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Hymenoplasty and virginity – an issue of socio-cultural morality and medical ethics

This article reflects the increasing complexity of the modern world, where the rich diversity of culture, morals, the law and religion, can have profound effects on medical practice. Sometimes there is considerable debate which is not in fact appropriate. This is illustrated in the concerns...

Junior doctors’ strike: is there light at the end of the tunnel?

Most urology departments will be affected one way or another by the ongoing industrial action by our junior colleagues. This article gives an interview between the BMJ team and Jeremy Hunt, UK Secretary of State for Health. We may or...

CROWN initiative – what is it about?

The editors of around 50 journals related to women’s health have joined forces to support the CROWN initiative (core outcomes in women’s health). The aim is to standardise the collection of outcomes for all trials in a specific dataset in...

Post-prostatectomy incontinence

Urinary incontinence following prostate surgery (post-prostatectomy incontinence or PPI) is a significant complication that can have a profoundly negative impact on the quality of life of patients suffering with it. It may become a barrier to physical activity and social...

Imaging of varicoceles

A varicocele is a collection of dilated, tortuous spermatic veins of the pampiniform venous plexus. It is seen in 10-15% of the general population and is associated with both primary and secondary infertility. A varicocele is the most common cause...

Uncovering the fate of small residual fragments

The concept of ‘stone free’ remains an enigma. To some urologists this refers to complete removal of all visible fragments, to others its removal of all ‘clinically significant’ fragments (generally regarded as fragments >2mm), and to some it is absence...

Optimisation of childhood spina bifida management – a prospective trial

Routh et al. describe a prospective trial which aims to determine the optimal urological management for children with spina bifida. The primary aim of neuropathic bladder management is to provide the patient with the best long-term quality of life with...

Medical expulsive therapy for paediatric urolithiasis

Children who have kidney stones are likely to have recurrences. Many initial stones are treated conservatively allowing for spontaneous passage of small stones if possible. Doxazocin or tamsulosin are known to dilate the ureter and allow spontaneous passage of stones...

Vitamin B12 deficiency in patients after enterocystoplasty

It is well known that enterocystoplasty within terminal ileum leads to vitamin B12 deficiency and regular monitoring of this post-surgery is essential. Often supplements need to be given because of deficiency in up to 40% of patients. These authors looked...

Paediatric chronic orchalgia

Testicular or scrotal / groin pain is common in children and often there is no apparent cause. This paper describes the authors’ experience over 10 years of boys >10 years seeking medical attention with testicular pain without anatomical abnormality or...

Adjuvant radiotherapy versus wait-and-see after radical prostatectomy

Optimum treatment modalities in prostate cancer continue to evolve, with debates at each stage of the evolution process, from focal therapy to radical treatment. In this randomised study, Wiegel et al. investigated the role of adjuvant radiotherapy following open radical...

Comparison of PCNL under spinal versus general anaesthesia

There are several advantages of performing percutaneous nephrolithotomy (PCNL) under spinal anaesthesia including lower cost, reduced adverse effects and less tracheal tube displacement. Another advantage is that the patient remains awake throughout making positioning easier and reducing the risk of...