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Botulinum toxin – from the sausage poison to urology
Botulinum toxin is the first biological toxin to be licensed for use in treating human disease and since its first therapeutic use in the early 1980s for strabismus has become widely used in the fields of ophthalmology, cosmetic surgery, migraine...Intravesical GAG replacement therapies for bladder pain syndrome / interstitial cystitis – an update
The barrier function of the glycosaminoglycan (GAG) layer of the urothelium was identified by Parsons in 1975, and intravesical therapies to treat chronic inflammatory conditions of the bladder were developed soon after. However, the active role of the urothelium in...
Can you boost your bladder with vitamin D?
Bladder overactivity is a common problem affecting the social functioning of children. Overactive bladder dry (OAB-dry) is a term (one not utilised by the International Children’s Continence Society) and refers to patients who are experiencing frequency, urgency and nocturia symptoms...
Prenatal spina bifida repair – does it have urological benefits in the longer term?
At present, I have one patient under my care who underwent prenatal closure of his spina bifida defect. Only with time, will we be able to determine whether this intervention has been of benefit for him from a urological standpoint....
PDE5I in LUTS – how do they work – no proof yet
Phosphodiesterase type 5 (PDE5) inhibitors used in erectile dysfunction (ED) have been shown to improve lower urinary tract symptoms (LUTS) as well. The mechanism is not well understood. One of the hypotheses for benign prostatic hyperplasia (BPH) – LUTS is...Neuromodulation for lower urinary tract dysfunction – an ICS update
Non-invasive and invasive electro-stimulation techniques have been extensively studied in the treatment of lower urinary tract and bowel dysfunction, including overactive bladder syndrome (OAB), non-obstructive chronic urinary retention, faecal incontinence and chronic pelvic pain. Currently, the most common indication for...Update on immunotherapy for non-muscle invasive transitional cell carcinoma of the bladder
Patients with high-risk non-muscle invasive bladder cancer (NMIBC) that have failed Bacillus Calmette-Guérin (BCG) treatment are a difficult group to treat, and many may not be suitable for the preferred treatment option of radical cystectomy. Bladder-preserving treatments for BCG-unresponsive high-risk...Artificial intelligence
Artificial intelligence concerns me. Generally, people still tend to be concerned that their livelihoods will be replaced by an all powerful, all knowing artificial intelligence (AI) system. This at a time when the world’s largest technology companies (Amazon, Google, Apple),...Post-prostatectomy incontinence
Urinary incontinence following prostate surgery (post-prostatectomy incontinence or PPI) is a significant complication that can have a profoundly negative impact on the quality of life of patients suffering with it. It may become a barrier to physical activity and social...An update on lower pole stone management for 2015
Introduction Urolithiasis is an increasing healthcare problem, with an estimated lifetime prevalence of up to 15% [1]. The number of interventions undertaken for stone disease has increased dramatically over recent years, particularly with respect to ureteroscopy and percutaneous nephrolithotomy (PCNL)...
Scrotal antegrade sclerotherapy for the adolescent varicocele
The incidence of varicocele in adolescent males is around 15%. Treatment indications include symptoms (pain) and evidence of a smaller testis. Numerous surgical techniques are described but there is a lack of randomised controlled trials (RCT), specifically in adolescents. This...
