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Management dilemma for very high-risk non–muscle-invasive bladder cancer

The European Association of Urology (EAU) guidelines recommend upfront radical cystectomy (RC) for very high-risk (VHR) non-muscle-invasive bladder cancer (NMIBC). However, real-world adoption is limited, as most patients are reluctant to undergo immediate bladder removal. The EAU 2021 risk model...

Robotic Urology Fellowship at UCLH

In November 2014, approaching my final year of training (ST7) in the West of Scotland (WoS) and just recently armed with my FRCS (Urol), I was at a crossroad in my clinical career. I was keen to pursue a consultant...

Planning and doing a fellowship: advice during the COVID-19 era

To paraphrase Shakespeare, to do, or not to do a fellowship, that is the question. That may be your question; whether or not to pursue a fellowship, even more so due to the uncertainty of the COVID-19 pandemic. There are...

The conservative assessment and treatment of mixed urinary and anal incontinence in women: a multidisciplinary approach

Mixed urinary incontinence Urinary incontinence (UI) is considered to be a highly prevalent condition; however, depending upon the definitions used, actual reported prevalence rates can vary significantly. The International Consultation on Incontinence (ICI) review [1], reported unadjusted prevalence estimates for...

What the Dickens?

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). In the last article we were in the modern world of films, this...

Cystoplasty

Case 1 A 48-year-old female, having previously had an augmentation ileocystoplasty 10 years ago, has been referred with right loin pain by the emergency department. A venous blood gas is performed shortly after triage with the following values: What is...

The how, why and when of bladder washouts: a guide

Bladder washouts are a treatment usually employed by the urology team, more often in an inpatient setting, and commonly indicated for haematuria with clot retention and catheter bypassing [1,2]. Bladder washout is a cornerstone of treatment in urology wards, yet...

Prostate abscess

Prostate abscess (PA) is a relatively uncommon clinical condition which is often difficult to diagnose because clinical symptoms are non-specific. It may be associated with a significant fatality rate, estimated to be between 3% and 30%, which may reflect its...

Nocturnal enuresis in children

Introduction Nocturnal enuresis is the complaint of bedwetting. The 2010 National Institute for Health & Care Excellence (NICE) guidelines define bedwetting as the “involuntary wetting during sleep without any inherent suggestion of frequency of bedwetting or pathophysiology” [1]. Bedwetting is...

ICS updates on continence care: what’s hot in physiotherapy after 80 years?

Origins of pelvic floor physiotherapy Physiotherapy, and in particular pelvic floor muscle training (PFMT) is nowadays first-line management for pelvic floor dysfunction (PFD). PFMT is originally attributed to Dr Arthur Kegel, hence the term Kegel exercises. Indeed, he was the...

Priapism

Priapism is defined as an abnormally persistent erection lasting greater than four hours, not associated with sexual desire [1]. Although relatively uncommon with an incidence of 1.5 per 100,000 [2], priapism has a risk of complications which can have a...

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,...