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History of prostate biopsy – part 2

For Part 1 of this topic is available here. The major limitations of the transrectal ultrasound (TRUS) guided prostate biopsy (PBx) protocols are the risk of profound sepsis and the risk of persistently significant false negative rates, related to the...

New charity launches to highlight urethral strictures – men’s silent epidemic

A new charity, the Collaboration for Urological Research and Education (CURE), has today called for urgent action to address one of Britain’s biggest silent epidemics – urethral strictures. Launching Stricture Awareness Month (SAM) in March, CURE has called on healthcare...

Neuromodulation for lower urinary tract dysfunction – an ICS update

Non-invasive and invasive electro-stimulation techniques have been extensively studied in the treatment of lower urinary tract and bowel dysfunction, including overactive bladder syndrome (OAB), non-obstructive chronic urinary retention, faecal incontinence and chronic pelvic pain. Currently, the most common indication for...

Hail the Portfolio Pathway!

In the United Kingdom, the pursuit of a surgical career traditionally follows a conventional pathway, primarily through the completion of specialty programmes accredited by the Royal College of Surgeons or the Intercollegiate Surgical Curriculum Programme (ISCP). However, for doctors with...

Post-prostatectomy incontinence

Urinary incontinence following prostate surgery (post-prostatectomy incontinence or PPI) is a significant complication that can have a profoundly negative impact on the quality of life of patients suffering with it. It may become a barrier to physical activity and social...

Botox® instillation into the bladder

Patients with refractory overactive bladder (OAB) may be offered OnabotulinumtoxinA (Botox®) as one of the third-line options. Given the invasive nature of requiring cystoscopy, injections via a needle and local anaesthesia, it would be simpler, more convenient and more accessible...

Convective radiofrequency water vapour thermal therapy for BPH

There are a number of new treatments for benign prostatic hyperplasia (BPH) on the market. This paper reports retrospective data for 129 patients treated with convective radiofrequency water vapour thermal therapy (Rezum) by a single surgeon. There is variable length...

The importance of second-look transurethral resection for superficial bladder cancer

This was a prospective study of 100 consecutive patients with a newly diagnosed superficial bladder tumour who underwent a second look transurethral resection of bladder tumour (TURBT) two to six weeks post initial resection. This essentially included pTa multiple and...

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...

Prostatic urethral lift provides good alternative to TURP for men with LUTS

Lower urinary tract symptoms (LUTS) due to prostatic enlargement resulting in bladder outflow obstruction are common. Transurethral resection of the prostate (TURP) remains the gold standard in operative management, however it is not without its risks. In this multicentre European...

Lasers in benign prostatic hyperplasia

Clinical benign prostatic hyperplasia (BPH) impacts on the quality of life of many men. It is intimately related to ageing, but exact calculations of its prevalence remain difficult since an accurate clinical definition still eludes us. Histological BPH has been...

Prostate artery embolisation

Introduction Benign prostatic hyperplasia (BPH), a common condition associated with ageing, affects 50% of those between the ages of 50 and 60 years, and as many as 90% of those older than 80 years. BPH is characterised by unregulated, benign...