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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?...

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...

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...

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)...

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...

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...

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,...

The microbial syndicate: dysbiosis and origins of recurrent UTIs

Traditional dogma held that urine was sterile. However, recent molecular studies have revealed an underground microbial community, known as the urinary microbiome or ‘urobiome’ [1]. Far from being harmful, this community of microorganisms helps modulate immune responses, regulate inflammation, and...

SUSPEND suspended MET

This review is on the recent groundbreaking evidence on medical expulsive therapy (MET). MET using alpha adrenergic blockers (like tamsulosin) are in regular clinical practice. Even though it is an off label prescription, it is well accepted and practised world...

Does more equal less in the management of acute renal colic?

Radiographs of kidneys, ureter and bladder (KUB) have long been used in the follow-up of patients with ureteral stones to reassess stone position and surgical planning. Emergence of computed tomography (CT) as the gold standard for the diagnosis of ureteral...

William Harvey – Not All Heart!

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). I expect you will have heard of William Harvey (1578-1657) the 17th Century...

I wasn’t expecting that! A series of unexpected radiology findings

Case 1 A 76-year-old diabetic man with a long-term catheter presents to the Emergency Department with rigors and non-specific abdominal pain. He has an elevated white cell count (WCC) and C-reactive protein (CRP). An abdominal and pelvic CT scan was...