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No Margin for Error: A Surgeon’s Struggle Repairing Hypospadias
No Margin for Error is not only a memoir of the ‘pound for pound’ most influential hypospadiologist of the 21st century, but also a blueprint to self-examination and improvement. It’s an essential read for any urologist starting their career to...The impact of menopause on bladder symptoms
The menopause is a natural process of ageing when the ovaries completely stop producing reproductive hormones (oestrogen and other sex steroids), and there are no monthly periods for 12 consecutive months. It normally occurs between the ages of 45-55 years...Cutting-edge or over-hyped? Evaluating the role of robotic surgery in the management of renal cell carcinoma
The quest for a minimally-invasive approach to major abdominal surgery finds its roots at the start of the previous century, when Georg Kelling first described the technique of ‘ceolioscopy’ to inspect intraabdominal organs in 1901 [1]. Since those early days,...
Does coiling of the proximal end of the ureteral stent affect stent-related symptoms?
Ureteral stents, first described by Zimskind in 1967, have become a critical tool in modern urology. They are widely used in various endourological procedures to drain obstructed or infected renal units and as a safety measure before or after surgeries....Bladder cancer – an overshadowed ‘volcano’
Bladder cancer has often been overshadowed by the limelight of prostate cancer. However, of all the urological cancers, bladder cancer is the only one which has shown a slight decline in age-standardised five-year survival rates over the last couple of...The role of an enhanced recovery protocol in patients undergoing robotic radical cystectomy
Enhanced recovery after surgery (ERAS) protocols are patient pathways designed to reduce surgical stress and accelerate postoperative recovery. Uptake of such protocols in colorectal surgery in particular has been high, however ERAS protocols developed or utilised in urological surgery have...Use of Clavien-Dindo classification in urology part 2 – upper tract
A classification system of surgical complications was proposed by Clavien in 1992 [1] and further modified by Dindo in 2004 [2]. Clavien-Dindo classification has since then been validated through many retrospective case series as well as in comparative studies to...
ASAP: is a repeat biopsy necessary?
This study examined the validity of current US and European guidelines on the management of patients diagnosed with atypical small acinar proliferation (ASAP). Current guidance states that these patients should undergo repeat biopsy within three to six months due to...
Comparing NSAIDs with antibiotics in the treatment of uncomplicated UTIs in women
Uncomplicated urinary tract infections (UTIs) are a common presentation in primary care, however there is increasing concern regarding antibiotic use and resistant organisms. In this double-blind randomised German study, the authors seek to establish if ibuprofen 400mg three times a...
Long term outcomes of primary ureterovesicostomy for the primary obstructive megaureter
Primary obstructive megaureter is dilatation of the ureter secondary to narrowing at the vesicoureteric junction (VUJ). Many (80%) require no intervention, however, a select number do for worsening hydroureteronephrosis, decreasing renal function, prolonged drainage time, recurrent urinary tract infections or...Nuptial night tragedy
Case 1 A fit and well 50-year-old gentleman presents to the emergency department with pain and swelling of his penis that started a few hours after he had a shower earlier in the day. On examination, the appearance is as...
