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All you need to know about percutaneous nephrolithotomy: supine versus prone and mini versus traditional

Introduction Since the first percutaneous nephrolithotomy (PCNL), the technique has undergone many innovations, including modifications in positioning, miniaturisation of instruments and combination with retrograde intra-renal surgery (see Table 1 for an outline of the history of the technique). Controversy has...

Functional and reconstructive urology

Case 1 A 45-year-old female presents with a one-year history of urinary leakage, especially worse on coughing. She is otherwise well, with no co-morbidities. What is the International Continence Society (ICS) definition of stress urinary incontinence (SUI)? What are the...

Pyonephrosis: is the kidney always doomed?

Pyonephrosis (Greek pyon ‘pus’ + nephros ‘kidney’) is defined in Campbell-Walsh Urology [1] as an infected hydro-nephrosis associated with suppurative destruction of the renal parenchyma which results in total or near total loss of renal function. The true incidence of...

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...

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,...

Bladder cancer

Case 1 A 78-year-old female presents with a week history of painless haematuria. She’s a smoker and used to work in the textiles industry. She underwent a flexible cystoscopy. What does this image show? What are the two-week wait National...

Discovering urology during the foundation programme

My journey to finding urology as a chosen career was not linear. During medical school, I always enjoyed studying urological and renal pathologies. I was exposed to one week of urology placement during my fourth year ‘surgical block’, where I...

EAU Patient Information 2019

Credible sources of medical information are difficult to find for patients and healthcare professionals. The European Association of Urologists (EAU) have updated their patient information website since our previous review last year. This digital review focuses on the patient information...

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...

Adults are just big kids: a paediatric surgeon’s experience in adult urology

As an ST8 trainee in paediatric general surgery and urology, I had firmly decided on subspecialisation in paediatric urology. Whilst preparing for the dreaded final Annual Review of Competency Progression (ARCP), the all-important question of “What next?” came to the...

Urolithiasis 2 – extracorporeal shockwave lithotripsy

- Click for Part 1 and Part 3 on this topic - Case scenario A 37-year-old male presents to A&E with 12 hours of intermittent, severe, left-sided loin to groin pain and multiple episodes of vomiting. Urine dipstick shows 2+...

Prevention of urethral stricture recurrence

Urethral stricture recurrence after urethral reconstruction is one of the most challenging problems in urology. With the increase in endoscopic surgery over the last three decades the incidence of urethral strictures has increased, with iatrogenic manipulation the leading aetiology in...