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Nocturnal enuresis in children

Introduction Nocturnal enuresis is the complaint of bedwetting. The 2010 National Institute for Health & Care Excellence (NICE) guidelines define bedwetting as the “involuntary wetting during sleep without any inherent suggestion of frequency of bedwetting or pathophysiology” [1]. Bedwetting is...

Management of stage 1 non-seminomatous germ cell tumours

Testicular cancer (TC) is the most successfully treated solid tumour, achieving a cure rate of 90-95% [1-3]. Testicular cancer is relatively rare with an incidence of 2207 cases in the UK in 2014 [4] and yet is the most common...

Assessment of the incidental adrenal lesion

Introduction The adrenal glands are seen on CT or MRI surrounded by fat in the peri-renal space. The right adrenal gland lies medial to the right lobe of the liver, lateral to the right crus of the diaphragm and superior...

Nocturia – the Cinderella of lower urinary tract symptoms

Nocturia is defined as waking during the night (at least once) to urinate. The important part of the definition relates to the necessity of sleep to precede the episode (although whether sleep must follow the episode is less clear). The...

Post-orgasmic illness syndrome

Introduction Disorders of ejaculation are a rare and poorly understood subsection of male sexual dysfunction. A paucity of evidence has hindered advances in definitions, epidemiology, pathophysiology and management. The licensing of a specific medication for premature ejaculation signalled the research...

The surgical management of female stress urinary incontinence in a post-mesh era

Trends in surgical management of women with stress urinary incontinence (SUI) have changed in recent times, mainly due to the ‘High Vigilance Pause’ placed on the use of mesh for SUI (and prolapse) surgery in July 2018 following an independent...

Use of MRI in the evaluation of prostate cancer: part 2

Diffusion weighted imaging and contrast enhanced imaging Introduction Magnetic resonance imaging (MRI) is widely used in localisation, staging and post-treatment follow-up of prostate cancer. In the previous issue, we discussed the usefulness of MRI in depicting prostate anatomy and pairing...

The role of transperineal template biopsies in the diagnosis of prostate cancer

The case In 2002, Mr A, a 64-year-old software engineer, was referred by his GP for further investigation of a raised prostate specific antigen (PSA) of 6.2. His prostate felt benign. He underwent transrectal ultrasound guided (TRUS) prostate biopsies. This...

Stuttering (recurrent ischaemic) priapism

Stuttering (recurrent ischaemic) priapism (SP) is a rare urological condition. Affected men will often experience almost daily prolonged and painful sleep related erections (SRE). Interestingly, these men report normal erections during the day and whilst awake. These episodes are usually...

Testicular cancer: management of stage I seminoma

Introduction Testicular cancer is the most frequently occurring solid tumour in men between the ages of 15 and 34 years [1]. About 60% of cases are seminomas and approximately 70-80% of them have, at presentation, clinical stage I disease. This...