-old gentleman underwent a CT scan after presenting with visible haematuria and weight loss. His comorbidities include hypertension, type II diabetes mellitis and hypercholesterolaemia. He is a smoker. Figure 1. Figure 2. What do Figures 1 and...

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...

Renal calculi: the role of imaging in pregnancy

Nephrolithiasis is the most common cause of non-obstetric abdominal pain in pregnancy. Accurate diagnosis is imperative as stone related complications can lead to pre-eclampsia, urosepsis, and premature labour [1,2]. In the general population, non-contrast cross sectional imaging is recommended by...