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Patterns of relapse and implications for post-nephrectomy surveillance in patients with high-risk NCC-RCC

The natural history of non-clear cell renal cell carcinoma (NCC-RCC) post-nephrectomy with curative intent remains poorly defined. The surveillance protocols are largely dependent on guidelines followed for clear cell RCC (CC-RCC). In this study, the authors evaluated the relapse patterns...

Intermittent self-catheterisation

Intermittent self-catheterisation (ISC) is used in everyday practice for bladder dysfunction. This study from Southampton, UK presents a Cochrane review of different catheter designs, user satisfaction and incidence of urinary tract infection (UTI), etc. The following factors were looked at:...

A Woman’s Guide to Pelvic Health

The authors, a combination of family physician and physiotherapist, work well together in this easy to read text, to provide a useful and patient-orientated guide to pelvic health. Many patients are not served well by the derisory amount of time...

Do complementary therapies work in painful bladder syndrome?

The aim of this systematic review was to evaluate the effectiveness of complementary therapies in the treatment of bladder pain syndrome. An electronic search identified 1454 articles; however, after review by two independent reviewers, this was reduced to 11 articles...

The role of acupuncture in managing overactive bladder

Overactive bladder (OAB) affects 17% of American men and women and represents a burden in terms of both quality of life and finances. Alternative therapies may be sought for this condition as there is a high drop-out rate with regards...

Fluoxetine for refractory night wetting in children – is it safe and effective?

Around 1-2% of teenagers above the age of 15 years and 2-6% of adults continue to wet the bed. Standard treatment often includes bladder advice, alarm therapy, desmopressin and anticholinergics. Tricyclic antidepressants (imipramine) can also be utilised. Unfortunately, most have...

Prostate cancer

Case 1 A 65-year-old man is referred to your two-week wait (2WW) clinic with a PSA of 7.0ng/mL. He has no lower urinary tract symptoms (LUTS), no past medical history, no family history of prostate cancer (PCa) and his performance...

Botulinum toxin – from the sausage poison to urology

Botulinum toxin is the first biological toxin to be licensed for use in treating human disease and since its first therapeutic use in the early 1980s for strabismus has become widely used in the fields of ophthalmology, cosmetic surgery, migraine...

Intravesical GAG replacement therapies for bladder pain syndrome / interstitial cystitis – an update

The barrier function of the glycosaminoglycan (GAG) layer of the urothelium was identified by Parsons in 1975, and intravesical therapies to treat chronic inflammatory conditions of the bladder were developed soon after. However, the active role of the urothelium in...

PDE5I in LUTS – how do they work – no proof yet

Phosphodiesterase type 5 (PDE5) inhibitors used in erectile dysfunction (ED) have been shown to improve lower urinary tract symptoms (LUTS) as well. The mechanism is not well understood. One of the hypotheses for benign prostatic hyperplasia (BPH) – LUTS is...

Prenatal spina bifida repair – does it have urological benefits in the longer term?

At present, I have one patient under my care who underwent prenatal closure of his spina bifida defect. Only with time, will we be able to determine whether this intervention has been of benefit for him from a urological standpoint....

Update on immunotherapy for non-muscle invasive transitional cell carcinoma of the bladder

Patients with high-risk non-muscle invasive bladder cancer (NMIBC) that have failed Bacillus Calmette-Guérin (BCG) treatment are a difficult group to treat, and many may not be suitable for the preferred treatment option of radical cystectomy. Bladder-preserving treatments for BCG-unresponsive high-risk...