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A research revolution

“The revolution is not an apple that falls when it is ripe. You have to make it fall.” Erenesto ‘Che’ Guevara There was a time, not so long ago, when you actually had to go to a library to read...

The surgical trainer – are we still evolving?

“We need a system and we will surely have it – which will produce not only surgeons, but surgeons of the highest type” William Halsted MD William Halsted, a famous American surgeon, is widely credited with developing the first formal...

Management of recurrent cystitis

Acute uncomplicated infective cystitis is most commonly seen in healthy women with a frequency of around 0.5-0.7 episodes per woman per year [1]. Around 10% of women report having had an episode of urinary tract infection (UTI) each year and...

Moving hospitals as a consultant urological surgeon: what are the challenges?

Despite over 100 unfilled consultant urological surgeon posts in the UK, the reasons why an established surgeon should wish to move hospitals can still be viewed with suspicion. Why is this the case, when in many other careers, both within...

Ambulatory local anaesthetic implantation of percutaneous sacral nerve stimulators

Background The current treatment paradigm for detrusor overactivity (DO) and dysfunctional voiding (DV) includes conservative measures, pharmacotherapy, intravesical onabotulinum toxin A (Botox®), sacral nerve modulation (SNM / SNS) and urinary diversion as a last resort [1]. Incidence of DO is...

Refining management of non-visible haematuria

The optimal evaluation of non-visible haematuria (NVH) continues to be debated, with competing interests of avoidance underdiagnosis and the harms of over-testing. Current National Institute for Health & Care Excellent (NICE) guidance recommends referral for patients ≥60 years with NVH....

Inpatient care of patients with established spinal cord injury - what a general urologist needs to know

Introduction Spinal cord injury (SCI) is a devastating, life-changing condition, which is currently irreversible. Depending on the level of the spinal cord affected (and whether the lesion is complete or incomplete), patients may subsequently develop reduced voluntary motor function, sensory...

HIV / AIDS – implications for the urologist

“It’s no fun to have HIV even though it’s viewed as a chronic, controllable disease. It means being wedded to the health system.” - Philip Berger, Associate Professor in the Department of Family and Community Medicine, Toronto, Canada; and leading...

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...

Read all about it Mar/Apr 2020

Read all about it... 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...

PFMT in males

Pelvic floor muscle training (PFMT) has been described since ancient times in Rome but Kegel popularised it to improve sexual and urinary health after childbirth. In the paediatric population, there is a paradigm shift towards biofeedback-based PFMT for lower urinary...

TPTNS: evaluation of a therapeutic option in the management of anticholinergic refractory overactive bladder

This is a prospective study evaluating the tolerability and efficacy of transcutaneous posterior tibial nerve stimulation (TPTNS) in patients with urodynamically proven overactive bladder (OAB), who have failed anticholinergic treatment. Forty-three patients were studied and followed up over a period...