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An overview of daytime wetting in children

It is estimated that daytime wetting affects one in seventy-five children over the age of five years [1]. Daytime wetting is commoner in younger children (1 in 7 aged 4.5 years, 1 in 20 aged 9.5 years) [1]. Many younger...

A guide for the assessment and management of post-obstructive diuresis

Acute urinary retention is a common condition encountered in the emergency situation and is initially managed by urethral catheterisation. This is often performed by nursing staff or junior doctors. Post-obstructive diuresis (POD) is a specific entity which may occur post...

Keep it simple: a proposal for a new definition of uncomplicated and complicated UTIs

Urinary tract infections (UTIs) are one of the most common bacterial infections in both community and healthcare settings, leading to frequent antibiotic use. They range widely in severity, from mild cases like cystitis to severe, potentially life-threatening conditions such as...

Sepsis syndrome in urology

There are approximately 100,000 cases of sepsis per year in the UK, of which 37,000 result in death (this is more than prostate cancer, breast cancer, HIV / AIDS and road traffic accidents combined). Urosepsis is defined as sepsis caused...

UTI Care – antibiotics or NSAIDs?

This is the cover story of a recent issue of the BMJ. As per the World Health Organization (WHO), antibiotic resistance is becoming a major economic and global problem. This is a randomised, double-blind study from 17 general practices in...

Emphysematous pyelonephritis: a review

Introduction Emphysematous pyelonephritis (EPN) is an acute, severe, necrotising, bacterial infection of the renal parenchyma and surrounding tissues, with gas in the renal parenchyma, collecting system or perinephric tissue. Although it is rare, it is potentially life threatening and early...

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,...

Meeting in the middle: a review of the rendezvous technique to treat impassable ureteric strictures and transected ureters

Introduction Complex ureteric strictures present a significant challenge with some patients undergoing multiple separate urological and radiological procedures to try to cross a stricture without success. Cross-departmental collaboration with uroradiology may allow a decrease in the number of separate interventions....

Simple cystectomy for benign disease

In the UK, due to cancer reorientation programmes by the NHS, radical cystectomies happen only in regional cancer centres. But there is no reason why simple cystectomies cannot take place in district general hospitals, often much closer to patients and...

Cumulative incidence of outcomes and urologic procedures after augmentation cystoplasty

The authors of this paper describe the cumulative incidence of outcomes and surgical procedures following paediatric augmentation cystoplasties in the USA. They included all children <18 years over an 11-year period in their study and used the Pediatric Health Information...

Benign upper tract abnormalities

Case 1 A 28-year-old lady has been referred to your clinic with right loin pain. She has no significant past medical history but mentions that she and her partner have been trying to get pregnant. She has an US renal...

Percutaneous ultrasound guided endoscopic lavage of perinephric abscess – different, but not necessarily better

Perinephric abscess is an uncommon but serious form of urosepsis. It develops as a consequence of the extension of an infection outside of the parenchyma of the kidney in acute pyelonephritis, or more rarely from haematogeneous spread of an infection...