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Prostate cancer management 1 – non-metastatic disease

You are referred a 68-year-old gentleman to the rapid access prostate clinic with a serum prostate specific antigen (PSA) of 12ug/L. He is otherwise fit and well with mild voiding lower urinary tract symptoms (LUTS). He undergoes a multi parametric...

SMILE: sustaining medical education in a lockdown environment

2020 posed challenges to medical education like never seen before. In an effort to contain and slow the spread of coronavirus all UK medical schools ceased or reduced face-to-face contact. This sudden, and for many, unexpected change resulted in pressures...

Mesh in urological surgery in the UK – background, reviews and current status

All UK urologists, unless they have been on a 10-year silent retreat, are by now aware of the controversy surrounding surgical use of mesh in general and urological / urogynaecological use of mesh for the surgical treatment of stress urinary...

Missed Meyer-Weigert duplex ureter during emergency ureteric stenting for ureteric stones

The Meyer-Weigert rule is a fundamental anatomical principle in urology that describes the typical orientation of ureteral orifices in duplex kidneys. In a duplex system, the upper pole ureter usually inserts inferomedially, while the lower pole ureter inserts superolaterally. This...

Urinary incontinence in women – part 1: terminology and diagnosis

Introduction Urinary incontinence (UI) is the involuntary and often embarrassing leakage of urine. It is a condition that is both under-reported and under-diagnosed, and when reported it is, unfortunately, often not assessed and managed adequately. Incontinence of urine is encountered...

Ejaculatory dysfunction: a review of current practice and guidelines

Introduction The ejaculatory process is paramount to procreation in nature. It is a complex orchestration of physiology that results in emission of the ejaculate into the posterior urethra followed by ejection of those fluids from the urethra and orgasm. The...

Complications of CISC

Introduction Clean intermittent self catheterisation (CISC) was first introduced and popularised by Lapides in 1972. Since then its utilisation has become widespread and it is now commonly used throughout the world as the preferred means of facilitating complete and effective...

The management of renal calculi – Pt 1

Renal calculi can be managed according to four treatment options: conservative management, extracorporeal shockwave lithotripsy (ESWL), flexible ureterorenoscopy (FURS) and percutaneous nephrolithotomy (PCNL). This is the first in a two-part series in Urology News (Part 2 available here) that will...

Thermal ablative techniques for small renal masses

The incidence of renal cell carcinoma has increased over the past decade which can be partly attributed to the increased use of imaging modalities [1,2]. Nephron sparing procedures for the management of small renal tumours have gained popularity which include...

What’s new in post prostatectomy incontinence?

With an ageing population, the number of men being diagnosed with prostate cancer each year is steadily rising. With more specific investigations, such as multiparametric magnetic resonance imaging (MpMRI) and transperineal biopsies, the number of cases diagnosed at an earlier...

The assessment and medical treatment of LUTS secondary to BPH

The term benign prostatic hyperplasia (BPH) describes prostate enlargement due to non-cancerous processes. Several aetiological mechanisms are involved, including hormonal and vascular alterations; abnormal regulation of apoptosis; and prostatic inflammation, which may stimulate cellular proliferation. With ageing, prostate enlargement can...

Management of recurrent cystitis

Acute uncomplicated infective cystitis is most commonly seen in healthy women with a frequency of around 0.5-0.7 episodes per woman per year [1]. Around 10% of women report having had an episode of urinary tract infection (UTI) each year and...