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Things I wish I knew before starting on-call as an CST in urology
When I started my first core surgical trainee (CST) job in urology, I had no prior exposure or experience. Quickly I realised the significant step up and responsibility involved. Covering multiple sites overnight is something that requires organisation and awareness...
Ten years of experience with intravesical and intrasphincteric botulinum toxin A in children
This is one of the longest follow-up studies of botulinum toxin A usage in children with bladder dysfunction in the paediatric literature. Fifty-three children had Botox® (Allergan) injected for a variety of reasons (spina bifida – 18, acquired cord injury...
Laparoscopic transposition of renal lower pole crossing vessels
The vascular hitch procedure for pelvi-ureteric junction obstruction (PUJO) was initially described by Hellstroem in1951 and has become popular again since the introduction of laparoscopy. There is still much controversy as to its efficiency. The authors of this paper analyse...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...The role of an enhanced recovery protocol in patients undergoing robotic radical cystectomy
Enhanced recovery after surgery (ERAS) protocols are patient pathways designed to reduce surgical stress and accelerate postoperative recovery. Uptake of such protocols in colorectal surgery in particular has been high, however ERAS protocols developed or utilised in urological surgery have...
Hypospadias – how long should follow-up be?
The optimal duration of follow-up following childhood hypospadias repair (to detect complications) is ill-defined. Several surgeons recommend it to include assessment during puberty. Some may worry that ‘rapid penile growth’, ‘erectile forces’ and ‘sexual activity’ could potentially stress previously successful...Penile Mondor’s disease
Mondor’s disease is a rare, self-limiting entity characterised by subcutaneous chord like bands throughout the body. These bands arise due to phlebitis of the subcutaneous vessels. Penile Mondor’s disease (PMD) is an isolated superficial thrombophlebitis of the superficial dorsal vein...
Chronic retention – all you need to know
Chronic retention – all you need to know Chronic urinary retention is a common presentation in elderly and frail patients. Two types should be recognised - low pressure chronic retention (LPCR) and high pressure chronic retention (HPCR). Acute-on-chronic retention occurs...
Prostatic artery embolisation – an option for select BPO patients
Few proponents of prostatic artery embolisation (PAE) regard it as a potential standard in future for benign prostatic obstruction (BPO) / benign prostatic hyperplasia (BPH) treatment. Present guidelines from the National Institute for Health & Care Excellence (NICE) and the...
Urethral stenosis after radiation therapy for prostate cancer
One of the most common causes of bladder outflow obstruction in post radiotherapy (RT) cases is urethral stenosis. These cases are miserable and moribund with poor flow rates, incomplete bladder emptying, recurrent urinary tract infections and haematuria. The reported incidence...Stereotactic body radiotherapy for oligometastatic disease secondary to urological cancer
The concept of oligometastatic disease is controversial. The traditional model of cancer, which most of us learnt at medical school, is of a disease which starts confined to an organ, for example the prostate, where it can be cured with...
