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The assessment and medical treatment of LUTS secondary to BPH

The term benign prostatic hyperplasia (BPH) describes prostate enlargement due to non-cancerous processes. Several aetiological mechanisms are involved, including hormonal and vascular alterations; abnormal regulation of apoptosis; and prostatic inflammation, which may stimulate cellular proliferation. With ageing, prostate enlargement can...

A practical guide to success in National Selection

Gidon Ellis and Jonathan Makanjuola were both selected at National Selection in 2012 for Urological Higher Surgical Training. Both were ranked first in their respective interview rounds that year. It is no mean feat. Having read their article – their...

Reflections on 20 years as an Army Reserve doctor: live a life less ordinary

It seems a very short time ago that my predecessor recruited me into my regiment as a surgical senior house officer during a varicose vein operation in a cottage hospital in Stroud, informing me that I would be only the...

Frequency-volume chart apps for nocturia: keeping urologists up at night

Background Nocturia is a bothersome symptom and the leading cause of disturbed sleep in adults. It is extremely common, with 55% of men and 60% of women aged 50 waking at least once in the night, with a further 20%...

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...

Mechanisms and prevention of catheterisation associated urethral injury (CAUI)

Urethral catheterisation is a common procedure performed by health professionals across different grades and specialties in a variety of clinical settings. An estimated 15-25% of hospitalised patients have a urinary catheter inserted during their inpatient stay and up to 13%...

All biochemical recurrences are equal, but some are more equal than others

Despite significant technological advancements, radical prostatectomy (RP) and radiotherapy (RT) are not always effective in curing localised prostate cancer (PCa). Many patients experience a rise in prostate-specific antigen (PSA), known as biochemical recurrence (BCR), leading to considerable anxiety and a...

Long-term complications of bulking agents in the treatment of SUI

Incontinence poses a substantial economic burden on the UK’s NHS, estimated at £536 million in 1999/2000, equivalent to approximately 1.1% of the total NHS spend, for both men and women. Over two decades later, this cost is expected to have...

Dual therapy for OAB in children

Overactive bladder (OAB) is a disorder frequently encountered by the paediatric urologist. Morin et al. report the results of the first known study on the efficacy of mirabegron (a β3 adrenoceptor agonist) as add-on therapy in paediatric patients with refractory...

Retropubic versus transobturator mid-urethral slings for stress incontinence

Mid-urethral slings are commonly used in the surgical management of stress urinary incontinence. This multicentre, randomised trial aimed to compare the safety and efficacy of the retropubic tension-free vaginal tape (TVT) with the transobturator tension-free vaginal tape (TVT-O) in a...

Tissue-based biomarkers steering clinical decisions in patients with urothelial cancer

Biomarkers play an essential role in the diagnosis and treatment of urothelial cancer (UC), with PD-L1, FGFR, and MMR proteins being the most clinically established. These biomarkers, derived from histological specimens, guide therapeutic decisions for bladder cancer (BCa) and upper...

Morbidity and mortality after surgery for LUTS

The market for bladder outflow obstruction surgery is currently wide open with new technologies such as Urolift® emerging. One of the key selling points of new technologies is the comparative safety and efficacy compared to traditional techniques such as transurethral...