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Erectile Dysfunction Part I: pathophysiology and risk factors

Introduction Erectile dysfunction (ED) is defined as the inability to achieve and maintain a penile erection, which is adequate for satisfactory sexual intercourse. The Massachusetts Male Ageing Study (MMAS) reported the results of a regional survey of men aged 40–69...

Conservative management of pelviureteric junction

Background Pelviureteric junction obstruction (PUJO) is defined as a functionally significant impairment of urine flow from the renal pelvis into the proximal ureter. For more than a century, surgery was considered the first-choice approach to management. However, the widespread use...

Prilocaine irrigation for pain relief after TURP

Transurethral resection of the prostate (TURP) is one of the commonest procedures undertaken by urologists. There are well known complications following the procedure which commonly include haematuria but also TUR syndrome, failure to pass urine and infections, amongst others. The...

Male urethrograms

An ascending urethrogram is the best initial radiographic technique to image a male patient’s urethra and is indicated for strictures, fistulae, trauma and urethral obstruction [1]. It is quick and straightforward to perform and is performed using an 8Fr Foley...

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...

A guided guide to the guide wire

The use of guide wires has become a core skill utilised by urologists, especially within the field of endourology. The authors take us through the development of the guide wire and their current use in urology. The history The first...

Urinary incontinence in women – part 1: terminology and diagnosis

Introduction Urinary incontinence (UI) is the involuntary and often embarrassing leakage of urine. It is a condition that is both under-reported and under-diagnosed, and when reported it is, unfortunately, often not assessed and managed adequately. Incontinence of urine is encountered...

Ketamine uropathy – an update

The first two case series that documented the association between urinary tract damage and recreational ketamine use were published 12 years ago [1,2]. Since then ketamine has maintained a controversial profile as an essential medication of expanding utility but with...

Outcomes of VUR in children with non-neurogenic dysfunction treated with Deflux

The 2010 American Urological Association (AUA) guidelines on primary vesicoureteral reflux (VUR) state that children with VUR and lower urinary tract dysfunction are less likely to have the VUR resolve spontaneously than those with primary VUR alone (31% vs. 61%)....

Intermittent vs. continuous hormonal therapy for metastatic prostate cancer

Continuous androgen deprivation therapy (cADT) is the standard management for metastatic prostate cancer (mPCa). Intermittent androgen deprivation therapy (iADT) is sought to have better quality of life (QoL) and adverse events profile during off-treatment period. This multicentre European randomised study...

Induction Switch

Changing medical jobs or working in multiple hospitals is often a frustrating experience. Switch wait times can be agonisingly long, and at least in my experience, hospital intranet telephone directories are frequently inaccurate and unhelpful in connecting to the relevant...

Selective denervation of the bladder

The treatment of refractory overactive bladder is currently limited to neuromodulation (sacral nerve stimulation or percutaneous tibial nerve stimulation) or botulinum toxin injections. Although all these options are valuable, they have their own limitations and may not be suitable for...