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Giggle incontinence – not a laughing matter!

For many decades, the condition of giggle incontinence (enuresis risoria, giggle micturition) has remained a rare and poorly understood condition. Patients (90% female) present in their teens, with the history revealing an issue for many years. It is debilitating and...

An inconvenient truth: reflections on the NHS

“What gets us into trouble is not what we don’t know. It’s what we know for sure that just ain’t so.” The above is a quote attributed to Mark Twain from the 2006 documentary, An Inconvenient Truth, which follows Al...

Use of Clavien-Dindo classification in urology part 1 – pelvic surgery

There is no widely accepted system to classify postoperative complications. It is necessary to compare the outcome and complications while validating a new surgical procedure or one of the surgical approaches of a particular condition. Several parameters have long been...

Surgical video – part 1: intraoperative video recording and storage

The use of digital technology has progressed in leaps and bounds and nowhere is this more apparent than in medicine and surgery. Footage of live surgery is now easily accessed on the internet or displayed at conferences. Thus, the 21st...

Bladder carcinoma MRI

Bladder malignancy is one of the commonest malignancies of the renal tract, accounting for approximately 6% of male malignancy and 2% of female malignancy. The incidence increases with patient age with 70% of patients being over the age of 65...

Medical statistics for urologists: part 2 – probability and hypothesis testing

Following on from Part 1 of this series (Part 3 available here), this article aims to build on other analytical techniques commonly used within medical research, focusing on simple examples. Probability and testing Before exploring hypothesis testing, it is vital...

Burnout: an increasing problem in urology

“What we mean, man,” said Chuck forcefully, “is this: how can we care for patients if nobody cares for us?” – Samuel Shem, The House of God, 1978. Samuel Shem’s (Steven Bergman, MD) satirical novel The House of God, has...

Frailty in urology – part 1

Part 2 of this topic can be found here Statement of the problem Clinical frailty carries an increased risk of poor health outcomes. The pathological process resulting in frailty is often overlooked and elucidating its aetiology and natural history are...

Visual-estimation (cognitive), image-fusion (software) and in-bore targeted prostate biopsy: is there an optimal approach?

The diagnostic superiority of multiparametric magnetic resonance imaging (mpMRI) prior to targeted and systematic prostate biopsy over systematic transrectal ultrasound-guided (TRUS) biopsy alone in the detection of clinically significant prostate cancer (csPCa) has been proven by multiple level 1 studies...

Urodynamics in review: stress urinary incontinence in women produced by the Urodynamics Committee of the ICS

Urodynamic studies (UDS) are the best tools to objectively assess the lower urinary tract dysfunction (LUTD) of various aetiologies [1]. According to the general understanding and consensus of the medical community UDS should be performed only when they will change...

Sperm selection techniques in assisted reproductive technologies: state of the ART?

Infertility is the inability to achieve pregnancy following one year of regular, unprotected intercourse (in the fertile phase of the menstrual cycle). Infertility is a common problem that affects between 7 and 15% of couples worldwide, with male factor infertility...