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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...

Adults with myelomeningocoele: life situation and bladder and bowel management

Long-term outcome studies of patients to include what happens at transition to adulthood are rare but increasing in the literature as paediatric urologists are questioning their long-term results more deeply. These authors aimed to assess life situation and bladder and...

Giggle incontinence – not a laughing matter!

For many decades, the condition of giggle incontinence (enuresis risoria, giggle micturition) has remained a rare and poorly understood condition. Patients (90% female) present in their teens, with the history revealing an issue for many years. It is debilitating and...

Urinary retention in women: what a general urologist should know

Urinary retention (UR) is classified by the International Continence Society (ICS) into acute (AUR) and chronic (CUR). AUR is defined as the “inability to pass any urine despite having a full bladder which is painfully distended and readily palpable or...

Infections and inflammation: Part 2

See also Part 1 and Part 3. Case 1 A 43-year-old lady presented to the urologist with a history of pain during bladder filling and associated frequency / urgency. She underwent standard microbiological and radiological investigations that are normal. She...

Radiological appearances of non-vascular renal anatomical variants

Anatomical variants of the renal tract are common and, although often asymptomatic, may present with complications. It is essential to identify anatomical variants, as this may have an impact upon surgical planning and management. This article aims to demonstrate radiological...

Lifestyle interventions for UI in women

Lifestyle interventions for urinary incontinence (UI) are supported by all major guidelines. The National Institute for Health and Care Excellence (NICE) guideline (CG171) from September 2013 (updated November 2015) [1] recommends lifestyle advice including dietary modifications such as caffeine reduction,...

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...

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...

The Mitrofanoff procedure: a continent revolution

Prior to 1980, surgeons had been struggling to provide a catheterisable, continent channel as an alternative to the native urethra, primarily for paediatric patients with congenital neuropathic bladder. In 1980, Professor Paul Mitrofanoff described the continent supravesical antireflux appendicovesicostomy [1]...

My UK reconstructive urology fellowship experience

Surgical training is a long and hard pathway. Having completed medical school, I undertook my internship at the Alfred Hospital in Melbourne. The Alfred Hospital is a leading tertiary teaching hospital in Australia’s second largest city. Prior to commencing my...

Developing a risk calculator to predict cancer in patients with haematuria: The IDENTIFY Study

Patients with haematuria require investigations to rule out urinary tract cancer. We know that the most common cancer found during these investigations is bladder cancer, whereas upper tract cancers such as renal cell carcinoma and upper urinary tract urothelial cancer...