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Mechanisms and prevention of catheterisation associated urethral injury (CAUI)

Urethral catheterisation is a common procedure performed by health professionals across different grades and specialties in a variety of clinical settings. An estimated 15-25% of hospitalised patients have a urinary catheter inserted during their inpatient stay and up to 13%...

Prostate biopsies without antibiotic cover – are we there yet?

Transperineal (TP) prostate biopsies are widely replacing the traditional transrectal route due to definite evidence of reduced infective complications. TP biopsies are usually performed with a single dose of antibiotic pre-procedure in most centres. In this article the authors attempt...

Urological in-flight medical events

The future of air travel may seem uncertain at the present time, but up until the COVID-19 pandemic, approximately 44,000 inflight medical emergencies occurred annually, averaging 1 in 604 flights. Some of you will have heard the heart-sink announcement “if...

Erectile Dysfunction Part I: pathophysiology and risk factors

Introduction Erectile dysfunction (ED) is defined as the inability to achieve and maintain a penile erection, which is adequate for satisfactory sexual intercourse. The Massachusetts Male Ageing Study (MMAS) reported the results of a regional survey of men aged 40–69...

Essential Revision Notes for the FRCS (Urol) Books 1 & 2

In the past a Professor of Urology was frequently quoted as saying “the curriculum for urology is urology”. Indeed that it is, but that definition did not give trainees at the time the much needed framework for navigating through a...

Selective denervation of the bladder

The treatment of refractory overactive bladder is currently limited to neuromodulation (sacral nerve stimulation or percutaneous tibial nerve stimulation) or botulinum toxin injections. Although all these options are valuable, they have their own limitations and may not be suitable for...

Penile cancer: a practical approach

Penile cancer is rare and accounts for less than 1% of all new cancer cases in males in the UK, with around 640 new cases diagnosed every year [1]. In England and Wales, the annual incidence is between 1.2 and...

Repeat transurethral resection in non-muscle invasive bladder cancer

The authors felt this is a big problem because there is no standardised practice on re-resection following initial transurethral resection of bladder tumour (TURBT). Getting detrusor muscle in the first specimen is thought to be important. However muscle is not...

The medical management of LUTS/BPH – an update

For many years it has been recognised by both medical professionals and the general public that the development of lower urinary tract symptoms (LUTS) is highly prevalent and is predominantly age-dependent. Medical professionals understand that in men this is often,...

Ejaculatory dysfunction and the treatment of LUTS

For years ejaculatory dysfunction in men following medical or surgical treatment of lower urinary tract symptoms (LUTS) was thought to be a result of disruption of the bladder neck mechanism and the subsequent retrograde flow of semen. Men commenced on...

Refining management of non-visible haematuria

The optimal evaluation of non-visible haematuria (NVH) continues to be debated, with competing interests of avoidance underdiagnosis and the harms of over-testing. Current National Institute for Health & Care Excellent (NICE) guidance recommends referral for patients ≥60 years with NVH....

The NICE Guideline on Urinary Incontinence: the management of urinary incontinence in women

Background Urinary incontinence (UI) is a common symptom that can affect women of all ages. It is difficult to estimate the prevalence of UI since it is often under-reported, although the Norwegian EPINCONT study looking at women over 20 reported...