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Refluxing ureteral reimplantation

Obstructed megaureters may be managed with temporising stents, cutaneous ureterostomies, or in older children with ureteral reimplantation (usually if the child is over one year of age). Cutaneous ureterostomies have risks of stomal stenosis, infection and leakage problems over nappies...

Antibiotics and flexible cystoscopy

This study is from Memorial Sloan-Kettering Hospital in New York, USA. Thousands of flexible cystoscopies are performed every day worldwide. Do they need antibiotic cover? Flexible cystoscopy may cause urinary tract infection (UTI) in less than 10% of cases. Asymptomatic...

Convective radiofrequency water vapour thermal therapy for BPH

There are a number of new treatments for benign prostatic hyperplasia (BPH) on the market. This paper reports retrospective data for 129 patients treated with convective radiofrequency water vapour thermal therapy (Rezum) by a single surgeon. There is variable length...

Urinary tract infections and antibiotics – the debate goes on

A large number of hospital patients and primary care patients suffer from recurrent urinary tract infection (UTI) and urosepsis. Some of these patients end up in intensive care units with multi-organ failure. New draft guidance from the National Institute for...

Prodromal period of Fournier’s gangrene

Necrotising soft tissue infections of the genitalia (NSTIG), commonly known as Fournier’s gangrene, is a rare but important surgical emergency associated with significant morbidity and mortality. It is estimated that every six hours of delay in surgical debridement leads to...

A guide for the assessment and management of post-obstructive diuresis

Acute urinary retention is a common condition encountered in the emergency situation and is initially managed by urethral catheterisation. This is often performed by nursing staff or junior doctors. Post-obstructive diuresis (POD) is a specific entity which may occur post...

‘The Rise of a Specialty’ – Exhibition at the Royal Society of Medicine

The founding of the Royal Society of Medicine’s (RSM) Urology Section 100 years ago this year was crucial to the establishment of urology as a specialty in Great Britain in its own right. To mark this anniversary, earlier this year...

Urological trauma – part 2

Part 1 of this topic is available here. Case 1 A 29-year-old male was attacked and kicked in his left flank. He presented to the emergency department with left flank pain and frank haematuria. He remained haemodynamically stable. 1. What...

Nuptial night tragedy

Case 1 A fit and well 50-year-old gentleman presents to the emergency department with pain and swelling of his penis that started a few hours after he had a shower earlier in the day. On examination, the appearance is as...

Renal calculi composition – Hounsfield units or dual energy CT?

In this, the inaugural uro-radiology article, Jane Belfield (Section Editor) considers the significance of Hounsfield units in defining stone composition. Despite its widespread adoption and referencing in stone MDTs, there are some very clear limitations. Jane explores the potential role...

Comparison of PCNL under spinal versus general anaesthesia

There are several advantages of performing percutaneous nephrolithotomy (PCNL) under spinal anaesthesia including lower cost, reduced adverse effects and less tracheal tube displacement. Another advantage is that the patient remains awake throughout making positioning easier and reducing the risk of...

Relax and take note of this!

Children with neurogenic bladders are at risk of renal compromise through high detrusor pressures. Management aims to provide continence and preserve the upper tracts by increasing capacity and compliance though early clean intermittent catheterisation and anticholinergics. Intradetrusor botulinum toxin has...