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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...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...
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...
Practical Functional Urology
Whilst there is nothing unique in the individual chapters in this book it is rare for so many focused areas of interest to be integrated quite so well under one cover. The topics covered range from bladder emptying disorders to...Urolithiasis – metabolic considerations
Case 1 A 32-year-old female patient is diagnosed with a ureteric calculus for the first-time. What type of metabolic evaluation investigations should be performed? When should stone analysis be repeated? What are the most common metabolic abnormalities associated with calcium...
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...
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...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...
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...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...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...
