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Benign prostatic hyperplasia: what are the benefits and harms of various surgical management options?

Benign prostatic hyperplasia (BPH) is characterised by stromal and epithelial prostatic cell hyperplasia. The enlarged prostate may be associated with voiding and storage lower urinary tract symptoms (LUTS). These have been predominantly attributed to bladder outlet obstruction (BOO), assumed to...

Online urology teaching

The COVID-19 crisis continues to disrupt our traditional models of teaching. Urological emergencies account for 20% of all acute surgical admissions and 5-10% of general practitioner visits [1]. Currently in the UK, undergraduate teaching on urology is not compulsory. Fewer...

All you need to know about percutaneous nephrolithotomy: supine versus prone and mini versus traditional

Introduction Since the first percutaneous nephrolithotomy (PCNL), the technique has undergone many innovations, including modifications in positioning, miniaturisation of instruments and combination with retrograde intra-renal surgery (see Table 1 for an outline of the history of the technique). Controversy has...

Urinary incontinence in women – part 2: management

In the second part of our comprehensive overview of urinary incontinence (UI) the authors explore the plethora of treatment options for this complex condition. (Part 1 available here). Conservative management Initial treatment of incontinence should be conservative. Caffeine reduction and...

Read all about it May/Jun 2018

It can be awkward when a patient asks you about a report in their favourite tabloid detailing an amazing research breakthrough or a ‘cutting-edge’ new treatment / test and you don’t know what they are talking about! So this section...

Functional and reconstructive urology

Case 1 A 45-year-old female presents with a one-year history of urinary leakage, especially worse on coughing. She is otherwise well, with no co-morbidities. What is the International Continence Society (ICS) definition of stress urinary incontinence (SUI)? What are the...

Hail the Portfolio Pathway!

In the United Kingdom, the pursuit of a surgical career traditionally follows a conventional pathway, primarily through the completion of specialty programmes accredited by the Royal College of Surgeons or the Intercollegiate Surgical Curriculum Programme (ISCP). However, for doctors with...

Is routine renal tumour biopsy associated with lower rates of benign histology following nephrectomy for small renal masses?

There has been a considerable increase in the detection of small renal masses (SRM). Approximately 20% of these turn out to be benign lesions on final histopathological analysis. Therefore upfront surgery can be overtreatment in such a group of patients....

What are the long-term outcomes of TOT and TVT procedures?

This is a systematic review between 2000 and 2016 evaluating the efficacy and safety of midurethral sling (MUS) procedures in women. Studies were included if the follow-up data was five years or more. Objective cure rates showed no significant difference...

Intermittent vs. continuous hormonal therapy for metastatic prostate cancer

Continuous androgen deprivation therapy (cADT) is the standard management for metastatic prostate cancer (mPCa). Intermittent androgen deprivation therapy (iADT) is sought to have better quality of life (QoL) and adverse events profile during off-treatment period. This multicentre European randomised study...

Long-term consequences of posterior urethral valves

These two papers give a very good summary of the long-term effects of posterior urethral valves (PUV) into adulthood and are worth a read. Pereira et al. It is well known that the consequences of posterior urethral valves extend well...

A ‘survival guide’ to an ST3 year in urology

Following success in national selection, it soon dawns on the successful candidate that entry into higher surgical training (HST) requires more than a little clinical knowledge. The role requires administrative and organisational skills not hitherto called upon. This additional skill...