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Cystitis Unmasked

Cystitis is often viewed as a heartsink diagnosis, and sometimes one of exclusion. The aetiology is multifactorial and misunderstood. Treatment has been based on dogma, and poor clinical and scientific evidence. The truth is, that despite the significant morbidity caused...

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...

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,...

Urological trauma – part 2

Part 1 of this topic is available here. Case 1 A 29-year-old male was attacked and kicked in his left flank. He presented to the emergency department with left flank pain and frank haematuria. He remained haemodynamically stable. 1. What...

Ketamine uropathy – an update

The first two case series that documented the association between urinary tract damage and recreational ketamine use were published 12 years ago [1,2]. Since then ketamine has maintained a controversial profile as an essential medication of expanding utility but with...

Urological emergencies app

BrainyDoc Ltd is back with another brand new educational app called ‘Urological Emergencies’. It is available as a free download for iPhone and iPad (iTunes) and Android mobile devices (Google Play). The Urological Emergencies app provides a series of topics...

Sexuality and erectile function in young men with spina bifida

As our patients with spina bifida (SB) continue to live longer into adulthood we recognise that many of these men experience challenges with sexual health, related to their underlying neurological function. Few studies on male sexual health in this population...

Hard flaccid syndrome

Chronic pelvic pain is defined as pain present below the level of the umbilicus with a duration of more than six months [1,2]. Chronic pelvic pain syndromes (CPPS) are highly prevalent in Western society, affecting both males and females. Studies...

BCG after TURBT – does timing matter?

Intravesical bacille Calmette–Guerin (BCG) therapy continues to be widely used for patients with intermediate / high-risk non-muscle invasive bladder cancer (NMIBC). In this article, the researchers identified the lack of sufficient evidence with regards to timing of BCG after transurethral...

Metastatic spinal cord compression – a review

Introduction Metastatic spinal cord compression (MSCC) is an oncological emergency that, unless diagnosed early and treated appropriately, can lead to significant morbidity and mortality, including paralysis and bladder and bowel dysfunction. MSCC can be defined as spinal cord or cauda...

Beta 3 receptors in OAB

More and more is written on Beta 3 receptors in human bladders and their role in detrusor relaxation. This study from Japan investigated human Beta 3 AR gene which is polymorphic. One hundred women with overactive bladder (OAB) and 101...

Prostate cancer series: diagnostics 1

- Click here for Part 2 - A 58-year-old male is referred to your rapid access prostate clinic with a prostate specific antigen (PSA) of 6.0ng/ml. He has no lower urinary tract symptoms (LUTS), past medical history (PMH), or family...