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The GMS hypospadias score

Hypospadias surgery has been carried out for decades. Descriptive parameters for hypospadias severity are variable and difficult to reproduce. The severity of abnormalities lies along a continuous spectrum. The paediatric urological fraternity is attempting to develop more reliable comparators for...

Cystolithotripsy using the holmium laser: evolving uses for the laser lithotrite

This small prospective study examined 20 patients who were undergoing laser cystolithotripsy for bladder stones. Laser lithotripsy was performed using either a 365 or 550µm holmium:YAG laser fibre with a power setting of 1.0J and a frequency of 10Hz. Stone...

Physiotherapy first for pelvic floor dysfunction

Physiotherapy should be included in first-line management options for pelvic organ prolapse and urinary incontinence in women [1,2]. Additionally, referral to physiotherapy is widely practised for the management of urinary incontinence in men, faecal incontinence, defecation disorders and various pelvic...

Training to be a urologist: how risky is it?

The NHS and urology face challenging times in trying to provide quality patient care efficiently and economically. Urology trainees are experiencing conflicting pressures with a new contract, a challenging on-call system and changing training requirements in an overstretched, centralised service...

Revirgination is not the same as hymenoplasty

The operation called hymenoplasty is requested by women all over the world before marriage if they have engaged in premarital sex. They think that by undertaking the procedure of hymenoplasty they will regain their lost virginity, a theory that is widely accepted by patients and medical professionals. We believe however that hymenoplasty restores...

Priapism

Priapism is defined as an abnormally persistent erection lasting greater than four hours, not associated with sexual desire [1]. Although relatively uncommon with an incidence of 1.5 per 100,000 [2], priapism has a risk of complications which can have a...

Urethral diverticulum: a review of the literature and local experience

Urethral diverticula are an uncommon finding on imaging. They are focal outpouchings of the urethra into the periurethral / urethrovaginal space, occurring more frequently in females (up to 6% of women) [1]. These diverticula are becoming more prevalent in clinical...

Stenting prior to URS or ESWL – does it increase ED visits and opiate prescriptions?

Ureteral stents are used to bypass obstructive stones, to dilate the ureter in order to facilitate ureteroscopy (URS), and to maintain patency / low intrarenal pressure following stone surgery. However, there can be morbidity (pain / voiding symptoms). Tasian et...

Retroperitoneal sepsis

Case 1 An 80-year-old woman presented with history of recurrent and recent cystitis, low grade pyrexia, abdominal and back pain, and pain on movement of the left hip which was observed to be flexed and externally rotated. What is the...

Sepsis syndrome in urology

There are approximately 100,000 cases of sepsis per year in the UK, of which 37,000 result in death (this is more than prostate cancer, breast cancer, HIV / AIDS and road traffic accidents combined). Urosepsis is defined as sepsis caused...

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...

Challenges of catheter associated urinary tract infection: is prevention better than cure?

Catheterisation is a common medical procedure in which a catheter (a hollow flexible tube) is inserted into the bladder in order to facilitate the drainage of urine. Catheters are usually passed into the bladder via the urethra, either to be...