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NICE backs laser for BPH

Benign prostatic hyperplasia affects 60% of men aged 60 or over. The medical technology division of the National Institute for Health & Care Excellence (NICE) has supported the GreenLight XPS laser system as a surgical tool. The specific indications are:...

Cortical stimulation for voiding dysfunction in multiple sclerosis

Voiding dysfunction (VD) increases morbidity in patients with multiple sclerosis (MS), and may be associated with urinary tract infections, stones and renal failure. Catheterisation is required when impaired hand function precludes self-catheterisation, which is associated with further morbidity. In this...

Catheters and incontinence after radical prostatectomy: Preparing (but not scaring) men

Every year about 6000 men in the UK undergo radical prostatectomy (RP) for treatment of prostate cancer [1]. Despite surgical advances, RP continues to be associated with significant side-effects including urinary incontinence (UI) [2]. Immediately following removal of the urinary...

Urethral pathology

Case 1 A 43-year-old lady presents with urinary incontinence and vaginal pain associated with intercourse. An initial CT scan is performed. Case courtesy of Radswiki, Radiopaedia.org, rID: 12056. Case courtesy of Radswiki, Radiopaedia.org, rID: 12056 What is the clinical diagnosis...

Bladder cancer: where are we with intravesical therapies?

In the United Kingdom, almost 10,500 new cases of bladder cancer were identified in 2013, with over 5000 deaths in 2012 [1]. Seventy percent of new cases will be non-muscle invasive bladder cancer (NMIBC) at diagnosis and therefore will be...

Getting it Right First Time in urology: the implementation phase

The Getting it Right First Time (GIRFT) programme is the largest and most comprehensive initiative to improve the quality and efficiency of individual clinical services that the NHS has ever instigated. The programme falls under the auspices of NHS Improvement...

Image-guided renal cryoablation

Introduction There has undoubtedly been a dramatic increase in the number of patients diagnosed with small renal masses in recent years [1]. The rapidly expanding use of CT has led to a large number of incidental diagnoses, but increasing longevity...

Challenging Cases in Urological Surgery: Cases With Expert Commentary (Challenging Concepts)

The authors’ intention with this book is to provide a consensus on a number of common, challenging and controversial topics in urology, which are examined from a multidisciplinary approach with insights from expert opinion and current evidence. Challenging Cases in...

Tamsulosin and spontaneous passage of ureteral stones in children

This was a retrospective analysis of data for five years from four institutions comparing stone passage rates in children with ureteric stones ≤10mm, aged 2-18, treated with tamsulosin vs. analgesia alone. The study identified 449 children, of whom 334 were...

Convatec Healthcare is changing

Forever Caring At Convatec, ‘forever caring’ is our promise to give patients and healthcare providers the support they need as we bring to life our vision of pioneering trusted medical solutions to improve the lives we touch. Existing complications of...

Should it be a mandatory requirement for medical students to receive the COVID-19 vaccine to attend clinical attachments?

The vast majority of medical students have positive attitudes towards the COVID-19 vaccine for themselves and patients, however, what about the small inevitable minority who resist it? Should they be prevented from attending clinical attachments in the NHS? It is...

Urinary tract stones

Case 1 What does this plain X-ray of kidneys, ureters and bladder (KUB) show? What, according to the 2009 The National Institute for Health and Care Excellence (NICE) guidelines, is the most appropriate first-line treatment? What factors do the NICE...