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A sigma six approach to improving nephrostomy and antegrade stent services at a district general hospital – an audit project

As hospitals merge into larger trusts there becomes a centralisation of some services. Interventional radiology (IR) has been one of those services. Our district general hospital runs bi-weekly lR lists following service centralisation. Urology and IR most commonly liaise on...

Lifestyle interventions for UI in women

Lifestyle interventions for urinary incontinence (UI) are supported by all major guidelines. The National Institute for Health and Care Excellence (NICE) guideline (CG171) from September 2013 (updated November 2015) [1] recommends lifestyle advice including dietary modifications such as caffeine reduction,...

‘No Deal’ Brexit – how might it impact urological practice in the UK?

On 29 March 2017, the Government of the United Kingdom of Great Britain & Northern Ireland triggered Article 50 of the Lisbon Treaty, formally starting the two-year period for talks with the European Union (EU) in which to reach a...

Management of RHC in prostate cancer with selective embolisation and hyperbaric oxygen therapy

Prostate cancer is one of the most prevalent malignancies affecting men worldwide. Radiotherapy is a common treatment modality for localised and locally advanced prostate cancer. While radiotherapy can be effective, it may lead to complications such as radiation-induced haemorrhagic cystitis...

An algorithm for the management of haemorrhagic cystitis

Haemorrhagic cystitis (HC) can be one of the most difficult conditions to treat in urological practice. It is characterised by intractable bleeding from the bladder and may be acute or chronic. The most frequently reported causal factors are radiotherapy (RT)...

Inguino-scrotal sarcomas

A sarcoma is a malignant tumour that originates from mesenchymal cells such as adipose tissue, bone, cartilage and smooth muscle. Although these tumours histologically do not originate from the urogenital tract, urologists are often involved in their diagnosis and management...

The surgical management of female stress urinary incontinence in a post-mesh era

Trends in surgical management of women with stress urinary incontinence (SUI) have changed in recent times, mainly due to the ‘High Vigilance Pause’ placed on the use of mesh for SUI (and prolapse) surgery in July 2018 following an independent...

The role of conservative renal colic treatment

Acute renal colic is a common emergency condition, which can arise from a variety of underlying conditions that affect the urinary tract, but it is usually associated with the passage of ureteral stones. Before considering expectant management or active intervention,...

Bladder cancer: where are we with intravesical therapies?

In the United Kingdom, almost 10,500 new cases of bladder cancer were identified in 2013, with over 5000 deaths in 2012 [1]. Seventy percent of new cases will be non-muscle invasive bladder cancer (NMIBC) at diagnosis and therefore will be...

Use of Clavien-Dindo classification in urology part 2 – upper tract

A classification system of surgical complications was proposed by Clavien in 1992 [1] and further modified by Dindo in 2004 [2]. Clavien-Dindo classification has since then been validated through many retrospective case series as well as in comparative studies to...

An update on erectile dysfunction guidelines and treatment options

Erectile dysfunction is defined as the persistent inability to attain and / or maintain an erection sufficient for sexual performance. Not only does this have a psychosocial impact, it also affects the quality of life of both the patients and...

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)...