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Developing a core outcome set for male fertility trials

Advances in fertility treatment since in vitro fertilisation was pioneered by Edwards and Steptoe, cumulating in the birth of Louise Brown in 1978, have been nothing short of remarkable [1]. Since then, a myriad of treatments has been developed for...

Chronic retention – all you need to know

Chronic retention – all you need to know Chronic urinary retention is a common presentation in elderly and frail patients. Two types should be recognised - low pressure chronic retention (LPCR) and high pressure chronic retention (HPCR). Acute-on-chronic retention occurs...

Testing radical prostatectomy in men with prostate cancer and oligometastases to the bone: a randomised controlled feasibility study

Prostate cancer is the commonest cancer and the second most frequent cause of cancer death in Western men [1]. The recent STAMPEDE data suggests a median survival of just 42.1 months in the control arm of metastatic men [2]. Current...

The microbial syndicate: dysbiosis and origins of recurrent UTIs

Traditional dogma held that urine was sterile. However, recent molecular studies have revealed an underground microbial community, known as the urinary microbiome or ‘urobiome’ [1]. Far from being harmful, this community of microorganisms helps modulate immune responses, regulate inflammation, and...

Outcome analysis of paediatric pyeloplasty

This prospective study from India included 744 patients of whom 112 had renal function less than or equal to 20% at the time of diagnosis. Thirty percent underwent a nephrostomy initially. Ten with no function had a nephrectomy. Of the...

Retention after Botox therapy in OAB

Treatment of overactive bladder (OAB) has a wide spectrum. The first step is lifestyle modifications, the second step is pharmacotherapy and the third line is intradetrusor injections with Botox®. This retrospective study is from Tennessee, USA in non-neurogenic and refractory...

Lifestyle interventions for UI in women

Lifestyle interventions for urinary incontinence (UI) are supported by all major guidelines. The National Institute for Health and Care Excellence (NICE) guideline (CG171) from September 2013 (updated November 2015) [1] recommends lifestyle advice including dietary modifications such as caffeine reduction,...

Cortical stimulation for voiding dysfunction in multiple sclerosis

Voiding dysfunction (VD) increases morbidity in patients with multiple sclerosis (MS), and may be associated with urinary tract infections, stones and renal failure. Catheterisation is required when impaired hand function precludes self-catheterisation, which is associated with further morbidity. In this...

Prostate abscess

Prostate abscess (PA) is a relatively uncommon clinical condition which is often difficult to diagnose because clinical symptoms are non-specific. It may be associated with a significant fatality rate, estimated to be between 3% and 30%, which may reflect its...

Worldwide flexible ureteroscopy practice uncovered

While guidelines recommend flexible ureteroscopy (fURS) for treating renal stones <1.5cm, considerable differences exist among urologists in the technique, use, and indications of fURS. In 2014, the Endourology Society set out to explore the differences in the fURS technique and...

Challenging Cases in Urological Surgery: Cases With Expert Commentary (Challenging Concepts)

The authors’ intention with this book is to provide a consensus on a number of common, challenging and controversial topics in urology, which are examined from a multidisciplinary approach with insights from expert opinion and current evidence. Challenging Cases in...

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...