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Antibiotics and flexible cystoscopy

This study is from Memorial Sloan-Kettering Hospital in New York, USA. Thousands of flexible cystoscopies are performed every day worldwide. Do they need antibiotic cover? Flexible cystoscopy may cause urinary tract infection (UTI) in less than 10% of cases. Asymptomatic...

Intermittent self-catheterisation

Intermittent self-catheterisation (ISC) is used in everyday practice for bladder dysfunction. This study from Southampton, UK presents a Cochrane review of different catheter designs, user satisfaction and incidence of urinary tract infection (UTI), etc. The following factors were looked at:...

MRU for diagnosis of paediatric ureteral stricture

Hydronephrosis is diagnosed antenatally in approximately 1-5% of all pregnancies. A rare cause is ureteral stricture, found in 4% of these cases. This study reports a series of 28 strictures diagnosed over a 10-year period by magnetic resonance urography (MRU)...

The PROMIS trial – time for multi-parametric MRI before a first prostate biopsy

Whilst the relatively random process of 12 core transrectal ultrasound guided (TRUS) prostate biopsy remains by far the most widely employed approach to prostate cancer diagnosis in the UK, its flaws as a standalone diagnostic strategy are increasingly apparent. TRUS-biopsy...

Clear cell urothelial carcinoma: a highly aggressive morphological variant in the bladder and upper urinary tract

Clear cell urothelial carcinoma (CCUC) is a rare morphological variant of transitional cell carcinoma (TCC). It can occur anywhere along the urothelial tract and is characterised histologically by high grade carcinoma with an abundance of clear, glycogen-rich cytoplasm [1]. Alternative...

Day-case monopolar and bipolar transurethral resection of the prostate

The aim of this study was to assess the safety and efficacy of performing monopolar (mTURP) and bipolar transurethral resection of prostate (bTURP) as a day-case. This was a prospective two-centre study. One centre performed day-case mTURP (group M) and...

Beware of the ambiguous testicular lump

In busy day-to-day practice, we are often faced with puzzling situations. A useful mnemonic is 4-T: torsion, trauma, tumour and tuberculosis (infections). This case review in the BMJ is about a 34-year-old man presenting to A&E with left testicular pain...

Ejaculatory dysfunction – too swift, too slow and the no-show

Timing is everything.’ Although an expression most frequently linked to comedy, timing also seems just as critical in the business of sexual climax. Indeed, many men worry about ejaculating. Too soon is embarrassing. Too slow is frustrating. And not ejaculating...

The final hurdle: the consultant interview

The consultant interview is undoubtedly the most important exam you’ll ever sit; but curiously even the best and most motivated trainee becomes somewhat fatalistic when approaching this, the most important of all hurdles. Gone are the days when deals were...

Practical surgical management of chronic testicular pain

Chronic testicular pain (CTP) is defined as constant or intermittent, unilateral or bilateral testicular pain of more than three months’ duration, which significantly interferes with the daily activities of the patient prompting medical advice [1-4]. This condition is commonly seen...

Challenges in urology during and after the COVID-19 pandemic: a trainee perspective

The COVID-19 pandemic has affected urological practice in many ways and at all levels. Social media has been set alight with the hashtag #NoTrainingTodayNoSurgeonsTomorrow highlighting the undesired consequences of the reduction in training opportunities. The impact has been considered by...

HIV-related stone disease – a potential new paradigm?

This paper discusses the management of patients with stone disease and HIV. The chronic nature of HIV infection is due in large part to the effectiveness of anti-retroviral therapies (ART). However, the role of protease inhibitors has been widely discussed...