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How successful is the transition to adult urology care in spina bifida?

These authors from Indianapolis, USA, aimed to assess rates and predictors of successful transition into adult care of spina bifida patients. They did this by a retrospective review of 77 patients discharged from a multidisciplinary paediatric clinic at a mean...

Feeling like a fraud — imposter syndrome: what it is and what to do about it

Have you ever been plagued by feelings of incompetence despite evidence to the contrary, then this article is for you. Dr Dunay Schmulian provides insight into imposter syndrome and what to do about it. Excerpt 1 Consultant:That was excellent, and...

Stepwise voltage ramping causes less renal haematomas than fixed maximal voltage ESWL

Extracorporeal shock wave lithotripsy (ESWL) remains the recommended first line treatment for stones <2cm in the renal pelvis and upper or mid-pole calyces (Türk C, Knoll T, Petrik A, et al. European Association of Urology Guidelines on Urolithiasis. 2014). There...

History of prostate biopsy – part 1

Part 2 of this topic is available here. Prostate biopsy (PBx) to exclude cancer has been part of clinical practice since the beginning of the 20th Century. PBx techniques have evolved over time to optimally address some of the unique...

Testosterone and erectile function – the debate goes on!

The most common causes of erectile dysfunction (ED) as per European Association of Urology (EAU) guidelines are: psychogenic, vasculogenic, neurogenic and hormonal. The EAU 2017 guidelines recommend measuring total testosterone (TS) level. This study is a meta-analysis of 14 randomised...

Update on urodynamic equipment performance

This article is from the steering committee of the International Continence Society (ICS) and it gives a comprehensive account of what is required from modern urodynamic machines. It will be of interest to purchasers, designers and clinical users (doctors and...

Performance of non-invasive tests in diagnosing BOO in men with LUTS

A large proportion of urology involves the treatment of bladder outflow obstruction (BOO) in men. Yet BOO in men is very difficult to accurately quantify with the only regular non-invasive test being uroflowmetry. Pressure flow urodynamics may be considered the...

PFMT in males

Pelvic floor muscle training (PFMT) has been described since ancient times in Rome but Kegel popularised it to improve sexual and urinary health after childbirth. In the paediatric population, there is a paradigm shift towards biofeedback-based PFMT for lower urinary...

Modern management of small renal masses

With the advent of widespread cross-sectional imaging there has been a surge in incidental detection of small renal masses (SRMs) and renal cell carcinoma (RCC) is now the seventh most common cancer in the UK. Whilst surgical excision for larger...

ESWL and URS for treatment of paediatric urolithiasis

Tejwani et al. have undertaken a comparative effectiveness study to characterise differences in procedure frequency, postoperative re-admissions and emergency room (ER) visits, and repeat treatment rates for children (≤18 years) with urolithiasis who underwent initial intervention with extracorporeal shock wave...

Active surveillance for small renal masses in younger patients

Active surveillance (AS) is discussed as an option for renal masses <2cm in patients with significant competing risks for mortality. This multicentre data from the US seeks to fill an important gap in current guidelines for provision of this option...

Prostatic artery embolisation versus sham

Randomised trials with use of sham is uncommon in the surgical literature, which makes this paper more interesting. Many different treatments are available for treating lower urinary tract symptoms / benign prostatic hyperplasia (LUTS / BPH). Prostatic artery embolisation (PAE)...