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History of prostate biopsy – part 2

For Part 1 of this topic is available here. The major limitations of the transrectal ultrasound (TRUS) guided prostate biopsy (PBx) protocols are the risk of profound sepsis and the risk of persistently significant false negative rates, related to the...

Suprapubic catheterisation – a core surgical trainee’s perspective

Suprapubic catheters (SPCs) are in widespread usage in medical practice and this review will focus on the pre-assessment, indications, methods and complications that are associated with the insertion of an SPC. Although suprapubic catheter insertions may be done electively or...

The bulbocavernosus reflex

Despite its first discovery predating the early-1940s, clinical application of the bulbocavernosus reflex (BCR) has been limited to date. The BCR traditionally involves contraction of the bulbo- and ischiocavernosus pelvic floor muscles, often referred to as the ‘bulbocavernosus muscle’, in...

Near-infrared fluorescence in robotic surgery

This is a systematic review and critical analysis of the current evidence on the applications of near-infrared fluorescence (NIRF) in robotic urologic surgery. It uses indocyanine green (ICG), a sterile water-soluble dye which has been tested in various fields. In...

The surgical management of female stress urinary incontinence in a post-mesh era

Trends in surgical management of women with stress urinary incontinence (SUI) have changed in recent times, mainly due to the ‘High Vigilance Pause’ placed on the use of mesh for SUI (and prolapse) surgery in July 2018 following an independent...

Prostate abscess

Prostate abscess (PA) is a relatively uncommon clinical condition which is often difficult to diagnose because clinical symptoms are non-specific. It may be associated with a significant fatality rate, estimated to be between 3% and 30%, which may reflect its...

Urinary retention in women: what a general urologist should know

Urinary retention (UR) is classified by the International Continence Society (ICS) into acute (AUR) and chronic (CUR). AUR is defined as the “inability to pass any urine despite having a full bladder which is painfully distended and readily palpable or...

The Mitrofanoff procedure: a continent revolution

Prior to 1980, surgeons had been struggling to provide a catheterisable, continent channel as an alternative to the native urethra, primarily for paediatric patients with congenital neuropathic bladder. In 1980, Professor Paul Mitrofanoff described the continent supravesical antireflux appendicovesicostomy [1]...

The stonecutters of 17th Century London

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). In the last article I told you about the prostatic punch. If you...

FRCS – the long way round

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). This month I am joined by my friend and fellow member of the...

Paediatric urology – peno-scrotal

Case 1 A four-year-old boy presents to clinic following GP referral unable to retract the foreskin (Figure 1). Figure 1. What is the diagnosis? The above condition may be pathological or physiological; clinically how can you differentiate this? Explain the...

Neurourology

Case 1 What are the urological indications for use of this medication? What is the mechanism of action when used in the bladder? What is the average duration of action? What are the contraindications to the use of this medication?...