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Patient decision aids in the management of stress urinary incontinence

Urinary incontinence is a common condition faced by up to 20-50% of women, which impairs quality of life and poses a significant socioeconomic burden to both the individual women involved and more widely to the NHS [1]. The overall cost...

The role of PET-CT imaging in prostate cancer

Prostate cancer (PCa) is the second most common cancer in the UK, with 43,000 cases in 2017-18 [1,2]. Accurate primary staging and the detection of suspected recurrence following treatment is vital for directing management and predicting prognosis. This has conventionally...

Comparative effectiveness of nephron sparing surgery vs ablation

Nephron sparing surgery (NSS) and minimally invasive modality of thermal ablation have attracted great attention as an alternative surgical treatment to radical nephrectomy (RN) for renal tumours <4cm. High quality evidence comparing disease specific survival (DSS) is lacking. This issue...

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...

Male infertility

Definitions Infertility is the inability of a sexually active, non-contracepting couple to achieve spontaneous pregnancy in one year [1]. About 15% of couples do not achieve pregnancy within one year and seek medical treatment for infertility. Semen parameters are standardised...

Comedy and continence – don’t make me laugh

I’m a pelvic physiotherapist and, in a fit of temper, I wrote a comedy show about pelvic floors after having yet another woman say to me: “I’ve been leaking since my baby was born.” “How old is your baby?” “He’s...

Tolerability and persistence in women prescribed mirabegron

Mirabegron is a beta-3 agonist used in the treatment of overactive bladder (OAB). Trials have shown reduced side-effects but equal efficacy when compared to anticholinergics. The authors wished to examine patients’ persistence with treatment, in a non-trial setting, over a...

Repeat transurethral resection in non-muscle invasive bladder cancer

The authors felt this is a big problem because there is no standardised practice on re-resection following initial transurethral resection of bladder tumour (TURBT). Getting detrusor muscle in the first specimen is thought to be important. However muscle is not...

Revirgination is not the same as hymenoplasty

The operation called hymenoplasty is requested by women all over the world before marriage if they have engaged in premarital sex. They think that by undertaking the procedure of hymenoplasty they will regain their lost virginity, a theory that is widely accepted by patients and medical professionals. We believe however that hymenoplasty restores...

A new treatment for genitourinary syndrome of menopause

Genitourinary syndrome of menopause (GSM) [1] is defined as a collection of symptoms and signs mainly associated with the progressive decrease in oestrogen levels. The lack of hormones, usually produced by the ovaries in fertile age, may lead to genital symptoms...

Retropubic versus transobturator mid-urethral slings for stress incontinence

Mid-urethral slings are commonly used in the surgical management of stress urinary incontinence. This multicentre, randomised trial aimed to compare the safety and efficacy of the retropubic tension-free vaginal tape (TVT) with the transobturator tension-free vaginal tape (TVT-O) in a...

Pelviva® pelvic floor muscle trainer

Female urinary incontinence affects one in three women. Pelviva is a pioneering single use, intra-vaginal medical device that provides one combined treatment for both stress and urgency urinary incontinence.