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A sigma six approach to improving nephrostomy and antegrade stent services at a district general hospital – an audit project

As hospitals merge into larger trusts there becomes a centralisation of some services. Interventional radiology (IR) has been one of those services. Our district general hospital runs bi-weekly lR lists following service centralisation. Urology and IR most commonly liaise on...

The importance of active investigation and follow-up in bladder injury

Bladder injury (BI) is uncommon, and patients are typically managed by large multidisciplinary teams, dealing concomitantly with other injuries or diagnoses. BI can be categorised by cause (traumatic vs. iatrogenic) or anatomical location (intraperitoneal vs. extraperitoneal), requiring differing approaches to...

Prostate cancer series: diagnostics 2

- Click here for Part 1 - A 68-year-old male was referred to the two-week wait prostatic clinic with a serum prostate specific antigen (PSA) of 17. He had no bothersome lower urinary tract symptoms, relevant past medical history or...

The management of renal calculi – Pt 1

Renal calculi can be managed according to four treatment options: conservative management, extracorporeal shockwave lithotripsy (ESWL), flexible ureterorenoscopy (FURS) and percutaneous nephrolithotomy (PCNL). This is the first in a two-part series in Urology News (Part 2 available here) that will...

Modern management of small renal masses

With the advent of widespread cross-sectional imaging there has been a surge in incidental detection of small renal masses (SRMs) and renal cell carcinoma (RCC) is now the seventh most common cancer in the UK. Whilst surgical excision for larger...

A negative ureteroscopy for stone disease: is it acceptable and is it avoidable?

Urinary tract stone disease and the consequent demand for endoscopic intervention in the upper urinary tract is an increasing phenomenon [1]. Although ureteroscopy is generally considered to be associated with low morbidity [2], risks do exist. Recognised complications include urothelial...

Bladder carcinoma MRI

Bladder malignancy is one of the commonest malignancies of the renal tract, accounting for approximately 6% of male malignancy and 2% of female malignancy. The incidence increases with patient age with 70% of patients being over the age of 65...

Testicular microlithiasis

Introduction Testicular microlithiasis (TML) was originally described in 1970 in a healthy four-year-old boy [1] and the first paper regarding microlithiasis as an entity seen on ultrasound was published in 1987 [2]. Testicular microlithiasis is seen on ultrasound as small,...

Use of bone windows in urological CT

Introduction Unenhanced computed tomography of kidneys, ureter and bladder (CTKUB) is the recommended gold standard investigation in patients with acute renal colic. CT urography is now a commonly used technique in the investigation of haematuria, for surgical planning and for...

The bilious solution of Monsieurs Calmette et Guérin

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). This month’s history story was inspired by a question from one of my...

Non-urothelial bladder malignancies

Case 1 An 80-year-old gentleman presented with a history of visible haematuria and recurrent urinary tract infections (UTIs). He has been performing intermittent self catheterisation (ISC) for detrusor underactivity for over 20 years. A flexible cystoscopy showed these appearances of...

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...