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An inconvenient truth: reflections on the NHS

“What gets us into trouble is not what we don’t know. It’s what we know for sure that just ain’t so.” The above is a quote attributed to Mark Twain from the 2006 documentary, An Inconvenient Truth, which follows Al...

UTI Care – antibiotics or NSAIDs?

This is the cover story of a recent issue of the BMJ. As per the World Health Organization (WHO), antibiotic resistance is becoming a major economic and global problem. This is a randomised, double-blind study from 17 general practices in...

UTI and VUR in children with mild antenatal hydronephrosis

This paper describes a retrospective analysis of 760 (608 males, 162 females) patients identified with mild antenatal hydronephrosis (defined by an anteroposterior (AP) pelvic diameter of 7-10mm in the third trimester and persistent postnatal dilation) looking at the incidence of...

Urinary incontinence in women – part 2: management

In the second part of our comprehensive overview of urinary incontinence (UI) the authors explore the plethora of treatment options for this complex condition. (Part 1 available here). Conservative management Initial treatment of incontinence should be conservative. Caffeine reduction and...

Androgen insensitivity in patients with proximal hypospadias

A number of surgeons use preoperative androgen stimulation for a period of time prior to hypospadias surgery. The aim is to increase glans circumference, penile length and improve prepucial vascularisation pre-surgery. Data confirming the results of these aims is scarce....

An overview of changes to urology training

Paediatric urology training A review of paediatric emergency services in the UK involving general surgery, urology and paediatric surgery was initiated due to the problems encountered by the lack of suitable experience outside large paediatric surgical units to deliver emergency...

Neuromodulation for lower urinary tract dysfunction – an ICS update

Non-invasive and invasive electro-stimulation techniques have been extensively studied in the treatment of lower urinary tract and bowel dysfunction, including overactive bladder syndrome (OAB), non-obstructive chronic urinary retention, faecal incontinence and chronic pelvic pain. Currently, the most common indication for...

Percutaneous ultrasound guided endoscopic lavage of perinephric abscess – different, but not necessarily better

Perinephric abscess is an uncommon but serious form of urosepsis. It develops as a consequence of the extension of an infection outside of the parenchyma of the kidney in acute pyelonephritis, or more rarely from haematogeneous spread of an infection...

BUS for urethral stricture

The earliest description of urethral stricture and its treatment occurred in the sixth century BC in India. A wide variety of factors can lead to stricture disease e.g. iatrogenic, urinary tract infection (UTI), sexually transmitted infections, catheters, trauma to the...

Challenges of upper tract urothelial carcinoma

Upper tract uroepithelial carcinoma (UTUC) is a fairly common disease which traditionally had poorer outcomes compared to bladder cancer. This is due to various factors leading to delayed diagnosis and problems in risk stratification. Continuing efforts have focused on early...

Things in a place they should not be!

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). I think we all have stories of objects inserted into the urethra and...

Stuttering (recurrent ischaemic) priapism

Stuttering (recurrent ischaemic) priapism (SP) is a rare urological condition. Affected men will often experience almost daily prolonged and painful sleep related erections (SRE). Interestingly, these men report normal erections during the day and whilst awake. These episodes are usually...