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Missed Meyer-Weigert duplex ureter during emergency ureteric stenting for ureteric stones

The Meyer-Weigert rule is a fundamental anatomical principle in urology that describes the typical orientation of ureteral orifices in duplex kidneys. In a duplex system, the upper pole ureter usually inserts inferomedially, while the lower pole ureter inserts superolaterally. This...

Nurse practitioner TRUS biopsy: training and preparation

As prostate cancer rates increase, many urology departments rely on multi-professional teams to diagnose and manage patients with prostate cancer. The aim of this article is to highlight the skills, training and preparation required for nurse practitioners to undertake trans-rectal...

ICS updates on continence care: making sense of detrusor underactivity and the underactive bladder

Countless epidemiological studies have established the frequent occurrence of lower urinary tract symptoms (LUTS) and the significant burden these symptoms incur. For the most part of the past three decades, there has been an overwhelming focus on detrusor overactivity (DO)...

Technology – Part 3

Case 1 Figure A. Figure B. What is shown in figures A and B? What is the diameter of each scope? What is the working channel size of each? What are the advantages of a digital versus optic flexible ureteroscope?...

An algorithm for the management of haemorrhagic cystitis

Haemorrhagic cystitis (HC) can be one of the most difficult conditions to treat in urological practice. It is characterised by intractable bleeding from the bladder and may be acute or chronic. The most frequently reported causal factors are radiotherapy (RT)...

Quality Improvement – how to get involved?

The General Medical Council (GMC) requires all trainee doctors to carry out Quality Improvement (QI) as part of our annual appraisal process [1]. Exactly what QI projects are and how to get involved is less widely understood. Traditionally surgical trainees...

What to expect when meeting a statistician

There are a growing number of statisticians working closely with medics from all specialties. They have different training but they are driven by the same goal: to perform high quality evidence-based clinical research [1,2]. In a perfect world we would...

Imaging and surveillance in sporadic renal angiomyolipoma: how and when to monitor effectively

Renal angiomyolipoma (AML) are benign tumours, accounting for approximately 2–3% of all renal neoplasms [1]. Seventy percent of renal AMLs are sporadic, and 20–30% are associated with genetic aetiology. They are composed of smooth muscle, blood vessels, and adipose tissue....

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...

Supporting return to clinical practice

There are many reasons for a clinician to take time away from clinical practice. These include parental leave, research, a period of ill health, a career break, or the opportunity to spend time pursuing other interests. At any one time,...

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...

Virtual reality: a novel approach to pain management during ESWL

Extracorporeal shock wave lithotripsy (ESWL) is a well-established treatment for kidney and ureteric stone disease, employing high-energy shock waves to fragment stones into smaller pieces for passage through the urinary tract. This article explores the application of virtual reality (VR)...