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Incidental findings on modern imaging

Incidentalomas can be defined in a variety of ways: 1) Imaging abnormality in a healthy, asymptomatic patient; 2) Imaging abnormality not related to a patient’s symptoms or the organs in question; 3) Findings discovered by chance which can potentially affect...

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...

Children with neuropsychiatric developmental disorders respond less well when treated for bladder bowel dysfunction

Bladder and bowel dysfunction (BBD) is a spectrum of lower urinary tract symptoms and voiding dysfunction accompanied by functional constipation and / or encopresis and may represent up to 47% of paediatric urology consultations. The BBD cycle pattern begins when...

An update on robotic surgery in urology

The early adoption of new technology has long been a trademark of urological surgeons. Like the introduction of the cystoscope, lasers and flexible endoscopy, the field of urology has witnessed a revolutionary transformation with the advent of robotic surgery. Robotic-assisted...

Long term outcomes of primary ureterovesicostomy for the primary obstructive megaureter

Primary obstructive megaureter is dilatation of the ureter secondary to narrowing at the vesicoureteric junction (VUJ). Many (80%) require no intervention, however, a select number do for worsening hydroureteronephrosis, decreasing renal function, prolonged drainage time, recurrent urinary tract infections or...

The process of medical innovation – evolving trends and future perspectives

In 2018 the United Kingdom Government spending on healthcare totalled almost £166 billion. Of this approximately 65% was attributed to providing curative or rehabilitation therapy, with health-related long-term care and provision of goods accounting for 25%. The remaining was accredited...

Uncovering the fate of small residual fragments

The concept of ‘stone free’ remains an enigma. To some urologists this refers to complete removal of all visible fragments, to others its removal of all ‘clinically significant’ fragments (generally regarded as fragments >2mm), and to some it is absence...

Renal masses

Case 1 A 70-year-old female presented under the medical team with malaise, weight loss, and deranged liver function tests (LFTs) and calcium (ALP 350, GGT 650, Serum bilirubin 29, normal aminotransferases, Ca 3.3). An abdominal ultrasound scan (USS) was performed...

Management of urological issues following genital gender affirmation surgery for individuals assigned female at birth

Gender incongruence arises when there is a mismatch between an individual’s gender identity and their sex assigned at birth. Genital gender affirmation surgery (GAS) is the final step of transition for transgender and non-binary individuals who experience gender incongruence. This...

Consent: your obligations in the modern, post-Montgomery era

There has been so much recent discussion and so much emphasis placed on the fundamental right that we all have to determine what is or is not done to us, the right to self-determination, that it would be either a...

Paediatric urology – peno-scrotal

Case 1 A four-year-old boy presents to clinic following GP referral unable to retract the foreskin (Figure 1). Figure 1. What is the diagnosis? The above condition may be pathological or physiological; clinically how can you differentiate this? Explain the...

Curing pure CIS with radical surgery: lessons learned

As carcinoma in situ (CIS) theoretically has no ability to invade or metastasise, performing radical cystectomy for CIS-only disease should be curative. In this single centre review over 37 years, 1964 patients undergoing cystectomy were analysed with 52 undergoing surgery...