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Reducing the burden of NMIBC: outpatient laser management in morbid patients

With non-muscle invasive bladder cancer (NMIBC) posing a significant burden on urological departments, alternative ways of safely and effectively managing these patients with a minimally invasive approach is desirable. As rates of recurrence are high but progression rates low, and...

Inpatient care of patients with established spinal cord injury - what a general urologist needs to know

Introduction Spinal cord injury (SCI) is a devastating, life-changing condition, which is currently irreversible. Depending on the level of the spinal cord affected (and whether the lesion is complete or incomplete), patients may subsequently develop reduced voluntary motor function, sensory...

LUTS update

Case study A 70-year-old, generally fit and well male attends your outpatient clinic. He has experienced a gradual deterioration in his voiding over the last few months. Specifically, he reports hesitancy, poor flow and nocturia. He denies visible haematuria. His...

The PROMIS trial – time for multi-parametric MRI before a first prostate biopsy

Whilst the relatively random process of 12 core transrectal ultrasound guided (TRUS) prostate biopsy remains by far the most widely employed approach to prostate cancer diagnosis in the UK, its flaws as a standalone diagnostic strategy are increasingly apparent. TRUS-biopsy...

Use of Clavien-Dindo classification in urology part 1 – pelvic surgery

There is no widely accepted system to classify postoperative complications. It is necessary to compare the outcome and complications while validating a new surgical procedure or one of the surgical approaches of a particular condition. Several parameters have long been...

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...

Bladder cancer

Case 1 A 78-year-old female presents with a week history of painless haematuria. She’s a smoker and used to work in the textiles industry. She underwent a flexible cystoscopy. What does this image show? What are the two-week wait National...

Urethroplasty: a review of indications, techniques and outcomes

Urethral stricture is the most common cause of lower urinary tract obstruction in men aged between 20 and 40, carrying an estimated overall prevalence of 0.5% in the UK [1] and results in around 17,000 hospital admissions annually [2]. Endoscopic...

Covid-19, cancer, and other calamities

The coronavirus (Covid-19) pandemic is upon us. The government and NHS are going full-steam ahead with their preparations for the onslaught, freeing up operating theatres, intensive care units, and even private hospital beds and staff, to accommodate the expected influx...

Electrical injury – all you need to know

The modern operating theatre presents a highly complex and busy environment with a huge variety of machines, devices and gadgets. This article from France will be of interest to urologists, nurses, anaesthetists and theatre managers alike. We all use electrical...

Transfer to tertiary paediatric hospitals for patients with testicular torsion

Although this articles comes from a tertiary centre in Columbus, USA, there are similarities with the current controversies in the UK. The authors carried out a five-year retrospective review looking at the surgical transfer of 125 patients (mean age 13.4,...

New concepts, emerging technologies and potential therapeutics in testicular torsion

This review article is worthy of reading in its entirety. It addresses current concepts in the management of one of the few paediatric urological emergencies. For every 100,000 males <25 years, 4.5 will have testicular torsion per year. Given that...