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Optimising weight loss advice in obese women with urinary incontinence: a review

Background The National Institute for Health & Care Excellence (NICE) guidance specifies that women with a body mass index (BMI) of over 30, combined with urinary incontinence or overactive bladder, should be advised to lose weight [1]. A BMI over...

Revirgination is not the same as hymenoplasty

The operation called hymenoplasty is requested by women all over the world before marriage if they have engaged in premarital sex. They think that by undertaking the procedure of hymenoplasty they will regain their lost virginity, a theory that is widely accepted by patients and medical professionals. We believe however that hymenoplasty restores...

Ureterocystostomy – novel surgery for the paediatric obstructed megaureter

Megaureter is a relatively common congenital urinary tract anomaly; obstructed non-refluxing megaureter is one variant. Initial management is conservative, with operative intervention reserved for symptomatic cases (recurrent pyelonephritis, pain, increasing dilatation or worsening renal function). Surgical options include cutaneous ureterostomy,...

ICS updates on continence care: what’s hot in physiotherapy after 80 years?

Origins of pelvic floor physiotherapy Physiotherapy, and in particular pelvic floor muscle training (PFMT) is nowadays first-line management for pelvic floor dysfunction (PFD). PFMT is originally attributed to Dr Arthur Kegel, hence the term Kegel exercises. Indeed, he was the...

Results of HoLEP in patients with prostate cancer and LUTS

Holmium laser enucleation of the prostate (HoLEP) is recommended for the management of benign prostatic obstruction. With similar functional outcomes and less morbidity compared to transurethral resection of the prostate (TURP), it has become a useful tool in the armament...

One cycle of adjuvant chemotherapy in tumours of the testis

Following a radical orchiectomy, current UK practice for newly diagnosed, high-risk, stage 1 nonseminomatous or combined germ cell tumours of the testis (NSCGCTT) is either two cycles of adjuvant chemotherapy with bleomycin, etoposide, cisplatin (BE360Px2) or surveillance with BE500Px3 on...

Robotic Urology Fellowship at UCLH

In November 2014, approaching my final year of training (ST7) in the West of Scotland (WoS) and just recently armed with my FRCS (Urol), I was at a crossroad in my clinical career. I was keen to pursue a consultant...

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...

Comedy and continence – don’t make me laugh

I’m a pelvic physiotherapist and, in a fit of temper, I wrote a comedy show about pelvic floors after having yet another woman say to me: “I’ve been leaking since my baby was born.” “How old is your baby?” “He’s...

Laparoscopic transposition of renal lower pole crossing vessels

The vascular hitch procedure for pelvi-ureteric junction obstruction (PUJO) was initially described by Hellstroem in1951 and has become popular again since the introduction of laparoscopy. There is still much controversy as to its efficiency. The authors of this paper analyse...

Adjustable Transobturator Male System® as a novel treatment for men with stress urinary incontinence

Stress urinary incontinence (SUI) in men is a debilitating condition, often occurring after prostate cancer surgery, with an incidence ranging from 4% to 40%. Key predictors of SUI post-prostatectomy include age, body mass index (BMI), comorbidity index, lower urinary tract...

Sustainable healthcare: what steps can urologists take?

Human health is intrinsically linked to environmental health, making the ever-pressing climate crisis fundamentally a public health emergency. The healthcare sector is responsible for 8% of the UK’s greenhouse gas (GHG) emissions worldwide [1]. As the largest publicly funded healthcare...