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Intravesical glycosaminoglycan analogue instillations for recurrent cystitis

Introduction The symptoms of recurrent cystitis can be triggered by inflammatory or infective causes. Bladder pain syndrome (BPS) and bacterial recurrent lower urinary tract infection can both present with symptoms of recurrent cystitis and cause significant morbidity in affected individuals....

The workplace environment and doctors’ health

It is well established that doctors have higher levels of stress, depression and suicide than the general population [1] and most other professional groups. In addition they have high levels of ‘burnout’. Research indicates that although burnout is correlated with...

#DontPayToStay Campaign – how one urology trainee led a successful campaign to eliminate charges for non-resident on call accommodation across England

The 2016 terms and conditions of service (junior doctor contract) introduced the following clause: 11. Where a doctor is rostered to work on a non-resident on-call working pattern and the doctor elects voluntarily, subject to the availability of accommodation, to...

New analysis by Prostate Cancer UK uncovers inequalities in mortality and refutes prevailing beliefs

Prostate cancer mortality rates continue to be higher in Black men than white men, latest analysis reports. The disparity persists across all levels of deprivation, challenging beliefs that socioeconomic differences alone explain ethnic differences in outcomes. Even in the least...

Comparing NSAIDs with antibiotics in the treatment of uncomplicated UTIs in women

Uncomplicated urinary tract infections (UTIs) are a common presentation in primary care, however there is increasing concern regarding antibiotic use and resistant organisms. In this double-blind randomised German study, the authors seek to establish if ibuprofen 400mg three times a...

CRP to predict the need for surgical intervention in acute renal colic

A previous paper has suggested that C-reactive protein (CRP) is a useful serum marker for determining the likelihood of a patient with renal colic requiring surgical intervention, the cut-off level being >28mg/l (specificity 88.9%, sensitivity 75.8%). This prospective observational study...

Can PET/CT help in selecting treatment for patients with muscle-invasive bladder cancer more appropriately?

Radical cystectomy is one of the most drastic procedures that urological patients have to undergo with a five-year mortality of around 50% in those with organ-confined disease at presentation. Traditional imaging is with contrast-enhanced computed tomography (CT) but lymphadenectomy often...

What should we do with the incidentally detected renal cyst in a child?

The introduction of routine prenatal screening in the early 1980s resulted in paediatric urologists being confronted with the dilemma of what to do with antenatally-detected urinary tract dilatation, many of whom, we now know, do not require long-term surveillance or...

Risk stratified approach to early intervention for renal colic

Existing guidance on this topic is based on older and smaller studies, and there remains variation in practice. This review of database outcomes of 1168 out of 3081 (38%) patients who underwent early intervention after presentation to nine Canadian emergency...

Preventive pharmacological therapy for kidney stones

Kidney stones are common, painful and are a chronic disease with a high lifetime risk of recurrence. Without treatment 35-50% of patients experience a second stone within five years of their first experience. Thiazide diuretics, alkali citrate treatment and allopurinol...

Pyonephrosis: is the kidney always doomed?

Pyonephrosis (Greek pyon ‘pus’ + nephros ‘kidney’) is defined in Campbell-Walsh Urology [1] as an infected hydro-nephrosis associated with suppurative destruction of the renal parenchyma which results in total or near total loss of renal function. The true incidence of...

The process of medical innovation – evolving trends and future perspectives

In 2018 the United Kingdom Government spending on healthcare totalled almost £166 billion. Of this approximately 65% was attributed to providing curative or rehabilitation therapy, with health-related long-term care and provision of goods accounting for 25%. The remaining was accredited...