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A review of the diagnosis and management of urethral caruncles

Introduction The innocuous urethral caruncle is the most common benign urethral lesion in females. It can pose a significant challenge to urologists due to the plethora of differentials and poor evidence surrounding management. In 1926, Ferrier eloquently described the macroscopic...

Fournier’s gangrene

Introduction Fournier’s gangrene (FG) is a rare but fulminant form of infective necrotising fasciitis affecting the perineum and external genitalia, which can rapidly progress along fascial planes. It most commonly affects men, but can occur in women and children, with...

Solifenacin for children and adolescents with overactive bladders

Solifenacin (VESIcare®) is the second-line anti-muscarinic medication of choice for my patients with overactive bladder (oxybutynin being my initial choice). However, currently, it remains unlicensed for use in children. Newgreen et al. have evaluated the long-term safety and efficacy of...

Consent Part 2

See Part 1 on this topic here Case 1 A 77 year old lady presents to the Emergency Department confused and generally unwell. She is septic and, on imaging, is found to have a 9mm obstructing right sided proximal ureteric...

Demanding cases or nightmares in endourology? May/June 2017

In the sixth article in this series the authors describe endourology nightmares involving ileal conduits and calculi. Case 1 A 69-year-old man who had a cystectomy and ileal conduit for muscle invasive bladder cancer, presented with an acute kidney injury...

The Underactive Bladder

For many, a diagnosis of an underactive or atonic bladder represents the end of the line in terms of management options. It remains a poorly understood and even more poorly appreciated condition, both in terms of underlying pathophysiology and alternatives...

Retention after Botox therapy in OAB

Treatment of overactive bladder (OAB) has a wide spectrum. The first step is lifestyle modifications, the second step is pharmacotherapy and the third line is intradetrusor injections with Botox®. This retrospective study is from Tennessee, USA in non-neurogenic and refractory...

Oestrogens and OAB

This is a multicentre study from Europe. The female genitals and lower urinary tract have a common embryological origin arising from urogenital sinus. Therefore, both could be sensitive to female sex steroid hormones. Oestrogens and progesterone receptors have been demonstrated...

New therapy for overactive bladder

Overactive bladder (OAB) is a complex symptom that can adversely affect quality of life. So far pharmacotherapy has focused on anti-cholinergic drugs. Recently, beta-adrenoreceptors have been identified as having an effect on the detrusor muscle and urothelium. Beta-3 is the...

PTNS in overactive bladder

This article will be of interest to those who undertake percutaneous tibial nerve stimulation (PTNS) or are planning to start doing so. This is a computer aided search between 2000-2011 to identify randomised controlled trials (RCT), controlled clinical trials (CCT)...

Mentorship and its role in surgical training

Is there a principle which could help address multiple challenges in surgical training? One which has potential to improve recruitment and retention of staff to our specialty, quality of patient care and surgeon morale? The author discusses the past present...

ICS updates in continence care: the role of the nurse continence specialist in continence services

The nurse who specialises in continence care is recognised as a key member of interdisciplinary teams seeking to deliver high quality integrated continence services. The recently published international service specifications for continence care [1] supports the use of specialist continence...